Your Health. Your Family. Your Choice.
|History of Changes from the VAERS Wayback Machine|
|Vaccination / Manufacturer||Lot / Dose||Site / Route|
|COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH||FC3183 / 4||LA / IM|
Administered by: Senior Living Purchased by: ??
Symptoms: Extra dose administered, No adverse event
Life Threatening? No
Birth Defect? No
Permanent Disability? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: Alzheimers Disease
Diagnostic Lab Data: none
CDC 'Split Type':
Write-up: COVID vaccine clinic for third dose held for residents at the HCF on 10/4/2021. Facility Director of Nursing took Public Health Staff around to resident''s rooms to administer vaccine. Director of Nursing had already completed the paper forms ahead of time. This resident was inadvertently given a fourth dose of the pfizer covid vaccine and it wasn''t discovered until entering the information into the immunization registry. No adverse effects reported at this time. Physician ARNP notified of incident.
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21525 Ridgetop Circle, Suite 100, Sterling, VA 20166