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

This is VAERS ID 1474742



Case Details

VAERS ID: 1474742 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: New York  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0191 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Interchange of vaccine products
SMQs:, Medication errors (broad)

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: N/a
Current Illness: N/a
Preexisting Conditions: N/a
Allergies: N/a
Diagnostic Lab Data: N/a
CDC Split Type:

Write-up: Patient came to facility to receive their second dose of COVID-19 mRNA vaccine. After administration, the clinician realized they had administered the incorrect mRNA vaccine as the patient''s vaccine card showed their first dose was a Moderna dose. Clinician notified the patient of the error. Clinician documented on the patient''s vaccine card that the second COVID-19 dose was Pfizer


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