VAERS Explorer
Back to explore

Report #2901604

Received Jun 27, 2026

ER / ED 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
Female
Age
17 yrs
State
CA
Recovered
Recovered
Vaccinated
Jun 27, 2026
Onset
Jun 27, 2026
Days to onset
0
Hospital days

Vaccines (1)

TypeNameManufacturerDoseLotRoute / Site
COVID19COVID19 (COVID19 (MODERNA))MODERNA33058190IM / LA

Symptoms (4)

Anaphylaxis treatmentChest painFeeling hotLoss of consciousness

Symptom narrative

Patient come in requesting spikevax vaccine, previously recieved pfizer covid back in 8/22/21. Confirmed with patient that there is no previous reaction to vaccine and only have allergy to amoxicillin. Confirmed medication and site of administration; patient received vaccine and were waiting for parent to received other vaccines. Patient received Spikevax (Lot: 3058190, SN XTAMXGCNT33X, Expiration: 12/24/26). While waiting, patient become unconscious, I noticed and rush over to prevent patient from falling off a chair. Patient then gain conscious, able to communicate but were complaining of chest burning and feel very hot; however, able to breath and no other symptoms. EMS were called and were instructed to administer epipen 0.3 mg single dose auto injection. EMS then arrive at the scene and transported patient to medical facility. patient remain conscious the entire time.

Current illness

n/a

Medical history

n/a

Other medications

mentioned seasonal allergy medication

Allergies

amoxicillin

Lab data

EMS arrived and transported patient to ER for future testing