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This is VAERS ID 1470127

History of Changes from the VAERS Wayback Machine

First Appeared on 7/16/2021

VAERS ID: 1470127
VAERS Form:2
Age:73.0
Sex:Female
Location:Kentucky
Vaccinated:2021-07-13
Onset:2021-07-13
Submitted:0000-00-00
Entered:2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039B21A / 3 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Extra dose administered

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: NKDA
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient is currently in the nursing home for rehabilitation. Patient was mistakenly given a 3rd dose of the Covid-19 Moderna vaccine. Patient received a Covid-19 Moderna vaccine on 1/18/21, 2/18/21, and 7/13/21.

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