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This is VAERS ID 1371469

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1371469
VAERS Form:2
Age:40.0
Sex:Female
Location:Wisconsin
Vaccinated:2021-06-03
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 ER8735 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: No adverse event, Expired product administered, Product storage error

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: FLUOXETINE 20 MG DAILY
Current Illness: NONE
Preexisting Conditions: ANXIETY, DEPRESSION, HYPERLIPEDEMIA
Allergies: SULFA ANTIBIOTICS
Diagnostic Lab Data: None completed at this time
CDC 'Split Type':

Write-up: Patient was administered an expired dose of PFIZER BIONTECH COVID 19 vaccination on 6/3/2021 at 0838. Vaccination was outside of the recommended time allowed following first vial puncture. Syringe containing Pfizer vaccination was approximately 12-16 hours out of the recommended 6 hour allotted time frame for administering. Writer contacted manufacturer, Pfizer regarding above error. Please use reference if further information is needed regarding call. No recommendation was given by manufacturer as this particular situation has not been studied in clinical studies to da,Client from Pfizer medical information notes they are unable to provide medical guidance regarding patients, it is up to the discretion of primary care provider to determine when patient can safely another COVID 19 vaccination. Patient was notified of error and is not currently experiencing any adverse side effects. Patient will contact clinic with any further concerns or development of symptoms listed in the Pfizer-Biotech Covid 19 emergency use authorization literature.

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