| Days after vaccination:||0
|Vaccination / Manufacturer
||Lot / Dose
||Site / Route|
|COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA
||009C21A / UNK
||- / -
Administered by: Pharmacy Purchased by: ?
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Supraventricular tachyarrhythmias (narrow), Dystonia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad)
Life Threatening? No
Birth Defect? No
Permanent Disability? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Previous Vaccinations: 2012
Other Medications: None
Current Illness: Rheumatoid Arthritis, Asthma, Basilar Migraines.
Preexisting Conditions: Rheumatoid Arthritis, Asthma, Basilar Migraines
Allergies: Tetracycline, Codeine, nuts, casin, fermented food
Diagnostic Lab Data: None at this time.
CDC Split Type:
Write-up: Wheezing, productive cough, 102.2 fever, bilateral leg edema, joint pain with edema, shortness of breath, chills, urinating every 45min - 1hour, A-Flutter, tightness in chest and back, profuse sweating, sore throat, neck swelling, and nausea. Took otc pain reliever.