Report #2863836

Received Oct 13, 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: Male
Age: 15 yrs
State: IN
Recovered: Recovered
Vaccinated: Sep 27, 2025
Onset: Sep 27, 2025
Days to onset: 0
Hospital days: —

Vaccines (2)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (PFIZER-BIONTECH))	PFIZER\BIONTECH	1	NA4452	IM / LA
COVID19-2	COVID19 (COVID19 (PFIZER-BIONTECH BIVALENT))	PFIZER\BIONTECH	UNK	na4452	IM / RA

Symptoms (10)

AstheniaDizzinessFlushingHyperhidrosisTremorHead injuryLoss of consciousnessSyncopeUnresponsive to stimuliUrinary incontinence

Symptom narrative

Systemic: Fainting / Unresponsive-Severe, Additional Details: Patient received vaccines. After standing up patient fainted and hit his head. became unconscious and lost bladder control. patient recovered consciousness and was taken by emt to emergency room. Mom returned to pharmacy a few days later and indicated patient was doing ok. had follow up appointment with primary care physician, Other Vaccines: VaccineTypeBrand: Fluarix; Manufacturer: GSK; LotNumber: Ld95Y; Route: im; BodySite: left deltoid; Dose: ; VaxDate: UNKNOWN