Report #2860393

Received Sep 22, 2025

ER / ED 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: 22 yrs
State: CA
Recovered: Recovered
Vaccinated: Sep 12, 2025
Onset: Sep 12, 2025
Days to onset: 0
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	UNK	3052671	IM / LA

Symptoms (7)

Blood glucose increasedDizzinessHypotensionInjection site bruisingSyncopeTremorUnresponsive to stimuli

Symptom narrative

Site: Bruising at Injection Site-Mild, Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Severe, Systemic: Hypotension-Severe, Systemic: Shakiness-Mild, Additional Details: Pt received 3 vaccines and after received third one, pt fainted and had body shake. Put pt layed down on the carpet floor. Paramedic came and pt had low BP and high sugar. PT had Type 1 diabetes. Paramedic gave IV fluid and took pt to hospital. , Other Vaccines: VaccineTypeBrand: flucelvax 2025-2026; Manufacturer: seqirus; LotNumber: 948395; Route: IM; BodySite: left arm; Dose: ; VaxDate: UNKNOWN, VaccineTypeBrand: Heplisav-B; Manufacturer: Dynavax Technology; LotNumber: 948203; Route: IM; BodySite: Right arm; Dose: ; VaxDate: UNKNOWN