National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1438804

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1438804
VAERS Form:2
Age:16.0
Sex:Male
Location:Florida
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 E38733 / 1 LA / IM

Administered by: Other      Purchased by: ??
Symptoms: No adverse event, Product reconstitution quality issue

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: none applicable at this time
CDC 'Split Type':

Write-up: Incorrect reconstitution of vial. 0.8 mg of saline diluent to complete vial instead of 1.8 as directed. No symptoms, no adverse effects Patient received correct 0.3ml dose concentration of vaccine in dose is higher due to incorrect reconstitution. Parent notified and informed to contact the clinic directly if any symptoms occur. Also informed to go to ER if life threatening symptoms occur. None have occurred at this time.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1438804&WAYBACKHISTORY=ON


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