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

This is VAERS ID 625930

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Case Details

VAERS ID: 625930 (history)  
Form: Version 1.0  
Age: 18.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2015-12-28
Onset:2015-12-29
   Days after vaccination:1
Submitted: 2016-02-18
   Days after onset:51
Entered: 2016-02-26
   Days after submission:8
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M13066 / 1 LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Influenza like illness, Injection site erythema, Myalgia, Pyrexia, Tuberculin test
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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: No other medications
Current Illness: No
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 12/28/2015, Tuberculin test
CDC Split Type: 2016012327

Write-up: This is a spontaneous report from a contactable physician. A 18-years-old male patient received TRUMENBA (Lot# M13066, Expiry Date 30Sep2016), intramuscular in the left deltoid at 0.5 ml, single on 28Dec2015 between 2:30 and 3:00 PM. The patient medical history and concomitant medications were not reported. On 29Dec2015 the patient experienced felt fluish and fever with outcome of recovered, muscle aches and large area of redness around the meningococcal group b injection site with outcome of unknown. The patient had no cough or flu symptoms. The patient underwent tuberculin test with MANTOUX (Manufacturer: Sanofi Pasteur, Lot number: C4858BA), intradermal in the left arm at 0.1 ml, single on 28Dec2015. The doctor saw the patient 30Dec2015.


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