Report #2867554

Received Oct 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: 57 yrs
State: MO
Recovered: Unknown
Vaccinated: Sep 24, 2025
Onset: Oct 6, 2025
Days to onset: 12
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
FLU3	INFLUENZA (SEASONAL) (FLUARIX)	GLAXOSMITHKLINE BIOLOGICALS	N/A	9CC9K	SYR / RA

Symptoms (2)

ArthralgiaShoulder injury related to vaccine administration

Symptom narrative

Employee reported ongoing pain in right shoulder/deltoid after receiving required seasonal influenza vaccine.

Current illness

Denied.

Medical history

Diabetes Mellitus

Other medications

Unknown.

Allergies

Unknown.

Lab data

Employee was referred for medical evaluation on 10/13/25and was diagnosed with SIRVA. Due to history of Diabetes, treatment remains conservative and employee was discharged from care.