Received Dec 17, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| COVID19 | COVID19 (COVID19 (PFIZER-BIONTECH)) | PFIZER\BIONTECH | 1 | NA4452 | IM / LA |
Systemic: Allergic: Rash Generalized-Medium, Additional Details: Patient developed a rash on her back after receiving the Pfizer Covid vaccine and Fluzone High Dose, Other Vaccines: VaccineTypeBrand: Fluzone High-Dose; Manufacturer: Sanofi-Pasteur; LotNumber: UT8820BA; Route: intramuscular; BodySite: left deltoid; Dose: ; VaxDate: 11/30/2025