Report #2874424

Received Dec 30, 2025

Hospitalized

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Overview

Sex: Male
Age: 68 yrs
State: IL
Recovered: Recovered
Vaccinated: Nov 6, 2025
Onset: Nov 7, 2025
Days to onset: 1
Hospital days: —

Vaccines (2)

Type	Name	Manufacturer	Dose	Lot	Route / Site
FLU4	INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE QUADRIVALENT)	SANOFI PASTEUR	1	ut8781ca	IM / LA
COVID19	COVID19 (COVID19 (UNKNOWN))	UNKNOWN MANUFACTURER	1	3052296	IM / LA

Symptoms (6)

ArthralgiaJoint injuryTachycardiaInjection site erythemaInjection site painInjection site swelling

Symptom narrative

Site: Pain at Injection Site-Severe, Site: Redness at Injection Site-Severe, Site: Swelling at Injection Site-Severe, Site: Shoulder Joint Injury (prolonged pain, tingling, etc.)-Severe, Other Vaccines: VaccineTypeBrand: Fluzone High Dose; Manufacturer: Sanofi; LotNumber: UT8781CA; Route: IM; BodySite: Left Arm; Dose: 1; VaxDate: 11/06/2025