generalized weakness/he again got weak; sweating; experienced dizziness; fainted; shaking; have pain in the back of his neck; blood pressure was a little low at 91/51; have pain in the lower back of the head; Initial information received on 13-Apr-2023 regarding an unsolicited valid serious courtesy case received from other health professional.  This case involves an unknown age male patient who had generalized weakness/he again got weak, sweating, experienced dizziness, fainted, shaking, have pain in the back of his neck, blood pressure was a little low at 91/51 and have pain in the lower back of the head after receiving vaccines trumenba and meningococcal A-C-Y-W135 (D conj) vaccine [Menactra].  The patient's past medical treatment(s), vaccination(s) and family history were not provided. It is unknown if the patient had any medical history, concomitant disease or risk factor.   On 04-Apr-2023, the patient received an unknown dose of suspects trumenba not produced by Sanofi Pasteur and meningococcal A-C-Y-W135 (D conj) vaccine (strength, form, expiry date and batch number unknown) via unknown route in unknown administration site for prophylactic vaccination.  On 04-Apr-2023 the patient had serious generalized weakness/he again got weak (asthenia), sweating (hyperhidrosis), dizziness (dizziness) and fainted (syncope) (same day latency) following the administration of meningococcal A-C-Y-W135 (D conj) vaccine and trumenba.   On 04-Apr-2023 the patient had shaking (tremor), pain in the back of his neck (neck pain), blood pressure was a little low at 91/51 (blood pressure abnormal) and pain in the lower back of the head (headache) following the administration of meningococcal A-C-Y-W135 (D conj) vaccine and trumenba.  Relevant laboratory test results included: Blood pressure measurement - On 04-Apr-2023: [blood pressure was a little low at 91/51] Computerised tomogram - On 04-Apr-2023: [Normal]  While admitted he had a cardiology and neurology consult. Overnight he continued to improve, he had a heart echo done, he had no symptoms and was discharged the next day.  Action taken: not applicable.  The patient was treated with normal saline, diphenhydramine hydrochloride (Benadryl), metoclopramide hydrochloride (Reglan), toradol and IV fluids for the events.  At time of reporting, the outcome was recovering / resolving for the events.  Seriousness criteria: The event syncope was assessed as medically significant. The patient was hospitalized on the same day for the events (asthenia, hyperhidrosis, dizziness, syncope). The patient was discharged on 05-Apr-2023 (hospitalization duration: 1 day).; Sender's Comments: Sanofi Company Comment dated 20-Apr-2023: This case involves an unknown age male patient who had generalized weakness/he again got weak, sweating, experienced dizziness, fainted, shaking, have pain in the back of his neck, blood pressure was a little low at 91/51 and have pain in the lower back of the head after receiving vaccines trumenba and meningococcal A-C-Y-W135 (D conj) vaccine [Menactra]. Based on the information provided regarding this case, causal role of the company suspect product cannot be excluded. However, lack of information regarding past medical treatment(s), family history information precludes comprehensive case assessment.