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

This is VAERS ID 629126

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Case Details

VAERS ID: 629126 (history)  
Form: Version 1.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2016-03-10
Onset:2016-03-10
   Days after vaccination:0
Submitted: 2016-03-24
   Days after onset:13
Entered: 2016-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS PP148901A / UNK LA / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR - / UNK UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Injection site pain, Musculoskeletal pain, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Tendinopathies and ligament disorders (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:
Allergies:
Diagnostic Lab Data:
CDC Split Type: US2016038974

Write-up: This case was reported by a physician via call center representative and described the occurrence of shoulder pain in a female patient who received BEXSERO (batch number PP-148901A, expiry date 30th September 2016). Concomitant products included MENACTRA. On 10th March 2016, the patient received BEXSERO .5 ml. On 10th March 2016, less than a day after receiving BEXSERO, the patient experienced shoulder pain and injection site pain. In March 2016, the patient experienced tingling of extremity. On an unknown date, the outcome of the shoulder pain and injection site pain were not recovered/not resolved and the outcome of the tingling of extremity was unknown. It was unknown if the reporter considered the shoulder pain, injection site pain and tingling of extremity to be related to BEXSERO. Additional details were as follows: The patient experienced deep left shoulder pain, painful to touch at injection site and tingling down left arm (less than a week after vaccination). The reporter was unable to provide patient''s date of birth.


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