Received Nov 24, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| COVID19 | COVID19 (COVID19 (UNKNOWN)) | UNKNOWN MANUFACTURER | 1 | 3052731 | IM / LA |
Site: Shoulder Joint Injury (prolonged pain, tingling, etc.)-Medium, Additional Details: Pt reports persistent pain and limited mobility in her arm after a vaccine nearly 2 months ago. Referred pt to medical care at her PCP. She has not had any formal diagnostic work up for this problem at this time., Other Vaccines: VaccineTypeBrand: Fluzone High Dose; Manufacturer: ; LotNumber: U8764BB; Route: Intramuscular; BodySite: Left Deltoid; Dose: 1; VaxDate: 09/02/2025