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From the 9/14/2017 release of VAERS data (an older release, current is 11/19/2021):

This is VAERS ID 616072

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Case Details

VAERS ID: 616072 (history)  
Form: Version 1.0  
Age: 17.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2015-12-03
Onset:2015-12-03
   Days after vaccination:0
Submitted: 2015-12-22
   Days after onset:19
Entered: 2015-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH J28923 / 1 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR 45180AA / 2 RA / IM

Administered by: Private       Purchased by: Private
Symptoms: Fatigue, Headache, Injected limb mobility decreased, Muscular weakness, Pain in extremity, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad)

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:
Other Medications:
Current Illness: Recurrent Headache; Recurrent back pain
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe constant pain (L) arm, could not lift x 3 days. Legs were weak, no walking x 1 day. Severe Headache x 3 days. Emesis x 1. Very tired.


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