Report #2860587

Received Sep 22, 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: Male
Age: 59 yrs
State: NY
Recovered: Recovered
Vaccinated: Sep 18, 2025
Onset: Sep 18, 2025
Days to onset: 0
Hospital days: —

Vaccines (2)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	1	3053583	LA
FLU3	INFLUENZA (SEASONAL) (FLUBLOK)	SANOFI PASTEUR	1	U8832AA	IM / LA

Symptoms (4)

DizzinessHyperhidrosisLoss of consciousnessSyncope

Symptom narrative

Patient fainted, became diaphoretic, light headed, shook briefly possible seizure? was unconscious for about 60 seconds.

Other medications

none

Allergies

codeine

Lab data

unknown