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Report #2873100

Received Nov 17, 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
66 yrs
State
IN
Recovered
Recovered
Vaccinated
Nov 13, 2025
Onset
Nov 14, 2025
Days to onset
1
Hospital days
—

Vaccines (1)

TypeNameManufacturerDoseLotRoute / Site
COVID19COVID19 (COVID19 (PFIZER-BIONTECH))PFIZER\BIONTECHUNKRX# 6112129N, NIM

Symptoms (14)

Back painChest X-ray normalComputerised tomogram head normalComputerised tomogram spine normalDifferential white blood cell count normalElectrocardiogram normalFull blood count normalHead injuryHyperhidrosisLoss of consciousnessMetabolic function test normalPhotophobiaPolyuriaVision blurred

Symptom narrative

Severe lower back pain experienced beginning at 2 AM and woke every 30-60 minutes during the night. Proceeded to urinate 4 times (very unusual). Upon arising at 7 AM, proceeded to kitchen, sat down to consume coffee. After 5 minutes, the kitchen lighting became overwhelming and vision was blurred. Proceeded to move back to bed, passed out in great room, making contact with curio table injuring two locations on head. Was only out for a few seconds and then crawled to the bed, where profuse sweating started while under the covers. After laying in bed for 15 minutes, relaxed on the couch, and returned to the kitchen for breakfast.

Current illness

None

Medical history

None

Other medications

Rosuvastatin 20 mg, Lisinopril/HCTZ 10/12.5, Flonase, Allergy relief Cetirizine HCl Capsules (10 mg) Antihistamine, One a day vitamin, Fiber powder

Allergies

None

Lab data

Contacted primary care physician office later that morning (no doctors in the office on 11/14) whereby the staff recommended visiting the local immediate care center. The P.A. at health facility recommended an assessment at the Emergency Room. Proceeded to health facility for CBC W AutoDiff, Comprehensive Metabolic Panel, CT Cervical Spine WO Contrast, CT Head WO Contrast , EKG, XR Chest Portable, ED RN Communication, Saline Lock. No abnormalities detected.

Prior vaccinations

Moderna Covid Vaccine in 2021