The patient's historical vaccine included FLUCELVAX QUADRIVALENT for past 3 seasons without any problems. In the past, the patient received MMR vaccine and experienced chest tightness. The patient had been taking unspecified concomitant medication for the past 10 years. On 06-Oct-2018, the patient was administered FLUCELVAX QIVc (dose: 0.5 ml, route of administration: intramuscular, anatomical location: deltoid, batch number: 252380 and expiry date: 31-May-2019). On the same day, 1 hour and 30 minutes after vaccination, the patient passed out while driving to home and immediately woke up without any injury. The patient also experienced slight chest tightness without breathing difficulty. The patient had left a message for her physician but did not feel the need to go to the emergency room. The patient had two more episodes of passing out at home and at work. The same day (06-Oct-2018), the patient felt that, the room started spinning during these episodes. On 07-Oct-2018, the patient could not feel her legs and the next thing she remembered that she was woken up by someone else. On 11-Oct-18 (Thursday), the patient passed out again at work. The patient went to hospital and underwent bloodwork and the blood test results showed an elevated liver enzyme. The patient did not receive any treatment for the events. On 31-Oct-2018, the patient's bloodwork and chest x-ray were done (results not reported), and she had to consult physician in 1 week over bloodwork and chest x-ray. On an unspecified date in Oct-2018, the patient underwent a magnetic resonance imaging (MRI) scan, and the results were not reported (results yet to come in two weeks). The specialist conducted more tests and was going to do liver biopsy to look for inflammatory markers in liver. It was reported that, patient's MRI was scheduled on 23-Nov-2018. The reporter stated that, all symptoms were continued in episodes but were not constant. At the time of this report, the patient had not recovered from the events. The reporter assessed the case as non-serious. Follow up received on 15-Oct-2018: The outcome of the events was changed from recovering to not recovered. It reported that, the patient passed out again at work on 11-Oct-18 (Thursday) and went to hospital, where she underwent bloodwork (unspecified). On 15-Oct-2018, the patient was waiting for lab test results. It was stated that, magnetic resonance imaging (MRI) scan would be scheduled for the patient. The narrative was amended accordingly. Follow-up report received on 27-Oct-2018: It was reported that, the patient had been taking unspecified concomitant medication for the past 10 years. Added lab tests [blood test (elevated liver enzyme) and MRI] in patient tab and events (asthenia, vertigo and elevated liver enzymes) in event tab. It was reported that, the patient had two more episodes of passing out at home and at work. The patient stated that, during these episodes, she felt that, the room started   spinning and she could not feel her legs and the next thing she remembered that she was woken up by someone else. The narrative was amended accordingly. Follow-up report received on 08-Nov-2018: The onset date of the events 'spinning sensation' was updated as 06-Oct-2018 and 'cannot feel the legs' was updated as 07-Oct-2018. The outcome of the events spinning sensation and cannot feel the legs was changed from not reported to not recovered. On 31-Oct-2018, the patient's bloodwork and chest x-ray were done, and she had to consult physician in 1 week over bloodwork and chest x-ray. The specialist conducted more tests and was going to do liver biopsy to look for inflammatory markers in liver. It was reported that, patient's MRI was scheduled on 23-Nov-2018. The reporter stated that, all symptoms were continued in episodes but were not constant. The narrative was amended accordingly.