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This is VAERS ID 1478310

History of Changes from the VAERS Wayback Machine

First Appeared on 7/23/2021

VAERS ID: 1478310
VAERS Form:2
Age:84.0
Sex:Female
Location:Alaska
Vaccinated:2021-07-01
Onset:2021-07-01
Submitted:0000-00-00
Entered:2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0198 / 3 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: a third dose was administered during community outreach vaccination in an village.
Current Illness: frail 83 year old female with several comorbidities.
Preexisting Conditions: several
Allergies: NA
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: While conducting a door to door vaccination and covid testing campaign on 7/1/21 I administered a third dose of the Pfizer vaccination to a Elder. She had received her first two doses 4/21 and 5/11/21. The family reported to us that she was due for her second dose. The patient is HOH and we were using the family as interpreter as well. We do not have access to patient records while doing these kinds of public health operations in the community.

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