Age: 46.0
Sex: F
Vaccine: COVID19
Symptoms: Blood pressure increased, Dysgeusia, Flushing, Headache, Peripheral swelling
Clinical narrative: Client received 2nd Moderna COVID vaccine (lot # 026B21A and expiration date 4/29/21) at 9:37AM. Nurse administered vaccine and after she walked client over to observation station and gave report to EMTs. PHN  asked RN  after she returned why client was walked over and RN informed lead of history of reaction to first moderna. PHN went to observation room, EMT had taken baseline vitals when she arrived at 942: blood pressure 126/82, pulse 84, oxygen 94%. PHN spoke with client who stated at this time feeling well. Per client first dose was given at location, client stated headache , throat itchiness, metal taste, flushing, blurry vision, and high blood pressure. That time she was given Benadryl and stayed 2hrs post vaccine for monitoring. Per client had spoken with primary doctor who recommended she still receive second dose. EMTs stayed with client. At 1002 client informed EMTs of flushed feeling and metallic taste. PHN informed and joined EMTs. Vitals: blood pressure 116/70, pulse 85, oxygen 97%. Client stated same symptoms as last time returning. Alert and oriented. Client denied shortness of breath. Face and hands flushed. PHN offered client Benadryl and client accepted, wanted PO only. Benadryl 50mg given PO. Client's sister was present, client was not driving. Allergies to Vit B. Medical history of hypertension, client did not take medication this morning. Vitals 1016: blood pressure 124/88, pulse 92, oxygen 98%. Client stated headache to frontal are, metallic taste, flushing in face and hands. 1021 vitals: blood pressure: 120/78, pulse 85, oxygen 98%. Client stated symptoms improving. Face flushing improving. Client alert and oriented. At 1026 client stated feeling hands were swelling, specifically right index finger. Client able to move hands, denied pain or tingling. Vitals: blood pressure: 116/78, pulse 85, oxygen 98%. At 1030 client wanted to use restroom, sister and EMT accompanied client. Client walked with steady gait there are back. After sitting down client stated feeling dizzy again. Vitals 1034: blood pressure: 126/82, pulse 80, oxygen 97%. No headache, no metallic taste, right index finger swollen and palms flushed. Client stated feeling tired. 1039 vitals: blood pressure: 120/80, pulse 79, oxygen 98%. 1044 vitals: blood pressure 122/80, pulse 81, oxygen 98%. Symptoms improved, swelling of right had same. Vitals 1053: blood pressure 124/82, pulse 82, oxygen 98%. Vitals 1109: blood pressure 126/100, pulse 85, oxygen 97%. Alert and oriented, per client feeling better. No headache, metallic taste, shortness of breath, headache, or flushed face. Swelling improved. Per client blood pressure higher since she did not take blood pressure medication this morning. Denied chest pain, blurry vision, or dizziness. 1114 vitals: blood pressure 118/90, pulse 84, oxygen 99%. Client stated all symptoms had resolved. ER precautions given to client. Last vitals at 1130: blood pressure 136/94, pulse 84, oxygen 98%. Client aware blood pressure diastolic high, still wanted to leave. Able to stand from chair with no dizziness. Client left facility with steady gait at 1131.