Report #2856148

Received Aug 29, 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: Female
Age: 11 yrs
State: AZ
Recovered: Unknown
Vaccinated: Aug 29, 2025
Onset: Aug 29, 2025
Days to onset: 0
Hospital days: —

Vaccines (6)

Type	Name	Manufacturer	Dose	Lot	Route / Site
UNK	VACCINE NOT SPECIFIED (NO BRAND NAME)	UNKNOWN MANUFACTURER	UNK	3N2ND	IM / RA
UNK	VACCINE NOT SPECIFIED (NO BRAND NAME)	UNKNOWN MANUFACTURER	UNK	Z008220	IM / LA
UNK	VACCINE NOT SPECIFIED (NO BRAND NAME)	UNKNOWN MANUFACTURER	UNK	Y1A201M	IM / LA
UNK	VACCINE NOT SPECIFIED (NO BRAND NAME)	UNKNOWN MANUFACTURER	UNK	9YB4G	IM / RA
UNK	VACCINE NOT SPECIFIED (NO BRAND NAME)	UNKNOWN MANUFACTURER	1	Y012921	IM / RA
UNK	VACCINE NOT SPECIFIED (NO BRAND NAME)	UNKNOWN MANUFACTURER	1	U8494AA	IM / LA

Symptoms (4)

CryingFallHead injurySyncope

Symptom narrative

Patient talking to RN, RN finished giving shots and turned around to get bandaids and patient fainted and fell off chair, to knees and hit head. Cold compress and to forehead and patient started crying. BP WNL, A&O, waited 20 minutes and left. Mother called today but didn't answer or return calls.

Current illness

none

Medical history

none

Other medications

none

Allergies

none

Lab data

none