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

This is VAERS ID 1328030

Case Details

VAERS ID: 1328030 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Unknown  
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: ?
Symptoms: Interchange of vaccine products
SMQs:, Medication errors (broad)

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:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received the Pfizer vaccine 28 days following the administration of the Moderna vaccine. The Moderna vaccine was given at a different location than this dose of Pfizer. Patient sat for the recommended 15 minutes for observation. He stated that he felt fine and left for home with his father. Both the patient and his father were told that getting one dose of each is not ideal but that there is no medical concerns associated with this. Told the potential side effects are the same for both vaccines. Told that there is no need for a second Pfizer. Will still be considered fully vaccinated in 2 weeks.

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