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From the 9/17/2021 release of VAERS data:

This is VAERS ID 611806



Case Details

VAERS ID: 611806 (history)  
Form: Version 1.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2015-11-11
Entered: 2015-11-25
   Days after submission:14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH - / UNK UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Pain, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (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: No other medications
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 2015271018

Write-up: This is a spontaneous report obtained from a contactable consumer who reported for her daughter. A female patient of an unspecified age and ethnicity received, on an unspecified date, TRUMENBA, single dose. Relevant medical history and concomitant medications were unknown. On an unspecified date, the patient experienced some pain and little bit of swelling. Clinical outcome of the events was unknown at the time of this report. Follow-up (10OCT2015): Follow-up attempts completed. No further information expected.


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