Received Sep 30, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| FLU3 | INFLUENZA (SEASONAL) (FLUZONE) | SANOFI PASTEUR | 2 | UT8792MA | IM / LA |
| HEP | HEP B (ENGERIX-B) | GLAXOSMITHKLINE BIOLOGICALS | 2 | 3N2ND | IM / RA |
| IPV | POLIO VIRUS, INACT. (IPOL) | SANOFI PASTEUR | 2 | Y1A201M | IM / RA |
| MMR | MEASLES + MUMPS + RUBELLA (MMR II) | MERCK & CO. INC. | 2 | Y013131 | SC / LA |
| TD | TD ADSORBED (TENIVAC) | SANOFI PASTEUR | 2 | U8492BA | IM / LA |
| VARCEL | VARICELLA (VARIVAX) | MERCK & CO. INC. | 2 | Y017061 | SC / RA |
9/30/25 12:12 pm - 17 year old male received 6 vaccines and had an episode of syncope. Patient did not eat anything before receiving vaccines. Patient was pale, clammy so legs were elevated and he was given graham crackers and Gatorade. 12:18 pm - Patient blood pressure 106/64 and Pulse 68. 12:21 pm - Notified provider and manager of incident. 12:30 pm - reassess blood pressure 110/66 and Pulse 72. 12:38 pm - Patient feeling better and left ambulatory with relative. 3:09 pm - Called to follow up on patient. Father stated that patient went back to school and patient has not notified him of being unwell. Advised father if patient had any other symptoms to take him to Emergency Room.
No
No
No
Cephalosporin
No