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This is VAERS ID 1484707

History of Changes from the VAERS Wayback Machine

First Appeared on 7/23/2021

VAERS ID: 1484707
VAERS Form:2
Age:38.0
Sex:Female
Location:Texas
Vaccinated:2021-07-18
Onset:2021-07-18
Submitted:0000-00-00
Entered:2021-07-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 08/17/2021 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Product storage error

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: none
Allergies: none
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Intern administered vaccine that had been open 17 hours ago on 7/18, Vaccine expired 5 pm on 7/17. Unable to contact patient.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1484707&WAYBACKHISTORY=ON


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