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

This is VAERS ID 1402886



Case Details

VAERS ID: 1402886 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-06-03
Onset:2021-06-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 1 LA / IM

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

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: Already received a dose of Janssen, should not have received a dose of Pfizer.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1402886


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