Report #2871840

Received Nov 10, 2025

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: 52 yrs
State: CA
Recovered: Unknown
Vaccinated: Nov 4, 2025
Onset: Nov 5, 2025
Days to onset: 1
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19-2	COVID19 (COVID19 (MODERNA BIVALENT))	MODERNA	UNK	3052663	IM / LA

Symptoms (2)

Injection site painRefusal of vaccination

Symptom narrative

Site: Pain at Injection Site-Mild, Systemic: Upset-Mild, Additional Details: Patient came in 5 minutes before lunch and asked for a flu vaccine. He was also asked if he wanted a COVID vaccine and he agreed to it. He filled out two questionnaires and signed for it. He was also told he was getting a flu vaccine and COVID vaccine before actually reciving the vaccine physically. After receiving the vacccines and signing for them he says that he complained that he wanted the COVID vaccine.