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

This is VAERS ID 1433576



Case Details

VAERS ID: 1433576 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-06-26
Onset:2021-06-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / 1 LA / IM

Administered by: School       Purchased by: ?
Symptoms: Incorrect dose administered
SMQs:, Medication errors (narrow)

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: NONE KNOWN
Current Illness: NONE KNOWN
Preexisting Conditions: NONE KNOWN
Allergies: NONE KNOWN
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: Higher than recommended dose administered to patient. Pt did not have any symptoms from injection immediately after through today, 3 days later. No complaints, local or systemic.


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