Received May 12, 2026
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| COVID19 | COVID19 (COVID19 (MODERNA)) | MODERNA | 1 | 8146545 | IM / LA |
| FLU3 | INFLUENZA (SEASONAL) (FLULAVAL) | GLAXOSMITHKLINE BIOLOGICALS | 1 | 724TF | IM / RA |
| TDAP | TDAP (ADACEL) | SANOFI PASTEUR | 1 | U8638AA | IM / LA |
About 5 minutes post-injection, patient fainted for a split second and woke up with seizure-like activity (eye roll up, blank stare, snoring-type breathing sounds, gurgling at mouth, followed by whole body shaking) that lasted an estimated 5-10 seconds. After event, patient became alert and responsive - patient was able to recite back his name, date of birth, current year, and grab onto vaccinator's hands. Patient's father states that patient has never had history of serious adverse event after injections, nor does patient have any history of neurologic conditions/medical conditions/medications. Of note, patient stated he didn't eat all day. Patient was observed for 30 minutes before leaving for home. Advised patient's father to connect with pediatrician for further assessment or ER for seizure reoccurance.
None
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NKDA
N/A