Received Oct 20, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| UNK | VACCINE NOT SPECIFIED (NO BRAND NAME) | UNKNOWN MANUFACTURER | 1 | UK223AA | SC / LA |
| UNK | VACCINE NOT SPECIFIED (NO BRAND NAME) | UNKNOWN MANUFACTURER | 1 | X1A261M | IM / LA |
| UNK | VACCINE NOT SPECIFIED (NO BRAND NAME) | UNKNOWN MANUFACTURER | 3 | 4BX39 | IM / LA |
F/U VAERS filed: unknown if Site RNs filed: 8/29/2025 12:56pm: call received from (withheld site name) LPN (withheld employee name) to discuss concerns for ADSM who developed anaphylactic rx following recent vaccines given on 8/27/2025 (given first YF, first typhoid, and 3rd HepB). Vaccine given 8/27/25 0834am Later that day 1020am taken by EMS to ER 1020 and admitted ICU on epi drip for bilateral eye/facial swelling, SOB, difficulty swallowing .... Released 8/29/2025 s/s resolved. (See below notes) As of 9/30/2025 assumed doing well...no f/u with HCP. Assigned (withheld number) 8/29/2025 12:56pm: call received from (withheld site name) LPN (withheld employee name) to discuss concerns for ADSM who developed anaphylactic rx following recent vaccines given on 8/27/2025 (given first YF, first typhoid, and 3rd HepB). PSR was completed which triggered this consult. Caller advised (withheld) completed screening form with no allergies or medical history reported. 3 vaccines administered and (withheld) waited in room with this nurse while she completed documentation of vaccines and CDC (withheld) card to provide to (withheld). Pt left w/o reporting any adverse reactions 15 min later. However PSR report states 15 min after receipt of vaccines she began to c/o itching to left eye that spread across entire face with chest tightness, lip swelling and difficulty swallowing. Left eyelid swelling greater than right. She had urticaria and went to ER at (withheld name) General where treated with epi injection x3 then epi drip, famotidine, benadryl, solumedrol, and admitted to ICU 8/27/2025. Meds continued with addition of albuterol neb treatments. Epi drip stopped 5am next day and within 2 hours pt c/o left eyelid swelling and given another dose epi IM w/full resolution and no return of symptoms - started or 40 mg oral prednisone daily. Labs drawn included IgE total 250 (0-114), CBC, Mag, Phos, and CPK 60 (30-165) all normal. Chem had low K at 3.0 and elev gluc at 163 (ate cinnamon Belvita crackers after vaccines given). ABG's were normal but pt put on BPAP while in ICU due to hx of childhood asthma that persists into adulthood well controlled. Lactic acid was elevated at 10.3 (0.5-2.0) and lactic acid plasma elevated 4.7 HAGMA. Acetaminophen, Beta Hydroxy, APTT, PT, INR all normal with neg ETOH. EKG NSR. ---- (withheld) denied any recent viral infection. VSS. ER admission 8/27/2025 - 1014am Arrived EMS from ship - given 2 rounds epi by EMS for facial swelling, SOB. 08/27/25 1016 -- -- HR 107 RR22 BP138/75 86 MM HG 100 % NRB Pt A/Ox4 General: She is in acute distress. Appearance: She is ill-appearing, toxic-appearing and diaphoretic... ED Course Acutely distressed, ill-appearing 20-year-old female who presents after an anaphylactic reaction to the first dose of the yellow fever vaccine. Patient arrived with paramedics, he is already given 2 rounds of epinephrine, the first 1 was via epinephrine pen. Patient received a DuoNeb treatment, Solu-Medrol 125 20 minutes prior to arrival. Per EMS, she had diffuse wheezing, significant urticaria and angioedema specifically in the periorbital regions bilaterally. Respiratory at bedside, will start patient on BiPAP given her resistance to initial rounds of epinephrine and still active wheezing. Patient still had wheezing appreciated on the lower lung fields on arrival despite 2 rounds of epinephrine. Immediately gave 0.3 of epinephrine on arrival 1020am. Gave 50 of Benadryl and Pepcid. Patient already received Solu-Medrol prior to arrival, will hold on that for now, will reevaluate due to longer onset. Additionally will start magnesium. Patient did not have immediate symptomatic relief with the third round of epinephrine, believe it is appropriate to start epinephrine drip at this time (1024am). Will start at 5, as it is for symptomatic relief. Patient is hemodynamically stable otherwise. Patient continues to improve with wheezing but continues to have persistent angioedema and periorbital edema. Will titrate epinephrine to 7. Consulted ICU for admission. PMHx of exercise-induced asthma (she used inhalers until age 9) ...... 8/28/2025 Symptoms of wheezing, urticaria, pruritus have resolved. Was on epinephrine drip overnight, but that was stopped this morning. Report of some left eye lid swelling present at around 7 AM, denies throat swelling, chest tightness, SOB, VSS, -she received epinephrine 0.3 mg IM and continued with famotidine, and that has been stable for several hours. .... 8/29/2025 Hospital Course: 20 y.o. female with primary admission diagnosis of anaphylaxis/angioedema after receiving a yellow fever vaccination required for the work. Required epinephrine gtt. After discontinuation required a one time dose of IM epinephrine for left eyelid swelling. Additional treated with steroid therapy. Felt back to her baseline midday on 8/28. Asymptomatic PM 8/28 into today. Discharging after one additional dose of prednisone. Labs drawn included IgE total 250 (0-114), CBC, Mag, Phos, and CPK 60 (30-165) all normal. Chem had low K at 3.0 and elev gluc at 163 (ate cinnamon Belvita crackers after vaccines given). ABG's were normal but pt put on BPAP while in ICU due to hx of childhood asthma that persists into adulthood well controlled. and mild wheezing in ER Lactic acid was elevated at 10.3 (0.5-2.0) and lactic acid plasma elevated 4.7 HAGMA. Acetaminophen, Beta Hydroxy, APTT, PT, INR all normal with neg ETOH. EKG NSR. ---- (wtihheld) denied any recent viral infection. VSS.
none
none; hx childhood asthma resolved
none
denies
lab, abg, EKG (see below)