National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1689816

Government Disclaimer on use of this data

History of Changes from the VAERS Wayback Machine

First Appeared on 9/17/2021

VAERS ID: 1689816
VAERS Form:2
Age:62.0
Sex:Female
Location:Texas
Vaccinated:2021-09-10
Onset:2021-09-10
Submitted:0000-00-00
Entered:2021-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER 1808980 / UNK - / IM

Administered by: Private      Purchased by: ??
Symptoms: Interchange of vaccine products

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

Write-up: PATIENT HAD BEEN VACCINATED WITH PFIZER VACCINE IN APRIL 2021. PATIENT DID NOT DIVULGE INFORMATION AND RECEIVED JANSSEN VACCINE. WHEN ENTERING INFORMATION IN TO IT WAS SHOWN THAT SHE HAD BEEN VACCINATED WITH PFIZER. PATIENT THEN ADMITS SHE WAS VACCINATED WITH PFIZER PREVIOUSLY AND HAD WANTED JANSSEN THEREFORE SHE ASKED FOR IT. PATIENT INFORMED THIS WILL BE REPORTED FOR SAFETY PURPOSES.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1689816&WAYBACKHISTORY=ON


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166