Report #2868691

Received Oct 27, 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: 89 yrs
State: CA
Recovered: Recovered
Vaccinated: Oct 16, 2025
Onset: Oct 16, 2025
Days to onset: 0
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (UNKNOWN))	UNKNOWN MANUFACTURER	N/A	3052155	IM / RA

Symptoms (5)

Cardiac disorderFatigueInjection site bruisingInjection site painTachycardia

Symptom narrative

Site: Bruising at Injection Site-Mild, Site: Pain at Injection Site-Mild, Systemic: Cardiac Disorder (diagnosed by MD)-Medium, Systemic: Tachycardia-Severe, Additional Details: Increase in heart rate, droopiness, Other Vaccines: VaccineTypeBrand: FLUAD; Manufacturer: Seqirus; LotNumber: 407264; Route: Intramuscular; BodySite: Left; Dose: ; VaxDate: UNKNOWN

Allergies

Phenobarbital