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

This is VAERS ID 629824

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Case Details

VAERS ID: 629824 (history)  
Form: Version 1.0  
Age: 17.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2016-03-25
Onset:2016-03-25
   Days after vaccination:0
Submitted: 2016-03-29
   Days after onset:4
Entered: 2016-03-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 151301D / 1 LA / IM

Administered by: Unknown       Purchased by: Public
Symptoms: Activities of daily living impaired, Injection site pain, Pain
SMQs:, Dementia (broad), 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? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: started augmentin later that day
Current Illness: Vaginitis
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Extreme pain at injection site and anterior to injection site. Unable to move arm without pain. Unable to perform ADLs days later - seen in office on 3/29/16 with extreme pain. Unable to swim (she is a swimmer).


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