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

This is VAERS ID 1371690



Case Details

VAERS ID: 1371690 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-06-02
Onset:2021-06-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0158 / 3 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Extra 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: unknown
Current Illness: unknown
Preexisting Conditions: unknown, in continuous care facility
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient was administered third dose of vaccine by health department staff. contacted health department to administer vaccines to new patients or those who only received one dose. When health department staff returned to agency to enter vaccines administered in Impact, it was noted that patient already received two doses administered on 1/14/21 and 2/12/21.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1371690


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