Received Oct 27, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| COVID19 | COVID19 (COVID19 (UNKNOWN)) | UNKNOWN MANUFACTURER | N/A | 6315mf002c | IM / LA |
Systemic: Body Aches Generalized-Severe, Systemic: Chills-Severe, Systemic: Fever-Severe, Additional Details: Patient particularly wanted to report hallucinations and nightmares, Other Vaccines: VaccineTypeBrand: Fluzone High Dose; Manufacturer: Sanofi; LotNumber: u8859da; Route: intramuscular; BodySite: left deltoid; Dose: ; VaxDate: UNKNOWN