Adverse Event Reporting

VAERS ID 922206
Gender Male
Age 62
StateCode OH
Pharmaceutical Company MODERNA
Lot Number
Number of vaccinations 1
Vaccinated 2020-12-28
Onset 2020-12-29
Condition Permanent Disability
Symptoms
  • Pain in extremity
  • Mobility decreased
  • Computerised tomogram normal
  • C-reactive protein increased
  • Muscular weakness
  • Sleep disorder
  • Loss of personal independence in daily activities
  • White blood cell count increased
  • Bursitis
  • Aspiration bursa
  • Culture
  • Magnetic resonance imaging abnormal
  • Shoulder injury related to vaccine administration

Current Illness

None

Preexisting Conditions

CAD Afib

Other Medications

Eliquis micardis. Metoprolol crestor asa

Previous Vaccinations

Allergies

Nkda

Laboratory Data

See above

Write-up

Arm weakness increased each day by post vaccine day 4 arm weak and unable to raise arm, conduct ADLs, painful interrupting sleep.
Unable to initiate movement in arm.
Use other arm to help move arm.
Went to ED on post vaccine day 4.
Wbc 12.
Crp 4.
CT no abscess.
Mri on 1/4 shows bursitis.
DX SIRVA.
Bursa aspirated.
Pending cultures.
PO MEDROL DOSEPAK.