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

This is VAERS ID 903017

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Case Details

VAERS ID: 903017 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Kansas  
Vaccinated:2020-12-16
Onset:2020-12-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 OT / OT

Administered by: Public       Purchased by: ?
Symptoms: Syringe issue
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: The nurse was tapping the syringe to get all the air out and the needle popped out of the vaccine vial and stuck to the sticker that was on the vial. 0.3ml of the vaccine was discarded with the syringe into the sharps box.


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