Report #2864257

Received Oct 8, 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: Female
Age: 77 yrs
State: NC
Recovered: Recovered
Vaccinated: Oct 7, 2025
Onset: Oct 7, 2025
Days to onset: 0
Hospital days: —

Vaccines (2)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	1	80777-04900-60	IM / LA
FLU3	INFLUENZA (SEASONAL) (FLUAD)	SEQIRUS, INC.	1	70461-0025-03	IM / LA

Symptoms (4)

Back painDizzinessDyspnoeaMalaise

Symptom narrative

Patient stated they felt ill, and light headed. Said they were short of breath and had back pain

Current illness

unknown

Medical history

ligament disorder, nephritis, migraines, rectal disease, respiratory system disorder

Other medications

ammonium lactate 12%, dicyclomine 10mg, estradiol 0.01%,

Allergies

unknown

Lab data

EMS and 911 responders tended to the patient afterwards, made sure they were going to be okay, they felt fine and went about their day. Was not transported, Never given anything here to subside any feelings.