Report #2875568

Received Nov 28, 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: 11 yrs
State: IL
Recovered: Recovered
Vaccinated: Nov 28, 2025
Onset: Nov 28, 2025
Days to onset: 0
Hospital days: —

Vaccines (2)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	1	3052860	IM / LA
FLU3	INFLUENZA (SEASONAL) (FLUCELVAX)	SEQIRUS, INC.	1	409415	IM / LA

Symptoms (1)

Loss of consciousness

Symptom narrative

After 1st administered, COVID vaccine monitored patient for a minute, then administered flu vaccine. Patient was observed closing eyes and slowly moving head forward, within seconds patient came to. Mom & dad present.

Current illness

None

Medical history

None

Other medications

None

Allergies

None

Lab data

None