chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 31.0
Sex: M
Vaccine: FLUN4
Symptoms: Nausea, Rash papular, Rash pruritic, Tenderness, Tubulointerstitial nephritis
Clinical narrative: 31 y/o M in usual state of good health, suddenly developed right flank pain with associated nausea. After 2 days of pain, patient sought evaluation on 15 Dec 2014. Afebrile. Normal exam except severe CVA tenderness on right. Creatinine 12/11.9 in ER. On 15 Dec 2014, admitted to Medical Center for evaluation and treatment of acute renal insufficiency, non-oliguric acute kidney failure. Started on IV normal saline fluid boluses and pain management with renal diet. Multiple labs and diagnostics completed - most consistent with acute interstitial nephritis. Pain improved over course of hospitalization and patient was discharged on 19 Dec 2014 in stable condition. He was discharged on sodium bicarbonate and OSCAL with Nephrology follow up as outpatient. 29 Dec 2014, Nephrology follow up: Asymptomatic. New onset of pruritic, bilateral papular elbow rash; no associated joint pain, warmth or swelling. No LE edema. No flank pain. Exam normal except for bilateral papular rash on elbows. FEB 2015, Nephrology follow up - Asymptomatic. Normal.
Age: 31.0
Sex: M
Vaccine: FLUN4
Symptoms: Ultrasound kidney abnormal
Clinical narrative: 31 y/o M in usual state of good health, suddenly developed right flank pain with associated nausea. After 2 days of pain, patient sought evaluation on 15 Dec 2014. Afebrile. Normal exam except severe CVA tenderness on right. Creatinine 12/11.9 in ER. On 15 Dec 2014, admitted to Medical Center for evaluation and treatment of acute renal insufficiency, non-oliguric acute kidney failure. Started on IV normal saline fluid boluses and pain management with renal diet. Multiple labs and diagnostics completed - most consistent with acute interstitial nephritis. Pain improved over course of hospitalization and patient was discharged on 19 Dec 2014 in stable condition. He was discharged on sodium bicarbonate and OSCAL with Nephrology follow up as outpatient. 29 Dec 2014, Nephrology follow up: Asymptomatic. New onset of pruritic, bilateral papular elbow rash; no associated joint pain, warmth or swelling. No LE edema. No flank pain. Exam normal except for bilateral papular rash on elbows. FEB 2015, Nephrology follow up - Asymptomatic. Normal.
Age: 41.0
Sex: F
Vaccine: FLU3
Symptoms: Abdominal X-ray, Blood culture, Catatonia, Chest X-ray, Computerised tomogram head
Clinical narrative: Awoke 10/1/15 at 10:00PM "shaking, I was in a catatonic state" transported to hospital ED by family.
Age: 41.0
Sex: F
Vaccine: FLU3
Symptoms: Lumbar puncture, Stool analysis, Tremor
Clinical narrative: Awoke 10/1/15 at 10:00PM "shaking, I was in a catatonic state" transported to hospital ED by family.
Sex: M
Vaccine: FLUN4
Symptoms: Headache, Sinus disorder
Clinical narrative: A report has been received from a health professional via medical representative, concerning a male patient. Relevant medical history, concurrent diseases and concomitant medications were not reported. On unspecified date, the patient got FLUMIST (intranasal). The patient experienced severe sinus symptoms and severe headache symptoms. Action taken and the outcome of the event of sinus symptoms and headache symptoms was unknown. The company physician assessed the events of sinus symptoms and headache symptoms to be serious due to criteria of medical importance.
Sex: F
Vaccine: FLUN4
Symptoms: Headache, Sinus disorder
Clinical narrative: A report has been received from a Health Professional concerning herself. No information regarding relevant history and concomitant medication was provided. The patient received FLUMIST (intranasal), once/single administration on an unknown date. The patient said that she had a severe headache and sinus symptoms for 1.5 weeks after she received the vaccine with Lot FJ2235. Action taken with FLUMIST was unknown. The outcome of the event of severe headache and sinus symptoms was unknown. The company physician considered sinus symptoms to be serious with seriousness criteria of important medical event and sinus symptoms to be non serious.
Sex: U
Vaccine: FLUN4
Symptoms: Arthralgia, Headache, Influenza like illness, Malaise, Myalgia
Clinical narrative: A report has been received from a Physician concerns a patient of unknown gender. No information regarding relevant history and concomitant medication was provided. The patient received FLUMIST (intranasal), 0.2 millilitres started on 09-Oct-2015. Reporter received complaint from a physician who contracted a flu-like syndrome shortly after receiving FLUMIST 09-Oct-2015. The patient received a dose from lot FJ2073 and started feeling ill with stuffy nose and sore throat, that evening. He had subsequently developed fevers, myalgias, arthralgias and headache along with persistent URI symptoms. Customer was planning to obtain a respiratory viral panel on 13-Oct-2015. Product quality complaint was reported for the patient. Action taken with FLUMIST was unknown. The outcome of URI symptoms, fever, arthralgia, sore throat, stuffy nose, myalgia, headache, feeling ill, flu-like syndrome and product quality complaint was unknown. The company physician assessed URI symptoms to be serious with seriousness criteria as important medical event and stuffy nose, fever, myalgia, arthralgia, headache, feeling ill, sore throat were assessed as non serious. Product quality complaint was identified from the additional source document and assessed as serious event with seriousness criteria of important medical event. The event of flu-like syndrome have been identified by the company physician from the source documents and added as non-serious adverse event.                    Adjudication Data Entry       Select the radio button next to any fields that need editing and enter data.   Box 7 Describe Adverse Event  (and treatment if any)
Sex: U
Vaccine: FLUN4
Symptoms: Nasal congestion, Oropharyngeal pain, Product quality issue, Pyrexia, Upper respiratory tract infection
Clinical narrative: A report has been received from a Physician concerns a patient of unknown gender. No information regarding relevant history and concomitant medication was provided. The patient received FLUMIST (intranasal), 0.2 millilitres started on 09-Oct-2015. Reporter received complaint from a physician who contracted a flu-like syndrome shortly after receiving FLUMIST 09-Oct-2015. The patient received a dose from lot FJ2073 and started feeling ill with stuffy nose and sore throat, that evening. He had subsequently developed fevers, myalgias, arthralgias and headache along with persistent URI symptoms. Customer was planning to obtain a respiratory viral panel on 13-Oct-2015. Product quality complaint was reported for the patient. Action taken with FLUMIST was unknown. The outcome of URI symptoms, fever, arthralgia, sore throat, stuffy nose, myalgia, headache, feeling ill, flu-like syndrome and product quality complaint was unknown. The company physician assessed URI symptoms to be serious with seriousness criteria as important medical event and stuffy nose, fever, myalgia, arthralgia, headache, feeling ill, sore throat were assessed as non serious. Product quality complaint was identified from the additional source document and assessed as serious event with seriousness criteria of important medical event. The event of flu-like syndrome have been identified by the company physician from the source documents and added as non-serious adverse event.                    Adjudication Data Entry       Select the radio button next to any fields that need editing and enter data.   Box 7 Describe Adverse Event  (and treatment if any)
Age: 53.0
Sex: F
Vaccine: FLU4
Symptoms: Dyspnoea, Pain, Paraesthesia, Pyrexia
Clinical narrative: Patient presented to clinic w/ shortness of breath, widespread aching, and feverish, tingling in hands and feet 3 days after receiving flu vaccine.
Age: 52.0
Sex: F
Vaccine: FLU3, VARZOS
Symptoms: Local reaction, Pain in extremity, Peripheral swelling
Clinical narrative: Left arm swelling and pain. Local reaction, fairly large, temp 98.9.
Age: 84.0
Sex: F
Vaccine: FLU3, TDAP
Symptoms: Injection site nodule, Injection site swelling
Clinical narrative: This case was reported by a pharmacist via call center representative and described the occurrence of injection site swelling in a 84-year-old female patient who received BOOSTRIX (batch number B4SD9, expiry date 24th September 2017). Concomitant products included FLUZONE. On 20th October 2015, the patient received the 1st dose of BOOSTRIX (intramuscular) .5 ml. On 20th October 2015, immediately after receiving BOOSTRIX, the patient experienced injection site swelling. On an unknown date, the outcome of the injection site swelling was recovering/resolving. It was unknown if the reporter considered the injection site swelling to be related to BOOSTRIX. Additional details provided were as follows: The healthcare professional reported that, the patient has received a dose of BOOSTRIX and experienced an injection site reaction. The healthcare professional reported that, this occurred right away after vaccination. According to the reporter the vaccine was given in the left deltoid and the site swelled and appeared to have a large bubble or a non-fluid filled nodule. At the time of reporting, the event appeared to be improving.
Age: 46.0
Sex: F
Vaccine: FLU4
Symptoms: Hypoaesthesia, Injection site erythema, Malaise, Muscular weakness, Sensory disturbance
Clinical narrative: This case was reported by a consumer via call center representative and described the occurrence of weakness of arms in a 46-year-old female patient who received FLUARIX quadrivalent (batch number 45YJ4, expiry date 20th June 2016). Concomitant products included FLONASE, cyanocobalamin and Multivitamin. On 17th October 2015, the patient received FLUARIX quadrivalent (intramuscular) .5 ml. On 18th October 2015, 1 days after receiving FLUARIX quadrivalent, the patient experienced weakness of arms, injection site erythema, numbness in fingers and feeling unwell. On an unknown date, the patient experienced abnormal sensation of limbs and feeling unwell were unknown. The reporter considered the weakness of arms, injection site erythema and numbness in fingers to be related to FLUARIX quadrivalent. It was unknown if the reporter considered the abnormal sensation of limbs and feeling unwell to be related to FLUARIX quadrivalent. Additional details were provided as follows: The reporter reported the report via web site. The next morning, after vaccination the patient experienced weakness of right arm and fingers of right arm were slightly numb (injected arm). During the same day when the events were started, the events were improved but the patient did not feel well and noticed a red mark (oval) on her shoulder at the injection site (injection site redness). In October 2015, less than a week after receiving FLUARIX quadrivalent, the patient's arm was still feeling odd (it had been two days from starting the odd feeling). Also, the weakness of arm was resolved but the fingers were still feeling strange and were very slightly numb. The reporter was called again and reported that, her whole right hand felt weak and finger numbness was specific to right hand. After that, all the weakness was resolved and finger numbness was also resolved but an odd feeling remained. Redness at injection site was resolving which turned to light pink.
Age: 65.0
Sex: F
Vaccine: FLU4
Symptoms: Contusion
Clinical narrative: This case was reported by a pharmacist via call center representative and described the occurrence of contusion in a 65-year-old female patient who received FLUARIX quadrivalent (batch number 329TN, expiry date 30th June 2016. In October 2015, the patient received FLUARIX quadrivalent .5 ml. On 6th October 2015, less than a week after receiving FLUARIX quadrivalent, the patient experienced contusion. On an unknown date, the outcome of the contusion was unknown. It was unknown if the reporter considered the contusion to be related to FLUARIX quadrivalent. Additional details were provided as follows: In October 2015, one week before the time of reporting, the patient received FLUARIX QIV. The patient experienced a large bruise (contusion) which was black or purple in colour after the vaccination. The healthcare professional reported that the patient came back to the doctor's office to report the adverse reaction experienced by her. The healthcare professional wanted to know the additional information or studies of the similar symptoms.
Age: 69.0
Sex: F
Vaccine: PNC13
Symptoms: Cellulitis, Injection site erythema, Injection site swelling
Clinical narrative: Redness, swelling right upper arm.
Age: 70.0
Sex: M
Vaccine: FLU3
Symptoms: Contusion, Mobility decreased, Pain
Clinical narrative: Soreness, couldn't lift arm above shoulder for about 3 days. Bruising started on 3rd of 4th day. No treatment needed.
Age: 65.0
Sex: F
Vaccine: VARZOS
Symptoms: Injection site induration, Injection site mass, Injection site pruritus, Injection site rash, Injection site warmth
Clinical narrative: Rash and itching at injection site. There was a hard lump area under the skin as well. Patient also said the skin felt warm.
Age: 56.0
Sex: F
Vaccine: FLU3
Symptoms: Drug administered to patient of inappropriate age, Erythema, Feeling hot, Pain, Pruritus
Clinical narrative: Patient reports itching, warmth and redness for a few hours after vaccine administration and next day.  Also, next day reports of extreme body aches all over. High dose was given - Sanofi consulted for recommendations with none provided.
Age: 48.0
Sex: M
Vaccine: FLU4
Symptoms: Antibody test negative, VIIth nerve paralysis
Clinical narrative: Experienced left side facial paralysis (Bell's Palsy) beginning approximately 2 hours after receipt of influenza vaccine at a community pharmacy near his home. Seen for urgent care visit at PCP's offic on 10/15/15 and treated with steroid taper beginning 10/15/15 x 10 days. As of 10/27/15 symptoms remain with little improvement.
Age: 86.0
Sex: F
Vaccine: FLU3
Symptoms: Pruritus, Rash
Clinical narrative: Patient noticed that she had a rash when she got out of the shower this morning. Rash is only on the top part of the chest/bottom of neck.  She is taking Benadryl to decrease itching.  Rash has not spread or caused any trouble breathing.
Age: 76.0
Sex: M
Vaccine: FLU3, PNC13, FLU3, PNC13
Symptoms: Erythema
Clinical narrative: Patient received Prevnar and FLuzone HD vaccination on 10-20, patient reports that redness began on day of vaccine but continued to spread over the next few days until arm was bright red from shoulder to elbow.
Age: 76.0
Sex: M
Vaccine: FLU3, PNC13, FLU3, PNC13
Symptoms: Injection site erythema
Clinical narrative: Patient received Prevnar and FLuzone HD vaccination on 10-20, patient reports that redness began on day of vaccine but continued to spread over the next few days until arm was bright red from shoulder to elbow.
Age: 76.0
Sex: M
Vaccine: FLU3, PNC13, FLU3, PNC13
Symptoms: Erythema
Clinical narrative: Patient received Prevnar and Fluzone HD in the left arm 10-20-15, reports that redness occurred at injection site and over the next few days spread to cover his entire arm from shoulder to elbow, patient reports no swelling, itching, or pain, just redness; patient advised on 10-26 when he presented to the pharmacy with redness to see physician and patient refused to do so, we are following up with patient.
Age: 76.0
Sex: M
Vaccine: FLU3, PNC13, FLU3, PNC13
Symptoms: Injection site erythema
Clinical narrative: Patient received Prevnar and Fluzone HD in the left arm 10-20-15, reports that redness occurred at injection site and over the next few days spread to cover his entire arm from shoulder to elbow, patient reports no swelling, itching, or pain, just redness; patient advised on 10-26 when he presented to the pharmacy with redness to see physician and patient refused to do so, we are following up with patient.
Age: 52.0
Sex: F
Vaccine: FLU3
Symptoms: Rash, Rash erythematous, Rash pruritic, Urticaria
Clinical narrative: Hives and slight rash on left side of neck and chest, itchy and red.  Did take Benadryl that did help.  Had a little rash area on chest next morning 10/27/15, took another dose of Benadryl that morning on 10/27/15.
Age: 33.0
Sex: M
Vaccine: FLUX(H1N1)
Symptoms: Influenza
Clinical narrative: Influenza.
Age: 5.0
Sex: M
Vaccine: DTAPIPV, MMRV
Symptoms: Abdominal pain upper, Diarrhoea, Urticaria
Clinical narrative: MOTHER REPORTS PT C/O "STOMACH HURTING AND DIARRHEA YESTERDAY EVENING.  HAD HIVES ALL OVER WHEN HE WOKE UP."  PATIENT DID SEE NP AT THE CLINIC.  PER MOM SAID THE "REACTION WAS DUE TO THE MEASLE VACCINE AND WAS TOLD TO GIVE PATIENT BENADRYL FOR THE HIVES."
Age: 48.0
Sex: F
Vaccine: FLU4
Symptoms: Injection site bruising
Clinical narrative: One inch by two inch bruising at injection site.
Age: 52.0
Sex: M
Vaccine: PPV
Symptoms: Headache, Myalgia, Nausea, Pyrexia
Clinical narrative: Fever to 103F, headache, myalgias, nausea.
Age: 78.0
Sex: F
Vaccine: FLU3, PNC13
Symptoms: Erythema, Pain, Pyrexia, Tenderness
Clinical narrative: On 10/25, pt reported redness, low grade fever (99.8 bl ~ 97.0) and tenderness.  On 10/26, area of redness was larger.  At time of IMZ, pt said she had pain but after observation, she said she was fine.
Age: 57.0
Sex: F
Vaccine: FLU4
Symptoms: Chest pain, Dizziness, Nausea, Pain
Clinical narrative: NAUSEA, DIZZINESS, CHEST PAIN, BODY ACHE.
Age: 21.0
Sex: F
Vaccine: FLU4
Symptoms: Asthenia, Headache, Influenza virus test negative, Malaise, Meningitis viral
Clinical narrative: Pt. came to office with body aches, weakness, and a headache. We did a flu test on her which was negative.
Age: 21.0
Sex: F
Vaccine: FLU4
Symptoms: Pain
Clinical narrative: Pt. came to office with body aches, weakness, and a headache. We did a flu test on her which was negative.
Age: 59.0
Sex: F
Vaccine: FLU4
Symptoms: Injection site joint pain
Clinical narrative: A constant pain internally felt in shoulder joint on left side. Vaccination was given in left arm. Shot was given high on outside of the upper left arm. No relief from over the counter pain or anti-inflammatories.
Age: 59.0
Sex: F
Vaccine: FLU3
Symptoms: Pruritus, Swelling
Clinical narrative: Swelling and itching started 2 days after vaccine administration. Patient self-treated by applying topical hydrocortisone and ice. Symptoms resolved after 1 week.
Age: 33.0
Sex: F
Vaccine: FLU4
Symptoms: Injection site pruritus, Injection site swelling, Lymphadenopathy
Clinical narrative: Swollen lymph nodes in neck, swollen itching injection site. Symptoms started within 24 hours of vaccine administration. Physician instructed patient to take cetirizine and ranitidine.
Age: 72.0
Sex: M
Vaccine: FLU3
Symptoms: Rash
Clinical narrative: Rash to both arms.
Age: 40.0
Sex: M
Vaccine: FLU3
Symptoms: Hypoaesthesia, Nausea, Tremor
Clinical narrative: Nauseous, shaking, numbness in both arms.
Age: 39.0
Sex: F
Vaccine: FLU4
Symptoms: Chills, Erythema, Pain, Pain in extremity, Peripheral swelling
Clinical narrative: Approximately 1 hour after administration of flu vaccine patient developed itching, swelling, pain, erythema in the right arm.  Also developed body aches and chills.
Age: 39.0
Sex: F
Vaccine: FLU4
Symptoms: Pruritus
Clinical narrative: Approximately 1 hour after administration of flu vaccine patient developed itching, swelling, pain, erythema in the right arm.  Also developed body aches and chills.
Age: 65.0
Sex: M
Vaccine: PNC13, TDAP
Symptoms: No adverse event, Wrong drug administered
Clinical narrative: There was no adverse event noted.  Client was given Tdap injection rather than a flu vaccine. No record of client having Tdap in past.
Age: 63.0
Sex: F
Vaccine: FLUR3
Symptoms: Nausea, Rash, Somnolence, Vomiting
Clinical narrative: Patient reported nausea, vomiting, drowsiness, rash.
Age: 73.0
Sex: F
Vaccine: FLU3
Symptoms: Injection site erythema, Injection site rash
Clinical narrative: Patient said she had developed a rash with grape-like clusters and redness near injection site.
Age: 0.5
Sex: F
Vaccine: DTAPIPVHIB, FLU3, HEP, PNC13, RV5
Symptoms: Intussusception, Ultrasound abdomen, Vomiting, X-ray
Clinical narrative: VOMITING, INTUSSUSCEPTION WITH FLUOROSCOPIC REDUCTION.
Age: 0.8
Sex: M
Vaccine: DTAPIPVHIB, PPV
Symptoms: Abnormal behaviour, Asthenopia, Body temperature increased, Diet refusal, Inability to crawl
Clinical narrative: Baby refused to eat and was having a hard time holding his head up while sitting in his high chair. I took him out and took his temperature which was I believe around 100 so I began to give him infant Tylenol but he started throwing up and turned pale as can be. I laid him down on the bed and he was attempting to roll over and crawl but couldn't crawl. He was having a hard time holding his head up when I sat him up as well and his eyes starting to get heavy. I then called the after hours line of his Pediatrician and told the nurse what he was experiencing. She suggested we take him to the nearest ER. They examined him and said he most likely had the flu which caused him to vomit and gave him some kind of anti-nausea medicine. I kept telling them he was fine earlier in the day before he received his shots except the fever and had only started acting this way a few hours after the shots. They said it was most likely a coincidence and not related. The next day he was very drowsy and just not himself so we took him back to his Pediatrician and explained everything that happened. He said the medicine they gave him in the ER causes drowsiness (something the ER did not tell us) and to give him until the afternoon to see if he started acting back to himself. He also said he may be sensitive to vaccines so in the future we'll have to keep an eye on that. By the afternoon he was crawling around and acting normal again.
Age: 0.8
Sex: M
Vaccine: DTAPIPVHIB, PPV
Symptoms: Influenza, Pallor, Posture abnormal, Somnolence, Vomiting
Clinical narrative: Baby refused to eat and was having a hard time holding his head up while sitting in his high chair. I took him out and took his temperature which was I believe around 100 so I began to give him infant Tylenol but he started throwing up and turned pale as can be. I laid him down on the bed and he was attempting to roll over and crawl but couldn't crawl. He was having a hard time holding his head up when I sat him up as well and his eyes starting to get heavy. I then called the after hours line of his Pediatrician and told the nurse what he was experiencing. She suggested we take him to the nearest ER. They examined him and said he most likely had the flu which caused him to vomit and gave him some kind of anti-nausea medicine. I kept telling them he was fine earlier in the day before he received his shots except the fever and had only started acting this way a few hours after the shots. They said it was most likely a coincidence and not related. The next day he was very drowsy and just not himself so we took him back to his Pediatrician and explained everything that happened. He said the medicine they gave him in the ER causes drowsiness (something the ER did not tell us) and to give him until the afternoon to see if he started acting back to himself. He also said he may be sensitive to vaccines so in the future we'll have to keep an eye on that. By the afternoon he was crawling around and acting normal again.
Age: 65.0
Sex: F
Vaccine: PNC13
Symptoms: Decreased appetite, Erythema, Headache, Injection site erythema, Injection site induration
Clinical narrative: Knot and swelling at site of injection (left arm) when woke up next morning. Began taking Benadryl and also saw physican on Saturday 10/24/15. No systemic sx's (fever or chills)- just pain, redness and swelling. Improved Saturday, then worsened again sunday with pain, increased redness. Decreased appetite. Headache. Saw patient today - no cellulitis, not toxic. Left deltoid area with redness 10cm x13cm induration, warm, red, painful to touch.
Age: 65.0
Sex: F
Vaccine: PNC13
Symptoms: Injection site nodule, Injection site pain, Injection site swelling, Injection site warmth, Pain
Clinical narrative: Knot and swelling at site of injection (left arm) when woke up next morning. Began taking Benadryl and also saw physican on Saturday 10/24/15. No systemic sx's (fever or chills)- just pain, redness and swelling. Improved Saturday, then worsened again sunday with pain, increased redness. Decreased appetite. Headache. Saw patient today - no cellulitis, not toxic. Left deltoid area with redness 10cm x13cm induration, warm, red, painful to touch.
Age: 65.0
Sex: F
Vaccine: PNC13
Symptoms: Swelling
Clinical narrative: Knot and swelling at site of injection (left arm) when woke up next morning. Began taking Benadryl and also saw physican on Saturday 10/24/15. No systemic sx's (fever or chills)- just pain, redness and swelling. Improved Saturday, then worsened again sunday with pain, increased redness. Decreased appetite. Headache. Saw patient today - no cellulitis, not toxic. Left deltoid area with redness 10cm x13cm induration, warm, red, painful to touch.
Age: 63.0
Sex: F
Vaccine: VARZOS
Symptoms: Injection site erythema
Clinical narrative: The patient described redness around the injection site.
Age: 7.0
Sex: M
Vaccine: FLUN4, FLUN4, FLUN4
Symptoms: Aggression, Agitation, Asthenia, CSF glucose normal, CSF mononuclear cell count increased
Clinical narrative: The patient was in his usual state of excellent health until approximately October 14th when he received the live attenuated influenza vaccine, FluMist.  Approximately one day later, he began having fevers of 100.5 degrees.  Subsequently, he became increasingly lethargic.  His mother noted that he was not as active as usual.  He was not able to fully participate in soccer practice.  On approximately October 19th, he developed fever to 101.3 degrees.  That evening, he began having nausea and vomiting. On October 20th, he continued to have fever as well as the persistent nausea and vomiting.  She also noted that he had enlarged lymph nodes in his neck. On approximately October 22nd, he developed a fever to 104.9 degrees.  He was seen by his pediatrician, who performed a rapid strep test that was positive. He was then started on amoxicillin.  On October 23rd, the fevers persisted. He became increasingly weak and lethargic.  At one point, he told his mother he was too weak to walk and asked her to take him to the bathroom.  She did this twice.  Subsequently, he became incontinent of urine.  He went back to his pediatrician's office where he was noted to have persistent nausea and vomiting as well as urinary incontinence.  At that point, he was referred to the emergency room. On arrival in the emergency room, he was initially afebrile.  Subsequently, he developed fever to 38.5 degrees.  His other vital signs were unremarkable.  He became increasingly agitated while in the emergency room.  He demonstrated aggression and restlessness.  He was, therefore, admitted to the intensive care unit. He had a CT scan of the brain performed that was unremarkable.  He then underwent a lumbar puncture; which showed 37 white cells, 7% of which were neutrophils, 93% were mononuclear. The glucose of 52 with a protein of nearly 60.  He was thought to have meningitis or meningoencephalitis.  He was started on empiric antibiotic therapy consisting of ceftriaxone and acyclovir.  An MRI was obtained on October 24th, which was completely unremarkable.  Throughout the day of October 25th, he became less and less responsive and became comatose.  On the evening of October 25th, he developed abnormal pattern respiration.  He is thought to be having seizures and was started on Keppra. Subsequently, his respiratory status improved.
Age: 7.0
Sex: M
Vaccine: FLUN4, FLUN4, FLUN4
Symptoms: CSF neutrophil count increased, CSF protein increased, CSF white blood cell count increased, Coma, Computerised tomogram head normal
Clinical narrative: The patient was in his usual state of excellent health until approximately October 14th when he received the live attenuated influenza vaccine, FluMist.  Approximately one day later, he began having fevers of 100.5 degrees.  Subsequently, he became increasingly lethargic.  His mother noted that he was not as active as usual.  He was not able to fully participate in soccer practice.  On approximately October 19th, he developed fever to 101.3 degrees.  That evening, he began having nausea and vomiting. On October 20th, he continued to have fever as well as the persistent nausea and vomiting.  She also noted that he had enlarged lymph nodes in his neck. On approximately October 22nd, he developed a fever to 104.9 degrees.  He was seen by his pediatrician, who performed a rapid strep test that was positive. He was then started on amoxicillin.  On October 23rd, the fevers persisted. He became increasingly weak and lethargic.  At one point, he told his mother he was too weak to walk and asked her to take him to the bathroom.  She did this twice.  Subsequently, he became incontinent of urine.  He went back to his pediatrician's office where he was noted to have persistent nausea and vomiting as well as urinary incontinence.  At that point, he was referred to the emergency room. On arrival in the emergency room, he was initially afebrile.  Subsequently, he developed fever to 38.5 degrees.  His other vital signs were unremarkable.  He became increasingly agitated while in the emergency room.  He demonstrated aggression and restlessness.  He was, therefore, admitted to the intensive care unit. He had a CT scan of the brain performed that was unremarkable.  He then underwent a lumbar puncture; which showed 37 white cells, 7% of which were neutrophils, 93% were mononuclear. The glucose of 52 with a protein of nearly 60.  He was thought to have meningitis or meningoencephalitis.  He was started on empiric antibiotic therapy consisting of ceftriaxone and acyclovir.  An MRI was obtained on October 24th, which was completely unremarkable.  Throughout the day of October 25th, he became less and less responsive and became comatose.  On the evening of October 25th, he developed abnormal pattern respiration.  He is thought to be having seizures and was started on Keppra. Subsequently, his respiratory status improved.
Age: 7.0
Sex: M
Vaccine: FLUN4, FLUN4, FLUN4
Symptoms: Decreased activity, Encephalitis, Hyporesponsive to stimuli, Intensive care, Lethargy
Clinical narrative: The patient was in his usual state of excellent health until approximately October 14th when he received the live attenuated influenza vaccine, FluMist.  Approximately one day later, he began having fevers of 100.5 degrees.  Subsequently, he became increasingly lethargic.  His mother noted that he was not as active as usual.  He was not able to fully participate in soccer practice.  On approximately October 19th, he developed fever to 101.3 degrees.  That evening, he began having nausea and vomiting. On October 20th, he continued to have fever as well as the persistent nausea and vomiting.  She also noted that he had enlarged lymph nodes in his neck. On approximately October 22nd, he developed a fever to 104.9 degrees.  He was seen by his pediatrician, who performed a rapid strep test that was positive. He was then started on amoxicillin.  On October 23rd, the fevers persisted. He became increasingly weak and lethargic.  At one point, he told his mother he was too weak to walk and asked her to take him to the bathroom.  She did this twice.  Subsequently, he became incontinent of urine.  He went back to his pediatrician's office where he was noted to have persistent nausea and vomiting as well as urinary incontinence.  At that point, he was referred to the emergency room. On arrival in the emergency room, he was initially afebrile.  Subsequently, he developed fever to 38.5 degrees.  His other vital signs were unremarkable.  He became increasingly agitated while in the emergency room.  He demonstrated aggression and restlessness.  He was, therefore, admitted to the intensive care unit. He had a CT scan of the brain performed that was unremarkable.  He then underwent a lumbar puncture; which showed 37 white cells, 7% of which were neutrophils, 93% were mononuclear. The glucose of 52 with a protein of nearly 60.  He was thought to have meningitis or meningoencephalitis.  He was started on empiric antibiotic therapy consisting of ceftriaxone and acyclovir.  An MRI was obtained on October 24th, which was completely unremarkable.  Throughout the day of October 25th, he became less and less responsive and became comatose.  On the evening of October 25th, he developed abnormal pattern respiration.  He is thought to be having seizures and was started on Keppra. Subsequently, his respiratory status improved.
Age: 7.0
Sex: M
Vaccine: FLUN4, FLUN4, FLUN4
Symptoms: Lymphadenopathy, Meningitis, Nausea, Nuclear magnetic resonance imaging normal, Pyrexia
Clinical narrative: The patient was in his usual state of excellent health until approximately October 14th when he received the live attenuated influenza vaccine, FluMist.  Approximately one day later, he began having fevers of 100.5 degrees.  Subsequently, he became increasingly lethargic.  His mother noted that he was not as active as usual.  He was not able to fully participate in soccer practice.  On approximately October 19th, he developed fever to 101.3 degrees.  That evening, he began having nausea and vomiting. On October 20th, he continued to have fever as well as the persistent nausea and vomiting.  She also noted that he had enlarged lymph nodes in his neck. On approximately October 22nd, he developed a fever to 104.9 degrees.  He was seen by his pediatrician, who performed a rapid strep test that was positive. He was then started on amoxicillin.  On October 23rd, the fevers persisted. He became increasingly weak and lethargic.  At one point, he told his mother he was too weak to walk and asked her to take him to the bathroom.  She did this twice.  Subsequently, he became incontinent of urine.  He went back to his pediatrician's office where he was noted to have persistent nausea and vomiting as well as urinary incontinence.  At that point, he was referred to the emergency room. On arrival in the emergency room, he was initially afebrile.  Subsequently, he developed fever to 38.5 degrees.  His other vital signs were unremarkable.  He became increasingly agitated while in the emergency room.  He demonstrated aggression and restlessness.  He was, therefore, admitted to the intensive care unit. He had a CT scan of the brain performed that was unremarkable.  He then underwent a lumbar puncture; which showed 37 white cells, 7% of which were neutrophils, 93% were mononuclear. The glucose of 52 with a protein of nearly 60.  He was thought to have meningitis or meningoencephalitis.  He was started on empiric antibiotic therapy consisting of ceftriaxone and acyclovir.  An MRI was obtained on October 24th, which was completely unremarkable.  Throughout the day of October 25th, he became less and less responsive and became comatose.  On the evening of October 25th, he developed abnormal pattern respiration.  He is thought to be having seizures and was started on Keppra. Subsequently, his respiratory status improved.
Age: 7.0
Sex: M
Vaccine: FLUN4, FLUN4, FLUN4
Symptoms: Respiration abnormal, Restlessness, Seizure, Streptococcus test positive, Urinary incontinence
Clinical narrative: The patient was in his usual state of excellent health until approximately October 14th when he received the live attenuated influenza vaccine, FluMist.  Approximately one day later, he began having fevers of 100.5 degrees.  Subsequently, he became increasingly lethargic.  His mother noted that he was not as active as usual.  He was not able to fully participate in soccer practice.  On approximately October 19th, he developed fever to 101.3 degrees.  That evening, he began having nausea and vomiting. On October 20th, he continued to have fever as well as the persistent nausea and vomiting.  She also noted that he had enlarged lymph nodes in his neck. On approximately October 22nd, he developed a fever to 104.9 degrees.  He was seen by his pediatrician, who performed a rapid strep test that was positive. He was then started on amoxicillin.  On October 23rd, the fevers persisted. He became increasingly weak and lethargic.  At one point, he told his mother he was too weak to walk and asked her to take him to the bathroom.  She did this twice.  Subsequently, he became incontinent of urine.  He went back to his pediatrician's office where he was noted to have persistent nausea and vomiting as well as urinary incontinence.  At that point, he was referred to the emergency room. On arrival in the emergency room, he was initially afebrile.  Subsequently, he developed fever to 38.5 degrees.  His other vital signs were unremarkable.  He became increasingly agitated while in the emergency room.  He demonstrated aggression and restlessness.  He was, therefore, admitted to the intensive care unit. He had a CT scan of the brain performed that was unremarkable.  He then underwent a lumbar puncture; which showed 37 white cells, 7% of which were neutrophils, 93% were mononuclear. The glucose of 52 with a protein of nearly 60.  He was thought to have meningitis or meningoencephalitis.  He was started on empiric antibiotic therapy consisting of ceftriaxone and acyclovir.  An MRI was obtained on October 24th, which was completely unremarkable.  Throughout the day of October 25th, he became less and less responsive and became comatose.  On the evening of October 25th, he developed abnormal pattern respiration.  He is thought to be having seizures and was started on Keppra. Subsequently, his respiratory status improved.
Age: 7.0
Sex: M
Vaccine: FLUN4, FLUN4, FLUN4
Symptoms: Vomiting
Clinical narrative: The patient was in his usual state of excellent health until approximately October 14th when he received the live attenuated influenza vaccine, FluMist.  Approximately one day later, he began having fevers of 100.5 degrees.  Subsequently, he became increasingly lethargic.  His mother noted that he was not as active as usual.  He was not able to fully participate in soccer practice.  On approximately October 19th, he developed fever to 101.3 degrees.  That evening, he began having nausea and vomiting. On October 20th, he continued to have fever as well as the persistent nausea and vomiting.  She also noted that he had enlarged lymph nodes in his neck. On approximately October 22nd, he developed a fever to 104.9 degrees.  He was seen by his pediatrician, who performed a rapid strep test that was positive. He was then started on amoxicillin.  On October 23rd, the fevers persisted. He became increasingly weak and lethargic.  At one point, he told his mother he was too weak to walk and asked her to take him to the bathroom.  She did this twice.  Subsequently, he became incontinent of urine.  He went back to his pediatrician's office where he was noted to have persistent nausea and vomiting as well as urinary incontinence.  At that point, he was referred to the emergency room. On arrival in the emergency room, he was initially afebrile.  Subsequently, he developed fever to 38.5 degrees.  His other vital signs were unremarkable.  He became increasingly agitated while in the emergency room.  He demonstrated aggression and restlessness.  He was, therefore, admitted to the intensive care unit. He had a CT scan of the brain performed that was unremarkable.  He then underwent a lumbar puncture; which showed 37 white cells, 7% of which were neutrophils, 93% were mononuclear. The glucose of 52 with a protein of nearly 60.  He was thought to have meningitis or meningoencephalitis.  He was started on empiric antibiotic therapy consisting of ceftriaxone and acyclovir.  An MRI was obtained on October 24th, which was completely unremarkable.  Throughout the day of October 25th, he became less and less responsive and became comatose.  On the evening of October 25th, he developed abnormal pattern respiration.  He is thought to be having seizures and was started on Keppra. Subsequently, his respiratory status improved.
Age: 7.0
Sex: M
Vaccine: FLUN4, FLUN4, FLUN4
Symptoms: Activities of daily living impaired, Asthenia, Blood test, CSF protein increased, CSF white blood cell count increased
Clinical narrative: The patient was in his usual state of excellent health until approximately October 14th when he received the live attenuated influenza vaccine, FluMist.  Approximately one day later, he began having fevers of 100.5 degrees.  Subsequently, he became increasingly lethargic.  His mother noted that he was not as active as usual.  He was not able to fully participate in soccer practice.  On approximately October 19th, he developed fever to 101.3 degrees.  That evening, he began having nausea and vomiting. On October 20th, he continued to have fever as well as the persistent nausea and vomiting.  She also noted that he had enlarged lymph nodes in his neck. On approximately October 22nd, he developed a fever to 104.9 degrees.  He was seen by his pediatrician, who performed a rapid strep test that was positive. He was then started on amoxicillin.  On October 23rd, the fevers persisted. He became increasingly weak and lethargic.  At one point, he told his mother he was too weak to walk and asked her to take him to the bathroom.  She did this twice.  Subsequently, he became incontinent of urine.  He went back to his pediatrician's office where he was noted to have persistent nausea and vomiting as well as urinary incontinence.  At that point, he was referred to the emergency room. On arrival in the emergency room, he was initially afebrile.  Subsequently, he developed fever to 38.5 degrees.  His other vital signs were unremarkable.  He became increasingly agitated while in the emergency room.  He demonstrated aggression and restlessness.  He was, therefore, admitted to the intensive care unit. He had a CT scan of the brain performed that was unremarkable.  He then underwent a lumbar puncture; which showed 37 white cells, 7% of which were neutrophils, 93% were mononuclear. The glucose of 52 with a protein of nearly 60.  He was thought to have meningitis or meningoencephalitis.  He was started on empiric antibiotic therapy consisting of ceftriaxone and acyclovir.  An MRI was obtained on October 24th, which was completely unremarkable.  Throughout the day of October 25th, he became less and less responsive and became comatose.  On the evening of October 25th, he developed abnormal pattern respiration.  He is thought to be having seizures and was started on Keppra. Subsequently, his respiratory status improved.
Age: 7.0
Sex: M
Vaccine: FLUN4, FLUN4, FLUN4
Symptoms: Central venous catheterisation, Cheyne-Stokes respiration, Coma, Computerised tomogram, Discomfort
Clinical narrative: The patient was in his usual state of excellent health until approximately October 14th when he received the live attenuated influenza vaccine, FluMist.  Approximately one day later, he began having fevers of 100.5 degrees.  Subsequently, he became increasingly lethargic.  His mother noted that he was not as active as usual.  He was not able to fully participate in soccer practice.  On approximately October 19th, he developed fever to 101.3 degrees.  That evening, he began having nausea and vomiting. On October 20th, he continued to have fever as well as the persistent nausea and vomiting.  She also noted that he had enlarged lymph nodes in his neck. On approximately October 22nd, he developed a fever to 104.9 degrees.  He was seen by his pediatrician, who performed a rapid strep test that was positive. He was then started on amoxicillin.  On October 23rd, the fevers persisted. He became increasingly weak and lethargic.  At one point, he told his mother he was too weak to walk and asked her to take him to the bathroom.  She did this twice.  Subsequently, he became incontinent of urine.  He went back to his pediatrician's office where he was noted to have persistent nausea and vomiting as well as urinary incontinence.  At that point, he was referred to the emergency room. On arrival in the emergency room, he was initially afebrile.  Subsequently, he developed fever to 38.5 degrees.  His other vital signs were unremarkable.  He became increasingly agitated while in the emergency room.  He demonstrated aggression and restlessness.  He was, therefore, admitted to the intensive care unit. He had a CT scan of the brain performed that was unremarkable.  He then underwent a lumbar puncture; which showed 37 white cells, 7% of which were neutrophils, 93% were mononuclear. The glucose of 52 with a protein of nearly 60.  He was thought to have meningitis or meningoencephalitis.  He was started on empiric antibiotic therapy consisting of ceftriaxone and acyclovir.  An MRI was obtained on October 24th, which was completely unremarkable.  Throughout the day of October 25th, he became less and less responsive and became comatose.  On the evening of October 25th, he developed abnormal pattern respiration.  He is thought to be having seizures and was started on Keppra. Subsequently, his respiratory status improved.
Age: 7.0
Sex: M
Vaccine: FLUN4, FLUN4, FLUN4
Symptoms: Disorientation, Dysstasia, Electroencephalogram abnormal, Encephalitis, Eye swelling
Clinical narrative: The patient was in his usual state of excellent health until approximately October 14th when he received the live attenuated influenza vaccine, FluMist.  Approximately one day later, he began having fevers of 100.5 degrees.  Subsequently, he became increasingly lethargic.  His mother noted that he was not as active as usual.  He was not able to fully participate in soccer practice.  On approximately October 19th, he developed fever to 101.3 degrees.  That evening, he began having nausea and vomiting. On October 20th, he continued to have fever as well as the persistent nausea and vomiting.  She also noted that he had enlarged lymph nodes in his neck. On approximately October 22nd, he developed a fever to 104.9 degrees.  He was seen by his pediatrician, who performed a rapid strep test that was positive. He was then started on amoxicillin.  On October 23rd, the fevers persisted. He became increasingly weak and lethargic.  At one point, he told his mother he was too weak to walk and asked her to take him to the bathroom.  She did this twice.  Subsequently, he became incontinent of urine.  He went back to his pediatrician's office where he was noted to have persistent nausea and vomiting as well as urinary incontinence.  At that point, he was referred to the emergency room. On arrival in the emergency room, he was initially afebrile.  Subsequently, he developed fever to 38.5 degrees.  His other vital signs were unremarkable.  He became increasingly agitated while in the emergency room.  He demonstrated aggression and restlessness.  He was, therefore, admitted to the intensive care unit. He had a CT scan of the brain performed that was unremarkable.  He then underwent a lumbar puncture; which showed 37 white cells, 7% of which were neutrophils, 93% were mononuclear. The glucose of 52 with a protein of nearly 60.  He was thought to have meningitis or meningoencephalitis.  He was started on empiric antibiotic therapy consisting of ceftriaxone and acyclovir.  An MRI was obtained on October 24th, which was completely unremarkable.  Throughout the day of October 25th, he became less and less responsive and became comatose.  On the evening of October 25th, he developed abnormal pattern respiration.  He is thought to be having seizures and was started on Keppra. Subsequently, his respiratory status improved.