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

This is VAERS ID 1328064



Case Details

VAERS ID: 1328064 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product administered to patient of inappropriate age
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: MOTHER STATED PATIENT WAS 12 YEARS OLD AND ELIGIBLE FOR VACCINATION. PATIENT IS ONLY 11 YEARS OLD AND NOT ELIGIBLE FOR VACCINATION


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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1328064


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