Report #2869199

Received Oct 28, 2025

HospitalizedER / ED visit

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Overview

Sex: Female
Age: 85 yrs
State: UT
Recovered: Recovered
Vaccinated: Oct 22, 2025
Onset: Oct 22, 2025
Days to onset: 0
Hospital days: 1

Vaccines (3)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	N/A	3052581	IM / RA
DF	DENGUE TETRAVALENT (DENGVAXIA)	SANOFI PASTEUR	N/A	407981	IM / RA
PNC20	PNEUMO (PREVNAR20)	PFIZER\WYETH	UNK	ma2488	IM / LA

Symptoms (5)

DehydrationPosture abnormalPresyncopePulse abnormalUrinary tract infection

Symptom narrative

After giving the vaccines and patient left the area with her husband, she was found by assisted living staff slumped in her wheelchair with a very weak pulse. EMS called and transported to hospital, kept overnight for observation and determined to have UTI and dehydration. Most likely vasal vagal response to the 3 injections. Discharged following day and staff reported she was doing well.

Current illness

DETERMINED AFTER HOSPITALIZATION THAT PATIENT HAD UTI AND WAS DEHYDRATED

Medical history

UNKNOWN

Other medications

UNKNOWN

Allergies

NKA

Lab data

unknown