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This is VAERS ID 1431360

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1431360
VAERS Form:2
Age:37.0
Sex:Male
Location:Louisiana
Vaccinated:2021-06-26
Onset:2021-06-26
Submitted:0000-00-00
Entered:2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8734 / 2 LA / IM

Administered by: Public      Purchased by: ??
Symptoms: Interchange of vaccine products

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: None
Allergies: None
Diagnostic Lab Data: N/A
CDC 'Split Type':

Write-up: Patient given Pfizer as their second dose when should have received Moderna. Patients first dose was Moderna 26 days prior on 6/1/2021.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1431360&WAYBACKHISTORY=ON


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