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This is VAERS ID 943708

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History of Changes from the VAERS Wayback Machine

First Appeared on 4/8/2021

VAERS ID: 943708
VAERS Form:2
Age:15.0
Sex:Male
Location:Ohio
Vaccinated:2021-01-05
Onset:2021-01-05
Submitted:0000-00-00
Entered:2021-01-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 RA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Medication error, Wrong patient

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: none. not actually an adverse reaction. patient is not actually old enough for vaccine.
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Error: Wrong Patient (documentation in EMR)


Changed on 5/7/2021

VAERS ID: 943708 Before After
VAERS Form:2
Age:15.0
Sex:Male
Location:Ohio
Vaccinated:2021-01-05
Onset:2021-01-05
Submitted:0000-00-00
Entered:2021-01-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 RA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Medication error, Wrong patient

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: none. not actually an adverse reaction. patient is not actually old enough for vaccine. vaccine.
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Error: Wrong Patient (documentation in EMR)


Changed on 5/14/2021

VAERS ID: 943708 Before After
VAERS Form:2
Age:15.0
Sex:Male
Location:Ohio
Vaccinated:2021-01-05
Onset:2021-01-05
Submitted:0000-00-00
Entered:2021-01-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 RA / IM

Administered by: Senior Living      Purchased by: ??
Symptoms: Medication error, Wrong patient

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: none. not actually an adverse reaction. patient is not actually old enough for vaccine. vaccine.
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Error: Wrong Patient (documentation in EMR)

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