Report #2865442

Received Oct 13, 2025

Hospitalized

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Overview

Sex: Male
Age: 65 yrs
State: CA
Recovered: Unknown
Vaccinated: Sep 13, 2025
Onset: Sep 13, 2025
Days to onset: 0
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
FLU4	INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE QUADRIVALENT)	SANOFI PASTEUR	1	u8859aa	IM / LA

Symptoms (9)

AstheniaDizzinessHeadacheInjection site painPainPain in extremityPain in jawPyrexiaRash

Symptom narrative

Site: Pain at Injection Site-Medium, Systemic: Body Aches Generalized-Severe, Systemic: Dizziness / Lightheadness-Medium, Systemic: Fever-Severe, Systemic: patient had fever for 3 weeks, pain in leg,jaw and headache. patient had rash in the back.-Medium, Systemic: Weakness-Medium, Additional Details: patient daughter called for the vaccine record. patient had fever, pain in leg and jaw. patient had developed rash on the back. patient is been hospitalized for almost week now. Patient is under observation and waiting for the diagnosis form doctor per daughter.