Received Jun 18, 2026
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| COVID19 | COVID19 (COVID19 (MODERNA)) | MODERNA | 5 | 3054592 | IM / LA |
Describe the adverse event as follows: Within 12 hours of receiving the vaccine, the patient experienced a noticeable increase in confusion. Additionally, the patient has demonstrated progressive physical weakness since the vaccination. The patient experienced a fall prior to the vaccine on 06/10/2026 and a subsequent fall on 06/12/2026. As a result of this decline, the patient is currently unable to walk with their cane and now requires the use of a wheelchair for mobility.
G30.1 Alzheimer's disease with late onset(Primary, Admission), F02.A3 Dementia in other diseases classified elsewhere, mild, with mood disturbance, F33.9 Major depressive disorder, recurrent, unspecified, Z95.2 Presence of prosthetic heart valve, I35.0 Nonrheumatic aortic (valve) stenosis, M25.552 Pain in left hip, L21.8 Other seborrheic dermatitis, R60.9 Edema, unspecified-BLE, R21 Rash and other nonspecific skin eruption, K08.89 Other specified disorders of teeth and supporting structures, I50.42 Chronic combined systolic (congestive) and diastolic (congestive) heart failure, I87.2 Venous insufficiency (chronic) (peripheral), H61.22 Impacted cerumen, left ear, C44.319 Basal cell carcinoma of skin of other parts of face, B37.2 Candidiasis of skin and nail(History of), R29.6 Repeated falls, L60.3 Nail dystrophy, J30.89 Other allergic rhinitis, E78.2 Mixed hyperlipidemia, I11.0 Hypertensive heart disease with heart failure, R53.82 Chronic fatigue, unspecified, F10.11 Alcohol abuse, in remission(History of), R63.5 Abnormal weight gain, Z79.82 Long term (current) use of aspirin, R26.0 Ataxic gait(History of), B35.1 Tinea unguium-left great toe(History of), F41.9 Anxiety disorder, unspecified, C44.311 Basal cell carcinoma of skin of nose(History of), N40.1 Benign prostatic hyperplasia with lower urinary tract symptoms-nocturia
As needed Tylenol ES Q 4 hours, ASA 81mg daily, Duloxetine 60mg daily, Ketoconozole 2% shampoo weekly, Lasix 20mg daily, Lisinopril 40mg daily, Quetiapine 25mg at bedtime, Rivastigmine tartrate 6mg daily, Trazadone 150mg dialy.
No Known allergies
no noted