Received Oct 7, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| COVID19 | COVID19 (COVID19 (MODERNA)) | MODERNA | 1 | 3052550 | IM / RA |
Systemic: Fainting / Unresponsive-Medium, Additional Details: Patient recieved 2 vaccines on 9/23/25 at 11:19am. We gave her the flu and moderna vaccine. After administering both vaccines the patient fainted and we called the ambulance. She was going in and out of conciousness but was breathing and was not having an allergic reaction. EMS came and took her to the Hospital. A couple hours later I called the father and he informed us that she is home and resting. Medical doctors checked her out and they were able to send her home. , Other Vaccines: VaccineTypeBrand: Flucelvax; Manufacturer: Seqirus; LotNumber: 407009; Route: IM; BodySite: Arm; Dose: 1; VaxDate: 09/23/2025
No known allergies