Received Nov 4, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| COVID19 | COVID19 (COVID19 (MODERNA)) | MODERNA | N/A | 8146670 | IM / LA |
| FLU3 | INFLUENZA (SEASONAL) (FLUAD) | SEQIRUS, INC. | N/A | 407268 | IM / LA |
| PNC20 | PNEUMO (PREVNAR20) | PFIZER\WYETH | UNK | MA2488 | IM / RA |
| VARZOS | ZOSTER (SHINGRIX) | GLAXOSMITHKLINE BIOLOGICALS | 1 | NY2AT | IM / RA |
Per caregiver: 10-8-25: bruising occurred in left arm about 2 inches below vaccine administration site along with pain and trouble lifting arm. Around 10-23-25: issue was reported to pharmacy to RPh. Patient was referred to ER, Urgent Care, or PCP and advised to follow up if applicable for VAERS report submission. Patient went to office approximately 10-28-25 to 10-30-25 due to worsening of symptoms (bruising spread down arm and has spread to back). Patient went to hospital on 10-31-25, and then went to another hospital on 11-3-25 for the same reason.
none reported
hypertension, high cholesterol, Parkinson's disease/Parkinsonism, pain, insomnia, diabetes
carbidopa/levodopa 25-100 mg tab, ezetimibe 10mg tab, isosorbide mononitrate 30 mg er tab, metformin 1000 mg tab, metoprolol tartrate 25 mg tab, olmesartan 20 mg tab, rosuvastatin 40 mg tab, temazepam 30 mg cap, tramadol 50 mg . otc fish oi
none reported
Per staff at office: cbc test: slightly low platelets. Per staff at first hospital: cbc test: doctor will be in on 11-5-25 to review/interpret labs. Staff at second hospital: "ultrasound, x-ray shoulder, lab drawn, hematology, chemistry, and coagulation." no blood clots noted, fractures found in left arm.