chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 1.73
Sex: F
Vaccine: DTAP
Symptoms: Abnormal behaviour, Autism, Crying, Facial dysmorphism, Irritability
Clinical narrative: Initial report received from a consumer on 04Oct05. A mother reported that her 22 month old daughter had inconsolable crying (1/2 hr episodes at a time), showed signs of being easily frustrated, began spinning in circles, had facial contortions, showed hand gesturing and was patting herself on the chest, four days after receiving the intra muscular injection of Daptacel (dose four) lot number C2253AA in the left thigh on 26Aug05. The pt received in concomitant the IM injection of Prevnar lot number A94451K in the left thigh. Pt's mom states that her daughter had 3 doses of Tripedia at ages 2, 4 and 6 months. Dates of administration not reported. She showed signs of Autism at 7 months of age. At 12 months they had her hearing checked because she was ignoring her mom and dad. The pt's hearing was good. Pt received MMR dose one at 12 months of age and experienced crying, fever and listlessness which was never reported. Mom stated they are working with a neurologist to prove autism. No further information was provided by the reporter.
Age: 1.73
Sex: F
Vaccine: DTAP
Symptoms: Listless, Pyrexia, Screaming
Clinical narrative: Initial report received from a consumer on 04Oct05. A mother reported that her 22 month old daughter had inconsolable crying (1/2 hr episodes at a time), showed signs of being easily frustrated, began spinning in circles, had facial contortions, showed hand gesturing and was patting herself on the chest, four days after receiving the intra muscular injection of Daptacel (dose four) lot number C2253AA in the left thigh on 26Aug05. The pt received in concomitant the IM injection of Prevnar lot number A94451K in the left thigh. Pt's mom states that her daughter had 3 doses of Tripedia at ages 2, 4 and 6 months. Dates of administration not reported. She showed signs of Autism at 7 months of age. At 12 months they had her hearing checked because she was ignoring her mom and dad. The pt's hearing was good. Pt received MMR dose one at 12 months of age and experienced crying, fever and listlessness which was never reported. Mom stated they are working with a neurologist to prove autism. No further information was provided by the reporter.
Age: 36.0
Sex: F
Vaccine: FLU3
Symptoms: Feeling hot, Paraesthesia
Clinical narrative: A 36 yr old female pt with a medical history of no known allergies, although a seasonal intake of Allegra was reported, no medical conditions and no illness at the time of the vaccination experienced warmth and parasthesia in her right side of the hip, back and stomach i.e. approximately 30 minutes following the IM, deltoid administration of the influenza vaccine (Fluzone) on an unspecified date.  The pt visited a doctor following the event. It was reported that the vaccine administered approx three weeks ago from the time of the report. The pt was going for an MRI and she had not recovered at the time of the report.
Age: 58.0
Sex: F
Vaccine: FLU3
Symptoms: Asthenia, Muscle spasms, Pain
Clinical narrative: Upper arm shoulder and eventually neck ached continuous for 1 year like when you get the flu shot. Then the spasms that lasted until 2004, Then weakness in the biceps and shoulder and neck. Now I have cramps in them so bad I have to straighten it out which hurt tremendously.
Age: 67.0
Sex: F
Vaccine: PPV
Symptoms: Chills, Haematoma, Hypersensitivity, Musculoskeletal stiffness, Oedema
Clinical narrative: Red, swollen, large hematoma, having chills and arm stiffness.
Age: 5.0
Sex: M
Vaccine: FLU3
Symptoms: Erythema, Feeling hot, Hypersensitivity, Oedema, Tenderness
Clinical narrative: R deltoid area is slightly swollen with mod. erythema 6cm x 6cm patch, mildly tender, warmth, full ROM of right UE. Mom states increased redness over 2 days. Advised pt to use Motrin and ice PRN.
Age: 1.0
Sex: M
Vaccine: DTAP, FLU3, VARCEL
Symptoms: Feeling hot, Injection site hypersensitivity, Injection site induration, Rash papular
Clinical narrative: Red, warm papules at injection site 1 firm lump subcutaneous.
Age: 73.0
Sex: M
Vaccine: FLU3, PPV
Symptoms: Hypersensitivity, Pain
Clinical narrative: Pt had Pneumovax in right arm 10/10/2005 developed redness and pain right upper arm 10/11/2005.
Age: 16.0
Sex: F
Vaccine: FLUN3
Symptoms: Dyspnoea, Fatigue, Head discomfort, Mucosal inflammation, Nasal congestion
Clinical narrative: A consumer reported that her 16 year old daughter received FluMist on 14 Dec 04 from her school clinic. Over the next 24 to 48 hours, the patient developed head cold, nasal congestion and tiredness. A couple of weeks later the patient still did not feel better. She was seen by her pediatrician, who on physical exam, said that the patient's nasal turbinate were swollen and clinically diagnosed her with sinus infection and prescribed oral Keflex (cephalexin) for 14 days. The symptoms, however continue. The pediatrician then prescribed Zyrtec (cetirizine hcl), Claritin (loratadine) and a saline nasal spray. In June 2005. she was referred to an allergist due to persistence of above symptoms. The patient underwent 60 different allergy testing which revealed that she was slightly allergic to pollen possibly from maple tree and ragweed. He prescribed oral Medrol. However, the allergist stated to the reporter that it was so mild that it should not produce the severity of the patient's symptoms. On 05 Jul 05, a CT scan of both sinuses showed sinus infection, swollen nasal turbinate and nasal septum deviation. The allergist prescribed Augmentin (co-amoxiclav) 1000 mg twice a day for 14 days and a nasal cortisone spray, which did not improve the patient's symptoms. In August 2005, the patient was referred to an ENT, who did a rhinoscope, which showed mild nasal septum deviation, sinus infection and excessive mucus production. The ENT physician suggested that a surgery to correct the nasal septum deviation should be done, but the reporter state she did not want the surgery done until the cause of the patient's chronic symptoms is known for sure. The reporter plans to bring patient back to the allergist and ask if a culture and sensitivity should be done. As of 06 Sep 05, the patient has not recovered from her symptoms, which now includes difficulty breathing due to the nasal congestion and pallor. The reporter state that the symptoms are possible related to FluMist.
Age: 16.0
Sex: F
Vaccine: FLUN3
Symptoms: Pallor, Sinusitis, Swelling
Clinical narrative: A consumer reported that her 16 year old daughter received FluMist on 14 Dec 04 from her school clinic. Over the next 24 to 48 hours, the patient developed head cold, nasal congestion and tiredness. A couple of weeks later the patient still did not feel better. She was seen by her pediatrician, who on physical exam, said that the patient's nasal turbinate were swollen and clinically diagnosed her with sinus infection and prescribed oral Keflex (cephalexin) for 14 days. The symptoms, however continue. The pediatrician then prescribed Zyrtec (cetirizine hcl), Claritin (loratadine) and a saline nasal spray. In June 2005. she was referred to an allergist due to persistence of above symptoms. The patient underwent 60 different allergy testing which revealed that she was slightly allergic to pollen possibly from maple tree and ragweed. He prescribed oral Medrol. However, the allergist stated to the reporter that it was so mild that it should not produce the severity of the patient's symptoms. On 05 Jul 05, a CT scan of both sinuses showed sinus infection, swollen nasal turbinate and nasal septum deviation. The allergist prescribed Augmentin (co-amoxiclav) 1000 mg twice a day for 14 days and a nasal cortisone spray, which did not improve the patient's symptoms. In August 2005, the patient was referred to an ENT, who did a rhinoscope, which showed mild nasal septum deviation, sinus infection and excessive mucus production. The ENT physician suggested that a surgery to correct the nasal septum deviation should be done, but the reporter state she did not want the surgery done until the cause of the patient's chronic symptoms is known for sure. The reporter plans to bring patient back to the allergist and ask if a culture and sensitivity should be done. As of 06 Sep 05, the patient has not recovered from her symptoms, which now includes difficulty breathing due to the nasal congestion and pallor. The reporter state that the symptoms are possible related to FluMist.
Age: 43.0
Sex: F
Vaccine: FLUN3
Symptoms: Unevaluable event
Clinical narrative: A non health professional from physician's office reported that a 43 year old female received an expired FluMist vaccine on 24 Aug 05. The nurse who administered the vaccine later found out that the FluMist vaccine's expiration date on the label was 11 May 05. The patient did not report any adverse event following receipt of the vaccine. The reporter causality is not provided.
Age: 67.0
Sex: F
Vaccine: FLUX, PPV
Symptoms: Arthralgia, Erythema, No reaction on previous exposure to drug, Oedema peripheral, Pain in extremity
Clinical narrative: Patient experienced large hive like reaction below the site of injection. The hive was about 8 inches long and covered the width of her biceps. She has had the Pneumovax before with out incident. Rt arm became too sore to sleep on. Following morning arm was swollen, Red, sore, became worse by the next day and was moving to the elbow also, went 25 mi to closest Emergency room - saw by doctor who prescribed CEPHALEXIN 500 mg for 10 days.
Age: 67.0
Sex: F
Vaccine: FLUX, PPV
Symptoms: Urticaria
Clinical narrative: Patient experienced large hive like reaction below the site of injection. The hive was about 8 inches long and covered the width of her biceps. She has had the Pneumovax before with out incident. Rt arm became too sore to sleep on. Following morning arm was swollen, Red, sore, became worse by the next day and was moving to the elbow also, went 25 mi to closest Emergency room - saw by doctor who prescribed CEPHALEXIN 500 mg for 10 days.
Age: 71.0
Sex: F
Vaccine: PPV
Symptoms: Injection site reaction, Urticaria
Clinical narrative: Large hive like reaction below injection site.
Age: 4.0
Sex: U
Vaccine: DTAP, IPV, MMR
Symptoms: Feeling hot, Injection site hypersensitivity, Injection site induration, Pain
Clinical narrative: First noticed 10/05/2005 35 x 40 right deltoid mm induration, Pain, hardness, warm, redness.
Age: 16.0
Sex: F
Vaccine: TD
Symptoms: Diplopia, Hypersensitivity
Clinical narrative: patient came in to receive a tetanus booster for school. Highly anxious at time of shot but tolerated procedure well. left facility and came back complained of double vision. Pulse of 72 noted and regular. Given Zyrtec 10mg per. Went home and found that pt went to ER via ambulance and found to have had allergic reaction to tetanus, Benadryl given pt released to home after treatment at ER.
Age: 4.0
Sex: M
Vaccine: DTAP, IPV, MMR
Symptoms: Hypersensitivity, Oedema
Clinical narrative: Red and swelling of left upper arm, pt can move left arm advised to apply ice compress.
Age: 1.28
Sex: F
Vaccine: HIBV, MMR
Symptoms: Gaze palsy, Hypotonia, Tic
Clinical narrative: Healthy child no previous illnesses. About 30 hours after vaccine was noted to have episodic upward both eye gaze movements that increased in frequency. No tonic/clonic movements of extremities. Had 1 episode where head became limp. Seen in ER and hospitalized. Video EEG negative, seen by Neurology diagnosed motor tic. 3 weeks post episode, eye movements almost all resolved.
Age: 5.0
Sex: M
Vaccine: DTAP, HEPA, IPV, MMR, PNC
Symptoms: Feeling hot, Hypersensitivity, Injection site induration, Injection site inflammation, Pain
Clinical narrative: Mother reported that pt developed approx 50 cm round induration on left arm with redness and pain reported, area warm to touch, inflammation started 24 hours following immunization, area of induration was beginning to subside on 10/07/2005.
Age: 1.03
Sex: F
Vaccine: HEP, MMR, VARCEL
Symptoms: Contusion, Platelet count decreased, Thrombocytopenic purpura
Clinical narrative: Patient seen in office with complaints of multiple bruises. CBC showed platelet count of 0. Referred to hematologist and hospitalized for Idiopathic thrombocytopenic purpura.
Age: 46.0
Sex: M
Vaccine: TD
Symptoms: Paraesthesia
Clinical narrative: 2 days after DT vaccine given had tingling on left hand and feet.
Age: 0.9
Sex: M
Vaccine: DTAPHEPBIP, HIBV, PNC
Symptoms: Irritability, Pyrexia
Clinical narrative: Prolonged 72 hour, low grade fever 100 and fussiness.
Age: 62.0
Sex: F
Vaccine: TD
Symptoms: Hypokinesia, Myalgia, Pain
Clinical narrative: Deep aching and burning pain in muscle area of left arm when raising or moving arm in any direction, unable to fully raise arm straight up, out and up or towards back. The information sheet given to me when I received the vaccine says it may last many months. To me 10 months is long enough. Please advise how much longer I will have this problem. I have had tetanus shots before, no problem. This is my last for sure.
Age: 1.25
Sex: F
Vaccine: MMR
Symptoms: Pyrexia, Rash maculo-papular
Clinical narrative: Fever up to 38.8 x 2 days, maculopapular rash on trunk x 6d cadescing on face, spreading to legs.
Age: 5.0
Sex: M
Vaccine: DTAP, IPV
Symptoms: Unevaluable event
Clinical narrative: NONE
Age: 72.0
Sex: F
Vaccine: PPV
Symptoms: Feeling hot, Injection site erythema, Injection site oedema, Injection site pain, Pyrexia
Clinical narrative: Client into HD day after shot (24 hrs later) upper right arm swollen and warm to the touch. Its also has erythema halfway around arm but on underneath side. No c/o itching or pain just soreness. Client took Tylenol and relates that swelling going down. Temp at HD 99.7.
Age: 2.0
Sex: M
Vaccine: PNC
Symptoms: Gait disturbance, Pain, Tremor
Clinical narrative: Thigh pain/limping, trembling.
Age: 2.0
Sex: M
Vaccine: DTAP
Symptoms: Injection site erythema, Injection site mass
Clinical narrative: Induration/erythema
Age: 8.0
Sex: F
Vaccine: HIBV, VARCEL
Symptoms: Drug ineffective, Viral infection
Clinical narrative: Had the chicken pox develop 08/27/2005
Sex: F
Vaccine: PPV
Symptoms: Hypersensitivity, Oedema
Clinical narrative: Red and swollen left upper arm extending deltoid to elbow.
Age: 1.01
Sex: F
Vaccine: MMR, VARCEL
Symptoms: Herpes zoster, Viral infection
Clinical narrative: Varicella vaccine 05/05, Shingles diagnosed 10/11/2005.
Age: 4.0
Sex: M
Vaccine: DTAP, IPV, MMR
Symptoms: Injection site hypersensitivity, Injection site oedema
Clinical narrative: Redness and swelling at injection site, prescribed Keflex 250/5m 1 1/2 tsp. BID for 10 days.
Age: 13.0
Sex: F
Vaccine: PPV
Symptoms: Feeling hot, Hypokinesia, Inflammation, Oedema, Pain
Clinical narrative: Swelling and inflammation of right arm, warm to touch, pain up and down arm, limitation in movement, skin shiny and taunt, fever to 101. Taken to ER for examination, Motrin given. No radiologic or blood studies.
Age: 13.0
Sex: F
Vaccine: PPV
Symptoms: Pyrexia, Skin disorder
Clinical narrative: Swelling and inflammation of right arm, warm to touch, pain up and down arm, limitation in movement, skin shiny and taunt, fever to 101. Taken to ER for examination, Motrin given. No radiologic or blood studies.
Age: 11.0
Sex: F
Vaccine: MMR, TD
Symptoms: Headache, Malaise, Pruritus, Pyrexia, Rash
Clinical narrative: On 10/3, malaise, headache, fever. On 10/05 pt developed a rash on face, spread to rest of body. Slightly itchy. Seen in office 10/06 RX Zyrtec for itchy.
Age: 24.0
Sex: M
Vaccine: HEPA, TD, TYP, YF
Symptoms: Chills, Headache, Malaise, Pyrexia, Swelling
Clinical narrative: Pt experienced  fever (102-99 degrees F)and chills starting 3 days after receiving vaccinations. Also had headache and right-sided neck swollen and tender gland(s). No stuffy nose,or sore throat. Malaise for 2-3 days feeling better by day 8.
Age: 24.0
Sex: M
Vaccine: HEPA, TD, TYP, YF
Symptoms: Tenderness
Clinical narrative: Pt experienced  fever (102-99 degrees F)and chills starting 3 days after receiving vaccinations. Also had headache and right-sided neck swollen and tender gland(s). No stuffy nose,or sore throat. Malaise for 2-3 days feeling better by day 8.
Age: 6.0
Sex: F
Vaccine: FLU3, PPV
Symptoms: Hypokinesia, Injection site warmth, Pain, Pyrexia, Swelling
Clinical narrative: R ARM-RED, SWOLLEN, WARM, TENDER, UNABLE TO MOVE ARM, TEMP 103.
Age: 6.0
Sex: F
Vaccine: FLU3, PPV
Symptoms: Tenderness
Clinical narrative: R ARM-RED, SWOLLEN, WARM, TENDER, UNABLE TO MOVE ARM, TEMP 103.
Age: 42.0
Sex: F
Vaccine: HEP
Symptoms: Diarrhoea, Nausea, Pain
Clinical narrative: Nausea, diarrhea, aches evening of vaccination and all of next day.
Age: 51.0
Sex: F
Vaccine: FLU3, PPV
Symptoms: Hypokinesia, Injection site warmth, Pain, Swelling
Clinical narrative: pt received pneumovax in am. returned to clinic in pm c/o L upper arm pain with decreased mobility.L upper arm (deltoid area) warm to touch with minor swelling. no erythema. pt denied numbness, tingling, weakness L hand. unable to raise L arm above head due to "pain." consult with MD. ice pack, rest, otc analgesics recommended. Phoned pt next day: minimal improvement. recommended f/u w MD.  Spoke with pt on 10/13/05. pt stated improved mobility: able to raise arm above head but stated arm still" painful." pt had not seen medical provider.pt missed two days of work.
Age: 7.0
Sex: M
Vaccine: JEV
Symptoms: Urticaria
Clinical narrative: Hives on abdomen and back, one day after vaccine administration.
Age: 54.0
Sex: F
Vaccine: FLU3
Symptoms: Dysphonia, Heart rate increased, Throat tightness, Urticaria
Clinical narrative: Rapid heart rate, hives to right arm, hoarseness, throat tightening.
Age: 0.6
Sex: M
Vaccine: FLU3
Symptoms: Irritability, Pyrexia, Sepsis
Clinical narrative: CHILD DEVELOPED HIGH FEVER AT 3AM. BECAME VERY IRRITABLE. WAS ADMITTED TO HOSPITAL FOR R/O SEPSIS.
Age: 39.0
Sex: M
Vaccine: SMALL
Symptoms: Chest pain, Chills, Dyspnoea, Electrocardiogram abnormal, Headache
Clinical narrative: This 39 year-old received his primary Smallpox vaccination on 07 September 2005.  He reported a dull left axilla pain "as if hit" with site tenderness (1-2/10 if left alone and 5-6/10 if touching site) beginning approximately September 9-10, 2005.  By 12 September 2005 he developed a fever, headache, chills with hot and cold sweats, and nausea. He advised medical who gave him Tylenol for his fevers and attributed his complaints to the Smallpox vaccination.    On 17 Sept 2005 he awoke with severe chest pain thinking he had "extreme gas".  Drinking soda did not help the pain nor make him burp.  He returned to his bunk, laid down and his pain worsened.  He described the pain as midsternal over his heart radiating down his left shoulder as if "I was having a heart attack."  "Someone was sitting on my chest" and "it hurt to breathe ... my lungs were being squeezed."  He complained of diaphoresis, nausea without vomiting, fevers of 102 degree Fahrenheit, and constant left axilla pain (5-6/10). He returned to medical where treatment began and he was transferred to hospital by ambulance.  Enroute the ambulance gave him SL NTG x 1 and morphine without relief of his symptoms.  Upon arrival to the hospital his EKG "looked funny" with a possible MI.  He was sent for a cardiac catherization which was normal. He spent one day in the hospital where Indocin was administered with partial relief of his pain. Morphine and Tylenol were used to supplement the Indocin without relief of breakthrough pain.  He stated only Indocin eased his discomfort.  He reported pain with breathing resolved by 19 Sept 2005, while the radiating shoulder pain resolved about 21 Sept 2005.    He reported a follow up exam by a cardiologist, 28 Sept 2005 where he reported a normal echocardiogram. He still complained that his "legs are swollen, hands feel numb and tingle as if dangled or leaned on too long" without pain.  He has an intermittent mild headache since discharged from the hospital he is unable to describe.   Review of available medical records noted the SMPX evaluation form was marked "NO" to question #12 concerning "having" chest pain, MI, angina. Further review located complaints of chest pain with negative echocardiogram, EKG and evaluations in 2001 and May 2005.  This service member did not advise anyone of past history of chest pain possibly due to the "wording" of the question. This service member had risk factors of race, HTN, family history CAD, obesity (wt 225 lbs), and elevated chol in December 2004 of 220. 12/22/05 Review of d/c summary. Final diagnosis was mild pericarditis likely secondary to viral syndrome. Pt stated he had low-grade fever and minor cough prior to admission. 12/22/05 Review of medical record - chest pain, fever & chills experienced a few days ago. Diagnosis was probable pericarditis.
Age: 39.0
Sex: M
Vaccine: SMALL
Symptoms: Hyperhidrosis, Hypokinesia, Injection site pain, Laboratory test abnormal, Nausea
Clinical narrative: This 39 year-old received his primary Smallpox vaccination on 07 September 2005.  He reported a dull left axilla pain "as if hit" with site tenderness (1-2/10 if left alone and 5-6/10 if touching site) beginning approximately September 9-10, 2005.  By 12 September 2005 he developed a fever, headache, chills with hot and cold sweats, and nausea. He advised medical who gave him Tylenol for his fevers and attributed his complaints to the Smallpox vaccination.    On 17 Sept 2005 he awoke with severe chest pain thinking he had "extreme gas".  Drinking soda did not help the pain nor make him burp.  He returned to his bunk, laid down and his pain worsened.  He described the pain as midsternal over his heart radiating down his left shoulder as if "I was having a heart attack."  "Someone was sitting on my chest" and "it hurt to breathe ... my lungs were being squeezed."  He complained of diaphoresis, nausea without vomiting, fevers of 102 degree Fahrenheit, and constant left axilla pain (5-6/10). He returned to medical where treatment began and he was transferred to hospital by ambulance.  Enroute the ambulance gave him SL NTG x 1 and morphine without relief of his symptoms.  Upon arrival to the hospital his EKG "looked funny" with a possible MI.  He was sent for a cardiac catherization which was normal. He spent one day in the hospital where Indocin was administered with partial relief of his pain. Morphine and Tylenol were used to supplement the Indocin without relief of breakthrough pain.  He stated only Indocin eased his discomfort.  He reported pain with breathing resolved by 19 Sept 2005, while the radiating shoulder pain resolved about 21 Sept 2005.    He reported a follow up exam by a cardiologist, 28 Sept 2005 where he reported a normal echocardiogram. He still complained that his "legs are swollen, hands feel numb and tingle as if dangled or leaned on too long" without pain.  He has an intermittent mild headache since discharged from the hospital he is unable to describe.   Review of available medical records noted the SMPX evaluation form was marked "NO" to question #12 concerning "having" chest pain, MI, angina. Further review located complaints of chest pain with negative echocardiogram, EKG and evaluations in 2001 and May 2005.  This service member did not advise anyone of past history of chest pain possibly due to the "wording" of the question. This service member had risk factors of race, HTN, family history CAD, obesity (wt 225 lbs), and elevated chol in December 2004 of 220. 12/22/05 Review of d/c summary. Final diagnosis was mild pericarditis likely secondary to viral syndrome. Pt stated he had low-grade fever and minor cough prior to admission. 12/22/05 Review of medical record - chest pain, fever & chills experienced a few days ago. Diagnosis was probable pericarditis.
Age: 39.0
Sex: M
Vaccine: SMALL
Symptoms: Pericarditis, Pyrexia
Clinical narrative: This 39 year-old received his primary Smallpox vaccination on 07 September 2005.  He reported a dull left axilla pain "as if hit" with site tenderness (1-2/10 if left alone and 5-6/10 if touching site) beginning approximately September 9-10, 2005.  By 12 September 2005 he developed a fever, headache, chills with hot and cold sweats, and nausea. He advised medical who gave him Tylenol for his fevers and attributed his complaints to the Smallpox vaccination.    On 17 Sept 2005 he awoke with severe chest pain thinking he had "extreme gas".  Drinking soda did not help the pain nor make him burp.  He returned to his bunk, laid down and his pain worsened.  He described the pain as midsternal over his heart radiating down his left shoulder as if "I was having a heart attack."  "Someone was sitting on my chest" and "it hurt to breathe ... my lungs were being squeezed."  He complained of diaphoresis, nausea without vomiting, fevers of 102 degree Fahrenheit, and constant left axilla pain (5-6/10). He returned to medical where treatment began and he was transferred to hospital by ambulance.  Enroute the ambulance gave him SL NTG x 1 and morphine without relief of his symptoms.  Upon arrival to the hospital his EKG "looked funny" with a possible MI.  He was sent for a cardiac catherization which was normal. He spent one day in the hospital where Indocin was administered with partial relief of his pain. Morphine and Tylenol were used to supplement the Indocin without relief of breakthrough pain.  He stated only Indocin eased his discomfort.  He reported pain with breathing resolved by 19 Sept 2005, while the radiating shoulder pain resolved about 21 Sept 2005.    He reported a follow up exam by a cardiologist, 28 Sept 2005 where he reported a normal echocardiogram. He still complained that his "legs are swollen, hands feel numb and tingle as if dangled or leaned on too long" without pain.  He has an intermittent mild headache since discharged from the hospital he is unable to describe.   Review of available medical records noted the SMPX evaluation form was marked "NO" to question #12 concerning "having" chest pain, MI, angina. Further review located complaints of chest pain with negative echocardiogram, EKG and evaluations in 2001 and May 2005.  This service member did not advise anyone of past history of chest pain possibly due to the "wording" of the question. This service member had risk factors of race, HTN, family history CAD, obesity (wt 225 lbs), and elevated chol in December 2004 of 220. 12/22/05 Review of d/c summary. Final diagnosis was mild pericarditis likely secondary to viral syndrome. Pt stated he had low-grade fever and minor cough prior to admission. 12/22/05 Review of medical record - chest pain, fever & chills experienced a few days ago. Diagnosis was probable pericarditis.
Age: 19.0
Sex: M
Vaccine: MNQ
Symptoms: Anaemia, Cholangitis, Colitis, Crohn's disease, Decreased appetite
Clinical narrative: Patient had Menactra vaccine 9/1/05 and developed decreased appetite around 9/23/05.  He then developed diarrhea 10/3/05 with subsequent severe bloody diarrhea, dehydration and thrombocytopenia (28K)and anemia.  Admittedto hospital 10/7/05.  Infectious etiologies for enterocolitis negative so far.  No evidence for HUS/TTP.  Colonoscopy 10/11 - severe pancolitis, terminal ileum ulcers, granular ulcers and cobblestone mucosa felt by GI c/w Crohn's disease.  Patient is still hospitalized with malnutrion and treated with IV Hydrocortisone and Asacol. Information from 60 day follow-up report states: inflammatory bowel disease currently controlled.
Age: 19.0
Sex: M
Vaccine: MNQ
Symptoms: Dehydration, Diarrhoea, Diarrhoea haemorrhagic, Gastric ulcer, Thrombocytopenia
Clinical narrative: Patient had Menactra vaccine 9/1/05 and developed decreased appetite around 9/23/05.  He then developed diarrhea 10/3/05 with subsequent severe bloody diarrhea, dehydration and thrombocytopenia (28K)and anemia.  Admittedto hospital 10/7/05.  Infectious etiologies for enterocolitis negative so far.  No evidence for HUS/TTP.  Colonoscopy 10/11 - severe pancolitis, terminal ileum ulcers, granular ulcers and cobblestone mucosa felt by GI c/w Crohn's disease.  Patient is still hospitalized with malnutrion and treated with IV Hydrocortisone and Asacol. Information from 60 day follow-up report states: inflammatory bowel disease currently controlled.
Age: 75.0
Sex: F
Vaccine: FLU3
Symptoms: Injection site erythema, Injection site swelling
Clinical narrative: ON 10-14-2005 PATIENT RETURNED TO PHARMACY FOR ANOTHER RX AND TOLD ME OF REACTION.  INJECTED UPPER ARM WAS VERY RED AND SWOLLEN. PATIENT REPORTED IT WAS VERY "TIGHT" BUT SWELLING HAD GONE DOWN AND SHE WAS IMPROVING.
Age: 79.0
Sex: M
Vaccine: FLU3
Symptoms: Chills, Diarrhoea, Nausea, Pyrexia, Rash
Clinical narrative: 10/07 c/o feeling of nausea about 8pm after supper. Pt reports developed temp of 108 F shaking , chills. Temp decreased to 106 rashy 10/08 am. C/O vomiting, diarrhea and shaking chills. 10/9 Temp 103 to 100. By 10/10 temp 99, feeling better. 10/11 afebrile, full recovery per pt. Patient did not call HCP for evaluation.
Age: 79.0
Sex: M
Vaccine: FLU3
Symptoms: Tremor, Vomiting
Clinical narrative: 10/07 c/o feeling of nausea about 8pm after supper. Pt reports developed temp of 108 F shaking , chills. Temp decreased to 106 rashy 10/08 am. C/O vomiting, diarrhea and shaking chills. 10/9 Temp 103 to 100. By 10/10 temp 99, feeling better. 10/11 afebrile, full recovery per pt. Patient did not call HCP for evaluation.
Age: 30.0
Sex: F
Vaccine: FLU3
Symptoms: Arthralgia, Blood pressure increased, Fatigue, Feeling hot, Hypersensitivity
Clinical narrative: 11/11/2005 7:00 arm red, inflamed, warm to touch approx size 1" dm. 11/12/05 joint achiness, no fever, no H/A, mild nausea, fatigue, redness, swelling 3" dm to arm. 11/13/2005 same symptoms but intensified, BP increased, itching to left arm receiving treatment.
Age: 30.0
Sex: F
Vaccine: FLU3
Symptoms: Injection site inflammation, Nausea, Oedema, Pruritus
Clinical narrative: 11/11/2005 7:00 arm red, inflamed, warm to touch approx size 1" dm. 11/12/05 joint achiness, no fever, no H/A, mild nausea, fatigue, redness, swelling 3" dm to arm. 11/13/2005 same symptoms but intensified, BP increased, itching to left arm receiving treatment.
Age: 4.0
Sex: F
Vaccine: DTAP, FLU3, IPV, MMR
Symptoms: Erythema, Oedema
Clinical narrative: Mild swelling, erythema.
Age: 72.0
Sex: F
Vaccine: FLU3
Symptoms: Hypersensitivity, Pruritus, Rash, Urticaria
Clinical narrative: Red rash, hives like area itching on arms and legs, took 25mg Benadryl lasted x 3 days.
Age: 43.0
Sex: F
Vaccine: FLU3, FLU3
Symptoms: Chest discomfort, Dyspnoea, Pruritus
Clinical narrative: Itchy throat, shortness of breath, chest tightness, given Benadryl 50mg 1M- resolved and AC'D from ER at 1855.
Age: 43.0
Sex: F
Vaccine: FLU3, FLU3
Symptoms: Chest discomfort, Dyspnoea, Pharyngolaryngeal pain, Pruritus
Clinical narrative: Itchy throat, shortness of breath, chest tightness, given Benadryl 50mg 1M- resolved and AC'D from ER at 1855.
Age: 54.0
Sex: F
Vaccine: FLU3
Symptoms: Malaise, Pharyngolaryngeal pain
Clinical narrative: Developed sore throat and general malaise approx 6 hours after injection. No SOB, no rash, no weakness, no treatment given.
Age: 56.0
Sex: F
Vaccine: FLU3, FLU3
Symptoms: Malaise, Paraesthesia
Clinical narrative: Felt tingling in left arm and shoulder and leg, general malaise. NO SOB, no weakness, no egg allergies, no treatments given.
Sex: F
Vaccine: FLU3
Symptoms: Headache, Malaise, Pyrexia
Clinical narrative: Generalized Malaise, headache, fever.
Age: 79.0
Sex: F
Vaccine: FLU3
Symptoms: Injection site haemorrhage, Injection site induration, Injection site pain, Injection site swelling
Clinical narrative: Injected flu vaccine into patients deltoid, pulled out needle pt started to bleed. While cleaning area and applying band aid a lump about the size of a nickel and raised c-4 cm came up on pts arm at site of injection. Pt stated it was very painful. Advised to apply ice and take Tylenol.
Age: 51.0
Sex: F
Vaccine: FLU3, PPV
Symptoms: Cellulitis, Urticaria
Clinical narrative: Pt developed pus inside a big welt. Was admitted to the hospital to drain welt, still in hospital as of 10/14/2005, pt is fine, right arm cellulitis per Dr office 10/14/2005. 11/1/05 Review of d/c summary confirms diagnosis of R deltoid cellulitis s/p flu & pneumococcal vaccines. Treated with Vancomycin. Per annual report-10/17/05 per telephone follow up to vaccine providers, both vaccines were administered in the R arm. The site of the cellulitis.
Age: 4.0
Sex: F
Vaccine: MMR
Symptoms: Abnormal behaviour, Cough, Crying, Ear pain, Irritability
Clinical narrative: Monday 02/09/2004 she says mouth hurts, legs hurt, cough, red watery eyes, eyes sensitive to light, tells me to shut the lights off! Cries all the time, irritable, temp 103.1, I gave her Tylenol and she said I just need to go to sleep. Which is unusual for her. Pediatrician on call said she must have just picked up virus while at the clinic, She claimed symptoms are not from MMR. Temp at 3am 102.7 I gave her Motrin. Tuesday 02/10/2004 9:20 am Motrin, 4:30pm temp 103.4. I gave her Tylenol. Eyes are still watering, red and sensitive to light. She is very irritable. She said her ears hurt when I towel dried her hair. Wed 02/11/2004 12:45 pm Temp 100.8 she said her neck hurt. 1:44pm Temp 101.9 Gave her Motrin. 02/23/2004 Office visit very bad ear infection. She had only 1 ear infection her whole childhood. She was in a lot of pain and nurse said it looked like ear drum was about to burst. Child was not herself for at least 2 months after MMR. She was not interested in her usual activities. She did not want to color or play with dolls. Everything bothered her especially her clothes. Nothing felt good on her skin, She cried all the time. After visiting a chiropractor and receiving treatment she was back to her usual happy self. I attempted to get this reported several times but each time I was told these symptoms are unreportable. I finally just gave up and did it myself, I believe she may have had aseptic meningitis or measles.
Age: 4.0
Sex: F
Vaccine: MMR
Symptoms: Lacrimation increased, Neck pain, Ocular hyperaemia, Otitis media, Pain
Clinical narrative: Monday 02/09/2004 she says mouth hurts, legs hurt, cough, red watery eyes, eyes sensitive to light, tells me to shut the lights off! Cries all the time, irritable, temp 103.1, I gave her Tylenol and she said I just need to go to sleep. Which is unusual for her. Pediatrician on call said she must have just picked up virus while at the clinic, She claimed symptoms are not from MMR. Temp at 3am 102.7 I gave her Motrin. Tuesday 02/10/2004 9:20 am Motrin, 4:30pm temp 103.4. I gave her Tylenol. Eyes are still watering, red and sensitive to light. She is very irritable. She said her ears hurt when I towel dried her hair. Wed 02/11/2004 12:45 pm Temp 100.8 she said her neck hurt. 1:44pm Temp 101.9 Gave her Motrin. 02/23/2004 Office visit very bad ear infection. She had only 1 ear infection her whole childhood. She was in a lot of pain and nurse said it looked like ear drum was about to burst. Child was not herself for at least 2 months after MMR. She was not interested in her usual activities. She did not want to color or play with dolls. Everything bothered her especially her clothes. Nothing felt good on her skin, She cried all the time. After visiting a chiropractor and receiving treatment she was back to her usual happy self. I attempted to get this reported several times but each time I was told these symptoms are unreportable. I finally just gave up and did it myself, I believe she may have had aseptic meningitis or measles.
Age: 4.0
Sex: F
Vaccine: MMR
Symptoms: Photophobia, Pyrexia, Screaming, Skin disorder, Somnolence
Clinical narrative: Monday 02/09/2004 she says mouth hurts, legs hurt, cough, red watery eyes, eyes sensitive to light, tells me to shut the lights off! Cries all the time, irritable, temp 103.1, I gave her Tylenol and she said I just need to go to sleep. Which is unusual for her. Pediatrician on call said she must have just picked up virus while at the clinic, She claimed symptoms are not from MMR. Temp at 3am 102.7 I gave her Motrin. Tuesday 02/10/2004 9:20 am Motrin, 4:30pm temp 103.4. I gave her Tylenol. Eyes are still watering, red and sensitive to light. She is very irritable. She said her ears hurt when I towel dried her hair. Wed 02/11/2004 12:45 pm Temp 100.8 she said her neck hurt. 1:44pm Temp 101.9 Gave her Motrin. 02/23/2004 Office visit very bad ear infection. She had only 1 ear infection her whole childhood. She was in a lot of pain and nurse said it looked like ear drum was about to burst. Child was not herself for at least 2 months after MMR. She was not interested in her usual activities. She did not want to color or play with dolls. Everything bothered her especially her clothes. Nothing felt good on her skin, She cried all the time. After visiting a chiropractor and receiving treatment she was back to her usual happy self. I attempted to get this reported several times but each time I was told these symptoms are unreportable. I finally just gave up and did it myself, I believe she may have had aseptic meningitis or measles.
Age: 4.0
Sex: F
Vaccine: MMR
Symptoms: Stomatitis, Viral infection
Clinical narrative: Monday 02/09/2004 she says mouth hurts, legs hurt, cough, red watery eyes, eyes sensitive to light, tells me to shut the lights off! Cries all the time, irritable, temp 103.1, I gave her Tylenol and she said I just need to go to sleep. Which is unusual for her. Pediatrician on call said she must have just picked up virus while at the clinic, She claimed symptoms are not from MMR. Temp at 3am 102.7 I gave her Motrin. Tuesday 02/10/2004 9:20 am Motrin, 4:30pm temp 103.4. I gave her Tylenol. Eyes are still watering, red and sensitive to light. She is very irritable. She said her ears hurt when I towel dried her hair. Wed 02/11/2004 12:45 pm Temp 100.8 she said her neck hurt. 1:44pm Temp 101.9 Gave her Motrin. 02/23/2004 Office visit very bad ear infection. She had only 1 ear infection her whole childhood. She was in a lot of pain and nurse said it looked like ear drum was about to burst. Child was not herself for at least 2 months after MMR. She was not interested in her usual activities. She did not want to color or play with dolls. Everything bothered her especially her clothes. Nothing felt good on her skin, She cried all the time. After visiting a chiropractor and receiving treatment she was back to her usual happy self. I attempted to get this reported several times but each time I was told these symptoms are unreportable. I finally just gave up and did it myself, I believe she may have had aseptic meningitis or measles.
Age: 0.39
Sex: M
Vaccine: DTAPHEPBIP, HIBV, PNC
Symptoms: Crying, Hypotonia, Injection site hypersensitivity, Injection site oedema, Screaming
Clinical narrative: Got 2nd dose of PCV7 and Hib in right thigh on 08/09/2005 approximately 10-15 minutes later thigh was red, swollen and pt seemed limp. Pt screamed immediately when shot was administered. Pt seen today and received HIB and Pediarix with no reaction. PCV7 was held.
Sex: U
Vaccine: DTAP, IPV, MMR
Symptoms: Erythema, Feeling hot, Oedema
Clinical narrative: 24 Hours after vaccine administered pt developed 10cm x 10cm erythema, warm, swelling over left deltoid.
Age: 79.0
Sex: M
Vaccine: PPV
Symptoms: Hypersensitivity, Oedema
Clinical narrative: Redness and swelling down to elbow on inside of arm.
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMR
Symptoms: Injection site erythema, Injection site hypersensitivity, Injection site oedema, Tenderness
Clinical narrative: 10/11/2005 red, swollen at vaccination site told to use ice and Tylenol. 10/13/2005 went to ER with 5cm erythematous firm and tender to touch on shoulder.
Age: 0.0
Sex: M
Vaccine: DTAP, HIBV, MMR
Symptoms: Erythema
Clinical narrative: Local redness two days later no other sequelae.
Age: 45.0
Sex: F
Vaccine: FLU3, PPV
Symptoms: Cellulitis, Hypersensitivity, Injection site erythema, Injection site hypersensitivity, Injection site warmth
Clinical narrative: Patient returned to pharmacy 2 days after injection, with red and warm area around right arm injection site.  I recommended her to see a physician.  Patient reported that they thinks this is minor celluitis or an allergic reation.  Patient was placed on Keflex 500mg 1tid x 10days.
Age: 1.0
Sex: F
Vaccine: MMR, VARCEL
Symptoms: Blister
Clinical narrative: LOCALIZED ERUPTION ON LEFT UPPER ARM ABOUT 4 DAYS AFTER VARICELLA VACCINE.  BLISTER LIKE LESION WITH SEVERAL SMALL RAISED LESIONS AROUND IT.
Age: 3.0
Sex: F
Vaccine: DTAP, MMR, VARCEL
Symptoms: Erythema, Injection site erythema, Injection site swelling, Irritability, Tenderness
Clinical narrative: CHILD PRESENTED TO ER WITH COMPLAINTS OF REDNESS AND SWELLING OF BILAT THIGHS POST INJECTION.  CHILD EXTREMELY FUSSY. REFUSED TO ALLOW STAFF TO TOUCH L. KNEE.   R. THIGH HAS SOFTBALL SIZE ERYTHEMA L. THIGH TO KNEE IS ERYTHEMOUS AND SWELLING AROUND MEDIAL TENDON.  TENDER TO PALPATION
Age: 61.0
Sex: M
Vaccine: FLU3
Symptoms: Erythema, Neck pain, Rash macular
Clinical narrative: After getting a company work assignment, my wife and I purchased the current flu vaccinations from a local drugstore.    Three days later, at 3:00 A.M., I was awakened by extreme pain in my neck.  The pain was such that I could not move, even the slightest, as even a movement tiny as a hair would create super intense pain in my neck.  Actually, it was a bit frightening because of not being able to move; even the tiniest movement brought excruciating pain to my neck.  After a time the intenseness subsided, however, the next few days movement in my neck was restricted by pain.  To this day (4 years later) I do not have the free neck movement I enjoyed prior to this experience.  A few months later I went to a dermatologist to check on some red blotches in different areas of my body.  I had had these skin blotches for many years without knowing what they were.  The dermatologist took one look and advised me I have eczema.  He gave me some topical cream to apply to the blotches.  A few days later in discussing this event - flu shot with eczema - a colleague at work described a similar situation with one of his family members.  He said they were advised to never get another flu shot again as it could be severe the next time.  Since that event in 2001, I have discontinued getting flu  shots for fear of re-experiencing such intense pain in my nect again in addition to fear of losing move free movement in my neck.  I do not know the specifics about the vaccine, i.e., manufacturer, type, or even the nurses who gave the shots.    I only submit this in order to help others with similar eczema symptoms as well as seeking information so that I may avoid similar experiences in the future.
Age: 0.19
Sex: M
Vaccine: DTAPHEPBIP, DTP, HIBV, PNC
Symptoms: Blood test, Convulsion, Developmental delay, Electroencephalogram, Hypotonia
Clinical narrative: Vaccine  date  lot#  exp date Pediatrix 09/27/04 AC21A001AA 09/05 Hib   09/27/04 0092P   10/06 Prevnar  09/27/04 A83578R  07/06      Pediatrix 11/23/04 AC21A008AA 10/05 Hib   11/23/04 0805P   10/06 Prevnar  11/23/04 A79659B  08/06      first seizure seen 12/21/2004     admitted to hospital 01/06/2005     seizure free 04/06/2005 - 04/26/2005  Prevnar  04/21/05 A67188A  01/07 Pediatrix 04/21/05 AC21A05AA 01/06      04/26/2005 seizures returned  No vaccines given for 4th set of shots. Seizure free since 05/17/2005  Follow-up Info Diagnoses:(1)Suspected symptomatic infantile spasms (2) Development Delay decreased muscle bulk as wellas decreased tone. He is hypotonic HIB 0082P  9/27/04-Wyeth HIB 0805P 11/23/04-Wyeth
Age: 0.19
Sex: M
Vaccine: DTAPHEPBIP, DTP, HIBV, PNC
Symptoms: Infantile spasms, Nuclear magnetic resonance imaging, Vaccine positive rechallenge, X-ray
Clinical narrative: Vaccine  date  lot#  exp date Pediatrix 09/27/04 AC21A001AA 09/05 Hib   09/27/04 0092P   10/06 Prevnar  09/27/04 A83578R  07/06      Pediatrix 11/23/04 AC21A008AA 10/05 Hib   11/23/04 0805P   10/06 Prevnar  11/23/04 A79659B  08/06      first seizure seen 12/21/2004     admitted to hospital 01/06/2005     seizure free 04/06/2005 - 04/26/2005  Prevnar  04/21/05 A67188A  01/07 Pediatrix 04/21/05 AC21A05AA 01/06      04/26/2005 seizures returned  No vaccines given for 4th set of shots. Seizure free since 05/17/2005  Follow-up Info Diagnoses:(1)Suspected symptomatic infantile spasms (2) Development Delay decreased muscle bulk as wellas decreased tone. He is hypotonic HIB 0082P  9/27/04-Wyeth HIB 0805P 11/23/04-Wyeth
Age: 39.0
Sex: F
Vaccine: FLUX
Symptoms: Abnormal behaviour, Aggression, Hostility, Injection site erythema, Injection site pain
Clinical narrative: apx 20 hours after administered a site reaction was noticed including redness, swelling, soreness and area was hot to the touch.  A moderated fever was present at this time and continued to increase.  Within 48 hours all over stiffness and body aches, lasting several days. Most alarming for the pt was a remarkable change of mood and behavior, including irritablity, hostility and aggression that has been increasing as of 10/12/05 and has not subsided with the stiffness and soreness.
Age: 39.0
Sex: F
Vaccine: FLUX
Symptoms: Injection site reaction, Injection site swelling, Injection site warmth, Irritability, Mood altered
Clinical narrative: apx 20 hours after administered a site reaction was noticed including redness, swelling, soreness and area was hot to the touch.  A moderated fever was present at this time and continued to increase.  Within 48 hours all over stiffness and body aches, lasting several days. Most alarming for the pt was a remarkable change of mood and behavior, including irritablity, hostility and aggression that has been increasing as of 10/12/05 and has not subsided with the stiffness and soreness.
Age: 39.0
Sex: F
Vaccine: FLUX
Symptoms: Musculoskeletal stiffness, Pain, Pyrexia
Clinical narrative: apx 20 hours after administered a site reaction was noticed including redness, swelling, soreness and area was hot to the touch.  A moderated fever was present at this time and continued to increase.  Within 48 hours all over stiffness and body aches, lasting several days. Most alarming for the pt was a remarkable change of mood and behavior, including irritablity, hostility and aggression that has been increasing as of 10/12/05 and has not subsided with the stiffness and soreness.
Age: 77.0
Sex: F
Vaccine: FLUX, PPV
Symptoms: Blister, Erythema, Face oedema, Pain, Swelling
Clinical narrative: Left arm sore, swollen and red to mid forearm. Jowls amd left cheek swollen. Small bisters on back of left arm
Age: 1.03
Sex: M
Vaccine: MMR, MNQ, VARCEL
Symptoms: Pyrexia
Clinical narrative: Very high tempurature occured one week after receiving vaccination.  No other symptoms, was not an ear infection or strep throat (was seen by doctor).  Did not have any rashes or other skin occurrences.  The temperature ranged from low grade, to in excess of 105 degrees.
Age: 16.0
Sex: F
Vaccine: HEPA, MNQ, HEPA, MNQ
Symptoms: Erythema multiforme, Myalgia, Pyrexia, Serum sickness
Clinical narrative: Initial report received from another manufacturer (reference number A0571315A) on 07Oct05, it was initially reported by a physician that a 15 yr old, female pt with a medical history of migraine, experienced erythema multiforme, two days after she received an IM injection of Menactra, lot number 01684AA on 03Aug05. She also received her first IM dose of Havrix, lot number AHAVB0532A on the same day. On 05Aug05, two days after the vaccinations, the pt experienced erythema multiforme, serum sickness, muscle pain and fever. The pt was seen at a physician's office. The physician considered the events to jeopardize the pt. The immunization series with Havrix was discontinued. The events were ongoing at the time of reporting. The physician considered the events possibly related to vaccination with Havrix. This report was reported to be serious (OMIC).
Age: 28.0
Sex: M
Vaccine: FLU3
Symptoms: Chills, Dehydration, Fatigue, Influenza like illness, Pyrexia
Clinical narrative: Rapid onset of flu symptoms ( chills, fatigue, mild dehydration, fever , 102.5 F temp at 6:30pm 10/10/2005. Spiked pm on 10/11/2005. Asymptomatic on 10/12/2005. Reaction not observed by health center.
Age: 57.0
Sex: F
Vaccine: FLU3, PPV
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site warmth
Clinical narrative: The injection sites are swollen, hot and red. The reactions occur after 28-30 hours. The flu and pneumococcal vaccines were given on the same arm on Wednesday 10/12. Patient took 1 Benadryl tab 25mg on Thursday night. She came in my pharmacy the next day, I instructed her to do ice pace and take Advil, ask to call back.