Received May 28, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| COVID19 | COVID19 (COVID19 (MODERNA)) | MODERNA | 1 | 3042646 | IM / LA |
Systemic: Blood Disorder (diagnosed by MD)-Severe, Additional Details: Platelets below 40, ambulance transport to hospital pt. mentioned another person had a similar adverse reaction when they had COVID and flu shots at same time), Other Vaccines: VaccineTypeBrand: Flu (Fluad Trivalent); Manufacturer: Seqirus; LotNumber: ; Route: ; BodySite: ; Dose: 1; VaxDate: 10/01/2024