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From the 7/23/2021 release of VAERS data:

This is VAERS ID 1299625



Case Details

VAERS ID: 1299625 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Inappropriate schedule of product administration
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: Currently undergoing treatment for cancer
Preexisting Conditions: memory care patient in a long term care setting
Allergies: Seasonal allergies: pollen
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient was given Janssen covid-19 vaccine on 5-2-2021, when doing Alert data entry after vaccination it was discovered that the patient had received Moderna Covid-19 Vaccine in Jan/Feb of 2021.


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