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Report #2880437
Received Jan 2, 2026
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.
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Overview
Sex
Male
Age
9 yrs
State
—
Recovered
Unknown
Vaccinated
Dec 22, 2025
Onset
Jan 2, 2026
Days to onset
11
Hospital days
—
Vaccines (2)
Type
Name
Manufacturer
Dose
Lot
Route / Site
COVID19
COVID19 (COVID19 (MODERNA))
MODERNA
UNK
3053855
IM / RA
TDAP
TDAP (ADACEL)
SANOFI PASTEUR
1
U8620BA
IM / RA
Symptoms (2)
Injection site pain
Injection site swelling
Symptom narrative
swelling, pain at injection site