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This is VAERS ID 1371327

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1371327
VAERS Form:2
Age:23.0
Sex:Male
Location:Illinois
Vaccinated:2021-06-02
Onset:2021-06-03
Submitted:0000-00-00
Entered:2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 2 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Inappropriate schedule of product administration

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

Write-up: Patient was given second dose post 9 days after the first dose.

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