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

This is VAERS ID 1371405



Case Details

VAERS ID: 1371405 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048C21A / 1 RA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048C21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Immediate post-injection reaction, Incorrect dose administered, Presyncope
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Medication errors (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
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: Patient was given the wrong dosage. She was given a double dose of vaccine. Patient was instantly light-headed. She has diabetes and had not eaten. Provider feels it was a vagal response instead of the vaccine reaction. Patient was monitored for 1 hour until symptoms resolved. Patient was contacted this afternoon, she is feeling much better.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1371405


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