Report #2879999

Received Dec 30, 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: 13 yrs
State: CT
Recovered: Recovered
Vaccinated: Dec 29, 2025
Onset: Dec 29, 2025
Days to onset: 0
Hospital days: —

Vaccines (2)

Type	Name	Manufacturer	Dose	Lot	Route / Site
FLU3	INFLUENZA (SEASONAL) (FLUCELVAX)	SEQIRUS, INC.	1	948403	IM / LA
HPV9	HPV (GARDASIL 9)	MERCK & CO. INC.	2	Z003112	IM / RA

Symptoms (3)

FallLip injurySyncope

Symptom narrative

Patient sustained an episode of syncope after vaccine administration that was observed by parent. Patient fell off of table, did not hit head, but did sustain a cut to the upper lip. Patient was immediately evaluated by Dr. and Dr. as well as nurses. Patient was given ice pack, feet were elevated with patient laying down. Dr. assessed blood pressure and evaluated lip and nose. Patient left office with mother.

Current illness

N/A

Medical history

Constipation, depression, cardiac murmur

Other medications

MELATONIN-THEANINE-5 HTP-LEMON OR, Pediatric Multiple Vitamins (MULTIVITAMIN CHILDRENS)

Allergies

Eggplant, nuts, pine, bee, environmental

Lab data

Assessment / evaluation by providers.