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This is VAERS ID 1440773

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1440773
VAERS Form:2
Age:62.0
Sex:Female
Location:New Jersey
Vaccinated:2021-07-01
Onset:2021-07-01
Submitted:0000-00-00
Entered:2021-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 033C21A / 2 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: No adverse event, Interchange of vaccine products, COVID-19, SARS-CoV-2 test positive

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: patient has reported no adverse event from her COVID vaccine. We are notifying you of an inadverdant admisnitration of the Moderna Vaccine to patient who had already received one dose fo the PFizer COVID vacccine. patient received Pfizer vaccine on 3/16/2021, developed COVID and was treated with monoclonal antibodies on 3/22/2021 . She presented for COVID vaccine and reported that she was instructed by her healthcare porvider that she could receive Moderna eben though she had started series with Pfizer. She had no reaction post vaccine and was instaructed that she had completed her mRNA vaccine series now.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1440773&WAYBACKHISTORY=ON

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