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This is VAERS ID 1437951

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1437951
VAERS Form:2
Age:23.0
Sex:Male
Location:California
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 EW0196 / 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: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient received one dose of Pfizer after already receiving one dose of Janssen in March 2021. The patient intentionally gave the wrong information to the pharmacy in hopes to boost their immunity.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1437951&WAYBACKHISTORY=ON


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