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

This is VAERS ID 1331285



Case Details

VAERS ID: 1331285 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-19
Onset:2021-05-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 034C21A / 2 - / 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? 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: Age 17 years 11 months and 5 days old at time of second dose Moderna vaccine. Patient here with father. Reports no complaints following his first dose of Moderna. Patient here with father. Advised that he was under the required age 18 for vaccine.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1331285


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