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

This is VAERS ID 1368754



Case Details

VAERS ID: 1368754 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Texas  
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 (MODERNA)) / MODERNA 025L20A / 1 - / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021C21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Inappropriate schedule of product administration, Incorrect dose administered
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: Moderna COVID-19 Vaccine: Higher-than-authorized dose volume administered Patient received 0.5 ml dose of Moderna Covid Vaccine on 1/11/21 and a 1 ml dose of Moderna Covid vaccine on 6/1/21.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1368754


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