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Report #2883539

Received Jan 31, 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
25 yrs
State
MO
Recovered
Unknown
Vaccinated
Jan 29, 2026
Onset
Jan 29, 2026
Days to onset
0
Hospital days
—

Vaccines (4)

TypeNameManufacturerDoseLotRoute / Site
COVID19COVID19 (COVID19 (MODERNA MNEXSPIKE))MODERNAUNK3052087IM / RA
FLU3INFLUENZA (SEASONAL) (FLUCELVAX)SEQIRUS, INC.UNK948426IM / RA
HEPAHEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS2Z27PBIM / LA
TDAPTDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSUNKE9X9AIM / LA

Symptoms (5)

FallHeadacheLoss of consciousnessMusculoskeletal discomfortPallor

Symptom narrative

Patient requested these 4 vaccines and they were given without event. He stood in the pharmacy window while I was printing his vaccination record. He was talking to me with no complaints. I printed his record, retrieved it from printer, and he was no longer at the window. I looked out and he was in supine position on the floor and not conscious. I immediately approached patient and my tech called EMS. I tapped his chest and yelled his name a couple of times until he became conscious. He was not having trouble breathing. I put his feet up on a chair, color returned to his face, and he conversed with me. I stayed by his side until EMS arrived. He mentioned his head hurt so I looked and did not see blood or a bump. He also mentioned his hip hurt but not too bad as he was able to move it freely. EMS worked with him for about 30 minutes and released him. He was going home to meet room mates.

Current illness

None

Medical history

None

Other medications

None

Allergies

None

Lab data

None other that what EMS did but I do not have any record of that.