Received Dec 15, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| FLU3 | INFLUENZA (SEASONAL) (FLULAVAL) | GLAXOSMITHKLINE BIOLOGICALS | N/A | 34N52 | IM / LA |
| HEP | HEP B (RECOMBIVAX HB) | MERCK & CO. INC. | 1 | Z003556 | IM / RA |
| TDAP | TDAP (ADACEL) | SANOFI PASTEUR | 1 | U8564AA | IM / LA |
RN #1: At approximately 1745 on 12/11/25 at the above clinic. This patient was vaccinated with HepB (Recombivax), Tdap (Adacel) and Influenza (Flulaval) by RN. Before the vaccination RN assessed that the patient had latex and Tramadol allergy. This RN and and RN #2 discussed the vaccines to be administered, I looked up the 3 vaccines and did not find that any of them contained latex. They are all prefilled syringes. RN administered the vaccine. The patient stayed in the building because she was working for the [name withheld] that sponsored the event. At approximately 1800 the patient came back to the vaccination area ? of itching and redness on both arms. RN spoke with patient because she is [withheld] speaking only, and assessed her. She did not ? breathing issues at initial assessment. A finger pulse ox monitor/heart rate monitor was put on the patient. There was no B/P cuff in the emergency kit or in bin 6 of the supplies. Because of the itching and redness with maculopapular rash, Benadryl liquid po 50 mg was given. The patient had no issues swallowing the medicine. Patient continued to ? of itching, with the rash and burning in her throat, she was also very shaky. We assisted the patient to move to a quieter area, she stood and moved to a different chair with minimal assistance. After sitting she continued to ? of symptoms and increased breathing troubles. Staff and I decided to give her Epinepherine 0.3 mg per standing orders and had (team member) call 911. Heart rate immediately shot up to an average of about 166. RN administered the Epi via the epi injector at 1824. EMS arrived around 1830 and assessed patient with monitor. Throat was slightly red and swollen and because of the meds given to patient did not administer any more meds, but advised a visit to the ED for monitoring especially when the epi wore off. Patient agreed and EMS transported her in ambulance at about 1845. After the incident the staff talked about the reason patient might have had anaphylaxis and concluded that the child bandaids we used may contain latex. Further research needed. Vital Signs for incident: Time Pulse Ox Heart Rate Meds 1810 96% 106 1817 96% 110 Benadryl given 1820 95% 112 1824 92% 114 Epi Given 1825 96% 168 RN #2: Patient was screened and noted that she had an allergy to latex and tramadol, and a history of hyperthyroidism. On consultation, I asked the patient for details on her allergy history. She reported that she experienced itching, a rash, and tightness in her throat after latex exposure in the past. After patient counseling, the patient consented to receiving Tdap, Hepatitis B and Flu vaccines. Based on the patient s insurance status, she was eligible to receive Adacel, Recombivax HB and Flulaval. I passed the completed vaccine card to the lead RN/dispenser (RN #1) and verbally noted that the patient had a latex allergy. I then electronically pulled up the package inserts for the three indicated vaccines for review, and did not see an indication that any had natural rubber latex packaging. The lead RN/dispenser returned with the vaccines after dispensing and double checking for noted latex on the packaging and reference docs. I then prepared and administered the three vaccines to the patient. Approximately 20 minutes after receiving the vaccines, the patient returned to the clinic complaining of itching and a rash to her arms. She was noted to have raised welts to her bilateral upper extremities, locally concentrated around the injection sites with some scratch marks and redness surrounding the sites. Reported no respiratory difficulties at this time. At 1810, she was started on a finger pulse ox monitor with a HR of 106, and a SpO2 of 96%. The BP cuff was not available in the emergency kit box, and MA staff were unable to locate a BP cuff for monitoring in the supply boxes or van; as a result, BP assessment was unavailable throughout our response. Per standing orders, I provided the patient with 50mg liquid Benadryl PO at 1817. HR at 1817 was 110, pulse ox 96%. Concern was raised that the bandaids applied may contain latex; removed all bandaids and cleansed upper arms with alcohol. The patient then reported that her itching was worsening and spreading to her legs, her throat was burning and itching and her breathing felt tight. Reported feeling shaky and panicky. At 1824, HR was 114, SpO2 92%. Based on the progression of her symptoms and prior allergy history, decision was made to give epinephrine per standing orders. Epinephrine autoinjector 0.3mg IM was administered to the lateral left thigh at 1824. EMS was called and directed to the clinic site by staff. EMS arrived at approximately 1829. EMS staff assessed patient and noted slight swelling to throat. Patient reported that her itching was improving after administration of epinephrine, but her throat still felt like it was tight and burning. HR noted to be in the 160 s on the EMS monitor following epi administration, SpO2 98%. EMS recommended that patient be transported to the emergency room for further monitoring following administration of epi autoinjector. Patient was agreeable to EMS transport and further monitoring in the emergency room. Patient s husband was called by the local clinic point-of-contact,
None disclosed
None disclosed
Thyroid Medicine
Latex, Tramadol
None at clinic site.