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From the 9/17/2021 release of VAERS data:

This is VAERS ID 1377693



Case Details

VAERS ID: 1377693 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 3 LA / 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: pt is a resident of a long tern care facility. Vaccination requested by facility. Facility unaware that patient was previously fully vaccinated before request was made and patient was inadvertently given a 3 dose of vaccine. Error found after administration.


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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1377693


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