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Report #2862343

Received Sep 30, 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
13 yrs
State
WI
Recovered
Recovered
Vaccinated
Sep 29, 2025
Onset
Sep 29, 2025
Days to onset
0
Hospital days
—

Vaccines (1)

TypeNameManufacturerDoseLotRoute / Site
FLU3INFLUENZA (SEASONAL) (FLUCELVAX)SEQIRUS, INC.1406984IM / LA

Symptoms (2)

FallStaring

Symptom narrative

Patient was the first of 4 people he was with receiving the flu vaccine. He appeared well until after the fourth person received the vaccine, about 10 minutes later. He was standing against the wall and he began staring and then falling. The vaccinator noticed and caught him as he was falling before he hit the floor or anything else. He was sat down on the floor and instructed by the vaccinator to place his head between his legs and breathe in through the nose and out through the mouth. He was also given a Sprite, which he drank, and a cold pack which he placed on the back of his neck and was monitored for another 10-15 minutes. He was with his parents. He left them after returning to baseline.

Current illness

none reported

Medical history

none reported

Other medications

none reported

Allergies

none reported