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This is VAERS ID 1769506

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/8/2021

VAERS ID: 1769506
VAERS Form:2
Age:37.0
Sex:Female
Location:Oregon
Vaccinated:2021-09-30
Onset:2021-09-30
Submitted:0000-00-00
Entered:2021-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FD0809 / 2 UN / IM

Administered by: Private      Purchased by: ??
Symptoms: Product preparation issue

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:
CDC 'Split Type':

Write-up: The vaccine was not diluted and the patient received 6 times the dose. The patient was contacted and notified of the error. No adverse events were reported.

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