Age: 58.0
Sex: F
Vaccine: COVID19, FLU3
Symptoms: Pruritus
Clinical narrative: POST COVID INJECTION NOTE:  11/30/24  Prior to immunization, pt explained that she had a reaction to all doses of Moderna:  Immunization History Administered Date(s) Administered   COVID-19 Moderna, External Administration 04/04/2021, 05/02/2021   COVID-19 mRNA LNP-S, PF (MODERNA),50 MCG/0.25 mL 12/15/2021   COVID-19 mRNA, PF, 12yrs-adult (Pfizer), 30 mcg/0.3mL 11/30/2024   INF H1N1-09 standard dose (Influenza H1N1-09). 10/30/2009   INFS Pres Free 18yrs-adult (Flublok quadrivalent) (influenza) 10/06/2018, 10/09/2019   INFS Pres Free 6mos-Adult (Flulaval Quadrivalent) (Influenza) 11/13/2021   INFS pres free 6mos-adult (Fluarix quadrivalent) (influenza) 09/26/2020, 12/10/2022   INFS pres free 6mos-adult (Fluzone quadrivalent) (influenza) 01/19/2024   INFS pres free 6mos-adult (Fluzone trivalent) (influenza) 11/30/2024   INFs (Influenza split virus ). 10/24/2006, 10/30/2009, 11/30/2011, 11/21/2012   INFs 18yrs-adult (Influenza) 12/12/2008   INFs 3yrs and over (FLUZONE) (Influenza) 10/28/2015   INFs 4yrs and over (FLUVIRIN) (Influenza) 11/25/2016, 12/29/2017   INFs pres free 3yrs-adult (Influenza) 11/20/2013, 10/16/2014   PNUcn13 (PREVNAR 13) (Pneumococcal conjugate, 13 valent) 10/28/2015   PPSV23 (Pneumococcal polysaccharide) 03/18/2009   TD pres free (Tetanus, Diphtheria) (TdVax), adsorbed 08/19/1992, 04/12/2006   Tdap (ADACEL) (Tetanus, diphtheria, acellular pertussis) 11/30/2011, 08/30/2024   ZOS (Herpes zoster recombinant) Shingrix 08/30/2024   Pt explained she had very itchy face and scalp in the past, no SOB.  She took antihistamines to help with the itchiness in the past. She did not bring it with her.  1155 - pt received:  COVID-19 mRNA, PF, 12yrs-adult (Pfizer), 30 mcg/0.3mL  LN0588 (HOSPITAL)  Right Deltoid by LVN  Post immunization pt said she does not feel any immediate reaction.   Advise pt stay post immunization for 15 minutes for OBSERVATION.   Pt agrees.  1203 - checked on pt and she said she is feeling fine.  Denies HA, SOB, Chest Pain and Itchiness.  1210 - 15 mins post immunization and pt explains she is experiencing MODERATE generalized itchiness.  No SOB, no pain, doesn't feel like her throat closing up. Denies HA and Chest Pain  Called Dr with pt by my side and he said to give her 25mg of Diphenhydramine.  25mg of Diphenhydramine given with water.  1218 - checked on pt and she feeling the same. MODERATE generalized itchiness.  1225 - 30 mins post injection.  Pt is still experiencing MODERERATE generalized itchiness.  Called Dr pt by my side and let him know that pt is still experiencing MODERERATE generalized itchiness. Asked for advice.  He asks if there are any visible rashes. Confirmed no. Injection side is not red or warm touch.   He says she can just continue with another dose of Diphenhydramine in 6 to 8 hours.  Pt stated she took Zrytec last time. He mentions she can take that as well. He cleared her to go home.  If she has extreme itchiness, SOB, throat feels like closing up, HA, chest pain, or anything life threatening she is advised to go to the ER or call 911.  She acknowledges.  1228 pt leaves facility. Pt is not in distress. She is still experiencing MODERATE generalized itchiness.