Report #2863869

Received Oct 7, 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: 28 yrs
State: CA
Recovered: Unknown
Vaccinated: Sep 29, 2025
Onset: Sep 29, 2025
Days to onset: 0
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	N/A	3052671	IM / LA

Symptoms (13)

Anaphylactic reactionAstheniaChest discomfortChest painChillsDizzinessDysphagiaDyspnoeaFlushingHyperhidrosisSyncopeThroat tightnessUnresponsive to stimuli

Symptom narrative

Systemic: Allergic: Anaphylaxis-Medium, Systemic: Allergic: Difficulty Breathing-Medium, Systemic: Allergic: Difficulty Swallowing, Throat Tightness-Medium, Systemic: Chest Tightness / Heaviness / Pain-Medium, Systemic: Chills-Severe, Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Severe, Systemic: Flushed / Sweating-Severe, Systemic: Weakness-Medium