Report #2846587

Received Jun 19, 2025

Office 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: 11 yrs
State: MA
Recovered: Unknown
Vaccinated: Jun 19, 2025
Onset: Jun 19, 2025
Days to onset: 0
Hospital days: —

Vaccines (2)

Type	Name	Manufacturer	Dose	Lot	Route / Site
MNQ	MENINGOCOCCAL CONJUGATE (MENQUADFI)	SANOFI PASTEUR	1	U8494AA	IM / LA
TDAP	TDAP (ADACEL)	SANOFI PASTEUR	6	3CA30C1	IM / LA

Symptoms (8)

FallHaematemesisHead injuryHeadacheMassPallorPalpitationsSyncope

Symptom narrative

Pt arriving to office at approx 9am. Pt received vaccines at approx 930am, <5 minutes later syncable episode resulting in pt falling backwards and hitting head. C/o of headache, small bump to back of head, vomiting x1. + PERRLA, VSS, pale in color, pt reports feeling like "heart is racing" AP-84. Advised to go to ED, mom declining states will go home and monitor pt for 1 hr and then determine if feels ED is appropriate. Concussion protocol reviewed w/ mom and states understanding. Pt leaving office, accompanied by parent, at approx 1040am.

Current illness

N/a

Medical history

Allergic Rhinitis

Other medications

Claritin 5mg chewable tab/daily. Tylenol 480mg provided in office

Allergies

NKA

Lab data

None.

Prior vaccinations

Mom reports hx of fainting w/ vaccines