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

This is VAERS ID 1437907



Case Details

VAERS ID: 1437907 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-06-04
Onset:2021-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 1 LA / SYR

Administered by: Public       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? Yes
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: Mother completed document stating child''s age was 12 years old. DOB= 11 years. Advised mother that the 2nd dose can be given after the child''s 12th birthday. No adverse reaction following vaccine was reported by the parent.


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