Age: 31.0
Sex: M
Vaccine: COVID19
Symptoms: Anxiety, Throat tightness
Clinical narrative: Progress Notes Healthcare Provider  Healthcare Facility 3/15/2021    Patient                                                                        Date:  3/15/2021                                                                                              Subjecti Patient is a 31 y.o. male who was seen at healthcare facility today for his first  dose of the COVID 19 vaccination.    He was given the Pfizer vaccination in the right deltoid muscle.   During his 15 minute waiting period after the injection, the patient began to experience throat tightness.  He denied rash, hives, welts, difficulty breathing, difficulty swallowing, wheezing, hoarseness, stridor, itching, lightheadedness, dizziness, facial swelling, lip swelling and tongue swelling.   This provider was notified of patient reaction and he was then assessed.   Monitored patient for severe reaction symptoms, including but not limited to blood pressure abnormality , hypotension, rapid progression of symptoms, respiratory distress and tongue swelling.    Past Medical History: Diagnosis Date ? Eczema   ? Morbid obesity with BMI of 40.0-44.9, adult (HCC)   ? Seasonal allergies       ALLERGY REVIEW OF SYSTEMS:  Patient denies chills, fever, malaise/fatigue, facial swelling, sore throat, frequent throat clearing, cough, chest tightness, shortness of breath, wheezing, rash, hives, eczema, itching of skin, vomiting, abdominal pain, dizziness and headaches       Previous Reactions: none to vaccines    Objective    Vitals Vitals:   03/15/21 1520 03/15/21 1528 BP: (!) 149/98 (!) 140/88 Pulse: 80 72 SpO2: 100% 100%        Physical Exam Vitals reviewed.  Constitutional:      General: He is not in acute distress.    Appearance: He is not ill-appearing or diaphoretic.  HENT:     Mouth/Throat:     Mouth: Mucous membranes are moist.     Pharynx: Oropharynx is clear.     Comments: Clear oropharynx. Eyes:     Conjunctiva/sclera: Conjunctivae normal.  Cardiovascular:     Rate and Rhythm: Normal rate and regular rhythm.     Heart sounds: Normal heart sounds.  Pulmonary:     Effort: Pulmonary effort is normal.     Breath sounds: Normal breath sounds and air entry.     Comments: Speaking full sentences. No throat clearing Skin:    General: Skin is warm.     Coloration: Skin is not pale.     Findings: No rash.  Neurological:     General: No focal deficit present.     Mental Status: He is alert and oriented to person, place, and time.  Psychiatric:        Mood and Affect: Mood normal.        Thought Content: Thought content normal.        Judgment: Judgment normal.         Assessment/Plan  Treatment included: water Follow up response to treatment: excellent. Patient discharge: Stable to go home and follow up with PCP.  Differential Diagnosis: Vaccine-Related Anxiety (include misc mental health)   Pt admits he was anxious prior to coming in today and felt anxious while he was in line for registration. He feels better after being evaluated here. He was observed for approx. 15 minutes. He requests to be here for his #2 pfizer vaccine. Request is reasonable.  Registration notified and will flag his chart for next time.    Healthcare Provider