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This is VAERS ID 1487408

History of Changes from the VAERS Wayback Machine

First Appeared on 7/23/2021

VAERS ID: 1487408
VAERS Form:2
Age:54.0
Sex:Female
Location:Pennsylvania
Vaccinated:2021-07-20
Onset:2021-07-01
Submitted:0000-00-00
Entered:2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / 2 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: No adverse event, Interchange of vaccine products

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

Write-up: Moderna was given as first dose, and Pfizer given as second dose in series. Pt had no reportable reaction at time of vaccination.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1487408&WAYBACKHISTORY=ON


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