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From the 9/10/2021 release of VAERS data:

This is VAERS ID 1368619



Case Details

VAERS ID: 1368619 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: California  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 2 RA / -

Administered by: Other       Purchased by: ?
Symptoms: Incorrect route of product administration, No adverse event
SMQs:, Drug abuse and dependence (broad), 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: PT RECEIVED VACCINATION 5 DAYS EARLY, DID NOT EXPERIENCE ANY ADVERSE EFFECTS NOR SIDE EFFECTS. ADULT SISTER MADE AWARE.


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