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

This is VAERS ID 1371662



Case Details

VAERS ID: 1371662 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-03-16
Onset:2021-06-03
   Days after vaccination:79
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0167 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Inappropriate schedule of product administration
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: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data: none
CDC Split Type:

Write-up: more than 6 weeks between doses in series.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1371662


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