National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1385945

History of Changes from the VAERS Wayback Machine

First Appeared on 6/11/2021

VAERS ID: 1385945
VAERS Form:2
Age:56.0
Sex:Male
Location:Kentucky
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 EW0191 / 2 LA / IM

Administered by: Other      Purchased by: ??
Symptoms: No adverse event, Interchange of vaccine products

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: denies
Preexisting Conditions: denies
Allergies: denies
Diagnostic Lab Data: n/a
CDC 'Split Type':

Write-up: pt presented for 2nd covid vaccine without vaccine card, reported hx of Pfizer vaccination. Later presented to have card filled out and noted hx of moderna-1st dose, Pfizer-2nd dose. reports feeling well, no adverse reactions per patient on 6/9/21

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1385945&WAYBACKHISTORY=ON


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166