Age: 19.0
Sex: F
Vaccine: MENB
Symptoms: Mobility decreased, Pain in extremity
Clinical narrative: Took voice message off of nurse line from mom stating that patient was seen 08/14/23 for a well visit. She was given a MenB vaccine and has since had pain in her arm and took advil last night due to pain in her arm. This morning when she woke up she was unable to lift her arm. Called and spoke with mom and she said that patient has to work today. I encouraged them to use heat instead of pain medications. Denies redness or swelling.  Encouraged to send photo via the portal of injection site.   Protocol Used: Immunization Reactions Protocol-Based Disposition: Home Care  Positive Triage Question: * Normal immunization reaction  Care Advice Discussed: * Reassurance and Education - Normal Reactions - Vaccines protect us against serious diseases. - Having some temporary symptoms from the shot is normal. - The symptoms mean the vaccine is working. They mean your immune system is building antibodies against the vaccine. The antibodies will protect you against the real disease. - These brief side effects do not cause any risks to your health. - There is no need to see your doctor for normal reactions, such as pain, swelling, redness or fever. * Vaccine Injection Site Reactions - Treatment - Some pain, redness and swelling at the injection site is NORMAL. It means the vaccine is working. Redness does not mean there's any infection. - Heat: For redness and pain, apply a heating pad or a warm wet washcloth to the area for up to 20 minutes. Repeat as needed. Reason: will increase blood flow to the area. It will also speed up healing. - Exception: can use a cold pack if your PCP recommends it, but only on the day of the shot. - Massage: Gently massage the injection site during the first few days. Do so several times a day. - No Pain Medicines: Try not to give any pain medicines for local reactions. Reason: pain medicines may reduce the body's normal immune response. Use local heat instead. The local pain rarely becomes bad. - Hives at Injection Site: If very itchy, can apply a 1% hydrocortisone cream OTC twice daily as needed. * General Body Symptoms from the Vaccine - Treatment - General symptoms usually start about 12 to 24 hours after the shot. They mean the immune system is turned on and doing its job. - General symptoms of feeling sick usually only last for one day, sometimes 2. - Follow the tips below to help your child feel better. - Tiredness: Encourage your child to rest or even sleep. Reason: The body needs all its energy going towards building antibodies against the vaccine. If we rest, the symptoms may pass sooner. - Poor appetite or even nausea: Drink extra fluids. Stay well hydrated. Reason: Good hydration keeps the body working at peak performance. - Chills: Wrap your child in a blanket. Reason: Warmth speeds up blood flow. - Muscle aches: Take a warm bath or shower. - Fussiness: Younger children may be more fussy than normal. They need extra holding and comforting. * Reasons To Call Back - Fever lasts over 3 days - Redness becomes larger than 2 inches (5 cm) - Redness gets worse after 3 days - Your child becomes worse * Meningococcal Vaccines - Sore injection site for 1 to 2 days occurs in 50%, with limited use of the arm in 15%. - These symptoms only last a few days. - It is impossible to get meningitis from the vaccine. Reason: there is no live meningococcal bacteria in the vaccine. - No serious reactions reported.