Age: 26.0
Sex: F
Vaccine: COVID19
Symptoms: Hypoaesthesia oral, Lethargy, Limb discomfort, Oropharyngeal discomfort, Respiratory rate increased
Clinical narrative: Patient was present at the clinic on 1/12/2022 for her first dose of Pfizer (lot FJ5683, received to the LD at 1142). At 1148, the client c/o L arm numbness that improved with movement. She then c/o that the tip of her tongue was numb and she c/o of circumoral numbness. No swelling or rash was noted upon visual assessment. She was offered benadryl by responding RNs, but she declined medication. No respiratory distress or discomfort was noted.  At 1153, the client appeared slightly lethargic and reported that she felt lightheaded. At approximately 1205, this writer was alerted to assist. At 1205, the client was assisted to lie down on the cot and reported that her s/s of lethargy/lightheadedness were improved upon laying down. Her VS at 1205 were: BP 118/82 laying, HR 104, SPO2 98% RA, T 97.9, RR 16.  At 1208, the client reported feeling like ?there is something in my throat?, no swelling or rash noted to face, lips, tongue. Oral mucosa appeared WNL. The client was provided juice and water and was able to drink and speak without difficulty. No respiratory distress was noted. VS at this time were: BP 108/70 laying, HR 91, SPO2 99% RA, RR 16. At 1210, the client reported no changes with numbness sensation to her nose, circumoral area, or the feeling of ?strangeness? to throat. She remained A+O and her respiratory status was WNL.  At 1215, the client reported that the ?heaviness? in her throat was going away, but that her nose and circumoral area continued to be numb. She was resting comfortably with no sign of distress or discomfort. VS at 1218: BP 104/66, HR 84, SPO2 97% RA, RR 16. She continued to display no s/s rash/swelling to face, lips, tongue/oral mucosa, throat, arms, or abdomen upon visualization. At 1220, the client reported that she felt dizzy again and that she felt ?weightless?, but that circumoral and tip-of-the-nose numbness had improved (stating ?I don?t feel it at all.?). She reported the weightless feeling had extended to her extremities. VS at 1223: BP 106/68, HR 83, SPO2 99% on RA, RR 16. No LOC, change in consciousness was noted. The client was able to converse in full sentences and drink fluids without difficulty.  At 1225, the client reported that the sensation of weightlessness had improved, but her chin was numb and that the numbness to her nose was returning. She then reported that her limbs felt heavy instead of light. At 1229, this writer placed a call to the provider on call, giving a report of the events, vitals, and assessments so far. The provider stated that he doubted this reaction was allergic in nature and that the client was most likely responding to sensations and changes triggered by anxiety, including classic features such as tingling of nose, hands, and lips caused by changes in pH s/t increased respirations. He reported that she should feel comfortable receiving her second dose and that she would be safe to go home, as long as someone could remain with her throughout the day and could call 911 if needed.  This writer communicated the provider?s response to the client and her brother (who would remain with her throughout the day). Both were provided education on what to watch for and when to seek out medical care, both verbalized understanding. The client reported that she felt ready to go home and that she would seek out advice from her own personal physician as well. VS at 1235: BP 108/70 sitting, HR 81, SPO2 100% RA, RR 16. The client exited the clinic at 1240, accompanied by her brother.