Triage for COVID 19 SEVERE post Vaccine Reaction VAERS reportable  Your concerns: Vaccine at noon without immediate effect. Driving home at 1400 developed itching and redness at scalp, face, neck, chest, back, arms and sides. Reports that she did not feel warm but looked like she had a sunburn. It appeared to fade over the next two hours but re-occurred at 1700 with all previous symptoms. She took 50mg of Benadryl and went to sleep. She woke at 0200 the re-occurrence of all symptoms, she did not take any Benadryl as that would make her too sleepy to come to work. The symptoms subsided and when we spoke at 1050 she had only small bumps/hive like spots on her fore arms and cleavage. They do not itch or burn at this time. Discussed with PA and Dr. after which  I spoke with patient again regarding pending plan. She will call the clinic if she has any further symptomatic episodes in the near future. We will investigate moving her second dose ahead 2 days from 1/12/2021 (day off) to 1/14/2021 this way she will be here at work should it happen again, she works 0630-1900. Med provider will consult with allergy to determine if further steps are needed for dose #2. Dept: Respiratory Therapy Have you missed work? #shifts: none Did you seek emergency care? none Date and Time of Vaccine: 12/22/2020 at 1200  Age at time of vaccination, 46 years 6 months Sex: female Was the vaccine received at facility? yes Site of vaccine (LD or RD):  RD Type of Vaccine Pfizer (X ) Moderna ( ) Other _______________ 1st or 2nd dose: first When did your symptoms start? 12/22/2020 at 1400 Please note reported symptoms yes or no, these symptoms are considered mild to moderate and are NOT VAERS reportable Injection site pain no Tiredness no Headache no Muscle Pain no Chills no Joint Pain no Fever (note temp if known) no Injection Site Swelling no  Injection Site Redness no Nausea no Feeling Unwell no Swollen Lymph Nodes (lymphadenopathy) no Other: no Employee reports THE FOLLOWING SEVERE post vaccine ADVERSE reactions (reportable): Difficulty breathing no Swelling of your face and throat no A fast heartbeat no A bad rash all over your body yes, see above Dizziness and weakness no If COVID-19 symptoms persist and/or worsen beyond 48 hours consider COVID-19 testing Treatment/Advise: see above Plan: see above If employee was vaccinated at another facility, they need to contact that facility , it is an expectation that the facility that gave the vaccine complete the VAERS report. N/A Employee verbalizes understanding and agreement with plan. yes VAERS report is completed electronically vaccine given at facility. Pending further review.  12/24/2020 01:51pm Follow up to VAER 12/23/2020 Patient called this morning to update regarding vaccine reaction. Yesterday she went home and did some shoveling. Later, around 1900, she developed a itchy, red rash that started on her chest and the right side of her neck which later covered her entire body. The skin on her face was bright red and very hot to the touch, there were small raised hives on her face which were likened to 'petechia if they were raised'. She took pictures of the raised/red areas. She took 50mg of Benadryl and went to sleep, when she woke at 0230 she was asymptomatic. Regarding the bumps on her forearms and cleavage, she has residual mottling on her arms. Updated providers.