| Days after vaccination:||20
|Vaccination / Manufacturer
||Lot / Dose
||Site / Route|
|COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA
||025L20A / 1
||LA / IM
Administered by: Private Purchased by: ?
Symptoms: Biopsy skin,
Type III immune complex mediated reaction,
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Vasculitis (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)
Life Threatening? No
Birth Defect? No
Permanent Disability? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
Extended hospital stay? No
Other Medications: Hydrochlorothiazide last taken 2 weeks prior to vaccine administration Levothyroxine Albuterol as needed Daily multivitamin
Current Illness: None.
Preexisting Conditions: Anxiety, HLD, HTN, hypothyroidism, rosacea, liver steatosis secondary to obesity Migraine, impaired fasting glucose without diagnosis of T2DM, obesity with BMI 40.5
Allergies: Codeine and morphine intolerance Sulfa antibiotics-prior hives seen on administration in her 20s
Diagnostic Lab Data: Punch biopsy of rash with result pending at time of report.
CDC Split Type:
Write-up: Onset of Petechial/purpural rash along BLE starting in thighs B/L with spread to abdomen and BUE. Probable Type III Hypersensitivity vs vasculitis. Came to hospital 01/28/2021. Treated with PO steroids 60 mg PO prednisone with rapid improvement. Testing still pending.