Report #2860758

Received Sep 23, 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: Female
Age: 58 yrs
State: NY
Recovered: Unknown
Vaccinated: Sep 23, 2025
Onset: Sep 23, 2025
Days to onset: 0
Hospital days: —

Vaccines (2)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	N/A	3052736	IM / LA
FLU3	INFLUENZA (SEASONAL) (FLUCELVAX)	SEQIRUS, INC.	N/A	406997	IM / RA

Symptoms (3)

FallHead injurySyncope

Symptom narrative

pt fell/fainted approximately 15 minutes after administration and hit her head, transported via ambulance for evaluation