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

This is VAERS ID 1840376

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Case Details

VAERS ID: 1840376 (history)  
Form: Version 2.0  
Age: 7.0  
Sex: Male  
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 entering information in state database that had given adult vaccine dose to pediatric patient. informed attending. spoke with infectious disease doctor. called mother. no adverse events at this time.


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