Received Oct 8, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| FLU3 | INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE) | SANOFI PASTEUR | N/A | UT8829BA | IM / LA |
Patient not 65 or older and should not have received high dose influenza vaccine, should have been administered regular dose vaccine. No reported adverse effects at time of completing this form.
Unknown
Unknown
Unknown
Unknown