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This is VAERS ID 1714167

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History of Changes from the VAERS Wayback Machine

First Appeared on 9/24/2021

VAERS ID: 1714167
VAERS Form:2
Age:17.0
Sex:Female
Location:Texas
Vaccinated:2021-09-14
Onset:2021-09-14
Submitted:0000-00-00
Entered:2021-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0185 / 1 RA / IM

Administered by: Other      Purchased by: ??
Symptoms: No adverse event, Expired product administered

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Topamax 150mg, Metformin 550mg, Trileptal 300mg
Current Illness: None
Preexisting Conditions: Epilepsy, anxiety disorder, Polycystic ovary syndrome
Allergies: None
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Vaccinated with expired vaccine by 09/14/2021. No adverse reactions noted.

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