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This is VAERS ID 948501

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History of Changes from the VAERS Wayback Machine

First Appeared on 4/16/2021

VAERS ID: 948501
VAERS Form:2
Age:16.0
Sex:Female
Location:Texas
Vaccinated:2021-01-15
Onset:2021-01-15
Submitted:0000-00-00
Entered:2021-01-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041L20A / 1 RA / IM

Administered by: Public      Purchased by: ??
Symptoms: Product administered to patient of inappropriate age

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: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: no adverse effects. reporting due to patient under the recommended age at time of administration


Changed on 5/7/2021

VAERS ID: 948501 Before After
VAERS Form:2
Age:16.0
Sex:Female
Location:Texas
Vaccinated:2021-01-15
Onset:2021-01-15
Submitted:0000-00-00
Entered:2021-01-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041L20A / 1 RA / IM

Administered by: Public      Purchased by: ??
Symptoms: Product administered to patient of inappropriate age

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: none
Current Illness: none
Preexisting Conditions: none
Allergies: none none
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: no adverse effects. reporting due to patient under the recommended age at time of administration


Changed on 5/21/2021

VAERS ID: 948501 Before After
VAERS Form:2
Age:16.0
Sex:Female
Location:Texas
Vaccinated:2021-01-15
Onset:2021-01-15
Submitted:0000-00-00
Entered:2021-01-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041L20A / 1 RA / IM

Administered by: Public      Purchased by: ??
Symptoms: Product administered to patient of inappropriate age

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: none
Current Illness: none
Preexisting Conditions: none
Allergies: none none
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: no adverse effects. reporting due to patient under the recommended age at time of administration

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=948501&WAYBACKHISTORY=ON


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