Age: 55.0
Sex: F
Vaccine: COVID19
Symptoms: Blepharospasm, Interchange of vaccine products, Oral discomfort, Palpitations
Clinical narrative: On 10/26/21, client came in with her husband requesting a Pfizer booster shot.  The client communicated to Co-Lead RN she previously received her one dose of the Janssen COVID19 vaccine (Lot# 1808978) in her right arm on 03/27/21 at approximately 13:00 at another COVID19 vaccination site.  At approximately 21:00, the client experienced a headache, pain at the injection site, a fever, fatigue, and swollen lymph nodes under her right arm.  The swollen lymph nodes lasted for one week and due to the continuing pain and discomfort, the client visited her doctor.  The client?s doctor took x-rays to ensure the client had no blood clots.  He also prescribed Tylenol to be taken twice a day for 2 weeks, after which the client?s swollen lymph nodes self-resolved.  The client also indicated she is diabetic, has high blood pressure, and is asthmatic.  Co-Lead RN conducted a medical consult with Clinical Leads who recommended the client be provided with the Pfizer booster as requested with a 30-minute observation.  The client received a COVID19 Pfizer booster shot (Lot# FF8839) at 13:26 and went to the observation area at 13:40. At approximately 13:45, the client notified the EMT that her lips were burning and she ?felt hot like she just ate hot chili peppers.?  The client also communicated that her heart was racing.  At 13:50, the Lead RN was notified, and the EMT took the client?s vitals (BP: 172/98 HR: 126, SPO2: 98%).  The client speaks another language, and the Lead RN utilized an interpreter for translation.  The client communicated she had anxiety about receiving her booster shot.  The Lead RN determined the client was alert and oriented to person, place time and event.   The Lead RN confirmed with the client that she was not experiencing any dizziness, shortness of breath, chest pain, or difficulty breathing.  The Lead RN also confirmed the client was not experiencing any swelling of the lips, tongue, or throat, and observed the client was not pale or diaphoretic.  Client confirmed she had taken her daily medications for her underlying health conditions and ate before coming to get the vaccine.  The EMT took client?s vitals again at 14:00 (BP: 178/94, HR: 120, SPO2% 99%).  Client stated her eyes were starting to pulsate and her heart was still racing.  Client was transferred to the zero-gravity chair to sit in a recline sitting position.  The Lead RN instructed the client to relax and take deep breaths.  Client was also given water, which she drank.  At 14:12, the EMT took the client?s vitals (BP: 157/75, HR: 105, SPO2: 99%).  Client stated the burning sensation in her lips was starting to go away and her heart felt like it was not beating as fast. She also stated that the pulsating sensation in her eyes had subsided.  The Co-Lead RN came to the observation area and educated the client in another language on both the potential side effects and adverse effects of the vaccine, when to seek medical attention, and ER precautions.  The Lead RN recommended the client be observed for an additional 15 minutes and the client agreed.  At 14:30 the EMT took the client?s vitals (BP: 139/76, HR: 96, SPO2: 98%).  Client stated she was feeling much better and would follow-up with her healthcare provider if she began to experience anything out of the ordinary as recommended.  Client left with her husband at 14:35 walking with a steady gait.