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This is VAERS ID 1371639

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1371639
VAERS Form:2
Age:55.0
Sex:Female
Location:Nebraska
Vaccinated:2021-06-01
Onset:2021-06-01
Submitted:0000-00-00
Entered:2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0168 / 2 LA / IM

Administered by: Public      Purchased by: ??
Symptoms: No adverse event, 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: Unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Patient received a first dose of Moderna and a second dose of Pfizer. Patient stated that they are doing fine.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1371639&WAYBACKHISTORY=ON


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