Age: 58.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness, Dry throat, Feeling hot
Clinical narrative: Client ( DOB:7/19/1962) received the 1st dose of Moderna COVID vaccine lot #021C21A and expiration date 5/26/21 at 1:10PM.  Client reports having history of anxiety, so client was seated in a gravity chair prior to injection. PHN  was notified by Nurse student that client is having dizziness. PHN finds patient sitting upright in gravity chair, alert and oriented x 4.  Client reports feeling dizziness and feeling "hot" sensation. Client denies chest pain, blurred vision, no headache, or shortness of breath. Client reports having a history of high blood pressure, history of severe panic attacks, anxiety, and borderline diabetes.  Client is taking lisinopril, metformin, aspirin and Xanax. Client reports eating lunch.  Vitals are taken at 1:18pm blood pressure: 124/80, pulse: 68 and oxygen: 97%.  PHN offer client water, client accepted water. At 1:21pm vitals: blood pressure:126/78, pulse:65, and oxygen:97%.  Client reports "feeling dizzy" when looking into her purse for vaccination card and reports feeling a dry throat.  Client reports no shortness of breath and no other symptoms. At 1:26pm client reports needing to take her Xanax to prevent a panic attack.  PHN advised client if she could get someone to pick her up drive due to the medication she is taking, client reports she has been taking her medication for years and it never makes her feel unable to drive; client stated she had no one available to pick her up.  At 1:27pm vitals: blood pressure:128/80, pulse:60, and oxygen:97%.  Client reports no changes in dizziness and dry throat, even with water.  Client reports no chest pain, no shortness of breath, and no headache.  At 1:32pm vitals: blood pressure:120/84, pulse:60, and oxygen:98%.  Client reports no changes. At 1:37pm vitals: blood pressure 118/80, pulse:60, and oxygen:96%. Client reports no chest pain, no headache, no dizziness, no trouble breathing, Client states that she "feels the same."  Client also reports having a pacemaker placed 10/2020.  At 1:40pm, PHN offers calling paramedics since there is no real improvement in her dizziness and PHN educated client that it is unsafe to drive while dizzy.  At 1:44pm vitals: blood pressure:110/80 and pulse:61 and oxygen: 97%.  Client reports feeling relaxed.  PHN discussed with client importance of following up with primary doctor about lack of improvement in dizziness post vaccine. PHN provided client with ER precautions.  At 1:51pm vitals: blood pressure:116/80, pulse:60, and oxygen:98%.  At 2:03pm vitals are blood pressure:118/80, pulse:60, and oxygen:97%. Client denies any chest pain, blurred vision, headache, or shortness of breath. Client reports no change in dizziness.  PHN offer paramedics again and at 2:04pm PHN calls 911. Fire and paramedics arrive at 2:14pm to assume care.  Client signed AMA with paramedics.  Client stayed seated a little longer due to dizziness-educated client about following up with provider and cardiologist and provided client with Crisis & Access Line. Also educated client about dangers of driving while dizzy.  Client reports her dizziness is somewhat improved.  Client accompanied to car walked out with a steady gait at 2:35pm.