Report #2850869

Received Jul 23, 2025

ER / ED visitOffice 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: 12 yrs
State: MI
Recovered: Unknown
Vaccinated: Jul 18, 2025
Onset: Jul 18, 2025
Days to onset: 0
Hospital days: —

Vaccines (2)

Type	Name	Manufacturer	Dose	Lot	Route / Site
MNQ	MENINGOCOCCAL CONJUGATE (MENVEO)	NOVARTIS VACCINES AND DIAGNOSTICS	1	57h54	IM / RA
TDAP	TDAP (BOOSTRIX)	GLAXOSMITHKLINE BIOLOGICALS	1	h4279	IM / LA

Symptoms (7)

FallLoss of consciousnessPulse absentRespiratory arrestResuscitationSkin lacerationWound closure

Symptom narrative

Patient went to check out after receiving both immunizations. Patient then passed out, fell backwards and hit his head on a door handle and was knocked unconscious. Patient lost pulse and CPR was initiated by his provider. Patient had laceration in the back of his scalp. EMS was called, patient regained pulse and respirations. Once EMS arrived patient was transferred

Current illness

none

Medical history

constipation, blood in urine

Lab data

CT scan and staples to laceration in the back of his head.