Received Nov 13, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| FLU3 | INFLUENZA (SEASONAL) (FLUZONE) | SANOFI PASTEUR | 1 | UT8792LA | IM / LA |
Not reaction to medication but suspected shoulder injury related to vaccine administration. Documented as Left Deltoid but per patient statement and witnessed by Mother at cart side , the injection was given in right deltoid, very high and anterior with immediate shoulder pain andha experienced progressive pain, reduced motion and weakness since date of injection. Reported to Supervisor on 11/7/2025 as complaints not resolving. It is believed this is likely a shoulder injury related to vaccination administration not a true vaccine allergy
none
PCOS
Doxyxycline, Eilnest, Metformin, Spironalactone
NKDA
none to date - pending MR, OT services and orthopedic consult if not responsive to antiinflammatory and supportive care