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

This is VAERS ID 628777

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Case Details

VAERS ID: 628777 (history)  
Form: Version 1.0  
Age: 17.0  
Sex: Female  
Location: Michigan  
   Days after vaccination:0
Submitted: 2016-03-23
   Days after onset:15
Entered: 2016-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)

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:
Diagnostic Lab Data:
CDC Split Type: US2016037775

Write-up: This case was reported by a other health professional via call center representative and described the occurrence of injection site pain in a 17-year-old female patient who received BEXSERO (batch number 149001, expiry date unknown). On 7th March 2016, the patient received BEXSERO .5 ml. On 7th March 2016, less than a day after receiving BEXSERO, the patient experienced injection site pain. The patient was treated with MOTRIN. On an unknown date, the outcome of the injection site pain was not recovered/not resolved. It was unknown if the reporter considered the injection site pain to be related to BEXSERO. Additional details were received as follows: This case was previously reported to a doctor. This case was reported by a certified medical assistant. The patient experienced pain at the injection site, for over 8 days. The patient had been taking over the counter MOTRIN to treat the pain. The reporter did not know the expiration date of the product. The reporter provided the 15th August 2015 as the revision date for the product.

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