Adverse Event Reporting

VAERS ID 933101
Gender Male
Age 29
StateCode OH
Pharmaceutical Company MODERNA
Lot Number 011L20A
Number of vaccinations 1
Vaccinated 2020-12-31
Onset 2020-12-31
Condition Permanent Disability
  • Injection site pain
  • Injected limb mobility decreased
  • Sleep disorder
  • Injection site discomfort
  • Loss of personal independence in daily activities
  • Bursitis
  • Magnetic resonance imaging abnormal
  • Shoulder injury related to vaccine administration
  • Tendon disorder

Current Illness


Preexisting Conditions


Other Medications


Previous Vaccinations



Laboratory Data

MRI SHOULDER RIGHT - Details Study Result Impression 1.
Supraspinatus and infraspinatus bursal surface tendinopathy without tear.
Anterosuperior glenoid labral tear with small intrasubstance paralabral cysts.
Subacromial/subdeltoid bursitis.
Narrative HISTORY: Acute pain of right shoulder.
TECHNIQUE: Noncontrast multiplanar MR images were obtained of the right shoulder.
FINDINGS: Rotator cuff: There is focal bursal surface thickening and hyperintensity of the infraspinatus critical-zone and insertion, and the supraspinatus leading-edge insertion.
No significant intrasubstance or surface tear is evident.
Subscapularis and teres minor tendons are normal.
Muscle bulk is maintained.
Glenoid labrum: Linear signal abnormality extends from the 12:00 through 2:00 positions anterior superiorly, with associated intralabral cysts measuring 0.
7 x 0.
5 x 0.
7 cm.
Glenohumeral articular cartilage: Normal.
Long head biceps tendon: Normal.
Coracoacromial arch: Acromioclavicular joint is normal.
Acromion is type- II.
There is no anterior or lateral acromial downsloping or spur.
Marrow: Normal.
Miscellaneous: Subacromial/subdeltoid bursal effusion is moderate.


Moderna vaccine dose #1 received in right shoulder on 12/31/20 at 2:15PM.
Injection was uneventful other than sensation of pressure.
I did notice at the time, but could not fully see, that the injection appeared to be much higher on the shoulder than normal.
I immediately came home afterwards and relaxed.
Approximately 2hrs later, I began experiencing extreme pain in my right shoulder.
As the night progressed, the pain worsened to 10/10 with inability to move my arm.
Later that night after requiring assistance to take off my shirt, I noticed that the bandaid overlying the injection site was very high, immediately below and bordering the acromion process.
This was concerning but I was hopeful the pain would go away over the next few days.
I took tylenol that night.
I woke up multiple times during the night because the pain was so severe.
When I woke up, the pain and inability to move my arm were still present.
I began taking 800mg ibuprofen and 1000mg tylenol alternating Q4 throughout the next few days.
The pain and disability remained so severe that I required assistance performing ADLs for the next 4 days.
On day four, with the pain not resolved and still severe despite consistent advil and tylenol use, I began having concern for shoulder injury related to vaccine administration.
The next day I decided to seek an evaluation by an orthopedist.
I am a physician and was unable to perform basic tasks and ADLs.
I happened to have a few days off after the injection but would not have been able to work had I not.
After an evaluation by the an orthopedic PA, I obtained an MRI of my right shoulder with results shown below - as I expected evidence of rotator cuff tendinopathy and subdeltoid bursitis consistent with SIRVA.
As of now, I still have limited range of motion and shoulder pain on the right which has improved slightly but is far from resolved.
I still have difficulty with certain ADLs including putting clothes on and off, lifting items, and tasks that require raising my right arm above my head.
I am concerned with the possibility of long term and/or permanent damage after reviewing the literature.
I am also concerned about how many other healthcare workers the person who gave me my vaccine may be injuring and/or causing permanent harm to.