Progress Notes Family Medicine    Pt called to follow up on covid-19 vaccine done on 02/26/21.  She reports she felt a little run down on Saturday (the following day of the injection).  She feels well today.  Denies any further questions or concerns.   Pt is appreciative of phone call.          Progress Notes Family Medicine    Attempt to call patient for follow up via phone. No answer.    Progress Notes Family Medicine Cosigned by: Expand AllCollapse All    STORMONT VAIL COVID VACCINE CLINIC  DOB:  2/1/1969  Date:  2/26/2021                                                                 a 52 y.o. female who was seen at COVID Vaccine Clinic today for her first  dose of the COVID 19 vaccination.    She was given the Pfizer vaccination in the right deltoid muscle.   During her 15 minute waiting period after the injection, the patient began to experience feeling flushed.  She denied rash, hives, welts, difficulty breathing, difficulty swallowing, wheezing, throat tightness, hoarseness, stridor, itching, lightheadedness, dizziness, facial swelling, lip swelling and tongue swelling.   This provider was notified of patient reaction and she was then assessed in the emergency bay area.   Monitored patient for severe reaction symptoms, including but not limited to blood pressure abnormality , chest pain, rapid progression of symptoms and respiratory distress.   PMH: anxiety/panic attacks. HTN on amlodipine since 3-4 months. 10 mg.      ALLERGY REVIEW OF SYSTEMS:  Patient denies chills, fever, malaise/fatigue, facial swelling, sore throat, frequent throat clearing, cough, chest tightness, shortness of breath, wheezing, rash, hives, eczema, itching of skin, dizziness and headaches    Feels flushed and hot Not diaphoretic:     Previous Reactions: none.  States she was anxious prior to her visit today about the vaccine.     Objective    Vitals Vitals:   02/26/21 1326 02/26/21 1336 02/26/21 1339 02/26/21 1351 BP: (!) 155/96 (!) 187/121 (!) 156/97 (!) 154/97 Patient Position:     Sitting   Pulse: (!) 109   99   Resp: (!) 24       SpO2: 100%   100%          Physical Exam Constitutional:      General: She is in acute distress (anxioius affect).     Appearance: She is obese.  Cardiovascular:     Rate and Rhythm: Tachycardia present.     Pulses: Normal pulses.     Heart sounds: Normal heart sounds.  Pulmonary:     Effort: Pulmonary effort is normal. Tachypnea (slightly 24) present.     Comments: Pt asked to remove mask to reduce her hyperventilation.  Neurological:     Mental Status: She is alert.  Psychiatric:        Attention and Perception: Attention normal.        Speech: Speech normal.        Behavior: Behavior normal.        Thought Content: Thought content normal.        Cognition and Memory: Cognition normal.     Comments: Tearful and slightly anxious         Assessment/Plan  Treatment included: water, snacks and ice pack Follow up response to treatment: good. Patient discharge: Stable to go home and follow up with PCP.  Differential Diagnosis: Vaccine-Related Anxiety (include misc mental health) (elevated blood pressure)   Pt observed approx 30 minutes. Pt improved in symptoms after rest, food, water and ice pack. Her bp was coming down. HR and RR normal.  Pt felt better. She wanted to leave as staying here is making her more anxious. Recommended that she monitor her bp at home. If persists to be elevated of 140/90 that she follow up with her pcp.  Pt voices understanding.  Pt has co-worker here with her whom walked out with her.