chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 1.0
Sex: M
Vaccine: MMR
Symptoms: Abnormal behaviour, Antisocial behaviour, Autism, Lethargy, Somnolence
Clinical narrative: Information has been received from a consumer, who is also a medical student, concerning her healthy 12 month old son who on 2/23/01 was vaccinated with a dose of MMR (lot # not reported). The mother reported that immediately after vaccination the patient became very lethargic and slept extreme amounts of time for two days. He regressed developmentally. He stopped talking, eating, and withdrew from reality. He started to do strange things. He avoided eye contact and assumed mannerisms with his hands and looked out the sides of his eyes. He did not want to be touched. He started banging his head against things until he was bruised. The mother reported that for four months his doctor said he was having tantrums. The mother reported that pediatric neurologists diagnosed him as having autistic spectrum and pervasive developmental delay. The mother reported that the patient that the patient has come a long way, but still has some component of the reported diagnosis. The patient has received early intervention of thirty hours per week. Upon internal review, autistic spectrum and pervasive developmental delay were determined to be other important medical evens (OMIC). Additional information has been requested.
Age: 22.0
Sex: M
Vaccine: HEP, HEP
Symptoms: Arterial thrombosis limb, Thrombosis
Clinical narrative: This case was reported by a nurse and described the occurrence of left brachial vein thrombosis in a 22 year old male patient who received hepatitis B vaccine recombinant. On 5/3/04, the patient received the first dose of Engerix B vaccine (lot ENG5588A4) in the left arm. On 5/6/04, the patient was seen in an emergency room and underwent a doppler ultrasound of the left arm. The ultrasound revealed left brachial vein thrombosis. The patient reported to the nurse that the adverse event began the day after receiving the injection. The event improved. Comment: Vein thrombosis was assessed as medically serious (OMIC). Follow UP: The immunization series with Engerix B was discontinued. The events resolved on 21MAY2004. The nurse considered the events to possibly be related to vaccination with Engerix B.
Age: 22.0
Sex: M
Vaccine: HEP, HEP
Symptoms: Injection site oedema, Venous thrombosis
Clinical narrative: This case was reported by a nurse and described the occurrence of left brachial vein thrombosis in a 22 year old male patient who received hepatitis B vaccine recombinant. On 5/3/04, the patient received the first dose of Engerix B vaccine (lot ENG5588A4) in the left arm. On 5/6/04, the patient was seen in an emergency room and underwent a doppler ultrasound of the left arm. The ultrasound revealed left brachial vein thrombosis. The patient reported to the nurse that the adverse event began the day after receiving the injection. The event improved. Comment: Vein thrombosis was assessed as medically serious (OMIC). Follow UP: The immunization series with Engerix B was discontinued. The events resolved on 21MAY2004. The nurse considered the events to possibly be related to vaccination with Engerix B.
Age: 4.0
Sex: M
Vaccine: DTAP, IPV, MMR
Symptoms: Cellulitis
Clinical narrative: Cellulitis developed in right arm.
Age: 53.0
Sex: F
Vaccine: FLUX, PPV
Symptoms: Myelitis transverse, Paresis, Urinary tract infection, Visual disturbance
Clinical narrative: Transverse myelitis. Paraparesis left side greater than right. Sensory level of T10. Medical records state abnormal vision. msv
Age: 37.0
Sex: M
Vaccine: ANTH, FLU3, TYP
Symptoms: Injection site mass
Clinical narrative: 37 yo male patient presented with complaint of lump on back of right upper arm after anthrax vaccine (dose #6). Pt states that he never had a reaction like this with any other dose of anthrax vaccine.
Age: 55.0
Sex: F
Vaccine: FLU3
Symptoms: Hypokinesia, Nerve injury, Pain, Shoulder pain
Clinical narrative: 3-22-04 4:45P Pt stated immediately after receiving the influenza vaccine in her left arm she has had constant pain. Denies any redness or swelling at that time. Pt stated left arm became progressively worse with movement and pain continued. On 3-19-04 pt saw internal medicine physician. The diagnosis was possible nerve damage. Pt referred to neurologist and EMG is scheduled on 3-29-04 at 10:00A. Client stated at this time she is unable to raise left arm for certain everyday tasks. She cannot shampoo hair, fasten seat belts, pull up nylons, and shut her car door with her left arm. Pain rated (9 1/2) on a scale of 0 to 10. She stated her pain is from left elbow to left shoulder. 4/19/04 TC received from client stating MRI of Left shoulder completed 04/09/04 showing normal aging but no cervical spine problems. Stated she was referred to a physical therapist who believes the "frozen shoulder" she now has may be due to a inflammatory process that may have "directly resulted from the flu shot injuring a nerve" She had no prior injury to the arm prior to the Flu shot and he highly suspects this has caused the symptoms. She will continue with PT.
Age: 33.0
Sex: F
Vaccine: LYME
Symptoms: Arthralgia, Headache, Joint stiffness, Myalgia
Clinical narrative: Immediately following all vaccines, muscle aches, joint tightness and pain, headaches stiffness and soreness. These symptoms are constant and do not go away. I am being treated by a neurologist and awaiting to see a Rheumatoid Arthritis doctor.
Age: 1.75
Sex: F
Vaccine: IPV, PNC
Symptoms: Aphasia, Mental retardation severity unspecified, Obsessive-compulsive disorder, Pyrexia
Clinical narrative: Immunizations of 3-4-03: Child had high temp 103.8. Ax Within 12 hrs after imm. Temp came down to 100.4 Ax with Tylenol. Temp stayed for several days. Temp was normal by 3-10-04. Child "back to her normal self." Immunizations of 4-8-03: Temp high 102.4 Ax after c midnight after imm. high temp cont- at least 2 days. Mom "thinks" she saw doctor. Approx 1 1/2 weeks later, child developed developmental delays. Mom states that approx. 1 1/2 weeks after imm. (0f 4/8/03) were given, pt stopped talking, stopped lifting up her arms to be held, developed a flat expression previously she had been "very happy" "bubbly", was saying a few words (mama, dada, up) and would hold her hands up (to be held) and say "up". She stopped looking at parents when they called her name. Audiologist determined hearing was normal. Testing shows that she is functioning at a 9 month level with communication skills and speech is "severely delayed." Therapies are currently being set up with Learning Center. Parents are trying dietary changes to determine possible allergies (ie stopped milk and switched to Isomil formula). She has appointment with neurologist 6/7/04 for testing. Mom also states child has developed obsessive compulsive behaviors. Was diagnosed by Learning Center as being "severely developmentally delayed."
Age: 0.83
Sex: M
Vaccine: DTAP, HIBV, PNC
Symptoms: Agitation, Contusion, Injection site mass, Irritability, Pyrexia
Clinical narrative: Bruised left leg, hard knot, very irritable, inconsolable x 2 days, low grade fever.
Sex: F
Vaccine: HEP, HEPA
Symptoms: Pain
Clinical narrative: Right deltoid pain 24 hours after injection continuing for 4 mos. Xrays done approx. Sept 2000 Results Normal per dr. Dr. prescribed Tylenol 3's gradual improvement. Today (04/16/02) Mostly improved occasional discomfort especially when raising arm good ROM No lumps no redness, no hardness- Not taking any medicine for discomfort.
Age: 1.0
Sex: F
Vaccine: DTAP, HIBV, IPV, MMR, VARCEL
Symptoms: Erythema, Pyrexia, Rash macular
Clinical narrative: 04/28/04 T.C from parent. Reports child was taken to clinic today for c/o elevated temp of 103.8 degrees F. Temp resolved when child was observed by RN. Child was given Carolec DM and went home. That same day after child returned home mother noted red blotchy areas on forehead, neck , shoulder, and hand areas
Age: 0.5
Sex: M
Vaccine: HIBV
Symptoms: Pyrexia
Clinical narrative: Fever started 5/6/04, reached 105 degrees, no local reaction supportive care recommended.
Age: 0.33
Sex: M
Vaccine: DTAP, HBHEPB, IPV, PNC
Symptoms: Pharyngitis, Pyrexia, Rash
Clinical narrative: Fever 105 for 2 days after DTaP and IPV and Comvax and Prevnar (2nd set) rash broke out on 3rd day, has mild pharyngitis.
Age: 21.0
Sex: F
Vaccine: HEP
Symptoms: Pyrexia, Rash maculo-papular
Clinical narrative: Diffuse maculopapular rash on trunk and extremities, low grade fever 100.4
Age: 1.08
Sex: M
Vaccine: MMR, VARCEL
Symptoms: Rash erythematous, Rash macular
Clinical narrative: 12 days after receiving MMR vaccine pt developed a red raised blotching diffuse rash on trunk, extremities face. Initial was separate spots but they condensed as the rash faded. He was also put on Amox and Tobrex eye drops.
Age: 3.0
Sex: F
Vaccine: DTAP
Symptoms: Erythema, Injection site induration, Rash, Urticaria
Clinical narrative: Had injection 04/29/04 on 04/30/04 pt woke up with rash and around inj site very red and hard. 5 inch diameter with scattered urticaria elsewhere. No SOB, no angio edema. ON 04/29/04 had Benadryl before injection.
Age: 38.0
Sex: F
Vaccine: MMR
Symptoms: Dizziness, Feeling hot, Injection site erythema, Injection site swelling
Clinical narrative: 05/07/04 client calls to report injection site is swollen, red and warm to touch. Fever at 99 and c/o dizziness since evening of 5/6/04. Rec: she apply cool compress to control fever, force fluids, and see medical provider. Client seen by Dr-given cortisone ointment, he felt dizziness was unrelated. 5/10/04 Client reports less swelling and redness
Age: 4.0
Sex: M
Vaccine: DTAP, HEP, IPV, MMR
Symptoms: Erythema, Swelling
Clinical narrative: Right thigh red and swollen area 16 cm x9.5cm, pt told by Dr to use ice and Benadryl
Age: 4.0
Sex: M
Vaccine: DTAP
Symptoms: Erythema, Swelling
Clinical narrative: Mother called triage nurse.  After shots were given, red and swollen. Next day-swelling from shoulder to elbow but feeling find. 04/02/04 shot given
Sex: U
Vaccine: DTAP
Symptoms: Erythema, Pruritus, Swelling
Clinical narrative: Local swelling, erythema with pruritus around injection site. Dephenyldramin prescribed with cool compresses.
Age: 2.5
Sex: M
Vaccine: DT
Symptoms: Lymphoedema, Swelling
Clinical narrative: Lymphademia, swelling left thigh.
Age: 27.0
Sex: M
Vaccine: ANTH, DT, FLU3, HEP, HEPA, SMALL
Symptoms: Blister, Pruritus, Skin ulcer
Clinical narrative: 05/8/04: Pt developed highly pruritic vesicular lesions. Pt is afebrile. 05/10/04: Pt placed in isolation-symptomatic tx. 05/12/04: some vesicles beginning to scale.  Nurse follow up on 07/28/04 states: "Complete."
Age: 4.0
Sex: M
Vaccine: DTAP, IPV
Symptoms: Cellulitis
Clinical narrative: Left leg cellulitis. Keflex 250 mg/5 ml
Age: 2.0
Sex: M
Vaccine: HBHEPB, VARCEL
Symptoms: Drug ineffective, Rash vesicular, Viral infection
Clinical narrative: Child was immunized 1/10/03. Mother called office 5/10/04 days child is covered with chicken pox. Immunization did not work.
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMR
Symptoms: Erythema, Injection site induration, Injection site warmth, Swelling
Clinical narrative: Local indurated, red , swollen, entire deltoid hot.
Age: 5.0
Sex: M
Vaccine: DTAP, IPV
Symptoms: Abscess, Erythema, Feeling hot, Injection site induration
Clinical narrative: Left delotid, red 5x9 cm area, warm to touch, firm, afebrile, dx sterile abscess. Ice.
Age: 5.0
Sex: M
Vaccine: DTAP, IPV, MMR, VARCEL
Symptoms: Injection site erythema, Injection site pain, Injection site warmth, Swelling
Clinical narrative: Pt got 4 prescribed immunizations IPV + DTaP in right arm. Area became quite swollen and red, hot and painful. Entire upper arm involved.
Age: 5.0
Sex: F
Vaccine: DTAP, IPV, MMR
Symptoms: Blister, Dermatitis bullous, Erythema, Hypersensitivity, Swelling
Clinical narrative: Severe local allergic in which there was around 7x8 inch area of erythema/swelling along with several raised bullae/ vesicles up to 1 inch in diameter.
Age: 5.0
Sex: F
Vaccine: DTAP, IPV, MMR, VARCEL
Symptoms: Erythema, Injection site warmth, Pain, Swelling
Clinical narrative: Received IPV+DTaP in left leg 5/10/04. Onset redness and pain 5/11/04. On 5/12/04 redness, pain, heat and swelling to left lateral thigh. 14cmx17cm. Dr suspects reaction to pertussus.
Age: 1.0
Sex: F
Vaccine: DTAP, HIBV, IPV, VARCEL
Symptoms: Convulsion, Pyrexia, Rash erythematous, Rash papular, Rash pustular
Clinical narrative: 5/11 increase temp 101 degrees (increase 104 degrees 5/10: brief seizure) 28 days scattered erythematous papules + cluster of papulopustular lesions just to right side of nose.
Age: 5.0
Sex: M
Vaccine: DTAP, IPV, MMR
Symptoms: Injection site erythema
Clinical narrative: Local reaction at vaccine site. No infection. Blanching 2" redness at site.
Age: 5.0
Sex: F
Vaccine: DTAP, IPV, MMR
Symptoms: Erythema, Injection site induration, Tenderness
Clinical narrative: 2" redness + moderate induration at right deltoid vaccine site mild + tender.
Age: 5.0
Sex: M
Vaccine: DTAP, IPV, MMR
Symptoms: Injection site erythema, Injection site swelling
Clinical narrative: Reddened right arm at site of injection 2" diameter + swollen
Age: 1.6
Sex: F
Vaccine: DTAP, IPV
Symptoms: Injection site erythema, Injection site swelling
Clinical narrative: Red, swollen thigh at injection site. The size of grapefruit.
Age: 5.0
Sex: F
Vaccine: DTAP, MMR
Symptoms: Injection site reaction
Clinical narrative: Large local reaction : left deltoid. 8 cm diameter.
Age: 1.08
Sex: F
Vaccine: HBHEPB, MMR, VARCEL
Symptoms: Unevaluable event
Clinical narrative: REAC UNEVAL.
Age: 0.5
Sex: F
Vaccine: DTAP, IPV
Symptoms: Injection site erythema, Injection site induration, Injection site rash, Injection site swelling, Irritability
Clinical narrative: Initial swelling around injection site, then itching red rash developed around injection site 5 days later and fussy more than usual. Seen in our office on 5-12-04 with 3cm area of induration with excoriation.
Age: 0.5
Sex: F
Vaccine: DTAP, IPV
Symptoms: Pruritus, Skin reaction
Clinical narrative: Initial swelling around injection site, then itching red rash developed around injection site 5 days later and fussy more than usual. Seen in our office on 5-12-04 with 3cm area of induration with excoriation.
Age: 36.0
Sex: M
Vaccine: ANTH, JEV, RAB
Symptoms: Injection site induration, Injection site reaction
Clinical narrative: Pt has local reaction measuring 60mm X 58 mm induration, 72mm X 80mm.  Pt instructed to use cold compresses over the weekend and return for follow-up on 17 May or the E.R. if he experiences any problems breathing or reaction gets bigger. Follow up 5/21/04: Patient has an induration measuring 35mm by 57mm.
Age: 0.17
Sex: M
Vaccine: DTAP, HIBV, IPV
Symptoms: Abnormal behaviour, Aspiration, Autism, Constipation, Eczema
Clinical narrative: Previously health baby. After shots - began constant screaming, all over body hives, eczema, severe reflux and aspiration, spit up bile, constipation, stopped sleeping, stopped eating, dropped weight from 95th % to 5%. Excess yeast worsened. Leaky gut syndrome, hypotonia, constant weeping eye. Eventually autistic symptoms: headbanging, spinning, stimming, speech and developmental delays. Severe food allergies, mercury toxicity.    Treated with diet, antifungals, homeopathy.  Nurse follow up on 09/01/04 states: "No new information."
Age: 0.17
Sex: M
Vaccine: DTAP, HIBV, IPV
Symptoms: Gastrooesophageal reflux disease, Hypersensitivity, Hypotonia, Laboratory test abnormal, Lacrimation increased
Clinical narrative: Previously health baby. After shots - began constant screaming, all over body hives, eczema, severe reflux and aspiration, spit up bile, constipation, stopped sleeping, stopped eating, dropped weight from 95th % to 5%. Excess yeast worsened. Leaky gut syndrome, hypotonia, constant weeping eye. Eventually autistic symptoms: headbanging, spinning, stimming, speech and developmental delays. Severe food allergies, mercury toxicity.    Treated with diet, antifungals, homeopathy.  Nurse follow up on 09/01/04 states: "No new information."
Age: 0.17
Sex: M
Vaccine: DTAP, HIBV, IPV
Symptoms: Oral intake reduced, Screaming, Sleep disorder, Speech disorder, Urticaria
Clinical narrative: Previously health baby. After shots - began constant screaming, all over body hives, eczema, severe reflux and aspiration, spit up bile, constipation, stopped sleeping, stopped eating, dropped weight from 95th % to 5%. Excess yeast worsened. Leaky gut syndrome, hypotonia, constant weeping eye. Eventually autistic symptoms: headbanging, spinning, stimming, speech and developmental delays. Severe food allergies, mercury toxicity.    Treated with diet, antifungals, homeopathy.  Nurse follow up on 09/01/04 states: "No new information."
Age: 0.17
Sex: M
Vaccine: DTAP, HIBV, IPV
Symptoms: Vomiting
Clinical narrative: Previously health baby. After shots - began constant screaming, all over body hives, eczema, severe reflux and aspiration, spit up bile, constipation, stopped sleeping, stopped eating, dropped weight from 95th % to 5%. Excess yeast worsened. Leaky gut syndrome, hypotonia, constant weeping eye. Eventually autistic symptoms: headbanging, spinning, stimming, speech and developmental delays. Severe food allergies, mercury toxicity.    Treated with diet, antifungals, homeopathy.  Nurse follow up on 09/01/04 states: "No new information."
Age: 5.0
Sex: F
Vaccine: DTAP, IPV, MMR
Symptoms: Erythema
Clinical narrative: Parents c/o 6" red area on upper leg.  Denies any fever.  Patient saw physician on 5-07-04 in reference to this reaction and again on 05/08/04.
Age: 47.0
Sex: F
Vaccine: TTOX
Symptoms: Hypoaesthesia, Hypokinesia, Pain, Peripheral coldness, Skin burning sensation
Clinical narrative: Patient was given Tenanus and Diphtheria on April 9, 2004.  After a week,noticed that pain was increasing. Also states that she felt a burning sensation running up and down her arm as well as numbness and cold finger tips.    Made appointment with doctor.  Was seen on April 19, 2004.  By this time, pain began to feel very sore but numbness and cold fingertips remain.  Also mentions that she feels as if she has a hole on her arm.  Patient states doctor told her that the pain on arm is not related to vaccine.  Patient also stated to doctor that she has never felt this way before.  Doctor gave no treatment and asked her to come back in a month.  Patient continues to feels a hole, numbness and cold finger tips. Patient has trouble lifting objects such as; holding a cup of water, grocery bags, household chores, and reaching for itmes.  Has also had to stop work because of the pain.  Patient has also had problems sleeing.  Her next appointment is scheduled for June 1, 2004.
Age: 5.0
Sex: F
Vaccine: DTAP, HEPA, IPV, MMR
Symptoms: Erythema, Feeling hot, Pain, Swelling
Clinical narrative: LEFT LEG PAIN, SWELLING, ERTHEMA, WARM TO TOUCH. WAS GIVEN ANTIBOTICS IF SWELLING INCREASES.
Age: 1.0
Sex: F
Vaccine: MMR, VARCEL
Symptoms: Drug ineffective, Infection
Clinical narrative: Contracted Varicella
Age: 30.0
Sex: M
Vaccine: ANTH
Symptoms: Arthritis, Discomfort, Pain
Clinical narrative: Recieved second anthrax vaccination in right arm and since that point the patient had pain/discomfort in (R) arm.  Pain/discomfort discribed as arthritic pain.  Pain started a few weeks after the 2nd shot and has persisted for approximately a year.  Pain has subsided within the last few months. Second anthrax vaccination was not available at the time of this report.  The patient suspects adverse reactions occured after second vaccination.
Age: 4.0
Sex: F
Vaccine: DTAP, HEPA, IPV, MMR
Symptoms: Injection site erythema, Injection site swelling
Clinical narrative: Swelling and erythmea around injection site 24 hours after injection.
Age: 21.0
Sex: M
Vaccine: SMALL, TYP, SMALL, TYP
Symptoms: Cellulitis, Conjunctivitis, Diplopia, Erythema, Eye inflammation
Clinical narrative: Patient developed left eye orbital cellulitis and blepharoconjunctivitis with symptoms first appearing 8 days after smallpox vaccination.  He was admitted to hospital on 04/01/2004 with Ophthalmology Consulted.  He was started on Cefuroxime IV and Ocuflox gtts OS.  No evidence of corneal involvement, per ophthalmology report.  Vision was 20/150 (left eye) and 20/20 right eye on 04/01/2004 and 20/60 (left eye) on 04/02/2004.  On 04/02/2004, he received VIG-IV with report of chills, nausea, dizziness, and rigors.  Symptoms subsided within 30 minutes, per patient report.  On 04/04/2004, ophthalmologist noted two corneal lesions and corneal clouding. (Diagnosis of keratitis, iritis.)  He also developed a pustule on his left lower eyelid. Viroptic eye gtts (1 drop OS 9 times a day) was started that day. Left eye vision decreased to only able to count fingers at 6 feet left eye, per ophthalmology report.  Pred Forte 1% OS 6 times a day was started on 04/05/04.  Acyclovir was started by ophthalmology on 04/07/04 after ophthalmologist noted dendritic pattern on exam. Pre-VIG specimen from Left eye that was sent to lab: Vaccinia PCR and culture Positive. HSV culture sent to local lab:  Negative. Patient was discharged from hospital on 4/12/04.  Vision at that time was 20/100 Left eye/pin hole was 20/70.  He continues to be followed by family practice and ophthalmology.  Vision per report of Family Practice on 04/30/04 was 20/70 left eye, 20/20 right eye. He has returned to work full-duty but remains non-deployable.
Age: 21.0
Sex: M
Vaccine: SMALL, TYP, SMALL, TYP
Symptoms: Eye irritation, Eye pain, Headache, Injection site hypersensitivity, Keratitis
Clinical narrative: Patient developed left eye orbital cellulitis and blepharoconjunctivitis with symptoms first appearing 8 days after smallpox vaccination.  He was admitted to hospital on 04/01/2004 with Ophthalmology Consulted.  He was started on Cefuroxime IV and Ocuflox gtts OS.  No evidence of corneal involvement, per ophthalmology report.  Vision was 20/150 (left eye) and 20/20 right eye on 04/01/2004 and 20/60 (left eye) on 04/02/2004.  On 04/02/2004, he received VIG-IV with report of chills, nausea, dizziness, and rigors.  Symptoms subsided within 30 minutes, per patient report.  On 04/04/2004, ophthalmologist noted two corneal lesions and corneal clouding. (Diagnosis of keratitis, iritis.)  He also developed a pustule on his left lower eyelid. Viroptic eye gtts (1 drop OS 9 times a day) was started that day. Left eye vision decreased to only able to count fingers at 6 feet left eye, per ophthalmology report.  Pred Forte 1% OS 6 times a day was started on 04/05/04.  Acyclovir was started by ophthalmology on 04/07/04 after ophthalmologist noted dendritic pattern on exam. Pre-VIG specimen from Left eye that was sent to lab: Vaccinia PCR and culture Positive. HSV culture sent to local lab:  Negative. Patient was discharged from hospital on 4/12/04.  Vision at that time was 20/100 Left eye/pin hole was 20/70.  He continues to be followed by family practice and ophthalmology.  Vision per report of Family Practice on 04/30/04 was 20/70 left eye, 20/20 right eye. He has returned to work full-duty but remains non-deployable.
Age: 21.0
Sex: M
Vaccine: SMALL, TYP, SMALL, TYP
Symptoms: Laboratory test abnormal, Lacrimal disorder, Photosensitivity reaction, Pruritus, Rash papular
Clinical narrative: Patient developed left eye orbital cellulitis and blepharoconjunctivitis with symptoms first appearing 8 days after smallpox vaccination.  He was admitted to hospital on 04/01/2004 with Ophthalmology Consulted.  He was started on Cefuroxime IV and Ocuflox gtts OS.  No evidence of corneal involvement, per ophthalmology report.  Vision was 20/150 (left eye) and 20/20 right eye on 04/01/2004 and 20/60 (left eye) on 04/02/2004.  On 04/02/2004, he received VIG-IV with report of chills, nausea, dizziness, and rigors.  Symptoms subsided within 30 minutes, per patient report.  On 04/04/2004, ophthalmologist noted two corneal lesions and corneal clouding. (Diagnosis of keratitis, iritis.)  He also developed a pustule on his left lower eyelid. Viroptic eye gtts (1 drop OS 9 times a day) was started that day. Left eye vision decreased to only able to count fingers at 6 feet left eye, per ophthalmology report.  Pred Forte 1% OS 6 times a day was started on 04/05/04.  Acyclovir was started by ophthalmology on 04/07/04 after ophthalmologist noted dendritic pattern on exam. Pre-VIG specimen from Left eye that was sent to lab: Vaccinia PCR and culture Positive. HSV culture sent to local lab:  Negative. Patient was discharged from hospital on 4/12/04.  Vision at that time was 20/100 Left eye/pin hole was 20/70.  He continues to be followed by family practice and ophthalmology.  Vision per report of Family Practice on 04/30/04 was 20/70 left eye, 20/20 right eye. He has returned to work full-duty but remains non-deployable.
Age: 21.0
Sex: M
Vaccine: SMALL, TYP, SMALL, TYP
Symptoms: Vaccination complication, Vision blurred
Clinical narrative: Patient developed left eye orbital cellulitis and blepharoconjunctivitis with symptoms first appearing 8 days after smallpox vaccination.  He was admitted to hospital on 04/01/2004 with Ophthalmology Consulted.  He was started on Cefuroxime IV and Ocuflox gtts OS.  No evidence of corneal involvement, per ophthalmology report.  Vision was 20/150 (left eye) and 20/20 right eye on 04/01/2004 and 20/60 (left eye) on 04/02/2004.  On 04/02/2004, he received VIG-IV with report of chills, nausea, dizziness, and rigors.  Symptoms subsided within 30 minutes, per patient report.  On 04/04/2004, ophthalmologist noted two corneal lesions and corneal clouding. (Diagnosis of keratitis, iritis.)  He also developed a pustule on his left lower eyelid. Viroptic eye gtts (1 drop OS 9 times a day) was started that day. Left eye vision decreased to only able to count fingers at 6 feet left eye, per ophthalmology report.  Pred Forte 1% OS 6 times a day was started on 04/05/04.  Acyclovir was started by ophthalmology on 04/07/04 after ophthalmologist noted dendritic pattern on exam. Pre-VIG specimen from Left eye that was sent to lab: Vaccinia PCR and culture Positive. HSV culture sent to local lab:  Negative. Patient was discharged from hospital on 4/12/04.  Vision at that time was 20/100 Left eye/pin hole was 20/70.  He continues to be followed by family practice and ophthalmology.  Vision per report of Family Practice on 04/30/04 was 20/70 left eye, 20/20 right eye. He has returned to work full-duty but remains non-deployable.
Age: 21.0
Sex: M
Vaccine: SMALL, TYP, SMALL, TYP
Symptoms: Cellulitis, Chills, Conjunctivitis, Corneal lesion, Dizziness
Clinical narrative: Patient developed left eye orbital cellulitis and blepharoconjunctivitis with symptoms first appearing 8 days after smallpox vaccination.  He was admitted to hospital on 04/01/2004 with Ophthalmology Consulted.  He was started on Cefuroxime IV and Ocuflox gtts OS.  No evidence of corneal involvement, per ophthalmology report.  Vision was 20/150 (left eye) and 20/20 right eye on 04/01/2004 and 20/60 (left eye) on 04/02/2004.  On 04/02/2004, he received VIG-IV with report of chills, nausea, dizziness, and rigors.  Symptoms subsided within 30 minutes, per patient report.  On 04/04/2004, ophthalmologist noted two corneal lesions and corneal clouding. (Diagnosis of keratitis, iritis.)  He also developed a pustule on his left lower eyelid. Viroptic eye gtts (1 drop OS 9 times a day) was started that day. Left eye vision decreased to only able to count fingers at 6 feet left eye, per ophthalmology report.  Pred Forte 1% OS 6 times a day was started on 04/05/04.  Acyclovir was started by ophthalmology on 04/07/04 after ophthalmologist noted dendritic pattern on exam. Pre-VIG specimen from Left eye that was sent to lab: Vaccinia PCR and culture Positive. HSV culture sent to local lab:  Negative. Patient was discharged from hospital on 4/12/04.  Vision at that time was 20/100 Left eye/pin hole was 20/70.  He continues to be followed by family practice and ophthalmology.  Vision per report of Family Practice on 04/30/04 was 20/70 left eye, 20/20 right eye. He has returned to work full-duty but remains non-deployable.
Age: 21.0
Sex: M
Vaccine: SMALL, TYP, SMALL, TYP
Symptoms: Iritis, Keratitis, Laboratory test abnormal, Nausea, Visual disturbance
Clinical narrative: Patient developed left eye orbital cellulitis and blepharoconjunctivitis with symptoms first appearing 8 days after smallpox vaccination.  He was admitted to hospital on 04/01/2004 with Ophthalmology Consulted.  He was started on Cefuroxime IV and Ocuflox gtts OS.  No evidence of corneal involvement, per ophthalmology report.  Vision was 20/150 (left eye) and 20/20 right eye on 04/01/2004 and 20/60 (left eye) on 04/02/2004.  On 04/02/2004, he received VIG-IV with report of chills, nausea, dizziness, and rigors.  Symptoms subsided within 30 minutes, per patient report.  On 04/04/2004, ophthalmologist noted two corneal lesions and corneal clouding. (Diagnosis of keratitis, iritis.)  He also developed a pustule on his left lower eyelid. Viroptic eye gtts (1 drop OS 9 times a day) was started that day. Left eye vision decreased to only able to count fingers at 6 feet left eye, per ophthalmology report.  Pred Forte 1% OS 6 times a day was started on 04/05/04.  Acyclovir was started by ophthalmology on 04/07/04 after ophthalmologist noted dendritic pattern on exam. Pre-VIG specimen from Left eye that was sent to lab: Vaccinia PCR and culture Positive. HSV culture sent to local lab:  Negative. Patient was discharged from hospital on 4/12/04.  Vision at that time was 20/100 Left eye/pin hole was 20/70.  He continues to be followed by family practice and ophthalmology.  Vision per report of Family Practice on 04/30/04 was 20/70 left eye, 20/20 right eye. He has returned to work full-duty but remains non-deployable.
Age: 22.0
Sex: M
Vaccine: HEP, HEP
Symptoms: Arterial thrombosis limb, Thrombosis
Clinical narrative: The morning after receiving a hepatitis B vaccine in left deltoid area, he developed upper and lower left arm swelling.  Venous duplex study confirmed brachial vein thrombosis.
Age: 22.0
Sex: M
Vaccine: HEP, HEP
Symptoms: Injection site oedema, Venous thrombosis
Clinical narrative: The morning after receiving a hepatitis B vaccine in left deltoid area, he developed upper and lower left arm swelling.  Venous duplex study confirmed brachial vein thrombosis.
Age: 2.0
Sex: M
Vaccine: DTAP, IPV, MMR, DTAP, IPV, MMR, DTAP, IPV, MMR
Symptoms: Autism
Clinical narrative: Information has been received regarding a case in litigation concerning a 32 month old male who on 07/25/01 was vaccinated with MMRII (Lot # not provided).  It was reported that the child was born on 01/04/00 and has been in the care and custody of his parents from birth to present.  He was born a perfectly normal, healthy baby boy.  Developmentally, neurologically and socially, he achieved every developmental milestone anticipated of all normally developing children.  On 03/17/00, at approximately two months of age, he received four vaccine injections, including: an inactivated poliovirus (IPV) vaccine; a haemophilus influenza type b (HIB) vaccine; a Hep B vaccine (manufacturer unknown); and acellular DTP shot (DTAP).  On 05/19/00, at approximately four months of age, he received four vaccine injections, including: an inactivated poliovirus (IPV) vaccine; a haemophilus influenza type b (HIB) vaccine; a Hep B vaccine (manufacturer unknown); and acellular DTP shot (DTAP).  On 07/25/01, at approximately 18 months of age, the child received three more vaccine injections, including an inactivated poliovirus (IPV) vaccine; acellular DTP shot (DTAP); and MMRII.  On 10/02/02 the pt was diagnosed with severe autism.  It was reported that, "Thimerosal used in vaccines and the MMR (measles, mumps, rubella) vaccine, individually and/or jointly combined caused (the child's) autism spectrum disorder.  Upon internal review, autism was considered to be an other important medical event (OMIC).  Additional information is expected.
Age: 2.0
Sex: F
Vaccine: MMR
Symptoms: Autism
Clinical narrative: Information has been received from the mother of a two year old female (date of birth was May, 1999) who in November 2000, was vaccinated with the first dose of MMRII.  In May, 2001 the pt was diagnosed with autism.  On 04/08/04, at the age of 4 years and 11 months, the pt was vaccinated with the second dose of MMRII (#646556/0813N).  Subsequently, the pt's mother stated that the "child is worse than before".  Upon medical review, autism was considered an other important medical event (OMIC). Additional information has been requested.
Age: 0.51
Sex: F
Vaccine: DTAP, HIBV, PNC
Symptoms: Convulsion, Erythema, Muscle twitching, Torticollis
Clinical narrative: Patient received immunizations at 9 AM. Given Tylenol and Dimetapp at noon. Child slept from 1 PM. At 5:00 PM, while child was in the jumper, the right side of her face and body became erythematous, head turned towards left and right side of body started to twitch with seizure like activity; lasted about 35 minutes. 911 was called after 5 minutes and taken to ER while still twitching. Given 2 injections and air lifted to hospital. Follow up: She should not receive immunization for pertussis in the future, even though we are not sure this caused the siezure. 7/28/04: pt seen in office this week. She has had 2 more seizures, 1 month apart both necessitated hospitalization in hospital. EG remains normal, but patient was placed on daily phenabarbitol. With appt this week, NP requested note from physician as to whether patient should received DTaP.
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMR
Symptoms: Conjunctivitis, Dysuria, Pharyngitis, Pyrexia, Rash morbilliform
Clinical narrative: 04/28/04: Dysuria, culture obtained, subsequently negative. 04/29/04: Fever 102.2, ill-appearing, morbilliform rash, pharyngitis, conjunctivitis, admitted to clinic to rule out Kawasaki Disease. Was seen by Infectious Disease specialist felt to be MMR reaction; symptoms resolved without treatment.  Nurse follow up on 05/17/04 states: "Add: Viral syndrome."
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMR
Symptoms: Vaccination complication, Vasculitis, Viral infection
Clinical narrative: 04/28/04: Dysuria, culture obtained, subsequently negative. 04/29/04: Fever 102.2, ill-appearing, morbilliform rash, pharyngitis, conjunctivitis, admitted to clinic to rule out Kawasaki Disease. Was seen by Infectious Disease specialist felt to be MMR reaction; symptoms resolved without treatment.  Nurse follow up on 05/17/04 states: "Add: Viral syndrome."
Sex: F
Vaccine: RAB, YF, RAB, YF
Symptoms: Difficulty in walking, Dizziness
Clinical narrative: Pt had IMMOVAX and Yellow Fever vaccine 1-23-2004. Next morning had episode of dizziness, difficulty walking. Over next 10 days had episode of dizziness 1-2x/day. Now resolved.
Sex: F
Vaccine: RAB, YF, RAB, YF
Symptoms: Difficulty in walking, Dizziness, Hypotension
Clinical narrative: Pt had IMMOVAX and Yellow Fever vaccine 1-23-2004. Next morning had episode of dizziness, difficulty walking. Over next 10 days had episode of dizziness 1-2x/day. Now resolved.
Age: 38.0
Sex: M
Vaccine: ANTH, MEN
Symptoms: Dermatitis, Rash maculo-papular
Clinical narrative: Following fourth anthrax shot, developed a nonpruritic maculopapular rash on neck around 12 days post vaccine. A dermatologist diagnosed as dermatitis and gave elodil cream. Following 5th shot anthrax 4/10/03 rash moved to involved face except scalp. Cream not resolving.
Age: 46.0
Sex: M
Vaccine: ANTH
Symptoms: Joint range of motion decreased, Oedema
Clinical narrative: Within 24 hours of second anthrax vaccination noted marked edema from site of injection down into wrist. Decreased ROM elbow and wrist. 10-14 day resolution. Treated with Motrin and cotaletin 250 mg po qid x 5 days.
Age: 1.0
Sex: F
Vaccine: DTAP, HIBV, MMR, VARCEL
Symptoms: Pyrexia, Rash
Clinical narrative: 1 yr old given DTaP, HIB, MMR and Varicella on 5-3-04. Mom reports slight temperature. Controlled with Tylenol on 5/5/04 had slight rash to  ABD 5/6/04. Gave Benadryl on 5/7/04 into clinic with increase in rash mostly on ABD+ back, some spots extremities-- increasing spots neck area.
Age: 29.0
Sex: F
Vaccine: HEP
Symptoms: Chills, Dyspnoea, Fatigue, Hyperhidrosis, Pruritus
Clinical narrative: Pt states shortly after leaving Dr and receiving Hep B, she felt really tired and went to sleep. Noted itching "all over" last night. Reports to Dr today c/o itching. Fine reddened papular rash noted on face. She also c/o sweating and chills this AM and some shortness of breath.
Age: 29.0
Sex: F
Vaccine: HEP
Symptoms: Rash papular, Somnolence
Clinical narrative: Pt states shortly after leaving Dr and receiving Hep B, she felt really tired and went to sleep. Noted itching "all over" last night. Reports to Dr today c/o itching. Fine reddened papular rash noted on face. She also c/o sweating and chills this AM and some shortness of breath.
Age: 42.0
Sex: F
Vaccine: HEPAB, TD, TYP
Symptoms: Abdominal pain, Hypoaesthesia, Muscular weakness, Paraesthesia
Clinical narrative: Had Td and Typhim V in left arm Thursday PM 3/4/04: arm sore. Tues, 3/8/04 client noticed that left arm was weak. Could not hold coffee cup- numb and tingling. Went to ER-- ruled out stroke, heart attack. PA aid it was a reaction to immunization. Pt states that gradually feeling strength came back to arm. Now only slight numbness. Left middle finger- strength good.
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMR
Symptoms: Erythema, Injection site warmth, Swelling
Clinical narrative: 4/14/04: Received vaccine. 4/15/04: LD swollen and red: hot to touch. 4/14: Recommended warm compresses previously when received vaccine if arm swelled. 4/15: Recommended to see NC or MD : and please let nurse at health department know what MD recommends.
Age: 9.0
Sex: F
Vaccine: HEP, IPV, MMR, TD, VARCEL
Symptoms: Abdominal pain upper, Cough, Lethargy, Pallor, Skin discolouration
Clinical narrative: After receiving immunizations, pt immediately developed fainting symptoms. Pale, faint, bluish face, lethargic acting, mild upset stomach / coughing up mucous.
Age: 9.0
Sex: F
Vaccine: HEP, IPV, MMR, TD, VARCEL
Symptoms: Syncope
Clinical narrative: After receiving immunizations, pt immediately developed fainting symptoms. Pale, faint, bluish face, lethargic acting, mild upset stomach / coughing up mucous.
Sex: M
Vaccine: PPV
Symptoms: Injection site erythema, Injection site swelling
Clinical narrative: Swelling and redness within hours of injection. Circumferential 10x15 cm region near injection site.
Age: 4.5
Sex: F
Vaccine: DTAP, IPV, MMR
Symptoms: Erythema
Clinical narrative: 2x2 inch erythematous area left thigh: compresses.
Age: 4.0
Sex: M
Vaccine: DTAP, IPV, MMR
Symptoms: Erythema, Feeling hot, Tenderness
Clinical narrative: Redness, hot sensation, soreness x 2 days. Recommended cold compresses and tylenol.
Age: 35.0
Sex: F
Vaccine: DT
Symptoms: Erythema, Swelling
Clinical narrative: Swelling, redness of the deltoid area. Left upper arm (1 inch diameter).
Age: 37.0
Sex: F
Vaccine: TD
Symptoms: Pyrexia
Clinical narrative: Fever , once daily, to 104x 30 days
Sex: U
Vaccine: DTAP, HEPA
Symptoms: Erythema, Feeling hot, Swelling
Clinical narrative: Pt got DTaP yesterday and Hep A today with left arm erythema and swelling at site. 4cmx5cm, warm. DTaP reaction reported. If worse tomorrow come to clinic. Rx: Administer ice. No more DTaP or hep A.
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMR
Symptoms: Erythema, Feeling hot, Swelling
Clinical narrative: Redness/ swelling warm to right deltoid area. Pt seen by doctor. Treated with Benadryl 12.5mg, tylenol 160 mg/ 5ml.
Age: 4.0
Sex: M
Vaccine: MMR, PNC, VARCEL
Symptoms: Drug ineffective, Viral infection
Clinical narrative: Chicken pox diagnosed on 5-6-04 by doctor.
Age: 4.0
Sex: M
Vaccine: DTAP, IPV
Symptoms: Inflammation, Injection site warmth, Urticaria
Clinical narrative: Large welt on left thigh: given sq IPV. Hot to touch. Inflammation.
Age: 4.0
Sex: F
Vaccine: DTAP, HEPA
Symptoms: Blister, Erythema, Injection site induration
Clinical narrative: 10cm oval of erythema, rock hard induration covered with firm tiny vesicles around 1mm in size with several (1/2 cm vesicles): did not break down with pressure.
Age: 5.0
Sex: M
Vaccine: DTAP, HEPA, IPV, MMR
Symptoms: Erythema, Injection site induration, Oedema, Pain
Clinical narrative: Pt experienced induration redness, edema left deltoid 1 day after receiving vaccine in left deltoid (DTaP). No anaphlaxis. No fever. Pain.
Age: 5.0
Sex: M
Vaccine: DTAP, IPV, MMR, VARCEL
Symptoms: Erythema, Feeling hot
Clinical narrative: 7cmx9cm red, slightly warm, but non-tender area all over left deltoid. No fluctrime. Afebrile. Marked area and recommended recheck in 24 hours.
Age: 48.0
Sex: F
Vaccine: TD
Symptoms: Chills, Fatigue, Headache, Injection site erythema, Injection site oedema
Clinical narrative: 04/02/04 @ 15:00: TD vaccine received.  Pt felt fine until 04/03/04 @ 19:00, had pain and swelling of upper arm and shoulder. Also, chills, fatigue, and light headache.  Pt took 1 Tylenol. 04/04/04 Noon: Itchiness, and redness of area started.  Pt took Tylenol once a day until now.
Age: 48.0
Sex: F
Vaccine: TD
Symptoms: Injection site pain, Pruritus
Clinical narrative: 04/02/04 @ 15:00: TD vaccine received.  Pt felt fine until 04/03/04 @ 19:00, had pain and swelling of upper arm and shoulder. Also, chills, fatigue, and light headache.  Pt took 1 Tylenol. 04/04/04 Noon: Itchiness, and redness of area started.  Pt took Tylenol once a day until now.
Age: 75.0
Sex: F
Vaccine: PPV
Symptoms: Injection site erythema, Injection site oedema, Injection site pain, Injection site warmth, Insomnia
Clinical narrative: Erytyemic reaction to Pneumovax-extensive swelling entire deltoid area with erythema and heat palpate.  Complained of pain entire upper arm/shoulder and axilla.  Applied ice at home unable to sleep last PM. Benadryl 25mg given and advised to take it every 8 hours for 48 hours.  Apply ice as much as possible and office visit any worsening. Consider abscess formation if progression.
Age: 12.0
Sex: F
Vaccine: HEP
Symptoms: Syncope
Clinical narrative: Hepatitis B vaccine 2 episodes of syncope after following Hep B Immunization (1st episode, 03/19/04).
Age: 6.0
Sex: M
Vaccine: DTAP, HEPA
Symptoms: Erythema, Oedema, Urticaria
Clinical narrative: Localized swelling/redness/hives per mother of child support.
Age: 0.6
Sex: M
Vaccine: DTAP, HIBV, PNC
Symptoms: Pyrexia
Clinical narrative: High fever (103.5) starting 7 hours after vaccine.
Sex: F
Vaccine: VARCEL
Symptoms: Injection site erythema, Injection site swelling, Pruritus
Clinical narrative: On 04/27 Varicella Vaccine given left thigh SC on 05/08/04, mom noticed 1/2 dollar size red, raised area with itching.  On 05/11/04 mom called UMA with report of quarter size red area with improvement noted. No other problems identified. Benadryl cream applied.
Age: 6.0
Sex: M
Vaccine: VARCEL
Symptoms: Injection site erythema, Injection site oedema
Clinical narrative: Localized redness and swelling deltoid area.
Age: 1.0
Sex: F
Vaccine: HBHEPB, MMR
Symptoms: Urticaria
Clinical narrative: Hives on torso 05/12/04 evening. Spread to arms/legs.  No angioedema/stridor/zep or neuro compresses noted.
Age: 4.0
Sex: F
Vaccine: IPV, MMR
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth
Clinical narrative: 3 inch diameter local red, raised, warm reaction.
Age: 4.0
Sex: M
Vaccine: IPV, MMR
Symptoms: Injection site erythema, Injection site oedema, Injection site pain, Injection site warmth, Pruritus
Clinical narrative: Redness and swollen on injection area. Also itchiness and warm to the touch.  Approximately 6x7 inches.  Pt had pain for 3 days.
Age: 5.0
Sex: F
Vaccine: HEPA, IPV, MMR
Symptoms: Injection site erythema, Injection site oedema, Injection site pain, Injection site warmth, Pruritus
Clinical narrative: Redness and swollen on injection area.  Also, itchiness and warm to the touch.  Pt had pain for 2 days.
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMR
Symptoms: Erythema, Face oedema, Nausea, Rash, Vomiting
Clinical narrative: Mom stated that around noon on 05/11/04, pt complained of feeling nauseous and then vomited.  Mom states several hours later she noticed a fire red rash on pt's legs (5-6pm).  Mom states about 8pm they took pt to medical center ER because by then the pt's eyes, cheeks, and ears had swelled up.  The ER doctor diagnosed pt with an allergic reaction and gave pt Benadryl and Liquid steroids.  Mom reports when she called me on 05/12/04 that decreased swelling, decreased rash, pt much better the next day.  ER doctor could not confirm that this event was related to the vaccinations.
Age: 1.0
Sex: F
Vaccine: DTAP, HIBV
Symptoms: Injection site erythema, Irritability, Pyrexia
Clinical narrative: 11PM the night of immunizations given-mom noticed a large red area around the injection site.  L/g fever, slightly fussy, no other symptoms, an area was larger, came to MD office.
Age: 48.0
Sex: F
Vaccine: YF
Symptoms: Arthralgia, Influenza like illness, Injection site erythema, Injection site oedema, Malaise
Clinical narrative: Pc from pt started Saut 05/01/04 (left) upper arm red, swollen, flu-like symptoms, achiness, joint pain, malaise, did not work Mon and Tues. Working today, much better exept still having joint pain.  05/07/04: Pt back to normal self.
Age: 48.0
Sex: F
Vaccine: YF
Symptoms: Pain
Clinical narrative: Pc from pt started Saut 05/01/04 (left) upper arm red, swollen, flu-like symptoms, achiness, joint pain, malaise, did not work Mon and Tues. Working today, much better exept still having joint pain.  05/07/04: Pt back to normal self.
Age: 4.0
Sex: M
Vaccine: DTAP, IPV
Symptoms: Feeling hot, Hyperhidrosis, Injection site erythema, Pruritus, Swelling
Clinical narrative: Client in today with Grandmother for swelling lt Deltoid.  Warm to touch and facila sweating no fever reported.  Symptoms started  5/5/04 at 9am redness to site itching
Age: 36.0
Sex: M
Vaccine: ANTH
Symptoms: Headache, Hypokinesia, Injection site mass, Injection site pain, Pain
Clinical narrative: This is a 36-year-old patient who received his first anthrax vaccination on April 17, 2003. On that day he also had a PPD placed. He reports that experienced immediate burning at the site but this soon resolved. He also developed a small lump at the site as well as an aching sensation. These symptoms continued for several weeks. When he received his second anthrax vaccination on July 7, 2003, he reports that he had identical symptoms, immediate burning that quickly resolved, a lump and an aching sensation that lasted for at least three weeks. Upon receiving his third anthrax vaccination, on July 23, 2003, the lump at the site remained for about 3 weeks again. Again, the ache in his upper arm developed; however, this time it persisted. He reports that both arms have a persistent dull ache on a daily basis that he rates a 2/10 in intensity. At times the sensation is throbbing. The sensation is greater in the right arm and at times wakes him from sleep. When he lifts objects over his head, this intensity increases to 6-7/10, quickly resolving when the lifting is stopped. He denies any weakness in his arms.  He also experienced a headache following each anthrax vaccination, however, denies that these were particularly bothersome. He did not use medications for relief of these symptoms.
Age: 36.0
Sex: M
Vaccine: ANTH
Symptoms: Sleep disorder, Thermal burn
Clinical narrative: This is a 36-year-old patient who received his first anthrax vaccination on April 17, 2003. On that day he also had a PPD placed. He reports that experienced immediate burning at the site but this soon resolved. He also developed a small lump at the site as well as an aching sensation. These symptoms continued for several weeks. When he received his second anthrax vaccination on July 7, 2003, he reports that he had identical symptoms, immediate burning that quickly resolved, a lump and an aching sensation that lasted for at least three weeks. Upon receiving his third anthrax vaccination, on July 23, 2003, the lump at the site remained for about 3 weeks again. Again, the ache in his upper arm developed; however, this time it persisted. He reports that both arms have a persistent dull ache on a daily basis that he rates a 2/10 in intensity. At times the sensation is throbbing. The sensation is greater in the right arm and at times wakes him from sleep. When he lifts objects over his head, this intensity increases to 6-7/10, quickly resolving when the lifting is stopped. He denies any weakness in his arms.  He also experienced a headache following each anthrax vaccination, however, denies that these were particularly bothersome. He did not use medications for relief of these symptoms.