Report #2863931

Received Oct 7, 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: 76 yrs
State: IL
Recovered: Not recovered
Vaccinated: Sep 14, 2025
Onset: Sep 23, 2025
Days to onset: 9
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	7+	3052155	IM / LA

Symptoms (3)

ArthralgiaInjection site painMobility decreased

Symptom narrative

Site: Pain at Injection Site-Medium, Site: Shoulder Joint Injury (prolonged pain, tingling, etc.)-Medium, Additional Details: Possible Sirva, patient claims they can't lift arm and had been 2 weeks since vaccine was administered. Counseled to follow up with md, Other Vaccines: VaccineTypeBrand: fluzone Highdose; Manufacturer: sanofi; LotNumber: U8764dB; Route: IM; BodySite: Left arm; Dose: ; VaxDate: UNKNOWN