Report #2875151

Received Nov 26, 2025

ER / ED visitOffice 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: 59 yrs
State: MN
Recovered: Unknown
Vaccinated: Nov 17, 2025
Onset: Nov 17, 2025
Days to onset: 0
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
TDAP	TDAP (BOOSTRIX)	GLAXOSMITHKLINE BIOLOGICALS	UNK	K4979	IM / RA

Symptoms (4)

AstheniaMusculoskeletal disorderPainPeriarthritis

Symptom narrative

pain, adhesive capsulitis, decreased strength and inability to use arm

Current illness

N/A

Medical history

hypertension, Factor V leiden mutation, DVT, Afib

Other medications

avapro, coreg, pardaxa, norvasc

Allergies

Penicillin