Received Sep 8, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| PNC20 | PNEUMO (PREVNAR20) | PFIZER\WYETH | N/A | MA2505 | IM / RA |
| TDAP | TDAP (ADACEL) | SANOFI PASTEUR | N/A | U8389AA | IM / LA |
Patient was found unresponsive and without vital signs at home at 10:45 AM on 9/6/25; approximately 72 hours after vaccine administration. Cardiopulmonary Resuscitation was initiated and emergency medical services were dispatch but patient was unable to be revived. Patient had multiple visits from licensed nurses and unlicensed caregivers between vaccination and event appearing well each time, the last being approximately 5:00 PM on 9/5/25.
None
Bipolar type 1, chronic opioid use, insomnia, nicotine dependence, constipation, hx concussion, obesity, BPH, Chronic Kidney disease IIIb; COPD; Type 2 diabetes, hyperlipidemia; hypertension; hypothyroidism; Lumbar spinal stenosis; obstructive sleep apnea; seizure disorder
Acetaminophen 650mg by mouth three times daily,; Amlodipine besylate/benazepril HCl 5-10 mg cap by mouth once daily; Cholecalciferol 5000 units by mouth once weekly, Divalproex 1000mg by mouth daily at bedtime, and 500mg every morning; Do
None
N/A