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

This is VAERS ID 1474387



Case Details

VAERS ID: 1474387 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-07-03
Onset:2021-07-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 009D21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Inappropriate schedule of product administration, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: PT PRESENTED TO PHARMACY FOR 2ND DOSE AT 2 WEEKS INSTEAD OF THE RECOMMENDED 4 TO 6 WEEKS. FIRST DOSE GIVEN 6/19/2021. SECOND 7/3/21. PT EXPERIENCED MILD SYMPTOMS AFTER SECOND DOSE (LOW GRADE TEMP, FATIGUE FOR APPROXIMATELY 24 HOURS). NO FOLLOW-UP CARE NECESSARY.


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