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

This is VAERS ID 1437897



Case Details

VAERS ID: 1437897 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-06-29
Onset:2021-06-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1816022 / 1 UN / SYR

Administered by: Private       Purchased by: ?
Symptoms: Product administered to patient of inappropriate age
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
Allergies: UNKNOWN
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 12 yo female injected by NP provider against management advice and consent signed by NP instead of a parent/legal guardian. We were advised by a public health nurse to report this as the administration of COVID-19 Janssen vaccine to a 12 year old is considered as a medication error due to the patient being under an unauthorized age group.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1437897


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