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This is VAERS ID 1440784

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1440784
VAERS Form:2
Age:56.0
Sex:Male
Location:North Carolina
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 053C12A / 1 RA / IM

Administered by: Public      Purchased by: ??
Symptoms: Expired product administered

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: Silvadene cream twice a day Nicotine 21mg Flovent 110mg 2 pumps twice daily Albuterol 1-2 puffs every 4 hours as needed Lisinopril 30 mg once daily Aspirin 81mg one daily Simvastatin 40mg once daily Metformin 500mg twice daily
Current Illness: none
Preexisting Conditions: Diabetes Hypertension Hyperlipidemia COPD
Allergies: none
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Health care professional administered an expired vaccine to this patient.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1440784&WAYBACKHISTORY=ON

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