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Report #2880802

Received Jan 6, 2026

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
NY
Recovered
Recovered
Vaccinated
Dec 22, 2025
Onset
Dec 22, 2025
Days to onset
0
Hospital days
—

Vaccines (2)

TypeNameManufacturerDoseLotRoute / Site
FLU3INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR1UT8873NAIM / RA
HPV9HPV (GARDASIL 9)MERCK & CO. INC.2Z011449IM / LA

Symptoms (5)

FallHead injuryHeadacheHypotoniaPain

Symptom narrative

Patient received flu and HPV vaccine at end of visit. After injections patient was speaking with writer and uncle and which time he leaned forward and rolled off exam room table onto floor. Dr. was immediately notified while writer and uncle attended to the patient. Patient believes he bumped his head on the left side, provider examined. Patient moved back to exam table and vitals were obtained. Vital were 113/64, 80 pulse and 96% O2. Patient laying in supine patient with legs elevated for 10 minutes. Patient reports headache with a pain level of 3, stated it was previously a 5. Patient reports not having ate or had anything to drink this morning. Patient was given cup of water. Checked on patient at 10 minutes. Patient still reports headache and uncle stated a bump on head. Vitals 115/70, 63 pulse and 98% O2. Provider notified.

Current illness

None

Medical history

ADHD

Other medications

Prescriptions include methylphenidate 30mg & 5 mg, Proair inhaler PRN

Allergies

No known allergies

Lab data

None