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||021B21A / 1||RA / IM|
Administered by: Public Purchased by: ??
Symptoms: No adverse event, Interchange of vaccine products, Inappropriate schedule of product administration
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: patient presented to clinic 7/12/2021 at 2:00pm for 2nd COVID vaccine. Patient completed the COVID 19 vaccine screening and consent form and said she was here for her 2nd dose. Nurse, RN asked her if her first dose had been Moderna and the patient said yes. Nurse administered the Moderna vaccine and then the client presented the nurse with her vaccine card which listed Pfizer as the first dose Lot #ER2613 administered by mobile vaccination bus on 5/22/2021 . Nurse informed patient of this. Patient had no adverse reactions and left after 15 min monitoring time.
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