Received Oct 6, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| FLU3 | INFLUENZA (SEASONAL) (FLUARIX) | GLAXOSMITHKLINE BIOLOGICALS | 1 | 2L353 | IM / LA |
Within 6 hours of vaccination, I have developed high fever (39.5°C), fatigue, and severe muscle pain plus dry throat and low blood pressure. Symptoms persisted for approximately 72 hours. No hospitalization was required, and I have since recovered fully.
No
No
Nothing to report
Are you pregnant or breastfeeding? No - Did you experience any significant problems after previous flu vaccinations? No - Are you ill at the moment? Do you have a fever? No - Are you allergic to eggs, chicken feathers, or any egg products? (If yes, please receive the vaccination from your PCP or elsewhere that can provide an egg-free brand of flu shot.) No - Are you allergic to any of the following: hydrocortisone, gentamicin sulfate, or ovalbumin? No - Do you suffer from any other allergic reaction? No - Are you taking any medications? Cortisone, steroid, Dilantin (phenytoin sodium), immunosuppressive medication, warfarin, treatment for seizures? No - Have you ever suffered from Guillain-Barre Syndrome? No