Your Health. Your Family. Your Choice.
|History of Changes from the VAERS Wayback Machine|
|Vaccination / Manufacturer||Lot / Dose||Site / Route|
|COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH||EW0191 / 1||RA / IM|
Administered by: Public Purchased by: ??
Symptoms: No adverse event, Incorrect product formulation administered
Life Threatening? No
Birth Defect? No
Permanent Disability? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Write-up: Patient was erroneously administered Pfizer COVID-19 vaccine instead of Moderna COVID-19 vaccine for his 2nd dose. Patient has not had an adverse reaction or symptoms during the observation period.
Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166