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Report #2875685

Received Dec 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
11 yrs
State
NC
Recovered
Recovered
Vaccinated
Nov 26, 2025
Onset
Nov 26, 2025
Days to onset
0
Hospital days
—

Vaccines (3)

TypeNameManufacturerDoseLotRoute / Site
FLU3INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALS14f2ajIM / LA
HPV9HPV (GARDASIL 9)MERCK & CO. INC.2Y018389IM / RA
MNQMENINGOCOCCAL CONJUGATE (MENQUADFI)SANOFI PASTEUR1U8599AAIM / LA

Symptoms (3)

Loss of consciousnessPosture abnormalStaring

Symptom narrative

Before vaccine administration patient was very worked up and scared for the shots. After administering the influenza vaccine (lot#4F2AJ) in left deltoid at 1423, patients head went limp and went into a daze - like state. Mother said this is normal for him although there is no record of this reaction to injections/shots in the medical record. There was no fall or injury associated with his passing out. Reporting RN called LPN into the room in case the patient passed out after the next vaccines. Per flowsheets, BP was 96/62 with HR 104. The patient was reportedly fine after the Meningococcal (Menquadfi) vaccination (#U8599AA) in LD (also timed at 1423). After the HPV vaccine (lot# Y018389) in the right deltoid (patients second HPV dose), the same reaction happened: his head went limp, his shoulders fell back and patient was still blank staring. Time of this administration was recorded at 1423 11/26. Per flowsheet, BP 98/62 at 1446. Reporter states they laid the patient down and obtained a manual BP on patient and reported to MD who assessed the patient and advised he lay down for 15 minutes. Patient was given food and water, and BP was additionally reassessed after 15 minutes. BP 96/60 at 1503. Patient stable when leaving clinic.

Current illness

None

Medical history

Abnormal weight loss; avoidant or restrictive food intake disorder, otorrhea and conductive hearing loss of l ear

Other medications

Boost for kids

Allergies

None

Lab data

None