chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 73.0
Sex: M
Vaccine: COVID19
Symptoms: Fungal infection, Leukocytosis, Pneumonia, Positive airway pressure therapy, SARS-CoV-2 test positive
Clinical narrative: COVID Vaccine Breakthrough Case  Pfizer Dose 1 3/23/21 (EN6204) Pfizer Dose 2 4/13/21 (EM9809) COVID Positive 9/1/21  9/1/21: 73-year-old male with a past medical history of CHF, CAD, recurrent left pulmonary effusions, pancreatic cancer status post Whipple procedure presents with worsening shortness of breath.  Of note patient was recently hospitalized for similar issues. Patient says after discharge he was feeling fine but started to developed shortness of breath and decreased appetite over the last 3 days.  Spoke to patient's daughter who stated that the patient had not been following dietary restrictions and had not been moving around much since discharge.  VNA Services did check with the patient after discharge.  Patient had been exposed to COVID during this entire time.  In the ED the patient had a positive COVID test and imaging showed bilateral pneumonia.  Patient will be admitted for evaluation of COVID.  9/11/21: Patient was admitted on September 1, 2021 for evaluation of bilateral COVID pneumonia.  Patient received a full course of remdesivir, 5 days of Decadron, 7 days of azithromycin and Rocephin.  Initially the patient was maintaining moderate oxygen supplementation starting at 3 L and was titrated down to 1 L. On the evening of day 6, the patient began to require additional oxygen supplementation and by day 7 the patient was requiring BiPAP.  Cardiology was consulted on day 5 and recommendations were to try to titrate Lasix down as the patient was improving at that time.  Due to a developing positive fluid balance Lasix was increased.  Nephrology was consulted on day 9 for worsening AKI and recommended that the patient may need hemodialysis in the near future.  Pulmonology was contacted and updated throughout the entire hospitalization and was formally consulted on day 10 and recommended that due to the patient's poor prognosis, against intubation and initiation of comfort care.  On day 9 the patient was made DNR with intubation.  Facility was contacted on day 10 due to the family's request and declined a transfer request. On day 10 the patient was started on Zosyn and Diflucan due to worsening leukocytosis and a wound culture taken during the hospitalization was positive for yeast; Infectious Disease was not available for consult the during this day. On day 11 the patient was noticed to have agonal breathing and the patient's daughter was contacted and made wishes for the patient to be a full DNR/DNI.  The patient was pronounced dead on September 11, 2021 at 10:45 a.m.
Age: 73.0
Sex: M
Vaccine: COVID19
Symptoms: Vaccine breakthrough infection
Clinical narrative: COVID Vaccine Breakthrough Case  Pfizer Dose 1 3/23/21 (EN6204) Pfizer Dose 2 4/13/21 (EM9809) COVID Positive 9/1/21  9/1/21: 73-year-old male with a past medical history of CHF, CAD, recurrent left pulmonary effusions, pancreatic cancer status post Whipple procedure presents with worsening shortness of breath.  Of note patient was recently hospitalized for similar issues. Patient says after discharge he was feeling fine but started to developed shortness of breath and decreased appetite over the last 3 days.  Spoke to patient's daughter who stated that the patient had not been following dietary restrictions and had not been moving around much since discharge.  VNA Services did check with the patient after discharge.  Patient had been exposed to COVID during this entire time.  In the ED the patient had a positive COVID test and imaging showed bilateral pneumonia.  Patient will be admitted for evaluation of COVID.  9/11/21: Patient was admitted on September 1, 2021 for evaluation of bilateral COVID pneumonia.  Patient received a full course of remdesivir, 5 days of Decadron, 7 days of azithromycin and Rocephin.  Initially the patient was maintaining moderate oxygen supplementation starting at 3 L and was titrated down to 1 L. On the evening of day 6, the patient began to require additional oxygen supplementation and by day 7 the patient was requiring BiPAP.  Cardiology was consulted on day 5 and recommendations were to try to titrate Lasix down as the patient was improving at that time.  Due to a developing positive fluid balance Lasix was increased.  Nephrology was consulted on day 9 for worsening AKI and recommended that the patient may need hemodialysis in the near future.  Pulmonology was contacted and updated throughout the entire hospitalization and was formally consulted on day 10 and recommended that due to the patient's poor prognosis, against intubation and initiation of comfort care.  On day 9 the patient was made DNR with intubation.  Facility was contacted on day 10 due to the family's request and declined a transfer request. On day 10 the patient was started on Zosyn and Diflucan due to worsening leukocytosis and a wound culture taken during the hospitalization was positive for yeast; Infectious Disease was not available for consult the during this day. On day 11 the patient was noticed to have agonal breathing and the patient's daughter was contacted and made wishes for the patient to be a full DNR/DNI.  The patient was pronounced dead on September 11, 2021 at 10:45 a.m.
Age: 52.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Blood test, Discomfort, Drooling, Dysgeusia, Eye pain
Clinical narrative: With the first shot, I had a sore spot on my arm and I was tired and fatigued for about a week.  With the 2nd shot (11am) I was fine for the first 5 (4pm) hours, then a horrible headache started.  About 6 hours after (6pm), my whole body felt extremely stiff and sore and I had to go to bed.  I took advil and tylenol, alternating these two every two hours.  I woke up at about 10 hours (9pm) after the shot and had body pains and a headache like I have never before had.  I took several hot baths, trying to get comfortable.  From 9pm that night and for the next 36 hours, I felt the most horrible flu symptoms I have ever had.  I felt hot and cold, and the body pains were very severe.  I started hallucinating that someone was stacking boxes on my eyeballs inside of my head and causing the excruciating pain in my head and about my eyes.  After 48 hours after the shot, the symptoms were better, but I was extremely fatigued for another 4 days.  Since then, I have had a horrible taste in my mouth that never goes away and started drooling from this side of my face about 3 months ago.
Age: 52.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Fatigue, Feeling of body temperature change, Hallucination, visual, Headache, Influenza
Clinical narrative: With the first shot, I had a sore spot on my arm and I was tired and fatigued for about a week.  With the 2nd shot (11am) I was fine for the first 5 (4pm) hours, then a horrible headache started.  About 6 hours after (6pm), my whole body felt extremely stiff and sore and I had to go to bed.  I took advil and tylenol, alternating these two every two hours.  I woke up at about 10 hours (9pm) after the shot and had body pains and a headache like I have never before had.  I took several hot baths, trying to get comfortable.  From 9pm that night and for the next 36 hours, I felt the most horrible flu symptoms I have ever had.  I felt hot and cold, and the body pains were very severe.  I started hallucinating that someone was stacking boxes on my eyeballs inside of my head and causing the excruciating pain in my head and about my eyes.  After 48 hours after the shot, the symptoms were better, but I was extremely fatigued for another 4 days.  Since then, I have had a horrible taste in my mouth that never goes away and started drooling from this side of my face about 3 months ago.
Age: 52.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Musculoskeletal stiffness, Pain, Pain in extremity
Clinical narrative: With the first shot, I had a sore spot on my arm and I was tired and fatigued for about a week.  With the 2nd shot (11am) I was fine for the first 5 (4pm) hours, then a horrible headache started.  About 6 hours after (6pm), my whole body felt extremely stiff and sore and I had to go to bed.  I took advil and tylenol, alternating these two every two hours.  I woke up at about 10 hours (9pm) after the shot and had body pains and a headache like I have never before had.  I took several hot baths, trying to get comfortable.  From 9pm that night and for the next 36 hours, I felt the most horrible flu symptoms I have ever had.  I felt hot and cold, and the body pains were very severe.  I started hallucinating that someone was stacking boxes on my eyeballs inside of my head and causing the excruciating pain in my head and about my eyes.  After 48 hours after the shot, the symptoms were better, but I was extremely fatigued for another 4 days.  Since then, I have had a horrible taste in my mouth that never goes away and started drooling from this side of my face about 3 months ago.
Age: 9.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect dose administered
Clinical narrative: Adult dose (30 mcg) inadvertently administered to pediatric patient.
Age: 43.0
Sex: F
Vaccine: COVID19
Symptoms: Inflammation, Pruritus, Urticaria
Clinical narrative: SINCE I RECEIVED THE J&J VACCINE (SINGLE DOSE) IN APRIL 2021, THIS WAS A BOOSTER. WOKE ON MORNING OF JAN 13 TO ITCHY SKIN AND MILD INFLAMMATION OF YELLOW JACKET STING SITE (RECEIVED A WEEK EARLIER) IN RIGHT ARM. (VACCINE WAS IN LEFT ARM) 8 HOURS LATER RETURNED HOME FROM WORK WITH SEVERE INFLAMMATION AND ITCHING OF STING SITE AND ITCHY HIVES SPREAD FROM LEFT ARMPIT ACROSS CHEST AND STOMACH TO RIGHT SHOULDER. TOOK BENADRYL AND APPLIED HYDROCORTISONE EVERY 4- HOURS SINCE EARLY MORNING, BUT PROVIDED VERY LITTLE RELIEF.
Age: 15.0
Sex: F
Vaccine: COVID19
Symptoms: Facial paralysis
Clinical narrative: Patient developed a right facial never palsy (Bell's palsy) one day after vaccination (first dose of Pfizer). Her symptoms are now resolving.
Age: 37.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site erythema, Injection site pain, Peripheral swelling, Swelling
Clinical narrative: "37 year old female usually healthy and without significant medical history presents for pain and swelling after covid booster.  She received her vaccine booster 01/04/2022 and experienced some pain with redness to the local area of her left deltoid that evening.  She does not like taking medications and so did not take any OTC analgesics.  The next day she awoke with increased pain and noted palpable swelling to her upper arm/shoulder area extending to her left anterior and lateral neck.  No dysphagia, no hoarseness, no difficulty swallowing, no shortness of breath.  No overlying redness. No fever.  The pain continues 01/06/2022 worse with even light palpation over the area as well as rotation of her head and neck."  "Left upper extremity deltoid area contiguous with the top of her shoulder and supraclavicular region indurated without overlying erythema, no fluctuance, tender to palpation.  No axillary lymphadenopathy"  "This is likely a noninfectious inflammation secondary to her Covid vaccine..."
Age: 45.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: During a review of the  Department of Health?s internal records, it was found that there might have been a possible temperature excursion with how the vaccine was stored with our mobile vendor.
Age: 88.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Asthenia, Death, Decreased appetite, Injection site pain, Nausea
Clinical narrative: Pain at injection site, complete loss of appetite, nausea/vomiting, weakness, and proctitis. Rushed to emergency on 3/19/2021. Discharged from hospital on 3/21/2021. Passed away on 4/22/2021
Age: 88.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Proctitis, Vomiting
Clinical narrative: Pain at injection site, complete loss of appetite, nausea/vomiting, weakness, and proctitis. Rushed to emergency on 3/19/2021. Discharged from hospital on 3/21/2021. Passed away on 4/22/2021
Age: 61.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Unevaluable event
Clinical narrative: unknown
Age: 21.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Cough, Nasal congestion, Sinus congestion, Upper-airway cough syndrome
Clinical narrative: post nasal drainage- nonproductive cough- sinus congestion- nasal congestion.        Patient denies headache- sore throat- fever- chills- shortness of breath- body aches- loss of taste- loss of smell- diarrhea- ear pain- swollen glands- chest congestion- chest tightness- chest pain- wheezing- sneezing- itchy eyes- ear drainage- ear fullness. symptoms starting 12/31/21
Age: 40.0
Sex: M
Vaccine: COVID19
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Asthenia, Blood chloride decreased, Blood creatinine increased
Clinical narrative: COVID Vaccine Breakthrough Case  Pfizer Dose 1 8/18/21 (EW0179) COVID Positive 8/30/21 Presented to and discharged from ED 8/31/21 Discharged to home 8/31/21  9/6/21: Patient is a 40-year-old male who presents to the ED today for worsening COVID-19 symptoms.  The patient tested positive for COVID-19 on 08/30/2021.  The patient complains of fevers, body aches, fatigue, shortness of breath that have been worsening.  The patient has been taking Tylenol and ibuprofen for relief of symptoms with minimal relief.  Patient also reports diarrhea and decreased appetite.  Patient has a past medical history significant for generalized anxiety, aortic stenosis, tachycardia.   Upon arrival to ED patient's O2 saturation was 88% on room air, patient was placed on 4 L nasal cannula with resolution of hypoxia.  Chest x-ray was performed and revealed marked interval increase in bilateral pneumonia concerning for atypical infection.  Patient's vital signs were as follows temperature 102°, heart rate 116, respirations 22, blood pressure 117/77.  Patient's laboratory results were significant for ESR 32, D-dimer 0.51, CRP 15.3, chloride 96, glucose 150, creatinine 1.48, ALT 77, AST 67, lipase 92. Due to elevated D-dimer, CT angio of chest was ordered to rule out PE.   Patient was seen and examined at the bedside in ED. Patient is lying in bed in no acute distress.  Patient is currently on 4 L oxygen via nasal cannula and oxygen saturation is at 99%.  Patient continues to complain of body aches, fatigue, weakness.  Patient states he has been progressively feeling worse over the last couple of days despite taking Tylenol, ibuprofen for relief of symptoms. Patient denies any history of COPD, asthma.  Patient denies any chest pain.  Patient is being admitted for COVID pneumonia.  9/10/21: The patient, in fairly good health, tested positive for COVID-19 on 08/30/2021.  He was given a pulse oximetry for home and home treatment plan, was noted to have 88% oxygenation on room air, and presented to the hospital for admission on 09/06/2021.  He received IV CAP antibiotics, dexamethasone and remdesivir, and had gradual improvement with him able to get off oxygen.  He did oxygen walk, did not require any supplemental oxygen with oxygenation 93% during ambulation.  Blood pressure 130/80, pulse 74 and regular.  He was afebrile.  He has he had a CT scan of the chest showing no signs of pulmonary emboli.  There were tiny bilateral pleural effusions and multifocal areas suggesting COVID-19 pneumonia.  Since there has been such nice improvement, patient will go home with no new medications.  Continue his activities of daily living.  He may return to work next week for light duty and full duty on September 20th, if he continues to do well.  Otherwise, follow up with doctor next week for re-evaluation.
Age: 40.0
Sex: M
Vaccine: COVID19
Symptoms: Blood glucose normal, C-reactive protein increased, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal
Clinical narrative: COVID Vaccine Breakthrough Case  Pfizer Dose 1 8/18/21 (EW0179) COVID Positive 8/30/21 Presented to and discharged from ED 8/31/21 Discharged to home 8/31/21  9/6/21: Patient is a 40-year-old male who presents to the ED today for worsening COVID-19 symptoms.  The patient tested positive for COVID-19 on 08/30/2021.  The patient complains of fevers, body aches, fatigue, shortness of breath that have been worsening.  The patient has been taking Tylenol and ibuprofen for relief of symptoms with minimal relief.  Patient also reports diarrhea and decreased appetite.  Patient has a past medical history significant for generalized anxiety, aortic stenosis, tachycardia.   Upon arrival to ED patient's O2 saturation was 88% on room air, patient was placed on 4 L nasal cannula with resolution of hypoxia.  Chest x-ray was performed and revealed marked interval increase in bilateral pneumonia concerning for atypical infection.  Patient's vital signs were as follows temperature 102°, heart rate 116, respirations 22, blood pressure 117/77.  Patient's laboratory results were significant for ESR 32, D-dimer 0.51, CRP 15.3, chloride 96, glucose 150, creatinine 1.48, ALT 77, AST 67, lipase 92. Due to elevated D-dimer, CT angio of chest was ordered to rule out PE.   Patient was seen and examined at the bedside in ED. Patient is lying in bed in no acute distress.  Patient is currently on 4 L oxygen via nasal cannula and oxygen saturation is at 99%.  Patient continues to complain of body aches, fatigue, weakness.  Patient states he has been progressively feeling worse over the last couple of days despite taking Tylenol, ibuprofen for relief of symptoms. Patient denies any history of COPD, asthma.  Patient denies any chest pain.  Patient is being admitted for COVID pneumonia.  9/10/21: The patient, in fairly good health, tested positive for COVID-19 on 08/30/2021.  He was given a pulse oximetry for home and home treatment plan, was noted to have 88% oxygenation on room air, and presented to the hospital for admission on 09/06/2021.  He received IV CAP antibiotics, dexamethasone and remdesivir, and had gradual improvement with him able to get off oxygen.  He did oxygen walk, did not require any supplemental oxygen with oxygenation 93% during ambulation.  Blood pressure 130/80, pulse 74 and regular.  He was afebrile.  He has he had a CT scan of the chest showing no signs of pulmonary emboli.  There were tiny bilateral pleural effusions and multifocal areas suggesting COVID-19 pneumonia.  Since there has been such nice improvement, patient will go home with no new medications.  Continue his activities of daily living.  He may return to work next week for light duty and full duty on September 20th, if he continues to do well.  Otherwise, follow up with doctor next week for re-evaluation.
Age: 40.0
Sex: M
Vaccine: COVID19
Symptoms: Computerised tomogram thorax abnormal, Decreased appetite, Diarrhoea, Dyspnoea, Fatigue
Clinical narrative: COVID Vaccine Breakthrough Case  Pfizer Dose 1 8/18/21 (EW0179) COVID Positive 8/30/21 Presented to and discharged from ED 8/31/21 Discharged to home 8/31/21  9/6/21: Patient is a 40-year-old male who presents to the ED today for worsening COVID-19 symptoms.  The patient tested positive for COVID-19 on 08/30/2021.  The patient complains of fevers, body aches, fatigue, shortness of breath that have been worsening.  The patient has been taking Tylenol and ibuprofen for relief of symptoms with minimal relief.  Patient also reports diarrhea and decreased appetite.  Patient has a past medical history significant for generalized anxiety, aortic stenosis, tachycardia.   Upon arrival to ED patient's O2 saturation was 88% on room air, patient was placed on 4 L nasal cannula with resolution of hypoxia.  Chest x-ray was performed and revealed marked interval increase in bilateral pneumonia concerning for atypical infection.  Patient's vital signs were as follows temperature 102°, heart rate 116, respirations 22, blood pressure 117/77.  Patient's laboratory results were significant for ESR 32, D-dimer 0.51, CRP 15.3, chloride 96, glucose 150, creatinine 1.48, ALT 77, AST 67, lipase 92. Due to elevated D-dimer, CT angio of chest was ordered to rule out PE.   Patient was seen and examined at the bedside in ED. Patient is lying in bed in no acute distress.  Patient is currently on 4 L oxygen via nasal cannula and oxygen saturation is at 99%.  Patient continues to complain of body aches, fatigue, weakness.  Patient states he has been progressively feeling worse over the last couple of days despite taking Tylenol, ibuprofen for relief of symptoms. Patient denies any history of COPD, asthma.  Patient denies any chest pain.  Patient is being admitted for COVID pneumonia.  9/10/21: The patient, in fairly good health, tested positive for COVID-19 on 08/30/2021.  He was given a pulse oximetry for home and home treatment plan, was noted to have 88% oxygenation on room air, and presented to the hospital for admission on 09/06/2021.  He received IV CAP antibiotics, dexamethasone and remdesivir, and had gradual improvement with him able to get off oxygen.  He did oxygen walk, did not require any supplemental oxygen with oxygenation 93% during ambulation.  Blood pressure 130/80, pulse 74 and regular.  He was afebrile.  He has he had a CT scan of the chest showing no signs of pulmonary emboli.  There were tiny bilateral pleural effusions and multifocal areas suggesting COVID-19 pneumonia.  Since there has been such nice improvement, patient will go home with no new medications.  Continue his activities of daily living.  He may return to work next week for light duty and full duty on September 20th, if he continues to do well.  Otherwise, follow up with doctor next week for re-evaluation.
Age: 40.0
Sex: M
Vaccine: COVID19
Symptoms: Feeling abnormal, Fibrin D dimer increased, Hypoxia, Impaired work ability, Lipase normal
Clinical narrative: COVID Vaccine Breakthrough Case  Pfizer Dose 1 8/18/21 (EW0179) COVID Positive 8/30/21 Presented to and discharged from ED 8/31/21 Discharged to home 8/31/21  9/6/21: Patient is a 40-year-old male who presents to the ED today for worsening COVID-19 symptoms.  The patient tested positive for COVID-19 on 08/30/2021.  The patient complains of fevers, body aches, fatigue, shortness of breath that have been worsening.  The patient has been taking Tylenol and ibuprofen for relief of symptoms with minimal relief.  Patient also reports diarrhea and decreased appetite.  Patient has a past medical history significant for generalized anxiety, aortic stenosis, tachycardia.   Upon arrival to ED patient's O2 saturation was 88% on room air, patient was placed on 4 L nasal cannula with resolution of hypoxia.  Chest x-ray was performed and revealed marked interval increase in bilateral pneumonia concerning for atypical infection.  Patient's vital signs were as follows temperature 102°, heart rate 116, respirations 22, blood pressure 117/77.  Patient's laboratory results were significant for ESR 32, D-dimer 0.51, CRP 15.3, chloride 96, glucose 150, creatinine 1.48, ALT 77, AST 67, lipase 92. Due to elevated D-dimer, CT angio of chest was ordered to rule out PE.   Patient was seen and examined at the bedside in ED. Patient is lying in bed in no acute distress.  Patient is currently on 4 L oxygen via nasal cannula and oxygen saturation is at 99%.  Patient continues to complain of body aches, fatigue, weakness.  Patient states he has been progressively feeling worse over the last couple of days despite taking Tylenol, ibuprofen for relief of symptoms. Patient denies any history of COPD, asthma.  Patient denies any chest pain.  Patient is being admitted for COVID pneumonia.  9/10/21: The patient, in fairly good health, tested positive for COVID-19 on 08/30/2021.  He was given a pulse oximetry for home and home treatment plan, was noted to have 88% oxygenation on room air, and presented to the hospital for admission on 09/06/2021.  He received IV CAP antibiotics, dexamethasone and remdesivir, and had gradual improvement with him able to get off oxygen.  He did oxygen walk, did not require any supplemental oxygen with oxygenation 93% during ambulation.  Blood pressure 130/80, pulse 74 and regular.  He was afebrile.  He has he had a CT scan of the chest showing no signs of pulmonary emboli.  There were tiny bilateral pleural effusions and multifocal areas suggesting COVID-19 pneumonia.  Since there has been such nice improvement, patient will go home with no new medications.  Continue his activities of daily living.  He may return to work next week for light duty and full duty on September 20th, if he continues to do well.  Otherwise, follow up with doctor next week for re-evaluation.
Age: 40.0
Sex: M
Vaccine: COVID19
Symptoms: Pain, Pleural effusion, Pneumonia, Pyrexia, Red blood cell sedimentation rate increased
Clinical narrative: COVID Vaccine Breakthrough Case  Pfizer Dose 1 8/18/21 (EW0179) COVID Positive 8/30/21 Presented to and discharged from ED 8/31/21 Discharged to home 8/31/21  9/6/21: Patient is a 40-year-old male who presents to the ED today for worsening COVID-19 symptoms.  The patient tested positive for COVID-19 on 08/30/2021.  The patient complains of fevers, body aches, fatigue, shortness of breath that have been worsening.  The patient has been taking Tylenol and ibuprofen for relief of symptoms with minimal relief.  Patient also reports diarrhea and decreased appetite.  Patient has a past medical history significant for generalized anxiety, aortic stenosis, tachycardia.   Upon arrival to ED patient's O2 saturation was 88% on room air, patient was placed on 4 L nasal cannula with resolution of hypoxia.  Chest x-ray was performed and revealed marked interval increase in bilateral pneumonia concerning for atypical infection.  Patient's vital signs were as follows temperature 102°, heart rate 116, respirations 22, blood pressure 117/77.  Patient's laboratory results were significant for ESR 32, D-dimer 0.51, CRP 15.3, chloride 96, glucose 150, creatinine 1.48, ALT 77, AST 67, lipase 92. Due to elevated D-dimer, CT angio of chest was ordered to rule out PE.   Patient was seen and examined at the bedside in ED. Patient is lying in bed in no acute distress.  Patient is currently on 4 L oxygen via nasal cannula and oxygen saturation is at 99%.  Patient continues to complain of body aches, fatigue, weakness.  Patient states he has been progressively feeling worse over the last couple of days despite taking Tylenol, ibuprofen for relief of symptoms. Patient denies any history of COPD, asthma.  Patient denies any chest pain.  Patient is being admitted for COVID pneumonia.  9/10/21: The patient, in fairly good health, tested positive for COVID-19 on 08/30/2021.  He was given a pulse oximetry for home and home treatment plan, was noted to have 88% oxygenation on room air, and presented to the hospital for admission on 09/06/2021.  He received IV CAP antibiotics, dexamethasone and remdesivir, and had gradual improvement with him able to get off oxygen.  He did oxygen walk, did not require any supplemental oxygen with oxygenation 93% during ambulation.  Blood pressure 130/80, pulse 74 and regular.  He was afebrile.  He has he had a CT scan of the chest showing no signs of pulmonary emboli.  There were tiny bilateral pleural effusions and multifocal areas suggesting COVID-19 pneumonia.  Since there has been such nice improvement, patient will go home with no new medications.  Continue his activities of daily living.  He may return to work next week for light duty and full duty on September 20th, if he continues to do well.  Otherwise, follow up with doctor next week for re-evaluation.
Age: 40.0
Sex: M
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: COVID Vaccine Breakthrough Case  Pfizer Dose 1 8/18/21 (EW0179) COVID Positive 8/30/21 Presented to and discharged from ED 8/31/21 Discharged to home 8/31/21  9/6/21: Patient is a 40-year-old male who presents to the ED today for worsening COVID-19 symptoms.  The patient tested positive for COVID-19 on 08/30/2021.  The patient complains of fevers, body aches, fatigue, shortness of breath that have been worsening.  The patient has been taking Tylenol and ibuprofen for relief of symptoms with minimal relief.  Patient also reports diarrhea and decreased appetite.  Patient has a past medical history significant for generalized anxiety, aortic stenosis, tachycardia.   Upon arrival to ED patient's O2 saturation was 88% on room air, patient was placed on 4 L nasal cannula with resolution of hypoxia.  Chest x-ray was performed and revealed marked interval increase in bilateral pneumonia concerning for atypical infection.  Patient's vital signs were as follows temperature 102°, heart rate 116, respirations 22, blood pressure 117/77.  Patient's laboratory results were significant for ESR 32, D-dimer 0.51, CRP 15.3, chloride 96, glucose 150, creatinine 1.48, ALT 77, AST 67, lipase 92. Due to elevated D-dimer, CT angio of chest was ordered to rule out PE.   Patient was seen and examined at the bedside in ED. Patient is lying in bed in no acute distress.  Patient is currently on 4 L oxygen via nasal cannula and oxygen saturation is at 99%.  Patient continues to complain of body aches, fatigue, weakness.  Patient states he has been progressively feeling worse over the last couple of days despite taking Tylenol, ibuprofen for relief of symptoms. Patient denies any history of COPD, asthma.  Patient denies any chest pain.  Patient is being admitted for COVID pneumonia.  9/10/21: The patient, in fairly good health, tested positive for COVID-19 on 08/30/2021.  He was given a pulse oximetry for home and home treatment plan, was noted to have 88% oxygenation on room air, and presented to the hospital for admission on 09/06/2021.  He received IV CAP antibiotics, dexamethasone and remdesivir, and had gradual improvement with him able to get off oxygen.  He did oxygen walk, did not require any supplemental oxygen with oxygenation 93% during ambulation.  Blood pressure 130/80, pulse 74 and regular.  He was afebrile.  He has he had a CT scan of the chest showing no signs of pulmonary emboli.  There were tiny bilateral pleural effusions and multifocal areas suggesting COVID-19 pneumonia.  Since there has been such nice improvement, patient will go home with no new medications.  Continue his activities of daily living.  He may return to work next week for light duty and full duty on September 20th, if he continues to do well.  Otherwise, follow up with doctor next week for re-evaluation.
Age: 31.0
Sex: F
Vaccine: COVID19
Symptoms: Chest pain, Dyspnoea, Electrocardiogram normal, Muscle spasms, Pain
Clinical narrative: I had chest pain on my left side which it was throbbing. It wasn't consistent and it was across my left side. Shortness of breath, I decided to go the ER in the afternoon and had an EKG to make sure nothing was wrong with my heart, Doctor said he believed I was having muscle cramping and I was sent home.
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Inappropriate schedule of product administration, No adverse event
Clinical narrative: Administered shot at 4 month interval after completing primary series of Moderna (2nd shot). Regulatory Authority recommends boosters at the 6 month interval after completing primary series of Moderna. Booster shot was administered two months earlier than intended. Patient was counseled on adverse effects to watch for post vaccination (fever, chills, fatigue, body aches) and she was also informed about the error. No other adverse details to report at this time.
Age: 56.0
Sex: M
Vaccine: COVID19
Symptoms: Dizziness, Tinnitus
Clinical narrative: Moderna  COVID 19 Vaccine.  Ringing in ears. Dizzieness
Age: 49.0
Sex: M
Vaccine: COVID19
Symptoms: Immediate post-injection reaction, Injection site induration, Injection site pain, Injection site pruritus, Injection site rash
Clinical narrative: I received a standard injection for my booster shot in my upper right arm. The day after the booster shot the muscle region immediately underneath the injection site was very firm and sore. The soreness gradually went away after about 36 hours while the stiffness persisted. A large red rash also began to appear on the skin of the upper right arm under the injection site. Its dimensions are about 4 inches across and 3 inches in height in a roughly oval configuration. It is warm to the touch, slightly itchy, has some red bumps on the skin, and a large red patch with the dimensions mentioned. I did not have any such reaction - nor any other side effect - after my first two doses in March and April 2021.
Age: 49.0
Sex: M
Vaccine: COVID19
Symptoms: Injection site reaction, Injection site warmth, Musculoskeletal stiffness, Rash erythematous
Clinical narrative: I received a standard injection for my booster shot in my upper right arm. The day after the booster shot the muscle region immediately underneath the injection site was very firm and sore. The soreness gradually went away after about 36 hours while the stiffness persisted. A large red rash also began to appear on the skin of the upper right arm under the injection site. Its dimensions are about 4 inches across and 3 inches in height in a roughly oval configuration. It is warm to the touch, slightly itchy, has some red bumps on the skin, and a large red patch with the dimensions mentioned. I did not have any such reaction - nor any other side effect - after my first two doses in March and April 2021.
Age: 30.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: During a review of internal records, it was found there might have been a possible temperature excursion with how the vaccine was stored with our mobile vendor.
Age: 41.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Contusion, Epistaxis, Eye contusion, Hiccups
Clinical narrative: COVID Vaccine Breakthrough Case  Pfizer Dose 1 5/6/21 (ER8736) Pfizer Dose 2 6/11/21 (EW0164) COVID Positive 9/1/2021  9/1/21: Presented to ED. 41-year-old man who presents with acute onset of nosebleed about an hour prior to presentation.  He presents with severe bleeding from the nose which was not controlled by compression at home, onset approximately 1 hour prior to presentation.  He had also noticed petechial rash over his trunk and extremities during the course of today, as well as bruises to his face and eye without prior trauma.  He also notes bleeding from his mouth from intraoral lesions which were noted upon awakening.  He denies any fever, bone pains, sore throat or significant lymph node swellings.  He denies any family history of hematologic disease or malignancy.  He presented to the emergency department where laboratories remarkable for platelet count of 1000.  Epistaxis course controlled with the application of a nasal rocket soaked in TXA and epinephrine.  He will be admitted to the hospitalist service for further treatment and hematologic evaluation.  9/7/21: 41-year-old man who presents with acute onset of nosebleed about an hour prior to presentation.  He presents with severe bleeding from the nose which was not controlled by compression at home, onset approximately 1 hour prior to presentation.  He had also noticed petechial rash over his trunk and extremities during the course of today, as well as bruises to his face and eye without prior trauma.  He also notes bleeding from his mouth from intraoral lesions which were noted upon awakening.  He denies any fever, bone pains, sore throat or significant lymph node swellings.  He denies any family history of hematologic disease or malignancy.  He presented to the emergency department where laboratories remarkable for platelet count of 1000.  Epistaxis course controlled with the application of a nasal rocket soaked in TXA and epinephrine.  He will be admitted to the hospitalist service for further treatment and hematologic evaluation.  While on admission his ITP workup was negative but he tested positive for COVID which could be the cause of his thrombocytopenia  He is s/p 3 doses of IVIG and 4 days of IV steroids  Oncology was available by phone consultation and ENT was consulted for epistaxis and he had his nasal packing removed 9/6  Patient's platelet count improved on above treatment. Today platelet count is 39 k with no active bleeding  Patient was cleared for discharge by oncology to follow up next week mon and tuesday. Case managers to set up appointment  He was also advised to follow up with ENT  Patient developed some hiccups and will be prescribed baclofen with follow up with his PCP
Age: 41.0
Sex: M
Vaccine: COVID19
Symptoms: Immunoglobulin therapy, Inappropriate schedule of product administration, Laboratory test normal, Mouth haemorrhage, Oral disorder
Clinical narrative: COVID Vaccine Breakthrough Case  Pfizer Dose 1 5/6/21 (ER8736) Pfizer Dose 2 6/11/21 (EW0164) COVID Positive 9/1/2021  9/1/21: Presented to ED. 41-year-old man who presents with acute onset of nosebleed about an hour prior to presentation.  He presents with severe bleeding from the nose which was not controlled by compression at home, onset approximately 1 hour prior to presentation.  He had also noticed petechial rash over his trunk and extremities during the course of today, as well as bruises to his face and eye without prior trauma.  He also notes bleeding from his mouth from intraoral lesions which were noted upon awakening.  He denies any fever, bone pains, sore throat or significant lymph node swellings.  He denies any family history of hematologic disease or malignancy.  He presented to the emergency department where laboratories remarkable for platelet count of 1000.  Epistaxis course controlled with the application of a nasal rocket soaked in TXA and epinephrine.  He will be admitted to the hospitalist service for further treatment and hematologic evaluation.  9/7/21: 41-year-old man who presents with acute onset of nosebleed about an hour prior to presentation.  He presents with severe bleeding from the nose which was not controlled by compression at home, onset approximately 1 hour prior to presentation.  He had also noticed petechial rash over his trunk and extremities during the course of today, as well as bruises to his face and eye without prior trauma.  He also notes bleeding from his mouth from intraoral lesions which were noted upon awakening.  He denies any fever, bone pains, sore throat or significant lymph node swellings.  He denies any family history of hematologic disease or malignancy.  He presented to the emergency department where laboratories remarkable for platelet count of 1000.  Epistaxis course controlled with the application of a nasal rocket soaked in TXA and epinephrine.  He will be admitted to the hospitalist service for further treatment and hematologic evaluation.  While on admission his ITP workup was negative but he tested positive for COVID which could be the cause of his thrombocytopenia  He is s/p 3 doses of IVIG and 4 days of IV steroids  Oncology was available by phone consultation and ENT was consulted for epistaxis and he had his nasal packing removed 9/6  Patient's platelet count improved on above treatment. Today platelet count is 39 k with no active bleeding  Patient was cleared for discharge by oncology to follow up next week mon and tuesday. Case managers to set up appointment  He was also advised to follow up with ENT  Patient developed some hiccups and will be prescribed baclofen with follow up with his PCP
Age: 41.0
Sex: M
Vaccine: COVID19
Symptoms: Petechiae, Platelet count decreased, Rash, SARS-CoV-2 test positive, Thrombocytopenia
Clinical narrative: COVID Vaccine Breakthrough Case  Pfizer Dose 1 5/6/21 (ER8736) Pfizer Dose 2 6/11/21 (EW0164) COVID Positive 9/1/2021  9/1/21: Presented to ED. 41-year-old man who presents with acute onset of nosebleed about an hour prior to presentation.  He presents with severe bleeding from the nose which was not controlled by compression at home, onset approximately 1 hour prior to presentation.  He had also noticed petechial rash over his trunk and extremities during the course of today, as well as bruises to his face and eye without prior trauma.  He also notes bleeding from his mouth from intraoral lesions which were noted upon awakening.  He denies any fever, bone pains, sore throat or significant lymph node swellings.  He denies any family history of hematologic disease or malignancy.  He presented to the emergency department where laboratories remarkable for platelet count of 1000.  Epistaxis course controlled with the application of a nasal rocket soaked in TXA and epinephrine.  He will be admitted to the hospitalist service for further treatment and hematologic evaluation.  9/7/21: 41-year-old man who presents with acute onset of nosebleed about an hour prior to presentation.  He presents with severe bleeding from the nose which was not controlled by compression at home, onset approximately 1 hour prior to presentation.  He had also noticed petechial rash over his trunk and extremities during the course of today, as well as bruises to his face and eye without prior trauma.  He also notes bleeding from his mouth from intraoral lesions which were noted upon awakening.  He denies any fever, bone pains, sore throat or significant lymph node swellings.  He denies any family history of hematologic disease or malignancy.  He presented to the emergency department where laboratories remarkable for platelet count of 1000.  Epistaxis course controlled with the application of a nasal rocket soaked in TXA and epinephrine.  He will be admitted to the hospitalist service for further treatment and hematologic evaluation.  While on admission his ITP workup was negative but he tested positive for COVID which could be the cause of his thrombocytopenia  He is s/p 3 doses of IVIG and 4 days of IV steroids  Oncology was available by phone consultation and ENT was consulted for epistaxis and he had his nasal packing removed 9/6  Patient's platelet count improved on above treatment. Today platelet count is 39 k with no active bleeding  Patient was cleared for discharge by oncology to follow up next week mon and tuesday. Case managers to set up appointment  He was also advised to follow up with ENT  Patient developed some hiccups and will be prescribed baclofen with follow up with his PCP
Age: 41.0
Sex: M
Vaccine: COVID19
Symptoms: Vaccine breakthrough infection
Clinical narrative: COVID Vaccine Breakthrough Case  Pfizer Dose 1 5/6/21 (ER8736) Pfizer Dose 2 6/11/21 (EW0164) COVID Positive 9/1/2021  9/1/21: Presented to ED. 41-year-old man who presents with acute onset of nosebleed about an hour prior to presentation.  He presents with severe bleeding from the nose which was not controlled by compression at home, onset approximately 1 hour prior to presentation.  He had also noticed petechial rash over his trunk and extremities during the course of today, as well as bruises to his face and eye without prior trauma.  He also notes bleeding from his mouth from intraoral lesions which were noted upon awakening.  He denies any fever, bone pains, sore throat or significant lymph node swellings.  He denies any family history of hematologic disease or malignancy.  He presented to the emergency department where laboratories remarkable for platelet count of 1000.  Epistaxis course controlled with the application of a nasal rocket soaked in TXA and epinephrine.  He will be admitted to the hospitalist service for further treatment and hematologic evaluation.  9/7/21: 41-year-old man who presents with acute onset of nosebleed about an hour prior to presentation.  He presents with severe bleeding from the nose which was not controlled by compression at home, onset approximately 1 hour prior to presentation.  He had also noticed petechial rash over his trunk and extremities during the course of today, as well as bruises to his face and eye without prior trauma.  He also notes bleeding from his mouth from intraoral lesions which were noted upon awakening.  He denies any fever, bone pains, sore throat or significant lymph node swellings.  He denies any family history of hematologic disease or malignancy.  He presented to the emergency department where laboratories remarkable for platelet count of 1000.  Epistaxis course controlled with the application of a nasal rocket soaked in TXA and epinephrine.  He will be admitted to the hospitalist service for further treatment and hematologic evaluation.  While on admission his ITP workup was negative but he tested positive for COVID which could be the cause of his thrombocytopenia  He is s/p 3 doses of IVIG and 4 days of IV steroids  Oncology was available by phone consultation and ENT was consulted for epistaxis and he had his nasal packing removed 9/6  Patient's platelet count improved on above treatment. Today platelet count is 39 k with no active bleeding  Patient was cleared for discharge by oncology to follow up next week mon and tuesday. Case managers to set up appointment  He was also advised to follow up with ENT  Patient developed some hiccups and will be prescribed baclofen with follow up with his PCP
Age: 44.0
Sex: F
Vaccine: COVID19
Symptoms: Headache, Hypoaesthesia, Oropharyngeal pain, Paraesthesia, Paraesthesia oral
Clinical narrative: My entire arm and hand was tingling and numb. I had face tingling and also my tongue and lip. My throat also feels tight and is hurting. I also had a headache.
Age: 44.0
Sex: F
Vaccine: COVID19
Symptoms: Throat tightness
Clinical narrative: My entire arm and hand was tingling and numb. I had face tingling and also my tongue and lip. My throat also feels tight and is hurting. I also had a headache.
Age: 19.0
Sex: M
Vaccine: UNK
Symptoms: Testicular swelling
Clinical narrative: swollen testicle
Age: 47.0
Sex: F
Vaccine: COVID19
Symptoms: Unevaluable event
Clinical narrative: PT HAD MULTIPLE PE AND WAS HOSPITALIZED
Age: 44.0
Sex: F
Vaccine: COVID19
Symptoms: Breast tenderness, Drainage, Herpes zoster, Lymphadenopathy, Mammogram
Clinical narrative: Starting on 04/06/2021, I noticed my lymph nodes were swollen underneath my arm. I had breast tenderness and leakage out of the left breast. I called my PCP and they wanted to see me. They sent me to get a mammogram and another evaluation like an ultrasound, which both came back indicating swelling. The lady who performed the mammogram indicated to me it was a common side effect after the vaccine. I did not follow up with my PCP again until I developed Shingles not to long afterwards. Since the case was mild, they did not give me anything for treatment. It resolved on its own in 14 days.
Age: 44.0
Sex: F
Vaccine: COVID19
Symptoms: Ultrasound scan
Clinical narrative: Starting on 04/06/2021, I noticed my lymph nodes were swollen underneath my arm. I had breast tenderness and leakage out of the left breast. I called my PCP and they wanted to see me. They sent me to get a mammogram and another evaluation like an ultrasound, which both came back indicating swelling. The lady who performed the mammogram indicated to me it was a common side effect after the vaccine. I did not follow up with my PCP again until I developed Shingles not to long afterwards. Since the case was mild, they did not give me anything for treatment. It resolved on its own in 14 days.
Age: 42.0
Sex: M
Vaccine: UNK
Symptoms: Product storage error
Clinical narrative: During a review of the Department of Health?s internal records, it was found that there might have been a possible temperature excursion with how the vaccine was stored with our mobile vendor.
Age: 64.0
Sex: F
Vaccine: COVID19, UNK
Symptoms: Axillary pain, Cough, Oropharyngeal pain, Pain in extremity
Clinical narrative: Soreness on arm seemed to wrap around under arm and armpit. Sore throat, cough
Age: 53.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Pain, Pyrexia, Vertigo
Clinical narrative: Patient stated the evening of vaccination she went to sleep and woke up later experiencing vertigo.  She then began to have fever, chill, and body aches exactly like she had when she was experiencing COVID-19 infection.   The patient is continuing to have symptoms 27 hours post vaccination.
Age: 60.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: During a review of the Department of Health?s internal records, it was found that there might have been a possible temperature excursion with how the vaccine was stored with our mobile vendor.
Age: 57.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Injected limb mobility decreased, Movement disorder, Pain, Pain in extremity
Clinical narrative: pharmacist missed the deltoid and injected the vaccine into a nerve at the base of the deltoid. I cannot move the arm midline, lift my arm up  or lift heavy objects.  i cannot push doors closed with my right arm without intense , overwhelming pain. The pain radiates down to my wrist and fingers.