Report #2863914

Received Oct 7, 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: 30 yrs
State: PA
Recovered: Recovered
Vaccinated: Oct 1, 2025
Onset: Oct 1, 2025
Days to onset: 0
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	1	8146367	IM / LA

Symptoms (5)

DizzinessImmediate post-injection reactionLoss of consciousnessSyncopeUnresponsive to stimuli

Symptom narrative

Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Severe, Additional Details: covid vaccine was 3rd given and pt became unconscious almost immediately after administration. regained consciousness after approx 45 sec to 1 min. pt has had similiar reactions to vaccine in the past due to severe phobia. we had pt remain seated on the floor for approx 10 min after regaining consciousness, then pt felt well enough to move to chair. pt remained seated in pharmacy area for approx 30 more minutes., Other Vaccines: VaccineTypeBrand: tdap (Boostrix); Manufacturer: gsk; LotNumber: 4ya34; Route: im; BodySite: right delt; Dose: 1; VaxDate: 10/01/2025, VaccineTypeBrand: influenza (Fluarix); Manufacturer: gsk; LotNumber: 2ca5m; Route: im; BodySite: left delt; Dose: 1; VaxDate: 10/01/2025