Received Jan 6, 2026
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| COVID19 | COVID19 (COVID19 (UNKNOWN)) | UNKNOWN MANUFACTURER | 1 | 6315MF005A | IM / LA |
Systemic: VACCINE BEGAN TO LEAK FROM SAFETY DEVICE DURING ADMINISTRATION-Mild, Additional Details: VACCINE BEGAN TO LEAK FROM SAFETY DEVICE DURING ADMINISTRATION, NEEDLE WAS CHANGED AND REST OF VACCINE WAS GIVEN, PATIENT WAS FINE AND NOT UPSET, Other Vaccines: VaccineTypeBrand: FLUECELVAX; Manufacturer: SEQIRUS; LotNumber: 410515; Route: IM; BodySite: LEFT ARM; Dose: ; VaxDate: UNKNOWN