Report #2883349

Received Jan 28, 2026

ER / ED visitOffice 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: 17 yrs
State: WI
Recovered: Recovered
Vaccinated: Jan 27, 2026
Onset: Jan 27, 2026
Days to onset: 0
Hospital days: —

Vaccines (3)

Type	Name	Manufacturer	Dose	Lot	Route / Site
FLU3	INFLUENZA (SEASONAL) (FLULAVAL)	GLAXOSMITHKLINE BIOLOGICALS	UNK	4D255	IM / LA
MNQ	MENINGOCOCCAL CONJUGATE (MENVEO)	NOVARTIS VACCINES AND DIAGNOSTICS	2	HB333	IM / RA
MNQ	MENINGOCOCCAL CONJUGATE (MENVEO)	NOVARTIS VACCINES AND DIAGNOSTICS	UNK	G334J	IM / LA

Symptoms (3)

Face and mouth X-rayFallSyncope

Symptom narrative

2o minutes after vaccine, when standing to get dressed, patient had syncopal episode and fell to the ground.

Current illness

Medical history

hearing loss

Other medications

none

Allergies

Robitussin

Lab data

Xray of jaw