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Report #2862445

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
42 yrs
State
ID
Recovered
Recovered
Vaccinated
Sep 30, 2025
Onset
Sep 30, 2025
Days to onset
0
Hospital days
—

Vaccines (1)

TypeNameManufacturerDoseLotRoute / Site
COVID19COVID19 (COVID19 (MODERNA))MODERNAUNK3052030IM / RA

Symptoms (2)

Loss of consciousnessPresyncope

Symptom narrative

Patient had vaso-vagal response and passed out after vaccine administration and quickly regained consciousness