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From the 10/8/2021 release of VAERS data:

This is VAERS ID 916248



Case Details

VAERS ID: 916248 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Illinois  
Vaccinated:2020-12-29
Onset:2020-12-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026L20A / 1 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: No adverse event, Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

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: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Unknown
Diagnostic Lab Data: None
CDC Split Type:

Write-up: NO ADVERSE EVENT OCCURRED A 17 year old EMS worker who was coming through out COVID-19 vaccination clinic received the vaccine. At the time, no one realized he was only 17 years old. Since the vaccine is only indicated for 18 years or older adults, I thought it best to report it here since it was technically an error. I spoke with the patient on 12/31/2020 to notify him of the error and he felt fine. He had no adverse reaction to the vaccine


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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=916248

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