Age: 40.0
Sex: F
Vaccine: COVID19
Symptoms: Inappropriate schedule of product administration, No adverse event
Clinical narrative: Dose 1 and Dose 2 administered at interval of 49 days; No adverse event; This spontaneous case was reported by a nurse and describes the occurrence of INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Dose 1 and Dose 2 administered at interval of 49 days) and NO ADVERSE EVENT (No adverse event) in a 40-year-old female patient who received mRNA-1273 (Spikevax) for COVID-19 prophylaxis.     Concurrent medical conditions included Penicillin allergy, Latex allergy, Immunoglobulin G4 related disease, Mitral valve prolapse, Mitral regurgitation and Myxomatous mitral valve degeneration. Concomitant products included AMFETAMINE ASPARTATE, AMFETAMINE SULFATE, DEXAMFETAMINE SACCHARATE, DEXAMFETAMINE SULFATE (ADDERALL) from 01-Feb-2016 to 08-May-2023, CLONAZEPAM from 01-Feb-2022 to 08-May-2023 and MILK THISTLE [SILYBUM MARIANUM] from 01-Mar-2020 to an unknown date for an unknown indication.   On an unknown date, the patient received second dose of mRNA-1273 (Spikevax) (unknown route) 1 dosage form. On an unknown date, received first dose of mRNA-1273 (Spikevax) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Dose 1 and Dose 2 administered at interval of 49 days) and NO ADVERSE EVENT (No adverse event). At the time of the report, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Dose 1 and Dose 2 administered at interval of 49 days) and NO ADVERSE EVENT (No adverse event) outcome was unknown.        For mRNA-1273 (Spikevax) (Unknown), the reporter considered NO ADVERSE EVENT (No adverse event) to be not related. No further causality assessment was provided for INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (Dose 1 and Dose 2 administered at interval of 49 days).    The patient's significant medical history included slightly elevated liver function tests and body mass index of 28.7.  The patient received Spikevax dose 1 on 20-JAN and dose 2 on 09-MAR of unknown year. The patient received Nexium 24-hour from 20-FEB-2023 and doxepin 10mg at night for insomnia from 1-MAR-2023 (stopped while using Paxlovid). The COVID symptoms were far more severe (with some ongoing) including the typical symptoms (but more pronounded) productive cough with yellow sputum, Shortness of Breath (SOB). On 08-May-2023, the patient was placed on Paxlovid for COVID-19 treatment, albuterol HFA inhaler 90 mcg every 4 hours, and 2 days later Flovent 220 mcg BID due to a diagnosis of an acute bronchospasm. On 10-May-2023, the Paxlovid was last administrated. After being prescribed Paxlovid, the patient had heart palpitations and SOB worsened. After 5 doses the patient went to the emergency department where the patient found out the BP as 172/109 (normal BP was 90s/50s), mag level was 1.3 (low range for test was 1.6), and (which was to be expected) white blood cell and neutrophil count was elevated. The next day the patient experienced a sudden onset of a pounding headache, worsening heart palpitations (after a 2GM mag infusion), and dizziness. Elevated BP continued until cardiologist prescribed 0.1mg clonidine. The patient was treated with clonidine 0.1 mg twice a day.