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

This is VAERS ID 625935

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Case Details

VAERS ID: 625935 (history)  
Form: Version 1.0  
Age: 12.0  
Sex: Male  
Location: Unknown  
Vaccinated:2016-01-17
Onset:2016-01-17
   Days after vaccination:0
Submitted: 2016-02-18
   Days after onset:32
Entered: 2016-02-26
   Days after submission:8
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M13066 / UNK UN / IM

Administered by: Other       Purchased by: Other
Symptoms: Headache, Injection site pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (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: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 2016032907

Write-up: This is a spontaneous report from a contactable physician through a Pfizer Sales Representative. A 12-year-old male patient, the doctor''s son, received one dose of TRUMENBA (lot M13066, Expiry Date: Sep2016), intramuscular on 17Jan2016 at 0.5 ml single dose for prevention of meningococcal disease. The patient medical history and the patient''s concomitant medications were not reported. The patient experienced muscle pain at site, headache and low grade fever on 17Jan2016. The outcome of the events was reported as recovered. The events were assessed as non-serious.


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