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This is VAERS ID 1447103

History of Changes from the VAERS Wayback Machine

First Appeared on 7/9/2021

VAERS ID: 1447103
VAERS Form:2
Age:28.0
Sex:Male
Location:Colorado
Vaccinated:2021-06-25
Onset:2021-06-25
Submitted:0000-00-00
Entered:2021-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 051C21A / 2 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: No adverse event, Interchange of vaccine products, Inappropriate schedule of product administration

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient had appointment scheduled at another facility for 21 day interval because it scheduled based on Pfizer, his first dose was moderna, they almost gave him Pfizer. He came here and all our safety check failed and he received the mderna vaccine 21 days from 1st dose. We realized after a few dates the error. Patient was contacted and reported no issue or side effect more than after the first dose.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1447103&WAYBACKHISTORY=ON


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