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

This is VAERS ID 1440648



Case Details

VAERS ID: 1440648 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Female  
Location: Iowa  
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 EW0191 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: No adverse event, Product storage error
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vaccine had was prepared the previous day at 10:00 am and was administered the next day at 2:30 pm. This was past the 6 hours of viability of a diluted vaccine. No adverse reaction noted. Provider recommended repeating the dose in 3 weeks and 3rd dose be administered 3 weeks later.


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