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

This is VAERS ID 616717



Case Details

VAERS ID: 616717 (history)  
Form: Version 1.0  
Age: 16.0  
Sex: Female  
Location: Unknown  
Vaccinated:2015-12-15
Onset:0000-00-00
Submitted: 2015-12-28
Entered: 2015-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS - / UNK UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Injection site nodule, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (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: Drug hypersensitivity
Allergies:
Diagnostic Lab Data:
CDC Split Type: US2015180415

Write-up: This case was reported by a nurse via sales rep and described the occurrence of injection site swelling in a 16-year-old female patient who received BEXSERO. Concurrent medical conditions included penicillin allergy. On 15th December 2015, the patient received BEXSERO .5 ml. In December 2015, less than a week after receiving BEXSERO, the patient experienced injection site swelling. On an unknown date, the outcome of the injection site swelling was unknown. It was unknown if the reporter considered the injection site swelling to be related to BEXSERO. Additional details were received as follows: In December 2015, less than a week (it was unsure whether injection site swelling occurred on same day of vaccination or next day) after receiving BEXSERO the patient experienced severe swelling at the injection site of the size of a baseball (swelled up into a knot) fro about 5 days and was still ongoing at the time of reporting. The patient was allergic to penicillin but did not have any latex allergy. The patient initials, date of birth, vaccine batch number and expiry date of vaccine were unknown. The call was escalated to medical information system.


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