Age: 37.0
Sex: F
Vaccine: COVID19
Symptoms: Immediate post-injection reaction, Throat irritation, Throat tightness
Clinical narrative: On April 6,2021 the patient received Covid IMZ 1 and had an anaphylactic reaction at the time immediately afterwards.  The complete details were not known until she returned on 04/27/21 to receive the 2nd IMZ for Covid. The patient listed on the CONSENT FORM that, she had ?allergies? to environmental things and did disclose this to the pharmacist, at the time. She had the ?back patch testing done? and had received allergy shots on a regular basis from a very young age for many years. The allergy testing resulted in her being allergic to weeds, grass, trees, all plants, bees, insects and more.  No medication allergies nor ingredient of medications allergies was noted, nor did pt note that she had ever had any issue with any IMZ in the past.        Pt received the 1st Covid IMZ on 04/06/21 at 8:02 am given by the Lead Tech CphT, she was immediately escorted to the waiting area? and stated that, ?within a minute she felt her throat closing up? and ?told the Health and Wellness associate?  - that was helping to sanitize the chairs for the day, that she didn?t feel good.  the associate immediately informed the pharmacist on duty . He went out to speak with the pt and had her sit on the floor and asked her to lye completely down on the floor.  The pt felt uncomfortable with this direction from the pharmacist and said she did not want to lye down, ---- as the floor was very dirty.  The pharmacist did not offer to get her a blanket, pillow nor did he ask any of the pharmacy associates to do so.  He also did not call the store management to assist with this ---- nor let them know she was having issues with the IMZ.  The patient said, ?she DID hold her hands up to her throat, and said she thought she was allergic to the vaccination? to the pharmacist---and he just returned to the pharmacy.  She ?thought? he was calling 911 or getting an epi-pen in case it needed to be administered. Pt stated that  returned to check on her after 15minutes, and then told her to set another 15 minutes and that her color looked better.  He seemed to think it was anxiety or a panic attack.  The patient stated that ?it was Not a panic attack? ?nor anxiety? at all.  She has taken Ativan since the age of 14 for other reasons, but she was not nervous about receiving the IMZ that day.        When the patient returned on 04/27/21, she informed the lead tech what had transpired on 04/06/21, and thought that it should be documented.  On 04/27/21, she was slightly apprehensive about receiving the IMZ, as she was worried it would happen again.  She was positive that she needed to complete the series and get the 2nd dose in spite of the concern.  I contacted the market director at the time and discussed the about events with her.  She said, ?it was OK to give it to her?, and to have the Epi-pen close by and have her under supervision at all times after the administration.       I gave her the 2nd IMZ on 04/27/21 at 9:31am and stayed by her side the entire time.  I had the epi-pen ?in ?hand" and the patient did say that her throat was scratchy and she became somewhat nervous, but as I continued to reassure her that I was there , and do matter what ?she would be OK?  and we would do whatever was necessary to be sure of that.  The patient had taken the Ativan on both 04/06/21 and 04/27/21 -- and it was not a panic attack nor anxiety as the pharmacist concluded or assumed on 04/06/21   The patient was upset on 04/27/21 that he had her sit on a dirty floor, did not come back to check on her except for 1 time -- and that was only to tell her to stay on the floor another 15 minutes.  She said, ?I don?t think he knows the protocol ?for a patient with an anaphylactic reaction??   She was very grateful  --- after waiting until she felt comfortable and steady to get up and go.  Before I administered the IMZ, I asked her, ?If she had anyone with her that was driving??  so, I?d know she was not alone in the store afterwards.       The patient did fine, and there was ?no need to administer? the Epi-Pen.  She was still concerned, ?that pharmacist did not know the proper protocol to follow for anaphylactic reactions??  She said, if he had been there on 04/27/2021, she was not going to have it done at that time.    I have statements from the administering technician and the associate that the patient first told ?she thought she was allergic? to the IMZ on 04/06/21.