Adverse Event Reporting

VAERS ID 926909
Gender Male
Age 34
StateCode MN
Pharmaceutical Company PFIZER\BIONTECH
Lot Number EK4176
Number of vaccinations 1
Vaccinated 2021-01-06
Onset 2021-01-06
Condition Permanent Disability
  • Injection site pain
  • Immediate post-injection reaction
  • Injected limb mobility decreased
  • Bursitis
  • Shoulder injury related to vaccine administration

Current Illness

No acute illness

Preexisting Conditions

Irritable bowel syndrome with diarrhea, eczema, osteopenia, positive human leukocyte antigen b27

Other Medications


Previous Vaccinations



Laboratory Data


Immediate pain and loss of range of movement of left shoulder.
Physical examination today demonstrates a healing injection site which is fairly superior on the left shoulder, and abduction of the left shoulder which is limited secondary to pain.
Patient's physician's impression is that he has a subdeltoid bursitis which was temporally associated to the COVID-19 vaccination.