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This is VAERS ID 1376583

History of Changes from the VAERS Wayback Machine

First Appeared on 6/11/2021

VAERS ID: 1376583
VAERS Form:2
Age:42.0
Sex:Female
Location:California
Vaccinated:2021-06-04
Onset:2021-06-04
Submitted:0000-00-00
Entered:2021-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 RA / IM

Administered by: Work      Purchased by: ??
Symptoms: No adverse event, Wrong product 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: NONE
Current Illness: NONE
Preexisting Conditions: DIABETES, HIGH BLOOD PRESSURE
Allergies: NONE
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: no adverse event happened after vaccination but there was an error in the covid -19 vaccine brand given. Pt should have received Moderna instead of Pfizer

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1376583&WAYBACKHISTORY=ON


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