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

This is VAERS ID 1840366

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Case Details

VAERS ID: 1840366 (history)  
Form: Version 2.0  
Age: 9.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-11-03
Onset:2021-11-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Incorrect dose administered, No adverse event
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: Realized when documenting in the state vaccine database that I had given adult dose covid vaccine to pediatric patient. Spoke with infectious disease doctor about what to look for. Child is not currently having any side effects but may expect to have more pronounced fever, chills, etc, according to the doctor I spoke with.


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