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This is VAERS ID 1734937

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/1/2021

VAERS ID: 1734937
VAERS Form:2
Age:24.0
Sex:Female
Location:Texas
Vaccinated:2021-09-25
Onset:2021-09-25
Submitted:0000-00-00
Entered:2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0179 / 3 RA / IM

Administered by: Other      Purchased by: ??
Symptoms: Extra dose administered, Device connection issue

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: None
Preexisting Conditions: None
Allergies: NKA
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: During an injection, the needle came apart from the syring. Additional dose was then given after.

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