Received Feb 25, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| VARCEL | VARICELLA (VARIVAX) | MERCK & CO. INC. | 2 | Y014868 | ID / LA |
Per the 02/19/2025 triage note from RN, "After 20 minutes, sight of shot displayed redness and mild swelling and itchiness. Dr. checked spot with patient and advised that is possible natural reaction from the injection given in the subcutaneous tissue of the lower forearm and stated benadryl would be prescribed for symptomatic relief and patient and mother acknowledged information." Patient and patient's mother left the medical office before receiving the benadryl from the Health Center pharmacy. Later that evening, the patient's parents took the patient to the Hospital emergency room. Per provider encounter note on 02/21/2025, "here to follow up ER visit. seen at facility 2 days ago after local reaction to the varicella vaccine. doing better, redness is smaller and not itchy, but hurts a lot. note reviewed, got benadryl, has been taking 25 mg every hours." "Current Medications Discontinued Benadryl Allergy 12.5 MG/5ML Liquid 5 ml Orally every 6 hrs prn , stop date 03/12/2025 Treatment 1. Acute urticaria Start diphenhydrAMINE HCl Capsule, 25 MG, 1 capsule, Orally, every 6 hours As needed, 7 days, 28 Capsule, Refills 1 Start predniSONE Tablet, 5 MG, 1 tablet, Orally, Once a day, 3 days, 3 Tablet, Refills 0 Notes: Nursing supervisor spoke with manufacturer and advised will need to repeat the dose due to not being given IM or SQ and to wait 30 days. will have patient return to see me after 30 days and update all vaccines and repeat the varicella. 2. Others Start Ibuprofen Tablet, 200 MG, 2 tablets, Orally, every 8 hours As needed, 7 days, 42 Tablet, Refills 1 On 02/20/2025, RN "Spoke to Merck Sharp & Dohme LLC. Spoke with representative. Case #02756830. Per Merck and CDC vaccine is invalid because there are no studies on vaccine efficacy when given in forearm. Per Merck, titers may be drawn to determine immunity. Based on results of titers, provider may decide to offer additional dose of Varivax. Merck states that immunity cannot be guaranteed with current second dose. Per Merck, should wait at least 28 days prior to administering additional dose. Reaction reported to Merck (Merck stated that they report all reactions to VAERS)".
Multivitamin 1 daily, Orally, Ibuprofen (200 MG Tablet)1 tablet with food or milk as needed every 8 hours prn, Orally
Penicillin