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This is VAERS ID 1385427

History of Changes from the VAERS Wayback Machine

First Appeared on 6/11/2021

VAERS ID: 1385427
VAERS Form:2
Age:16.0
Sex:Female
Location:California
Vaccinated:2021-06-04
Onset:2021-06-04
Submitted:0000-00-00
Entered:2021-06-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 2 LA / -

Administered by: Other      Purchased by: ??
Symptoms: Immunisation, Product administration error

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: RN TRIED TO VACCINATE AND PUNCTURED PT''S LEFT DELTOID AND PT PULLED AWAY. DOSE WAS NOT ADMINISTERED. BHS WAS CALLED AND PT WAS TAKEN TO PRIVACY AREA. FULL DOSE WAS ADMINISTERED TO RIGHT DELTOID WITHOUT COMPLICATIONS.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1385427&WAYBACKHISTORY=ON


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