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

This is VAERS ID 1776799

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Case Details

VAERS ID: 1776799 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-10-01
Onset:2021-10-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 30148A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Interchange of vaccine products, Pain, Wrong product administered
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown, none on pharmacy record.
Current Illness: None at time of vaccination
Preexisting Conditions: Atopic Dermatitis, according to patient profile on record.
Allergies: None on file
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Came in for a routine flu vaccine, was inadvertently given the Pfizer COVID-19 vaccine instead. Patient had already received two doses of the Moderna vaccine in the past, however this dose *was* roughly six months after her second Moderna dose. Patient did not exhibit any unusual adverse effects for the shot (reported soreness), but we are reporting in an abundance of caution.


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