Report #2863234

Received Oct 5, 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: 35 yrs
State: PA
Recovered: Recovered
Vaccinated: Oct 5, 2025
Onset: Oct 5, 2025
Days to onset: 0
Hospital days: —

Vaccines (4)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	UNK	3051995	IM / LA
FLU3	INFLUENZA (SEASONAL) (FLUBLOK)	SANOFI PASTEUR	UNK	u8832aa	IM / RA
HEP	HEP B (HEPLISAV-B)	DYNAVAX TECHNOLOGIES CORPORATION	UNK	944943	IM / RA
TDAP	TDAP (BOOSTRIX)	GLAXOSMITHKLINE BIOLOGICALS	UNK	px3p7	IM / LA

Symptoms (2)

DisorientationSyncope

Symptom narrative

pt signs of syncope, never actually fainted. became very disoriented but back to normal within 10min. applied ice to pt neck, laid down , elevated feet