Received Jan 12, 2026
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| COVID19 | COVID19 (COVID19 (UNKNOWN)) | UNKNOWN MANUFACTURER | N/A | 3052671 | IM / LA |
Systemic: Confusion-Severe, Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Severe, Systemic: Flushed / Sweating-Severe, Systemic: Nausea-Medium, Systemic: Shakiness-Medium, Systemic: Visual Changes/Disturbances-Severe, Additional Details: patient fainted and became confused. Complained of loss of vision/blurry. Was pale, sweating and shaky. Refused ambulance with multiple offers to call paramedics. Called friend for her to come drive her home. When patient left, was feeling some better. Suggested going to be checked by doctor if no better or worse. Called patient around 1:40pm, patient states feeling much better. Told her to let us know if she needed anything, Other Vaccines: VaccineTypeBrand: Flucelvax; Manufacturer: seqirus; LotNumber: 948432; Route: IM; BodySite: ; Dose: ; VaxDate: 01/03/2026