Report #2863490

Received Oct 6, 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: 48 yrs
State: NH
Recovered: Unknown
Vaccinated: Sep 26, 2025
Onset: Sep 26, 2025
Days to onset: 0
Hospital days: —

Vaccines (2)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	UNK	Lot Number: 305	IM / RA
FLU3	INFLUENZA (SEASONAL) (FLUZONE)	SANOFI PASTEUR	UNK	u8881ca	—

Symptoms (3)

Injection site painPainWrong technique in product usage process

Symptom narrative

He reports the first vaccine caused him so much pain that radiated from his shoulder down to his fingers that he jumped and verbalized it to the RN administering it. He reports the injection "came from high up with a downward angle" to his right upper shoulder. He reports he has never felt similar pain in the past with vaccine administration. He reports he felt no pain with the second vaccine.

Current illness

gerd, diverticulosis, esophagitis, OSA, constipation, prediabetes

Other medications

Naproxen, pantoprazole

Allergies

NKDA

Lab data

n/a