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

This is VAERS ID 626212

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Case Details

VAERS ID: 626212 (history)  
Form: Version 1.0  
Age: 21.0  
Sex: Female  
Location: Arizona  
Vaccinated:2016-02-25
Onset:0000-00-00
Submitted: 2016-02-25
Entered: 2016-02-29
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV9: HPV (GARDASIL 9) / MERCK & CO. INC. L026602 / 1 RA / UN
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 149001 / 1 LA / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U5216AA / 2 LA / UN
TD: TD ADSORBED (TENIVAC) / SANOFI PASTEUR U4669AA / 2 LA / UN

Administered by: Private       Purchased by: Private
Symptoms: Drug administered to patient of inappropriate age
SMQs:, Medication errors (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:
Current Illness: Cold
Preexisting Conditions: Asplenia
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: None stated.


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