Received Sep 15, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| COVID19 | COVID19 (COVID19 (MODERNA)) | MODERNA | 1 | 3051995 | IM / LA |
Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Severe, Systemic: Nausea-Severe, Systemic: Shakiness-Medium, Systemic: Vomiting-Severe, Additional Details: Patient was seated in wheelchair. Roughly 5 minutes after administration of both vaccines, she was unresponsive to voice and touch with eyes closed. About 5 minutes later, she started to open her eyes and make made mouth movements indicating she was going to vomit. By the time paramedics arrived, she was speaking and said she was dizzy and nauseous. Went on stretcher to ambulance to evaluate possible need to transport to hospital. Unable to reach family for follow-up by end of day., Other Vaccines: VaccineTypeBrand: Fluzone High Dose 2025-2026; Manufacturer: Sanofi-Pasteur; LotNumber: UT8804AA; Route: Intramuscular; BodySite: Left arm; Dose: 1; VaxDate: 09/05/2025