chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 5.0
Sex: F
Vaccine: COVID19
Symptoms: Herpes simplex test negative, Metabolic function test, Myalgia, Myositis, Pain in extremity
Clinical narrative: I saw the patient on 12/10/21 with complaints of muscle aches, as well as a vaginal ulcer. She received her COVID vaccines on 11/12/21, then 12/4/21. Mom reported that after her first vaccine, she had muscle aches in her forearms, shins, and feet - Mom was vague on the exact date this started.  This resolved, then after her 2nd COVID vaccine, she again had muscle aches.  On 12/8/21 she had trouble walking and arm pain. Also, she also had a vaginal ulcer that appeared around 12/1/21. Of note, Mom reported that everyone in the house had a URI around 11/19/21. Her exam on 12/10/21 was normal, aside from the vaginal ulcer.  When I called Mom to discuss the labs on 12/14/21, pt.'s muscle pain and vaginal ulcer had resolved. I suspect she had myositis, but it's not clear if that was due to the vaccine or the URI that Mom reported. It's not clear if the vaginal ulcer is related to the myalgias or not.
Age: 5.0
Sex: F
Vaccine: COVID19
Symptoms: Upper respiratory tract infection, Vaginal ulceration
Clinical narrative: I saw the patient on 12/10/21 with complaints of muscle aches, as well as a vaginal ulcer. She received her COVID vaccines on 11/12/21, then 12/4/21. Mom reported that after her first vaccine, she had muscle aches in her forearms, shins, and feet - Mom was vague on the exact date this started.  This resolved, then after her 2nd COVID vaccine, she again had muscle aches.  On 12/8/21 she had trouble walking and arm pain. Also, she also had a vaginal ulcer that appeared around 12/1/21. Of note, Mom reported that everyone in the house had a URI around 11/19/21. Her exam on 12/10/21 was normal, aside from the vaginal ulcer.  When I called Mom to discuss the labs on 12/14/21, pt.'s muscle pain and vaginal ulcer had resolved. I suspect she had myositis, but it's not clear if that was due to the vaccine or the URI that Mom reported. It's not clear if the vaginal ulcer is related to the myalgias or not.
Age: 67.0
Sex: M
Vaccine: PPV
Symptoms: Chills, Headache, Injection site pain, Injection site swelling, Nausea
Clinical narrative: Severe swelling and pain at injection site with nausea headache fever chills and rash on body
Age: 67.0
Sex: M
Vaccine: PPV
Symptoms: Pyrexia, Rash
Clinical narrative: Severe swelling and pain at injection site with nausea headache fever chills and rash on body
Age: 37.0
Sex: M
Vaccine: COVID19
Symptoms: Urticaria
Clinical narrative: Chronic hives
Age: 28.0
Sex: M
Vaccine: COVID19
Symptoms: Urticaria
Clinical narrative: Been having hives come and go every about 30/45 minutes
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: Asthma, Chest discomfort, Ear discomfort, Throat irritation
Clinical narrative: Moderate to Severe burning throat, ear pressure, Moderate tight chest, Mild to Moderate Asthma exacerbation
Age: 18.0
Sex: F
Vaccine: COVID19
Symptoms: Lymph node pain, Lymphadenopathy, Nausea, Pain in extremity
Clinical narrative: My left arm grew increasingly sore and painful. My left lymph nodes in my arm pit grew increasingly swollen 24 hours after my shot. My left lymph nodes in my arm pit were visibly large and swollen and extremely painful the night of the seventeenth, around 32 hours after my shot. I have a high pain tolerance and I considered going to urgent care that night if the pain continued. When I woke up the morning of the 18th the pain had reduced but was still noticeable, swelling had subsided. The night of the 19th, 48 hours after symptoms started, swelling has gone away but left arm pit lymph nodes are still painful to touch.  I would say right under arm lymph nodes were slightly swollen the night of the 17th, but not painful. Occasional nausea up to 48 hours after shot.  I took no pain medication or anti-inflammatories.
Age: 31.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Anxiety, Depression, Tinnitus
Clinical narrative: 90 minutes after receiving my 2nd dose of Phizer on December 14th 2021 , I experienced ringing in my ears. After visiting an EN that my heaT  December 17th, it was his opinion that the 2nd shot was the cause of the tinnitus. He prescribed me Prednisone. I have yet to feel any relief yet, and the 6 days of constant ringing has caused severe anxiety and depression.
Age: 29.0
Sex: F
Vaccine: COVID19
Symptoms: Adverse reaction, Mechanical urticaria, Pain, Pruritus, Urticaria
Clinical narrative: 8 days after the booster I developed severe dermatographia. 2 days after that my reaction developed into severe painful and itchy hives / welts covering my body which was treated with oral + topical steroids and multiple types of antihistamines. The steroids worked for the hives / welts however the dermatographia has persisted to this day which means I am now going on 5 weeks of this reaction. I continue to take antihistimes daily although they do not seem to help.
Age: 13.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Urticaria
Clinical narrative: Patient broke out in hives for 3 days afterwards.  She required a prescription medication.
Age: 32.0
Sex: F
Vaccine: COVID19
Symptoms: Burning sensation, Chills, Nausea, Pain, Pyrexia
Clinical narrative: Pain and stinging upon injection. Followed by a strong burning sensation that lasted for approximately an hour and a half afterwards. 24 hours after receiving the booster, I had a low grade fever, chills, and was nauseous. My first two doses were Pfizer and I did not have any of these reactions with them.
Age: 45.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Cough, Malaise, Oropharyngeal pain, Pain
Clinical narrative: COVID positive on 12/18/2021. Symptoms: cough, sore throat, fever, body aches, flem, general malaise
Age: 45.0
Sex: M
Vaccine: COVID19
Symptoms: Productive cough, Pyrexia, SARS-CoV-2 test positive
Clinical narrative: COVID positive on 12/18/2021. Symptoms: cough, sore throat, fever, body aches, flem, general malaise
Age: 67.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Asthenia, Blood glucose increased, Injection site pain, Pain in extremity
Clinical narrative: Severe pain in both arms starting at the point of injection down to my hands, lasting from 1 hour to 4 or 5 hous.  My doctor said it could not be from the injection and blew me off.  I never know when the pain will start or stop.  But so far it has happened about twice a month and seems to be getting worse. And now I am also getting weak and my blood sugar in the morning is between 80 and 110.  When it used to be about 100, with NO medication.
Age: 34.0
Sex: F
Vaccine: COVID19
Symptoms: Blood test, Computerised tomogram, Echocardiogram, Electrocardiogram, Magnetic resonance imaging
Clinical narrative: Pericarditis, pericardial effusion that required drain procedure
Age: 34.0
Sex: F
Vaccine: COVID19
Symptoms: Pericardial drainage, Pericardial effusion, Pericarditis, Ultrasound scan
Clinical narrative: Pericarditis, pericardial effusion that required drain procedure
Age: 39.0
Sex: F
Vaccine: COVID19
Symptoms: Headache, Lymphadenopathy, Muscle spasms, Pyrexia
Clinical narrative: Swollen lymph node in left armpit tennis ball size- pain meds, cold compress, heat compression non treatment helps Fever, headache, leg cramps-?treated with Tylenol
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Extra dose administered, No adverse event
Clinical narrative: The patient scheduled and arrived to the pharmacy for a booster (3rd) COVID vaccination.  She initially could not find her card and being a family member of the pharmacy, we looked at the scheduler to determine that she was indeed due for her 3rd booster dose. She received the dose without incident.  Upon entering the vaccine into database, it was discovered that this patient had already received a booster dose on November 3rd.  Upon discussing with her, she then remembered the 3rd dose.  She is not immune suppressed and therefore does not require a 4th dose of vaccine.  The patient was monitored for 24 hours and reports no adverse response to her dose.  A new, correct vaccine card has been provided for the patient.
Age: 36.0
Sex: F
Vaccine: COVID19
Symptoms: Lymph node pain, Lymphadenopathy, Pain in extremity, Pruritus, Rash
Clinical narrative: Swollen and tender lymph node under clavicle bone on the left side - went away after 14 days. Sore upper left arm - went away after 4 days. Swollen lymph node left armpit area - went away after 1 week. Bumps and itching started around injection site and spread to upper back, and to the upper right arm - bumps went away after 3 days.
Age: 24.0
Sex: F
Vaccine: COVID19
Symptoms: Mechanical urticaria, Pruritus, Rash
Clinical narrative: Dermatographia with rash/dermatographia symptoms beginning 10 days after booster dose.   Extremely itchy and persistent.
Age: 5.0
Sex: M
Vaccine: COVID19
Symptoms: Lymphadenopathy, Oral discomfort
Clinical narrative: Burning lip Swollen armpit gland
Age: 41.0
Sex: M
Vaccine: COVID19
Symptoms: Hypoaesthesia
Clinical narrative: Left side of face numbness. Resolved within 24 hours
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: Migraine, Pyrexia, Tinnitus
Clinical narrative: Dramatically increased tinitus that has persisted almost 2 months  Probably started that evening but d/t high fever and migraine it was not noted However it has been obviously much worse within 2 days after vaccine and not resolving No treatment
Age: 33.0
Sex: M
Vaccine: COVID19
Symptoms: Discomfort, Dyspepsia, Pruritus, Urticaria
Clinical narrative: Dec 15 - 6PM - itchy scalp, waistline, arms, collar; 10PM - itchy all over, particularly in areas where I've scratched --  Dec 16 - 2AM - heartburn symptoms develop at this time as well, becoming increasingly intense; 5AM - hives across body. Took omeprazole and claritin to deal with both symptoms, little effect over the course of the day.  Took Tums liberally. Dec 17 - 6AM - hives remain, mainly in areas with lots of friction; heartburn remains uncomfortable.  Took omeprazole and claritin for symptoms, some positive results from omeprazole (less heartburn), little effect from claritin.  Tums as needed. Dec 18 - 6AM - hives remain, anywhere where I have friction and anywhere I scratch/rub.  heartburn improving.  Took omeprazole and zyrtec for symptoms, substantial improvement in hives -- still exist but in fewer, smaller, less itchy patches, mostly around wrists and hairline.  Tums as needed.  9PM - took Zyrtec. Dec 19 - 7am - hives exist, but remain less substantial.   Took pepcid and zyrtec; hearburn is mostly gone.
Age: 24.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site erythema, Injection site swelling, Pruritus
Clinical narrative: About 24 hours after receiving the vaccine, I noticed redness and swelling at the site of injection. About golf ball sized. Itching and redness has persisted.
Age: 16.0
Sex: M
Vaccine: COVID19
Symptoms: Product administered to patient of inappropriate age
Clinical narrative: Family was (Privacy) and  even with an interpreter there was a language barrier.  Mother stated that son was over 18 and that he was here for his moderna booster.  Participant was administered the moderna booster by the medical personnel and the paperwork was signed off by the assisting RN.  The error in the age was not noticed until the information was being put in the immunization registry.
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Migraine, Tinnitus
Clinical narrative: Tinnitus-High pitched humming/whistle that started after about 48 hours after vaccine. Able to cover ears and thump lower back of head at same time with fingers to relax muscle (dentist recommended online). After doing maneuver intermittently over few hours it would go away, but come back over time. I'm a nurse and looked up and saw it was a possible side affect and most went away after 2 weeks. It continued to come and go and would cause migraine when it continued for long periods. Tylenol and IBU didnt help so had to keep ice pack on head to get some relief.  At first could drown out with alarms noise and people at work and with TV at home to sleep. Length of time it continued without a break got worst with time. Now it's been a month and it seems to be getting worst. Will see Dr soon as possible knowing there's nothing for them to do unfortunately.  I don't know if this is permanent or there's still time for it to go away only time will tell.
Age: 55.0
Sex: F
Vaccine: COVID19
Symptoms: Intermenstrual bleeding, Postmenopausal haemorrhage
Clinical narrative: Breakthrough postmenopausal bleeding approximately 20 hours after booster shot.
Age: 42.0
Sex: M
Vaccine: COVID19
Symptoms: Discomfort, Swelling
Clinical narrative: Swelling and discomfort in left arm pit
Age: 27.0
Sex: F
Vaccine: COVID19
Symptoms: Ear pain, Erythema, Pruritus, Rash papular, Rash pruritic
Clinical narrative: hives on back, neck, face, and shoulders. Very itchy scalp. Developed 10 days after moderna booster shot. Hot ears to the touch and very red. Sore behind ears from itchy/rash. Anywhere you put contact would results in a line of raised hives/rashes. Benadryl works to resolve hives and rash, but reoccur when Benadryl wears off.  Woke up sunday morning 12/19/2021 with left side of my face swollen.
Age: 27.0
Sex: F
Vaccine: COVID19
Symptoms: Skin warm, Swelling face, Urticaria
Clinical narrative: hives on back, neck, face, and shoulders. Very itchy scalp. Developed 10 days after moderna booster shot. Hot ears to the touch and very red. Sore behind ears from itchy/rash. Anywhere you put contact would results in a line of raised hives/rashes. Benadryl works to resolve hives and rash, but reoccur when Benadryl wears off.  Woke up sunday morning 12/19/2021 with left side of my face swollen.
Age: 29.0
Sex: F
Vaccine: COVID19
Symptoms: Feeling abnormal, Paraesthesia
Clinical narrative: Occasional shooting and tingling sensation through extremities. Worse with movement and touching cold surfaces.
Age: 11.0
Sex: F
Vaccine: COVID19
Symptoms: Menstrual disorder
Clinical narrative: Mother notes the day after the vaccine, she started her first period. She is not sure if this is a side effect of the vaccine, but felt this data point was worth sharing.
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Astigmatism, Eye pain, Pain, Pain in extremity, Pyrexia
Clinical narrative: Pain in arm,body aches, fever for 2 days.  Two weeks after I started seeing blurred lights (like astigmatism) pain behind eyes and strange feeling in eyes.  I can still see like before but I am seeking lights as though I am looking at a twinkling star.
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Vision blurred, Visual impairment
Clinical narrative: Pain in arm,body aches, fever for 2 days.  Two weeks after I started seeing blurred lights (like astigmatism) pain behind eyes and strange feeling in eyes.  I can still see like before but I am seeking lights as though I am looking at a twinkling star.
Age: 29.0
Sex: F
Vaccine: COVID19
Symptoms: Dysmenorrhoea, Heavy menstrual bleeding, Menstruation irregular
Clinical narrative: Period started 16 days early with none of my usual PMS symptoms and was unusually painful and heavy
Age: 42.0
Sex: M
Vaccine: COVID19
Symptoms: Arthralgia, Loss of personal independence in daily activities, Magnetic resonance imaging abnormal, Pain, Sleep disorder
Clinical narrative: About 2 to 4 weeks, some persistent shoulder pain started, and kept steady for the following months. It was bothersome especially when trying to sleep on the should, but occasionally also some movements. After taking a third dose in mid November 2021 (Moderna), and after the acute pain of the shot passed (3 days), the previous persistent pain became a lot worse, and now hurts with almost every movement and seems to be getting worse every week. I will soon do more tests.
Age: 42.0
Sex: M
Vaccine: COVID19
Symptoms: Tendon injury
Clinical narrative: About 2 to 4 weeks, some persistent shoulder pain started, and kept steady for the following months. It was bothersome especially when trying to sleep on the should, but occasionally also some movements. After taking a third dose in mid November 2021 (Moderna), and after the acute pain of the shot passed (3 days), the previous persistent pain became a lot worse, and now hurts with almost every movement and seems to be getting worse every week. I will soon do more tests.
Age: 32.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Fully vaccinated employee tested + for covid 19
Age: 70.0
Sex: M
Vaccine: COVID19
Symptoms: Ejaculation failure, Erectile dysfunction
Clinical narrative: erectile disfunction,  inability to maintain erection during coitus , no ejaculation , over many events and efforts over two month period
Age: 50.0
Sex: F
Vaccine: VARZOS
Symptoms: Fatigue, Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
Clinical narrative: Pain, swelling, redness and warmth at injection site; fatigue, nausea
Age: 50.0
Sex: F
Vaccine: VARZOS
Symptoms: Nausea
Clinical narrative: Pain, swelling, redness and warmth at injection site; fatigue, nausea
Age: 63.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Acoustic stimulation tests normal, Cerumen removal, Constipation, Dry throat, Dysphagia
Clinical narrative: My tinnitus got worse after the second shot.  The ringing in my ears got worse. The increase ringing in my years started a fews days after my second dose of the Moderna vaccine.  I went to the Ear Nose and Throat doctor in July or Early August of 2021. The doctor cleaned my ears to remove ear wax. I was also given a hearing test. My hearing was normal.  I also notice that when I drive on the interstate or a road where the speed limit is 55 or greater my tinnitus gets louder. This can also happen when I drive to the store or make short trips.   So basically my tinnitus is now is louder and very much unpredictable.  Since driving is now effecting my tinnitus I am now seeking a medical accommodation from the Administration to work from home so that I do not have to drive to work. I have a medical disability from the Administration.  This was obtain in 2016.  Also after the second dose my throat was dry. It was difficult to swallow. I had to drink a lot of water. I had to eat soup and soft foods for a few weeks. I also got constipated. The constipation lasted a few days.
Age: 63.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Impaired driving ability, Tinnitus
Clinical narrative: My tinnitus got worse after the second shot.  The ringing in my ears got worse. The increase ringing in my years started a fews days after my second dose of the Moderna vaccine.  I went to the Ear Nose and Throat doctor in July or Early August of 2021. The doctor cleaned my ears to remove ear wax. I was also given a hearing test. My hearing was normal.  I also notice that when I drive on the interstate or a road where the speed limit is 55 or greater my tinnitus gets louder. This can also happen when I drive to the store or make short trips.   So basically my tinnitus is now is louder and very much unpredictable.  Since driving is now effecting my tinnitus I am now seeking a medical accommodation from the Administration to work from home so that I do not have to drive to work. I have a medical disability from the Administration.  This was obtain in 2016.  Also after the second dose my throat was dry. It was difficult to swallow. I had to drink a lot of water. I had to eat soup and soft foods for a few weeks. I also got constipated. The constipation lasted a few days.
Age: 61.0
Sex: F
Vaccine: UNK
Symptoms: Asthenia, Blood pressure increased, Computerised tomogram head, Condition aggravated, Dizziness
Clinical narrative: Severe weakness and dizziness.  Blood pressure spiked the first night to 164/112.  Spent 3 days in bed not able to do much at all.
Age: 61.0
Sex: F
Vaccine: UNK
Symptoms: Laboratory test, X-ray of pelvis and hip
Clinical narrative: Severe weakness and dizziness.  Blood pressure spiked the first night to 164/112.  Spent 3 days in bed not able to do much at all.
Age: 69.0
Sex: U
Vaccine: FLU4
Symptoms: Axillary pain, Joint range of motion decreased, Pain in extremity
Clinical narrative: Sore arm, Lack of Range of motion sore arm pit
Age: 12.0
Sex: M
Vaccine: COVID19
Symptoms: Underdose
Clinical narrative: Patient received Pfizer Covid Vaccine for pediatrics instead of Adult (12 yrs an older) dose. No side effects reported.
Age: 42.0
Sex: F
Vaccine: COVID19
Symptoms: Chest discomfort, Erythema, Influenza like illness, Pain in extremity, Peripheral swelling
Clinical narrative: pressure in chest, right arm soreness with redness & swelling, flu-like symptoms
Age: 56.0
Sex: M
Vaccine: COVID19
Symptoms: Pulmonary embolism
Clinical narrative: Employee advises that he was diagnosed with a Pulmonary Embolism the first week of November Narrative:
Age: 40.0
Sex: F
Vaccine: COVID19
Symptoms: Myalgia, Pain in extremity, Pyrexia
Clinical narrative: Myalgia, Fever, SORE ARM Narrative:
Age: 33.0
Sex: M
Vaccine: COVID19
Symptoms: Chills, Fatigue, Headache, Pyrexia
Clinical narrative: Headache, Fever, chills, fatigue Narrative:
Age: 57.0
Sex: M
Vaccine: COVID19
Symptoms: Chills, Headache, Hypertension, Myalgia
Clinical narrative: Headache, Myalgia, HYPERtension, chills Narrative:
Age: 63.0
Sex: M
Vaccine: COVID19
Symptoms: Arthralgia, Chills, Myalgia, Nausea, Pyrexia
Clinical narrative: Myalgia, Arthralgia, Fever, NauseaVomiting, chills Narrative:
Age: 63.0
Sex: M
Vaccine: COVID19
Symptoms: Vomiting
Clinical narrative: Myalgia, Arthralgia, Fever, NauseaVomiting, chills Narrative:
Age: 45.0
Sex: F
Vaccine: COVID19
Symptoms: Headache, Injection site pain, Lethargy, Myalgia, Pyrexia
Clinical narrative: Headache, Myalgia, Fever, Lethargic, Sore Around Injection Site Narrative:
Age: 54.0
Sex: M
Vaccine: COVID19
Symptoms: Headache, Nausea, Vomiting
Clinical narrative: Headache & NauseaVomiting Narrative:
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Computerised tomogram normal
Clinical narrative: Narrative: 65 yo male with NICM, EF 20% s/p AICD, prior hx of chronic ETOH use in remission, severe tophacious gout on chronic prednisone, admitted with progressive dyspnea, cough productive of yellow sputums, weakness with a recent fall patient reports that he has visited 3 different ERs in the past week due to these same sx, as told at outside ED that he had COVID after an all day ER visit, but d/c to home. patient had both covid vaccines. ROS positive for loose stool, absent for any abdominal pain, negative for n/v HOSPITAL COURSE: 1. Acute COVID-19 pneumonia -CXR with bilateral infiltrates -Patient never actually required any oxygen and was never hypoxic and the patient's main symptoms were generalized weakness -Patient did undergo a CT scan on the inpatient setting it was fairly unremarkable -Patient is already on chronic prednisone at home and this has not been increased -Patient is not a candidate for remdesivir in the setting of his GFR being around 20-25 -Patient was evaluated by physical therapy and the recommendation was for rehab, the patient was medically stable for days but needed 10 days of quarantine 2. Acute bacterial pneumonia -Certainly possible given the chest x-ray findings as well as the elevated white blood cell count that the patient does have a superimposed bacterial pneumonia and will order a CT scan to further clarify -Patient completed Rocephin on the inpatient setting
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Diarrhoea, Dyspnoea, Fall, Glomerular filtration rate decreased, Lung infiltration
Clinical narrative: Narrative: 65 yo male with NICM, EF 20% s/p AICD, prior hx of chronic ETOH use in remission, severe tophacious gout on chronic prednisone, admitted with progressive dyspnea, cough productive of yellow sputums, weakness with a recent fall patient reports that he has visited 3 different ERs in the past week due to these same sx, as told at outside ED that he had COVID after an all day ER visit, but d/c to home. patient had both covid vaccines. ROS positive for loose stool, absent for any abdominal pain, negative for n/v HOSPITAL COURSE: 1. Acute COVID-19 pneumonia -CXR with bilateral infiltrates -Patient never actually required any oxygen and was never hypoxic and the patient's main symptoms were generalized weakness -Patient did undergo a CT scan on the inpatient setting it was fairly unremarkable -Patient is already on chronic prednisone at home and this has not been increased -Patient is not a candidate for remdesivir in the setting of his GFR being around 20-25 -Patient was evaluated by physical therapy and the recommendation was for rehab, the patient was medically stable for days but needed 10 days of quarantine 2. Acute bacterial pneumonia -Certainly possible given the chest x-ray findings as well as the elevated white blood cell count that the patient does have a superimposed bacterial pneumonia and will order a CT scan to further clarify -Patient completed Rocephin on the inpatient setting
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Pneumonia bacterial, Productive cough, Sputum discoloured, White blood cell count increased
Clinical narrative: Narrative: 65 yo male with NICM, EF 20% s/p AICD, prior hx of chronic ETOH use in remission, severe tophacious gout on chronic prednisone, admitted with progressive dyspnea, cough productive of yellow sputums, weakness with a recent fall patient reports that he has visited 3 different ERs in the past week due to these same sx, as told at outside ED that he had COVID after an all day ER visit, but d/c to home. patient had both covid vaccines. ROS positive for loose stool, absent for any abdominal pain, negative for n/v HOSPITAL COURSE: 1. Acute COVID-19 pneumonia -CXR with bilateral infiltrates -Patient never actually required any oxygen and was never hypoxic and the patient's main symptoms were generalized weakness -Patient did undergo a CT scan on the inpatient setting it was fairly unremarkable -Patient is already on chronic prednisone at home and this has not been increased -Patient is not a candidate for remdesivir in the setting of his GFR being around 20-25 -Patient was evaluated by physical therapy and the recommendation was for rehab, the patient was medically stable for days but needed 10 days of quarantine 2. Acute bacterial pneumonia -Certainly possible given the chest x-ray findings as well as the elevated white blood cell count that the patient does have a superimposed bacterial pneumonia and will order a CT scan to further clarify -Patient completed Rocephin on the inpatient setting
Age: 72.0
Sex: M
Vaccine: COVID19
Symptoms: Condition aggravated, Death, Neoplasm malignant
Clinical narrative: Narrative:  72yo male patient with esophageal cancer with metastasis to the liver died at home on 11/9/2021. Past Medical History: Secondary malignant neoplasm of liver (SHistory of antineoplastic chemotherapy (SCT 125211000119106) Iron deficiency anemia (SCT 87522002) Seen by palliative care medicine service (SCT 305824005) History of radiation therapy (SCT 429479Malignant tumor of lower third of esophagus (SCT 187727005) Hypertension (SCT 38341003) Nontraumatic AKI (acute kidney injury) (SCT 140031000119103) Prostatitis (ICD-9-CM 601.9) Abdominal aortic aneurysm (SCT 233985008) Bronchitis, not specified as acute or chChronic obstructive lung disease (SCT 13645005) Health Maintenance (ICD-9-CM V65.9) Dizziness (ICD-9-CM 780.4) Basal cell carcinoma - primary (ICD-9-CMHyperlipidemia (SCT 55822004) Occlusion and Stenosis of Carotid ArteryChronic obstructive lung disease (SCT 13645005) Gastro-esophageal reflux disease withoutBenign prostatic hyperplasia (SCT 266569009) Active problem list reviewed Pt received covid vaccines on 3/3/21, 3/31/21 & 9/7/21. This death from cancer, not related to covid vaccines.
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Chest discomfort, Chronic obstructive pulmonary disease, Cough, Dyspnoea
Clinical narrative: Narrative:  Patient received Janssen COVID 19 Vaccine in May 2021. The patient tested positive for COVID 19 on October 2021. The patient was  admitted to the hospital with COPD exacerbation, cough, fever, and shortness of breath. The patient was treated with dexamethasone and nebulizers. The patient left the hospital against medical advice on 15 October 2021. The patient was  readmitted to the hospital on 11 November 2021 with pneumonia, cough, and chest tightness and treated. The patient was discharged in stable condition on 16 November 2021.
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Pneumonia, Pyrexia, SARS-CoV-2 test positive
Clinical narrative: Narrative:  Patient received Janssen COVID 19 Vaccine in May 2021. The patient tested positive for COVID 19 on October 2021. The patient was  admitted to the hospital with COPD exacerbation, cough, fever, and shortness of breath. The patient was treated with dexamethasone and nebulizers. The patient left the hospital against medical advice on 15 October 2021. The patient was  readmitted to the hospital on 11 November 2021 with pneumonia, cough, and chest tightness and treated. The patient was discharged in stable condition on 16 November 2021.
Age: 74.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Asthenia, COVID-19, Cough, SARS-CoV-2 test positive, Wheezing
Clinical narrative: Narrative: Patient had moderna vaccines on 2/12/21 and 3/12/2021. Presented to ED with cough, wheeze and weakness. Tested positive for covid on 11/16/2021.
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Death
Clinical narrative: Narrative:  74yo male patient with PMH: Hyperlipidemia (SCT 55822004) Migraine (SCT 37796009) Lymphedema (SCT 234097001) Cellulitis (SCT 128045006) Hip pain (SCT 49218002) Chronic obstructive lung disease (SCT 13645005) Tobacco Use Disorder (ICD-9-CM 305.1) Essential hypertension (SCT 59621000) Morbid Obesity (ICD-9-CN 278.01 Diabetes (ICD-9-CM 250.00) died at hospital on 11/16/2021. Pt had received covid vaccines at place unknown on 2/4/21 & 2/25/21. This death is likely not related to the vaccinations due to patient's comorbidities, advanced age, and length of time from vaccine administration.
Age: 72.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Death, Dyspnoea, Intestinal obstruction, Malaise
Clinical narrative: Narrative:  Patient received 3 doses of the Moderna vaccine 2 shots and one booster. Patient tested positive for Covid 19 on 9/23/2021 presented to the hospital on 9/30/2021 for SOB and respiratory failure; then his covid symptoms improved during his stay. He then passed away of other complications due to a bowel obstruction. Reported per EUA
Age: 72.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Respiratory failure, SARS-CoV-2 test positive
Clinical narrative: Narrative:  Patient received 3 doses of the Moderna vaccine 2 shots and one booster. Patient tested positive for Covid 19 on 9/23/2021 presented to the hospital on 9/30/2021 for SOB and respiratory failure; then his covid symptoms improved during his stay. He then passed away of other complications due to a bowel obstruction. Reported per EUA
Age: 71.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: COVID-19, COVID-19 pneumonia, SARS-CoV-2 test positive
Clinical narrative: Narrative: Patient received the COVID 19 Moderna vaccine in Mar/April 2021. The patient tested positive on 23 October 2021 and was hospitalized on 24 October 2021 with COVID pneumonia. The patient was treated and discharged on 31 October 2021.
Age: 87.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Sepsis
Clinical narrative: Narrative: Patient recieved vaccines in Jan(11, 2021) and Feb from a pharmacy. Patient hospitalized with covid/sepsis on 11/8. reported per EUA
Age: 50.0
Sex: M
Vaccine: PPV, TDAP
Symptoms: Hypersensitivity, Injection site discomfort, Injection site erythema, Injection site pain, Injection site warmth
Clinical narrative: Narrative:  pt presents for triage, c/o allergic reaction to TDAP given 8/26/21 pt rt upper arm, red below deltoid and above elbow...warm to touch. pt states didn't noticed till yesterday. took 2 benedryl tabs last night. states sore and burning sensation . Right upper arm with 3in X 3in area warm, red. No swelling. Feels like a sunburn. No blisters. Area appears to be allergic reaction and he di dhave some imprvement with burning discomfort after benadryl 50mg last night. VSS w/ no SOB, facial or throat edema, or wheezing. Afebrile
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Erythema, Injection site erythema, Injection site pruritus
Clinical narrative: Narrative: Patient received booster COVID 19 Moderna vaccine on 30 November 2021. The patient experienced redness to chest, injection site, and itching. The patient was treated with methylprednisolone dose pack for six days. The patient's rash was improving after receiving the dose pack.
Age: 58.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Chest pain, SARS-CoV-2 test positive
Clinical narrative: Narrative: Patient got covid-19 vaccines on 3-22-2021 and 4-13-2021. Patient tested positive on 10-6-2021, admitted to the hospital on 10-9-2021 for chest pain. He was discharged on 10-12-2021 and monitored in quarantine at home. He was readmitted to the hospital on 10-26-2021 after coming to a pain appt already scheduled and complaining of chest pain that was constant. He was treated and discharged on 10/29/2021
Age: 84.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: COVID-19, COVID-19 pneumonia, SARS-CoV-2 test positive
Clinical narrative: Narrative:  Patient received two doses of Pfizer COVID 19 vaccine in Feb/Mar 2021. The patient tested positive for COVID 19 on 27 August 2021 and was admitted to the hospital with COVID Pneumonia. The patient was treated with remdesivir and dexamethasone and was discharged on 23 September 2021 in stable condition.
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Chills, Fatigue, Headache, Musculoskeletal stiffness
Clinical narrative: Headache, Myalgia, Arthralgia,  Chills, fatigue, stiffness Narrative:
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Myalgia
Clinical narrative: Headache, Myalgia, Arthralgia,  Chills, fatigue, stiffness Narrative:
Age: 53.0
Sex: F
Vaccine: COVID19
Symptoms: Angina pectoris, Myocardial infarction
Clinical narrative: Angina Myocardial infarction Narrative:  employee reports 3 separate  hospitalizations related to MI
Age: 60.0
Sex: M
Vaccine: COVID19
Symptoms: Arthralgia, Ataxia, Dysuria, Electromyogram, Lumbar radiculopathy
Clinical narrative: Narrative: Patient received second Moderna 4/26/2021 vaccination. He had no prior LEFT shoulder pain or complaints. He was hospitalized following a UTI and thought to have had a cerebellar stroke due to ataxia; however, MRI was negative. Patient had EMGs done, multiple confounding factors that can be found in his outside medical records from the hospital in system from 7/21/2021 including lumbar radiculopathy, neuropathy, h/o of severe ETOH dependence. However, recent MRI dated 12/13/2021 for worsening LEFT shoulder pain concerning for rare disorder, Parsonage Turner Syndrome, affecting that joint. Patient states the LEFT shoulder pain significantly worsened from a 4/10 to 8-9/10 pain in about 14-21 days after the 11/10/2021 for Moderna 3rd dose, requesting an MRI for the shoulder as well as seeing an orthopedic surgeon who recommended the MRI (but whose specialty was not shoulders). The MRI findings and the time frame are why an ADE is suspected. Furthermore, MRI of the brain confirmed no cause for the ataxia (i.e., no cerebellar stroke) from his June/July 2021 MRI to eval for his ataxia. A consult for neurology f/u is pending. EMGs of UE and LE were done in June/July 2021. Also significant is that patient's rehab has improved faster than expected by KT/PT. This lends to a possible vaccine reaction; although, a constellation of other contributing factors remain. Also potentially related is that patient had obstructive uropathy during this period. It is uncertain whether this may also be part of this, but he had been urinating better prior to his hospitalization on or about June 11,2021, and while he was treated for prostatitis, one would have expected him to have been at baseline more rapidly with treatment. This is resolving finally in these last two month.
Age: 60.0
Sex: M
Vaccine: COVID19
Symptoms: Magnetic resonance imaging abnormal, Magnetic resonance imaging head normal, Neuralgic amyotrophy, Neuropathy peripheral, Prostatitis
Clinical narrative: Narrative: Patient received second Moderna 4/26/2021 vaccination. He had no prior LEFT shoulder pain or complaints. He was hospitalized following a UTI and thought to have had a cerebellar stroke due to ataxia; however, MRI was negative. Patient had EMGs done, multiple confounding factors that can be found in his outside medical records from the hospital in system from 7/21/2021 including lumbar radiculopathy, neuropathy, h/o of severe ETOH dependence. However, recent MRI dated 12/13/2021 for worsening LEFT shoulder pain concerning for rare disorder, Parsonage Turner Syndrome, affecting that joint. Patient states the LEFT shoulder pain significantly worsened from a 4/10 to 8-9/10 pain in about 14-21 days after the 11/10/2021 for Moderna 3rd dose, requesting an MRI for the shoulder as well as seeing an orthopedic surgeon who recommended the MRI (but whose specialty was not shoulders). The MRI findings and the time frame are why an ADE is suspected. Furthermore, MRI of the brain confirmed no cause for the ataxia (i.e., no cerebellar stroke) from his June/July 2021 MRI to eval for his ataxia. A consult for neurology f/u is pending. EMGs of UE and LE were done in June/July 2021. Also significant is that patient's rehab has improved faster than expected by KT/PT. This lends to a possible vaccine reaction; although, a constellation of other contributing factors remain. Also potentially related is that patient had obstructive uropathy during this period. It is uncertain whether this may also be part of this, but he had been urinating better prior to his hospitalization on or about June 11,2021, and while he was treated for prostatitis, one would have expected him to have been at baseline more rapidly with treatment. This is resolving finally in these last two month.
Age: 60.0
Sex: M
Vaccine: COVID19
Symptoms: Urinary tract infection, Urinary tract obstruction
Clinical narrative: Narrative: Patient received second Moderna 4/26/2021 vaccination. He had no prior LEFT shoulder pain or complaints. He was hospitalized following a UTI and thought to have had a cerebellar stroke due to ataxia; however, MRI was negative. Patient had EMGs done, multiple confounding factors that can be found in his outside medical records from the hospital in system from 7/21/2021 including lumbar radiculopathy, neuropathy, h/o of severe ETOH dependence. However, recent MRI dated 12/13/2021 for worsening LEFT shoulder pain concerning for rare disorder, Parsonage Turner Syndrome, affecting that joint. Patient states the LEFT shoulder pain significantly worsened from a 4/10 to 8-9/10 pain in about 14-21 days after the 11/10/2021 for Moderna 3rd dose, requesting an MRI for the shoulder as well as seeing an orthopedic surgeon who recommended the MRI (but whose specialty was not shoulders). The MRI findings and the time frame are why an ADE is suspected. Furthermore, MRI of the brain confirmed no cause for the ataxia (i.e., no cerebellar stroke) from his June/July 2021 MRI to eval for his ataxia. A consult for neurology f/u is pending. EMGs of UE and LE were done in June/July 2021. Also significant is that patient's rehab has improved faster than expected by KT/PT. This lends to a possible vaccine reaction; although, a constellation of other contributing factors remain. Also potentially related is that patient had obstructive uropathy during this period. It is uncertain whether this may also be part of this, but he had been urinating better prior to his hospitalization on or about June 11,2021, and while he was treated for prostatitis, one would have expected him to have been at baseline more rapidly with treatment. This is resolving finally in these last two month.
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: Chronic obstructive pulmonary disease, Death, Iron deficiency anaemia
Clinical narrative: Narrative:  68yo male patient was discharged from inpatient admission on 11/4/21 to home. Pt died at home on 11/14/2021. Pt's DISCHARGE DIAGNOSIS: Iron deficiency anemia, POA Acute exacerbation COPD with history of chronic hypoxic respiratory failure, POA CAD s/p PCI, POA Insulin Dependent T2DM, POA Diabetic neuropathy, POA PAD s/p stent, POA AAA s/p EVAR, POA Anxiety, POA Peptic ulcer disease, POA Hyperlipidemia, POA Debility, POA Dementia, POA Pt had received covid vaccines on 2/14/21 & 3/13/21. This death is likely not related to the vaccinations due to comorbidities, age, and length of time from vaccine administration.
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Chills, Fatigue, Headache
Clinical narrative: Narrative: Headache, Arthralgia, chills, and fatigue .
Age: 59.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Chills, Headache, Myalgia, Pain in extremity
Clinical narrative: Headache, Myalgia, chills, sore right arm Narrative:
Age: 44.0
Sex: M
Vaccine: COVID19
Symptoms: Cough, Fatigue, Headache, Muscle fatigue, Pyrexia
Clinical narrative: Headache, Fever, CoughWheeze, NASAL DRIP, MUSCLE FATIGUE, EXHAUSTION Narrative:
Age: 44.0
Sex: M
Vaccine: COVID19
Symptoms: Rhinorrhoea, Wheezing
Clinical narrative: Headache, Fever, CoughWheeze, NASAL DRIP, MUSCLE FATIGUE, EXHAUSTION Narrative:
Age: 40.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal pain upper, Diarrhoea, Malaise, Myalgia, Pain
Clinical narrative: Myalgia, Diarrhea, stomach pains Narrative: Per nursing report: "received the Covid vaccine Tuesday morning [5/25]. She called in due to being sick [5/26]. C/o body aches and 1 episode of diarrhea and stomach pains."
Age: 44.0
Sex: M
Vaccine: PPV
Symptoms: Chills, Hyperhidrosis, Pruritus, Rash, Rash papular
Clinical narrative: Narrative:  11/20/21 Per Center Note, pt reports developing rash after pneumonia vaccine on 11/18/21; states the evening of 11/18/21, he had chills; on 11/19/21, he was sweating and then developed a generalized itchy, raised rash; pt reports using hydrocortisone with some improvement; methylprednisolone and diphenhydramine ordered
Age: 23.0
Sex: F
Vaccine: COVID19
Symptoms: Headache, Nausea, Vomiting
Clinical narrative: Headache & NauseaVomiting Narrative:
Age: 40.0
Sex: M
Vaccine: COVID19
Symptoms: Ear congestion
Clinical narrative: congestion in left ear, progressively getting worse  Narrative:
Age: 54.0
Sex: F
Vaccine: VARZOS
Symptoms: Injection site erythema, Injection site oedema, Injection site pruritus, Injection site reaction, Injection site swelling
Clinical narrative: Narrative:  reports edema, itching, TTP and erythema at injection site (right proximal tricep area) RUE (right proximal tricep) 7x5 cm area of erythema/edema/TTP. Apply ice to affected area 4-6 times per day. DIPHENHYDRAMINE HCL as needed for itching. Apply HYDROCORTISONE 1% OINTMENT for redness and swelling.
Age: 65.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Cough, Diarrhoea, Dyspnoea, Fall
Clinical narrative: Narrative:  The patient received two doses of Pfizer COVID 19 vaccine in Mar 2021. The patient tested positive for COVID 19 on 9 December 2021. The patient was admitted to the hospital on 9 December after syncope episode and severe bout of diarrheal episodes that led to a patient falling. The patient also experienced cough and shortness of breath. The patient was treated with antitussive medication, azithromycin, fluids, and monitored appropriately. The patient was discharged on 13 December 2021 in stable condition.
Age: 65.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: SARS-CoV-2 test positive, Syncope
Clinical narrative: Narrative:  The patient received two doses of Pfizer COVID 19 vaccine in Mar 2021. The patient tested positive for COVID 19 on 9 December 2021. The patient was admitted to the hospital on 9 December after syncope episode and severe bout of diarrheal episodes that led to a patient falling. The patient also experienced cough and shortness of breath. The patient was treated with antitussive medication, azithromycin, fluids, and monitored appropriately. The patient was discharged on 13 December 2021 in stable condition.
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Death, Pneumonia, SARS-CoV-2 test positive, Vaccination failure
Clinical narrative: Narrative:  67yo male patient with recent new renal failure and 4 cm infrarenal AAA and 9 cm L common iliac artery aneurysm also with hx of CAD. On 11/21/21 pt covid + with pneumonia inpatient admission. Pt had received covid vaccine (J&J) on 3/29/21. Vaccine breakthru/failure infection. Pt was discharged home on oxygen & dexamethasone 6mg tablets on 11/28/21 as pt demanding to leave AMA. On 11/29/21 pt died at home likely of covid infection
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Vaccine breakthrough infection
Clinical narrative: Narrative:  67yo male patient with recent new renal failure and 4 cm infrarenal AAA and 9 cm L common iliac artery aneurysm also with hx of CAD. On 11/21/21 pt covid + with pneumonia inpatient admission. Pt had received covid vaccine (J&J) on 3/29/21. Vaccine breakthru/failure infection. Pt was discharged home on oxygen & dexamethasone 6mg tablets on 11/28/21 as pt demanding to leave AMA. On 11/29/21 pt died at home likely of covid infection
Age: 73.0
Sex: M
Vaccine: COVID19
Symptoms: Death, Road traffic accident
Clinical narrative: Narrative: 73yo male patient with severe CAD, HFEF 41%, HTN, HLD, DM, persistent atrial fibrillation, OSA-CPAP, MVA Aug. 2021 died on 11/20/2021. Pt had received covid vaccines on 2/26/21 & 3/26/2021. This death is likely not related to the vaccinations due to comorbidities, age, and length of time from vaccine administration
Age: 63.0
Sex: M
Vaccine: COVID19
Symptoms: Death
Clinical narrative: Narrative:  62 yo male patient with substance abuse, etOH abuse and colorectal rectal cancer treated outside of agency died on 11/8/2021. Last medical note on 7/27/21. Pt had received covid vaccines on 3/18/21 & 4/15/21 from a church. Likely death not related to vaccines given cancer diagnosis.
Age: 34.0
Sex: M
Vaccine: COVID19
Symptoms: Feeling cold, Headache, Pruritus, Rash
Clinical narrative: Headache, itching all over, rash left arm, feeling cold Narrative:
Age: 36.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Impaired work ability, Myalgia
Clinical narrative: Myalgia, fatigue Narrative: Severe muscle pain and fatigue 5/27/2021 resulting in unable to work 5/7/2021.
Age: 32.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Headache, Myalgia, Nausea, Vomiting
Clinical narrative: Headache, Myalgia, NauseaVomiting, fatigue Narrative:
Age: 65.0
Sex: M
Vaccine: COVID19
Symptoms: Death
Clinical narrative: Narrative: 65yo male patient with metastatic liver cancer in treatment at facility died on 11/7/2021. Pt had received one covid vaccine on 7/29/2021 (J&J). Death is not related to covid vaccine.
Age: 88.0
Sex: M
Vaccine: COVID19
Symptoms: Death
Clinical narrative: Narrative:  88yo male patient with CURRENT PROBLEM LIST: Code Description Z85.46 History of malignant neoplasm of prostate (SCT 428262008) I67.9 Cerebrovascular disease (SCT 62914000) I48.20 Chronic atrial fibrillation (SCT 426749004) M10.9 Gout (SCT 90560007) N18.30 Chronic kidney disease stage 3 (SCT 433144002) G47.33 Obstructive sleep apnea of adult (SCT 1101000119103) D64.9 Anemia (SCT 271737000) J44.9 Chronic obstructive lung disease (SCT 13645005) I31.4 Cardiac tamponade (SCT 35304003) N40.1 Benign prostatic hypertrophy without outflow obstruction (SCT 254902007) E78.5 Hyperlipidemia (SCT 55822004) I10. Benign essential hypertension (SCT 38341003) died at home on 10/30/2021 during skilled home health . Pt had received covid vaccines on 1/19/21 & 2/23/21. This death is likely not related to the vaccinations due to patient's comorbidities, advanced age, and length of time from vaccine administration.
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Death
Clinical narrative: Narrative:  78 yo M with a h/o HFpEF G1DD (3/2021), non-obstructive CAD (per 2/2018 cath), paroxysmal atrial fibrillation s/p synchronized cardioversion (4/2020), hx of heavy EtOH use in recent remission, ILD likely 2/2 occupational asbestos exposure vs seronegative RA, HTN, DM, PVD, HLD died on 12/7/21 at ER (non-agency hospital). Pt had received covid vaccines on 2/4/21 & 3/8/21. This death is likely not related to the vaccinations due to patient's comorbidities, advanced age, and length of time from vaccine administration.