Received Oct 13, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| COVID19 | COVID19 (COVID19 (PFIZER-BIONTECH)) | PFIZER\BIONTECH | UNK | na4452 | IM / LA |
Systemic: Fainting / Unresponsive-Mild, Systemic: Flushed / Sweating-Mild, Additional Details: Patient had 3 Vaccines tonight 10/09/2025. He felt a little light headed after the vaccines. Pt sat down in waiting area after vaccines then he fainted for a minute. He refused when he was asked to get ambulance and his partner refused that we call EMS. Him and his partner said this happens every time he gets vaccinated. Pt watied till he was better and got his color back then his partner drove him back home., Other Vaccines: VaccineTypeBrand: Boostrix TDAP Vaccine; Manufacturer: Glaxosmithkline; LotNumber: 292H2; Route: IM; BodySite: Right deltoid; Dose: unknown; VaxDate: 10/09/2025, VaccineTypeBrand: Fluarix 2025-2026; Manufacturer: Glaxosmithkline; LotNumber: 2NG23; Route: IM; BodySite: Left deltoid; Dose: unknown; VaxDate: 10/09/2025