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This is VAERS ID 903017

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History of Changes from the VAERS Wayback Machine

First Appeared on 12/18/2020

VAERS ID: 903017
VAERS Form:2
Age:47.0
Sex:Female
Location:Kansas
Vaccinated:2020-12-16
Onset:2020-12-16
Submitted:0000-00-00
Entered:2020-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 OT / OT

Administered by: Public      Purchased by: ??
Symptoms: Syringe 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 nurse was tapping the syringe to get all the air out and the needle popped out of the vaccine vial and stuck to the sticker that was on the vial. 0.3ml of the vaccine was discarded with the syringe into the sharps box.


Changed on 12/24/2020

VAERS ID: 903017 Before After
VAERS Form:2
Age:47.0
Sex:Female
Location:Kansas
Vaccinated:2020-12-16
Onset:2020-12-16
Submitted:0000-00-00
Entered:2020-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 OT / OT

Administered by: Public      Purchased by: ??
Symptoms: Syringe 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 nurse was tapping the syringe to get all the air out and the needle popped out of the vaccine vial and stuck to the sticker that was on the vial. 0.3ml of the vaccine was discarded with the syringe into the sharps box.


Changed on 12/30/2020

VAERS ID: 903017 Before After
VAERS Form:2
Age:47.0
Sex:Female
Location:Kansas
Vaccinated:2020-12-16
Onset:2020-12-16
Submitted:0000-00-00
Entered:2020-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 OT / OT

Administered by: Public      Purchased by: ??
Symptoms: Syringe 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 nurse was tapping the syringe to get all the air out and the needle popped out of the vaccine vial and stuck to the sticker that was on the vial. 0.3ml of the vaccine was discarded with the syringe into the sharps box.


Changed on 5/7/2021

VAERS ID: 903017 Before After
VAERS Form:2
Age:47.0
Sex:Female
Location:Kansas
Vaccinated:2020-12-16
Onset:2020-12-16
Submitted:0000-00-00
Entered:2020-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 OT / OT

Administered by: Public      Purchased by: ??
Symptoms: Syringe 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 nurse was tapping the syringe to get all the air out and the needle popped out of the vaccine vial and stuck to the sticker that was on the vial. 0.3ml of the vaccine was discarded with the syringe into the sharps box.


Changed on 5/21/2021

VAERS ID: 903017 Before After
VAERS Form:2
Age:47.0
Sex:Female
Location:Kansas
Vaccinated:2020-12-16
Onset:2020-12-16
Submitted:0000-00-00
Entered:2020-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 OT / OT

Administered by: Public      Purchased by: ??
Symptoms: Syringe 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 nurse was tapping the syringe to get all the air out and the needle popped out of the vaccine vial and stuck to the sticker that was on the vial. 0.3ml of the vaccine was discarded with the syringe into the sharps box.

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