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Report #2856669

Received Sep 3, 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
Female
Age
5 yrs
State
MD
Recovered
Not recovered
Vaccinated
Nov 22, 2021
Onset
Nov 22, 2021
Days to onset
0
Hospital days
—

Vaccines (1)

TypeNameManufacturerDoseLotRoute / Site
DTAPIPVDTAP + IPV (KINRIX)GLAXOSMITHKLINE BIOLOGICALS5px27DIM / LA

Symptoms (5)

Gait inabilityMuscular weaknessPain in extremityPeripheral swellingTic

Symptom narrative

Per the family recalled to the physician on 9/3/2025 and who requested that this form be completed. left arm swelling and pain. inability to walk well for a week due to leg pain and weakness. Since the vaccination with a facial motor tic that comes and goes.

Current illness

not recalled by parents

Medical history

motor tics

Other medications

not recalled by parents

Allergies

none

Lab data

The family did not seek medical attention at the time.