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Report #2839004

Received Apr 30, 2025

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
14 yrs
State
TX
Recovered
Recovered
Vaccinated
Apr 22, 2025
Onset
Apr 22, 2025
Days to onset
0
Hospital days
—

Vaccines (2)

TypeNameManufacturerDoseLotRoute / Site
MNQMENINGOCOCCAL CONJUGATE (MENQUADFI)SANOFI PASTEUR1U8361AAIM / RA
TDAPTDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS1X449YIM / LA

Symptoms (2)

PallorSyncope

Symptom narrative

Patient received MCV4 & TDap. Patient stared at the wall, became pale, then fainted while sitting in chair. Patient leaned towards nurse on right side. Noted skin warm and clammy. Patient awoke in approximately 30 seconds, he stated he could not see or hear, then stated he hears weird noises. Laid patient on a mat on his left side after complaints of dizziness. Asked nurse to assist with next patient and obtained an ice pack from Nurse. This nurse obtained VS, placed cool towel on back of neck, ice pack on forehead, later provided water. Patient returned to baseline at 1604, he denied dizziness and stated he felt like his normal self. Color normal for ethnicuty, gait steady. Mom stated this has never happened before but has been complaining of dizziness and light-headedness for a few weeks. Provided resource list of clinics and encouraged to follow up with PCP. Vital signs % 1553: 108/60, HR-51, 94% RA, RR-18. 1556: HR-62, 98% RA. 1604: 110162, HR-67, 97%-RA, RR-18.

Current illness

None reported

Medical history

None reported

Other medications

None reported

Allergies

Penicillin, Amoxicillin

Lab data

None required.