chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 76.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Cytology, Explorative laparotomy, General physical health deterioration, Iatrogenic injury, Imaging procedure abnormal
Clinical narrative: Provider summary "77-year-old male with a past medical history significant for prostate cancer status post radiation treatments in 2019 who was found after recent workup for weakness and chills, to have a sigmoid stricture.  This progressed to a partial large bowel obstruction.  Biopsies of the sigmoid colon were negative for neoplasm, but preoperative imaging did demonstrate significant retroperitoneal lymphadenopathy; PSA normal.  The patient underwent an exploratory laparotomy and Hartmann procedure for progressive bowel distension on 6/2/22; at the time of the operation, 1 L of ascites was removed and was sent for cytology.   Postoperatively, patient had ongoing sepsis and peritonitis  Repeat imaging raised suspicion for retained foreign body.  Underwent reopening of laparotomy and removal of a retained foreign body on 6/5/22.     Due to worsening tachycardia and clinical deterioration yesterday, and concern for possible perforated viscous, patient was taken back to the OR for reopening of his laparotomy.  No evidence of perforated viscous or intra-abdominal sepsis was identified.  Ascites was sent for cytology and liver biopsies x2 were performed, due to a cirrhotic-appearing liver.   On 6/8, the patient again showed evidence of clinical deterioration. Repeat COVID test was positive.  Patient started on Remdesivir (therapy completed on 6/13) and dexamethasone (to continue through 6/18).  Fluconazole added d/t peritoneal cultures (d/c'd 6/14 per ID's recommendations). The patient continued to improve clinically and diet was advanced appropriately. He will be discharged to a skilled nursing facility in stable condition. Patient discharged with prescription for beta blocker per Hospitalist recommendation given inpatient tachycardia."
Age: 76.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Intestinal dilatation, Intestinal obstruction, Large intestinal obstruction, Large intestinal stenosis, Liver disorder
Clinical narrative: Provider summary "77-year-old male with a past medical history significant for prostate cancer status post radiation treatments in 2019 who was found after recent workup for weakness and chills, to have a sigmoid stricture.  This progressed to a partial large bowel obstruction.  Biopsies of the sigmoid colon were negative for neoplasm, but preoperative imaging did demonstrate significant retroperitoneal lymphadenopathy; PSA normal.  The patient underwent an exploratory laparotomy and Hartmann procedure for progressive bowel distension on 6/2/22; at the time of the operation, 1 L of ascites was removed and was sent for cytology.   Postoperatively, patient had ongoing sepsis and peritonitis  Repeat imaging raised suspicion for retained foreign body.  Underwent reopening of laparotomy and removal of a retained foreign body on 6/5/22.     Due to worsening tachycardia and clinical deterioration yesterday, and concern for possible perforated viscous, patient was taken back to the OR for reopening of his laparotomy.  No evidence of perforated viscous or intra-abdominal sepsis was identified.  Ascites was sent for cytology and liver biopsies x2 were performed, due to a cirrhotic-appearing liver.   On 6/8, the patient again showed evidence of clinical deterioration. Repeat COVID test was positive.  Patient started on Remdesivir (therapy completed on 6/13) and dexamethasone (to continue through 6/18).  Fluconazole added d/t peritoneal cultures (d/c'd 6/14 per ID's recommendations). The patient continued to improve clinically and diet was advanced appropriately. He will be discharged to a skilled nursing facility in stable condition. Patient discharged with prescription for beta blocker per Hospitalist recommendation given inpatient tachycardia."
Age: 76.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Malnutrition, Peritonitis, Post procedural sepsis, Proctitis, Prostatic specific antigen normal
Clinical narrative: Provider summary "77-year-old male with a past medical history significant for prostate cancer status post radiation treatments in 2019 who was found after recent workup for weakness and chills, to have a sigmoid stricture.  This progressed to a partial large bowel obstruction.  Biopsies of the sigmoid colon were negative for neoplasm, but preoperative imaging did demonstrate significant retroperitoneal lymphadenopathy; PSA normal.  The patient underwent an exploratory laparotomy and Hartmann procedure for progressive bowel distension on 6/2/22; at the time of the operation, 1 L of ascites was removed and was sent for cytology.   Postoperatively, patient had ongoing sepsis and peritonitis  Repeat imaging raised suspicion for retained foreign body.  Underwent reopening of laparotomy and removal of a retained foreign body on 6/5/22.     Due to worsening tachycardia and clinical deterioration yesterday, and concern for possible perforated viscous, patient was taken back to the OR for reopening of his laparotomy.  No evidence of perforated viscous or intra-abdominal sepsis was identified.  Ascites was sent for cytology and liver biopsies x2 were performed, due to a cirrhotic-appearing liver.   On 6/8, the patient again showed evidence of clinical deterioration. Repeat COVID test was positive.  Patient started on Remdesivir (therapy completed on 6/13) and dexamethasone (to continue through 6/18).  Fluconazole added d/t peritoneal cultures (d/c'd 6/14 per ID's recommendations). The patient continued to improve clinically and diet was advanced appropriately. He will be discharged to a skilled nursing facility in stable condition. Patient discharged with prescription for beta blocker per Hospitalist recommendation given inpatient tachycardia."
Age: 76.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Removal of foreign body, Retroperitoneal lymphadenopathy, SARS-CoV-2 test positive, Tachycardia, Thrombocytopenia
Clinical narrative: Provider summary "77-year-old male with a past medical history significant for prostate cancer status post radiation treatments in 2019 who was found after recent workup for weakness and chills, to have a sigmoid stricture.  This progressed to a partial large bowel obstruction.  Biopsies of the sigmoid colon were negative for neoplasm, but preoperative imaging did demonstrate significant retroperitoneal lymphadenopathy; PSA normal.  The patient underwent an exploratory laparotomy and Hartmann procedure for progressive bowel distension on 6/2/22; at the time of the operation, 1 L of ascites was removed and was sent for cytology.   Postoperatively, patient had ongoing sepsis and peritonitis  Repeat imaging raised suspicion for retained foreign body.  Underwent reopening of laparotomy and removal of a retained foreign body on 6/5/22.     Due to worsening tachycardia and clinical deterioration yesterday, and concern for possible perforated viscous, patient was taken back to the OR for reopening of his laparotomy.  No evidence of perforated viscous or intra-abdominal sepsis was identified.  Ascites was sent for cytology and liver biopsies x2 were performed, due to a cirrhotic-appearing liver.   On 6/8, the patient again showed evidence of clinical deterioration. Repeat COVID test was positive.  Patient started on Remdesivir (therapy completed on 6/13) and dexamethasone (to continue through 6/18).  Fluconazole added d/t peritoneal cultures (d/c'd 6/14 per ID's recommendations). The patient continued to improve clinically and diet was advanced appropriately. He will be discharged to a skilled nursing facility in stable condition. Patient discharged with prescription for beta blocker per Hospitalist recommendation given inpatient tachycardia."
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Stored in freezer > 2 weeks
Age: 61.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Stored in freezer > 2 weeks
Age: 90.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Vaccinated pt admitted with covid infection
Age: 61.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Stored in freezer >2 weeks
Age: 81.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Stored in freezer > 2 weeks
Age: 101.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Fall, Hip fracture, Open reduction of fracture, SARS-CoV-2 test positive
Clinical narrative: Pt to ED 6/14 via EMS for fall. 6/15 pt underwent OPEN REDUCTION INTERNAL FIXATION OF RIGHT HIP FRACTURE, pt to recovery / no distress. 6/16 Pt is A/Ox1, VSS on 3L NC, pt is calm and cooperative. 6/17 Pt is A/Ox1/2, VSS on 3L NC. 6/18 Patient is A/O x1/2, VSS on 3L NC. 6/20 pt resting on bed comfortably; A&O x 1. 6/21 pt is COVID+, pt discharged.
Age: 75.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Anticoagulant therapy, Antiplatelet therapy, Asthenia, Asymptomatic COVID-19, Computerised tomogram abdomen abnormal
Clinical narrative: Provider summary: "75-year-old male history chronic obstructive pulmonary disease, tobacco use, CAD, PVD, HTN, HLD, hypothyroidism, and trigeminal neuralgia who presented to the ER on 06/17 for short of breath and weakness.  Of note, recent hospitalization 6/9/22-6/13/22 for urologic procedure to remove left duplicate ureter as this was causing frequent infections.  Procedure was aborted due to difficulty in dissection.  He was discharged in stable condition but upon returning to the ER this time his HGB was 7.2 and given symptoms he was provided 1 unit PRBC.  He did not show any evidence of reduced UOP or gross hematuria and takes ASA/clopidogrel for fem-pop bypass on 03/2022.  CT abdomen/pelvis showed left renal hematoma.  He was hemodynamically stable and antiplatelets were continued given their indication and Urology recommended observation.  His hemoglobin began to trend up the next day and repeat CT scan showed stability hematoma.  Patient was okay for discharge and will follow-up with urology as there are plans for tertiary center evaluation for his GU issues.  No complications during stay.   COVID-19 -positive 6/10/22, vaccinated, asymptomatic, 10 day quarantine from positive test, normoxic, not antiviral candidate"
Age: 75.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Dyspnoea, Genitourinary operation, Haemoglobin decreased, Hyperlipidaemia, Peripheral artery bypass
Clinical narrative: Provider summary: "75-year-old male history chronic obstructive pulmonary disease, tobacco use, CAD, PVD, HTN, HLD, hypothyroidism, and trigeminal neuralgia who presented to the ER on 06/17 for short of breath and weakness.  Of note, recent hospitalization 6/9/22-6/13/22 for urologic procedure to remove left duplicate ureter as this was causing frequent infections.  Procedure was aborted due to difficulty in dissection.  He was discharged in stable condition but upon returning to the ER this time his HGB was 7.2 and given symptoms he was provided 1 unit PRBC.  He did not show any evidence of reduced UOP or gross hematuria and takes ASA/clopidogrel for fem-pop bypass on 03/2022.  CT abdomen/pelvis showed left renal hematoma.  He was hemodynamically stable and antiplatelets were continued given their indication and Urology recommended observation.  His hemoglobin began to trend up the next day and repeat CT scan showed stability hematoma.  Patient was okay for discharge and will follow-up with urology as there are plans for tertiary center evaluation for his GU issues.  No complications during stay.   COVID-19 -positive 6/10/22, vaccinated, asymptomatic, 10 day quarantine from positive test, normoxic, not antiviral candidate"
Age: 75.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Procedure aborted, Quarantine, Red blood cell transfusion, Renal haematoma
Clinical narrative: Provider summary: "75-year-old male history chronic obstructive pulmonary disease, tobacco use, CAD, PVD, HTN, HLD, hypothyroidism, and trigeminal neuralgia who presented to the ER on 06/17 for short of breath and weakness.  Of note, recent hospitalization 6/9/22-6/13/22 for urologic procedure to remove left duplicate ureter as this was causing frequent infections.  Procedure was aborted due to difficulty in dissection.  He was discharged in stable condition but upon returning to the ER this time his HGB was 7.2 and given symptoms he was provided 1 unit PRBC.  He did not show any evidence of reduced UOP or gross hematuria and takes ASA/clopidogrel for fem-pop bypass on 03/2022.  CT abdomen/pelvis showed left renal hematoma.  He was hemodynamically stable and antiplatelets were continued given their indication and Urology recommended observation.  His hemoglobin began to trend up the next day and repeat CT scan showed stability hematoma.  Patient was okay for discharge and will follow-up with urology as there are plans for tertiary center evaluation for his GU issues.  No complications during stay.   COVID-19 -positive 6/10/22, vaccinated, asymptomatic, 10 day quarantine from positive test, normoxic, not antiviral candidate"
Age: 16.0
Sex: M
Vaccine: DTAPIPV
Symptoms: No adverse event, Product administered to patient of inappropriate age
Clinical narrative: DTaP/IPV given to 16 year old patient for tetanus series to get caught up on vaccines for school. These vaccines are still valid per CDC (will not need re-vaccination to get caught up and can continue on current catch up schedule). Tolerated the vaccine well. No signs/symptoms reported to us following this vaccination.
Age: 65.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Stored in freezer > 2 weeks.
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Stored in freezer >2 weeks
Age: 70.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Stored in freezer > 2 weeks
Age: 45.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Stored in freezer > 2 weeks.
Age: 18.0
Sex: M
Vaccine: MNQ
Symptoms: Dysarthria, Hyperhidrosis, Hypotonia, Urticaria
Clinical narrative: Roughly 5 minutes post vaccine administration, patient became sweaty, lost some muscle tone, slurring speech, and hives on his neck. Patient was laid down on the floor, feet elevated, and ice packs placed. No loss of airway or trouble breathing, no swelling in tongue/lips/throat
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Administration Error - vaccine given beyond use date
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Cough, Headache, Laboratory test abnormal, Laryngitis
Clinical narrative: I had cold symptoms, cough sneezing laryngitis and headache. I waited five days to test and was positive. i was treating a lot of the joint pain with Ibprophen.  I was positive for 11 days.  I still have cold like symptoms.
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Nasopharyngitis, Sneezing
Clinical narrative: I had cold symptoms, cough sneezing laryngitis and headache. I waited five days to test and was positive. i was treating a lot of the joint pain with Ibprophen.  I was positive for 11 days.  I still have cold like symptoms.
Age: 84.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site nodule, Mobility decreased, Pain in extremity, Peripheral swelling
Clinical narrative: arm swelling and large nodule at injection site. Swelling still present 2+ months after injection when patient presented in June 2022. She could not lift her arm above her head by early June. I had her take ibuprofen q8H for 4-5 days and swelling did reduce but nodule is still present as well as arm pain.
Age: 16.0
Sex: F
Vaccine: MNQ
Symptoms: Fall, Immediate post-injection reaction, Loss of consciousness, Seizure like phenomena
Clinical narrative: 06/22/22 1425 administered Menactra to LD while patient was seated. Patient stated, "That wasn't bad." Patient immediately lost consciousness and fell to left side towards mother while this nurse was washing hands. This nurse ran to patient. Patient had 10 second seizure like activity before returning to baseline. Oriented to person, place, and time. Denied vision changes, vertigo, and pain. BP 98/68 with pulse 60. Monitored patient for 10 minutes. Mother refused EMS, but agreed to take patient to ED. Assisted patient to wheelchair and then to car.
Age: 80.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Anticoagulant therapy, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Chronic kidney disease
Clinical narrative: Provider Summary "Patient was treated for sepsis due to COVID 19 pneumonia in setting of hypoxia with Decadron.  With elevated D-dimer of > 7,000 and intermediate probability patient was treated empirically for PE.  With advanced stage IV CKD CT Angio was not obtained.  Patient was transitioned from IV Heparin to Eliquis with plan to complete 3 months of anticoagulation.  Patient was continued on antibiotics with initial leukocytosis and possible RUL infiltrate on CXR.  He was discharged on Doxycycline and Cefdinir to complete 5 days of therapy.  By time of discharge patient had been weaned off supplemental oxygen and was feeling much better. "
Age: 80.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Fibrin D dimer increased, Hypoxia, Leukocytosis, SARS-CoV-2 test positive, Sepsis
Clinical narrative: Provider Summary "Patient was treated for sepsis due to COVID 19 pneumonia in setting of hypoxia with Decadron.  With elevated D-dimer of > 7,000 and intermediate probability patient was treated empirically for PE.  With advanced stage IV CKD CT Angio was not obtained.  Patient was transitioned from IV Heparin to Eliquis with plan to complete 3 months of anticoagulation.  Patient was continued on antibiotics with initial leukocytosis and possible RUL infiltrate on CXR.  He was discharged on Doxycycline and Cefdinir to complete 5 days of therapy.  By time of discharge patient had been weaned off supplemental oxygen and was feeling much better. "
Age: 64.0
Sex: M
Vaccine: COVID19
Symptoms: Product administration error, Product use issue
Clinical narrative: Administration Error - vaccine administered beyond use date.
Age: 35.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Administration Error- vaccine administered beyond use date
Age: 8.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Abdominal distension, Anticoagulant therapy, Cardiac arrest, Carditis, Dermatitis
Clinical narrative: She developed inflamed lymph nodes (lymphadenitis), all over the body rash, ongoing fever for more than 3 weeks. She was diagnosed with MIS-C, her heart, intestines, lungs, skin and liver were inflamed. She was hospitalized and treated with immunoglobulin, steroids, anticoagulant, fever reducing medications, etc. By the second treatment, her belly started getting distended, her lungs were filled with liquids. She was transferred to ICU and her heart stopped beating right there.
Age: 8.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Gastrointestinal inflammation, Hepatitis, Immunoglobulin therapy, Intensive care, Lymphadenitis
Clinical narrative: She developed inflamed lymph nodes (lymphadenitis), all over the body rash, ongoing fever for more than 3 weeks. She was diagnosed with MIS-C, her heart, intestines, lungs, skin and liver were inflamed. She was hospitalized and treated with immunoglobulin, steroids, anticoagulant, fever reducing medications, etc. By the second treatment, her belly started getting distended, her lungs were filled with liquids. She was transferred to ICU and her heart stopped beating right there.
Age: 8.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Multisystem inflammatory syndrome in children, Pneumonitis, Pulmonary oedema, Pyrexia, Rash
Clinical narrative: She developed inflamed lymph nodes (lymphadenitis), all over the body rash, ongoing fever for more than 3 weeks. She was diagnosed with MIS-C, her heart, intestines, lungs, skin and liver were inflamed. She was hospitalized and treated with immunoglobulin, steroids, anticoagulant, fever reducing medications, etc. By the second treatment, her belly started getting distended, her lungs were filled with liquids. She was transferred to ICU and her heart stopped beating right there.
Age: 22.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered, Product administration error
Clinical narrative: Administration Error - vaccine administered beyond use date
Age: 57.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: COVID-19, Extra dose administered, Vaccine breakthrough infection
Clinical narrative: Fully vaccinated and boosted times 2.   COVID infection breakthrough
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Biopsy skin abnormal, Purpura
Clinical narrative: Smaller flare up of original diagnosis purpura anularis telangiectodes (purple spots). Treatment is to continue supplements prescribed/recommend before: Vitamin C and Rutin.
Age: 29.0
Sex: F
Vaccine: COVID19
Symptoms: Cardiac monitoring, Computerised tomogram thorax, Dizziness, Electrocardiogram, Heart rate increased
Clinical narrative: I had racing heart beat. My heart rate from 12:00 PM until I went to the emergency room and was discharged around 9:30 PM stayed between 135 and 192. I was dizzy, as well.
Age: 12.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Administration Error - vaccine administered beyond use date
Age: 76.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Eyelid function disorder, Fatigue, Sleep disorder
Clinical narrative: She got her vaccine, she had no reaction to anything, and then later that evening she went to bed, then she realized about 2 1/2 hours later she had not fallen to sleep.  She drank some sleepy time tea, some herbal remedies to try to relax her to sleep and nothing helped.  She has not been able to nap, her eyes do not want to stay open, she's tired and exhausted and if she goes to sleep she sleeps for a few hours, and the other night she did sleep for 5 hours, but otherwise sparse sleeping.  She went to UC today who had not heard of the symptoms being related to the vaccine, but she did read about it online, and she was given a prescription for sleeping pills.  She wants to know if this is going to be something she has forever or is it going to go away.
Age: 76.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Anxiety, Insomnia, Stress
Clinical narrative: She got her vaccine, she had no reaction to anything, and then later that evening she went to bed, then she realized about 2 1/2 hours later she had not fallen to sleep.  She drank some sleepy time tea, some herbal remedies to try to relax her to sleep and nothing helped.  She has not been able to nap, her eyes do not want to stay open, she's tired and exhausted and if she goes to sleep she sleeps for a few hours, and the other night she did sleep for 5 hours, but otherwise sparse sleeping.  She went to UC today who had not heard of the symptoms being related to the vaccine, but she did read about it online, and she was given a prescription for sleeping pills.  She wants to know if this is going to be something she has forever or is it going to go away.
Age: 17.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Administration Error - vaccine administered beyond use date.
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Oropharyngeal pain, Pyrexia, SARS-CoV-2 test positive
Clinical narrative: I had an extremely sore throat, worse than when I had strep throat years ago. It started Sunday and progressed to Monday evening when my son brought me an at-home COVID-19 test. At that time, I was running a fever 103.6F. The test came back positive unfortunately. The fever continued for about 2-3 days, so I contacted my pulmonologist. He prescribed me Paxlovid for my contraction of COVID-19; I started taking it day 3 of my symptoms, and 3 days later of taking the prescription, I started feeling way better. My temperature went back to normal body temperature and the sore throat had disappeared.
Age: 91.0
Sex: F
Vaccine: COVID19
Symptoms: Inappropriate schedule of product administration, Incorrect dose administered, Product administration error
Clinical narrative: THIS WAS AN ADMINISTRATION ERROR. THE PATIENT DID NOT HAVE ANY AE DURING THE TIME WE MONITORED HER. PATIENT PRESENTED TO THE MOBILE VACCINE CLINIC ON 6/15. SHE STATED SHE HAD NEVER RECEIVED A COVID VACCINATION AND THIS WOULD BE HER FIRST DOSE. SHE SELECTED MODERNA. 0.5 ML OF THE MODERNA VACCINE WAS ADMINISTERED. UPON ENTERING THE DOSE INTO ICARE, IT WAS DISCOVERED THAT THIS WAS ACTUALLY THE PATIENT'S 3RD DOSE. AS SUCH, THE BOOSTER DOSE OF 0.25 MG SHOULD HAVE BEEN ADMINISTERED. THERE WAS >=4 MONTHS SINCE HER SECOND DOSE. OF NOTE, SHE RECEIVED 2 DOSES OF PFIZER FOR HER PRIMARY SERIES, ACCORDING TO ICARE, WHICH WERE SPACED APPROPRIATELY.  PATIENT AGAIN PRESENTED TO THE MOBILE VACCINE CLINIC ON 6/22. SHE AGAIN STATED SHE HAD NEVER RECEIVED A COVID VACCINATION AND THIS WOULD BE HER FIRST DOSE. SHE AGAIN SELECTED MODERNA. 0.5 ML OF THE MODERNA VACCINE WAS ADMINISTERED. UPON ENTERING THE DOSE INTO I-CARE, IT WAS NOTICED THIS WAS ACTUALLY THE 4TH VACCINE DOSE, THUS 0.25 MG SHOULD HAVE BEEN ADMINISTERED. ADDITIONALLY, ONLY 1 WEEK HAD PASSED BETWEEN THE 2 DOSES. PATIENT DENIED ANY ADVERSE EVENTS FOLLOWING VACCINATION ON 6/15 AND 6/22.
Age: 83.0
Sex: M
Vaccine: VARZOS
Symptoms: Extra dose administered, No adverse event
Clinical narrative: A third dose of the Shingrix was administered to this patient. Patient and wife came into the pharmacy to receive the 2nd dose of Shingrix per provider instructions. However, patient had already received his 2nd dose and a 3rd dose was administered.   Patient did not have an adverse response to the vaccination and is tolerating well thus far.
Age: 60.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Asthenia, COVID-19, Cough, Diabetic ketoacidosis, Dyspnoea
Clinical narrative: Provider summary: "Patient is a 61 YO male with a PMHx of T2 DM on insulin, diabetic neuropathy, HTN, HLD, microcytic anemia, GERD, PUD, CAD s/p CABG, depression, anxiety, and OSA who presented with hyperglycemia. Pt reports that for the past 2-3 weeks, he has been having progressively worsening weakness. It started around his groin areas and moved to his entire body. He now struggles to get his daily activities done due to weakness and reports multiple falls during this time period. He has numbness on his lower extremities at baseline. He denies recent illness. Pt states that he has been feeling nauseated for the past 2-3 weeks and did vomit about a week ago. He does admit that he does not use insulin regularly because he feels like it is not helping much (though he states that he knows that it is not true). He believes he has been using insulin every other day for the last 3 weeks. He denies sick contacts and is unsure where he may have gotten COVID-19. He does report getting dry coughs and SOB for the past 1 week. He also endorses having black stools, which started about 2 weeks ago.     DKA resolved following IVF resuscitation and K+/Mg+ replacement in the ED. Diet restarted and blood glucose controlled with 50 units of glargine and lispo sliding scale insuline. Held over night due to concerns for recent falls. Neurological status remained at baseline throughout stay. It is recommended that he follow-up with neurology for lumbar spine findings on MRI dated 5/9/2022. Patient seen by gastroenterology who recommend outpatient elective endoscopy once COVID-19 has resolved. PT recommends outpatient physical therapy in the home while OT thinks that inpatient post-acute occupational therapy would be beneficial."
Age: 60.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Faeces discoloured, Fall, Hyperglycaemia, Hypoaesthesia, Loss of personal independence in daily activities
Clinical narrative: Provider summary: "Patient is a 61 YO male with a PMHx of T2 DM on insulin, diabetic neuropathy, HTN, HLD, microcytic anemia, GERD, PUD, CAD s/p CABG, depression, anxiety, and OSA who presented with hyperglycemia. Pt reports that for the past 2-3 weeks, he has been having progressively worsening weakness. It started around his groin areas and moved to his entire body. He now struggles to get his daily activities done due to weakness and reports multiple falls during this time period. He has numbness on his lower extremities at baseline. He denies recent illness. Pt states that he has been feeling nauseated for the past 2-3 weeks and did vomit about a week ago. He does admit that he does not use insulin regularly because he feels like it is not helping much (though he states that he knows that it is not true). He believes he has been using insulin every other day for the last 3 weeks. He denies sick contacts and is unsure where he may have gotten COVID-19. He does report getting dry coughs and SOB for the past 1 week. He also endorses having black stools, which started about 2 weeks ago.     DKA resolved following IVF resuscitation and K+/Mg+ replacement in the ED. Diet restarted and blood glucose controlled with 50 units of glargine and lispo sliding scale insuline. Held over night due to concerns for recent falls. Neurological status remained at baseline throughout stay. It is recommended that he follow-up with neurology for lumbar spine findings on MRI dated 5/9/2022. Patient seen by gastroenterology who recommend outpatient elective endoscopy once COVID-19 has resolved. PT recommends outpatient physical therapy in the home while OT thinks that inpatient post-acute occupational therapy would be beneficial."
Age: 60.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Magnetic resonance imaging spinal abnormal, Nausea, SARS-CoV-2 test positive, Vomiting
Clinical narrative: Provider summary: "Patient is a 61 YO male with a PMHx of T2 DM on insulin, diabetic neuropathy, HTN, HLD, microcytic anemia, GERD, PUD, CAD s/p CABG, depression, anxiety, and OSA who presented with hyperglycemia. Pt reports that for the past 2-3 weeks, he has been having progressively worsening weakness. It started around his groin areas and moved to his entire body. He now struggles to get his daily activities done due to weakness and reports multiple falls during this time period. He has numbness on his lower extremities at baseline. He denies recent illness. Pt states that he has been feeling nauseated for the past 2-3 weeks and did vomit about a week ago. He does admit that he does not use insulin regularly because he feels like it is not helping much (though he states that he knows that it is not true). He believes he has been using insulin every other day for the last 3 weeks. He denies sick contacts and is unsure where he may have gotten COVID-19. He does report getting dry coughs and SOB for the past 1 week. He also endorses having black stools, which started about 2 weeks ago.     DKA resolved following IVF resuscitation and K+/Mg+ replacement in the ED. Diet restarted and blood glucose controlled with 50 units of glargine and lispo sliding scale insuline. Held over night due to concerns for recent falls. Neurological status remained at baseline throughout stay. It is recommended that he follow-up with neurology for lumbar spine findings on MRI dated 5/9/2022. Patient seen by gastroenterology who recommend outpatient elective endoscopy once COVID-19 has resolved. PT recommends outpatient physical therapy in the home while OT thinks that inpatient post-acute occupational therapy would be beneficial."
Age: 23.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site erythema, Vaccination site induration, Vaccination site warmth
Clinical narrative: Large, red splotch at vaccine site that is warm to the touch and firm
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Ocular neoplasm, Pupil dilation procedure, Vitreous disorder
Clinical narrative: On June 9, I felt like the retina was detaching from the eye, no pain, it felt like the sensation of pulling a muscle, it was a growth inside the eye, I went to the doctor, and they confirmed that it was a Vitreous; but there is no treatment, I will go on July to check my eye again.
Age: 63.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Interchange of vaccine products
Clinical narrative: Vaccinated with one booster
Age: 98.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, Blood sodium decreased, Decreased appetite, Discomfort, Dizziness
Clinical narrative: Dizziness, loss of appetite, generalized discomfort, and weakness started 1 week (on 5/30/22) after COVID-19 booster #2 (4th dose) on 5/23/22. Dizziness got worse prior to emergency room visit on 6/19/22, treated with normal saline IV 2 liters, magnesium sulfate 2 grams IV, and Tylenol 650 mg. Patient?s daughter had telephone appointment for ER follow-up on 6/22/22 with me and had requested that I report this adverse event, since patient also had prolonged dizziness after COVID-19 vaccine dose #2 on 4/4/2021 that started 6 days after COVID-19 vaccine and required hospitalization on 4/18/4/19/2021. Dizziness had resolved temporarily in June 2021,  but then dizziness returned on July 2021 to December 2021. Patient did vestibular rehab via physical therapy and massage therapy of neck/upper back, which led to resolution of dizziness and patient doing well between December 2021 to May 2022. Patient also had dizziness for 2 days after COVID-19 vaccine dose #1 on 3/14.  Patient did NOT have symptoms after COVID-19 booster #1 (dose 3) on 12/20/2021. Patient had Pfizer-BioNTech for all 4 doses of COVID-19 vaccines.
Age: 98.0
Sex: M
Vaccine: COVID19
Symptoms: Electrocardiogram normal, Extra dose administered, Full blood count, Lipase normal, Metabolic function test
Clinical narrative: Dizziness, loss of appetite, generalized discomfort, and weakness started 1 week (on 5/30/22) after COVID-19 booster #2 (4th dose) on 5/23/22. Dizziness got worse prior to emergency room visit on 6/19/22, treated with normal saline IV 2 liters, magnesium sulfate 2 grams IV, and Tylenol 650 mg. Patient?s daughter had telephone appointment for ER follow-up on 6/22/22 with me and had requested that I report this adverse event, since patient also had prolonged dizziness after COVID-19 vaccine dose #2 on 4/4/2021 that started 6 days after COVID-19 vaccine and required hospitalization on 4/18/4/19/2021. Dizziness had resolved temporarily in June 2021,  but then dizziness returned on July 2021 to December 2021. Patient did vestibular rehab via physical therapy and massage therapy of neck/upper back, which led to resolution of dizziness and patient doing well between December 2021 to May 2022. Patient also had dizziness for 2 days after COVID-19 vaccine dose #1 on 3/14.  Patient did NOT have symptoms after COVID-19 booster #1 (dose 3) on 12/20/2021. Patient had Pfizer-BioNTech for all 4 doses of COVID-19 vaccines.
Age: 98.0
Sex: M
Vaccine: COVID19
Symptoms: Platelet count decreased, SARS-CoV-2 test negative, Serum ferritin normal, Troponin, Urine analysis normal
Clinical narrative: Dizziness, loss of appetite, generalized discomfort, and weakness started 1 week (on 5/30/22) after COVID-19 booster #2 (4th dose) on 5/23/22. Dizziness got worse prior to emergency room visit on 6/19/22, treated with normal saline IV 2 liters, magnesium sulfate 2 grams IV, and Tylenol 650 mg. Patient?s daughter had telephone appointment for ER follow-up on 6/22/22 with me and had requested that I report this adverse event, since patient also had prolonged dizziness after COVID-19 vaccine dose #2 on 4/4/2021 that started 6 days after COVID-19 vaccine and required hospitalization on 4/18/4/19/2021. Dizziness had resolved temporarily in June 2021,  but then dizziness returned on July 2021 to December 2021. Patient did vestibular rehab via physical therapy and massage therapy of neck/upper back, which led to resolution of dizziness and patient doing well between December 2021 to May 2022. Patient also had dizziness for 2 days after COVID-19 vaccine dose #1 on 3/14.  Patient did NOT have symptoms after COVID-19 booster #1 (dose 3) on 12/20/2021. Patient had Pfizer-BioNTech for all 4 doses of COVID-19 vaccines.
Age: 63.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Acute kidney injury, Acute respiratory failure, Alkalosis hypochloraemic, Asthenia, Blood creatinine normal
Clinical narrative: Provider summary "This is a 64-year-old morbidly obese male a history of diabetes mellitus type 2. Patient awoke this morning around 7:00 a.m. disoriented and confused.  His roommate called EMS who arrived to find patient was hypoglycemic.  Patient was encouraged to eat and blood sugar improved.  Patient refused transport to the ER at that time.  Patient is significantly came over later that morning found his blood sugar to be 380. Patient gave himself 20 units of NovoLog.  Significant other checked on him later in the evening and noticed that he was quite lethargic and sleepy.  She encouraged him to go to the emergency department but he again resisted.  Later the patient called significant other back stating he was ready to go to the emergency department because he was ?overwhelmed and exhausted.?  Patient presented emergency department where he spent some time in the a waiting room as ER staff thought he had left before being seen.  Patient became very disoriented and lethargic.  He was found have a blood sugar of 19. Patient brought back to emergency department and his hypoglycemic event was managed.  During his stay in the ER he was became hypoxic with room air saturations in the 80s.  Oxygen saturation improved with supplemental oxygen.  Further testing showed him to be COVID positive.  Patient is still lethargic and oriented x2.  Hospitalist service has been asked to see for further evaluation and management of toxic metabolic encephalopathy due to hypoglycemia and hypoxia from COVID."   Admitted on 6/2.  Started on dexamethasone and IV antibiotics, oxygen supplementation. He did fair, sugars  stabilized, his condition improved, remains very weak.  At the time of discharge there is no confusion, no more dyspnea.  He requires 2 L of oxygen per home O2 evaluation.  He is doing spirometry.  He had issues with contraction alkalosis, his diuretics were held temporarily, contraction alkalosis improved.  His blood pressure is lower side.  He was noted to have chronic kidney disease, his creatinine remained stable throughout his hospital stay.  His ACE inhibitor was held temporarily. Blood pressure stabilized on discharge, he is being resumed on  the lower dose of ACE inhibitor.  Lasix is resumed on discharge, remains off Zaroxolyn.  Hydrochlorothiazide was discontinued permanently.  His sugars varied, his doses of insulin were adjusted.  He was noted to be persistently hypoglycemic,  he needs significantly less Lantus now been at home, doing well with 15 units every evening.  He is following a diabetic diet.   He is being discharged in stable condition, going home with visiting nurses, PT and OT, 2 L of oxygen, hospital bed was recommended as well in the setting of his acute on chronic respiratory failure  Due to covid and extreme debility."
Age: 63.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Blood glucose decreased, Blood glucose increased, COVID-19, Chronic kidney disease, Confusional state
Clinical narrative: Provider summary "This is a 64-year-old morbidly obese male a history of diabetes mellitus type 2. Patient awoke this morning around 7:00 a.m. disoriented and confused.  His roommate called EMS who arrived to find patient was hypoglycemic.  Patient was encouraged to eat and blood sugar improved.  Patient refused transport to the ER at that time.  Patient is significantly came over later that morning found his blood sugar to be 380. Patient gave himself 20 units of NovoLog.  Significant other checked on him later in the evening and noticed that he was quite lethargic and sleepy.  She encouraged him to go to the emergency department but he again resisted.  Later the patient called significant other back stating he was ready to go to the emergency department because he was ?overwhelmed and exhausted.?  Patient presented emergency department where he spent some time in the a waiting room as ER staff thought he had left before being seen.  Patient became very disoriented and lethargic.  He was found have a blood sugar of 19. Patient brought back to emergency department and his hypoglycemic event was managed.  During his stay in the ER he was became hypoxic with room air saturations in the 80s.  Oxygen saturation improved with supplemental oxygen.  Further testing showed him to be COVID positive.  Patient is still lethargic and oriented x2.  Hospitalist service has been asked to see for further evaluation and management of toxic metabolic encephalopathy due to hypoglycemia and hypoxia from COVID."   Admitted on 6/2.  Started on dexamethasone and IV antibiotics, oxygen supplementation. He did fair, sugars  stabilized, his condition improved, remains very weak.  At the time of discharge there is no confusion, no more dyspnea.  He requires 2 L of oxygen per home O2 evaluation.  He is doing spirometry.  He had issues with contraction alkalosis, his diuretics were held temporarily, contraction alkalosis improved.  His blood pressure is lower side.  He was noted to have chronic kidney disease, his creatinine remained stable throughout his hospital stay.  His ACE inhibitor was held temporarily. Blood pressure stabilized on discharge, he is being resumed on  the lower dose of ACE inhibitor.  Lasix is resumed on discharge, remains off Zaroxolyn.  Hydrochlorothiazide was discontinued permanently.  His sugars varied, his doses of insulin were adjusted.  He was noted to be persistently hypoglycemic,  he needs significantly less Lantus now been at home, doing well with 15 units every evening.  He is following a diabetic diet.   He is being discharged in stable condition, going home with visiting nurses, PT and OT, 2 L of oxygen, hospital bed was recommended as well in the setting of his acute on chronic respiratory failure  Due to covid and extreme debility."
Age: 63.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Disorientation, Dyspnoea, Fatigue, Generalised oedema, Hypoglycaemia
Clinical narrative: Provider summary "This is a 64-year-old morbidly obese male a history of diabetes mellitus type 2. Patient awoke this morning around 7:00 a.m. disoriented and confused.  His roommate called EMS who arrived to find patient was hypoglycemic.  Patient was encouraged to eat and blood sugar improved.  Patient refused transport to the ER at that time.  Patient is significantly came over later that morning found his blood sugar to be 380. Patient gave himself 20 units of NovoLog.  Significant other checked on him later in the evening and noticed that he was quite lethargic and sleepy.  She encouraged him to go to the emergency department but he again resisted.  Later the patient called significant other back stating he was ready to go to the emergency department because he was ?overwhelmed and exhausted.?  Patient presented emergency department where he spent some time in the a waiting room as ER staff thought he had left before being seen.  Patient became very disoriented and lethargic.  He was found have a blood sugar of 19. Patient brought back to emergency department and his hypoglycemic event was managed.  During his stay in the ER he was became hypoxic with room air saturations in the 80s.  Oxygen saturation improved with supplemental oxygen.  Further testing showed him to be COVID positive.  Patient is still lethargic and oriented x2.  Hospitalist service has been asked to see for further evaluation and management of toxic metabolic encephalopathy due to hypoglycemia and hypoxia from COVID."   Admitted on 6/2.  Started on dexamethasone and IV antibiotics, oxygen supplementation. He did fair, sugars  stabilized, his condition improved, remains very weak.  At the time of discharge there is no confusion, no more dyspnea.  He requires 2 L of oxygen per home O2 evaluation.  He is doing spirometry.  He had issues with contraction alkalosis, his diuretics were held temporarily, contraction alkalosis improved.  His blood pressure is lower side.  He was noted to have chronic kidney disease, his creatinine remained stable throughout his hospital stay.  His ACE inhibitor was held temporarily. Blood pressure stabilized on discharge, he is being resumed on  the lower dose of ACE inhibitor.  Lasix is resumed on discharge, remains off Zaroxolyn.  Hydrochlorothiazide was discontinued permanently.  His sugars varied, his doses of insulin were adjusted.  He was noted to be persistently hypoglycemic,  he needs significantly less Lantus now been at home, doing well with 15 units every evening.  He is following a diabetic diet.   He is being discharged in stable condition, going home with visiting nurses, PT and OT, 2 L of oxygen, hospital bed was recommended as well in the setting of his acute on chronic respiratory failure  Due to covid and extreme debility."
Age: 63.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Hypotension, Hypoxia, Lethargy, SARS-CoV-2 test positive, Somnolence
Clinical narrative: Provider summary "This is a 64-year-old morbidly obese male a history of diabetes mellitus type 2. Patient awoke this morning around 7:00 a.m. disoriented and confused.  His roommate called EMS who arrived to find patient was hypoglycemic.  Patient was encouraged to eat and blood sugar improved.  Patient refused transport to the ER at that time.  Patient is significantly came over later that morning found his blood sugar to be 380. Patient gave himself 20 units of NovoLog.  Significant other checked on him later in the evening and noticed that he was quite lethargic and sleepy.  She encouraged him to go to the emergency department but he again resisted.  Later the patient called significant other back stating he was ready to go to the emergency department because he was ?overwhelmed and exhausted.?  Patient presented emergency department where he spent some time in the a waiting room as ER staff thought he had left before being seen.  Patient became very disoriented and lethargic.  He was found have a blood sugar of 19. Patient brought back to emergency department and his hypoglycemic event was managed.  During his stay in the ER he was became hypoxic with room air saturations in the 80s.  Oxygen saturation improved with supplemental oxygen.  Further testing showed him to be COVID positive.  Patient is still lethargic and oriented x2.  Hospitalist service has been asked to see for further evaluation and management of toxic metabolic encephalopathy due to hypoglycemia and hypoxia from COVID."   Admitted on 6/2.  Started on dexamethasone and IV antibiotics, oxygen supplementation. He did fair, sugars  stabilized, his condition improved, remains very weak.  At the time of discharge there is no confusion, no more dyspnea.  He requires 2 L of oxygen per home O2 evaluation.  He is doing spirometry.  He had issues with contraction alkalosis, his diuretics were held temporarily, contraction alkalosis improved.  His blood pressure is lower side.  He was noted to have chronic kidney disease, his creatinine remained stable throughout his hospital stay.  His ACE inhibitor was held temporarily. Blood pressure stabilized on discharge, he is being resumed on  the lower dose of ACE inhibitor.  Lasix is resumed on discharge, remains off Zaroxolyn.  Hydrochlorothiazide was discontinued permanently.  His sugars varied, his doses of insulin were adjusted.  He was noted to be persistently hypoglycemic,  he needs significantly less Lantus now been at home, doing well with 15 units every evening.  He is following a diabetic diet.   He is being discharged in stable condition, going home with visiting nurses, PT and OT, 2 L of oxygen, hospital bed was recommended as well in the setting of his acute on chronic respiratory failure  Due to covid and extreme debility."