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This is VAERS ID 1371690

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1371690
VAERS Form:2
Age:70.0
Sex:Female
Location:Ohio
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 EW0158 / 3 RA / IM

Administered by: Public      Purchased by: ??
Symptoms: Extra dose administered

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, in continuous care facility
Allergies: none
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Patient was administered third dose of vaccine by health department staff. contacted health department to administer vaccines to new patients or those who only received one dose. When health department staff returned to agency to enter vaccines administered in Impact, it was noted that patient already received two doses administered on 1/14/21 and 2/12/21.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1371690&WAYBACKHISTORY=ON


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