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From the 9/3/2021 release of VAERS data:

This is VAERS ID 1377874



Case Details

VAERS ID: 1377874 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Iowa  
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 (JANSSEN)) / JANSSEN 1808980 / 1 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Interchange of vaccine products
SMQs:, Medication errors (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NA
Current Illness: NA
Preexisting Conditions: NA
Allergies: NA
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Patient had a skin reaction (cellulitis) after Moderna vaccine. After a discussion with physician and patient and pharmacy the patient was instructed to receive a Janssen vaccine


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1377874


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