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Report #2856879

Received Sep 4, 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
Female
Age
79 yrs
State
ME
Recovered
Not recovered
Vaccinated
Aug 29, 2024
Onset
Aug 29, 2024
Days to onset
0
Hospital days
—

Vaccines (2)

TypeNameManufacturerDoseLotRoute / Site
COVID19COVID19 (COVID19 (PFIZER-BIONTECH))PFIZER\BIONTECH7+LM2215IM / RA
FLU3INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUNKUT8437DAIM / LA

Symptoms (3)

ArthralgiaShoulder injury related to vaccine administrationX-ray

Symptom narrative

Patient developed SIRVA following the Covid-19 vaccination on 8/29/2024. The SIRVA was detected when the patient came into the office on 7/25/25 for right shoulder pain.

Medical history

Chronic pain, primary insomnia, type 2 diabetes mellitus, diabetic nephropathy, major depressive disorder, hypertensive chronic kidney disease, atherosclerotic heart disease, left carotid stenosis, peripheral vascular disease, atherosclerosis of aorta, COPD with chronic bronchitis, chronic kidney disease stage 3a, hypothyroidism (acquired), neurogenic pruritus, obstructive sleep apnea

Other medications

Isosorbide mononitrate ER 30 mg tablet extended release, Crestor 40 mg, Detrol LA 4 mg extended release, Cymbalta 60 mg delayed release particles 2 caps once a day, Furosemide 20 mg tablet, Farxiga 10 mg tablet once a day, Metformin Hcl ER

Allergies

Celexa, effexor, paxil, codeine, demerol, allergra, moxifloxacin, metronidazole, lisinopril, losartan, spiriva handihaler, thimersol, flonase, quinones

Lab data

x-ray on 7/25/25, MRI upcoming on 9/7/25, sports medicine evaluation on 8/26/25