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Report #2867657

Received Oct 22, 2025

A note on interpretation. VAERS reports are unverified and may be incomplete or coincidental. A report does not establish that a vaccine caused an event, and counts should not be used to calculate incidence or infer causation. Full disclaimer

Overview

Sex
Female
Age
78 yrs
State
CA
Recovered
Unknown
Vaccinated
Sep 26, 2025
Onset
Sep 26, 2025
Days to onset
0
Hospital days
—

Vaccines (1)

TypeNameManufacturerDoseLotRoute / Site
FLU3INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEUR1U8830DAIM / RA

Symptoms (2)

Extra dose administeredNo adverse event

Symptom narrative

Patient present for office visit with Dr. Patient received High Dose Flu vaccine per provider's order. Per patient immunization history patient had received High Dose Flu Vaccine on 9/17/25 at the Pharmacy. No adverse reaction observed on 9/26/25 post vaccine administration. Patient stable upon discharge. Patient returned for follow-up visit, with another provider on 10/20/25. No adverse reaction from High Dose Flu Vaccine reported.

Current illness

Low Vitamin B-12 level, Episodic cluster headache, not intractable

Medical history

Bilateral hearing loss, Acquired right flat foot, Anemia, Asymptomatic varicose veins of unspecified lower extremity, Atherosclerosis of aorta, Atrial paroxysmal tachycardia, Bilateral hearing loss, Chronic pain disorder, Diverticulosis of colon, Generalized anxiety disorder, Genital herpes simplex, Insomnia, Irritable bowel syndrome, Long term (current) use of anticoagulants, Low back pain, unspecified, Migraine with aura, Non-toxic multinodular goiter, Obstructive sleep apnea syndrome in adult, Osteoarthritis of left knee, Peripheral venous insufficiency, Personal history of transient ischemic attack (TIA), and cerebral infarction without residual deficits, Senile degeneration of brain, Senile purpura, Hypertension, Raynaud's disease without gangrene, Hyperlipidemia, Paroxysmal atrial fibrillation, Anxiety and depression, Episodic cluster headache, not intractable.

Other medications

Citalopram(celexa), Eliquis, Meloxicam (Mobic), Ubrogepant (Ubrelvy), pregabalin (Lyrica), Amlodipine (Norvasc), Fluticasone Propionate (Flonase), Alendronate (Fosamax), Atorvastatin (Lipitor), Losartan-hydrochlorothiazide (Hyzaar), Tizanid

Allergies

Penicillins, Fentanyl, Lactose, Penicillin G

Lab data

n/a