Received Dec 1, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| COVID19 | COVID19 (COVID19 (PFIZER-BIONTECH)) | PFIZER\BIONTECH | UNK | NA0589 | IM / RA |
Site: Itching at Injection Site-Mild, Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Site: Shoulder Joint Injury (prolonged pain, tingling, etc.)-Mild, Additional Details: Patient reports that injection site became a little swollen after vaccine administration. After 24 hours patient developed a big, red welt/sphere raised by a few centimeters. Reported that injection site pain increased as swelling increased over time. Patient has not measured development over past 48 hours. Injection site about 2-3 inches from shoulder, patient did disclose experiencing some mild tingling in fingers and a little itchy., Other Vaccines: VaccineTypeBrand: Fluarix 2025-2026; Manufacturer: GlaxoSmithKline (GSK); LotNumber: 5R4CY; Route: Intramuscular; BodySite: Right Deltoid; Dose: 1; VaxDate: 11/19/2025
Patient marked "yes" on questionnaire regarding allergy to latex or other vaccine component but did not specify detailed allergy.