Report #2871829

Received Nov 10, 2025

ER / ED 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: Female
Age: 63 yrs
State: NY
Recovered: Unknown
Vaccinated: Oct 22, 2025
Onset: Oct 23, 2025
Days to onset: 1
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (UNKNOWN))	UNKNOWN MANUFACTURER	UNK	3052864	IM / LA

Symptoms (3)

HypotensionInjection site painThrombosis

Symptom narrative

Site: Pain at Injection Site-Mild, Systemic: acute blood clot-Severe, Systemic: Hypotension-Mild, Other Vaccines: VaccineTypeBrand: boostrix tdap; Manufacturer: glaxosmithonline; LotNumber: 94kg2; Route: intramuscular; BodySite: left arm; Dose: ; VaxDate: UNKNOWN