National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1474742

History of Changes from the VAERS Wayback Machine

First Appeared on 7/16/2021

VAERS ID: 1474742
VAERS Form:2
Age:67.0
Sex:Male
Location:New York
Vaccinated:2021-07-15
Onset:2021-07-15
Submitted:0000-00-00
Entered:2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 LA / IM

Administered by: Other      Purchased by: ??
Symptoms: Interchange of vaccine products

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

Write-up: Patient came to facility to receive their second dose of COVID-19 mRNA vaccine. After administration, the clinician realized they had administered the incorrect mRNA vaccine as the patient''s vaccine card showed their first dose was a Moderna dose. Clinician notified the patient of the error. Clinician documented on the patient''s vaccine card that the second COVID-19 dose was Pfizer

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1474742&WAYBACKHISTORY=ON


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166