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From the 9/14/2017 release of VAERS data (an older release, current is 1/14/2022):

This is VAERS ID 625917

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Case Details

VAERS ID: 625917 (history)  
Form: Version 1.0  
Age: 16.0  
Sex: Female  
Location: Unknown  
Vaccinated:2015-11-06
Onset:2015-11-06
   Days after vaccination:0
Submitted: 2016-02-18
   Days after onset:104
Entered: 2016-02-26
   Days after submission:8
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV9: HPV (GARDASIL 9) / MERCK & CO. INC. - / UNK RA / UN
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH - / UNK LA / UN
MNQ: MENINGOCOCCAL CONJUGATE (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK LA / UN

Administered by: Other       Purchased by: Other
Symptoms: Injection site erythema, Injection site pain, Injection site warmth, Malaise, Neck pain, Pyrexia, Tenderness
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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: No other medications
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 2015387136

Write-up: This is a spontaneous report from a contactable nurse via a Pfizer sales representative. A 16-year-old female patient of an unspecified ethnicity received a single dose of TRUMENBA in the left arm, a single dose of MCV4 (manufacturer unknown) in the left arm and a single dose of HPV9 (manufacturer unknown) in the right arm, all 06Nov2015. Medical history and concomitant medications were not reported. The patient complained later on 06Nov2015 (Friday) that she had a swelling at the base of her shoulder and she felt sick. Over the weekend on Saturday and Sunday (07Nov2015 and 08Nov2015), the patient had fevers on and off. She took ibuprofen (manufacturer unknown) and she was presented to the office on 07Nov2015 and her shoulder looked red and it was hot to touch, according to the nurse. The patient continued to complain of sharp pain and tenderness from the shoulder to the upper neck. The patient recovered from fevers. The outcome of all over events was unknown. The doctors did not know but they suspect that all these side effects were related to the vaccines. They did not know if it was the combination of the vaccines or a single vaccine. Follow-up (07JAN2016): Follow-up attempts are completed. No further information is expected.


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