Report #2860580

Received Sep 22, 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: 84 yrs
State: MI
Recovered: Recovered
Vaccinated: Sep 17, 2025
Onset: Sep 17, 2025
Days to onset: 0
Hospital days: —

Vaccines (2)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	7+	3052731	IM / LA
FLU3	INFLUENZA (SEASONAL) (FLUAD)	SEQIRUS, INC.	1	407246	IM / LA

Symptoms (1)

Back pain

Symptom narrative

Shortly after injection, patient left pharmacy and walked to the back of the store to continue shopping, about 2-3 minutes into this walk, he felt a sharp pain in his back/side and needed to sit down and rest. Store team contacted EMS, vitals were assessed and were WNL and patient refused transport to emergency room as he was feeling better.

Medical history

History of cancer- immunocompromised by chemotherapy (currently under treatment), hypothyroidism, hypertension