chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMR, VARCEL
Symptoms: Injection site erythema, Rash maculo-papular
Clinical narrative: Vaccines administered yesterday 12/03/2003, no status symptoms of any adverse reactions at this date, child came home from school and had a reddened area splotchy over entire deltoid area.  Clients aunt called instructed to put ice on it.  Benadryl 3/4 tsp given to cont giving Benadryl tonight and in AM.  See MD, brought in by grandmother 12/04 @ 16:15.  12/11/2003: Family states child well, did not see MD.
Age: 1.1
Sex: M
Vaccine: HBHEPB, MMR, PNC, VARCEL
Symptoms: Urticaria
Clinical narrative: Child was given 12 month shots on 12/12/2003, parent denied any febrile illness in child for 7 days.  Stated allergy to amoxicillin, no reaction to any other immunizations: MMR, Varicella, Comvax, Prevnar, PPD done.  Mother states child fine until 23:30, Saturday 12/13/2003.  Parent checked on child before retiring and found child in bed covered with large urticaria, no respiratory problem.  To ER, child received epinephrine IV given Benadryl and steroid and and Benadryl for 5 days.  Child checked by pediatrician on Monday 12/15/2003, no problem
Age: 0.17
Sex: F
Vaccine: DTAP, HEP, HIBV, IPV, PNC
Symptoms: Staring
Clinical narrative: Mother stated after pt received immunization on 10/9/03, later that night she noticed that her daughter began to stare upwards not making any eye contact.  Lasted about 6 minutes.
Age: 32.0
Sex: M
Vaccine: HEPA, TYP, YF
Symptoms: Anorexia, Contusion, Dyspnoea, Eczema, Headache
Clinical narrative: Since receiving vaccine, patient has had continuous headaches, malaise, nausea, anorexa and low-grade fever on a couple of occasions.  He has had a slightly pruritic, erythematous rash on both arms, which waxes and wanes.  Mild shortness of breath, but no wheezing.  He notes easy bruising, but no bleeding.  Feels better the day of doctor's appointment.  Exam is normal today except for eczematous rash in both antecubital fossae.  Patient says this is resolving.
Age: 32.0
Sex: M
Vaccine: HEPA, TYP, YF
Symptoms: Malaise, Nausea, Pruritus, Pyrexia, Rash erythematous
Clinical narrative: Since receiving vaccine, patient has had continuous headaches, malaise, nausea, anorexa and low-grade fever on a couple of occasions.  He has had a slightly pruritic, erythematous rash on both arms, which waxes and wanes.  Mild shortness of breath, but no wheezing.  He notes easy bruising, but no bleeding.  Feels better the day of doctor's appointment.  Exam is normal today except for eczematous rash in both antecubital fossae.  Patient says this is resolving.
Age: 26.0
Sex: M
Vaccine: ANTH, FLU3
Symptoms: Amnesia, Back pain, Diarrhoea, Dizziness, Dyspnoea
Clinical narrative: Member states of having symtoms of Fatigue, Headache,Dizziness,Low back pain,Slight fever,Numbness of the hands,Memory loss,Nausea and Diarrhea,Shortness of breath and blurred vision. Member begin to have symtoms two days after the anthrax shot. Patient received his fourth vaccination.The area of the vaccination was the size of a softball in accordance to the emergency room visit on 09 Dec 03. Member continues to have similiar symtoms after ER visit and was seen again on 15 Dec 03. Member was presribed medication again and released.
Age: 26.0
Sex: M
Vaccine: ANTH, FLU3
Symptoms: Fatigue, Headache, Hypoaesthesia, Injection site oedema, Nausea
Clinical narrative: Member states of having symtoms of Fatigue, Headache,Dizziness,Low back pain,Slight fever,Numbness of the hands,Memory loss,Nausea and Diarrhea,Shortness of breath and blurred vision. Member begin to have symtoms two days after the anthrax shot. Patient received his fourth vaccination.The area of the vaccination was the size of a softball in accordance to the emergency room visit on 09 Dec 03. Member continues to have similiar symtoms after ER visit and was seen again on 15 Dec 03. Member was presribed medication again and released.
Age: 26.0
Sex: M
Vaccine: ANTH, FLU3
Symptoms: Pyrexia, Vision blurred
Clinical narrative: Member states of having symtoms of Fatigue, Headache,Dizziness,Low back pain,Slight fever,Numbness of the hands,Memory loss,Nausea and Diarrhea,Shortness of breath and blurred vision. Member begin to have symtoms two days after the anthrax shot. Patient received his fourth vaccination.The area of the vaccination was the size of a softball in accordance to the emergency room visit on 09 Dec 03. Member continues to have similiar symtoms after ER visit and was seen again on 15 Dec 03. Member was presribed medication again and released.
Age: 64.0
Sex: M
Vaccine: FLU3
Symptoms: Pain
Clinical narrative: Client states R. arm was sore x5 days following injection. States soreness then radiated into back muscles.  States he has seen a M.D. and a homeopathic for this incident and is currently participating in physical therapy for past several weeks.
Age: 10.0
Sex: F
Vaccine: FLU3
Symptoms: Dizziness
Clinical narrative: Dizziness within 3 hours of shot given at approx 4:30 pm Dec 15th continues on to today Dec. 17th. Dizziness is mild.   #9 I wrote unknown as my daughter continues to be dizzy as I submit this report.
Age: 56.0
Sex: M
Vaccine: ANTH
Symptoms: Hypersensitivity
Clinical narrative: Member had an alleged allergic reaction to anthrax shot in October. His last shot was given in June. This was the conclusion of the members Primary Care Manager.
Age: 34.0
Sex: F
Vaccine: FLU3
Symptoms: Dyspnoea, Heart rate increased, Paraesthesia, Tachycardia, Tremor
Clinical narrative: Tachycardia, HR 130's, tremors, shortness of breath. The medical record received on 2/17/04 states arm numb.
Age: 1.1
Sex: M
Vaccine: HIBV, MER, PNC, VARCEL
Symptoms: Oedema, Rash
Clinical narrative: RASH ON R LEG SWOLLEN/ RED; L LEG FEW "RASH" TYPE BUMPS. R LEG RECEIVED VACCINE
Age: 66.0
Sex: F
Vaccine: PPV
Symptoms: Feeling hot, Oedema, Pain, Rash erythematous
Clinical narrative: PT COMPLAINED OF RED/RAISED AREA ABOUT SIZE OF QUARTER ON 12/12/03 IN THE AFTERNOON; BY 12/13/03 RED/WARM AREA ON ARM DOWN TO ELBOW, SWOLLEN. CONTINUED WITH PAIN AND SWELLING/REDNESS UNTIL 12/16/03.  QUESTION OF REACTION TO MEDICATION VS REACTION TO ADMINISTRATION.  TYLENOL/ADVIL/BENEDRYL OR CLARITIN/WARM COMPRESSES
Age: 16.0
Sex: M
Vaccine: DTAPH, HIBV, IPV, MMR, PNC
Symptoms: Abasia, Insomnia, Irritability, Pyrexia, Synovitis
Clinical narrative: My son spiked a fever with no other symptoms 7 days after vaccinations and 2 weeks after the vaccination he stopped sleeping and became irritable.  He then woke up  unable to walk and was diagnosed with toxic synovitis after x-rays and blood tests at the hospital.
Age: 0.0
Sex: F
Vaccine: HEP, HEPA
Symptoms: Nasal congestion, Pulmonary congestion, Pyrexia
Clinical narrative: FEVER STARTEDE 12/16/2003 THEN DEVELOPED CHEST AND NASAL CONGESTION.
Age: 42.0
Sex: M
Vaccine: FLUX, HEP, HEPA, MEN, SMALL, TYP
Symptoms: Cardiomyopathy, Chest pain, Dyspnoea, Electrocardiogram abnormal
Clinical narrative: Patient developed chest pain and shortness of breath 55 days after smallpox vaccination ( revaccinee).  Hospitalized.  Patient had abnormal EKG and normal cardiac enzymes.  Echocardiogram showed akinetic inferior septum and inferior wall, LVEF =40-45%.  Cardiac cath showed normal cardiac enzymes and left ventriculogram showed LVEF =42%.  Diagnoses with mild cardiomyopathy
Age: 52.0
Sex: M
Vaccine: FLU3
Symptoms: Eczema
Clinical narrative: Patient developed eczema type break-out all over his body. Patient had been diagnosed this year with eczema. Patient went to his Dermatologist who now treating him with steroids. Patient questions the dry heat in his house as being a probabal cause. He received the flu shot from us on October 3,2003 but this was reported to my office on December 16, 2003. I am reporting this because patients Dermatologist said the flu shot gave him the outbreak.
Age: 7.0
Sex: M
Vaccine: FLU3
Symptoms: Dehydration, Pharyngitis, Pyrexia, Vomiting
Clinical narrative: Within four hours of vaccine, he had a fever of 102.5. The next day, his tonsils were swollen with white spots in addition to the fever. That night, he began vomiting. Two days later, his fever spiked to 105.1 in the middle of the day. Until he was admitted, we were using tylenol/Motrin for his fever. On day three he was given amoxicillin for strep, even though the strep test came back negative. Day four he was admitted to the hostpital. During the stay at the hospital, he was given a IV fluids, a variety of antibiotics, rocephin, and decadron (sp?) to reduce the swelling of his tonsils. The medical records received on 1/28/04 states dehydration.
Age: 18.0
Sex: F
Vaccine: FLUN3
Symptoms: Chills, Fatigue, Neck pain, Pharyngolaryngeal pain, Rash
Clinical narrative: Sore throat, neck pain, chills, tired, slight rash (splochy red marks) on chest.
Age: 46.0
Sex: F
Vaccine: YF
Symptoms: Abdominal pain, Chills, Diarrhoea, Headache, Hypochromic anaemia
Clinical narrative: From initial information received on 12/08/03 through an enhanced surveillance program conducted by the CDC (VAERS 183045), regarding an adverse event occurring in the USA, it was reported that a 46 year old female pt received her first dose of the YF-VAX, lot number UB126AB, administered SC in the left arm on 03/20/02 at 15:00.  Five days later, the pt developed a fever of 103 degrees F, non-bloody diarrhea, severe body aches so severe she could not stand for anything to touch her skin, and restlessness.  Headache, myalgia, rigors and crampy abdominal pain area also listed in the consultation report.  The pt was seen in the ER the following day and she was hospitalized.  The pt was found on admission to have severe hypochromic microcytic anemia with a hemoglobin and hematocrit of 7.2 g/dL and 25% respectively.  After ovrnight hydration, the hemoglobin and hematocrit fell to 6.9 g/dL and 23%.  The pt refused transfusion of red cells.  Iron studies revealed a serum iron of 10, an iron binding capacity of 29% and ferritin of 18.  The impression from the exams was severe iron deficiency anemia, likely secondary to menstrual blood loss.  No history of GI or GU bleeding of melena.  No history of pica but moderatly symptomatic from her anemia.  Intolerance of oral iron supplementation in the past and developed severe pain after the beginning of the infusion of NSAID which was subsequently stopped.  Another impression was acute colitis and febrile illness.  Her blood, stool and urine cultures were negative.  The pt was treated with iron, Cipro, and hydration and discharged from the hospital three days later.  No specimens were sent to CDC for testing.  No further follow up took place as the pt did not have health insurance and did not return for her follow up visit.  The pt's daughter stated that after the pt was discharged from the hospital, she learned that 10-12 persons who ate at the same church lunch as the pt just prior to her illness, had developed food borne illnesses.  The pt's recovery status is currently unknown. Fron additional information received 12/21/03 from the Centers for Disease Control and Prevention Yellow Fever Working Group, the final decision from the CDC is that this event is not related to the yellow fever vaccine.
Age: 46.0
Sex: F
Vaccine: YF
Symptoms: Laboratory test abnormal, Myalgia, Pain, Pyrexia, Restlessness
Clinical narrative: From initial information received on 12/08/03 through an enhanced surveillance program conducted by the CDC (VAERS 183045), regarding an adverse event occurring in the USA, it was reported that a 46 year old female pt received her first dose of the YF-VAX, lot number UB126AB, administered SC in the left arm on 03/20/02 at 15:00.  Five days later, the pt developed a fever of 103 degrees F, non-bloody diarrhea, severe body aches so severe she could not stand for anything to touch her skin, and restlessness.  Headache, myalgia, rigors and crampy abdominal pain area also listed in the consultation report.  The pt was seen in the ER the following day and she was hospitalized.  The pt was found on admission to have severe hypochromic microcytic anemia with a hemoglobin and hematocrit of 7.2 g/dL and 25% respectively.  After ovrnight hydration, the hemoglobin and hematocrit fell to 6.9 g/dL and 23%.  The pt refused transfusion of red cells.  Iron studies revealed a serum iron of 10, an iron binding capacity of 29% and ferritin of 18.  The impression from the exams was severe iron deficiency anemia, likely secondary to menstrual blood loss.  No history of GI or GU bleeding of melena.  No history of pica but moderatly symptomatic from her anemia.  Intolerance of oral iron supplementation in the past and developed severe pain after the beginning of the infusion of NSAID which was subsequently stopped.  Another impression was acute colitis and febrile illness.  Her blood, stool and urine cultures were negative.  The pt was treated with iron, Cipro, and hydration and discharged from the hospital three days later.  No specimens were sent to CDC for testing.  No further follow up took place as the pt did not have health insurance and did not return for her follow up visit.  The pt's daughter stated that after the pt was discharged from the hospital, she learned that 10-12 persons who ate at the same church lunch as the pt just prior to her illness, had developed food borne illnesses.  The pt's recovery status is currently unknown. Fron additional information received 12/21/03 from the Centers for Disease Control and Prevention Yellow Fever Working Group, the final decision from the CDC is that this event is not related to the yellow fever vaccine.
Age: 21.0
Sex: F
Vaccine: YF, YF
Symptoms: Abdominal pain, Dyspnoea, Muscle spasms, Urticaria
Clinical narrative: From initial information received on 12/08/2003 through an enhanced surveillance program conducted by the CDC (VAERS # 213396), it was reported that a 21 year old female pt received a dose of Yellow Fever vaccine (manufacturer, lot number, route and site of administration not reported) on 12/02/2003.  Approximately 15 minutes later, the pt developed shortness of breath, abdominal pain, generalized hives and leg cramps.  She was treated with Benadryl, epinephrine and steroids and immediately sent to the ER by ambulance.  The pt's recovery status was not reported.  No other information was provided at this time. From additiona linfo received on 12/15/03 from the CDC, a copy of the VAERS form filled out by the initial reporter was provided. It was reported that the event occurred in the USA. The administered Yellow Fever vaccine lot number was UB492AA, and it was administered SC in the right arm. Reportedly, the pt had not previously received a Yellow Fever vaccine. The responsible physician's and vaccine administrator's info was provided. It was reported that the pt was treated with Epinephrine 1:1000 SC .3mg, IV MSO4 4mg, Benadryl 25mg p.o., Solu-Medrol 40mg IV, and Benadryl 25mg IM. The pt was sent to the ER. Reportedly, the pt received multiple vaccines within four weeks of the vaccination, but the details are unknown. her pre-existing medical conditions include asthma. The pt's recovery status is currently unknown. Follow up on 01/09/04: "From additional information received on 12/28/03 from the CDC it was reported that the pt was treated and recovered.  No other information was provided."
Age: 14.0
Sex: F
Vaccine: TD, TD
Symptoms: Arthralgia, Pain, Urticaria
Clinical narrative: 8 days after immunization, symptoms began and continued for 6 days. Serum sickness is the diagnosis given to her symptoms which included dizziness, shortness of breath, chest pain, facial edema, urticarial rash, postration, joint pain and light and noise sensitivity. Benadryl 50mg po and Zyrtec 10mg po, Advil po.
Age: 14.0
Sex: F
Vaccine: TD, TD
Symptoms: Arthralgia, Chest pain, Dizziness, Dyspnoea, Face oedema
Clinical narrative: 8 days after immunization, symptoms began and continued for 6 days. Serum sickness is the diagnosis given to her symptoms which included dizziness, shortness of breath, chest pain, facial edema, urticarial rash, postration, joint pain and light and noise sensitivity. Benadryl 50mg po and Zyrtec 10mg po, Advil po.
Age: 14.0
Sex: F
Vaccine: TD, TD
Symptoms: Prostration, Serum sickness, Urticaria
Clinical narrative: 8 days after immunization, symptoms began and continued for 6 days. Serum sickness is the diagnosis given to her symptoms which included dizziness, shortness of breath, chest pain, facial edema, urticarial rash, postration, joint pain and light and noise sensitivity. Benadryl 50mg po and Zyrtec 10mg po, Advil po.
Age: 1.68
Sex: F
Vaccine: FLU3
Symptoms: Aspiration, Vomiting
Clinical narrative: Pt discovered dead in bed with vomitus.  Autopsy reveal aspiration of formula.  Full autopsy report pending.  Pt was the product of a preterm 25 week gestation with a birth weight of 1lb 6oz.  Her neonatal course was prolonged and complicated by ligation of a patent ductus arteriosus, Broncopulmonary Dysplasia, Gastro-Esophageal Reflux Disorder, Retinopathy of Prematurity status post laser surgery, and a grade 4 intraventricular hemorrhage with severe developmental delay and cerebral palsy.  Neonatal hospitalization discharge date = 07/15/2002.  Her latest MRI showed a porencephalic cyst.  During her NICU course she also lost the tips of her left fingers 2,3,4 and 5 secondary to a PIC line complication.  Her developmental issues, constipation and poor weight gain were her most active problems.  Her weight gain had improved after starting supplemental Pediasure at 17 months of age.  She was seen in our office 11/24/03 for a weight check and incidentally found to have a upper respiratory tract infection and bilateral otitis media.  She was afebrile and nontoxic appearing with no wheezing or other adventitious chest sounds at that time.  For her otitis media she was prescribed Omnicef.  Because she looked well, she also received her second dose of influenza vaccine.  She had received her first dose of influenza vaccine on 10/23/2003 w/out incident or adverse reaction.
Age: 3.0
Sex: M
Vaccine: HIBV
Symptoms: Chills, Pyrexia, Sepsis, White blood cell disorder
Clinical narrative: From initial info received on 12/08/2003 from a literature report entitled "Obstacles to the Elimination of Haemophilus influenzae Type b Disease: Three Illustrative Cases" published in Pediatrics in December 2003, Volume 112, Number 6, pp. 1465-1466 regarding an adverse event, it was reported that a 3-year-old male pt received a 4th dose of Hib Vaccine (lot #, manufacturer, route and site of administration not reported) on an unspecified date at the age of 18 months. At the age of 3, on an unspecified date, he presented with a one-day history of fever and rigors. The temperature was 39.2 degrees C, and the leukocyte count was 8000 per mm3 with 88% neutrophils. He was discharged without antibiotic therapy. The pt was recalled and hospitalized the next day because a blood culture yielded Gram-negative rods subsequently identified as Hib resistant to ampicillin and susceptible to ceftriaxone. A second blood culture performed on the day of admission was sterile. Examination of the cerebrospinal fluid (CSF), including latex agglutination for Hib capsular polysaccharide antigen (obtained after 2 doses of ceftriaxone was normal. The pt received 3 days of ceftriaxone and was discharged to complete 7 days of cefpodoxime. He had previously been immunized with a Hib conjugate vaccine at 2, 4 and 6 months of age. He lived at home with his parents and did not attend day care. Immunoloic studies revealed normal total serum immunoglobulins, subclasses, and total hemolytic complement. The concentration of serum antibody to the serotype b H influenzae capsule obtained during the 2nd day of the hospitalization was 0.45 ug/mL by enzyme-linked immunosorbent assay. Two months later, the level was 2.0 ug/mL. The serum anti-hepatitis B surface antibody was in the protective range. No other info was provided and the pt's outcome was not reported. The reporter of this case is the same as for case 2003-03329.
Age: 3.0
Sex: F
Vaccine: VARCEL
Symptoms: Medication error, Pruritus, Rash erythematous, Skin ulcer
Clinical narrative: Information has been received from a RN concerning a 44 month old white female with an amoxicillin allergy who on 03/05/2001 was vaccinated with a second dose of varicella virus vaccine live (Oka/Merck) (Lot # 636368/1341K), SC.  There was no illness at the time of vaccination.  On 11/18/03 in the AM the pt presented with "red bumps, fluid filled, crusty lesions and itchiness on face, thighs, back and stomach."  Subsequently, the pt recovered.  The reporter considered "red bumps, fluid filled, crusty lesions and itchiness on face, thighs, back and stomach" to be other important medical events (OMIC).  Additional information has been requested. The follow up received on 12/16/03 states the pt was treated with Atarax and fully recovered. Follow-up info from the reporter stated that "red bumps, fluid filled, crusty lesions and itchiness on face, thighs, back and stomach" are not considered to be other important medical events. Additional inof has been requested. This rreport no longer meets the criteria for expedited submission to the FDA.
Age: 42.0
Sex: M
Vaccine: FLU3
Symptoms: Deafness, Hearing impaired
Clinical narrative: A report was received from a health care professional on 10/31/2003, concerning a 43 or 44 year old male vaccinee who was deaf 3 days after receiving Fluvirin on 10/24/03.  On 10/27/03, the vaccinee was completely deaf after receiving Fluvirin on 10/24/03.  The vaccinee has consulted with an ENT specialist and has further appointments scheduled with the specialist.  The reporter indicated that the vaccinee has experienced tinnitus for the past 5 years. The vaccinee is not taking any concomitant medications and has no known drug allergies.  The reporter indicated that the vaccinee has received the influenza vaccine each year for the past 5 years and experienced no hearing impairments.  This is the first year the vaccinee has received Fluvirin influenza vaccine.  There was insufficient information to determine the reporter's causality assessment.  Update: 12/05/03: Further information received from a health care professional indicated that the vaccinee was 42 years old and experienced sudden hearing loss in his right ear, which was disabling, 24 hours after receiving Fluvirin on 10/26/03.  The vaccinee had not recovered at the time of this report.  The reporter has assessed the relationship of the vaccine to the event as probable.  Follow up pending. The 15-day follow up received on 1/13/04 states further info received from a health care professional indicated that the vaccinee was still diabled and deafness was permanent on testing on two occasions. Follow up pending.
Age: 1.5
Sex: M
Vaccine: DTAP, IPV
Symptoms: Anorexia, Asthenia, Dehydration, Hypoglycaemia, Laboratory test abnormal
Clinical narrative: Developed fever on 12/02/03, but normal behavior.  On 12/03/03 maintained fever--measured at 101.3 F, developed extreme lethargy, loss of appetite, and weakness.  Evaluation demonstrated hypoglycemia.  Subsequent evaluation demonstrated metabolic results consistent with Probable Medium Chain Acyl-CoA Dehydrog. Defic.
Age: 1.5
Sex: M
Vaccine: DTAP, IPV
Symptoms: Lethargy, Pyrexia
Clinical narrative: Developed fever on 12/02/03, but normal behavior.  On 12/03/03 maintained fever--measured at 101.3 F, developed extreme lethargy, loss of appetite, and weakness.  Evaluation demonstrated hypoglycemia.  Subsequent evaluation demonstrated metabolic results consistent with Probable Medium Chain Acyl-CoA Dehydrog. Defic.
Age: 3.6
Sex: M
Vaccine: FLU3
Symptoms: Laboratory test abnormal, Rhinorrhoea, White blood cell count increased
Clinical narrative: Runny nose for a few days prior to the vaccine.
Age: 11.0
Sex: F
Vaccine: FLU3
Symptoms: Erythema
Clinical narrative: Local erythema, color,
Age: 0.6
Sex: M
Vaccine: FLU3
Symptoms: Cough, Influenza, Pyrexia, Rhinorrhoea
Clinical narrative: Pt with (+) influenza (a) 1 week later.  (-) pt office visit. The medical record received on 12/29/03 states cough, fever and runny nose.
Age: 5.0
Sex: F
Vaccine: FLU3
Symptoms: Urticaria
Clinical narrative: Flu vaccine administered on 12/11/03.  On 12/14/03 grandmother states the pt broke out in hives.  She was advised to administer Benadryl every 6 hours which seems to have helped with the hives.
Age: 34.0
Sex: F
Vaccine: FLU3
Symptoms: Chest discomfort, Dyspnoea, Pyrexia
Clinical narrative: Fever, shortness of breath, tight chest, about 20 minutes after vaccine.  Tx: breating tx's and cortisone shot.
Age: 10.0
Sex: F
Vaccine: FLU3, HEPA, PPV, VARCEL
Symptoms: Injection site inflammation, Injection site oedema
Clinical narrative: Varicella given SC approximately 10 min after injection, inflam and swelling appeared at site.  Child stated no problem, no palpatation, no breathing problem. Given Benadryl 12.5/5 10mL at 11:50.  Follow up with school nurse-inflam and swelling-no change at 11:30.  Update: 12/16/03, School nurse redness gone by 12/11/03, no further problems.
Age: 52.0
Sex: M
Vaccine: FLU3
Symptoms: Pain
Clinical narrative: Left upper deltoid/shoulder pain aggravated by raising left arm above shoulder level and behind head x 1 month.
Age: 28.0
Sex: F
Vaccine: FLU3, TYP
Symptoms: Anorexia, Chills, Diarrhoea, Headache, Hot flush
Clinical narrative: W/in 24 hours after vaccines, I experienced heavy vomiting, diarrhea, lower body aches, hot flashes, cold chills.  Headache soreness in lower left calf muscle.  Loss of appetite.
Age: 28.0
Sex: F
Vaccine: FLU3, TYP
Symptoms: Pain, Vomiting
Clinical narrative: W/in 24 hours after vaccines, I experienced heavy vomiting, diarrhea, lower body aches, hot flashes, cold chills.  Headache soreness in lower left calf muscle.  Loss of appetite.
Age: 48.0
Sex: F
Vaccine: FLU3
Symptoms: Rash erythematous, Rash pruritic
Clinical narrative: Developed a raised itchy rash all over my body prominent on hands, underside of arms, on thighs, hips, legs, top of feet.  The rash appeared day after shot and persisted for a week.  No other symptoms such as fever.  I felt fine otherwise.
Age: 24.0
Sex: M
Vaccine: ANTH, FLU3
Symptoms: Injection site pain, Injection site swelling, Pruritus, Urticaria
Clinical narrative: A raised welt where the shot was given.  Very sore and itchy.
Age: 44.0
Sex: M
Vaccine: FLUX
Symptoms: Abdominal pain upper, Back pain, Cough, Diarrhoea, Eye pain
Clinical narrative: Headaches, back pains, sweating, fever, stomach aches, coughing a lot, spitting up while salty spit.  Eyes hurting.  Fast heartbeat.  Diarrhea.  My side hurts feeling weak.
Age: 44.0
Sex: M
Vaccine: FLUX
Symptoms: Headache, Heart rate increased, Hemiparesis, Hyperhidrosis, Pyrexia
Clinical narrative: Headaches, back pains, sweating, fever, stomach aches, coughing a lot, spitting up while salty spit.  Eyes hurting.  Fast heartbeat.  Diarrhea.  My side hurts feeling weak.
Sex: F
Vaccine: VARCEL
Symptoms: Hypersensitivity, Hyperventilation
Clinical narrative: Allergic reaction, pt was taken to ER at hospital for hyperventilation on 12/09/03, pt never came into office.
Age: 40.0
Sex: F
Vaccine: PPV
Symptoms: Injection site rash, Pain
Clinical narrative: Arm pain-radiating to neck and back rash at injection site and proximal arm.  Treated with Medrol/Atarax.
Age: 30.0
Sex: M
Vaccine: ANTH, TTOX
Symptoms: Injection site erythema, Injection site oedema, Pruritus, Tenderness
Clinical narrative: Swelling of bicep area on left arm, redness and itching. Tenderness/tightness when arm is stretched out.  Swelling moved to upper part of forearm.  All within 2 days of shot.
Age: 9.0
Sex: M
Vaccine: HEP
Symptoms: Eye irritation, Rash macular
Clinical narrative: Macular rash - mild on dorsum of hands and a few on arms, chest, abdomen. Reportedly had hives earlier. No dyspnea. Left eye started itching in the night after Hep B vac.
Age: 5.0
Sex: M
Vaccine: HEPA
Symptoms: Haematuria
Clinical narrative: Hematuria with red blood cell casts ALP 237, AST 169Z, ALT 1250 WBC 19.4 with left shift all clearing rapidly in 2-3 days. Child was not ill clinically. Brought in because of hematuria. Still following.
Age: 28.0
Sex: F
Vaccine: TD
Symptoms: Abscess
Clinical narrative: Abscess formation at site of injection.
Age: 5.0
Sex: F
Vaccine: DTAP, MMR
Symptoms: Feeling hot, Injection site erythema, Injection site oedema, Pain
Clinical narrative: A few hours after (vaccine) administered, right thigh had significant swelling, diffuse, erythema, increased warmth, and mild tenderness, examined 12/10/03 11 AM.
Age: 61.0
Sex: F
Vaccine: PPV
Symptoms: Pain
Clinical narrative: Pt developed very significant right shoulder pain.  After persistent pain an MRI was ordered and a rotation cuff tear was noted.  Pt underwent repair by orthopedics 05/06/03.  Doing well at physical 12/17/03.
Age: 0.33
Sex: M
Vaccine: DTAP, HEP, HIBV, IPV, PNC
Symptoms: Irritability, Pyrexia
Clinical narrative: Mother and baby stop by in the clinic the following day after baby had vaccinations reported baby had temperature of 38.5 C (101.3 F) and was fussy.  Mom stated gave son Tylenol and gave sponge bath.  Mom stated after 6 hours of taking Tylenol baby was fine.
Age: 66.0
Sex: F
Vaccine: PPV
Symptoms: Injection site erythema, Injection site oedema, Injection site warmth, Urticaria
Clinical narrative: Hot, red, localized swelling left deltoid extending down to elbow.  Very sharp urticaria like border.
Age: 0.5
Sex: F
Vaccine: DTAP, HIBV, IPV, PNC
Symptoms: Crying, Decreased appetite, Screaming
Clinical narrative: Pt went to ER with crying for 6 hours, decreased appetite, no fever.
Age: 0.33
Sex: M
Vaccine: DTAP, HIBV, IPV, PNC
Symptoms: Dyskinesia, Torticollis
Clinical narrative: Day after vaccines pt had an episode characterized by rocking his head back and forth from side to side motion and jerking of the arms or legs. Pt had eyes closed at the time. No more activity until 11/24/03. Electrolytes. Electoencephalogram.
Sex: M
Vaccine: HEPAB
Symptoms: Headache
Clinical narrative: This case was reported by a physician and described the occurrence of headache in a male pt who received hepatitis A inactivated and hepatitis B recombinant vaccine (Twinrix) for prophylaxis.  The pt's medical history included hepatitis A infection, hepatitis B infection, and HIV infection.  There were no concurrent medications.  On 09/16/2003 the pt received the 1st dose of Twinrix; it was not known at the time of immunization that the pt had previous hepatitis A and B infections.  One day post-immunization, on 09/17/2003, the pt experienced "severe" headache.  The pt was seen by the physician.  The outcome of the event is unknown.  The physician considered the headache to be possibly related to vaccination with Twinrix.  The Twinrix immunization series was discontinued because of the previous hepatitis A and B infections, not because of headache.
Sex: M
Vaccine: HEPAB
Symptoms: Laboratory test abnormal, Unevaluable event
Clinical narrative: This case was reported by a nurse and described an adult male who did not respond to the hepatitis B component of hepatitis A inactivated and hepatitis B recombinant vaccine (Twinrix).  On unspecified dates, the pt received three injections of Twinrix.  Approximately six to eight weeks after the third injection, serology results revealed a "positive" titer for hepatitis A, but an negative titer for hepatitis B.  Comment: The reporter indicated that "three or four" pt's experienced negative hepatitis B titers following receipt of Twinrix.  However, no identifiers were provided for the pt's.
Age: 33.0
Sex: F
Vaccine: HEPAB
Symptoms: Injection site reaction, Pruritus
Clinical narrative: This case was reported by a nurse and described the occurrence of injection site pruritis in a 33 year old female pt who received hepatitis A inactivated and hepatitis B recombinant vaccine (Twinrix) for prophylaxis.  The pt's medical history included allergies to nickel and mercury.  Concurrent medications were not reported.  On 07/08/03, the pt received her first dose of Twinrix.  On 08/08/03, the pt received the second dose of Twinrix.  On the same date, at an unspecified time post-immunization, the pt experienced itching at the injection site.  The itching persisted as of 10/27/03.  The reporting nurse considered the event was possibly related to vaccination with Twinrix.
Age: 58.0
Sex: M
Vaccine: HEPAB
Symptoms: Confusional state, Depression, Headache, Nausea, Vomiting
Clinical narrative: This case was reported by a nurse and described the occurrence of headache in a 58 year old male patient who received hepatitis A inactivated and hepatitis B recombinant vaccine (Twinrix) for prophylaxis.  The pt has no known history of drug or food allergies.  The pt received no concurrent medications.  On 09/25/03, the pt received his first dose of Twinrix w/out incident.  The same day, the pt also received inactivated poliomyelitis virus vaccine (IPOL, AP), tetanus and diphtheria toxoids adsorbed (manufacturer unknown), and typhoid vaccine (manufacturer unknown).  The pt received his second dose of Twinrix on 10/27/03.  On the evening of 10/29/03, the pt reported that he consumed alcohol (wine).  On 10/30/03, at 3:00am the pt awoke with a "severe headache" and nausea.  The nurse stated that the pt reported he "got up and took an aspirin and felt confused and depressed, and later vomited."  The pt went back to sleep and upon wakening continued to experienced mild nausea and headache.  The confusion, depression, and vomiting resolved on 31oct2003. The immunization series with Twinrix was discontinued. The nurse considered the events to be related to vaccinationwith Twinrix.
Age: 30.0
Sex: F
Vaccine: HEPAB
Symptoms: Erythema, Pruritus, Urticaria
Clinical narrative: This case was reported by a nurse and described the occurrence of hives in a 30 year old female pt who received hepatitis A inactivated and hepatitis B recombinant vaccine (Twinrix) for prophylaxis.  The pt's medical history was not reported.  There were no concurrent medications.  On 10/27/03, the pt received the second dose of Twinrix (Lot # HAB235A4).  On 10/29/03, 48 hours post-immunization, the pt experienced itching hands followed by hives, itching and redness over her entire body.  The events were unresolved as of 10/31/2003.  The nurse considered the events to be possibly related to vaccination with Twinrix.
Age: 2.0
Sex: M
Vaccine: FLU3
Symptoms: Rash erythematous
Clinical narrative: Right arm between wrist and elbow, oval shape red raised one bump per mom.  Denies other problems. Instruted to call PMD if worsens or go to ER
Age: 8.0
Sex: M
Vaccine: FLUN3
Symptoms: Vomiting
Clinical narrative: Vomitting
Age: 42.0
Sex: F
Vaccine: FLUX
Symptoms: Chills, Lymphadenopathy, Shoulder pain
Clinical narrative: Received vaccine 12/12/03.  On 12/15/03, woke with lymph node swelling over my collar bone and severe pain in shoulder.  Later that day it got to the point that I could not use my arm well.  The next day, 12/16/03, I went to the emergency room because of the pain and swelling.  The doctor treated it with a sling and pain medication and told me to follow-up if it does not resolve in 2 days.  The night of 12/17/03, I went to bed with chills.  On 12/18/03, at 1:00am I woke with severe pain in my shoulder.  I went back to the emergency room.  The doctor recommended that I remove the sling.  He gave me a prescription for doxycycline and some pain medicine.  I am still in a lot of pain, but will be starting the antibiotics today.
Age: 8.0
Sex: M
Vaccine: VARCEL
Symptoms: Herpes zoster, Viral infection
Clinical narrative: shingles episode with h/o varicella immunization, no h/o clinical chicken pox. (Could not reach parent back for more info--phone disconnected)
Age: 69.0
Sex: F
Vaccine: FLU3
Symptoms: Breast disorder female, Fatigue, Oedema, Pain, Pyrexia
Clinical narrative: 24 hours after flu vaccine shot, client states her L arm was very sore, increasing pain over next few days.  By 11/14, she noticed enlarged nodes, axillary L.  Yesterday (11/18) she noted enlarged, tender nodes under R arm (axillary area).  11/19 some soreness in neck - feels like she has fever and increased fatigue.  11/20 MD visit/diagnosis - sinusitis & "breast problems" - "not from vaccine"  MD advised mammo.
Age: 69.0
Sex: F
Vaccine: FLU3
Symptoms: Sinusitis
Clinical narrative: 24 hours after flu vaccine shot, client states her L arm was very sore, increasing pain over next few days.  By 11/14, she noticed enlarged nodes, axillary L.  Yesterday (11/18) she noted enlarged, tender nodes under R arm (axillary area).  11/19 some soreness in neck - feels like she has fever and increased fatigue.  11/20 MD visit/diagnosis - sinusitis & "breast problems" - "not from vaccine"  MD advised mammo.
Age: 0.3
Sex: M
Vaccine: FLU3
Symptoms: Drug administration error
Clinical narrative: none. The follow up received on 1/5/04 states child given flu vax inappropriately (under age)-no adverse reaction.
Age: 5.0
Sex: M
Vaccine: FLUX
Symptoms: Erythema, Oedema, Rash pruritic, Urticaria
Clinical narrative: Patient received 2nd dose of influenza vaccine on 12/08/03.  The next morning he woke up with a red itchy rash.  That day he went to the doctor and was diagnosed with hives.  Benadryl was used as the course of treatment.  The next day the red itchy rash was accompanied with swelling, particularly around the face and hands.  The hives lasted through 12/13/03.
Age: 34.0
Sex: M
Vaccine: MEN
Symptoms: Asthenia, Fatigue, Hypoaesthesia
Clinical narrative: Patient reported vaccinated arm felt "asleep" during night following vaccination. (Weakness and numbness.) Sx resolved by following morning but sensation of "fatigue" in affected arm persisted for two days.
Age: 4.0
Sex: F
Vaccine: 6VAX-F
Symptoms: Convulsion
Clinical narrative: Onset of seizures following DTaP at 4 months 4 days later. Given DTaP again at 6 months (against my wishes) on Dec 16 and has had 3 seizures since. Within 5 hours, then 14 hours and the last was the next day.
Age: 0.3
Sex: M
Vaccine: DTAP, HEP, HIBV, IPV
Symptoms: Sudden infant death syndrome
Clinical narrative: Infant death, diagnosed as Sudden Infant Death Syndrome 02/04/2004 Autopsy report rec'd -- COD was SIDS.
Age: 0.33
Sex: F
Vaccine: DTAPHEPBIP, HIBV, PNC
Symptoms: Convulsion, Pyrexia
Clinical narrative: Seizure (<5 minutes, generalized, resolved by the time EMS arrived. Transported to hospital for sepsis/seizure evaluation. Tx for 48 hours with Abx and Acyclovir. The hospital record received on 2/24/04 states fever.
Age: 48.0
Sex: F
Vaccine: FLU3
Symptoms: Blood pressure increased, Dizziness, Dyspnoea, Heart rate decreased, Laryngospasm
Clinical narrative: 13:25: Pt in waiting room, came to counter and stated she didn't feel well.  Was very pale.  Stated having problems breathing.  13:26: Pt assisted to site down. MD notified immediately-crammed pt ordered Epipen auto inject O.3 mg given IM left thigh.  13:36: BP-156/120; 13:39: O2 @ 2L per made started per MD.  13:40 BP: 148/118, pulse oximetry 99% pulse 14.  13:50: Pt transported to ER by ambulance. The medical records received on 2/24/04 states dizziness and tight in throat.
Age: 48.0
Sex: F
Vaccine: FLU3
Symptoms: Malaise
Clinical narrative: 13:25: Pt in waiting room, came to counter and stated she didn't feel well.  Was very pale.  Stated having problems breathing.  13:26: Pt assisted to site down. MD notified immediately-crammed pt ordered Epipen auto inject O.3 mg given IM left thigh.  13:36: BP-156/120; 13:39: O2 @ 2L per made started per MD.  13:40 BP: 148/118, pulse oximetry 99% pulse 14.  13:50: Pt transported to ER by ambulance. The medical records received on 2/24/04 states dizziness and tight in throat.
Age: 39.0
Sex: F
Vaccine: FLU3
Symptoms: Hypokinesia, Pain
Clinical narrative: Pt received flu shot in an outreach clinic on 11/21/03.  Within a few days she had pain in arm and difficulty in using "right arm".  Unable to reach in closet.  Has pain day and night.  Not always consistant at time can do a motion and it's ok, but next time causes pain.
Age: 6.0
Sex: F
Vaccine: FLU3
Symptoms: Erythema, Oedema, Pruritus
Clinical narrative: Erythema and swelling left upper arm, pruritic per pt.  Area involved is from top of left arm to elbow.
Age: 6.0
Sex: M
Vaccine: FLU3
Symptoms: Erythema, Rash macular, Rash pruritic, Urticaria
Clinical narrative: Red, diffuse, macular and urticarial all over body, slightly itchy, started day after injection.  Appointment on 11/20/03.  Gave Orapred 15mg/5ml 4 tsp every day.  Pt has fully recovered.
Age: 66.0
Sex: F
Vaccine: PPV
Symptoms: Erythema, Injection site erythema, Injection site pain
Clinical narrative: Redness described right arm injection site.  Redness size of silver dollar.  ON Sat. 12/13/03, by 14:00, had spread from upper right arm to neck that progressed down arm to chest wall and around breast.  Redness site including under her right arm were very painful.  No swelling, no itching, no shortness of breath or tightness in throat.  Also felt nauseated.  Recommends pt be seen by HCP.  Seen in ER 12/13/03 17:30 by MD.  Diagnosed as drug reaction.  MD also stated she probably had pneumonia before.  Prescribed Benadryl.  Took Benadryl and felt very sleepy.  By Sunday 12/14/03, redness had began to fade and pallor was decreasing.  Feeling much better today.  Continued fading of redness and pain.  Advised to call MD and inform of reaction.
Age: 37.0
Sex: F
Vaccine: FLU3
Symptoms: Hypoaesthesia, Migraine, Musculoskeletal stiffness, Nausea, Pyrexia
Clinical narrative: All symptoms began within 12 hours of receiving vaccine: 1) 3 migraine headaches, pt has not had migraines in 20 years. 2) neck stiffness 3) numbness along right side of neck 4) throat constriction 5) temp 99.1 6) nausea.  Symptoms bothersome x2-3 days after vaccine.  Pt felt better about 11/24/03.  Pt had never received flu vaccine before.
Age: 37.0
Sex: F
Vaccine: FLU3
Symptoms: Throat tightness
Clinical narrative: All symptoms began within 12 hours of receiving vaccine: 1) 3 migraine headaches, pt has not had migraines in 20 years. 2) neck stiffness 3) numbness along right side of neck 4) throat constriction 5) temp 99.1 6) nausea.  Symptoms bothersome x2-3 days after vaccine.  Pt felt better about 11/24/03.  Pt had never received flu vaccine before.
Age: 34.0
Sex: M
Vaccine: FLU3
Symptoms: Rash pruritic
Clinical narrative: Awakened early AM, 12/08/03 with a irritating itchy rash covering 70% of body.  No difficulty breathing.  Rash persisted.  Reported by phone at 08:10.  Advised follow up at ER incase of anaphylaxis.  NP @ER could not determine conclusively that the reaction was caused by the vaccine.  Administered steroids IM and prescribed Hydroxyzine HCL 50mg and Prednisone 4mg, to be taken if reaction persists.
Age: 66.0
Sex: F
Vaccine: PPV
Symptoms: Erythema, Injection site pain
Clinical narrative: Pt woke up day after injection with a very very painful left arm, slight redness just above elbow, not at injection site, redness increased and pain worsened over the next 2 days.  Pt reports pain and redness resolved by 12/17/03.
Age: 5.0
Sex: F
Vaccine: MMR, VARCEL
Symptoms: Abscess
Clinical narrative: Watery bumps on face, back and legs.
Sex: M
Vaccine: PPV
Symptoms: Cellulitis, Erythema
Clinical narrative: Pt came into clinic 1 day after pneumococcal vaccine with right upper arm cellulitis to erythema 20x17cm.  Shot 12/01.
Age: 0.2
Sex: M
Vaccine: DTAPHEPBIP, HIBV, PNC
Symptoms: Anorexia, Crying, Fatigue, Irritability, Mydriasis
Clinical narrative: 11/19/03 @ 17:00: Mom called 15:39 states baby had reaction to shots.  Shots given at 14:30 11/10/03, baby started screaming at 18:00 lasted 3.5 hrs until 21:30.  Baby was exhausted and would not nurse.  Slept until 03:00.  Looked pale, breast fed normally next day, baby was very sleeping and has continued to sleep more than usual, naps 1.5 -2 hours.  Fussy and grouching when awake-fights his feedings.  Injection site did not appear abnormal.  No fever, mom gave Tylenol x3.  Mom noticed pupils are small even when in dimly lit room-past 3 days 11/17-18-19.  "Zoning out", but responds when mom talks to him-pupils do dilate when mom uses flashlight, then takes it away.  Starin episodes started yesterday 11/18.  Over weekend 11/15-17, baby had hives after breast feeding-they went away after about 20 minutes, seem to be related to pressure points where baby was held while feeding.  None since 11/17.
Age: 0.2
Sex: M
Vaccine: DTAPHEPBIP, HIBV, PNC
Symptoms: Pallor, Staring, Urticaria
Clinical narrative: 11/19/03 @ 17:00: Mom called 15:39 states baby had reaction to shots.  Shots given at 14:30 11/10/03, baby started screaming at 18:00 lasted 3.5 hrs until 21:30.  Baby was exhausted and would not nurse.  Slept until 03:00.  Looked pale, breast fed normally next day, baby was very sleeping and has continued to sleep more than usual, naps 1.5 -2 hours.  Fussy and grouching when awake-fights his feedings.  Injection site did not appear abnormal.  No fever, mom gave Tylenol x3.  Mom noticed pupils are small even when in dimly lit room-past 3 days 11/17-18-19.  "Zoning out", but responds when mom talks to him-pupils do dilate when mom uses flashlight, then takes it away.  Starin episodes started yesterday 11/18.  Over weekend 11/15-17, baby had hives after breast feeding-they went away after about 20 minutes, seem to be related to pressure points where baby was held while feeding.  None since 11/17.
Age: 34.0
Sex: M
Vaccine: ANTH
Symptoms: Cellulitis, Rash erythematous
Clinical narrative: Developed cellulitis, large erythematous rash within 48 hours of receiving anthrax vaccination
Age: 38.0
Sex: F
Vaccine: FLUN3
Symptoms: Chest pain, Dyspnoea, Headache, Pyrexia, Throat tightness
Clinical narrative: Family had flu vaccination.  When mom had flu mist had bad reaction.  Sore throat and headache/fever.  Concerned that will give to children.  Does have fever. Cough. No trouble breathing.
Age: 61.0
Sex: F
Vaccine: PPV
Symptoms: Erythema, Oedema, Pyrexia, Tenderness
Clinical narrative: Right upper arm red, swollen, tender to touch, redness under arm. fever for 24 hours. received injection on Wednesday. became red wednesday afternoon, fever during the night, increase in redness over next day. in clinic to be seen on Friday.
Age: 48.0
Sex: F
Vaccine: FLU3
Symptoms: Cough, Dry throat, Pain, Pyrexia, Rhinorrhoea
Clinical narrative: Patient noted generalized aches 12/16/2003 around 2 PM.  Temperature was 104.  She took Tylenol at 4 PM and midnight and again the morning of 12/17. Complaints of fever, dry cough, runny nose and dry throat. No headache, no respiratory distress.
Age: 1.0
Sex: M
Vaccine: DTAP, HIBV, MMR, VARCEL
Symptoms: Pyrexia, Rash
Clinical narrative: PATIENT CAME TO OFFICE COMPLAINING OF FEVER FOR A COUPLE DAYS AND DOTS ALL OVER BODY. RECIEVED ONE YEAR SHOTS ON 12-10-03. DIAGNOSED AS REACTION TO VARIVAX. NO TREATMENT NECESSARY.
Age: 29.0
Sex: M
Vaccine: ANTH, MEN
Symptoms: Erythema, Oedema, Pain
Clinical narrative: SORE, REDNESS AND SWELLING TO LEFT ARM. STARTED 3 DAYS AFTER ANTHRAX SHOT. TX APPLY COLD COMPRESS TO AREA, NAPROSYN 500MG, BENADRYL 25MG,RETURN TO CLINIC IF WORSENS.
Age: 27.0
Sex: F
Vaccine: FLU3
Symptoms: Dysgeusia, Feeling hot, Paraesthesia
Clinical narrative: approximately 10 jminutes after receiving flu vaccine, experienced tingling sensation around mouth, metallic taste and a warm sensation that spread from mouth up through nose.  Given 10cc Benadryl PO (25 mg). BP 120/78       110/78 at 2:35 p.m.
Age: 56.0
Sex: F
Vaccine: FLU3
Symptoms: Neuralgia, Pain
Clinical narrative: Approximately 6 hours after receiving immunization developed "horrible pain" under left arm radiating to left shoulder, nect, and back of head.  Pain increases with movement.  Saw primary physician one day after receiving vaccine who diagnosed neuralgia secondary to influenza immunization.
Age: 20.0
Sex: F
Vaccine: SMALL
Symptoms: Chills, Dermatitis bullous, Injection site erythema, Nausea, Pyrexia
Clinical narrative: This is a 20 y/o ? black active duty military member who received her primary smallpox vaccination on 12/08/03. She states that she progressed fine through the first week after her vaccination and did not develop any viremic symptoms. On 12/15/03 she reported with her fellow soldiers to immunizations to have a 7-day wound check. She stated that the medic told her it looked great and was "just exactly how it is supposed to look". She told me that the medic pressed all around the outside edges of the site. He was wearing gloves, however patient states that she never saw him change gloves between patients and "there were a lot of us".  On 12/17/03, she removed the bandage and states that the area under the gauze part of the bandage was "red and blistered". She also began having viremic symptoms of fever, chills and nausea at this time. Her viremic symptoms last approximately 4 days.