Received Oct 13, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| COVID19-2 | COVID19 (COVID19 (MODERNA BIVALENT)) | MODERNA | 1 | 3052741 | IM / LA |
Site: Bruising at Injection Site-Medium, Site: Itching at Injection Site-Medium, Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Additional Details: reddness/swelling is under deltoid in a wide strip across front of arm - 1 or both vaccines probably given too low and irritated nerve - pt reports swelling occured a day after vaccine given and its itchy and sore, Other Vaccines: VaccineTypeBrand: flublock; Manufacturer: pfizer; LotNumber: u8832aa; Route: im; BodySite: left deltoid; Dose: 1; VaxDate: 10/03/2025