Received Mar 30, 2026
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| FLU3 | INFLUENZA (SEASONAL) (FLUZONE) | SANOFI PASTEUR | 1 | U8787AA | IM / LA |
| HEP | HEP B (ENGERIX-B) | GLAXOSMITHKLINE BIOLOGICALS | UNK | 9K34M | IM / LA |
| MMR | MEASLES + MUMPS + RUBELLA (MMR II) | MERCK & CO. INC. | UNK | Y019931 | SC / RA |
| VARCEL | VARICELLA (VARIVAX) | MERCK & CO. INC. | UNK | Z015169 | SC / RA |
Vaccines for immigration status. Requested to receive all today. Five needed vaccines in stock, will call next week when IPV is in stock. Pt states he grew up and does not have any of his vaccination records. Reports NKA and no adverse effects with past vaccinations. After third vaccine administered, pt reported that his wife told him that he had to share with us that he is very prone to passing out with pain, fever, shots, etc. He stated that he was doing well and was not dizzy or feeling faint. Fourth vaccine administered. Became unconscious, head and extremities limp, eyes glazed, one short moan. Supported pt to remain in the chair and ammonia placed under his nose. Second nurse, joined us. Regained consciousness in approx 30 sec. Fully alert and appropriate conversation. After about 2 minutes, pt lost consciousness again, head and extremities limp, eyes rolled back., short moan and one gurgle. PA joined us. Supported in chair and ammonia held under nose. In and out of consciousness for approx 2 min. Resp even and unlabored. Very clammy, diaphoretic, and pale. O2 sat 95%, HR 64. Reported that his wife was in the car, she was brought in. Pt alert and responding appropriately. Drank 2 small can coke and ate cheese crackers. Monitored for 35 min with no further episodes. Resp even and unlabored. Pink facial tones. Alert and oriented x3. Taken to truck via wheelchair and transferred self to truck. Pt and wife instructed to stay inside from hot weather, drink lots of water, call 911 if any further episodes. Both state understanding Wife assumed care of the pt.
None
Patient reports that he faints easily and frequently anytime he experiences pain, mild injury, fever, lab draw, injections, etc. Patient reports that this has occurred all of his life.
Unknown
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Fainting during childhood vaccines, dates unknown