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From the 1/14/2022 release of VAERS data:

This is VAERS ID 1808278

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Case Details

VAERS ID: 1808278 (history)  
Form: Version 2.0  
Age: 1.42  
Sex: Male  
Location: Illinois  
Vaccinated:2021-10-20
Onset:2021-10-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS 4L9E4 / 4 LL / IM
FLU4: INFLUENZA (SEASONAL) (FLUARIX QUADRIVALENT) / GLAXOSMITHKLINE BIOLOGICALS 3SE27 / N/A RL / -
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH EH9810 / 4 RL / IM

Administered by: Private       Purchased by: ?
Symptoms: Product storage error
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin, ibuprofen, Tylenol
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: The refrigerator that houses the vaccines experienced a temperature excursion. The FLUARIX and INFANRIX vaccines were considered to be out of range and therefore invalid.


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