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VAERS ID: 2275462

AGE: 8| SEX: M|State: HI

Description

Error: Incorrect Reconstitution-

Symptoms

Product preparation issue

Vaccines

VAX DATE: 02 May 2022 | ONSET DATE: 02 May 2022 | DAYS TO ONSET: 0
Vaccine TypeManufacturerVaccine NameDoseRouteSiteLot
  • COVID19
  • PFIZERBIONTECH
  • COVID19 (COVID19 (PFIZER-BIONTECH))
  • 2
  • IM
  • LA
  • fl8094

RECVDATE:12 May 2022
CAGE_YR:8
CAGE_MO:
RPT_DATE:
DIED:
DATEDIED:
L_THREAT:
ER_VISIT:
HOSPITAL:
HOSPDAYS:
X_STAY:
DISABLE:
RECOVD:Y
LAB_DATA:
V_ADMINBY:PHM
OTHER_MEDS:
CUR_ILL:
HISTORY:
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:2
TODAYS_DATE:12 May 2022
BIRTH_DEFECT:
OFC_VISIT:
ER_ED_VISIT:
ALLERGIES:
V_FUNDBY:
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