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

This is VAERS ID 616670

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Case Details

VAERS ID: 616670 (history)  
Form: Version 1.0  
Age: 19.0  
Sex: Female  
Location: Unknown  
   Days after vaccination:0
Submitted: 2015-10-29
   Days after onset:20
Entered: 2015-12-29
   Days after submission:61
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Injection site nodule, Pain in extremity
SMQs:, 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: Loratadine
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: PHEH2015US020627

Write-up: Case number PHEH2015US020627, is an initial spontaneous report from a consumer received on 12 Oct 2015. This report refers to a 19-year-old female patient. Past medical history was not reported. Past medical vaccination included flu vaccine of unknown manufacture on 29 Sep 2015 (10 days prior to BEXSERO). Concomitant medication included loratadine (manufacturer unknown). She was vaccinated with BEXSERO (batch number and expiry date: not reported) at left arm on 09 Oct 2015. On same day, few hours after vaccination she started experiencing a sore arm, and there was a knot at the injection site. She stated that her arm was more sore than she usually experiences with vaccines, and had lasted longer than usual. The symptoms were improving, but not yet resolved. The seriousness and causality of events were not reported.

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