Report #2869805

Received Oct 31, 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: 74 yrs
State: GA
Recovered: Recovered
Vaccinated: Oct 6, 2025
Onset: Oct 7, 2025
Days to onset: 1
Hospital days: —

Vaccines (2)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	N/A	3052549	IM / RA
FLU3	INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)	SANOFI PASTEUR	N/A	u8855ca	IM / LA

Symptoms (2)

Eye movement disorderLoss of consciousness

Symptom narrative

patient reports that the day after receiving vaccinations, she passed out and was unaware of what was going on around her. She said her husband reports that her eyes rolled back in her head. He kept slapping her to snap her out of it, which she eventually did about a minute or 2 later. She was fine thereafter.

Current illness

none

Medical history

polymyalgia rheumatica, GERD, hypothyroidism, neuropathy

Other medications

sucralfate, pregabalin, Synthroid, prednisone, pantoprazole, Women's Senior multivitamins, vitamin D,

Allergies

penicillin, Tamiflu

Lab data

none

Prior vaccinations

mild fever and pain