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From the 11/26/2021 release of VAERS data:

This is VAERS ID 1750252

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Case Details

VAERS ID: 1750252 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 3 LA / IM

Administered by: School       Purchased by: ?
Symptoms: Interchange of vaccine products
SMQs:, Medication errors (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: unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Unknown
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: Patient verbally confirmed twice that she was to receive Pfizer. I checked her card and made sure the dates of 1st and 2nd shot made her eligible for a 3rd dose. I overlooked the fact that it was Moderna on her card. I gave the vaccine and turned to fill out the card. That is when I noticed that the first two shots were another mRNA (Moderna). I told the patient that I gave her Pfizer and she was supposed to stay in the Moderna dose series. Patient was not alarmed at all. She said she was actually glad she received Pfizer. I apologized and of course will double check going forward. I check them every time. I am not sure what made my attention draw away from checking the series. Patient is not harmed or upset.


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