chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 97.0
Sex: M
Vaccine: COVID19-2, FLUA4
Symptoms: Lung disorder, Lung infiltration, Pneumonia, Pneumonia aspiration, Sepsis
Clinical narrative: Discharge Provider: DO Primary Care Provider: NP Admission Date: 10/16/2022 Discharge Date: Oct 20, 2022   PRESENTING PROBLEM: Severe sepsis Pneumonia of right lower lobe due to infectious organism Sepsis with acute hypoxic respiratory failure, due to unspecified organism, unspecified whether septic shock present    HOSPITAL COURSE: Patient is a 97-year-old gentleman, resident of long-term facility who has been declining over the past several weeks and has become less responsive.  He was diagnosed with COVID-19 and August of 2022.  Past medical history includes chronic atrial flutter, chronic obstructive pulmonary disease, coronary artery disease.  Patient was treated for sepsis and at admission is chest x-ray revealed hazy infiltrate and airspace disease of the right lower lung.  Patient wishes to be made comfortable, no aggressive treatments, no vasopressors cardiac resuscitation, no CPR no BiPAP and no intubation/ventilation were respected.  Patient's family agreed with his wishes to be kept comfortable and allow a natural death. The patient was treated with antibiotics for healthcare associated pneumonia.  He was placed in appropriate isolation precautions.  He was seen by appropriate therapies and care management.  It was felt difficult to advance his antibiotics due to inability to safely swallow.  It was suspected current issues were at least in part related aspiration pneumonia.  Wishes to generally proceed in a comfort oriented treatment plan were respected. The patient was seen by hospice on 10/19/2022 and the outcome of this meeting with family was the desire to return to his place of residence under the care of hospice.  Roxanol was added to his medical regimen.  Arrangements for return to long-term facility under hospice care were made today.  Antibiotics will be discontinued.  Code status at discharge is do not resuscitate.  Prognosis is poor/terminal, family aware.
Age: 32.0
Sex: F
Vaccine: FLUC4
Symptoms: Unevaluable event
Clinical narrative: Patient describes vaccine being given in the tricep area and a mound at the site at the time of administration.  Question whether this was given subcutaneously rather than intramuscularly.
Age: 41.0
Sex: F
Vaccine: FLU4
Symptoms: Erythema, Gait disturbance, Pain in extremity, Pruritus, Rash
Clinical narrative: Flulaval vaccine given IM in left deltoid on Friday, 10/21/22.  Pt. emailed this nurse on Monday, 10/24/22 stating that she developed a painful "rash".  Pt instructed to come to  Clinic for assessment.  Pt. presents with several large, red whelps on LLE , 3 on RLE and one on each arm.  Areas raised, red, painful to touch.  Pt. reports that she woke up at about 4:00am on 10/22/22 with severe itching on both legs.  As time progressed, she noted several areas on her legs that were painful and made it difficult to walk.  States that as time progressed, she developed more red, painful areas.  Denies any breathing difficulties or SOB at this time.  Instructed to use hydrocortisone cream and Diphenhydramine.  Encouraged patient to go to her PCP walk-in clinic for assessment and treatment.  Instructed to go to ER if any breathing difficulties occur.  Emailed and spoke with patient on 10/25/22.  Pt. states that the OTC medications have helped some but areas are still painful and red.  Denied any new whelps.  Denies any breathing difficulties. States she already has an appointment with her PCP on 10/28/22 and will have PCP assess and treat as needed.
Age: 41.0
Sex: F
Vaccine: FLU4
Symptoms: Swelling, Tenderness, Urticaria
Clinical narrative: Flulaval vaccine given IM in left deltoid on Friday, 10/21/22.  Pt. emailed this nurse on Monday, 10/24/22 stating that she developed a painful "rash".  Pt instructed to come to  Clinic for assessment.  Pt. presents with several large, red whelps on LLE , 3 on RLE and one on each arm.  Areas raised, red, painful to touch.  Pt. reports that she woke up at about 4:00am on 10/22/22 with severe itching on both legs.  As time progressed, she noted several areas on her legs that were painful and made it difficult to walk.  States that as time progressed, she developed more red, painful areas.  Denies any breathing difficulties or SOB at this time.  Instructed to use hydrocortisone cream and Diphenhydramine.  Encouraged patient to go to her PCP walk-in clinic for assessment and treatment.  Instructed to go to ER if any breathing difficulties occur.  Emailed and spoke with patient on 10/25/22.  Pt. states that the OTC medications have helped some but areas are still painful and red.  Denied any new whelps.  Denies any breathing difficulties. States she already has an appointment with her PCP on 10/28/22 and will have PCP assess and treat as needed.
Age: 28.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Laboratory test abnormal, SARS-CoV-2 test positive
Clinical narrative: 09/03/22 presents to ED for "abnormal labs". PMHx of "end-stage renal disease on hemodialysis, Lynch syndrome, seizure disorder"
Age: 85.0
Sex: M
Vaccine: COVID19-2, COVID19-2
Symptoms: Anaemia, Asthenia, Atrioventricular block second degree, Blood thyroid stimulating hormone normal, COVID-19
Clinical narrative: Admission Date: 10/17/2022 Discharge Date: 10/24/2022   DETAILS OF HOSPITAL STAY: Patient is an 85-year-old man with a past medical history of coronary artery disease, atrial fibrillation, hyperlipidemia, CHF, mild dementia, who presented to the emergency department due to generalized weakness and worsening shortness of breath.  Was found to be hypoxic in 80s and was placed on 2 L of oxygen.  His lab workup was consistent with leukocytosis and COVID-19 PCR was positive.  Chest x-ray was consistent with persistent moderate pulmonary fibrosis with superimposed mild airspace disease.   He was admitted to the hospital, started Decadron and remdesivir which he finished in hospital 10/23. Discharged on 4 more days of Decadron 6 mg po daily.  Patient showed some improvement in terms of symptoms and feels better.  By the time of discharge he was on RA. Unfortunately he has generalized wa          He has history of paroxysmal A. Fib, but during this hospitalization his heart rates have been ranging between 20-50 and EKG consistent with Mobitz type 1 AV block.  EP was consulted, and they had no plan for pacemaker as patient was completely asymptomatic. Echocardiogram was within normal limits.  All other lab workup which included TSH was within normal limits.  Patient will benefit with a heart monitor for 14 days at the time of discharge. Chronic diastolic dysfunction, AS s/p bioprosthetic valve, CAD s/p CABG were well controlled.  Net IO Since Admission: -2,450 mL [10/24/22 1440]  Mild anemia and Thrombocytopenia stable. PT/OT recommended SAR, but patient wife did not want him to wait until 10/28 when out of respiratory isolation, so he was discharged home. Family is around to help wife.
Age: 85.0
Sex: M
Vaccine: COVID19-2, COVID19-2
Symptoms: Chest X-ray abnormal, Condition aggravated, Coronary artery bypass, Coronary artery disease, Diastolic dysfunction
Clinical narrative: Admission Date: 10/17/2022 Discharge Date: 10/24/2022   DETAILS OF HOSPITAL STAY: Patient is an 85-year-old man with a past medical history of coronary artery disease, atrial fibrillation, hyperlipidemia, CHF, mild dementia, who presented to the emergency department due to generalized weakness and worsening shortness of breath.  Was found to be hypoxic in 80s and was placed on 2 L of oxygen.  His lab workup was consistent with leukocytosis and COVID-19 PCR was positive.  Chest x-ray was consistent with persistent moderate pulmonary fibrosis with superimposed mild airspace disease.   He was admitted to the hospital, started Decadron and remdesivir which he finished in hospital 10/23. Discharged on 4 more days of Decadron 6 mg po daily.  Patient showed some improvement in terms of symptoms and feels better.  By the time of discharge he was on RA. Unfortunately he has generalized wa          He has history of paroxysmal A. Fib, but during this hospitalization his heart rates have been ranging between 20-50 and EKG consistent with Mobitz type 1 AV block.  EP was consulted, and they had no plan for pacemaker as patient was completely asymptomatic. Echocardiogram was within normal limits.  All other lab workup which included TSH was within normal limits.  Patient will benefit with a heart monitor for 14 days at the time of discharge. Chronic diastolic dysfunction, AS s/p bioprosthetic valve, CAD s/p CABG were well controlled.  Net IO Since Admission: -2,450 mL [10/24/22 1440]  Mild anemia and Thrombocytopenia stable. PT/OT recommended SAR, but patient wife did not want him to wait until 10/28 when out of respiratory isolation, so he was discharged home. Family is around to help wife.
Age: 85.0
Sex: M
Vaccine: COVID19-2, COVID19-2
Symptoms: Dyspnoea, Echocardiogram normal, Electrocardiogram abnormal, Hypoxia, Laboratory test abnormal
Clinical narrative: Admission Date: 10/17/2022 Discharge Date: 10/24/2022   DETAILS OF HOSPITAL STAY: Patient is an 85-year-old man with a past medical history of coronary artery disease, atrial fibrillation, hyperlipidemia, CHF, mild dementia, who presented to the emergency department due to generalized weakness and worsening shortness of breath.  Was found to be hypoxic in 80s and was placed on 2 L of oxygen.  His lab workup was consistent with leukocytosis and COVID-19 PCR was positive.  Chest x-ray was consistent with persistent moderate pulmonary fibrosis with superimposed mild airspace disease.   He was admitted to the hospital, started Decadron and remdesivir which he finished in hospital 10/23. Discharged on 4 more days of Decadron 6 mg po daily.  Patient showed some improvement in terms of symptoms and feels better.  By the time of discharge he was on RA. Unfortunately he has generalized wa          He has history of paroxysmal A. Fib, but during this hospitalization his heart rates have been ranging between 20-50 and EKG consistent with Mobitz type 1 AV block.  EP was consulted, and they had no plan for pacemaker as patient was completely asymptomatic. Echocardiogram was within normal limits.  All other lab workup which included TSH was within normal limits.  Patient will benefit with a heart monitor for 14 days at the time of discharge. Chronic diastolic dysfunction, AS s/p bioprosthetic valve, CAD s/p CABG were well controlled.  Net IO Since Admission: -2,450 mL [10/24/22 1440]  Mild anemia and Thrombocytopenia stable. PT/OT recommended SAR, but patient wife did not want him to wait until 10/28 when out of respiratory isolation, so he was discharged home. Family is around to help wife.
Age: 85.0
Sex: M
Vaccine: COVID19-2, COVID19-2
Symptoms: Leukocytosis, Lung disorder, Pulmonary fibrosis, SARS-CoV-2 test positive, Thrombocytopenia
Clinical narrative: Admission Date: 10/17/2022 Discharge Date: 10/24/2022   DETAILS OF HOSPITAL STAY: Patient is an 85-year-old man with a past medical history of coronary artery disease, atrial fibrillation, hyperlipidemia, CHF, mild dementia, who presented to the emergency department due to generalized weakness and worsening shortness of breath.  Was found to be hypoxic in 80s and was placed on 2 L of oxygen.  His lab workup was consistent with leukocytosis and COVID-19 PCR was positive.  Chest x-ray was consistent with persistent moderate pulmonary fibrosis with superimposed mild airspace disease.   He was admitted to the hospital, started Decadron and remdesivir which he finished in hospital 10/23. Discharged on 4 more days of Decadron 6 mg po daily.  Patient showed some improvement in terms of symptoms and feels better.  By the time of discharge he was on RA. Unfortunately he has generalized wa          He has history of paroxysmal A. Fib, but during this hospitalization his heart rates have been ranging between 20-50 and EKG consistent with Mobitz type 1 AV block.  EP was consulted, and they had no plan for pacemaker as patient was completely asymptomatic. Echocardiogram was within normal limits.  All other lab workup which included TSH was within normal limits.  Patient will benefit with a heart monitor for 14 days at the time of discharge. Chronic diastolic dysfunction, AS s/p bioprosthetic valve, CAD s/p CABG were well controlled.  Net IO Since Admission: -2,450 mL [10/24/22 1440]  Mild anemia and Thrombocytopenia stable. PT/OT recommended SAR, but patient wife did not want him to wait until 10/28 when out of respiratory isolation, so he was discharged home. Family is around to help wife.
Age: 85.0
Sex: M
Vaccine: COVID19-2, COVID19-2
Symptoms: Acute kidney injury, Bladder catheterisation, Bradycardia, Cardiac pacemaker insertion, Chest X-ray abnormal
Clinical narrative: Admission Date: 10/17/2022 Discharge Date: 10/24/2022   DETAILS OF HOSPITAL STAY: Patient is an 85-year-old man with a past medical history of coronary artery disease, atrial fibrillation, hyperlipidemia, CHF, mild dementia, who presented to the emergency department due to generalized weakness and worsening shortness of breath.  Was found to be hypoxic in 80s and was placed on 2 L of oxygen.  His lab workup was consistent with leukocytosis and COVID-19 PCR was positive.  Chest x-ray was consistent with persistent moderate pulmonary fibrosis with superimposed mild airspace disease.   He was admitted to the hospital, started Decadron and remdesivir which he finished in hospital 10/23. Discharged on 4 more days of Decadron 6 mg po daily.  Patient showed some improvement in terms of symptoms and feels better.  By the time of discharge he was on RA. Unfortunately he has generalized wa          He has history of paroxysmal A. Fib, but during this hospitalization his heart rates have been ranging between 20-50 and EKG consistent with Mobitz type 1 AV block.  EP was consulted, and they had no plan for pacemaker as patient was completely asymptomatic. Echocardiogram was within normal limits.  All other lab workup which included TSH was within normal limits.  Patient will benefit with a heart monitor for 14 days at the time of discharge. Chronic diastolic dysfunction, AS s/p bioprosthetic valve, CAD s/p CABG were well controlled.  Net IO Since Admission: -2,450 mL [10/24/22 1440]  Mild anemia and Thrombocytopenia stable. PT/OT recommended SAR, but patient wife did not want him to wait until 10/28 when out of respiratory isolation, so he was discharged home. Family is around to help wife.
Age: 85.0
Sex: M
Vaccine: COVID19-2, COVID19-2
Symptoms: Dyspnoea, Haematuria, Hypervolaemia, Hypotension, Intensive care
Clinical narrative: Admission Date: 10/17/2022 Discharge Date: 10/24/2022   DETAILS OF HOSPITAL STAY: Patient is an 85-year-old man with a past medical history of coronary artery disease, atrial fibrillation, hyperlipidemia, CHF, mild dementia, who presented to the emergency department due to generalized weakness and worsening shortness of breath.  Was found to be hypoxic in 80s and was placed on 2 L of oxygen.  His lab workup was consistent with leukocytosis and COVID-19 PCR was positive.  Chest x-ray was consistent with persistent moderate pulmonary fibrosis with superimposed mild airspace disease.   He was admitted to the hospital, started Decadron and remdesivir which he finished in hospital 10/23. Discharged on 4 more days of Decadron 6 mg po daily.  Patient showed some improvement in terms of symptoms and feels better.  By the time of discharge he was on RA. Unfortunately he has generalized wa          He has history of paroxysmal A. Fib, but during this hospitalization his heart rates have been ranging between 20-50 and EKG consistent with Mobitz type 1 AV block.  EP was consulted, and they had no plan for pacemaker as patient was completely asymptomatic. Echocardiogram was within normal limits.  All other lab workup which included TSH was within normal limits.  Patient will benefit with a heart monitor for 14 days at the time of discharge. Chronic diastolic dysfunction, AS s/p bioprosthetic valve, CAD s/p CABG were well controlled.  Net IO Since Admission: -2,450 mL [10/24/22 1440]  Mild anemia and Thrombocytopenia stable. PT/OT recommended SAR, but patient wife did not want him to wait until 10/28 when out of respiratory isolation, so he was discharged home. Family is around to help wife.
Age: 85.0
Sex: M
Vaccine: COVID19-2, COVID19-2
Symptoms: Orthostatic hypotension, Pneumonia, Pulmonary oedema, Renal impairment
Clinical narrative: Admission Date: 10/17/2022 Discharge Date: 10/24/2022   DETAILS OF HOSPITAL STAY: Patient is an 85-year-old man with a past medical history of coronary artery disease, atrial fibrillation, hyperlipidemia, CHF, mild dementia, who presented to the emergency department due to generalized weakness and worsening shortness of breath.  Was found to be hypoxic in 80s and was placed on 2 L of oxygen.  His lab workup was consistent with leukocytosis and COVID-19 PCR was positive.  Chest x-ray was consistent with persistent moderate pulmonary fibrosis with superimposed mild airspace disease.   He was admitted to the hospital, started Decadron and remdesivir which he finished in hospital 10/23. Discharged on 4 more days of Decadron 6 mg po daily.  Patient showed some improvement in terms of symptoms and feels better.  By the time of discharge he was on RA. Unfortunately he has generalized wa          He has history of paroxysmal A. Fib, but during this hospitalization his heart rates have been ranging between 20-50 and EKG consistent with Mobitz type 1 AV block.  EP was consulted, and they had no plan for pacemaker as patient was completely asymptomatic. Echocardiogram was within normal limits.  All other lab workup which included TSH was within normal limits.  Patient will benefit with a heart monitor for 14 days at the time of discharge. Chronic diastolic dysfunction, AS s/p bioprosthetic valve, CAD s/p CABG were well controlled.  Net IO Since Admission: -2,450 mL [10/24/22 1440]  Mild anemia and Thrombocytopenia stable. PT/OT recommended SAR, but patient wife did not want him to wait until 10/28 when out of respiratory isolation, so he was discharged home. Family is around to help wife.
Age: 35.0
Sex: M
Vaccine: FLU4
Symptoms: Cough, Feeding disorder, Headache, Insomnia, Oropharyngeal pain
Clinical narrative: Headache Extremely sore throat unable to eat, speak or sleep Cough
Age: 35.0
Sex: M
Vaccine: FLU4
Symptoms: Speech disorder
Clinical narrative: Headache Extremely sore throat unable to eat, speak or sleep Cough
Age: 57.0
Sex: M
Vaccine: FLU4
Symptoms: Extra dose administered, Underdose
Clinical narrative: Patient only received a partial dose of Flulaval prefilled syringe. Per CDC guidelines a full dose was administered immediately afterwards.
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Abnormal behaviour, Acute respiratory failure, COVID-19, Cardiac failure congestive, Chemotherapy
Clinical narrative: Discharge Provider: DO Primary Care Provider: DO Admission Date: 10/14/2022 Discharge Date: 10/16/2022  HOSPITAL COURSE 74-year-old presented to ER with four days of not acting right.  She was more hypoxic than at baseline.  See H&P for full details.  Chest x-ray showed emphysema.  COVID was positive.  Clinically she had a COPD exacerbation 2° COVID.  Admitted and treated with Solu-Medrol, Symbicort, Spiriva, albuterol MDI.  Given three days Remdesivir.  She did very well during the hospitalization.  On the 2nd day of hospitalization she was stable on her home 2 L and did not desaturate with ambulation.  We felt she would benefit from three days of Remdesivir and she agreed; this was completed.  Today she is able to maintain saturations while ambulating up to 90 ft.  She feels well and would like to go home.  She is stable for this.  DISCHARGE DIAGNOSES 1. COVID positive 2. Acute exacerbation of end-stage oxygen-dependent chronic obstructive pulmonary disease 3. Acute hypoxic respiratory failure on chronic hypoxic/hypercarbic respiratory failure 2° #1 and #2  4. Chronic diastolic CHF 5. HTN 6. SSS s/p pacemaker 7. History of PE and RLL arterial thrombosis 2° mass 8. RLS 9. HLD 10. History of genital HSV 11. Chronic pain syndrome 12. History of recurrent SCC lung 13. Left DCIS 14. Chronic thrombocytopenia/lymphopenia 2° bone marrow suppression from chemotherapy
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Chest X-ray abnormal, Chronic left ventricular failure, Chronic obstructive pulmonary disease, Condition aggravated, Emphysema
Clinical narrative: Discharge Provider: DO Primary Care Provider: DO Admission Date: 10/14/2022 Discharge Date: 10/16/2022  HOSPITAL COURSE 74-year-old presented to ER with four days of not acting right.  She was more hypoxic than at baseline.  See H&P for full details.  Chest x-ray showed emphysema.  COVID was positive.  Clinically she had a COPD exacerbation 2° COVID.  Admitted and treated with Solu-Medrol, Symbicort, Spiriva, albuterol MDI.  Given three days Remdesivir.  She did very well during the hospitalization.  On the 2nd day of hospitalization she was stable on her home 2 L and did not desaturate with ambulation.  We felt she would benefit from three days of Remdesivir and she agreed; this was completed.  Today she is able to maintain saturations while ambulating up to 90 ft.  She feels well and would like to go home.  She is stable for this.  DISCHARGE DIAGNOSES 1. COVID positive 2. Acute exacerbation of end-stage oxygen-dependent chronic obstructive pulmonary disease 3. Acute hypoxic respiratory failure on chronic hypoxic/hypercarbic respiratory failure 2° #1 and #2  4. Chronic diastolic CHF 5. HTN 6. SSS s/p pacemaker 7. History of PE and RLL arterial thrombosis 2° mass 8. RLS 9. HLD 10. History of genital HSV 11. Chronic pain syndrome 12. History of recurrent SCC lung 13. Left DCIS 14. Chronic thrombocytopenia/lymphopenia 2° bone marrow suppression from chemotherapy
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Hyperlipidaemia, Hypertension, Hypoxia, Lymphopenia, Myelosuppression
Clinical narrative: Discharge Provider: DO Primary Care Provider: DO Admission Date: 10/14/2022 Discharge Date: 10/16/2022  HOSPITAL COURSE 74-year-old presented to ER with four days of not acting right.  She was more hypoxic than at baseline.  See H&P for full details.  Chest x-ray showed emphysema.  COVID was positive.  Clinically she had a COPD exacerbation 2° COVID.  Admitted and treated with Solu-Medrol, Symbicort, Spiriva, albuterol MDI.  Given three days Remdesivir.  She did very well during the hospitalization.  On the 2nd day of hospitalization she was stable on her home 2 L and did not desaturate with ambulation.  We felt she would benefit from three days of Remdesivir and she agreed; this was completed.  Today she is able to maintain saturations while ambulating up to 90 ft.  She feels well and would like to go home.  She is stable for this.  DISCHARGE DIAGNOSES 1. COVID positive 2. Acute exacerbation of end-stage oxygen-dependent chronic obstructive pulmonary disease 3. Acute hypoxic respiratory failure on chronic hypoxic/hypercarbic respiratory failure 2° #1 and #2  4. Chronic diastolic CHF 5. HTN 6. SSS s/p pacemaker 7. History of PE and RLL arterial thrombosis 2° mass 8. RLS 9. HLD 10. History of genital HSV 11. Chronic pain syndrome 12. History of recurrent SCC lung 13. Left DCIS 14. Chronic thrombocytopenia/lymphopenia 2° bone marrow suppression from chemotherapy
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Respiratory failure, Restless legs syndrome, SARS-CoV-2 test positive, Sinus node dysfunction, Thrombocytopenia
Clinical narrative: Discharge Provider: DO Primary Care Provider: DO Admission Date: 10/14/2022 Discharge Date: 10/16/2022  HOSPITAL COURSE 74-year-old presented to ER with four days of not acting right.  She was more hypoxic than at baseline.  See H&P for full details.  Chest x-ray showed emphysema.  COVID was positive.  Clinically she had a COPD exacerbation 2° COVID.  Admitted and treated with Solu-Medrol, Symbicort, Spiriva, albuterol MDI.  Given three days Remdesivir.  She did very well during the hospitalization.  On the 2nd day of hospitalization she was stable on her home 2 L and did not desaturate with ambulation.  We felt she would benefit from three days of Remdesivir and she agreed; this was completed.  Today she is able to maintain saturations while ambulating up to 90 ft.  She feels well and would like to go home.  She is stable for this.  DISCHARGE DIAGNOSES 1. COVID positive 2. Acute exacerbation of end-stage oxygen-dependent chronic obstructive pulmonary disease 3. Acute hypoxic respiratory failure on chronic hypoxic/hypercarbic respiratory failure 2° #1 and #2  4. Chronic diastolic CHF 5. HTN 6. SSS s/p pacemaker 7. History of PE and RLL arterial thrombosis 2° mass 8. RLS 9. HLD 10. History of genital HSV 11. Chronic pain syndrome 12. History of recurrent SCC lung 13. Left DCIS 14. Chronic thrombocytopenia/lymphopenia 2° bone marrow suppression from chemotherapy
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site erythema, Injection site mass, Injection site pain, Injection site pustule, Injection site urticaria
Clinical narrative: Medium sized lump for todays, reddening, soreness at site, then a small raised pustual or hive that has lasted for about a week.  Called to report and turned in records but could not get in touch with provider.
Age: 66.0
Sex: F
Vaccine: PNC20
Symptoms: Ear pruritus, Injection site pain, Pruritus, Rash, Swelling
Clinical narrative: I started itching after 48 hours (evening oct22nd) then developed small raised itchy welts. The itching was initially restricted to ears, under arms, in groin area and side of waist. The itching gradually increased over next few days(23rd oct) with the welts becoming more raised into hives.  Evening and morning are the worst for itching. The hives have spread much further over  my torso, back, kneck. Hives in head have turned into rigid bumps today (oct27). I had ro start taking Benydryl (oct 27th) as the itching and hives have become worse. I have experiencec no other symptoms, except for injection site soreness for one day.
Age: 66.0
Sex: F
Vaccine: PNC20
Symptoms: Urticaria
Clinical narrative: I started itching after 48 hours (evening oct22nd) then developed small raised itchy welts. The itching was initially restricted to ears, under arms, in groin area and side of waist. The itching gradually increased over next few days(23rd oct) with the welts becoming more raised into hives.  Evening and morning are the worst for itching. The hives have spread much further over  my torso, back, kneck. Hives in head have turned into rigid bumps today (oct27). I had ro start taking Benydryl (oct 27th) as the itching and hives have become worse. I have experiencec no other symptoms, except for injection site soreness for one day.
Age: 59.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Asthenia, COVID-19, Chest pain, SARS-CoV-2 test positive
Clinical narrative: 09/04/22 presents to ED for "chest pain and weakness". PMHx of "HIV/AIDS and hypertension"
Age: 79.0
Sex: F
Vaccine: COVID19
Symptoms: Anticoagulant therapy, Asthenia, Atrial fibrillation, Bone lesion, Breast cancer metastatic
Clinical narrative: Discharge Provider: PA-C Attending Physician: MD Primary Care Provider at Discharge: MD  Admission Date: 10/16/2022 Discharge Date: 10/24/2022  PRESENTING PROBLEM: Generalized weakness [R53.1]   HOSPITAL COURSE: Patient is a 80 y.o. female metastatic breast cancer, chronic diastolic heart failure, permanent atrial fibrillation on Coumadin, hypothyroidism, depression who presented with worsening weakness and multiple falls. She had been seen in ED on 10/13 w/ hallucinations and found to be COVID positive, she was discharged to follow up outpatient. She presented back to ED on 10/16 and was found to be tachcardic and mildly hypotensive. She did have brief episode of severe hypotension and hypoxia which resolved after fluids. CT head was negative. CT thorax/abd/pelvis showed concern for metastatic disease. Care was discussed with oncology who recommended admission to medicine.     Following admission pt completed 5 day course of remdesivir for COVID. She had no further episodes of hypoxia. She was seen by PT/OT with recommendations for SAR.    Regarding her ill defined sclerotic and lytic bone lesions, oncology was consulted. Recommended continue letrozole and holding palbociclib and follow up outpatient. It was recommended she have outpatient MRI brain to evaluate for metastatic disease given hallucinations.    She was note to have new pancytopenia, which stabilized. Peripheral smear without clear etiology for pancytopenia. Possibly related to acute illness. Recommend follow up CBC within 1 week and heme-onc follow up if persistent. She does have a follow up oncology visit scheduled on 10/26.   She was incidentally found to have a thyroid nodule on CT. Ultrasound revealing two thyroid nodules of concern, for which FNA biopsy recommended. Information forwarded to PCP via Epic and discussed with patient/placed on follow up information on discharge paperwork.    Coumadin was also held on admission with concern for recurrent falls. This was discussed with the patient and her son, ultimately felt benefit higher than risk (chadsvsac 4, hasbled 1) especially as plan for rehab and hopeful for LTC following. Alternative agents were discussed with the patient and her son, and she was started on eliquis.   Once cleared from respiratory isolation, she was felt stable to transfer to subacute rehab on 10/24. All follow up recommendations discussed in detail prior to discharge.
Age: 79.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Chronic left ventricular failure, Computerised tomogram abdomen abnormal, Computerised tomogram head normal, Computerised tomogram thorax abnormal
Clinical narrative: Discharge Provider: PA-C Attending Physician: MD Primary Care Provider at Discharge: MD  Admission Date: 10/16/2022 Discharge Date: 10/24/2022  PRESENTING PROBLEM: Generalized weakness [R53.1]   HOSPITAL COURSE: Patient is a 80 y.o. female metastatic breast cancer, chronic diastolic heart failure, permanent atrial fibrillation on Coumadin, hypothyroidism, depression who presented with worsening weakness and multiple falls. She had been seen in ED on 10/13 w/ hallucinations and found to be COVID positive, she was discharged to follow up outpatient. She presented back to ED on 10/16 and was found to be tachcardic and mildly hypotensive. She did have brief episode of severe hypotension and hypoxia which resolved after fluids. CT head was negative. CT thorax/abd/pelvis showed concern for metastatic disease. Care was discussed with oncology who recommended admission to medicine.     Following admission pt completed 5 day course of remdesivir for COVID. She had no further episodes of hypoxia. She was seen by PT/OT with recommendations for SAR.    Regarding her ill defined sclerotic and lytic bone lesions, oncology was consulted. Recommended continue letrozole and holding palbociclib and follow up outpatient. It was recommended she have outpatient MRI brain to evaluate for metastatic disease given hallucinations.    She was note to have new pancytopenia, which stabilized. Peripheral smear without clear etiology for pancytopenia. Possibly related to acute illness. Recommend follow up CBC within 1 week and heme-onc follow up if persistent. She does have a follow up oncology visit scheduled on 10/26.   She was incidentally found to have a thyroid nodule on CT. Ultrasound revealing two thyroid nodules of concern, for which FNA biopsy recommended. Information forwarded to PCP via Epic and discussed with patient/placed on follow up information on discharge paperwork.    Coumadin was also held on admission with concern for recurrent falls. This was discussed with the patient and her son, ultimately felt benefit higher than risk (chadsvsac 4, hasbled 1) especially as plan for rehab and hopeful for LTC following. Alternative agents were discussed with the patient and her son, and she was started on eliquis.   Once cleared from respiratory isolation, she was felt stable to transfer to subacute rehab on 10/24. All follow up recommendations discussed in detail prior to discharge.
Age: 79.0
Sex: F
Vaccine: COVID19
Symptoms: Depression, Fall, Hallucination, Hypotension, Hypothyroidism
Clinical narrative: Discharge Provider: PA-C Attending Physician: MD Primary Care Provider at Discharge: MD  Admission Date: 10/16/2022 Discharge Date: 10/24/2022  PRESENTING PROBLEM: Generalized weakness [R53.1]   HOSPITAL COURSE: Patient is a 80 y.o. female metastatic breast cancer, chronic diastolic heart failure, permanent atrial fibrillation on Coumadin, hypothyroidism, depression who presented with worsening weakness and multiple falls. She had been seen in ED on 10/13 w/ hallucinations and found to be COVID positive, she was discharged to follow up outpatient. She presented back to ED on 10/16 and was found to be tachcardic and mildly hypotensive. She did have brief episode of severe hypotension and hypoxia which resolved after fluids. CT head was negative. CT thorax/abd/pelvis showed concern for metastatic disease. Care was discussed with oncology who recommended admission to medicine.     Following admission pt completed 5 day course of remdesivir for COVID. She had no further episodes of hypoxia. She was seen by PT/OT with recommendations for SAR.    Regarding her ill defined sclerotic and lytic bone lesions, oncology was consulted. Recommended continue letrozole and holding palbociclib and follow up outpatient. It was recommended she have outpatient MRI brain to evaluate for metastatic disease given hallucinations.    She was note to have new pancytopenia, which stabilized. Peripheral smear without clear etiology for pancytopenia. Possibly related to acute illness. Recommend follow up CBC within 1 week and heme-onc follow up if persistent. She does have a follow up oncology visit scheduled on 10/26.   She was incidentally found to have a thyroid nodule on CT. Ultrasound revealing two thyroid nodules of concern, for which FNA biopsy recommended. Information forwarded to PCP via Epic and discussed with patient/placed on follow up information on discharge paperwork.    Coumadin was also held on admission with concern for recurrent falls. This was discussed with the patient and her son, ultimately felt benefit higher than risk (chadsvsac 4, hasbled 1) especially as plan for rehab and hopeful for LTC following. Alternative agents were discussed with the patient and her son, and she was started on eliquis.   Once cleared from respiratory isolation, she was felt stable to transfer to subacute rehab on 10/24. All follow up recommendations discussed in detail prior to discharge.
Age: 79.0
Sex: F
Vaccine: COVID19
Symptoms: Hypoxia, Pancytopenia, SARS-CoV-2 test positive, Smear test, Tachycardia
Clinical narrative: Discharge Provider: PA-C Attending Physician: MD Primary Care Provider at Discharge: MD  Admission Date: 10/16/2022 Discharge Date: 10/24/2022  PRESENTING PROBLEM: Generalized weakness [R53.1]   HOSPITAL COURSE: Patient is a 80 y.o. female metastatic breast cancer, chronic diastolic heart failure, permanent atrial fibrillation on Coumadin, hypothyroidism, depression who presented with worsening weakness and multiple falls. She had been seen in ED on 10/13 w/ hallucinations and found to be COVID positive, she was discharged to follow up outpatient. She presented back to ED on 10/16 and was found to be tachcardic and mildly hypotensive. She did have brief episode of severe hypotension and hypoxia which resolved after fluids. CT head was negative. CT thorax/abd/pelvis showed concern for metastatic disease. Care was discussed with oncology who recommended admission to medicine.     Following admission pt completed 5 day course of remdesivir for COVID. She had no further episodes of hypoxia. She was seen by PT/OT with recommendations for SAR.    Regarding her ill defined sclerotic and lytic bone lesions, oncology was consulted. Recommended continue letrozole and holding palbociclib and follow up outpatient. It was recommended she have outpatient MRI brain to evaluate for metastatic disease given hallucinations.    She was note to have new pancytopenia, which stabilized. Peripheral smear without clear etiology for pancytopenia. Possibly related to acute illness. Recommend follow up CBC within 1 week and heme-onc follow up if persistent. She does have a follow up oncology visit scheduled on 10/26.   She was incidentally found to have a thyroid nodule on CT. Ultrasound revealing two thyroid nodules of concern, for which FNA biopsy recommended. Information forwarded to PCP via Epic and discussed with patient/placed on follow up information on discharge paperwork.    Coumadin was also held on admission with concern for recurrent falls. This was discussed with the patient and her son, ultimately felt benefit higher than risk (chadsvsac 4, hasbled 1) especially as plan for rehab and hopeful for LTC following. Alternative agents were discussed with the patient and her son, and she was started on eliquis.   Once cleared from respiratory isolation, she was felt stable to transfer to subacute rehab on 10/24. All follow up recommendations discussed in detail prior to discharge.
Age: 79.0
Sex: F
Vaccine: COVID19
Symptoms: Thyroid mass, Ultrasound thyroid abnormal
Clinical narrative: Discharge Provider: PA-C Attending Physician: MD Primary Care Provider at Discharge: MD  Admission Date: 10/16/2022 Discharge Date: 10/24/2022  PRESENTING PROBLEM: Generalized weakness [R53.1]   HOSPITAL COURSE: Patient is a 80 y.o. female metastatic breast cancer, chronic diastolic heart failure, permanent atrial fibrillation on Coumadin, hypothyroidism, depression who presented with worsening weakness and multiple falls. She had been seen in ED on 10/13 w/ hallucinations and found to be COVID positive, she was discharged to follow up outpatient. She presented back to ED on 10/16 and was found to be tachcardic and mildly hypotensive. She did have brief episode of severe hypotension and hypoxia which resolved after fluids. CT head was negative. CT thorax/abd/pelvis showed concern for metastatic disease. Care was discussed with oncology who recommended admission to medicine.     Following admission pt completed 5 day course of remdesivir for COVID. She had no further episodes of hypoxia. She was seen by PT/OT with recommendations for SAR.    Regarding her ill defined sclerotic and lytic bone lesions, oncology was consulted. Recommended continue letrozole and holding palbociclib and follow up outpatient. It was recommended she have outpatient MRI brain to evaluate for metastatic disease given hallucinations.    She was note to have new pancytopenia, which stabilized. Peripheral smear without clear etiology for pancytopenia. Possibly related to acute illness. Recommend follow up CBC within 1 week and heme-onc follow up if persistent. She does have a follow up oncology visit scheduled on 10/26.   She was incidentally found to have a thyroid nodule on CT. Ultrasound revealing two thyroid nodules of concern, for which FNA biopsy recommended. Information forwarded to PCP via Epic and discussed with patient/placed on follow up information on discharge paperwork.    Coumadin was also held on admission with concern for recurrent falls. This was discussed with the patient and her son, ultimately felt benefit higher than risk (chadsvsac 4, hasbled 1) especially as plan for rehab and hopeful for LTC following. Alternative agents were discussed with the patient and her son, and she was started on eliquis.   Once cleared from respiratory isolation, she was felt stable to transfer to subacute rehab on 10/24. All follow up recommendations discussed in detail prior to discharge.
Age: 68.0
Sex: F
Vaccine: COVID19-2
Symptoms: Expired product administered
Clinical narrative: Vaccine administered was expired.
Age: 56.0
Sex: F
Vaccine: UNK
Symptoms: Body temperature increased, Hypotension, Tachycardia, Unresponsive to stimuli
Clinical narrative: Unresponsive,  Tachycardia, Low bp, Temp 104 (sent to Er)
Age: 60.0
Sex: M
Vaccine: COVID19-2
Symptoms: Expired product administered
Clinical narrative: Administered expired vaccine.
Age: 5.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: NO reported adverse event - Pfizer pediatric lot FL2757 has stability data that might've been short-dated and expired 9/30/22 but was then found to have stability data through October 19. Efficacy and stability is supported, this is just precautionary reporting per protocol.
Age: 92.0
Sex: U
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, Cervical vertebral fracture, SARS-CoV-2 test positive
Clinical narrative: 09/04/22 presents to ED for "worsening cervical fracture". PMHx of "recent fall" "CAD s/p CABG X4, AF (xarelto), PPM, HTN, and HLD"
Age: 12.0
Sex: M
Vaccine: TDAP
Symptoms: Cellulitis, Erythema, Pain, Skin warm, Swelling
Clinical narrative: REDNESS, SWELLING, PAIN, HOT TO THE TOUCH DX: CELLULITIS BEING TREATED WITH KEFLEX
Age: 4.0
Sex: F
Vaccine: DTAPIPV, MMRV
Symptoms: Injection site erythema, Injection site induration, Injection site swelling, Injection site warmth
Clinical narrative: Redness, warmth and swelling of left thigh where Quadracel was given on 10/20/22, began on 10/21/22 and worsened over 2 days then started to resolve.   Large 6x6 cm  oval  slightly indurated fading erythema regressing according to marker outlines.  At its worst, erythema nearly covered entire anterolateral left thigh.  Reassured Mom that reaction appears to be resolving.  May continue cool compress, Benadryl and Cortaid as needed
Age: 68.0
Sex: F
Vaccine: COVID19-2
Symptoms: Chest discomfort, Fatigue, Pain, Productive cough, Respiratory tract congestion
Clinical narrative: I experienced a body aches  and extreme fatigue from Sunday, 10/23 through Tuesday 10/25. On 10/25 I felt congested, tight in the chest and coughing up green phlegm so I decided to go to Urgent Care. I had been traveling on 10/21 maskless so I figured I caught something while traveling. I was prescribed Z-Pac antibiotic, Methyprednisolone tablets and Albuterol inhaler which I am currently still taking and improving slightly.
Age: 68.0
Sex: F
Vaccine: COVID19-2
Symptoms: SARS-CoV-2 test negative, Sputum discoloured
Clinical narrative: I experienced a body aches  and extreme fatigue from Sunday, 10/23 through Tuesday 10/25. On 10/25 I felt congested, tight in the chest and coughing up green phlegm so I decided to go to Urgent Care. I had been traveling on 10/21 maskless so I figured I caught something while traveling. I was prescribed Z-Pac antibiotic, Methyprednisolone tablets and Albuterol inhaler which I am currently still taking and improving slightly.
Age: 66.0
Sex: M
Vaccine: COVID19-2
Symptoms: COVID-19, Exposure to SARS-CoV-2, Fatigue, Pyrexia, Rhinorrhoea
Clinical narrative: On 10/16/2022, I had a runny nose and postnasal drip. I tested myself for COVID-19 and it was negative. On 10/17/2022, I had the same symptoms, and some added mild fatigue. I tested negative for COVID-19 again that day. That evening, I developed a low-grade fever of 100 degrees that I treated with a single dose of Ibuprofen and the fever never returned. My wife had tested positive, so I was convinced that my symptoms were the same, so on 10/18/2022, I went to be tested at a local pharmacy and it was positive. I was already beginning to feel better and by 10/19/2022, I was basically asymptomatic. I had a telehealth visit with my doctor who informed me that I could take Paxlovid, but he felt I did not really need it. I declined the anti-viral since my symptoms were minimal. I tested myself again on either 10/22 or 10/23 and I was negative.
Age: 66.0
Sex: M
Vaccine: COVID19-2
Symptoms: SARS-CoV-2 test positive, Upper-airway cough syndrome
Clinical narrative: On 10/16/2022, I had a runny nose and postnasal drip. I tested myself for COVID-19 and it was negative. On 10/17/2022, I had the same symptoms, and some added mild fatigue. I tested negative for COVID-19 again that day. That evening, I developed a low-grade fever of 100 degrees that I treated with a single dose of Ibuprofen and the fever never returned. My wife had tested positive, so I was convinced that my symptoms were the same, so on 10/18/2022, I went to be tested at a local pharmacy and it was positive. I was already beginning to feel better and by 10/19/2022, I was basically asymptomatic. I had a telehealth visit with my doctor who informed me that I could take Paxlovid, but he felt I did not really need it. I declined the anti-viral since my symptoms were minimal. I tested myself again on either 10/22 or 10/23 and I was negative.
Age: 58.0
Sex: M
Vaccine: COVID19-2
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: COVID +
Age: 55.0
Sex: F
Vaccine: COVID19
Symptoms: Cardiac stress test normal, Chest pain, Dyspnoea exertional, Heart rate increased, Influenza like illness
Clinical narrative: About 24 hours after receiving the fourth COVID vaccine (Pfizer), I started to feel ill. I started to experience flu like symptoms at first. I figured it was because of recently receiving the vaccine. It persisted and I started experiencing tachycardia and chest pains. I went to the ER. I was given two doses of nitroglycerin. There was a cardiac work-up completed and everything came back normal. They attributed my pains to the vaccine. I was kept off of work and strenuous activities for a couple of weeks. It has been six months and I still experience a high heart rate and become out of breath when I try to perform any activities.
Age: 55.0
Sex: F
Vaccine: COVID19
Symptoms: Laboratory test normal, Malaise, Tachycardia
Clinical narrative: About 24 hours after receiving the fourth COVID vaccine (Pfizer), I started to feel ill. I started to experience flu like symptoms at first. I figured it was because of recently receiving the vaccine. It persisted and I started experiencing tachycardia and chest pains. I went to the ER. I was given two doses of nitroglycerin. There was a cardiac work-up completed and everything came back normal. They attributed my pains to the vaccine. I was kept off of work and strenuous activities for a couple of weeks. It has been six months and I still experience a high heart rate and become out of breath when I try to perform any activities.
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, Fatigue, Laboratory test, Loss of personal independence in daily activities
Clinical narrative: I experienced exhaustion, what usually takes an hour to do takes me four hours to do, the last 11 years of boating it takes me 15-30 minutes to do the anchor it takes me 4 hours to do. I have little to no energy
Age: 69.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Abdominal pain, COVID-19, Fistula of small intestine, Hypertension, Intestinal perforation
Clinical narrative: 09/04/22 presents to ED for "abdominal pain". PMHx of "Anemia, Fistula of vagina to small intestine (03/2022), History of blood transfusion (03/2022), Hypertension, Osteoporosis, Ovarian mass, Pneumonia (03/2022), SBO (small bowel obstruction) (CMS/HCC), and Small bowel perforation (CMS/HCC) (03/2022)"
Age: 69.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Osteoporosis, Ovarian mass, Pneumonia, SARS-CoV-2 test positive, Small intestinal obstruction
Clinical narrative: 09/04/22 presents to ED for "abdominal pain". PMHx of "Anemia, Fistula of vagina to small intestine (03/2022), History of blood transfusion (03/2022), Hypertension, Osteoporosis, Ovarian mass, Pneumonia (03/2022), SBO (small bowel obstruction) (CMS/HCC), and Small bowel perforation (CMS/HCC) (03/2022)"
Age: 69.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Transfusion, Vaginal fistula
Clinical narrative: 09/04/22 presents to ED for "abdominal pain". PMHx of "Anemia, Fistula of vagina to small intestine (03/2022), History of blood transfusion (03/2022), Hypertension, Osteoporosis, Ovarian mass, Pneumonia (03/2022), SBO (small bowel obstruction) (CMS/HCC), and Small bowel perforation (CMS/HCC) (03/2022)"
Age: 76.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Death
Clinical narrative: Patient expired.
Age: 71.0
Sex: F
Vaccine: COVID19-2
Symptoms: Asthenia, Chills, Decreased appetite, Diarrhoea, Headache
Clinical narrative: During the night after the shot, chills, fever, extreme thirst, nausea, vomiting, diarrhea; within 24 hours, weakness, headache, muscle ache,  nausea, continued vomiting and diarrhea, and loss of appetite,. These symptoms continued for 48 hours after the vaccine and then began to lift on day 3.  Unable to work or function for a full two days. These side effects are similar to those experienced with an earlier Moderna booster. Initial (Pfizer) shots also produced strong side effects, though not as severe and lengthy.