Received Oct 27, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| TDAP | TDAP (BOOSTRIX) | GLAXOSMITHKLINE BIOLOGICALS | 1 | F9K3L | IM / RA |
Systemic: Fainting / Unresponsive-Severe, Systemic: Flushed / Sweating-Severe, Systemic: Hypotension-Severe, Additional Details: Vasovagal syncopal episode approximately 10-15 seconds following vaccine administration of Covid, Flu and Tdap. Episode characterized by brief loss of consciousness, pallor, body stiffening, and bradycardia with HR in the 30s. No seizure activity, tongue biting, or incontinence noted. Rapid recovery following administration of epinephrine 0.3mg IM to right upper thigh and supportive measures. V/S post EPI at 7:15pm BP 65/41, HR 53, RR 20, O2 98%, Other Vaccines: VaccineTypeBrand: Flucelvax; Manufacturer: Seqirus; LotNumber: 406998; Route: IM; BodySite: LD; Dose: ; VaxDate: 10/06/2025, VaccineTypeBrand: Pfizer Comirnaty Covid-19; Manufacturer: Pfizer; LotNumber: MY9548; Route: IM; BodySite: LD; Dose: ; VaxDate: 10/06/2025