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This is VAERS ID 1437690

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1437690
VAERS Form:2
Age:15.0
Sex:Female
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 EW0191 / 2 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Fatigue, Pain, Pyrexia, Incorrect dose administered, Incorrect product formulation administered

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol was taken hours after vaccine administration
Current Illness: none
Preexisting Conditions: none
Allergies: nkda
Diagnostic Lab Data: n/a
CDC 'Split Type':

Write-up: Patient was given 0.3 mL of undiluted Pfizer Vaccine by pharmacist on duty. It was suppose to be the patients second dose. Patient received 6 times the dose. Patient developed severe fatigue and body aches about 12 hours later. Patient visited the urgent care overnight due to fever. Patient is currently resting at home and being monitored 24 hours after the administration of the vaccine.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1437690&WAYBACKHISTORY=ON


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