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

This is VAERS ID 946915

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Case Details

VAERS ID: 946915 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: New York  
Vaccinated:2020-12-29
Onset:2020-12-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 AR / IM

Administered by: Other       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:
Current Illness: no adverse events reported post vaccination but was notified that a 17 year old was inadvertently administered a Moderna COVID dose #1
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: There was no adverse event from the vaccination itself but we were advised to file a report in VAERS by the vaccine manufacturer because we were notified that a 17 year old received a first dose of the Moderna vaccine before it was realized that she was under age. She and her family reported no adverse reactions from the vaccine.


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