Report #2874391

Received Nov 24, 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: Male
Age: 80 yrs
State: CA
Recovered: Not recovered
Vaccinated: Oct 28, 2025
Onset: Oct 29, 2025
Days to onset: 1
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (UNKNOWN))	UNKNOWN MANUFACTURER	N/A	3052996	IM / RA

Symptoms (3)

Bell's palsyInjection site painVisual impairment

Symptom narrative

Site: Pain at Injection Site-Severe, Systemic: Bell's Palsy-Severe, Systemic: localized to patient's right side of face-Severe, Systemic: Visual Changes/Disturbances-Medium, Other Vaccines: VaccineTypeBrand: Fluad; Manufacturer: SeQirus; LotNumber: 407274; Route: intramuscular; BodySite: left arm; Dose: n/a; VaxDate: 10/28/2025

Allergies

tetracycline, benzoin tincture