Report #2866671

Received Oct 17, 2025

HospitalizedER / 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: 88 yrs
State: IL
Recovered: Unknown
Vaccinated: Oct 16, 2025
Onset: Oct 17, 2025
Days to onset: 1
Hospital days: —

Vaccines (2)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA MNEXSPIKE))	MODERNA	1	3052731	IM / LA
FLU3	INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)	SANOFI PASTEUR	1	U8800DA	IM / LA

Symptoms (1)

Systemic inflammatory response syndrome

Symptom narrative

SIRS, Systematic Inflammatory Response Syndrome

Current illness

Medical history

Other medications

CYCLOBENZAPRINE, DONEPEZIL, SERTRALINE, ACETAMINOPHEN, VIT D3