VAERS ID: 2327620

AGE: 9| SEX: M|STATE: VA

Description

technician gave vaccine to the patient without mixing with nacl patient is having fever and rm pain started at night

Symptoms

Pain in extremity, Product preparation issue, Pyrexia

Vaccines

VAX DATE: 06-21-2022| ONSET DATE: 06-21-2022| DAYS TO ONSET: 0
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 3 COVID19 PFIZER\BIONTECH fl8095 IM LA

RECVDATE:06-22-2022
RPT_DATE:
CAGE_YR:9
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:U
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:N
LAB_DATA:
V_ADMINBY:PHM
OTHER_MEDS:
CUR_ILL:
HISTORY:
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:2
TODAYS_DATE:06-22-2022
BIRTH_DEFECT:U
OFC_VISIT:Y
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:

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