| Days after vaccination:||0
|Vaccination / Manufacturer
||Lot / Dose
||Site / Route|
|COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN
||1808609 / 1
||LA / IM
Administered by: Pharmacy Purchased by: ?
Symptoms: Blood pressure measurement,
SMQs:, Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad)
Life Threatening? No
Birth Defect? No
Permanent Disability? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Other Medications: unknown
Current Illness: unknown. none that we were aware of
Preexisting Conditions: unknown
Diagnostic Lab Data: Has a history of a severe reaction to prednisone. upon inquiring, patient stated it caused insomnia for about a year and was unable to work. No history of any sort of anaphylactic reaction.
CDC Split Type:
Write-up: Within a minute of receiving the vaccine, pt reported itchy/tingly sensation in her mouth and throat. Initially stated she could breathe/swallow just fine but very quickly stated the swallowing was getting more difficult. 911 was called followed by 0.3 mg EpiPen in her right outer thigh and 50mg of oral Benadryl. Her BP was then taken around 4:45 and it was 162/93 at which point EMT arrived and took over.