chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 84.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Hypotension, Hypoxia, Lung opacity, Respiratory tract congestion, Rhinorrhoea
Clinical narrative: Currently in the ED 10.26.21;  Hospitalized (10.14-10.17);  COVID-19 positive (10.14.21);  fully vaccinated  Admission Date: 10/14/2021 Discharge Date: 10/17/2021 PRESENTING PROBLEM: Hypoxia [R09.02] Acute respiratory failure with hypoxia [J96.01] Pneumonia due to COVID-19 virus [U07.1, J12.82] HOSPITAL COURSE: Patient is an 85-year-old male who presented to the emergency department on 10/14/2021 with chief complaint of shortness of breath and cough.  Patient is fully vaccinated with Moderna.  In the emergency department, patient was hypoxemic and placed on supplemental oxygen.  Lab work revealed a sodium of 126.  Chest x-ray showed bilateral subtle opacities consistent with COVID 19 pneumonia.  Patient was admitted to the Internal Medicine Service.  Patient was started on Decadron.  He was outside the window for remdesivir.  Patient did improve during his stay.  He was able to be weaned off of supplemental oxygen.  PT/OT evaluated the patient recommended home with assist.  Patient was recommended follow up his primary care physician.  He was discharged home in stable condition. In ED CURRENTLY at hospital 10.26.21.  Was seen in urgent care setting first:  Patient is a 85 y.o. male who presents to the Urgent Care with FATIGUE (and weak covid pos 10/14 )  Patient prior to surgery today for weakness.  He reports that at 14 he was admitted to the hospital for home med and discharge and 17. He reports since leaving the hospital he has worsened and developed increasing weakness.  He reports that he did have a cough but this has improved.  He reports that he initially also had some abdominal pain and this has also improved.  He reports currently ages has generalized weakness and fatigue.  He reports he is covered vaccinated.  Patient reports his blood pressure was low at home.  He denies any fevers, chills, chest pain, shortness of breath, nausea, vomiting, diarrhea, dysuria, urinary frequency, or any other complaints.  Patient reports he has been using his home inhalers in use his rescue inhaler earlier this morning. Patient is a 85-year-old male.  He is alert, oriented with no signs acute distress.  Patient's blood pressure is 103/88 for major vital signs within normal limits.  On exam patient does speak clearly and in full sentences overall seems short of breath.  Upper lung fields and expiratory wheezes but remainder of lung fields are clear.  Abdomen soft and nontender without rebound tenderness or guarding.  Posterior oropharynx is clear and patent formation membranes are moist.  Her major patient exam was unremarkable.  Discussed with patient are limited testing availability is here in the Urgent Care and benefits of the emergency department.  Discussed with him my concerns for possible electrolyte abnormalities or worsening of the pneumonia.  Patient verbalized understanding of this he like to go to bladder emergency department for further evaluation and treatment.  Patient was discharged with his wife in stable condition.
Age: 84.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: SARS-CoV-2 test positive, Surgery, Wheezing
Clinical narrative: Currently in the ED 10.26.21;  Hospitalized (10.14-10.17);  COVID-19 positive (10.14.21);  fully vaccinated  Admission Date: 10/14/2021 Discharge Date: 10/17/2021 PRESENTING PROBLEM: Hypoxia [R09.02] Acute respiratory failure with hypoxia [J96.01] Pneumonia due to COVID-19 virus [U07.1, J12.82] HOSPITAL COURSE: Patient is an 85-year-old male who presented to the emergency department on 10/14/2021 with chief complaint of shortness of breath and cough.  Patient is fully vaccinated with Moderna.  In the emergency department, patient was hypoxemic and placed on supplemental oxygen.  Lab work revealed a sodium of 126.  Chest x-ray showed bilateral subtle opacities consistent with COVID 19 pneumonia.  Patient was admitted to the Internal Medicine Service.  Patient was started on Decadron.  He was outside the window for remdesivir.  Patient did improve during his stay.  He was able to be weaned off of supplemental oxygen.  PT/OT evaluated the patient recommended home with assist.  Patient was recommended follow up his primary care physician.  He was discharged home in stable condition. In ED CURRENTLY at hospital 10.26.21.  Was seen in urgent care setting first:  Patient is a 85 y.o. male who presents to the Urgent Care with FATIGUE (and weak covid pos 10/14 )  Patient prior to surgery today for weakness.  He reports that at 14 he was admitted to the hospital for home med and discharge and 17. He reports since leaving the hospital he has worsened and developed increasing weakness.  He reports that he did have a cough but this has improved.  He reports that he initially also had some abdominal pain and this has also improved.  He reports currently ages has generalized weakness and fatigue.  He reports he is covered vaccinated.  Patient reports his blood pressure was low at home.  He denies any fevers, chills, chest pain, shortness of breath, nausea, vomiting, diarrhea, dysuria, urinary frequency, or any other complaints.  Patient reports he has been using his home inhalers in use his rescue inhaler earlier this morning. Patient is a 85-year-old male.  He is alert, oriented with no signs acute distress.  Patient's blood pressure is 103/88 for major vital signs within normal limits.  On exam patient does speak clearly and in full sentences overall seems short of breath.  Upper lung fields and expiratory wheezes but remainder of lung fields are clear.  Abdomen soft and nontender without rebound tenderness or guarding.  Posterior oropharynx is clear and patent formation membranes are moist.  Her major patient exam was unremarkable.  Discussed with patient are limited testing availability is here in the Urgent Care and benefits of the emergency department.  Discussed with him my concerns for possible electrolyte abnormalities or worsening of the pneumonia.  Patient verbalized understanding of this he like to go to bladder emergency department for further evaluation and treatment.  Patient was discharged with his wife in stable condition.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Asthenia, Feeling abnormal, Hypersomnia, Syncope
Clinical narrative: Slept 6 days and night - collapsed twice - still extremely weak and brain fog
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Upon charting the given vaccine, it was found that the vial had expired 10/15/2021.
Age: 39.0
Sex: M
Vaccine: COVID19
Symptoms: Immunodeficiency, Oropharyngeal discomfort, Oropharyngeal pain, Pain, Pyrexia
Clinical narrative: After the vaccine: Pain in the injection site area - mild to moderate pain. General fatigue - started the evening of the 21st. That continued for the next 24 hours or so. The evening of 22nd, I started to experience body aches, fever, and just probably more moderate fatigue. Those continued throughout the weekend. I treated with Tylenol. Monday, yesterday, the fever subsided. As well as a lot of the body aches and everything. Now I'm dealing with a bad sore throat with lesions and sores in my throat. I have been developing the classic hand, foot, mouth sores and hand and feet as well. I haven't reached to my doctor because my son had it and my wife has it as well. So I haven't sought care as there is really no treatment for it.
Age: 1.5
Sex: F
Vaccine: HEPA
Symptoms: Blood test normal, Chest X-ray normal, Computerised tomogram normal, Electroencephalogram normal, Generalised tonic-clonic seizure
Clinical narrative: At 6:50 the patient went into a generalized tonic-clonic seizure. She seized for 8-10 minutes. She was taken by squad to Community hospital where she was admitted to the ER. They did a chest x-ray, CT scan, and blood work. All came back normal. She was then sent and admitted to Hospital main campus. They did and EEG which also came back normal.
Age: 60.0
Sex: M
Vaccine: COVID19
Symptoms: Blood gases, Blood magnesium, C-reactive protein, COVID-19, Computerised tomogram thorax
Clinical narrative: Patient contracted COVID after being fully vaccinated Cough, fever, congestion, body aches, hypoxia
Age: 60.0
Sex: M
Vaccine: COVID19
Symptoms: Cough, Electrocardiogram, Fibrin D dimer, Full blood count, Hypoxia
Clinical narrative: Patient contracted COVID after being fully vaccinated Cough, fever, congestion, body aches, hypoxia
Age: 60.0
Sex: M
Vaccine: COVID19
Symptoms: Inflammation, Metabolic function test, Pain, Procalcitonin, Pyrexia
Clinical narrative: Patient contracted COVID after being fully vaccinated Cough, fever, congestion, body aches, hypoxia
Age: 60.0
Sex: M
Vaccine: COVID19
Symptoms: Respiratory tract congestion, Scan with contrast, Troponin
Clinical narrative: Patient contracted COVID after being fully vaccinated Cough, fever, congestion, body aches, hypoxia
Age: 81.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Upon charting the given vaccine, it was found that the vial had expired 10/15/2021.
Age: 81.0
Sex: M
Vaccine: COVID19
Symptoms: Balance disorder, Computerised tomogram head, Dysarthria, Dysstasia, Gait inability
Clinical narrative: Pt was unable to stand up from a chair;  unable to walk, except for baby steps; balance worse;  speech more slurred.
Age: 81.0
Sex: M
Vaccine: COVID19
Symptoms: Laboratory test normal, Magnetic resonance imaging head, Vaccination complication
Clinical narrative: Pt was unable to stand up from a chair;  unable to walk, except for baby steps; balance worse;  speech more slurred.
Age: 78.0
Sex: F
Vaccine: COVID19
Symptoms: Peripheral swelling, Thrombosis, Ultrasound scan
Clinical narrative: My left foot became swollen; I had blood clots in my left lower leg and also in my groin.
Age: 50.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Moderna Vaccine expired 10/20/2021 at 0600 at refrigerator temperature. Vaccine administered approximately 4 hours after expiration time on 10/20/2021. Moderna Manufacturing company consulted and stated: It is recommended that the vaccine be used by 30 days to the expiration date and time; however, it is ok to use by the end of the day on the 30th day. No treatment required.
Age: 70.0
Sex: M
Vaccine: COVID19
Symptoms: Chills, Dysphonia, Fatigue, Lip swelling, Pruritus
Clinical narrative: On 02/25/2021 at 6:00 am I awoke with raised itchy urticaria on both lower arms. By 12:00 noon the urticaria spread to upper arms with intense itching. By 9:00 pm the urticaria spread to upper chest. I self-treated with OTC oral diphenhydramine 50 mg and local application of hydrocortisone 1% cream. Itching became worse by 02/26/2021 at 4:00 am. Took another dose of diphenhydramine 50 mg. During 02/26/2021 and 02/27/2021 urticaria spread to neck and lower torso, lips swelled, voice became hoarse. Felt fatigued and had occasional chills, but no fever. I took diphenhydramine 25 mg every 4 hours for relief. By 02/28/2021 all symptoms subsided and felt better. I notified my Primary Care Physician.
Age: 70.0
Sex: M
Vaccine: COVID19
Symptoms: Urticaria
Clinical narrative: On 02/25/2021 at 6:00 am I awoke with raised itchy urticaria on both lower arms. By 12:00 noon the urticaria spread to upper arms with intense itching. By 9:00 pm the urticaria spread to upper chest. I self-treated with OTC oral diphenhydramine 50 mg and local application of hydrocortisone 1% cream. Itching became worse by 02/26/2021 at 4:00 am. Took another dose of diphenhydramine 50 mg. During 02/26/2021 and 02/27/2021 urticaria spread to neck and lower torso, lips swelled, voice became hoarse. Felt fatigued and had occasional chills, but no fever. I took diphenhydramine 25 mg every 4 hours for relief. By 02/28/2021 all symptoms subsided and felt better. I notified my Primary Care Physician.
Age: 56.0
Sex: M
Vaccine: COVID19
Symptoms: Biopsy skin normal, Chills, Eyelid abrasion, Eyelid injury, Facial pain
Clinical narrative: Severe dermatologic reaction with systemic illness and elevated LFT's and Heme finding post booster.  9/15 - Lesions on foot & hands, mild malaise, chills, (-) fever, LFT's rising - held Rybelsus, start Glyburide Continue ceterzine and advil 9/19 - Progressive lesions and pain on feet, hand, and now face (-) oral lesions or optho lesions Repeat CBC and LFT labs, rx pain med 9/22 - Pain gone, lesions lessened, fingers sensitive 9/24 - No systemic illness, skin resolving 9/28 - No systemic sx at all.  No fever, chills, abd pain, nausea, cp, diarrehea. Notes skin is sloughing with new skin looking healthy- slightly sensitive. Overall, recovering.
Age: 56.0
Sex: M
Vaccine: COVID19
Symptoms: Full blood count, Liver function test increased, Malaise, Mean cell haemoglobin concentration decreased, Oral disorder
Clinical narrative: Severe dermatologic reaction with systemic illness and elevated LFT's and Heme finding post booster.  9/15 - Lesions on foot & hands, mild malaise, chills, (-) fever, LFT's rising - held Rybelsus, start Glyburide Continue ceterzine and advil 9/19 - Progressive lesions and pain on feet, hand, and now face (-) oral lesions or optho lesions Repeat CBC and LFT labs, rx pain med 9/22 - Pain gone, lesions lessened, fingers sensitive 9/24 - No systemic illness, skin resolving 9/28 - No systemic sx at all.  No fever, chills, abd pain, nausea, cp, diarrehea. Notes skin is sloughing with new skin looking healthy- slightly sensitive. Overall, recovering.
Age: 56.0
Sex: M
Vaccine: COVID19
Symptoms: Pain in extremity, Paraesthesia, Pyrexia, Skin exfoliation, Skin laceration
Clinical narrative: Severe dermatologic reaction with systemic illness and elevated LFT's and Heme finding post booster.  9/15 - Lesions on foot & hands, mild malaise, chills, (-) fever, LFT's rising - held Rybelsus, start Glyburide Continue ceterzine and advil 9/19 - Progressive lesions and pain on feet, hand, and now face (-) oral lesions or optho lesions Repeat CBC and LFT labs, rx pain med 9/22 - Pain gone, lesions lessened, fingers sensitive 9/24 - No systemic illness, skin resolving 9/28 - No systemic sx at all.  No fever, chills, abd pain, nausea, cp, diarrehea. Notes skin is sloughing with new skin looking healthy- slightly sensitive. Overall, recovering.
Age: 56.0
Sex: M
Vaccine: COVID19
Symptoms: Skin reaction, Systemic infection
Clinical narrative: Severe dermatologic reaction with systemic illness and elevated LFT's and Heme finding post booster.  9/15 - Lesions on foot & hands, mild malaise, chills, (-) fever, LFT's rising - held Rybelsus, start Glyburide Continue ceterzine and advil 9/19 - Progressive lesions and pain on feet, hand, and now face (-) oral lesions or optho lesions Repeat CBC and LFT labs, rx pain med 9/22 - Pain gone, lesions lessened, fingers sensitive 9/24 - No systemic illness, skin resolving 9/28 - No systemic sx at all.  No fever, chills, abd pain, nausea, cp, diarrehea. Notes skin is sloughing with new skin looking healthy- slightly sensitive. Overall, recovering.
Age: 87.0
Sex: M
Vaccine: COVID19
Symptoms: Acute respiratory failure, Aspiration, Asthenia, COVID-19, Chest X-ray abnormal
Clinical narrative: Hospitalized (10.14.21 - 10.21.21);  COVID-19 positive (10.14.21);  Fully Vaccinated  Admission Date: 10/14/2021 Discharge Date: Oct 21, 2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Transaminitis  Hypoxia Generalized weakness AMS (altered mental status) COVID-19 virus infection COVID-19 HOSPITAL COURSE: Patient is an 87-year-old male with past medical history of hypothyroidism, type 2 diabetes, chronic systolic heart failure status post pacemaker, history of CVA with residual left-sided weakness, wheelchair bound who presented to the hospital with COVID-19 infection.  Patient was fully vaccinated.  Patient was admitted to the hospital due to altered mental status and generalized weakness in the setting of a scope infection.  Patient was not hypoxic but for a brief moment during admission.  The patient was globally weak and had progressive difficulty ambulating at home until the 20th brought into the ER.  In the ER he was found to have elevated LFTs, general weakness.  Neurology was consulted who recommended CT of the head which was unremarkable aside from chronic changes.  Chest x-ray was done which showed no cardiopulmonary disease.  due to his LFT elevation of the liver ultrasound was performed which showed no evidence of portal vein thrombosis.  Patient was a candidate for monoclonal antibody therapy which he received and tolerated well.  For about 20 the patient had an aspiration event, became more confused, and had 1 fever.  Chest x-ray showed aspiration pneumonitis, white blood cell count was normal, procalcitonin was normal.  Patient recovered quickly, never required oxygen.  Short of breath was consulted who recommended NPO while the patient was confused, this resolved and the patient was able to advance back to a general diet prior to discharge.  patient was evaluated by Physical therapy and Occupational therapy who recommended subacute rehab given the patient's profound weakness in the setting of his recent infection.  Patient was unable to stand without significant assistance.  The patient's wife and daughter were insistent that the patient would do better at home and wanted to set up home health nursing and were adamant that they can't care for the patient better at home than at rehab.  Patient's daughter was heavily involved in the patient's care, she was very concerned about specifically his thyroid medication and felt that missing a few doses of his thyroid medication contributed significantly to his acute decompensation in the hospital.  Given has improvement in mental status, improvement in his vitals, he was afebrile, he was tolerating a general diet, and received adequate therapy for his COVID-19 infection the patient was considered stable for discharge home with home health care with the family support.  I discussed with the daughter that the patient be brought back if caring for him at home becomes unsafe, overwhelming, or cumbersome for the patient and her family.  Patient and family were in agreement this plan discharge home in stable condition
Age: 87.0
Sex: M
Vaccine: COVID19
Symptoms: Computerised tomogram head normal, Confusional state, Dyspnoea, Dysstasia, Gait disturbance
Clinical narrative: Hospitalized (10.14.21 - 10.21.21);  COVID-19 positive (10.14.21);  Fully Vaccinated  Admission Date: 10/14/2021 Discharge Date: Oct 21, 2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Transaminitis  Hypoxia Generalized weakness AMS (altered mental status) COVID-19 virus infection COVID-19 HOSPITAL COURSE: Patient is an 87-year-old male with past medical history of hypothyroidism, type 2 diabetes, chronic systolic heart failure status post pacemaker, history of CVA with residual left-sided weakness, wheelchair bound who presented to the hospital with COVID-19 infection.  Patient was fully vaccinated.  Patient was admitted to the hospital due to altered mental status and generalized weakness in the setting of a scope infection.  Patient was not hypoxic but for a brief moment during admission.  The patient was globally weak and had progressive difficulty ambulating at home until the 20th brought into the ER.  In the ER he was found to have elevated LFTs, general weakness.  Neurology was consulted who recommended CT of the head which was unremarkable aside from chronic changes.  Chest x-ray was done which showed no cardiopulmonary disease.  due to his LFT elevation of the liver ultrasound was performed which showed no evidence of portal vein thrombosis.  Patient was a candidate for monoclonal antibody therapy which he received and tolerated well.  For about 20 the patient had an aspiration event, became more confused, and had 1 fever.  Chest x-ray showed aspiration pneumonitis, white blood cell count was normal, procalcitonin was normal.  Patient recovered quickly, never required oxygen.  Short of breath was consulted who recommended NPO while the patient was confused, this resolved and the patient was able to advance back to a general diet prior to discharge.  patient was evaluated by Physical therapy and Occupational therapy who recommended subacute rehab given the patient's profound weakness in the setting of his recent infection.  Patient was unable to stand without significant assistance.  The patient's wife and daughter were insistent that the patient would do better at home and wanted to set up home health nursing and were adamant that they can't care for the patient better at home than at rehab.  Patient's daughter was heavily involved in the patient's care, she was very concerned about specifically his thyroid medication and felt that missing a few doses of his thyroid medication contributed significantly to his acute decompensation in the hospital.  Given has improvement in mental status, improvement in his vitals, he was afebrile, he was tolerating a general diet, and received adequate therapy for his COVID-19 infection the patient was considered stable for discharge home with home health care with the family support.  I discussed with the daughter that the patient be brought back if caring for him at home becomes unsafe, overwhelming, or cumbersome for the patient and her family.  Patient and family were in agreement this plan discharge home in stable condition
Age: 87.0
Sex: M
Vaccine: COVID19
Symptoms: Hypoxia, Infection, Liver function test increased, Mental status changes, Pneumonitis aspiration
Clinical narrative: Hospitalized (10.14.21 - 10.21.21);  COVID-19 positive (10.14.21);  Fully Vaccinated  Admission Date: 10/14/2021 Discharge Date: Oct 21, 2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Transaminitis  Hypoxia Generalized weakness AMS (altered mental status) COVID-19 virus infection COVID-19 HOSPITAL COURSE: Patient is an 87-year-old male with past medical history of hypothyroidism, type 2 diabetes, chronic systolic heart failure status post pacemaker, history of CVA with residual left-sided weakness, wheelchair bound who presented to the hospital with COVID-19 infection.  Patient was fully vaccinated.  Patient was admitted to the hospital due to altered mental status and generalized weakness in the setting of a scope infection.  Patient was not hypoxic but for a brief moment during admission.  The patient was globally weak and had progressive difficulty ambulating at home until the 20th brought into the ER.  In the ER he was found to have elevated LFTs, general weakness.  Neurology was consulted who recommended CT of the head which was unremarkable aside from chronic changes.  Chest x-ray was done which showed no cardiopulmonary disease.  due to his LFT elevation of the liver ultrasound was performed which showed no evidence of portal vein thrombosis.  Patient was a candidate for monoclonal antibody therapy which he received and tolerated well.  For about 20 the patient had an aspiration event, became more confused, and had 1 fever.  Chest x-ray showed aspiration pneumonitis, white blood cell count was normal, procalcitonin was normal.  Patient recovered quickly, never required oxygen.  Short of breath was consulted who recommended NPO while the patient was confused, this resolved and the patient was able to advance back to a general diet prior to discharge.  patient was evaluated by Physical therapy and Occupational therapy who recommended subacute rehab given the patient's profound weakness in the setting of his recent infection.  Patient was unable to stand without significant assistance.  The patient's wife and daughter were insistent that the patient would do better at home and wanted to set up home health nursing and were adamant that they can't care for the patient better at home than at rehab.  Patient's daughter was heavily involved in the patient's care, she was very concerned about specifically his thyroid medication and felt that missing a few doses of his thyroid medication contributed significantly to his acute decompensation in the hospital.  Given has improvement in mental status, improvement in his vitals, he was afebrile, he was tolerating a general diet, and received adequate therapy for his COVID-19 infection the patient was considered stable for discharge home with home health care with the family support.  I discussed with the daughter that the patient be brought back if caring for him at home becomes unsafe, overwhelming, or cumbersome for the patient and her family.  Patient and family were in agreement this plan discharge home in stable condition
Age: 87.0
Sex: M
Vaccine: COVID19
Symptoms: Ultrasound liver normal, White blood cell count normal
Clinical narrative: Hospitalized (10.14.21 - 10.21.21);  COVID-19 positive (10.14.21);  Fully Vaccinated  Admission Date: 10/14/2021 Discharge Date: Oct 21, 2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Transaminitis  Hypoxia Generalized weakness AMS (altered mental status) COVID-19 virus infection COVID-19 HOSPITAL COURSE: Patient is an 87-year-old male with past medical history of hypothyroidism, type 2 diabetes, chronic systolic heart failure status post pacemaker, history of CVA with residual left-sided weakness, wheelchair bound who presented to the hospital with COVID-19 infection.  Patient was fully vaccinated.  Patient was admitted to the hospital due to altered mental status and generalized weakness in the setting of a scope infection.  Patient was not hypoxic but for a brief moment during admission.  The patient was globally weak and had progressive difficulty ambulating at home until the 20th brought into the ER.  In the ER he was found to have elevated LFTs, general weakness.  Neurology was consulted who recommended CT of the head which was unremarkable aside from chronic changes.  Chest x-ray was done which showed no cardiopulmonary disease.  due to his LFT elevation of the liver ultrasound was performed which showed no evidence of portal vein thrombosis.  Patient was a candidate for monoclonal antibody therapy which he received and tolerated well.  For about 20 the patient had an aspiration event, became more confused, and had 1 fever.  Chest x-ray showed aspiration pneumonitis, white blood cell count was normal, procalcitonin was normal.  Patient recovered quickly, never required oxygen.  Short of breath was consulted who recommended NPO while the patient was confused, this resolved and the patient was able to advance back to a general diet prior to discharge.  patient was evaluated by Physical therapy and Occupational therapy who recommended subacute rehab given the patient's profound weakness in the setting of his recent infection.  Patient was unable to stand without significant assistance.  The patient's wife and daughter were insistent that the patient would do better at home and wanted to set up home health nursing and were adamant that they can't care for the patient better at home than at rehab.  Patient's daughter was heavily involved in the patient's care, she was very concerned about specifically his thyroid medication and felt that missing a few doses of his thyroid medication contributed significantly to his acute decompensation in the hospital.  Given has improvement in mental status, improvement in his vitals, he was afebrile, he was tolerating a general diet, and received adequate therapy for his COVID-19 infection the patient was considered stable for discharge home with home health care with the family support.  I discussed with the daughter that the patient be brought back if caring for him at home becomes unsafe, overwhelming, or cumbersome for the patient and her family.  Patient and family were in agreement this plan discharge home in stable condition
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Dyspnoea, Headache, Illness, Nausea
Clinical narrative: Sick, nausea. headache Symptoms of covid 19 Breathing issues
Age: 78.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Upon charting the given vaccine, it was found that the vial had expired 10/15/2021.
Age: 65.0
Sex: F
Vaccine: COVID19, FLU4
Symptoms: Inappropriate schedule of product administration, No adverse event
Clinical narrative: pt received a 2nd high dose flu shot (2 weeks apart)-no adverse reaction reported at the time or next day
Age: 92.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Asthenia, COVID-19, Chest discomfort, Chills, Fall
Clinical narrative: Pt was admitted with left-sided chest discomfort and weakness and increased falling at home.  a couple days into his hospital stay he developed a sore throat, fever, and chills and was COVID positive.
Age: 92.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Oropharyngeal pain, Pyrexia, SARS-CoV-2 test positive
Clinical narrative: Pt was admitted with left-sided chest discomfort and weakness and increased falling at home.  a couple days into his hospital stay he developed a sore throat, fever, and chills and was COVID positive.
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Dehydration, Fatigue, Headache, Memory impairment
Clinical narrative: I was constantly tired, I'm still tired as of now. Extreme fatigue and major headaches. It felt like migraines and they were all on her right eye socket. I just took pain meds. I still ended up getting covid-19 and the my symptoms increase.  I got covid-19 from the 6th to the 23rd of October. I'm having a hard time remember, things. I had an emergency at hospital, but I'm unable to remember the situation. I was sent there after my visit to the urgent care. It was around May or June.  It's hard to remember.  For instance i was supposed to call someone yesterday, and I'm still unable to recall who I was suppose to call.  I was given a lot of fluids in the Urgent care, due to extreme dehydration.
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: Migraine, SARS-CoV-2 test positive
Clinical narrative: I was constantly tired, I'm still tired as of now. Extreme fatigue and major headaches. It felt like migraines and they were all on her right eye socket. I just took pain meds. I still ended up getting covid-19 and the my symptoms increase.  I got covid-19 from the 6th to the 23rd of October. I'm having a hard time remember, things. I had an emergency at hospital, but I'm unable to remember the situation. I was sent there after my visit to the urgent care. It was around May or June.  It's hard to remember.  For instance i was supposed to call someone yesterday, and I'm still unable to recall who I was suppose to call.  I was given a lot of fluids in the Urgent care, due to extreme dehydration.
Age: 66.0
Sex: M
Vaccine: FLUA4
Symptoms: Back pain, Headache, Myalgia
Clinical narrative: Pt called and claimed he received his shot on 10/19 and started getting headaches, muscle aches in his back, neck and arms on 10/22. He states hes been taking ibuprofen but the muscle aches continue to move around.
Age: 34.0
Sex: F
Vaccine: COVID19
Symptoms: Breast mass, Cyst, Lymphadenopathy, Mammogram, Ultrasound scan
Clinical narrative: Palpable Swollen lymph nodes in both armpits as well as palpable lump cyst in left breast, confirmed with mammogram and sonogram as complicated cyst
Age: 22.0
Sex: F
Vaccine: COVID19
Symptoms: Ageusia, Anosmia, Chills, Cough, Dyspnoea
Clinical narrative: cough, nasal congestion, sore throat, chills, shortness of breath with activity, body aches, loss of taste, loss of smell, chest congestion. starting on 10/21/21
Age: 22.0
Sex: F
Vaccine: COVID19
Symptoms: Nasal congestion, Oropharyngeal pain, Pain, Pulmonary congestion
Clinical narrative: cough, nasal congestion, sore throat, chills, shortness of breath with activity, body aches, loss of taste, loss of smell, chest congestion. starting on 10/21/21
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: Anosmia, COVID-19, Fatigue, Mobility decreased, SARS-CoV-2 test positive
Clinical narrative: After the second covid moderna vaccine. Could not move for 1-2 days could not even lift her head up. Per pt was very sudden and very intense.  Additionally pt tested positive for Covid 2.5 months after being  fully vaccinated . Pt had fatigue and  lost sense of smell and did at two at home covid test both tests were positive did not get reported as positive test to CDC
Age: 42.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Moderna Vaccine expired 10/20/2021 at 0600 at refrigerator temperature. Vaccine administered approximately 4.5 hours after expiration time on 10/20/2021. Moderna Manufacturing company consulted and stated: It is recommended that the vaccine be used by 30 days to the expiration date and time; however, it is ok to use by the end of the day on the 30th day. No treatment required.
Age: 56.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Immunodeficiency, Pain, Rash, Skin discolouration
Clinical narrative: I have developed an extensive rash on both of my lower legs. It?s on the calves. Stings a little, not raised, looks darker than yesterday  in areas. Started 15 days after my booster shot (10/9). First shot on 3/19 and second on 4/9
Age: 56.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Arthralgia, Chills, Headache, Immunisation, Rash
Clinical narrative: I have developed an extensive rash on both of my lower legs. It?s on the calves. Stings a little, not raised, looks darker than yesterday  in areas. Started 15 days after my booster shot (10/9). First shot on 3/19 and second on 4/9
Age: 56.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Vertigo
Clinical narrative: I have developed an extensive rash on both of my lower legs. It?s on the calves. Stings a little, not raised, looks darker than yesterday  in areas. Started 15 days after my booster shot (10/9). First shot on 3/19 and second on 4/9
Age: 53.0
Sex: M
Vaccine: COVID19
Symptoms: Back pain, Chronic inflammatory demyelinating polyradiculoneuropathy, Computerised tomogram thorax normal, Dysuria, Echocardiogram normal
Clinical narrative: He had tingling and numbness in skin, then back pain, then he had difficulty urinating, then he had persistent tachycardia, then his tingling and numbness were worse and worse then he was diagnosed with chronic inflammatory demyelinating polyneuritis.
Age: 53.0
Sex: M
Vaccine: COVID19
Symptoms: Electrocardiogram ambulatory abnormal, Electromyogram abnormal, Hypoaesthesia, Paraesthesia, Sinus tachycardia
Clinical narrative: He had tingling and numbness in skin, then back pain, then he had difficulty urinating, then he had persistent tachycardia, then his tingling and numbness were worse and worse then he was diagnosed with chronic inflammatory demyelinating polyneuritis.
Age: 85.0
Sex: M
Vaccine: COVID19
Symptoms: Brain stem haemorrhage, Computerised tomogram head abnormal, Congenital cerebrovascular anomaly, Hypertensive crisis, Mental status changes
Clinical narrative: Vaccination received on 10/21/21. On 10/24 resident developed sudden change in mental status with hypertensive crisis requiring transfer to the Emergency Department.
Age: 66.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Error: Improper storage (temperature).
Age: 21.0
Sex: F
Vaccine: COVID19
Symptoms: Paralysis, Tremor
Clinical narrative: paralysis and tremor of the right thumb
Age: 83.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Moderna Vaccine expired 10/20/2021 at 0600 at refrigerator temperature. Vaccine administered approximately 4 hours after expiration time on 10/20/2021. Moderna Manufacturing company consulted and stated: It is recommended that the vaccine be used by 30 days to the expiration date and time; however, it is ok to use by the end of the day on the 30th day. No treatment required.
Age: 36.0
Sex: F
Vaccine: COVID19
Symptoms: Swelling face
Clinical narrative: Patient has history of receiving dermal filler 10 months prior to vaccination. Approximately 10 days following receipt of Pfizer/BioNTech COVID-19 Dose 1, she reports swelling of the left side of her face and undereye in the area of her prior dermal filler injection. She took tylenol and benadryl, and the symptoms resolved after 2-3 days.
Age: 31.0
Sex: M
Vaccine: FLU4
Symptoms: No adverse event, Product storage error
Clinical narrative: Vaccine had been stored outside recommended temperature range. No adverse event experienced by patient
Age: 34.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Tested positive for COVID 10/26/21 after being fully vaccinated.
Age: 19.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Moderna Vaccine expired 10/20/2021 at 0600 at refrigerator temperature. Vaccine administered approximately 4.5 hours after expiration time on 10/20/2021. Moderna Manufacturing company consulted and stated: It is recommended that the vaccine be used by 30 days to the expiration date and time; however, it is ok to use by the end of the day on the 30th day. No treatment required.
Age: 28.0
Sex: F
Vaccine: COVID19
Symptoms: Dyspnoea, Electrocardiogram normal, Pleuritic pain, Tachycardia, Troponin increased
Clinical narrative: Patient presented with pleuritic chest pain for 2 days after her second Pfizer vaccine dose. Symptoms were accompanied by shortness of breath, tachycardia, and elevated troponin. EKG showed normal sinus tachycardia without ST segment/T waves/PR  changes. CT PE was negative. Further NSTEMI rule-out was negative. Denied fever, nausea, vomiting, headaches, palpitations.
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Polymerase chain reaction
Clinical narrative: Hospitalization due to COVID 19 Reported per Janssen COVID-19 Vaccine EUA
Age: 39.0
Sex: F
Vaccine: COVID19
Symptoms: Blood blister, Tremor
Clinical narrative: Few days after the vaccine I started feeling skin tremors in my lower leg on the left side. The tremors felt like I was sitting on my cell phone on vibrate. They seemed to be in sync with my heart beat. They lasted over a week, then went away. Later I noticed in the same location of the tremors there were some blood blisters. None of this was painful.
Age: 37.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Moderna Vaccine expired 10/20/2021 at 0600 at refrigerator temperature. Vaccine administered approximately 5 hours after expiration time on 10/20/2021. Moderna Manufacturing company consulted and stated: It is recommended that the vaccine be used by 30 days to the expiration date and time; however, it is ok to use by the end of the day on the 30th day. No treatment required.
Age: 8.0
Sex: M
Vaccine: COVID19
Symptoms: Product administered to patient of inappropriate age
Clinical narrative: wrong age group
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness, Inner ear inflammation, Nausea, Vertigo
Clinical narrative: Vertigo and Dizziness.  About 3 months after 2nd shot.   I have had Vertigo BPPV in the past and was given the Epley Maneuver ...however it did not work this time....this was a completely different Vertigo accompanied with Dizziness and Nausa. that did not respond to the normal PT exercises for BPPV. I took Dramamine....which only made me want to sleep. Then Cortisone for Inflamation of inner ear.... And then Meloxicam....for inflamation....for the inner ear I was told and to help with the Arthritic pain.   I also had Accupuncture,,,which did help but since only x amount of treatments are covered with insurance and once I stopped the vertigo/dizziness resumed.  I was told to take Allerga thinking it was fluid in an inner ear issue. Am still as of today 10/26/2021 still having issues.  Some days it is just Dizziness reaching down to pick something up ...getting out of bed too quickly....other days full fledged Vertigo. It comes and goes....be fine for a few days then back with a vengence.
Age: 90.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Death, Fatigue, Imaging procedure abnormal, Pneumonitis
Clinical narrative: Death due to extensive pneumonitis, with onset three weeks after breakthrough COVID-19 infection diagnosed on September 22, 2021; initially presenting as severe fatigue necessitating hospitalization.
Age: 90.0
Sex: M
Vaccine: COVID19
Symptoms: Vaccine breakthrough infection
Clinical narrative: Death due to extensive pneumonitis, with onset three weeks after breakthrough COVID-19 infection diagnosed on September 22, 2021; initially presenting as severe fatigue necessitating hospitalization.
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Chills, Cough, Fatigue, Headache
Clinical narrative: Patient contracted COVID after being fully vaccinated Cough, Congestion, Headache, Body Aches, Fever, Fatigue, Chills
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: Pain, Pyrexia, Respiratory tract congestion, SARS-CoV-2 test positive
Clinical narrative: Patient contracted COVID after being fully vaccinated Cough, Congestion, Headache, Body Aches, Fever, Fatigue, Chills
Age: 44.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Moderna Vaccine expired 10/20/2021 at 0600 at refrigerator temperature. Vaccine administered approximately 5.5 hours after expiration time on 10/20/2021. Moderna Manufacturing company consulted and stated: It is recommended that the vaccine be used by 30 days to the expiration date and time; however, it is ok to use by the end of the day on the 30th day. No treatment required.
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Polymerase chain reaction
Clinical narrative: Hospitalization due to COVID-19 Reported per Moderna COVID-19 Vaccine EUA
Age: 46.0
Sex: F
Vaccine: COVID19
Symptoms: Interchange of vaccine products
Clinical narrative: Error: Wrong Vaccine Formulation  (ex. different manufact. initial and booster).
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Dizziness, Heart rate increased, Hypertension, Hypotension
Clinical narrative: I got the full dose of the Moderna Covid-19 vaccine Fever Chills Dizziness-took my blood pressure and it was really low I was staying hydrated through the process My heart rate was normal My blood pressure went really high the next day-09/8/2021 And my blood pressure drop low and my heart rate was high at 90 The fever broke after a few hours
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect dose administered, Pyrexia
Clinical narrative: I got the full dose of the Moderna Covid-19 vaccine Fever Chills Dizziness-took my blood pressure and it was really low I was staying hydrated through the process My heart rate was normal My blood pressure went really high the next day-09/8/2021 And my blood pressure drop low and my heart rate was high at 90 The fever broke after a few hours
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Erythema, Pain, Peripheral swelling
Clinical narrative: I woke up in the morning and the ankle area of my foot was red, swollen and painful to walk on. I?ve never had a problem there before. Two days after the occurrence, the pain is beginning to subside, after doing some home remedies.
Age: 28.0
Sex: M
Vaccine: COVID19
Symptoms: Interchange of vaccine products
Clinical narrative: Error: Wrong Vaccine Formulation  (ex. different manufact. initial and booster)-
Age: 17.0
Sex: M
Vaccine: FLU4, HPV9, MNQ
Symptoms: Dizziness, Fall, Head injury, Loss of consciousness
Clinical narrative: approx. two minutes after vaccines were administered, patient was sitting in the chair in the exam room waiting to be discharged, when he became dizzy, fell off the chair to the floor, hitting his head. patient was unconscious for a brief moment. the hospital rapid response team was called. Patient was evaluated on the floor and then transferred to the emergency department for evaluation.
Age: 58.0
Sex: F
Vaccine: COVID19
Symptoms: Immunodeficiency, Lymphadenopathy
Clinical narrative: lymphadenopathy after booster dose
Age: 64.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Anticoagulant therapy, Bile duct stone, Blood creatinine increased, Blood folate normal, Blood glucose decreased
Clinical narrative: Hospitalized 10.15.21 - 10.22.21;  COVID-19 positive (10.15.21);  fully vaccinated    Admission Date: 10/15/2021 Discharge Date: 10/22/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Hypoglycemia [E16.2] Type 2 diabetes mellitus with hypoglycemia without coma, without long-term current use of insulin (HCC) [E11.649] COVID-19 virus infection [U07.1] HOSPITAL COURSE: Patient is a 64 y.o. female  who presents to hospital with low blood sugar.  Patient developed necrotizing fasciitis in July of this year requiring extensive surgery.  She then developed a DVT, cholecystitis and choledocholithiasis requiring cholecystectomy in August.  Since then she reports episodes of recurrent hypoglycemia.  She is a poor historian but states that she passed out last night and was brought in by EMS after her sugar was found to be 34.  Last took her diabetes meds on 10/13.  She received multiple boluses of dextrose and a dextrose infusion but continued to have hypoglycemia.  Workup also showed her to be COVID positive.  A chest xray did not reveal any infiltrates and she was at her baseline oxygen.  Because of her chronic oxygen therapy she is not a candidate for monoclonal antibody therapy.  Due to her persistent hypoglycemia she was referred to the hospital for further evaluation and care. 10/22 and Hospital Course:  Patient was treated with dexamethasone.  She slowly improved with pulmonary toilet, pronation as able, incentive spirometry.  For the last day of her hospitalization she was weaned down to 3-4 L per nasal cannula.  She was ambulating with assistance and was really hoping to go home, stating she has her daughter and family members to help her.  Patient did receive a dose of IV Lasix and has a net -8.2 L fluid balance.  She was tolerating a good diet, her vital signs have been stable.  Renal function has remained stable as well, creatinine 1.12 on day of discharge.  Patient completed 5 days of remdesivir.  She was felt to not need further Decadron on day of discharge.  It is felt that the risk of ongoing she will continue Decadron to complete 10 days, she still has episodes of desaturation with ambulation..  She will continue on home oxygen.  She will follow up closely with her primary care provider.  Patient was also no to have anemia, normocytic.  Peripheral smear did show some rouleaux present.  Ferritin, B12, folate and reticulocyte count normal.  She showed no evidence of bleeding.  She will need this followed up as an outpatient.  Possibly Hematology referral as well as Gastroenterology evaluation.  Patient is stable for discharge. Patient will continue Eliquis for her history of DVT. Addendum: We did get patient up in she desatted on 3 L, we will hold on discharge until she is assessed by respiratory therapy, oxygen is titrated appropriately and she does not have any further such desaturations.