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

This is VAERS ID 630835

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Case Details

VAERS ID: 630835 (history)  
Form: Version 1.0  
Age: 16.0  
Sex: Female  
Location: California  
Vaccinated:2016-04-04
Onset:2016-04-07
   Days after vaccination:3
Submitted: 2016-04-07
   Days after onset:0
Entered: 2016-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M37314 / UNK UN / IM

Administered by: Public       Purchased by: Public
Symptoms: Drug administered to patient of inappropriate age, No adverse event
SMQs:, Medication errors (narrow)

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: rash~Meningococcal B (Trumenba)~1~16.00~Patient
Other Medications: Benzoyl peroxide
Current Illness: None
Preexisting Conditions: No known allergies
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt. waited 15 min no reaction.


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