Received Mar 28, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| MNQ | MENINGOCOCCAL CONJUGATE (MENVEO) | NOVARTIS VACCINES AND DIAGNOSTICS | 1 | AMAB056A | IM / RL |
| TYP | TYPHOID VI POLYSACCHARIDE (TYPHIM VI) | SANOFI PASTEUR | 1 | X1A261M | IM / LL |
| YF | YELLOW FEVER (YF-VAX) | SANOFI PASTEUR | 1 | UK134AA | SC / RL |
2yo Male presented to Immunization Clinic for travel vaccines with provider prescription. Vaccines were administered as follow IM Route: Typhoid (Typhim VI): 0.5 ml Lot# X1A261M Meningococcal ACWY (Menveo): 0.5ml Lot # AMAB056A Subcutaneous Route: Yellow Fever (YF-Vax): 0.5ml Lot# UK134AA Vaccines were administered around 1411. 24 minutes later, father of patient called for help because he believed the patient was having an allergic reaction. Upon assessment, he displayed signs of facial angioedema, watery eyes and cough. Epinephrine Autoinjector (0.15mg) lot # 3FE588 was administered immediately in the left vastus lateralis at 1435 and Rapid response team was activated. Initial set of vitals signs taken at 1438 BP: 139/91 RR :30 breaths per minute O2 :100% HR 117 bpm Rapid Response Team showed up at 1438 (within 3 minutes) and transferred patient to the Emergency Department for further treatment and observation. Father of patient denied any history of allergies or adverse events following vaccination. Prior to vaccine administration, he answered "no" to all relevant questions as listed in DD 3110 "Routine Immunization Screening Form: Pediatric" Routine Vaccine Screening Routine vaccine peds sick today : No Routine vaccine peds serious reaction : No Routine vaccine peds allergies : No Routine vaccine peds nervous system : No Routine vaccine peds health problem : No Routine vaccine peds immune system : No Routine vaccine peds immune system : No Routine vaccine peds blood products : No Routine vaccine peds intussusception : No Routine vaccine peds asthma : No Routine vaccine peds splenectomy : No Routine vaccine peds vasovagal : No Routine vaccine peds recent vaccines : No Routine vaccine peds pregnant : No
None
None
None per father of patient
None
Refer these questions to the ED department.