Received May 19, 2026
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| COVID19 | COVID19 (COVID19 (UNKNOWN)) | UNKNOWN MANUFACTURER | UNK | 3052996 | IM / RA |
Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Additional Details: Patient should to elbow was red and hard, was given antibiotics by his prescriber, prescriber believes patient got an infection from the vaccine., Other Vaccines: VaccineTypeBrand: Capvaxive; Manufacturer: ; LotNumber: z013655; Route: Intramuscular; BodySite: Right Arm; Dose: 1; VaxDate: 04/13/2026