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This is VAERS ID 1377693

History of Changes from the VAERS Wayback Machine

First Appeared on 6/11/2021

VAERS ID: 1377693
VAERS Form:2
Age:82.0
Sex:Female
Location:Virginia
Vaccinated:2021-06-04
Onset:2021-06-04
Submitted:0000-00-00
Entered:2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 3 LA / 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt is a resident of a long tern care facility. Vaccination requested by facility. Facility unaware that patient was previously fully vaccinated before request was made and patient was inadvertently given a 3 dose of vaccine. Error found after administration.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1377693&WAYBACKHISTORY=ON


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