Received Oct 28, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| FLU3 | INFLUENZA (SEASONAL) (FLUBLOK) | SANOFI PASTEUR | 1 | U8832BA | IM / LA |
After vaccination was given, patient got up to leave with mother and had a syncopal episode: fell down, hit her right temple on this provider's swivel chair and fell back onto the floor. Didn't hit her head on the floor. Minor, 3mm in length (<0.5mm width) bruise noted beside of right eye. Gave patient lollipop and water, sat in a chair. Alert and oriented. Pallor of skin. Reports her head hurts where she hit the chair. No acute distress. PERRLA. Rendered first aid to patient. See incident report. Made patient wait for 20 minutes and she exhibited no acute distress. Discussed with mother to notify health professional before daughter receives vaccination of syncopal episode. Go to the ER if episode of syncope after visit, seizure activity. Mother agreeable and has no further questions or concerns.
Reported a cough for a week prior to vaccination
denies
unknown
Denies
N/A