Received Nov 7, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| COVID19 | COVID19 (COVID19 (PFIZER-BIONTECH)) | PFIZER\BIONTECH | 2 | NA4457 | IM / LA |
| FLU3 | INFLUENZA (SEASONAL) (FLUBLOK) | SANOFI PASTEUR | 1 | TFAA2504 | IM / LA |
Per our front end store associates, patient was at checkout with groceries and looked pale and suddenly fainted. Per our front end associates, this occurred at 5:38 PM and that is when they called paramedics. Patient received both Flu and COVID-19 vaccines at approximately 5:27 PM prior to adverse event. At the time both vaccines were done, patient seemed fine and did not show any signs of dizziness or fainting.
Patient did not list any illnesses on vaccine consent form at the time of vaccination or up to one month prior. Patient selected "No" on question 1 where it asks, "Do you have any of the following symptoms today? Fever, cough, shortness of breath, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, diarrhea"
Based on Bupropion XL 300 mg prescription, patient potentially has Major Depressive Disorder or Seasonal Affective Disorder
Patient did not list any medications on vaccine consent form but patient did pick up his Bupropion XL 300 mg before receiving both Flu and COVID-19 vaccines.
Patient did not list any allergies to medications, food, or other products on vaccine consent form. Patient does not have any allergies listed on his profile at the pharmacy.
N/A at the time, front end store associates called paramedics and patient was taken to the hospital.