Rough Shifting/ Hesitation when Accelerating?

Every time it shifts on normal acceleration it shakes hard. It hesitates to go when accelerating, just giving it a little gas to try and pass someone. The RPMs also bounce about 100-200 constantly while steadily cruising. This has been happening for about 2 months but seems to be getting a little worse over time and the shakes are getting rougher.

I just did a fresh oil and oil filter change, new air filter, replaced all of the spark plugs and cleaned the throttle body. (Still has the same issues)
No check engine light until about a few days ago, the code is P219A. I'm not sure if it's related or if that's something new.

Thanks for any help!