Received Sep 1, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| VARZOS | ZOSTER (SHINGRIX) | GLAXOSMITHKLINE BIOLOGICALS | 2 | 2A3HY | IM / RA |
Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Severe, Systemic: Hypotension-Mild, Systemic: Seizure-Medium, Additional Details: Patient received 3 vaccines at appointment. After giving the last vaccine (shingrix), patient was unresponsive and fainted. When trying to elevate legs, patient seemed to have a small seizure episode (patient seemed to have some muscle jerks) but then became responsive and confused on what had happened. Patient did fall off of chair and knocked into empty plastic bins. Patient did not hit head and stated has happened to him two times before. Nurse practitioner at clinic checked on patient, Other Vaccines: VaccineTypeBrand: FLUBLOK; Manufacturer: PROTEIN SCIENCES CORPORATION; LotNumber: U8823CA; Route: INTRAMUSCULAR; BodySite: LEFT ARM; Dose: ; VaxDate: UNKNOWN, VaccineTypeBrand: CAPVAXIVE; Manufacturer: MERCK; LotNumber: Z004302; Route: INTRAMUSCULAR; BodySite: LEFT ARM; Dose: ; VaxDate: UNKNOWN