Received Jun 16, 2026
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| HEPA | HEP A (VAQTA) | MERCK & CO. INC. | 2 | Z005852 | IM / LA |
| MENB | MENINGOCOCCAL B (BEXSERO) | NOVARTIS VACCINES AND DIAGNOSTICS | 1 | 2P77Y | IM / LA |
| VARCEL | VARICELLA (VARIVAX) | MERCK & CO. INC. | 2 | Z010438 | SC / LA |
8:52 am Imm checklist reviewed with pt and patient?s mother. No medical problems or recent illnesses were reported. Vaccines reviewed with pt and pt?s mother. No contraindications for administering vaccines were noted. 8:55 am Patient received 3 vaccines (Hep A, Men B, and Varicella). 8:56 am Near syncopal episode began ? Pt became weak, pale, and diaphoretic. Pt remained conscious. Pupils are equal and reactive. 8:57 am Attempted to lay patient down due to feeling pt feeling dizzy, but pt began dry heaving, which resulted in vomiting. 8:58 am Attempted to take pts vital signs during vomiting episode, but unable to get accurate reading. 9:02 am After pt?s nausea improved, vital signs obtained. HR 39, BP 81/56, O2 98%, and RR 20 and non-labored. Patient reports ?I feel weak and want to go to sleep.? Continued to monitor pt. 9:04 am After questioning pt?s mother multiple times about any recent illness or medical issues, pts mom reports ?He failed his school physical for sports and followed up with his doctor. We were told he has thickening of his heart and needs to see a heart specialist. We do not have an appointment yet.? 9:06 am Vital signs obtained HR 44, BP 91/56, O2 98% RR 18, non-labored. Offered patient crackers, but pt refused. Pt began taking sips of water. 9:08 am Pt became more alert and continued to sip water. Pt stated, ?I feel like I need to use the rest room?. 9:10 am Patient attempted to stand up but was too weak to stand and began dry heaving again, which resulted in vomiting. 9:12 am Vital signs obtained HR 54 BP 92/59 O2 99%, RR 18, non-labored. Pt continued to show signs of extreme weakness. Discussed calling EMS with pts mother and she agreed. Called EMS. 9:15 am Continued to monitor pt while waiting for EMS. Vital signs obtained HR 62 BP 95/21 O2 99% RR 16, non-labored. 9:18-9:22 am EMS arrived; gave report to EMS; pt assisted to stretcher; pt transported to ER by EMS.
None reported by patient or patient's mother prior to immunizations being administered
None reported by patient or patient's mother prior to immunizations being administered
None
None
No medical tests or laboratory tests available to be performed at Public Health Facility.