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

This is VAERS ID 926748

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Case Details

VAERS ID: 926748 (history)  
Form: Version 2.0  
Age: 14.0  
Sex: Male  
Location: Nevada  
Vaccinated:2021-01-07
Onset:2021-01-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J20 -2A / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Product administered to patient of inappropriate age
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: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Medication Error - 0.5 mgs of Moderna Vaccination administered to person less than 18 years old (14 year old patient). No Symptoms or complaints. Parent contacted - advised to watch for any untoward signs or symptoms.


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