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Report #2850811

Received Jul 22, 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
10 yrs
State
CA
Recovered
Recovered
Vaccinated
Jul 21, 2025
Onset
Jul 21, 2025
Days to onset
0
Hospital days
—

Vaccines (2)

TypeNameManufacturerDoseLotRoute / Site
HPV9HPV (GARDASIL 9)MERCK & CO. INC.2Z002903IM / LA
TDAPTDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSUNK9JT4SIM / LA

Symptoms (3)

Eye movement disorderHungerPallor

Symptom narrative

Pt was going to receive 2 vaccines Tdap Booster and HPV # 2 to complete series. Pt was a bit nervous and requested both vaccines to be administered on Left arm, while he held his mother's hand with his right hand. Tdap was the first vaccine administered on Left Arm. Pt tolerated well and was surprised how well he did. I had asked pt to tell me about what he had done for summer break to allow him to distract himself from the next vaccine. HPV # 2 was administered on Left Arm. Both vaccines were completed by 0933. Pt was surprised how well he tolerated both vaccines. I was informing MOC that pt would need to wait 15 minutes after the vaccine to rule out any adverse reaction. Shortly after mentioning post vaccine instructions. At 0934 MOC noticed pt looking pale and eye rolling up. Pt leaned towards me and and MOC to notify any nursing staff in our nursing station. I also verbally called a code Blue in rrom 3, while exam room door was open. 0934 Dr entered the exam room and assisted in laying pt on the exam table. Vitals were obtained at 0934. Pt was responsive and still a little out of it, but was able to answer all questions to provider. MOC was informed by provider that pt was ok, but would recommend to wait the 15 minutes. Apple juice was offered to pt. 0936 Pt was alert, skin color was back to normal and was conversing. Vitals were obtained at 0937. Pt was very cooperative with vitals. Vitals were obtained at 0941. Pt communicated was feeling better and hungry. Pt was discharged at 0953

Current illness

N/A

Medical history

N/A

Other medications

N/A

Allergies

NKA

Lab data

N/A