Report #2836234

Received Apr 15, 2025

ER / ED 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: 89 yrs
State: MN
Recovered: Recovered
Vaccinated: Oct 7, 2024
Onset: Oct 7, 2024
Days to onset: 0
Hospital days: —

Vaccines (2)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	UNK	304335	IM / RA
FLU3	INFLUENZA (SEASONAL) (FLUAD)	SEQIRUS, INC.	UNK	388486	IM / RA

Symptoms (1)

Memory impairment

Symptom narrative

Patient went to dining room per facility staff and client stated "I'm Falling" did not fall but blanked out per residents at the dining room table. denies breathing problems, denies check, back or arm pain, no nausea. EMS notified per facility staff. Pt. took BP medics this am and had supra pubic catheter flushed. Wife present during event.