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

This is VAERS ID 1782401

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Case Details

VAERS ID: 1782401 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-09-30
Onset:2021-09-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient presented to the pharmacy to get a covid vaccine and told this reporter that he hadn''t been vaccinated yet. It turns out that he had already received a dose of the Janssen vaccine at a different pharmacy. Therefore the vaccination on 9/30/21 was unnecessary.


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