Age: 43.0
Sex: F
Vaccine: COVID19, FLUC4
Symptoms: Discomfort, Erythema, Feeling hot, Pruritus, Rash
Clinical narrative: Client presented to the vaccine site with her mother and received her COVID vaccine Pfizer Booster (lot #FL3198) in the L arm at 1715 and the Fucelvax Influenza vaccine (lot #308496) in the R arm at 1716 by vaccinator. At 1735 the client notifiedEMT that she "feels hot" and EMT immediately notified Lead RN . RN assessed the client while EMT provided the client water and took client's vitals. RN assessed a rash across the client's chest. Client was A&O x4 and denied SOB, dizziness, nausea, and pain. No swelling observed. Client stated that her lower arms felt "itchy". Client stated she had NKDA, no chronic conditions, and did not have a reaction to her first 2 doses of Pfizer or previous Influenza Vaccines. Client stated the last time she received the Influenza vaccine was 2 years ago. At 1735 client's vitals were 180/108, HR 99, SPO2 99%, and RR 18. RN recommended that the client take IM Benadryl to help relieve symptoms. Client agreed to taking Benadryl and EMT assisted client to zero gravity chair. At 1742 RN drew up 50mg of Benadryl and administered to the client in the L arm, 1 inch away from the Flucelvax injection. During administration of IM Benadryl, some of the vaccine was wasted and leaked out of the syringe. RN notified Vaccine Operations Leadswho advised that re-administration of Benadryl is not indicated. At 1752 clients vitals were BP 140/106, HR 85, SPO2 98%, and RR 16. Client reported that the last time she ate was around 12pm. EMT provided client another water and saltine crackers.  RN educated the client on the effects of Benadryl and the client verbalized understanding. At 1757 the client stated that the "heat" sensation was almost gone and stated "the pumping of my heart is much better".  RN observed very mild redness on the chest, and no rash on the chest or arms was observed. Client stated that her itchiness on the arms was "almost better" and stated that she felt very mild itchiness on her back. RN assessed client's back and did not observe any redness or rash. At 1800 client's vitals were BP 136/98, HR 78, SPO2 98% and RR 16. The client continued to drink water and ate crackers. After futher assessment, the client remembered that she has an allergy to sulfa drugs and ampicillin. Client is not taking any medication. At 1609 client stated she "doesn't feel hot anymore". RN advised the client that she should not drive home and her mom who was with her said they will call her uncle to pick them up.  RN advised the client remain in observation for a full 30 minutes after administration of Benadryl. At 1815 client's vitals were 148/106, HR 86 SPO2 100% and RR 16. Client stated the itchiness on her arms and upper back was returning but it was "bearable". RN recommended calling EMS due to return of symptoms but client denied. At 1620 client stated the heat was returning and she felt like there was a "heaviness" in her throat. RN notified client that due to symptoms, protocol requires activation of EMS. RN activated EMS at 1620. At 1621 the client was A&O x4, client's SPO2 was 100%, and no swelling of the face, neck, or throat was observed. RN assessed erythema on the chest and upper back. At 1625 EMS assumed care of client.