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

This is VAERS ID 1330707



Case Details

VAERS ID: 1330707 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-21
Onset:2021-05-19
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025B21A / 1 RA / IM

Administered by: Public       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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Not known
Current Illness: None
Preexisting Conditions: None known
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Moderna given to client under age 18. No adverse events noted at date deviation was recognized (5/19/2021)


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1330707


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