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This is VAERS ID 1474759

History of Changes from the VAERS Wayback Machine

First Appeared on 7/16/2021

VAERS ID: 1474759
VAERS Form:2
Age:56.0
Sex:Male
Location:D.C.
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 EW0180 / 2 RA / IM

Administered by: Public      Purchased by: ??
Symptoms: Interchange of vaccine products, Inappropriate schedule of product administration

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:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient received Moderna Vaccine 04/05/2021, and left the country, he came into the clinic today and asked for a Pfizer Covid-19 vaccine. He stated that since he missed his return date for Moderna of 05/05/2021. He would like to get the Pfizer Covid-19 vaccine. He stated that he had discussed it with his PCP.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1474759&WAYBACKHISTORY=ON

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