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This is VAERS ID 1437055

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1437055
VAERS Form:2
Age:31.0
Sex:Male
Location:Texas
Vaccinated:2021-06-29
Onset:2021-06-29
Submitted:0000-00-00
Entered:2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Incorrect product formulation 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: Error: Wrong Vaccine Formulation (ex. different manufact. initial and booster)-

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1437055&WAYBACKHISTORY=ON

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