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This is VAERS ID 1371529

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1371529
VAERS Form:2
Age:32.0
Sex:Female
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 (MODERNA)) / MODERNA 039B21A / 2 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Migraine, Neck pain, Pain in extremity, Vomiting, Peripheral swelling, Vaccination error, 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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt went to clinic to get her 2nd dose of the Pfizer vaccine and was given Moderna instead. Pt was told to call us to report the vaccination error. Pt says her left arm is very painful and she is vomiting, has a migraine along with neck pain.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1371529&WAYBACKHISTORY=ON


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