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

This is VAERS ID 628703

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Case Details

VAERS ID: 628703 (history)  
Form: Version 1.0  
Age: 16.0  
Sex: Male  
Location: New York  
Vaccinated:2016-03-21
Onset:2016-03-21
   Days after vaccination:0
Submitted: 2016-03-23
   Days after onset:2
Entered: 2016-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU4: INFLUENZA (SEASONAL) (FLUARIX QUADRIVALENT) / GLAXOSMITHKLINE BIOLOGICALS 3343R / 1 LA / IM
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M37314 / 1 LA / IM

Administered by: Unknown       Purchased by: Public
Symptoms: Chills, Dizziness, Headache, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular 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: Adderall XR 20MG (1 PO daily)
Current Illness: No
Preexisting Conditions: ADHD
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Chills, bodyache, fever, dizzy, headache.


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