Your Health. Your Family. Your Choice.
|History of Changes from the VAERS Wayback Machine|
|Vaccination / Manufacturer||Lot / Dose||Site / Route|
|COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA||004C21A / 1||LA / IM|
Administered by: Other Purchased by: ??
Symptoms: Interchange of vaccine products
Life Threatening? No
Birth Defect? No
Permanent Disability? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Diagnostic Lab Data:
CDC 'Split Type':
Write-up: The patient scheduled himself for his first dose of Moderna. On 03/08/2021 at another vaccine site. Patient did not tell the staff that he had a vaccine. Informed us this was his first vaccine.
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