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

This is VAERS ID 1440496



Case Details

VAERS ID: 1440496 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-06-29
Onset:2021-06-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0196 / 1 LA / IM

Administered by: Pharmacy       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: none
Current Illness:
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: incorrect mixing covid shot Pfizer brand administered as second dose, patient originally received moderna brand as first dose


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1440496


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