Age: 81.0
Sex: F
Vaccine: COVID19
Symptoms: Skin burning sensation, Skin warm, Substance-induced psychotic disorder, Urticaria
Clinical narrative: Day 1: 01/07/21 Moderna Vaccine Dose #1 was given in left arm. No side effects noticed. Day 2: 01/08/21   No side effects noticed.  Day 3: 01/09/21   Left arm slightly sore (no action taken).  Days 4-9: 01/10/21 to 01/15/21 No side effects noted.  Day 10: 01/16/21 (T:98.0) Woke up to a large welt, hot to the touch, no pain on upper left arm - below injection site.  Began 25mg Benadryl (25 mg) 2 doses taken.  Day 11: 01/17/21 (T:98.2) Welt increasing, hot to the touch, slight burning on back of neck also.  Took Benadryl (25mg) twice during the day and Tylenol (650 mg) twice during the day. Day 12: 01/18/21 (T:98.0) Rash seems to be flattening out spreading a little, neck rash seems slightly worse. Burns. Day 13: 01/19/21 (T:98.6) No change in symptoms Took Benadryl (25mg) twice  Day 14: 01/20/21 (T:98.3) Rash seems to be spreading into the armpit area. Neck area is larger and burning.  Took three Benadryl (25mg) during the day-Tylenol                    2 tabs (650 mg) at bedtime.                                                            Day 15: 01/21/21 (T:98.3) feeling tired. Rash is spreading under both armpits and neck. Back seems to be itching a lot too.  Took Benadryl (25mg) three times. Day 16: 01/22/21 (T:98.6) Rash is really bad!  Area of original welt is slightly larger. Took Benadryl (25mg) 6 am, 12pm, 6pm 10, pm and 3am. Will call MD on Monday. Used Shea Butter lotion (little help). Day 17: 01/23/21 (T:98.0) Rash is worse, both arms and larger neck areas hot to the touch burning sensation. Benadryl (25mg) 6:30 am. (37.5mg)10:30sm, (37.5                    mg) 3:30 pm, (25mg.) 8:30 pm. 2 Tylenol (650 mg.) 9:00 pm.  Day 18: 01/24/21 (T:98.8) Rash is still worse and spreading (will call MD tomorrow). Benadryl (25 mg) 6:30 am and 11: 45 am, 2 tabs of Tylenol (650 mg)                  noon and 4:00 pm. Shea butter lotion not helping. Applied ice, seemed to ease burning sensation but still miserable. Day 19: 01/25/21 (T:98.4) Saw Dr.  who prescribed RX: Prednisone 60 mg daily for 5 days, Benadryl 25-50 mg for itching, oatmeal baths, cortisone 1% cream or lotion, I picked up my RX and a new package of Benadryl/Banophen. Went home and took Benadryl (50 mg) 2 tablets at 9:30 am,1:30 pm and 5:15 pm, mistakenly believing they were 25mg tabs because of packaging change and miniscule text on bottle and difficult to find directions. Also Prednisone 60 mg, 10:00 am. Took 2 Tylenol (650 mg) 12:45pm and5:20 pm. I did not realize that the Benadryl dosage was different! Actually double! So I took 300 mgs of Benadryl. Took an oatmeal bath at 5:30 pm. Around 6:30pm I felt a                    little dizzy. So I went to bed because I did not feel right.  I was not making any sense.  When my daughter FaceTime?d me and realized I was slurring my words. She phoned her sister to do a wellness check.    2021 Covid Vaccine   They found me still incoherent and unsteady. I did not realize that the bottle of Benadryl was a different dosage! Dr.  office and spoke to doctor on call. They suspected steroid psychosis. We had not yet puzzled out the exceeded dose of Benadryl/Banophen. Used oximeter during night to monitor breathing, which was normal. Day 20: 01/26/21 (T:98.2) Prednisone dosage was decreased to 40 mg daily (due to question of psychosis). No cortisone cream or lotion. The dosage of Benadryl was discovered and resolved.  Rash is still spreading over body. Now on lower stomach.  Benadryl (25 mg), one tablet at 9:30am, Benadryl (12.5mg) at 2:00 pm, 9:30 pm.  2 Tylenol (650 mg) at 1:20 am, Pepcid AC (new addition  at 10:00 am, Prednisone (40 mg) noon. Trying aloe and calamine. Day 21: 01/27/21 (T:98.4) Rash on neck and underarms spreading, also back is now raw. Feeling less fidgety. Pain slightly better. Benadryl (25mg) 7:30 am, 3:30 pm, 10:00 pm, Prednisone (40 mg.) 9:00 am, Pepcid AC, 2:00 pm. Day 22: 01/28/21 Feeling slightly better, Benadryl (25 mg) 6:50 am,1:00 pm, 7:30 pm. Prednisone (40 mg.) 6:15 am.  Pepcid AC, 1:00 pm.  Day 23: 01/29/21 (T:98.6) Rash is still spreading. Benadryl (25mg.) 3:30 am, 9:00 am, 2:30 pm, 8 ;38 pm, Prednisone 7:30 am, Pepcid AC 2:00 pm. Day 24: 01/30/ 21 really itching, neck burning, Benadryl (25mg) 2:05 am,8:00 am, 2:30 pm, 8:30 pm, 1:30 am. Prednisone (30 mg) 8:00 am, Pepcid AC 3:30 pm  Day 25: 01/31/21 Oatmeal bath at 1:30 am. Benadryl (25 mg) 7:35 am,1:45 pm, 7:10 pm, Prednisone (20 mg.) 7:30 am & 1:00 pm total 40 mg. Pepcid AC 5:00 pm. 2 Tylenol (650 mg) 6:00 pm. Neck bright red again and rash worse on forearms and hands. Wearing gloves in effort not to scratch. Misery continues. 2021 Covid Vaccine    Day 26: 02/01/21 (T:98.6) Benadryl (25 mg.) 2:30 am, 7:50am, very itchy, did not use ice for last 12 hours. Rash is now in the groin area. 20mg prednisone at 9:55am. 2 Tylenol (650mg) 11:45am. 12:10pm Pepcid AC. Saw new dermatologist who prescribed Rx strength steroid cream.