Report #2871776

Received Nov 10, 2025

Hospitalized

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Overview

Sex: Female
Age: 15 yrs
State: IL
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 (UNKNOWN))	UNKNOWN MANUFACTURER	N/A	8146743	IM / LA

Symptoms (10)

AstheniaDizzinessFatigueFlushingHyperhidrosisLethargyNauseaSyncopeTremorUnresponsive to stimuli

Symptom narrative

Systemic: Dizziness / Lightheadness-Severe, Systemic: Exhaustion / Lethargy-Severe, Systemic: Fainting / Unresponsive-Severe, Systemic: Flushed / Sweating-Severe, Systemic: Nausea-Severe, Systemic: Shakiness-Severe, Systemic: Weakness-Severe, Additional Details: A few minutes after the vaccine patient became unresponsive. Breathing regular, eyes open and moving rapidly. Called EMS, provided sternum rubs, elevated feet, monitored blood pressure (90/57). Per mom, gets queasy after vaccinations but no history of fainting. EMS took patient out on a stretcher., Other Vaccines: VaccineTypeBrand: Fluarix; Manufacturer: GSK; LotNumber: 2LY39; Route: Intramuscular; BodySite: Left arm; Dose: N/A; VaxDate: 11/01/2025

Allergies

Per mom, none