Received Mar 5, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| HEP | HEP B (ENGERIX-B) | GLAXOSMITHKLINE BIOLOGICALS | 1 | T5D73 | IM / LA |
| MMR | MEASLES + MUMPS + RUBELLA (MMR II) | MERCK & CO. INC. | 2 | Y000225 | SC / LA |
| TDAP | TDAP (BOOSTRIX) | GLAXOSMITHKLINE BIOLOGICALS | 2 | 3RE73 | IM / LA |
On 03/04/2025 requested to be vaccinated for an immigration process (Hepatitis B, TDAP, MMR, Varicella, Flu). Pre-screen assessment of immunization completed. Client denied any allergy or significant medical history. At 9:02am RN administered Hepatitis B dose#1 and TDAP dose #2 both to the left deltoid, MMR dose #2 Left Arm. Immediately following the MMR vaccine client complained of discomfort and light headedness. At 9:03 am client became pale and complained of dizziness. RN paused the vaccination. At 9:04am client experienced decreased consciousness and began to slide out of the chair. She was immediately assisted to semi-fowler's position in a reclining chair. RN requested additional assistance from another staff RN and PHN, who helped with client transfer and the recording of vital signs and referred to policy for syncope event. At 9:05 am blood pressure:70/40, pulse 46, SpO2 sat 99%, temperature -97.2. Client was unresponsive for about 30 seconds with opened eyes. At 9:07 am client complains of slight headache and asked what happened. Vital signs were taken as follows: 9:14am- blood pressure 78/48, pulse 49, SpO2 sat 99%, temperature 97.7. At 9:18am client stated she felt a little dizzy, blood pressure 65/39, pulse 49, SpO2 sat 99%, temperature 97.6; At 9:20am client's skin color back to normal, speech normal, blood pressure 82/48, P52, spO2 sat 99%, temperature 7.8; 9:27 blood pressure 100/67, p58, SpO2 sat 99%, client denied dizziness. Client was offered to stop vaccination and postpone till next visit, client responded that she feels much better and insist to continue vaccination. Client was offered cup of coffee with sugar per her request. Client is alert and oriented to person, place and time. At 9:36 am RN administered Flu vaccine to the right deltoid, client tolerated well; 9:38am Varicella vaccine was administered right arm by RN, client tolerated well, blood pressure 105/72, P54. At 9:41am client independently transitioned to standing position, no evidence of rebound symptoms, vital signs: blood pressure 106/73, P59, spO2 sat 99%, temperature 97.8. RN provided instruction to follow up with medical provider or seeking urgent/emergency services if symptoms return. Client confirmed and agreed. Client was strongly encouraged to call a family member for a ride, client refused to call. At 9:55 am client, denied further symptoms, was alert and oriented to person place and time and in no apparent distress and ambulated without assistance out of the clinic. The phone number of the clinic was given to the client, and she was encouraged to call back on arrival to home. At 10:25am RN received a phone call from the client that she arrived safely and denied recurrent symptoms or any distress. As a response to this event, the team will conduct a review and drill of response to syncope event in the clinic per policy.
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