Report #2869956

Received Nov 1, 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: Male
Age: 14 yrs
State: IN
Recovered: Recovered
Vaccinated: Nov 1, 2025
Onset: Nov 1, 2025
Days to onset: 0
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA MNEXSPIKE))	MODERNA	1	—	IM / RA

Symptoms (2)

Loss of consciousnessPallor

Symptom narrative

Technician administered the vaccine to patient. Upon receiving vaccine, the patient passed out for a few seconds and his skin became very pale. The pharmacist then came in the room and checked the patients blood pressure and HR which were both below normal limits. After drinking some fluids, the patients vitals stabilized and his skin color returned to normal as well.