Received Sep 8, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| HEPA | HEP A (HAVRIX) | GLAXOSMITHKLINE BIOLOGICALS | 1 | H3N97 | IM / LL |
| HIBV | HIB (PEDVAXHIB) | MERCK & CO. INC. | UNK | X020943 | IM |
| MMR | MEASLES + MUMPS + RUBELLA (MMR II) | MERCK & CO. INC. | 1 | Y015995 | SC / LL |
| PNC20 | PNEUMO (PREVNAR20) | PFIZER\WYETH | 4 | LN4931 | IM / LL |
| VARCEL | VARICELLA (VARIVAX) | MERCK & CO. INC. | 1 | Y017915 | SC / RL |
RED BLOTCHY PATCHES APPEARED TO FOREHEAD 10 MINUTES POST VACCINATION. DR ASSESSED PATIENT. NO S/S OF RESPIRATORY DISTRESS OR ANAPHYLAXIS, ORDERED 5ML OF BENADRYL PO FOR PATIENT. PATIENT CONSUMED WITHOUT DIFFICULTY. PATIENT RE-ASSESSED, EXIT FACILITY IN STABLE CONDITION.
No known illnesses
No pre-existing
no known medications
Mom states NKA
NONE ORDERED. PHONE CALL TO PATIENT PHONE NUMBER LISTED ON FILE 5 HOURS AFTER INCIDENT. NO ANSWER. VOICE MAIL LEFT TO RETURN CALL TO THE CLINIC.