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

This is VAERS ID 1478039



Case Details

VAERS ID: 1478039 (history)  
Form: Version 2.0  
Age: 91.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-07-15
Onset:2021-07-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025B21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Aggression, Underdose
SMQs:, Dementia (broad), Hostility/aggression (narrow), 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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was combative and only 0.3 mL of the dose was able to be administered before the patient tried to bite the nurse administering the vaccine.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1478039


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