Report #2841853

Received May 20, 2025

HospitalizedER / ED visit

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Overview

Sex: Female
Age: 66 yrs
State: —
Recovered: Recovered
Vaccinated: May 13, 2025
Onset: May 14, 2025
Days to onset: 1
Hospital days: —

Vaccines (3)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	UNK	3046714	IM / RA
HEP	HEP B (HEPLISAV-B)	DYNAVAX TECHNOLOGIES CORPORATION	1	944943	IM / LA
MMR	MEASLES + MUMPS + RUBELLA (PRIORIX)	GLAXOSMITHKLINE BIOLOGICALS	1	GE974	SC / LA

Symptoms (1)

Systemic inflammatory response syndrome

Symptom narrative

Patient was admitted to hospital and diagnosed with Systemic inflammatory response syndrome (sirs). The exact date and time of event were not communicated to us nor was the length and duration of treatment

Lab data

unknown to us