Report #2853425

Received Aug 8, 2025

Office visit

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: 16 yrs
State: WA
Recovered: Not recovered
Vaccinated: Jul 29, 2025
Onset: Jul 31, 2025
Days to onset: 2
Hospital days: —

Vaccines (3)

Type	Name	Manufacturer	Dose	Lot	Route / Site
IPV	POLIO VIRUS, INACT. (IPOL)	SANOFI PASTEUR	4	Y1A201M	IM / RA
MENB	MENINGOCOCCAL B (BEXSERO)	NOVARTIS VACCINES AND DIAGNOSTICS	1	49M9N	IM / LA
MNQ	MENINGOCOCCAL CONJUGATE (MENVEO)	NOVARTIS VACCINES AND DIAGNOSTICS	2	DL4YY	IM / LA

Symptoms (5)

ArthralgiaBursitisMobility decreasedShoulder injury related to vaccine administrationUltrasound joint

Symptom narrative

Received above vaccines on 7/29/2025. Mom called clinic 7/31, reported pt. having significant left shoulder pain with reduced range of motion. Seen / examined by physician 8/1/2025: Noted to have significant global left shoulder pain and reduced range of motion. No injection sites were identified on 8/1. Physician suspected SIRVA. Ordered Ultrasound left shoulder; pt. treated with prednisone and over counter NSAID.

Current illness

Ulcerative colitis, Seasonal allergies

Medical history

Ulcerative colitis

Other medications

mesalamine 400 mg - 3 capsules by mouth twice daily; Zyrtec 10 mg daily

Allergies

No Known Allergies

Lab data

Left shoulder Ultrasound performed 8/7/2025: Results showed left subacromial bursitis with subscapularis muscle involvement. Left shoulder MRI ordered, not yet completed as of this writing.