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

This is VAERS ID 1440427



Case Details

VAERS ID: 1440427 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-07-01
Onset:2021-07-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048B21A / 2 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? 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: AT AN OFF SITE LOCATION HE RECEIVED MODERNA BRAND VACCINE. ON 3/14/2021 HE RECIEVED PFIZER BRAND FROM ANOTHER ORGANIZATION LOT NUMBER WAS EN6202 IN MARCH. HE UNDERSTANDS THE SERIER IS COMPLETE.


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