chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 28.0
Sex: F
Vaccine: MMR, TD, VARCEL
Symptoms: Loss of consciousness, Musculoskeletal stiffness, Pallor, Urinary incontinence
Clinical narrative: After receiving the PPD, TD and varicella patient became quite pale. She was assisted in putting her head down between her knees. After about 5-10 seconds she lifted her head, good color had returned and she appeared alert. She was placed on an exam table for the fourth (MMR) injection. She was alert and responding appropriately. Within seconds of giving the MMR she developed a tonic seizure, arched neck, very stiff, clenched jaw and her color went from very pale to cyanotic. Attempted to establish and airway by pulling on lower jaw. Was able to open her jaw just enough for her to take one breath. She then started clonic movement and lost bladder control. She again became cyanotic. The entire episode lasted about 60-90 seconds. 911 was called. She finally relaxed and regained consciousness. BP 110/72 P.80 R.20. 911 arrived a few minutes later, checked Vital signs again and did a blood sugar. She was advised to go to ER because she has no history of seizure. She refused because of lack of health insurance.
Age: 15.0
Sex: M
Vaccine: HEP, TD, VARCEL
Symptoms: Injection site reaction, Skin ulcer
Clinical narrative: Inflammatory lesion in site of vaccination noticed 2 days ago, no fever, lesions are spreading.
Age: 4.0
Sex: F
Vaccine: DTAP, MMR
Symptoms: Hypersensitivity, Oedema, Pain
Clinical narrative: Mom noticed it on 09/10/2005am that it was red and swollen, child stated it felt sore. Pt is to ice and Tylenol as directed and put on Augmentin 200/25.5mg/5ml.
Age: 21.0
Sex: M
Vaccine: TTOX
Symptoms: Dizziness, Hypoaesthesia, Nausea, Pain, Pallor
Clinical narrative: Donor stated approx. 5hrs after shot was given he began to experience it. Arm pain going down left side of body with it. Thumb pain, mild dizziness, nausea, paleness, and numbness tingling in shoulder. Donor states symptoms lasted approx 12 hours and resolved on their own with no treatment required.
Age: 21.0
Sex: M
Vaccine: TTOX
Symptoms: Paraesthesia
Clinical narrative: Donor stated approx. 5hrs after shot was given he began to experience it. Arm pain going down left side of body with it. Thumb pain, mild dizziness, nausea, paleness, and numbness tingling in shoulder. Donor states symptoms lasted approx 12 hours and resolved on their own with no treatment required.
Age: 34.0
Sex: F
Vaccine: TYP
Symptoms: Asthenia, Hypoaesthesia, Pain
Clinical narrative: Flare up of symptoms of multiple Sclerosis, saw doctor on day she took last fader was given steroid pack. Took more steroids 2 weeks. 2 weeks after that given IV. Steroids. (weakness, numbness,pain).
Age: 1.63
Sex: M
Vaccine: DTAP, IPV
Symptoms: Pyrexia
Clinical narrative: High fever 5 days after vaccination. DTaP and IPV fever went up to 106 degrees.
Age: 0.37
Sex: F
Vaccine: DTAP, HBHEPB, IPV, PNC
Symptoms: Bacterial infection, Convulsion, Epilepsy, Pyrexia, Sepsis
Clinical narrative: Pt suffered a prolonged seizure 24 hrs after receiving, presented in status epilepticus x 2 hrs. Seizure felt likely to be secondary to UTI but Pt's T max was 101. Neurologist could not rule out a vaccine related event. Currently unk whether she will have residual deficits.
Age: 0.37
Sex: F
Vaccine: DTAP, HBHEPB, IPV, PNC
Symptoms: Urinary tract infection
Clinical narrative: Pt suffered a prolonged seizure 24 hrs after receiving, presented in status epilepticus x 2 hrs. Seizure felt likely to be secondary to UTI but Pt's T max was 101. Neurologist could not rule out a vaccine related event. Currently unk whether she will have residual deficits.
Age: 1.22
Sex: M
Vaccine: HIBV, MMR, PNC, VARCEL
Symptoms: Cerebellar ataxia, Dermatitis bullous
Clinical narrative: PT received Varivax on 08/05/05 developed acute cerebellar ataxia on 09/01/2005 seen in ER a follow up by Pedia. neurologist on  09/01/2005 developed acute generalized Varicella like rash all over.
Sex: F
Vaccine: MMR, TD
Symptoms: Dyspnoea, Respiratory distress
Clinical narrative: Reported 30-40 min after vaccine administration in respiratory distress, airway difficulty crowing. Epinephrine 0.3cc given sq O2 at 4 liters. IV solumedrol and IV Benadryl 50mg given improvement of breathing some continued cough when transported on O2 to medical center.
Age: 0.34
Sex: M
Vaccine: DTAP, HBHEPB, IPV, PNC
Symptoms: Pyrexia
Clinical narrative: Fever since 4 o'clock this morning.
Age: 68.0
Sex: F
Vaccine: TD
Symptoms: Headache, Hypoaesthesia, Injection site pain, Pain, Thermal burn
Clinical narrative: Immed. soreness, pain at site soon after developed headache, pain became deep, severe, burning like extended down arm, top of hand numb. Pain very severe even with prescription analgesic, causing patient to stay awake at night, unable to manage her usual job routine, (hairdresser).
Age: 3.0
Sex: M
Vaccine: VARCEL
Symptoms: Rash, Rash pruritic
Clinical narrative: Started with rash on 09/10/2005 (mom described as a few red bumps) today 09/13/2005 many more itchy.
Age: 0.35
Sex: M
Vaccine: DTAP, HBHEPB, IPV, PNC
Symptoms: Hypersensitivity, Injection site induration, Rash
Clinical narrative: Red rash and a knot, ice it and watch to see if its better.
Age: 1.25
Sex: F
Vaccine: MMR, VARCEL
Symptoms: Urticaria
Clinical narrative: Following varicella/MMR vaccine given on thighs B/L hives noted about 1/4 inch welts resolved in 3-4 mins. Responded to Benadryl. patient watched for 20 min for no other reaction.
Age: 15.0
Sex: M
Vaccine: TD
Symptoms: Dizziness, Hyperhidrosis, Syncope, Vomiting
Clinical narrative: About 1 min after TD injection, pt complained of dizziness, follow by diaphoresis, vomiting, syncope in rapid succession. Pt recovered with in 10 minutes and left under parental supervision.
Age: 6.0
Sex: M
Vaccine: DTAP, IPV, MMR
Symptoms: Injection site oedema, Pruritus
Clinical narrative: Adverse reaction left arm feels tight and is swollen shoulder to elbow, complained of itching. No redness noted but arm felt warm.
Age: 0.12
Sex: M
Vaccine: DTAPHEPBIP, HIBV, PNC
Symptoms: Injection site oedema, Irritability, Oedema, Pyrexia
Clinical narrative: Fussiness, swelling, fever of 102, swelling at injection site LVL.
Age: 1.15
Sex: F
Vaccine: DTAPH
Symptoms: Medication error
Clinical narrative: No adverse reaction. Noted 1 component of Trihibit was expired (DTap).
Age: 1.74
Sex: M
Vaccine: HBPV
Symptoms: Dermatitis bullous, Pyrexia, Viral infection
Clinical narrative: Mild looking Chicken Pox spots on rightleg /same side as immunization injection.  Also fever 102.6  This occured 1 week after the shot.
Age: 1.1
Sex: M
Vaccine: DTAP, HBHEPB, MMR, PNC, VARCEL
Symptoms: Erythema, Rash vesicular
Clinical narrative: Left lateral thigh is with an area of erythema with a vesicular eruption, There is a clustered aea of these vesicles that are crusted over and then 3 solo vesicles that are crusted over as well.  There is a slight erthema surrounding the vesicles. but no warmness and it is not extending past the local area.  There is a slight induration around the vesicles as well.
Age: 0.18
Sex: M
Vaccine: DTAP, HBHEPB, IPV, PNC
Symptoms: Melaena, Neutropenia, Petechiae, Thrombocytopenia, White blood cell disorder
Clinical narrative: The patient received vaccines on 9/8/05 w/ no complications. Two days later the patient had blood streaked stools.  On 9/11/05 the patient had diffuse petechiae and platelet count of 5,000.  Pt. was transfused with platelets and follow up count was 40,000.  The following day 9/13/05 the platelet count was 9,000.  IVIG was given 9/13/05 and platelet count prior to discharge was 24,000.  The remaining CBC was WBC 5.2, H/H 9.1/25.5 with absolute neutrophil count of 0.4 so patient was also neutropenic upon discharge.  The patient had no other symptoms. Per 60 day follow up report: I was a medical student on team. I would suggest contacting this patient's PMD whose info was provided.
Age: 41.0
Sex: F
Vaccine: HEP, TD
Symptoms: Flushing, Nausea, Rash, Vomiting
Clinical narrative: Immediately after Hep B injection, patient felt flush and nauseated.  When patient got home, 30 minutes later, vomited x2.  States red blotches appeared on chest and face.
Age: 4.0
Sex: F
Vaccine: DTAP, IPV
Symptoms: Cellulitis, Lobar pneumonia
Clinical narrative: Possible RLL pneumonia and cellulitis rt arm.  To ER 9/2/02-tx with Augmentin, motrin, benedryl. 9/03/05- To Dr. Dr. reports localized reaction.
Age: 16.0
Sex: F
Vaccine: MNQ, VARCEL
Symptoms: Asthenia, Dizziness, Vomiting
Clinical narrative: Developed extreme weakness, fatigue (couldn't keep her eyes open), dizziness and vomiting one hour after receiving Menactra and Varivax #1. Symptoms lasted for 2-3 days finally prompting her to go the emergency room for evaluation. There had blood work and was given one pill for vomiting which then stopped.
Age: 27.0
Sex: F
Vaccine: PPV
Symptoms: Back pain, Chest pain, Coma
Clinical narrative: Patient with spinal muscular atrophy.  Wheelchair bound, very abnormal habitus.  She developed chest pain and then back pain 1 minute after IM vaccination; then became unresponsive.  Initially unable to feel pulse.  Responded to lying down and conservative care.  Back to normal in about 10 minutes.
Age: 0.17
Sex: F
Vaccine: DTAPHEPBIP, HIBV, PNC
Symptoms: Irritability
Clinical narrative: Parents note that patient was extremely fussy for 3 weeks after receiving immunizations.  There were no concurrent illnesses.  No fever, vomiting, diarrhea, congestion, cough or rash.  No lumps at the injection site.
Age: 22.0
Sex: F
Vaccine: HEP
Symptoms: Dizziness, Dyspnoea, Face oedema, Fatigue, Headache
Clinical narrative: 9 hours after receiving Hep.B vaccine developed severe hives on her extremities. Feet, Face Hands and neck became severly swollen. Fever 101.9. Diff. breathing.  Lasted 3 days. ER visit x2. Information received from medical records states difficulty breathing, dizzy, headache, neck pain and fatigue. msv Medical record states facial edema. msv
Age: 22.0
Sex: F
Vaccine: HEP
Symptoms: Neck pain, Oedema peripheral, Pyrexia, Urticaria
Clinical narrative: 9 hours after receiving Hep.B vaccine developed severe hives on her extremities. Feet, Face Hands and neck became severly swollen. Fever 101.9. Diff. breathing.  Lasted 3 days. ER visit x2. Information received from medical records states difficulty breathing, dizzy, headache, neck pain and fatigue. msv Medical record states facial edema. msv
Age: 31.0
Sex: F
Vaccine: RUB, RUB
Symptoms: Asthenia, Headache, Lethargy, Lymphadenopathy, Malaise
Clinical narrative: Rash with urticaria, lymphadenopathy, headache, lethargy, weakness, fever, malaise.  RhoGAM was administered two days prior to the Rubella Vaccine.
Age: 31.0
Sex: F
Vaccine: RUB, RUB
Symptoms: Pyrexia, Rash, Urticaria
Clinical narrative: Rash with urticaria, lymphadenopathy, headache, lethargy, weakness, fever, malaise.  RhoGAM was administered two days prior to the Rubella Vaccine.
Age: 31.0
Sex: F
Vaccine: RUB, RUB
Symptoms: Rash
Clinical narrative: Rash with urticaria, lymphadenopathy, headache, lethargy, weakness, fever, malaise.  RhoGAM was administered two days prior to the Rubella Vaccine.
Age: 38.0
Sex: F
Vaccine: FLU3
Symptoms: Pain, Paraesthesia
Clinical narrative: From initial information received on 23Dec04 from a health care professional regarding an adverse event occurring, it was reported that a 38 yr old female pt received a dose of Fluzone SV 2004-2005 USP, lot number U1523AA, with an expiration date of 30Jun05, administered in the left deltoid on 06Nov04 at 11:00AM. The route of administration was not reported. Two days later, on 09Nov04 at 10:00AM, the pt developed bilateral leg pain. In was suggested by the reporter that the pt is seen for a neurologist consultation, which was scheduled for 14Jan05. Reportedly, the pt did not recover from this events and is under physician's care. Follow up information received on 08Sep05 from a health care professional. It was reported that the pt experienced bilateral leg paresthesia and was referred to a neurologist. An x-ray of the lumbar spine was performed on 30Nov04 and an MRI of the brain on 15Dec04, but no results were provided. The pt lost time at work, but is reportedly is doing well now. It was not reported whether she completely recovered from the events. Based upon the new information provided, this case is being upgraded to serious. (OMIC)
Age: 86.0
Sex: M
Vaccine: FLU3
Symptoms: Asthenia, Atelectasis, Atherosclerosis, Extensor plantar response, Gait disturbance
Clinical narrative: From initial information received on Mar 16 2004 from a physicians office, regarding an adverse event, It was reported that an 85 year old male patient received Fluzone SV 2003-2004 USP, lot number U1131AA, administered intra muscularly in the left deltoid on Nov 10 2003. The patient had no reaction at the time of vaccination. He visited his physician for a regular office visit on Dec 31 2003 and had no complaints. On Jan 02 2004, he was seen in the ER for bilateral leg and arm weakness. this was his second visit to the ER, but no details were provided regarding his first visit. He was admitted to the hospital on Jan 02 2004 and was diagnosed with Guillain Barre syndrome. The patients recovery status is unknown. From additional information received on May 28 2004 from a physician, the patients hospital records were provided. The patient was admitted to the hospital on Jan 02 2004 with a three to four day history of progressive arm and leg weakness to the point where he had to walk with a cane and felt like he could fall when he was ambulating. Vital signs were stable on admission. Upon initial exam, the patient appeared weak and had difficulty getting out of bed. He was unable to push himself into a sitting position using his arms. His lower extremities appeared to be areflexic. He had a slightly positive Babinski. Romberg testing was negative. Pronator drift testing was also negative. His gait was watched without ataxia. Cerebellar testing of the lower extremities was normal. The patient denied concurrent fever, shortness or breath, coughing, muscle fasciculations or numbness or tingling of the hands or feet. He also denied exposure to botulism. Reportedly, the patient had not had any tick bites or traveled recently, A CAT scan of the brain on Jan 02 2004 revealed chronic findings with no acute anomaly identified. The patients recovery status was not reported. Follow up information received on Sept 12 2005. It was reported that the patient has recovered from these events. No further information is expected.
Age: 86.0
Sex: M
Vaccine: FLU3
Symptoms: Guillain-Barre syndrome, Haemoglobin decreased, Hypokinesia, Hyporeflexia, Laboratory test abnormal
Clinical narrative: From initial information received on Mar 16 2004 from a physicians office, regarding an adverse event, It was reported that an 85 year old male patient received Fluzone SV 2003-2004 USP, lot number U1131AA, administered intra muscularly in the left deltoid on Nov 10 2003. The patient had no reaction at the time of vaccination. He visited his physician for a regular office visit on Dec 31 2003 and had no complaints. On Jan 02 2004, he was seen in the ER for bilateral leg and arm weakness. this was his second visit to the ER, but no details were provided regarding his first visit. He was admitted to the hospital on Jan 02 2004 and was diagnosed with Guillain Barre syndrome. The patients recovery status is unknown. From additional information received on May 28 2004 from a physician, the patients hospital records were provided. The patient was admitted to the hospital on Jan 02 2004 with a three to four day history of progressive arm and leg weakness to the point where he had to walk with a cane and felt like he could fall when he was ambulating. Vital signs were stable on admission. Upon initial exam, the patient appeared weak and had difficulty getting out of bed. He was unable to push himself into a sitting position using his arms. His lower extremities appeared to be areflexic. He had a slightly positive Babinski. Romberg testing was negative. Pronator drift testing was also negative. His gait was watched without ataxia. Cerebellar testing of the lower extremities was normal. The patient denied concurrent fever, shortness or breath, coughing, muscle fasciculations or numbness or tingling of the hands or feet. He also denied exposure to botulism. Reportedly, the patient had not had any tick bites or traveled recently, A CAT scan of the brain on Jan 02 2004 revealed chronic findings with no acute anomaly identified. The patients recovery status was not reported. Follow up information received on Sept 12 2005. It was reported that the patient has recovered from these events. No further information is expected.
Age: 86.0
Sex: M
Vaccine: FLU3
Symptoms: Lymphopenia, Red blood cell count decreased, Skin nodule, Urine analysis abnormal
Clinical narrative: From initial information received on Mar 16 2004 from a physicians office, regarding an adverse event, It was reported that an 85 year old male patient received Fluzone SV 2003-2004 USP, lot number U1131AA, administered intra muscularly in the left deltoid on Nov 10 2003. The patient had no reaction at the time of vaccination. He visited his physician for a regular office visit on Dec 31 2003 and had no complaints. On Jan 02 2004, he was seen in the ER for bilateral leg and arm weakness. this was his second visit to the ER, but no details were provided regarding his first visit. He was admitted to the hospital on Jan 02 2004 and was diagnosed with Guillain Barre syndrome. The patients recovery status is unknown. From additional information received on May 28 2004 from a physician, the patients hospital records were provided. The patient was admitted to the hospital on Jan 02 2004 with a three to four day history of progressive arm and leg weakness to the point where he had to walk with a cane and felt like he could fall when he was ambulating. Vital signs were stable on admission. Upon initial exam, the patient appeared weak and had difficulty getting out of bed. He was unable to push himself into a sitting position using his arms. His lower extremities appeared to be areflexic. He had a slightly positive Babinski. Romberg testing was negative. Pronator drift testing was also negative. His gait was watched without ataxia. Cerebellar testing of the lower extremities was normal. The patient denied concurrent fever, shortness or breath, coughing, muscle fasciculations or numbness or tingling of the hands or feet. He also denied exposure to botulism. Reportedly, the patient had not had any tick bites or traveled recently, A CAT scan of the brain on Jan 02 2004 revealed chronic findings with no acute anomaly identified. The patients recovery status was not reported. Follow up information received on Sept 12 2005. It was reported that the patient has recovered from these events. No further information is expected.
Sex: M
Vaccine: HEP
Symptoms: Speech disorder
Clinical narrative: Information has been received from a physician concerning a pediatric male who was vaccinated with a dose of hep B virus vaccine rHBsAg (yeast). Subsequently the pt required speech therapy. Unspecified medical attention was sought. There was no product quality complaint involved. The event which required speech therapy was considered to be an other important medical event (OMIC). No further information is available.
Age: 1.37
Sex: M
Vaccine: HIBV, PNC
Symptoms: Autism
Clinical narrative: This case was considered medically important (OMIC). Information regarding Prevnar (pneumococcal 7 valent conjugate vaccine (diphtheria crm197 protein) injection) was received from healthcare professional regarding a 3 yr old male pt who developed autism. At 16 months of age, the pt received the third dose on 17Apr01. The pt also received the fourth dose of Hib titer vaccine (haemophilus b conjugate vaccine (diphtheria crm197 protein conjugate) (injection) on 17Apr01. Pt's medical history reported as negative. Indication for Prevnar was immunization. Product was administered on 17Apr01 Dose regimen was 1 dose (IM). Additional suspect medication included Hib titer vaccine (haemophilus b conjugate vaccine (diphtheria crm 197 protein conjugate) injection), diphtheria/tetanus toxoids/acellular pertussis vaccine (diphtheria/tetanus toxoid/acellular pertussis vaccine) and hep V vaccine. Concomitant medications were not reported. A physician reported that pt was diagnosed with autism at the age of 3.5 years (Jun 03). No additional information was available at the time of this report.
Age: 74.0
Sex: F
Vaccine: DPP, PPV, TD
Symptoms: Injection site erythema, Injection site warmth
Clinical narrative: PATIENT NOTED REDNESS AND WARMTH IN RIGHT UPPER ARM AROUND INCISION SITE 3" IN SIZE.
Age: 2.0
Sex: F
Vaccine: HEPA
Symptoms: Pyrexia, Vomiting
Clinical narrative: Fever and vomiting that night starting at 6-7pm.
Age: 33.0
Sex: F
Vaccine: TD
Symptoms: Cough, Dry throat, Eye irritation
Clinical narrative: Approx 4 hours after administration patient c/o itching of eyes, nose, throat, then arms, legs began to itch, no hives.  Did develop a cough and still has it.  No SOB.
Age: 20.0
Sex: M
Vaccine: ANTH, SMALL
Symptoms: Blood bilirubin increased, Injection site erythema, Pain, Pyrexia, Rash
Clinical narrative: Seen at ER on 9/9/05 with c/o swelling, redness, rash and arm pain x 2 days. Rash present to arms, chest and face. L arm with redness (Smallpox vaccination site) and R arm with enlarged reaction (Anthrax vaccination site) temp 99.1. Levaquin 500mg and Benadryl 50mg ordered.
Age: 20.0
Sex: M
Vaccine: ANTH, SMALL
Symptoms: Swelling
Clinical narrative: Seen at ER on 9/9/05 with c/o swelling, redness, rash and arm pain x 2 days. Rash present to arms, chest and face. L arm with redness (Smallpox vaccination site) and R arm with enlarged reaction (Anthrax vaccination site) temp 99.1. Levaquin 500mg and Benadryl 50mg ordered.
Age: 18.0
Sex: F
Vaccine: HEP, HEPA, SMALL, TYP
Symptoms: Musculoskeletal stiffness, Myalgia, Shoulder pain
Clinical narrative: Presented to the ER on 8/25/05 with c/o myalgia, L shoulder pain with stiff neck. Had received Small Pox vaccination to the L arm on 8/15/05. Orders given for for Mortin prin and no PT for 3 days.
Age: 7.0
Sex: F
Vaccine: DTAPHEPBIP
Symptoms: Erythema, Rash macular, Swelling
Clinical narrative: Four days after Pediatrix in Left deltoid-arm are swollen, red and macular rash.
Age: 0.12
Sex: F
Vaccine: DTAPHEPBIP, HIBV, PNC
Symptoms: Leukocytosis, Pyrexia, Somnolence, Strabismus, Vaccination complication
Clinical narrative: Patient experienced fever (T max of 102.4), transient strabismus, and drowsiness several hours after administration of vaccines.  Patient was admitted to hospital and work-up was done to rule out sepsis. Discharge summary information states post vaccine complecation. msv
Age: 4.0
Sex: M
Vaccine: DTAP, HEPA, IPV, MMR
Symptoms: Erythema, Infection, Injection site warmth, Rash, Rash macular
Clinical narrative: LEFT THIGH SWELLING WITH BLOTCHY RED RASH, WARM TO TOUCH.  LOCAL REACTION.  PT CURRENTLY ON AUGMENTIN AND ERYTHROMYCIN FOR ORBITAL EYE INFECTION.  PT TREATED WITH BENADRYL PRN IF LEG BOTHERS HIM.
Age: 4.0
Sex: M
Vaccine: DTAP, HEPA, IPV, MMR
Symptoms: Swelling
Clinical narrative: LEFT THIGH SWELLING WITH BLOTCHY RED RASH, WARM TO TOUCH.  LOCAL REACTION.  PT CURRENTLY ON AUGMENTIN AND ERYTHROMYCIN FOR ORBITAL EYE INFECTION.  PT TREATED WITH BENADRYL PRN IF LEG BOTHERS HIM.
Age: 6.0
Sex: M
Vaccine: DTAP, IPV, MMR
Symptoms: Musculoskeletal stiffness, Swelling
Clinical narrative: Mother called into Health Dept on 09/07/2005 and talked to RN. Mother reports that her son's lt arm was swollen 3 times normal. Denies that he had any fever but that he complained that it was stiff. Mother states that it lasted for 3 days. She states that she gave tylenol and applied a cool compress.
Age: 0.14
Sex: F
Vaccine: DTAPHEPBIP, HIBV, PNC
Symptoms: Decreased appetite, Depressed level of consciousness, Hypotonia, Laboratory test abnormal, Nasal congestion
Clinical narrative: Per mother, patient received 2 month immunizations on afternoon of 9/9/05, was given dose of tylenol after shots.  Went home, had feeding before bed for the evening and was acting normally.  Patient did not wake up for 4 am feed, and then had to be woken up for 8 am feed.  She did take the bottle, but then was floppy and difficult to keep awake.  Fever upon arrival to ER, was admitted for septic workup which was negative. Follow-up report states: 9/23/05 Medical records x 15 pgs received and reviewed. Final diagnosis was "fever, congestion, and decreased po intake after having received 2 months vaccinations on the day prior to admisson." Septic workup was negative. It was noted that infant had frontal skull bone fracture on 8/31 from falling from bed, with no neurologic sequelae. Also infant had prenatal cocaine expose. To follow up with peds primary care on 9/19/05 and neurosurgery on 9/15 (previously scheduled FU for depressed skull fracture). There were no medications prescribed. Pt was discharged in good condition. Records submitted for scanning. No additional COSTARTS. Case marked complete/closed and paper report filed/sem.
Age: 0.14
Sex: F
Vaccine: DTAPHEPBIP, HIBV, PNC
Symptoms: Pyrexia, Somnolence
Clinical narrative: Per mother, patient received 2 month immunizations on afternoon of 9/9/05, was given dose of tylenol after shots.  Went home, had feeding before bed for the evening and was acting normally.  Patient did not wake up for 4 am feed, and then had to be woken up for 8 am feed.  She did take the bottle, but then was floppy and difficult to keep awake.  Fever upon arrival to ER, was admitted for septic workup which was negative. Follow-up report states: 9/23/05 Medical records x 15 pgs received and reviewed. Final diagnosis was "fever, congestion, and decreased po intake after having received 2 months vaccinations on the day prior to admisson." Septic workup was negative. It was noted that infant had frontal skull bone fracture on 8/31 from falling from bed, with no neurologic sequelae. Also infant had prenatal cocaine expose. To follow up with peds primary care on 9/19/05 and neurosurgery on 9/15 (previously scheduled FU for depressed skull fracture). There were no medications prescribed. Pt was discharged in good condition. Records submitted for scanning. No additional COSTARTS. Case marked complete/closed and paper report filed/sem.
Age: 44.0
Sex: M
Vaccine: TTOX
Symptoms: Abscess, Bacterial infection, Hyperhidrosis, Pyrexia
Clinical narrative: Apprx. 06/01/2005  (lost paperwork) I presented myself at emergency with an abscess/staph infection in my right thigh area. (this being the third such infection requiring hospital treatment in the last 24 months.)(left forearm, right thigh, right buttock....and now left hand.) After lancing and draining I was asked if I wanted a Tetanus booster previously I had refused the booster but today I was getting quite concerned about repeticious nature of these staph infections so I asked for the tetanus booster. Approx. 12 hours after leaving the hospital I had what I would term a physical meltdown. My system was bouncing from cold sweats to high fever and I was unable to move except for to sleep. almost 18 hours later after remembering that I had some Benedryl and taking them I finally was able to stand...feed myself...etc. My memory of the details of those 18 hours is foggy. However I can tell you without doubt there was a point that I felt certain I wasnt going to live. I did not report the incident until my visit yesterday to emergency.....for another staph infection that in 24 hours had my left hand near bursting from swelling.
Age: 58.0
Sex: F
Vaccine: FLU3, HEPAB, IPV, PPV
Symptoms: Headache, Injection site pain, Injection site swelling, Myalgia, Pyrexia
Clinical narrative: The morning after the innoculations I had a headache, sore muscles, pain and swelling at the injection site, and a fever. The fever reached a maximum of 103.4 at 5:30 PM on June 9,2005.  Tylenol and Ibuprufen were taken to reduce the fever.  A course of Cephalexin was started at 11:30 PM on June 10.  Temperature returned to normal by the morning of June 11.  The headache and sore muscles had subsided by that time, as well.  The injection site on the right arm was still sore and red (3 inches in diameter) for more than 2 weeks.
Age: 58.0
Sex: F
Vaccine: FLU3, HEPAB, IPV, PPV
Symptoms: Vasodilation procedure
Clinical narrative: The morning after the innoculations I had a headache, sore muscles, pain and swelling at the injection site, and a fever. The fever reached a maximum of 103.4 at 5:30 PM on June 9,2005.  Tylenol and Ibuprufen were taken to reduce the fever.  A course of Cephalexin was started at 11:30 PM on June 10.  Temperature returned to normal by the morning of June 11.  The headache and sore muscles had subsided by that time, as well.  The injection site on the right arm was still sore and red (3 inches in diameter) for more than 2 weeks.
Age: 4.0
Sex: M
Vaccine: DTAP, IPV, MMR, PNC
Symptoms: Agitation, Chills, Crying, Decreased appetite, Fatigue
Clinical narrative: Normal after vaccines. Ate normal dinner, went to bed at regular time woke up at 2am tossing and turning no regular after 3am. Sat up at 5am shiver, dozed off and on. UP at 7am started crying 8:30am, whiny,tired, irritable, doesn't want to eat, clingy.
Age: 4.0
Sex: M
Vaccine: DTAP, IPV, MMR, PNC
Symptoms: Irritability, Restlessness, Sleep disorder
Clinical narrative: Normal after vaccines. Ate normal dinner, went to bed at regular time woke up at 2am tossing and turning no regular after 3am. Sat up at 5am shiver, dozed off and on. UP at 7am started crying 8:30am, whiny,tired, irritable, doesn't want to eat, clingy.
Age: 35.0
Sex: M
Vaccine: HEP, HEPA, TD, TYP
Symptoms: Abdominal pain, Chills, Influenza like illness, Pyrexia
Clinical narrative: Pt received oral Tylenol 09/09/2005. 1st dose taken approx 4pm. Pt had slight fever and flu like symptoms. Next dose was 09/11/2005 pt had fever 102.5. Fever remained elevated on and off next day also. chills and flu like symptoms. also abdominal pain which was severe at times.
Age: 1.56
Sex: M
Vaccine: PNC
Symptoms: Convulsion, Pyrexia, Vomiting
Clinical narrative: 09/08/2005 Low grade fever on set 5:30 pm fever continued thu the night then seizures 09/10/2005 2:30am, 6:30am and 8:00am. Seizures lasted 2-3 seconds (?), vomiting 1 time.
Age: 0.62
Sex: M
Vaccine: IPV, PNC
Symptoms: Injection site urticaria, Skin ulcer, Urticaria
Clinical narrative: Urticarial lesions surrounding shot sites, self resolved after one hour. New urticarial self resolving lesions erupting over extremities. No lip swelling or shortness of breath.
Age: 18.0
Sex: F
Vaccine: MEN
Symptoms: Dizziness, Loss of consciousness
Clinical narrative: 09/07/2005 12:50 called patient -LM to return call. 09/08/2005 1:55 called patient she was going to class and could not talk, asked to return call after class. 09/09/2005 return call from patient. Asked to relate incident to me. Stated has 8:30 appointment, She was not aware that she had to wait 20 min in waiting room. She saw other students walking out and though it was OK if she left. She felt slight dizzy while walking to car, got into car and drove home she was on her street when she blacked out she came to when she hit the curb. She wasn't sure what happened unsure of time of accident. Did not seek medical Rx after accident.
Age: 0.03
Sex: M
Vaccine: DTAP, IPV
Symptoms: Cellulitis, Hypersensitivity, Pyrexia
Clinical narrative: Fever Started on Friday am, disapated by Saturday am. Child awoke with small red area on Saturday. By Saturday night patient went to ER with a 19 cm long x 5 cm wide area of cellulitis. Treated with Amoxil 600IM then given Keflex 500 QID and will reduce to TID. Seen 09/12/2005 in office still having area of redness.
Age: 4.0
Sex: M
Vaccine: DTAP, IPV, MMR, PNC, VARCEL
Symptoms: Feeling hot, Hypersensitivity, Oedema, Pyrexia
Clinical narrative: Local redness and swelling of arm, hot to the touch. Low grade fever no itching no N/VID.
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMR
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site warmth, Pruritus
Clinical narrative: Reaction on left upper Deltoid area. Swollen and slight itching, redness hot to touch. Denies pain or any limitation to move arm.
Age: 56.0
Sex: F
Vaccine: MMR
Symptoms: Arthralgia, Asthenia, Dizziness, Dysphonia, Headache
Clinical narrative: Received MMR 09/01/2005 States on 09/05/2005 at approx 10pm, she started feeling bad on 09/06/2005 complained of headache, nausea, joint pain, numbness, tingling to left side. Bilateral leg cramps, hoarseness, glands in neck swollen. Dr informed her she had an adverse reaction to the MMR injection and was given Vicodin for pain. She is call him today for a follow up appt in 3 weeks. At this time 09/12/2005 9:30am patient states she feels better each day, however she is still weak, light headed and continues to have leg cramps. It was recommended that she refuse future MMR injections.
Age: 56.0
Sex: F
Vaccine: MMR
Symptoms: Hypoaesthesia, Lymphadenopathy, Malaise, Muscle spasms, Nausea
Clinical narrative: Received MMR 09/01/2005 States on 09/05/2005 at approx 10pm, she started feeling bad on 09/06/2005 complained of headache, nausea, joint pain, numbness, tingling to left side. Bilateral leg cramps, hoarseness, glands in neck swollen. Dr informed her she had an adverse reaction to the MMR injection and was given Vicodin for pain. She is call him today for a follow up appt in 3 weeks. At this time 09/12/2005 9:30am patient states she feels better each day, however she is still weak, light headed and continues to have leg cramps. It was recommended that she refuse future MMR injections.
Age: 56.0
Sex: F
Vaccine: MMR
Symptoms: Paraesthesia
Clinical narrative: Received MMR 09/01/2005 States on 09/05/2005 at approx 10pm, she started feeling bad on 09/06/2005 complained of headache, nausea, joint pain, numbness, tingling to left side. Bilateral leg cramps, hoarseness, glands in neck swollen. Dr informed her she had an adverse reaction to the MMR injection and was given Vicodin for pain. She is call him today for a follow up appt in 3 weeks. At this time 09/12/2005 9:30am patient states she feels better each day, however she is still weak, light headed and continues to have leg cramps. It was recommended that she refuse future MMR injections.
Age: 5.0
Sex: M
Vaccine: DTAP, IPV
Symptoms: Feeling hot, Hypersensitivity
Clinical narrative: Arm red, hot to touch, extended over large portion of right upper arm.
Age: 4.0
Sex: M
Vaccine: DTAP, IPV, MMR
Symptoms: Pyrexia
Clinical narrative: Fever 103.8 2 hours after shots.
Age: 6.0
Sex: F
Vaccine: DTAP, HEPA, MMR
Symptoms: Feeling hot, Hypersensitivity, Oedema
Clinical narrative: Left arm swollen, red and hot 12 hours after injection.
Age: 0.16
Sex: M
Vaccine: DTAPHEPBIP, HIBV, PNC
Symptoms: Irritability, Pyrexia, Rash
Clinical narrative: 1s vaccines 03/24/2005 at 3pm. 4 hours later fussy, irritable , Tylenol given at 2 and 6pm. Up all night, fever 101 under arm, Tylenol continued. Heat rash like spots 03/24/2005, rash resolved about a day later. MD seen, did not consider infant to have had allergic response, advised vaccines be given separately.
Age: 36.0
Sex: U
Vaccine: DTAP, IPV, MMR
Symptoms: Medication error, Rash
Clinical narrative: On 09/13/2005 mom reported that on 09/06/2005 while her child received shots. The vaccine from one shot squirted her,the mother, in the mouth. Exactly which vaccine is unknown but she received MMR, IPV and DTaP, she said single vaccine in Left arm. Reports she broke out in rash individual red spots started on 09/12 pm and increasing number 9/13/2005 spreading to arms and back. Referred her to her doctor.
Age: 5.0
Sex: F
Vaccine: DTAP, IPV, MMR
Symptoms: Injection site hypersensitivity, Injection site oedema, Pruritus
Clinical narrative: 10 cm local symptom at site after 24 hours. Entire upper arm swelling, redness, itch extending up back to neck. Down volar forearm.
Age: 3.0
Sex: M
Vaccine: HEP, HEPA
Symptoms: Cellulitis, Oedema, Urticaria
Clinical narrative: Significant Urticarial Rash, swelling, cellulitis to bilat thighs.
Age: 4.0
Sex: M
Vaccine: DTAP, IPV
Symptoms: Injection site oedema, Pyrexia
Clinical narrative: Swollen arm at the injection site (right arm). Temperature 103. Benadryl, Tylenol Q 4-6, PRN.
Sex: M
Vaccine: DTAPHEPBIP, HIBV, PNC
Symptoms: Cellulitis
Clinical narrative: Bilateral thigh Cellulitis.
Age: 12.0
Sex: M
Vaccine: TDAP
Symptoms: Myalgia, Pyrexia, Vomiting
Clinical narrative: 104.7 fever with in 24 hours, myalgias, vomit x 2.
Age: 34.0
Sex: F
Vaccine: MMR
Symptoms: Arthralgia, Joint swelling
Clinical narrative: Within 3- to 6 months acute wandering joint pain and swelling later to be addressed as auto-immune in nature. Now chronic multi joint swelling.
Age: 0.41
Sex: M
Vaccine: DTAP, HIBV, IPV, PNC
Symptoms: Crying, Irritability, Somnolence
Clinical narrative: Child received vaccination around 2:30 PM. Was fussy and drowsy for remainder of day and went to sleep around 7:00PM.  Child woke up screaming at 9:00 PM. He was inconsolable and continued screaming and crying for 4 hours.  Touching or holding him seemed to make it worse.  Called nurse at 12:30 AM.  Said to take him to hospital. He was taken to the emergency room at 1:00 AM. The doctor said that it was probably a reaction to the vaccine and to give him more Tylenol.  He began to settle down and would alternate between crying and going in and out of sleep.  The next two days he would not eat or drink from a bottle and would sleep only for an hour at a time.  He would nurse a little bit and take Pedialite from a syringe.  He lost 1 pound over the next 3 days.  He was irritable and would stopped reacting as usual to family members or toys for the next week.  His eating and sleeping pattern gradually returned to normal after 8 days and he has begun responding to stimuli again.
Age: 51.0
Sex: M
Vaccine: LYME
Symptoms: Arthralgia, Fatigue, Nerve injury, Visual disturbance
Clinical narrative: I had 3 Shots of Lymerix over the course of one year and got a bad reaction to them. Fatigue, joint pain, nerve damage, eye sight over the past 5 years.
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMR, PPV
Symptoms: Febrile convulsion, Grand mal convulsion, Injection site erythema, Injection site swelling, Pyrexia
Clinical narrative: The day of the shots, her arm became swollen and red at the site of one of four injections.   I was told to ice it and give tylenol. that night she began running a fever and throwing up.  Again ice and tylenol to get fever down... before 2 weeks were up, she had a grand mal seizure caused by fever. She was treated in the emergency room and released.. her doctor diagnosed it febrile seizure.  Since then, i do believe that she has had at least 3 more seizure, but cuz they have happened at night and not seen they are not being counted as seizures.  Also since those set of shots, she will run fevers for no reason at all ( not sick in any way).. and they will last for like 3-5 days..
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMR, PPV
Symptoms: Vomiting
Clinical narrative: The day of the shots, her arm became swollen and red at the site of one of four injections.   I was told to ice it and give tylenol. that night she began running a fever and throwing up.  Again ice and tylenol to get fever down... before 2 weeks were up, she had a grand mal seizure caused by fever. She was treated in the emergency room and released.. her doctor diagnosed it febrile seizure.  Since then, i do believe that she has had at least 3 more seizure, but cuz they have happened at night and not seen they are not being counted as seizures.  Also since those set of shots, she will run fevers for no reason at all ( not sick in any way).. and they will last for like 3-5 days..
Age: 0.0
Sex: M
Vaccine: HEP
Symptoms: Autism, Neurodevelopmental disorder
Clinical narrative: LEARNING DISABLED, AUTISM.  No new terms reported in MedRecords rec/d 244217.
Age: 5.0
Sex: M
Vaccine: DTAP, IPV, DTAP, IPV
Symptoms: Anaphylactic reaction, Face oedema, Rash, Urticaria
Clinical narrative: Initial report received from a health care professional on Sep 08 2005 a three year old male patient received an intra muscular injection of Daptacel, lot number C2184AA, in the left arm and a dose of IPOL, lot number Y0241, subcutaneously in the right arm in Sept 08 2005. 45 minutes post vaccination, the patient developed a bright red, itchy face, He was taken to the emergency room with respiratory issues and diagnosed with anaphylaxis, He was treated with epinephrine, Solumedrol and a histamine blocker, An allergist was consulted. At the time of this report the patient was still in the emergency. It is unknown whether he recovered from the events. (OMIC)
Age: 5.0
Sex: M
Vaccine: DTAP, IPV, DTAP, IPV
Symptoms: Anaphylactic reaction, Hypersensitivity, Pruritus, Respiratory disorder
Clinical narrative: Initial report received from a health care professional on Sep 08 2005 a three year old male patient received an intra muscular injection of Daptacel, lot number C2184AA, in the left arm and a dose of IPOL, lot number Y0241, subcutaneously in the right arm in Sept 08 2005. 45 minutes post vaccination, the patient developed a bright red, itchy face, He was taken to the emergency room with respiratory issues and diagnosed with anaphylaxis, He was treated with epinephrine, Solumedrol and a histamine blocker, An allergist was consulted. At the time of this report the patient was still in the emergency. It is unknown whether he recovered from the events. (OMIC)
Age: 1.08
Sex: F
Vaccine: PNC
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth
Clinical narrative: Redness (size of silver dollar), swelling and warm at site of injection.  Started at 24 hours post shot. Lasting 2 days.
Sex: F
Vaccine: YF
Symptoms: Injection site hypersensitivity, Injection site induration, Injection site inflammation, Injection site swelling, Injection site warmth
Clinical narrative: Yellow fever reaction. ? elevated LFTS post vaccine. Patient came in for IPV polio booster for international travel and recounted the following information. Received Yellow fever vaccine here on August 18 2005. Lot no UE498AA Exp date Jan 2006. 5ml left arm sq by RN. No other immunizations were given that day. She did have Hepatitis A, Tetanus dip booster, and oral Typhoid at another facility after that date in Sept 05. She says that the Y fever vaccine made her arm feel sensitive at the time it was given and it got red at the site right away. Saturday 8-20th am noted local inflammation about 6" at vaccine site, red, hot raised, sore, burning sensations and it lasted for 2 days more. The next week she had a PE HX scheduled with her PMD (routine) and labs were done because she is taking Aldactone for acne and the MD wanted to check renal labs with this medication. She has been notified by her MD about the elevated LFT labs from that visit and was wondering if they might be associated with the YF reaction?  The MD also drew labs for hepatitis and she is negative for A and C both, she has had prior HBV vaccination as she is a nurse practitioner here.
Sex: F
Vaccine: YF
Symptoms: Liver function test abnormal, Pain, Skin burning sensation
Clinical narrative: Yellow fever reaction. ? elevated LFTS post vaccine. Patient came in for IPV polio booster for international travel and recounted the following information. Received Yellow fever vaccine here on August 18 2005. Lot no UE498AA Exp date Jan 2006. 5ml left arm sq by RN. No other immunizations were given that day. She did have Hepatitis A, Tetanus dip booster, and oral Typhoid at another facility after that date in Sept 05. She says that the Y fever vaccine made her arm feel sensitive at the time it was given and it got red at the site right away. Saturday 8-20th am noted local inflammation about 6" at vaccine site, red, hot raised, sore, burning sensations and it lasted for 2 days more. The next week she had a PE HX scheduled with her PMD (routine) and labs were done because she is taking Aldactone for acne and the MD wanted to check renal labs with this medication. She has been notified by her MD about the elevated LFT labs from that visit and was wondering if they might be associated with the YF reaction?  The MD also drew labs for hepatitis and she is negative for A and C both, she has had prior HBV vaccination as she is a nurse practitioner here.
Age: 0.44
Sex: F
Vaccine: DTAPHEPBIP, HIBV, PNC
Symptoms: Abnormal sleep-related event, Sudden infant death syndrome
Clinical narrative: Autopsy pending. Autopsy rec'd 1031/2005 -- COD was SIDS w/cosleeping w/both parents.
Age: 1.33
Sex: F
Vaccine: DTAP, IPV, VARCEL
Symptoms: Anaphylactic reaction, Dyspnoea, Erythema, Laboratory test abnormal, Rash
Clinical narrative: Immunizations given 9/10/05. On 9/11/05 at about 8 PM, child with SOB, stridor, retractions; seen in ER and given breathing treatment. Breathing OK but flat red rash all over. Rx with steroid shots, PO Prednisolone and Zyrtec. Fine when seen 9/12/05. To talk to allergist 9/13/05. Medical records state anaphylaxis reaction. msv
Age: 1.33
Sex: F
Vaccine: DTAP, IPV, VARCEL
Symptoms: Stridor
Clinical narrative: Immunizations given 9/10/05. On 9/11/05 at about 8 PM, child with SOB, stridor, retractions; seen in ER and given breathing treatment. Breathing OK but flat red rash all over. Rx with steroid shots, PO Prednisolone and Zyrtec. Fine when seen 9/12/05. To talk to allergist 9/13/05. Medical records state anaphylaxis reaction. msv
Age: 4.0
Sex: F
Vaccine: DTAP, HEPA, IPV, MMR
Symptoms: Hypersensitivity, Pharyngolaryngeal pain, Pruritus
Clinical narrative: Epi Pen Jr. administered sq at 11;55 admitted to Pedi floor, Approximately 1 hour after administration of vaccines, pt returned to clinic with severe itching, redness of ears and scratchy throat.
Age: 2.0
Sex: M
Vaccine: DTAP
Symptoms: Cellulitis, Gait disturbance, Injection site induration, Oedema, Pain
Clinical narrative: Swelling 3 inches larger than right thigh. Induration, reticular rash 2 cm above knee to groin, Diff walking on leg. Discharge summary states cellulitis, pain. msv
Age: 2.0
Sex: M
Vaccine: DTAP
Symptoms: Rash
Clinical narrative: Swelling 3 inches larger than right thigh. Induration, reticular rash 2 cm above knee to groin, Diff walking on leg. Discharge summary states cellulitis, pain. msv
Age: 4.0
Sex: M
Vaccine: DTAP, IPV, MM
Symptoms: Hypersensitivity, Oedema
Clinical narrative: Right arm red and swollen. Advised to apply cool compress and my give Tylenol for discomfort.
Age: 5.0
Sex: F
Vaccine: DTAP, IPV
Symptoms: Oedema, Pruritus
Clinical narrative: Left arm swollen and itchy. Reassured reaction to gradually diminish.
Age: 18.0
Sex: M
Vaccine: MNQ
Symptoms: Contusion, Pain, Pruritus, Rash erythematous
Clinical narrative: 09/15 pt called complaining of red bumps under left axilla that itch at times and bruised sore area on top of left shoulder at clavicle area that's beginning to feel better.
Sex: M
Vaccine: DTAP, HEPA, IPV, MMR
Symptoms: Feeling hot, Injection site oedema, Injection site reaction
Clinical narrative: Significant swelling of left thigh, secondary to DTap, skin slightly warm.
Age: 39.0
Sex: F
Vaccine: PPV
Symptoms: Chills, Dehydration, Fatigue, Feeling hot, Hyperhidrosis
Clinical narrative: Site of injection swollen, red, warm, tender. Systemic low grade fever, sweats, chills, diffuse body ache, fatigue, feels dehydrated.
Age: 39.0
Sex: F
Vaccine: PPV
Symptoms: Injection site hypersensitivity, Injection site oedema, Pain, Pyrexia, Tenderness
Clinical narrative: Site of injection swollen, red, warm, tender. Systemic low grade fever, sweats, chills, diffuse body ache, fatigue, feels dehydrated.
Age: 5.0
Sex: M
Vaccine: DTAP, IPV, MMR
Symptoms: Hypersensitivity, Oedema
Clinical narrative: Red swollen right upper arm, cool compresses.
Age: 1.81
Sex: F
Vaccine: UNK
Symptoms: Feeling hot, Hypersensitivity, Injection site induration, Urticaria
Clinical narrative: Enlarging indurated area on left thigh, red, warm to touch. NON tender 15cm x 8cm. Large hive
Age: 28.0
Sex: F
Vaccine: TD
Symptoms: Musculoskeletal stiffness, Pain
Clinical narrative: Phone call 05/12/2005 report sore and stiff right arm after tetanus shot, now sore shoulder and neck she believes to be related to tetanus, did not return to office.
Age: 49.0
Sex: M
Vaccine: TYP
Symptoms: Headache, Nausea, Stomach discomfort
Clinical narrative: Headache, upset stomach, nausea.