Received Apr 3, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| PNC21 | PNEUMO (CAPVAXIVE) | MERCK & CO. INC. | 1 | y013009 | IM / LA |
Systemic: Allergic: Difficulty Breathing-Severe, Systemic: Allergic: Difficulty Swallowing, Throat Tightness-Severe, Additional Details: patient had history of difficulty breathing after moderna vaccine. patient waited 15 min after vaccine came up to counter within 5 min with difficulty breathing gave her 2 benadryl 25mg and still having problem breathing so I gave her epi-pen 0.3mg into her outer thigh. still having problem breathing I called 911 they assessed her vitals and she declined to go with ambulance. she drove home. I called her to make sure she got home safely. she is going to follow up with Md. , Other Vaccines: VaccineTypeBrand: shingrix; Manufacturer: glaxosmithkline; LotNumber: k2bb7; Route: right arm intramuscularly; BodySite: right arm intramuscularly; Dose: 01; VaxDate: 02/21/2025
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