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From the 11/19/2021 release of VAERS data:

This is VAERS ID 1685431

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Case Details

VAERS ID: 1685431 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: California  
Vaccinated:2021-09-09
Onset:2021-09-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FC3184 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose administered, Interchange of vaccine products, Wrong product administered
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: UNKNOWN
Current Illness: UNKNOWN
Preexisting Conditions: UNKNOWN
Allergies: NKA
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: PATIENT WAS EXPECTED TO RECEIVE A HIGH DOSE FLU VACCINE ON SEPTEMBER 9, 2021 BUT RECEIVED A DOSE OF COVID PFIZER INSTEAD. AFTER THE INCIDENT THE PATIENT STATED THAT SHE ALREADY RECEIVED A 2 DOSES OF MODERNA IN THE PAST


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