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

This is VAERS ID 954011

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Case Details

VAERS ID: 954011 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-01-14
Onset:2021-01-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030L20A / 1 RA / IM

Administered by: Private       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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft, Estradiol, Clobetasol
Current Illness: None
Preexisting Conditions: Anxiety, Aphthous Stomatitis, Eczema
Allergies: NKDA
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient is under the age of 18 and should not have received the vaccine


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