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

This is VAERS ID 1474973



Case Details

VAERS ID: 1474973 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: New Jersey  
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 EW0187 / 1 LA / IM

Administered by: Private       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:
Current Illness: None
Preexisting Conditions: Mental health
Allergies: Sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient arrived to receive first dose of the Pfizer Covid Vaccine and stated he had not received any other covid vaccines. After appropriate screening questions and signed consent obtained, Pfizer Covid vaccine was administered to this patient. While documenting this vaccine administration, it was noted that he had received the J&J vaccine in April 0f 2021. Afterwards patient admitted to receiving the J&J vaccine in April 2021 and wanted to receive the Pfizer mRNA vaccine as a booster.


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