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

This is VAERS ID 631264

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Case Details

VAERS ID: 631264 (history)  
Form: Version 1.0  
Age: 16.0  
Sex: Female  
Location: Arizona  
Vaccinated:2016-04-08
Onset:2016-04-09
   Days after vaccination:1
Submitted: 2016-04-11
   Days after onset:2
Entered: 2016-04-13
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M51858 / 2 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR M37315 / 1 RA / IM

Administered by: Private       Purchased by: Private
Symptoms: Pain, Rash erythematous, Rash macular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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: BENADRYL
Current Illness:
Preexisting Conditions: Hearing loss
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Red, blotchy rash from elbow to shoulder. Extreme soreness.


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