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This is VAERS ID 1372038

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1372038
VAERS Form:2
Age:14.0
Sex:Female
Location:South Carolina
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 EW0167 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: No adverse event, Product preparation issue

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: Improper dilution of vial resulted in 15 microgram dose. Parent informed.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1372038&WAYBACKHISTORY=ON

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