Report #2867059

Received Oct 20, 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: Male
Age: 9 yrs
State: IL
Recovered: Recovered
Vaccinated: Oct 13, 2025
Onset: Oct 13, 2025
Days to onset: 0
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
FLU4	INFLUENZA (SEASONAL) (FLUARIX QUADRIVALENT)	GLAXOSMITHKLINE BIOLOGICALS	N/A	je74j	IM / LA

Symptoms (13)

Anaphylactic reactionArthralgiaAstheniaConfusional stateDizzinessFatigueHypotensionLethargyNauseaPallorPyrexiaSyncopeUnresponsive to stimuli

Symptom narrative

Systemic: Allergic: Anaphylaxis-Mild, Systemic: Confusion-Mild, Systemic: Dizziness / Lightheadness-Medium, Systemic: Exhaustion / Lethargy-Medium, Systemic: Fainting / Unresponsive-Medium, Systemic: Fever-Medium, Systemic: Hypotension-Medium, Systemic: Joint Pain-Medium, Systemic: Nausea-Medium, Systemic: Weakness-Medium, Additional Details: the pt collapsed while he was going away of the vaccination area with his parents. then his dad brought him back to the pharmacy area. pharmacist called 911 and they responded immedietly. the pt was concious but weak and pale. his blood pressure was low.

Allergies

non