Vaccine received on 1/21- had 30 sec seizure like activity that evening. Remained alert and oriented per baseline. Sitting in recliner after evening meal when staff found already deceased. Had extensive health history and comorbidities.

Subclavian DVT in right arm. Observed prominent veins on right shoulder and chest evening January 12th. Some weakness and discoloration in right arm. Saw PCP on January 13th, d-dimer performed in office. Ultrasound performed evening january 13th, DVT diagnosed. Referred to ER. Prescribed Eliquis Starter Pack for DVT/PE, began taking evening January 13th. Currently on Day 17 of treatment, minor improvement in symptoms but veins still prominently visible, weakness and discolouration in right arm persists, and some pain in right shoulder/chest area. No personal history of DVT, no family history of DVT except assosciated with Stage 4 lung cancer (mother, age 77).

Upset stomach at 3 pm/vomiting and diarrhea started at 4 pm. until 7 pm/cold chills from 6 pm to 11pm/ sensitive stomach until Jan. 14th.

Covid-19 Breakthrough Infection

Latent Autoimmune Diabetes in Adults (LADA) diagnosed. Initial diabetes diagnosis Blood sugar of 488mg/dl and HbA1c of 8.4 discovered in ER visit for Hemoptysis secondary to a later discovered mycobacterium intracellulare infection in left lobe of lung. This infection occurred likely from a decreased immune system caused by elevated blood glucose. Follow-up with endocrinologist found positive Antibodies to glutamic acid decarboxylase (GAD). Prior to Covid-19 vaccine fasting blood glucose results were below 100mg/dl.

Duplicate RSV vaccine was given to patient. Patient had a dose of the vaccine on 09/15/23 and again on 01/27/25.

Patient received a second M-M-R II vaccines 3 days after previously receiving another M-M-R II vaccine at another pharmacy. Patient came in another day with their information from another pharmacy showing they got the M-M-R II already but did not mention at the time of vaccine that they received any vaccines recently. Two patients came in together, report for other patient already submitted.

Gave pediatric dose to adult patient.

Patient received a second M-M-R II vaccines 3 days after previously receiving another M-M-R II vaccine at another pharmacy. Patient came in another day with their information from another pharmacy showing they got the M-M-R II already but did not mention at the time of vaccine that they received any vaccines recently.

Patient received the 2024/2025 formulation of Fluad and Spikevax on 9/25/24 at a visit with his doctor’s office and again on 12/2/24 at an immunization clinic put on by Pharmacy. No adverse reactions at the time of vaccination.