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Report #2897480

Received May 21, 2026

Reports are unverified and do not show that a vaccine caused an event. Full disclaimer

Overview

Sex
Male
Age
4 yrs
State
CA
Recovered
Recovered
Vaccinated
May 21, 2026
Onset
May 21, 2026
Days to onset
0
Hospital days
—

Vaccines (3)

TypeNameManufacturerDoseLotRoute / Site
DTAPDTAP (DAPTACEL)SANOFI PASTEUR14CA37C1IM / RA
IPVPOLIO VIRUS, INACT. (IPOL)SANOFI PASTEUR1Y1D78P1IM / LA
MMRVMEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD)MERCK & CO. INC.1Z009078SC / RA

Symptoms (3)

Cold sweatDisorientationPallor

Symptom narrative

Pale, clammy skin, mildly disoriented. Mom of patient ensured patient got juice and some water and was feeling better upon leaving clinic.

Current illness

None

Medical history

None

Other medications

None

Allergies

None