Received Oct 14, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| FLU3 | INFLUENZA (SEASONAL) (FLULAVAL) | GLAXOSMITHKLINE BIOLOGICALS | 6 | F4A7R | IM / LA |
| MENB | MENINGOCOCCAL B (TRUMENBA) | PFIZER\WYETH | 1 | LL0641 | IM / LA |
| TDAP | TDAP (BOOSTRIX) | GLAXOSMITHKLINE BIOLOGICALS | 1 | 9JT4S | IM / LA |
| VARCEL | VARICELLA (VARIVAX) | MERCK & CO. INC. | 1 | Z008082 | SC / LA |
Patient was administered all 4 vaccines on Left arm / deltoid. As vaccines were being administered, patient mentioned that he was feeling well and was talking. Upon injecting the last vaccine (Influenza), patient was inquiring regarding if not eating before vaccination could cause fainting. Patient then became pale and his eyes started rolling back. Patient was making sounds as if gasping for air and shaking. Patient was laid down and ice pack was placed on the back of patient's neck. Patient's name was called out a few times but no response was received by patient. Provider FNP was pulled into the room for advise. After around 1-2 minutes of unresponsiveness, patient started laughing and asking what had happened. Patient mentioned that he had lost consciousness and did not recall any of the events after receiving the last vaccine. Provider FNP advised that patient not receive other vaccines that he was due for at this time. Patient was instructed to sit back for a few minutes to make sure that he was feeling better. While patient was sitting for a few minutes, he was also brought in a cup of water and was instructed to take small sips of water. After 10 minutes, patient got up and stated that he was feeling better and was ready to go home.
Sore Throat - no fevers 24 hours prior to vaccination
No known chronic conditions
None
None
No tests or labs ran at this time