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Report #2866087

Received Oct 15, 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
Female
Age
10 yrs
State
TX
Recovered
Unknown
Vaccinated
Oct 15, 2025
Onset
Oct 15, 2025
Days to onset
0
Hospital days
—

Vaccines (1)

TypeNameManufacturerDoseLotRoute / Site
FLU3INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURN/AUT8817MAIM / RA

Symptoms (4)

Musculoskeletal stiffnessPallorStaringUnresponsive to stimuli

Symptom narrative

Pt was loading into her car outside and was unresponsive to mom, staring and stiff, mentioned arms were pulled up against chest but not witnessed by provider--EMS called Parents were carrying her out of the car on MD arrival Brought to room 1, she had pallor, was unresponsive estimated 30 seconds, no jerking movements noted, normal tone Placed 2 L Ox by NC for comfort and helped her slow breathing No desats, poc glucose was 100 Mild pink rash noted upper left arm superior to bandaid from today's blood draw Pt stated she felt weird -denied blacking out Mom said pt had a similar reaction about 3 years ago but could not explain -no hx vaccine reactions-received Fluzone today RD EMS arrived and transporting to (withheld ER name) for further observation, post ictal vs vasovagal reaction

Current illness

Irregular Menstrual Cycle and Seasonal Allergies

Medical history

None

Other medications

cetirizine (ZYRTEC) 10 mg tablet

Allergies

Amoxicillin-pot Clavulanate Phenylephrine-dextromethorphan

Lab data

None