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This is VAERS ID 1371632

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1371632
VAERS Form:2
Age:56.0
Sex:Female
Location:New Hampshire
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 (MODERNA)) / MODERNA 022C21A / 2 LA / IM

Administered by: Private      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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient received 2nd dose too early. First dose was administered 5/14/2021 and second dose was administered 6/3/2021 when it was due to be given 6/11/2021.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1371632&WAYBACKHISTORY=ON


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