Report #2866409

Received Oct 16, 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: 23 yrs
State: IL
Recovered: Recovered
Vaccinated: Oct 16, 2025
Onset: Oct 16, 2025
Days to onset: 0
Hospital days: —

Vaccines (2)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA MNEXSPIKE))	MODERNA	1	3052671	IM / LA
FLU3	INFLUENZA (SEASONAL) (FLUBLOK)	SANOFI PASTEUR	1	tfaa2546	IM / RA

Symptoms (3)

DizzinessLoss of consciousnessPallor

Symptom narrative

pt complained of dizziness and passed out for less than a minute, gave water and orange juice and after a a couple minutes she was fine her color came back and can communicate

Current illness

pt is autistic, depression, a few months ago passed out because of dehydration

Medical history

depression, autistic

Other medications

abilify, effexor, zyrtec, ortho-tricyclen

Allergies

latex, dye, certain soaps

Lab data

n/a