Report #2870166

Received Nov 3, 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: Male
Age: 54 yrs
State: IN
Recovered: Recovered
Vaccinated: Sep 25, 2025
Onset: Oct 25, 2025
Days to onset: 30
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
FLU4	INFLUENZA (SEASONAL) (FLUARIX QUADRIVALENT)	GLAXOSMITHKLINE BIOLOGICALS	1	5R4CY	IM / LA

Symptoms (7)

ChillsDizzinessFlushingHyperhidrosisParaesthesiaSyncopeUnresponsive to stimuli

Symptom narrative

Systemic: Chills-Medium, Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Tingling (specify: facial area, extemities)-Medium, Additional Details: pt has history of fainting and dizziness with previous vaccines. his wife came with him in case he had a reaction . Pharmacy called 911 after pt fainted and he was alert but was taken to ER. pharmacist followed up with his wife next day and he was in ER for a few hours and released and is to follow up with his dr. Pt feeling better and went to the store next day.

Allergies

shellfish