Received Oct 13, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| COVID19 | COVID19 (COVID19 (UNKNOWN)) | UNKNOWN MANUFACTURER | 1 | 6315MF002C | IM / LA |
Systemic: Body Aches Generalized-Severe, Systemic: Chills-Severe, Systemic: Dizziness / Lightheadness-Severe, Systemic: Exhaustion / Lethargy-Severe, Systemic: Fever-Severe, Systemic: Flushed / Sweating-Severe, Systemic: Headache-Severe, Systemic: Joint Pain-Severe, Systemic: Numbness (specify: facial area, extremities)-Severe, Systemic: Shakiness-Severe, Systemic: Tingling (specify: facial area, extemities)-Severe, Systemic: Unable to Sleep-Severe, Systemic: Weakness-Severe, Additional Details: Patient noted previous MD has diagnosed him with "systemic vaccine injury" - causing neurological issues. Patient did research and wanted to still try to get NOVAVAX vaccine and stated that he had numbness/tingling on hands, in addition to previously selected ADRs/outcomes. Patient had follow up with providers after vaccination and assured patient it was likely common side effects but will continue to monitor outpatient. Patient stated they will keep pharmacy updated on progress/recovery.