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This is VAERS ID 1368440

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1368440
VAERS Form:2
Age:16.0
Sex:Female
Location:Arizona
Vaccinated:2021-06-01
Onset:2021-06-01
Submitted:0000-00-00
Entered:2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 2 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: No adverse event, Expired product administered

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: No known drug allergy
Diagnostic Lab Data: N/A
CDC 'Split Type':

Write-up: Patient was inadvertently administered pfizer vaccine dose that was less than 30 minutes beyond use time. No known treatment or adverse effects. Unable to reach patient.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1368440&WAYBACKHISTORY=ON


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