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This is VAERS ID 1368638

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1368638
VAERS Form:2
Age:36.0
Sex:Female
Location:Iowa
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 (JANSSEN)) / JANSSEN 1821288 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Interchange of vaccine products

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:
Current Illness:
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Pt received incorrect mfg of covid vaccine, She should have received her second moderna , not the janssen. Pt had received her first covid shot (moderna mfg) in January. She thought that since it had been so long she should start over with a different mfg. The patients history was not checked prior to giving vaccination.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1368638&WAYBACKHISTORY=ON


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