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From the 1/7/2022 release of VAERS data:

This is VAERS ID 950623

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Case Details

VAERS ID: 950623 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-01-16
Onset:2021-01-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041L20A / 1 LA / IM

Administered by: Pharmacy       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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient is 17 years and 10 months and she works at a physical therapy clinic. She answered the screening questions on the website and got the ok to get the vaccine. Vaccine was given to the patient but the EUA for Covid-19 Moderna vaccine is for 18 years and older. The patient did not develop any type of reaction. BUT due to the EUA we had to call the patient after she has already received the vaccine and inform her that we are not able to administer the second dose until further instruction from the AICP.


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