Report #2839481

Received May 5, 2025

A note on interpretation. VAERS reports are unverified and may be incomplete or coincidental. A report does not establish that a vaccine caused an event, and counts should not be used to calculate incidence or infer causation. Full disclaimer

Overview

Sex: Male
Age: 74 yrs
State: PA
Recovered: Unknown
Vaccinated: Apr 14, 2025
Onset: Apr 14, 2025
Days to onset: 0
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	UNK	3046731	IM / LA

Symptoms (7)

ArthralgiaConfusional stateDizzinessFatigueInjection site painInjection site swellingLethargy

Symptom narrative

Site: Pain at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Systemic: Confusion-Medium, Systemic: Dizziness / Lightheadness-Medium, Systemic: Exhaustion / Lethargy-Medium, Systemic: Joint Pain-Medium, Additional Details: patient recieved 3 vaccines on the same day, Other Vaccines: VaccineTypeBrand: shingrix; Manufacturer: glaxosmithline; LotNumber: 55th4; Route: left deltoid; BodySite: arm; Dose: ; VaxDate: 04/14/2025, VaccineTypeBrand: bostrix tdap vaccine; Manufacturer: glaxosmithline; LotNumber: dy3k7; Route: left deltoid; BodySite: arm; Dose: ; VaxDate: 04/14/2025