Received Jul 29, 2026
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| MNQ | MENINGOCOCCAL CONJUGATE (MENQUADFI) | SANOFI PASTEUR | 1 | U8680AA | IM / RA |
| MNQ | MENINGOCOCCAL CONJUGATE (MENQUADFI) | SANOFI PASTEUR | 1 | U8680AA | IM / LA |
| TDAP | TDAP (BOOSTRIX) | GLAXOSMITHKLINE BIOLOGICALS | 1 | 37R35 | IM / LA |
Approximately 48?72 hours following administration of MenACWY and Tdap on 07/23/2026, patient (adolescent male, high school senior) developed right periorbital/eyelid swelling with pain on eye movement and difficulty fully opening the right eye. Eye symptoms first noted 07/25/2026 (Saturday); household caregiver (father) administered eye drops at that time. On 07/26/2026 (Sunday), patient developed high-grade fever (measured 102.6°F) with associated tachycardia. Sunday night, patient experienced night terrors, confusion, irritability, nonsensical sleep-talking, and ambulatory disorientation. Lethargy and markedly diminished appetite noted beginning 07/24/2026 (day after vaccination), with patient returning to sleep on couch at 9:30 AM after reporting feeling rested. Patient evaluated at urgent care 07/26/2026; started on amoxicillin-clavulanate (Augmentin) for presumed right eye cellulitis. Continuous antipyretics (ibuprofen) administered; fever reduced but did not normalize until late morning 07/27/2026. Follow-up visit with Dr 07/27/2026: fever resolved, right eye opening improved to approximately 3/4 normal capacity (improved from prior day), eye pain with movement fully resolved. Lungs clear to auscultation. Pupils reactive bilaterally. Patient still with diminished appetite, nasal congestion, and postnasal drip cough when supine. Contextual note: Father recently diagnosed with pneumonia and inadvertently coughed near patient, raising concern for coincident bacterial transmission to the eye as alternative or contributing etiology. Right eye cellulitis and high-grade fever are not listed as known side effects of meningococcal vaccine per current prescribing information. Inactivated vaccine formulation reduces concern for vaccine-induced infection. VAERS report filed given temporal association and atypical presentation.
None
None
NKDA
Urinalysis/urine culture: Negative ? no bacterial growth (07/27/2026) Throat swab (rapid strep/strep culture): Negative (07/27/2026) CBC and BMP: Ordered; not yet drawn as of 07/27/2026 due to dehydration (unable to obtain venous access). Results pending.