Report #2869670

Received Oct 30, 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: 0.5 yrs
State: DC
Recovered: Recovered
Vaccinated: Oct 29, 2025
Onset: Oct 29, 2025
Days to onset: 0
Hospital days: —

Vaccines (5)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	1	3053238	IM / LL
DTPPVHBHPB	DTAP+IPV+HIB+HEPB (VAXELIS)	MSP VACCINE COMPANY	3	U7836AA	IM / RL
FLU3	INFLUENZA (SEASONAL) (FLUZONE)	SANOFI PASTEUR	1	U8889CA	IM / LL
PNC20	PNEUMO (PREVNAR20)	PFIZER\WYETH	3	LN4932	IM / RL
RV5	ROTAVIRUS (ROTATEQ)	MERCK & CO. INC.	3	Y009789	PO / MO

Symptoms (6)

CyanosisEye movement disorderImmediate post-injection reactionParalysisRespiratory arrestUnresponsive to stimuli

Symptom narrative

Pt became unresponsive, turned blue and stopped breathing immediately after receiving routine administration of 6 month vaccines, COVID and Influenza. Pt. became flaccid, eyes rolled back in her head, and she stopped breathing immediately after receiving the Prevnar vaccine. Sternal rub administered by nurse and patient immediately taken to physician where continued external stimuli was provided and patient began to respond. Color improved and patient began to cry. Vital signs obtained and patient observed for approximately 15 minutes. Patient returned to baseline and was discharged home with parents without further incident.

Current illness

None

Medical history

None

Other medications

None

Allergies

NKDA

Lab data

None