chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Sex: U
Vaccine: PNC
Symptoms: Bacterial infection, Drug ineffective, Immune system disorder, Sepsis
Clinical narrative: This case was considered medically important (OMIC). Information regarding Prevenar (pneumococcal 7-valent conjugate vaccine (diphtheria crm197 protein) injection) was received from a healthcare professional regarding a pt who experienced a streptococcal septicemia infection and developed a response to only 3 or 4 of the serotypes. The pt received the fourth dose on an unspecified date. Relevant medical history was not provided. Indication for Prevnar was immunisation. Product was administered on an unspecified date. Dose regimen was 1 dose 1 time per day IM. Concomitant medication were not reported. A physician reported that the pt received all 4 doses of Prevnar and developed a streptococcal septicemia infection (pneumococcal sepsis) (drug ineffective). Date were not provided. Antibody level testing determined that the child developed a response to only 3 or 4 of the unspecified serotypes but not to those remaining (decreased immune responsiveness). Pt recovery status is unknown.
Age: 34.0
Sex: F
Vaccine: MMR
Symptoms: Acute respiratory distress syndrome, Drug ineffective, Hypoxia, Laboratory test abnormal, Pneumonia
Clinical narrative: It was reported in published articles, titles as stated above that a 34 year old female phlebotomist, with a history of smoking and no other co existing conditions, who at 12 months of age was vaccianted with a dose of MMR II. It was reported that the pt experienced vaccine failure and was hospitalized for severe measles. Serum drawn four days after the onset of the rash was positive for anti measles IgM and IgG, Her direct source of exposure could not be identified, but she worked at the hospital where two measles pts had been treated. It was noted that it could not determined whether the case represented a primary vaccine failure ( a failure of the vaccine to induce immunity) or a secondary vaccine failure (the result of wandering immunity). It was noted that the severity of the case suggested the former, since secondary vaccine failures tended to produce mild disease. It was reported that the pt required six days of ventilator support for pneumonia complicated by the acute respiratory distress syndrome. Additional information has been requested.
Age: 34.0
Sex: F
Vaccine: MMR
Symptoms: Rash morbilliform, Viral infection
Clinical narrative: It was reported in published articles, titles as stated above that a 34 year old female phlebotomist, with a history of smoking and no other co existing conditions, who at 12 months of age was vaccianted with a dose of MMR II. It was reported that the pt experienced vaccine failure and was hospitalized for severe measles. Serum drawn four days after the onset of the rash was positive for anti measles IgM and IgG, Her direct source of exposure could not be identified, but she worked at the hospital where two measles pts had been treated. It was noted that it could not determined whether the case represented a primary vaccine failure ( a failure of the vaccine to induce immunity) or a secondary vaccine failure (the result of wandering immunity). It was noted that the severity of the case suggested the former, since secondary vaccine failures tended to produce mild disease. It was reported that the pt required six days of ventilator support for pneumonia complicated by the acute respiratory distress syndrome. Additional information has been requested.
Age: 71.0
Sex: M
Vaccine: VARZOS
Symptoms: Dyspnoea, Heart rate increased, Nervousness, Tachycardia
Clinical narrative: Information has been received from a 71 year old retired physician with no known allergies and hypercholesterolaemia who on 7/11/06 was vaccinated in the left arm with a dose of varicella zoster virus vaccine live. Concomitant therapy included ezetimibe. A couple weeks after vaccination on 7/27/06, the pt experienced tachycardia that was persisted. He was seen by a two cardiologists and had an echocardiogram done which did not show anything. Two EKGs were done and his HR was 110-120. He also reported that he was having a little shortness of breath occasionally,but didn't think, it was related to vaccination. He did not have any other cardiovascular problems. The physician reported his sustained tachycardia to be potentially life threatening and disabling because he wasn't sure if his tachycardia was self limiting and temporary or would cause additional problems. He reported that he was nervous when his HR was high for 2-3 weeks. His cardiologist recommended unspecified medication, however the physician refused to take any medication. As of 8/10/06 the physician reported that his heartrate was gradually slowing down, it was 90-100 which was better than before but still not back to normal. Four months prior to vaccination the pt scheduled knee surgery for 8/22/06. He explained that he would proceed with the surgery as long as his heart rate was back to normal. Additional information has been requested.
Age: 11.0
Sex: F
Vaccine: HEP, TDAP
Symptoms: Coordination abnormal, Dizziness, Encephalopathy, Fatigue, Incoherent
Clinical narrative: Seen by PCP, Peds MD on 8/4/06. Was well at visit and received HepB and DTaP. Later that night, developed nausea and vomiting and fatigue. Lethargy and altered mental status persisted and she developed ataxia and dizziness along with incoherent and inappropriate speech. Went to ER and admitted with encephalopathy on 8/6 and discharged home 8/10/06. Signs and symptoms persisted until 8/9.
Age: 11.0
Sex: F
Vaccine: HEP, TDAP
Symptoms: Lethargy, Nausea, Sopor, Vomiting
Clinical narrative: Seen by PCP, Peds MD on 8/4/06. Was well at visit and received HepB and DTaP. Later that night, developed nausea and vomiting and fatigue. Lethargy and altered mental status persisted and she developed ataxia and dizziness along with incoherent and inappropriate speech. Went to ER and admitted with encephalopathy on 8/6 and discharged home 8/10/06. Signs and symptoms persisted until 8/9.
Age: 25.0
Sex: F
Vaccine: VARCEL
Symptoms: Diarrhoea, Dizziness, Feeling cold, Hot flush, Hyperhidrosis
Clinical narrative: Pneumonia, Spleen infection, enlarged spleen, diarrhea, hot/cold sweat, runny nose, dizziness. ER records for DOS 7/20/06: DC DX: flank pain, early pneumonia. Continued to have the small area of inflammation and stranding in the tip of the spleen but there was no surrounding involvement of colon. DC home.
Age: 25.0
Sex: F
Vaccine: VARCEL
Symptoms: Infection, Pneumonia, Rhinorrhoea, Spleen disorder, Splenomegaly
Clinical narrative: Pneumonia, Spleen infection, enlarged spleen, diarrhea, hot/cold sweat, runny nose, dizziness. ER records for DOS 7/20/06: DC DX: flank pain, early pneumonia. Continued to have the small area of inflammation and stranding in the tip of the spleen but there was no surrounding involvement of colon. DC home.
Age: 50.0
Sex: M
Vaccine: ANTH, MEN, SMALL, TYP, YF
Symptoms: Arthralgia, Asthenia, Blood cholesterol increased, Cardiac disorder, Cardiomyopathy
Clinical narrative: Chest pain, high blood pressure, palpitations, fatigue, weakness, heart arrythm, Joint pain, muscular pain, hearing loss, visual disturbances, high cholesterol. Listed diagnoses are chronic tobacco abuse, Alcohol abuse, cardiomyopathy, Diabetes Mellitis, and depression.
Age: 50.0
Sex: M
Vaccine: ANTH, MEN, SMALL, TYP, YF
Symptoms: Chest pain, Depression, Diabetes mellitus, Fatigue, Hypertension
Clinical narrative: Chest pain, high blood pressure, palpitations, fatigue, weakness, heart arrythm, Joint pain, muscular pain, hearing loss, visual disturbances, high cholesterol. Listed diagnoses are chronic tobacco abuse, Alcohol abuse, cardiomyopathy, Diabetes Mellitis, and depression.
Age: 50.0
Sex: M
Vaccine: ANTH, MEN, SMALL, TYP, YF
Symptoms: Hypoacusis, Myalgia, Palpitations, Visual disturbance
Clinical narrative: Chest pain, high blood pressure, palpitations, fatigue, weakness, heart arrythm, Joint pain, muscular pain, hearing loss, visual disturbances, high cholesterol. Listed diagnoses are chronic tobacco abuse, Alcohol abuse, cardiomyopathy, Diabetes Mellitis, and depression.
Age: 10.0
Sex: F
Vaccine: HEPA
Symptoms: Abdominal pain, Alanine aminotransferase increased, Aspartate aminotransferase increased, Diarrhoea, Haematochezia
Clinical narrative: Pt vomited shortly after hepatitis A vaccine then developed intermittent crampy abdominal pain, with transient heme positive stools and elevated LFT's. DC DX: Viral Hepatitis/Diarrhea Seen several years ago with chronic intermittent abdominal pain, questionable functional abdominal pain syndrome v. abdominal migraine. Chronic abdominal pain, mild non-localized peri-umbilical, some anxiety relation, ex: had before therapy visit Wednesday and before this visit this am. Also intermittent severe abdominal pain, screens, rolls on floor, often relieved by bowel movements. no distention, vomiting, hard abdomen, clear obstructive symptoms; did happen after peanut/pad Thai meal. Some headache diarrhea with eating, 1 test positive C diff, diarrhea with mucus, little blood; fever resolved spontaneous, subsequently treated with Flagyl. Weight loss concerning lost 5# but has regained 2-3#., appetite never high but baseline again, bowel movements in general daily, no chronic constipation, hard strain, wide, pain, blood no chronic diarrhea. Always thin. Note given Hep A vaccine prior to illness, Impression: C. diff, diarrhea, ALT all resolved but some concern poor weight gain and acute abdominal pain episodes on top mild chronic abdominal pain. IBS may be significant component also abdominal migraine component, questionable possible Crohn's disease is concern with Omp-C Ab positive. Family HX of GI problems.
Age: 10.0
Sex: F
Vaccine: HEPA
Symptoms: Hepatitis, Laboratory test abnormal, Liver function test abnormal, Red blood cell sedimentation rate increased, Vomiting
Clinical narrative: Pt vomited shortly after hepatitis A vaccine then developed intermittent crampy abdominal pain, with transient heme positive stools and elevated LFT's. DC DX: Viral Hepatitis/Diarrhea Seen several years ago with chronic intermittent abdominal pain, questionable functional abdominal pain syndrome v. abdominal migraine. Chronic abdominal pain, mild non-localized peri-umbilical, some anxiety relation, ex: had before therapy visit Wednesday and before this visit this am. Also intermittent severe abdominal pain, screens, rolls on floor, often relieved by bowel movements. no distention, vomiting, hard abdomen, clear obstructive symptoms; did happen after peanut/pad Thai meal. Some headache diarrhea with eating, 1 test positive C diff, diarrhea with mucus, little blood; fever resolved spontaneous, subsequently treated with Flagyl. Weight loss concerning lost 5# but has regained 2-3#., appetite never high but baseline again, bowel movements in general daily, no chronic constipation, hard strain, wide, pain, blood no chronic diarrhea. Always thin. Note given Hep A vaccine prior to illness, Impression: C. diff, diarrhea, ALT all resolved but some concern poor weight gain and acute abdominal pain episodes on top mild chronic abdominal pain. IBS may be significant component also abdominal migraine component, questionable possible Crohn's disease is concern with Omp-C Ab positive. Family HX of GI problems.
Age: 24.0
Sex: F
Vaccine: ANTH, MEN
Symptoms: Antineutrophil cytoplasmic antibody, Antinuclear antibody, Blood thyroid stimulating hormone, C-reactive protein, DNA antibody
Clinical narrative: She received her fifth anthrax vaccine, along with meningococcal vaccine on 10/04/04. She does not recall any significant local reaction or prolonged or debilitating systemic symptoms following vaccine receipt. She began experiencing left foot pain in early Feb 2005, She was first seen in military hospital. Medical notation of splint applied on right lower extremity between 2/2/05 and 2/14/05 fro suspected right foot stress fracture. Note from 2/16/05 with CC right calf pain since 2/12 was followed by an ultrasound to rule out DVT. Service member was admitted on 2/17/05 for right lower extremity DVT and was started on Lovenox and Coumadin. On 2/2205, she was med evac'd to hospital with diagnosis of right popliteal vein deep venous thrombosis confirmed by Doppler study on 2/17. At that time, she was taking Coumadin as directed. On 2/23/05, she was cleared for duty through Internal Medicine on Lovenox and Coumadin. She then transferred on 3/4/05. On 3/14/05 she was tested through the clinic and findings were positive for factor V leiden mutation (heterozygous disorder, but service member did not received results until Oct 2005. She also reports being told she has anti thrombin 3 deficiency, but there are no lab reports in the medical records available. Service member was a light smoker at the time she developed DVT. She had stopped her BCPs in Feb 2004. GYN noted from 8/04 notes birth control abstinence. With her initial presentation of right calf pain, she did not experienced any chest pain, fever, shortness of breath, or hemoptysis. She had no previous history of deep vein thrombosis or pulmonary embolus and denies any family history of thrombosis. Note in chart mentions possible family history of hypercoagulable disorder. Symptom Pain start 2/2004 comment right foot pain. Follow-up: Patient became pregnant before being separated from the military. She was placed on subcutaneous heparin throughout her pregnancy. She delivered a 6 pounds 8 ounce baby boy on 2/20/07 at 37 weeks 2 days. Initial APGAR was 8 at one minute and 9 at 5 minutes. On February 21st the infant began experiencing respiratory difficulties and was transferred to medical center where he expired later that day. Final diagnoses: sepsis, distributive septic shock, pulmonary hypertension, respiratory distress, and metabolic acidosis. Culture from patient on admission was positive for Group B strep.
Age: 24.0
Sex: F
Vaccine: ANTH, MEN
Symptoms: Deep vein thrombosis, Electrocardiogram normal, Fracture, Full blood count, Hypercoagulation
Clinical narrative: She received her fifth anthrax vaccine, along with meningococcal vaccine on 10/04/04. She does not recall any significant local reaction or prolonged or debilitating systemic symptoms following vaccine receipt. She began experiencing left foot pain in early Feb 2005, She was first seen in military hospital. Medical notation of splint applied on right lower extremity between 2/2/05 and 2/14/05 fro suspected right foot stress fracture. Note from 2/16/05 with CC right calf pain since 2/12 was followed by an ultrasound to rule out DVT. Service member was admitted on 2/17/05 for right lower extremity DVT and was started on Lovenox and Coumadin. On 2/2205, she was med evac'd to hospital with diagnosis of right popliteal vein deep venous thrombosis confirmed by Doppler study on 2/17. At that time, she was taking Coumadin as directed. On 2/23/05, she was cleared for duty through Internal Medicine on Lovenox and Coumadin. She then transferred on 3/4/05. On 3/14/05 she was tested through the clinic and findings were positive for factor V leiden mutation (heterozygous disorder, but service member did not received results until Oct 2005. She also reports being told she has anti thrombin 3 deficiency, but there are no lab reports in the medical records available. Service member was a light smoker at the time she developed DVT. She had stopped her BCPs in Feb 2004. GYN noted from 8/04 notes birth control abstinence. With her initial presentation of right calf pain, she did not experienced any chest pain, fever, shortness of breath, or hemoptysis. She had no previous history of deep vein thrombosis or pulmonary embolus and denies any family history of thrombosis. Note in chart mentions possible family history of hypercoagulable disorder. Symptom Pain start 2/2004 comment right foot pain. Follow-up: Patient became pregnant before being separated from the military. She was placed on subcutaneous heparin throughout her pregnancy. She delivered a 6 pounds 8 ounce baby boy on 2/20/07 at 37 weeks 2 days. Initial APGAR was 8 at one minute and 9 at 5 minutes. On February 21st the infant began experiencing respiratory difficulties and was transferred to medical center where he expired later that day. Final diagnoses: sepsis, distributive septic shock, pulmonary hypertension, respiratory distress, and metabolic acidosis. Culture from patient on admission was positive for Group B strep.
Age: 24.0
Sex: F
Vaccine: ANTH, MEN
Symptoms: Laboratory test abnormal, Laboratory test normal, Metabolic acidosis, Pain in extremity, Pain in extremity
Clinical narrative: She received her fifth anthrax vaccine, along with meningococcal vaccine on 10/04/04. She does not recall any significant local reaction or prolonged or debilitating systemic symptoms following vaccine receipt. She began experiencing left foot pain in early Feb 2005, She was first seen in military hospital. Medical notation of splint applied on right lower extremity between 2/2/05 and 2/14/05 fro suspected right foot stress fracture. Note from 2/16/05 with CC right calf pain since 2/12 was followed by an ultrasound to rule out DVT. Service member was admitted on 2/17/05 for right lower extremity DVT and was started on Lovenox and Coumadin. On 2/2205, she was med evac'd to hospital with diagnosis of right popliteal vein deep venous thrombosis confirmed by Doppler study on 2/17. At that time, she was taking Coumadin as directed. On 2/23/05, she was cleared for duty through Internal Medicine on Lovenox and Coumadin. She then transferred on 3/4/05. On 3/14/05 she was tested through the clinic and findings were positive for factor V leiden mutation (heterozygous disorder, but service member did not received results until Oct 2005. She also reports being told she has anti thrombin 3 deficiency, but there are no lab reports in the medical records available. Service member was a light smoker at the time she developed DVT. She had stopped her BCPs in Feb 2004. GYN noted from 8/04 notes birth control abstinence. With her initial presentation of right calf pain, she did not experienced any chest pain, fever, shortness of breath, or hemoptysis. She had no previous history of deep vein thrombosis or pulmonary embolus and denies any family history of thrombosis. Note in chart mentions possible family history of hypercoagulable disorder. Symptom Pain start 2/2004 comment right foot pain. Follow-up: Patient became pregnant before being separated from the military. She was placed on subcutaneous heparin throughout her pregnancy. She delivered a 6 pounds 8 ounce baby boy on 2/20/07 at 37 weeks 2 days. Initial APGAR was 8 at one minute and 9 at 5 minutes. On February 21st the infant began experiencing respiratory difficulties and was transferred to medical center where he expired later that day. Final diagnoses: sepsis, distributive septic shock, pulmonary hypertension, respiratory distress, and metabolic acidosis. Culture from patient on admission was positive for Group B strep.
Age: 24.0
Sex: F
Vaccine: ANTH, MEN
Symptoms: Pulmonary hypertension, Respiratory distress, Sepsis, Septic shock, Streptococcus test positive
Clinical narrative: She received her fifth anthrax vaccine, along with meningococcal vaccine on 10/04/04. She does not recall any significant local reaction or prolonged or debilitating systemic symptoms following vaccine receipt. She began experiencing left foot pain in early Feb 2005, She was first seen in military hospital. Medical notation of splint applied on right lower extremity between 2/2/05 and 2/14/05 fro suspected right foot stress fracture. Note from 2/16/05 with CC right calf pain since 2/12 was followed by an ultrasound to rule out DVT. Service member was admitted on 2/17/05 for right lower extremity DVT and was started on Lovenox and Coumadin. On 2/2205, she was med evac'd to hospital with diagnosis of right popliteal vein deep venous thrombosis confirmed by Doppler study on 2/17. At that time, she was taking Coumadin as directed. On 2/23/05, she was cleared for duty through Internal Medicine on Lovenox and Coumadin. She then transferred on 3/4/05. On 3/14/05 she was tested through the clinic and findings were positive for factor V leiden mutation (heterozygous disorder, but service member did not received results until Oct 2005. She also reports being told she has anti thrombin 3 deficiency, but there are no lab reports in the medical records available. Service member was a light smoker at the time she developed DVT. She had stopped her BCPs in Feb 2004. GYN noted from 8/04 notes birth control abstinence. With her initial presentation of right calf pain, she did not experienced any chest pain, fever, shortness of breath, or hemoptysis. She had no previous history of deep vein thrombosis or pulmonary embolus and denies any family history of thrombosis. Note in chart mentions possible family history of hypercoagulable disorder. Symptom Pain start 2/2004 comment right foot pain. Follow-up: Patient became pregnant before being separated from the military. She was placed on subcutaneous heparin throughout her pregnancy. She delivered a 6 pounds 8 ounce baby boy on 2/20/07 at 37 weeks 2 days. Initial APGAR was 8 at one minute and 9 at 5 minutes. On February 21st the infant began experiencing respiratory difficulties and was transferred to medical center where he expired later that day. Final diagnoses: sepsis, distributive septic shock, pulmonary hypertension, respiratory distress, and metabolic acidosis. Culture from patient on admission was positive for Group B strep.
Age: 24.0
Sex: F
Vaccine: ANTH, MEN
Symptoms: Ultrasound Doppler abnormal
Clinical narrative: She received her fifth anthrax vaccine, along with meningococcal vaccine on 10/04/04. She does not recall any significant local reaction or prolonged or debilitating systemic symptoms following vaccine receipt. She began experiencing left foot pain in early Feb 2005, She was first seen in military hospital. Medical notation of splint applied on right lower extremity between 2/2/05 and 2/14/05 fro suspected right foot stress fracture. Note from 2/16/05 with CC right calf pain since 2/12 was followed by an ultrasound to rule out DVT. Service member was admitted on 2/17/05 for right lower extremity DVT and was started on Lovenox and Coumadin. On 2/2205, she was med evac'd to hospital with diagnosis of right popliteal vein deep venous thrombosis confirmed by Doppler study on 2/17. At that time, she was taking Coumadin as directed. On 2/23/05, she was cleared for duty through Internal Medicine on Lovenox and Coumadin. She then transferred on 3/4/05. On 3/14/05 she was tested through the clinic and findings were positive for factor V leiden mutation (heterozygous disorder, but service member did not received results until Oct 2005. She also reports being told she has anti thrombin 3 deficiency, but there are no lab reports in the medical records available. Service member was a light smoker at the time she developed DVT. She had stopped her BCPs in Feb 2004. GYN noted from 8/04 notes birth control abstinence. With her initial presentation of right calf pain, she did not experienced any chest pain, fever, shortness of breath, or hemoptysis. She had no previous history of deep vein thrombosis or pulmonary embolus and denies any family history of thrombosis. Note in chart mentions possible family history of hypercoagulable disorder. Symptom Pain start 2/2004 comment right foot pain. Follow-up: Patient became pregnant before being separated from the military. She was placed on subcutaneous heparin throughout her pregnancy. She delivered a 6 pounds 8 ounce baby boy on 2/20/07 at 37 weeks 2 days. Initial APGAR was 8 at one minute and 9 at 5 minutes. On February 21st the infant began experiencing respiratory difficulties and was transferred to medical center where he expired later that day. Final diagnoses: sepsis, distributive septic shock, pulmonary hypertension, respiratory distress, and metabolic acidosis. Culture from patient on admission was positive for Group B strep.
Age: 18.0
Sex: F
Vaccine: HEPA, MNQ
Symptoms: Injection site pain, Injection site swelling, Nausea
Clinical narrative: Pt felt nausea, soreness in right arm and later had swelling in right arm, was taken to ER and told to use warm compresses.
Age: 1.0
Sex: F
Vaccine: DTAP, HEPA, HIBV, MMR, PNC
Symptoms: Rash, Urticaria
Clinical narrative: 1 yr old received vaccines listed below. Mother and child returned to clinic 2 hrs post vaccination. Child presents with wheals on legs and arms and generalized rash on abdomen. Dr notified and child given oral Benadryl (12.5mg) at 2:20PM. Parent given written instructions to continue oral Benadryl for 24 hrs post vaccination. Child wt 29lbs. Telephone call today to parent. Pt recovered. Rash and wheals subsided. Child eating and drinking. No fever, fully recovered. Mother instructed to pre-medicate child prior to next vaccinations. Give Benadryl 30 min to 1 hr prior to vaccinations.
Age: 11.0
Sex: F
Vaccine: TDAP
Symptoms: Influenza like illness, Injection site erythema, Injection site swelling, Myalgia, Pyrexia
Clinical narrative: 8/9/06 child received Tdap L deltoid. On 8/10/06 had flu like symptoms, aching all over, fever (low grade, mom did not take). L deltoid region swollen about size of tennis ball. Tylenol, compresses and Benadryl given. Today 8/14/06 swelling and redness now under left arm, very tender.
Age: 11.0
Sex: F
Vaccine: TDAP
Symptoms: Tenderness
Clinical narrative: 8/9/06 child received Tdap L deltoid. On 8/10/06 had flu like symptoms, aching all over, fever (low grade, mom did not take). L deltoid region swollen about size of tennis ball. Tylenol, compresses and Benadryl given. Today 8/14/06 swelling and redness now under left arm, very tender.
Age: 5.0
Sex: M
Vaccine: MMR, TDAP
Symptoms: Feeling hot, Injection site erythema, Injection site swelling
Clinical narrative: Redness, warmth, swelling.
Age: 19.0
Sex: M
Vaccine: HEP, MNQ
Symptoms: Medication error
Clinical narrative: Pt in clinic for Hep B #2. Parent asked if any other immunizations were needed before college. Meningococcal was offered and discussed. Immunization was requested and given on 8/08/06 it was discovered he had received meningococcal on 7/25/06.
Age: 14.0
Sex: M
Vaccine: MNQ, TDAP
Symptoms: Injection site erythema, Injection site swelling, Pruritus, Pyrexia
Clinical narrative: Fever up to 103.5 8/4/06 through 8/6/06. Redness, itching and swelling left upper arm. Area of redness measured 9.0cm x 17.2cm on 8/7/06.
Age: 18.0
Sex: M
Vaccine: TDAP
Symptoms: Bursitis, Injection site pain, Tendonitis
Clinical narrative: Pain in right arm, onset after injection persisting to time of report, sports medicine consult pending.
Age: 12.0
Sex: F
Vaccine: TDAP
Symptoms: Abdominal pain upper, Nausea, Pyrexia
Clinical narrative: Nausea, stomach ache, fever to 102.
Age: 49.0
Sex: F
Vaccine: MNQ
Symptoms: Dizziness, Headache, Myalgia, Pyrexia
Clinical narrative: Patient awakened 08/03/2006 approximately 12:00 am with fever, headache, myalgias, dizziness.  Presented to clinic on 08/03/2006 at 2:00 pm with continued symptoms.  Patient evaluated for other etiology and sent home, advised symptomatic treatment.  Patient called next day-reported feeling much improved.
Age: 31.0
Sex: M
Vaccine: TDAP
Symptoms: Erythema
Clinical narrative: Reddened swollen left deltoid 4" diameter. (Patient thinks he might have had tetanus immunization 6 years ago, has no documentation.
Age: 5.0
Sex: M
Vaccine: DTAP, IPV, MMRV
Symptoms: Cellulitis, Erythema, Injection site inflammation, Injection site warmth, Pain
Clinical narrative: Right leg warm, red, and inflamed.  Temperature 99.9.  Mom states decrease on activity.  Complain of pain.  Diagnosed with cellulitis. Treated with Duricef 500/5 3 cc twice a day.  Area 8 by 6 centimeter.
Age: 5.0
Sex: M
Vaccine: DTAP, IPV, MMRV
Symptoms: Pyrexia
Clinical narrative: Right leg warm, red, and inflamed.  Temperature 99.9.  Mom states decrease on activity.  Complain of pain.  Diagnosed with cellulitis. Treated with Duricef 500/5 3 cc twice a day.  Area 8 by 6 centimeter.
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMRV
Symptoms: Urticaria
Clinical narrative: 08/03/2006 Phone call from mom stating welt on right thigh size of fifty cent piece.  08/04/2006 area on right thigh welt size of mom's hand.  Ibuprofen, if not helping by 08-05-2006 start Cephalexin.  08/05/2006 Cephalexin started.
Age: 12.0
Sex: F
Vaccine: TDAP
Symptoms: Anorexia, Headache, Pyrexia
Clinical narrative: Headache, fever 101-102 within 24 hours of administration, loss of appetite, no vomiting, no cough.
Age: 58.0
Sex: F
Vaccine: ANTH
Symptoms: Unevaluable event
Clinical narrative: None stated
Age: 16.0
Sex: M
Vaccine: TDAP
Symptoms: Dizziness, Headache, Loss of consciousness
Clinical narrative: Patient complains of bad headache, lightheaded, dizzy, blackout spell
Age: 12.0
Sex: M
Vaccine: TDAP
Symptoms: Abdominal pain upper, Diarrhoea, Headache, Myalgia, Vomiting
Clinical narrative: Soreness all over, headache, legs hurt, stomach ache, vomiting, diarrhea
Age: 3.0
Sex: M
Vaccine: DTAPHEPBIP, HIBV, PNC
Symptoms: Erythema, Swelling
Clinical narrative: Shoddier left inguinal nodes, swollen left thigh, mild erythema inner aspect, no induration at injection site.
Age: 7.0
Sex: M
Vaccine: VARCEL
Symptoms: Erythema, Injection site warmth, Swelling
Clinical narrative: Redness, swelling, warm to touch.  Outer margin of induration is 50 centimeter, inner margin is 32 centimeter in diameter.  Tender to touch as well.
Age: 5.0
Sex: F
Vaccine: DTAP, IPV, MMR
Symptoms: Feeling hot, Injection site erythema, Injection site oedema
Clinical narrative: L forearm red, edematous and warm to touch from 2" below shoulder to elbow.
Age: 6.0
Sex: M
Vaccine: DTAP, IPV, MMR
Symptoms: Feeling hot, Injection site erythema, Injection site oedema
Clinical narrative: 24hrs after immunizations r deltoid area from shoulder to elbow red, edematous and warm to touch.
Age: 4.0
Sex: M
Vaccine: DTAP, IPV, MMR
Symptoms: Feeling hot, Injection site erythema, Injection site mass, Injection site pain, Injection site swelling
Clinical narrative: Mother reports that within 2 hrs of vaccine injection pt develops erythema, swelling and pain. On exam, left anterior thigh area was indurated, warm, hot and tender and erythema 10cm diameter
Age: 9.0
Sex: M
Vaccine: HEPA
Symptoms: Erythema, Rash pruritic, Urticaria
Clinical narrative: Pt returned to mobile medical van approx 2 to 3 hrs after being immunized, complaining of pruritic rash. He was observed to have erythema and urticaria around neck, upper, chest and upper back area. Given PO diphenhydramine 25mg. Rash and itching subsided over next 1 1/2 hr then completely resolved. Not accompanied by any oropharyngeal edema or wheeze.
Age: 26.0
Sex: F
Vaccine: RAB
Symptoms: Arthralgia, Asthenia, Fall, Headache, Hypoaesthesia
Clinical narrative: Pt described since last vaccine, headaches, fever, joint/body aches, several episodes of bilateral leg numbness/weakness resulting in falling down.
Age: 26.0
Sex: F
Vaccine: RAB
Symptoms: Myalgia, Pyrexia
Clinical narrative: Pt described since last vaccine, headaches, fever, joint/body aches, several episodes of bilateral leg numbness/weakness resulting in falling down.
Age: 4.0
Sex: F
Vaccine: PNC
Symptoms: Vaccine positive rechallenge
Clinical narrative: Secondary reaction to Prevnar vaccine.
Age: 10.0
Sex: F
Vaccine: HEPA, VARCEL
Symptoms: Feeling hot, Injection site erythema, Injection site mass, Pruritus
Clinical narrative: 3 1/2" x 3" red induration on right post arm with localized heat and itching. Treatment oral Benadryl and Hydrocortisone cream.
Age: 12.0
Sex: M
Vaccine: HEPA, VARCEL
Symptoms: Feeling hot, Injection site erythema, Injection site mass
Clinical narrative: 1 3/4" x 1 3/4" red induration on right post arm, localized heat. Treatment: Benadryl (oral) and Pramosone (hydrocortisone cream)
Age: 5.0
Sex: F
Vaccine: HEPA, VARCEL
Symptoms: Feeling hot, Injection site erythema, Injection site mass, Injection site swelling, Skin discolouration
Clinical narrative: 2 3/4 x 2 red induration on right post arm, with localized heat and middle of swollen area red/purple, tender to touch. Oral Benadryl and topical hydrocortisone cream treatment.
Age: 5.0
Sex: F
Vaccine: HEPA, VARCEL
Symptoms: Tenderness
Clinical narrative: 2 3/4 x 2 red induration on right post arm, with localized heat and middle of swollen area red/purple, tender to touch. Oral Benadryl and topical hydrocortisone cream treatment.
Age: 4.0
Sex: M
Vaccine: DTAP, IPV, MMR
Symptoms: Injection site erythema, Injection site swelling
Clinical narrative: Red and swollen
Age: 3.0
Sex: M
Vaccine: DTAP
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth
Clinical narrative: Left thigh swelling, redness, warmth.  Quite significant swelling extending to knee.  Patient is recovering.
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMR
Symptoms: Cellulitis, Injection site erythema, Injection site pain, Injection site swelling
Clinical narrative: Patients arm became swollen, red and painful on next day after receiving vaccine (left).  Was taken to ER and diagnosed with cellulitis.  Treated with antibiotic.  Still a knot 8/11/06 but improved.
Age: 12.0
Sex: M
Vaccine: TD
Symptoms: Rash, Urticaria
Clinical narrative: According to mother, child developed hive like rash one hour after receiving vaccine, no other symptoms, but requiring benadryl every 4-6 hours x 3 days.  As of 8/9/06, doing much better but mother will take him to PMD 8/10/06.
Sex: F
Vaccine: MMR, PNC, VARCEL
Symptoms: Pyrexia, Rash
Clinical narrative: Temperature started on 8/5/06 of 104.  Fever ended on 8/8/06.  Also had rash for 2 days starting on 8/7/06.
Age: 1.25
Sex: F
Vaccine: DTAP, VARCEL
Symptoms: Injection site induration, Injection site mass, Injection site nodule, Injection site pain, Skin irritation
Clinical narrative: 8-10 days after DTaP given in left vastus lateralis a honey-crusted, irritated, tender, nodular area developed.  There had been a hard painless lump present within 2 days or so.  Augmentin ES 3/4 tsp bid x 10 days.
Age: 0.55
Sex: M
Vaccine: PNC
Symptoms: Vomiting
Clinical narrative: Vomiting after receiving Prevnar on 07/31/2006 and Daptacel 07/24/2006.  Referred to emergency room on 07/31/2006 for check. Symptoms less than 24 hours.  Event occurred hours after vaccination.  The same evening the shots were given.
Age: 0.53
Sex: M
Vaccine: DTAP
Symptoms: Vomiting
Clinical narrative: Vomiting this evening both shots were given (PREVNAR 07/31/2006 and DAPTACEL 07/24/2006).  Symptoms resolved in less than 24 hours.
Age: 1.25
Sex: F
Vaccine: DTAP, HIBV, PNC
Symptoms: Skin ulcer, Viral infection
Clinical narrative: Varicella lesions covering entire body.  Specifically upper back, arms, and left hand, afebrile- apparently not pruritic.
Age: 47.0
Sex: F
Vaccine: MMR
Symptoms: Arthralgia, Headache, Lethargy, Pyrexia, Rash
Clinical narrative: Rash, fever, suboccipital, post auricular and cervical lymphadenopathy, joint pain, lethargy, headache.  Antibiotics, pain medications, bed rest for 1 week. About six weeks for full recovery.
Age: 47.0
Sex: F
Vaccine: MMR
Symptoms: Viral infection
Clinical narrative: Rash, fever, suboccipital, post auricular and cervical lymphadenopathy, joint pain, lethargy, headache.  Antibiotics, pain medications, bed rest for 1 week. About six weeks for full recovery.
Age: 1.01
Sex: M
Vaccine: MMR, PNC, VARCEL
Symptoms: Pyrexia, Rash morbilliform
Clinical narrative: MMR and Varicella at 07/31/2006, fever 101-105 for 3-5 days and rash measles like and non-infected vesicles.
Sex: F
Vaccine: DTAP, IPV, MMR
Symptoms: Rash
Clinical narrative: Rash approximately 6 inches around site-no streaking
Age: 23.0
Sex: M
Vaccine: RAB
Symptoms: Dysphagia, Dyspnoea, Throat tightness
Clinical narrative: Approximately 35 minutes after receiving rabies vaccine, while walking home, experienced a tight feeling in throat, slight difficulty breathing and swallowing, symptoms lasted 1-2 minutes and then went away.  Denies any other symptoms or any further problems.
Age: 4.0
Sex: M
Vaccine: DTAP, IPV, MMR
Symptoms: Oedema
Clinical narrative: Left deltoid and edematous secondary to DtaP, no purulence or drainage noted.  Edema visible but non tender.  Approximately 2/3 deltoid affected.  BENADRYL and ice three times a day when needed to arm.
Sex: F
Vaccine: VARCEL
Symptoms: Arthralgia, Arthritis, Joint swelling, Pyrexia, Urticaria
Clinical narrative: Questionable serum sickness. Urticaria, arthralgia, arthritis, joint swelling, fever
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMR
Symptoms: Confusional state, Faecal incontinence, Febrile convulsion, Hypotonia, Loss of consciousness
Clinical narrative: Patient with 10-15 minutes episode of unconsciousness, limpness and incontinence described.  Patient taken to emergency department locally by emergency medical services and found to have fever to 102.8.  Patient with positive post ictal confusion, resolved completely.  Diagnosed with febrile seizure, no source of fever identified.
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMR
Symptoms: Pyrexia
Clinical narrative: Patient with 10-15 minutes episode of unconsciousness, limpness and incontinence described.  Patient taken to emergency department locally by emergency medical services and found to have fever to 102.8.  Patient with positive post ictal confusion, resolved completely.  Diagnosed with febrile seizure, no source of fever identified.
Age: 4.0
Sex: M
Vaccine: DTAP, IPV, MMR
Symptoms: Convulsion
Clinical narrative: Seizure episodes lasted 12 minutes about 10 minutes after giving Tdap, IPV, MMR. Given diazepam 10 mg,  Transferred by EMS to MCG.
Age: 6.0
Sex: M
Vaccine: DTAP
Symptoms: Erythema, Feeling hot, Swelling, Urticaria
Clinical narrative: Swelling in right arm, warm to the touch, some redness noted and hives broke out to torso and arms. 25 mg of Benadryl given at Urgent Care and rapid strep test performed.
Age: 0.02
Sex: F
Vaccine: HEP
Symptoms: Irritability, Lethargy, Pyrexia
Clinical narrative: Irritable, fever, lethargy. Negative rule out sepsis and Ceftriaxone for 2 doses. Onset (few hours) after Hep B vaccine
Age: 25.0
Sex: F
Vaccine: HEP, TDAP
Symptoms: Hypoaesthesia, Injection site induration, Swelling, Tenderness
Clinical narrative: Patient describes symptoms after leaving clinic (about 15  minutes), tongue started to go numb and remained numb until 8/8/06 at around 9am. Tongue not numb on 8/8/06 Arm very sore, swollen, knot size of golfball. Took Benadryl 8/8/06 as instructed by physician.
Age: 5.0
Sex: F
Vaccine: DTAP, IPV, MMR
Symptoms: Erythema, Feeling hot, Injection site nodule, Pain
Clinical narrative: Cecliian received her DTAP vaccine in her right thigh. she developed a large warm nodule and pain during the days after the immunization and gradually pain and redness resolved (but a small nodule remains). The vaccine was given in the anterior lower (distal) half of the right thigh which may have continuation to the reaction.
Age: 4.0
Sex: M
Vaccine: DTAP, IPV, MMR
Symptoms: Erythema, Feeling hot, Swelling
Clinical narrative: Patient received DTaP in left deltoid the following morning patient was noted to have LUE swelling with erythema and warmth of LUE from deltoid to elbow. Patient was seen.
Age: 4.0
Sex: F
Vaccine: DTAP, HEPA, IPV, MMR
Symptoms: Erythema, Feeling hot, Swelling
Clinical narrative: Right upper arm with redness and swelling. Hot to touch. Treatment instructed to use cold compresses and give Tylenol as needed for pain.
Age: 5.0
Sex: M
Vaccine: DTAP, HEPA, IPV, MMR
Symptoms: Erythema, Feeling hot, Swelling
Clinical narrative: Left arm swollen, warmth, erythema (deltoid). Treatment: Advil alternate with Tylenol, cold compresses.
Age: 5.0
Sex: M
Vaccine: DTAP, IPV, MMR
Symptoms: Feeling hot, Swelling
Clinical narrative: 6 inch x 3 inch swelling/warmth to site of DTaP injection, no problem with breathing.
Age: 11.0
Sex: F
Vaccine: VARCEL
Symptoms: Erythema, Swelling
Clinical narrative: Right upper arm slight red and swollen.
Age: 6.0
Sex: F
Vaccine: HEPA, PNC
Symptoms: Injection site erythema, Injection site pain, Injection site swelling
Clinical narrative: Swelling, pain, redness 9.5 cm x 6 cm. Rx: Hydrocortisone cream 1% to area BID Benadryl 25 mg PO qid prn itching or swelling Only slight bruise left on 8/8/06.
Age: 4.0
Sex: M
Vaccine: DTAP, IPV, MMR
Symptoms: Anaphylactic reaction, Rash
Clinical narrative: Patient returned to office 1.5 hours after injections with complaints of rash all over and itching.  Patient was given epinephrine 0.15 mg.
Age: 56.0
Sex: F
Vaccine: PPV
Symptoms: Chills, Hyperhidrosis, Lymph node pain, Malaise, Myalgia
Clinical narrative: Patient complained of hives on left deltoid, muscle aches, chills, sweating, elevated temperature, left axillary lymph node tenderness, malaise.  Patient took Benadryl and ibuprofen for symptoms.
Age: 56.0
Sex: F
Vaccine: PPV
Symptoms: Pyrexia, Urticaria
Clinical narrative: Patient complained of hives on left deltoid, muscle aches, chills, sweating, elevated temperature, left axillary lymph node tenderness, malaise.  Patient took Benadryl and ibuprofen for symptoms.
Age: 0.37
Sex: M
Vaccine: DTAP, HIBV, IPV, PNC
Symptoms: Pyrexia
Clinical narrative: Patient with fever 103.5 F.
Age: 5.0
Sex: M
Vaccine: DTAP, HEPA, IPV, MMR
Symptoms: Feeling hot, Injection site erythema, Injection site pain, Injection site rash
Clinical narrative: Developed hot erythematous tender rash on left deltoid area one day after receiving vaccinations.  No fevers, vomiting or seizures.
Age: 21.0
Sex: M
Vaccine: SMALL
Symptoms: Diarrhoea, Nausea
Clinical narrative: Presented to ER on 7/14/06 with c/o nausea and diarrhea. States that she had received smallpox vaccination the previous day. Started not feeling well one hour after vaccination. Afebrile. Diagnosed as vaccine reaction per ER report. CBC and BMP were done, those results are not available at this time. Was given Imodium, Tylenol 500mg 2 tabs, Phenergan, and Tordol at time of visit. Discharged with orders to push fluids, Compazine 10mg po q 6-8 hours prn nausea, Tylenol 500mg 2 pills every four hours as needed and follow up the next day.
Age: 24.0
Sex: M
Vaccine: HEP, SMALL
Symptoms: Injection site inflammation, Injection site pain, Otitis media, Rash, Viral infection
Clinical narrative: Presented to clinic 08/01/06 with c/o HA, smallpox site soreness, and bumps to head times 3 days. Poxlike lesions observed to face/scalp. L arm pox site inflammed. Left Otitis Media noted. Diagnosed with smallpox viremia as well. Orders given for Motrin and Zithromax. Quarters times 24 hours and follow up at clinic the next day.
Age: 39.0
Sex: M
Vaccine: SMALL
Symptoms: Asthma, Chills, Dyspnoea, Ear pain, Hyperhidrosis
Clinical narrative: Presented to Clinic on 8/12/06 with c/o sneezing, ear pain, throat pain, painful swollowing body aches, chills, and sweats x 1 day. Afebrile at time of visit. Diagnoses as smallpox flu like symptoms and allergies. Orders given for quarters x 24 hours, Allegra 180mg po q day, Robitussin prn and push fluids, RTC TMC PRN. Was then seen at ER later that day for Respiratory Distress/difficulty breathing. O2 sats were in the 80's in the ER but improved initially on O2. CXR showed a questionable fluffy infiltrate along the right cardiac border. Patient was admitted for O2 and IV therapy and breathing treatments. Pt. received IV Levaquin 750mg every 24 hours as well as Solumedrol 125mg every 24 hours IV. Patient was maintained on 2L of O2 during hospital stay. O2 sats maintained in the 90's when O2 was removed. Wheeze persisted on discharge. D/C'd 8/13/06 with light duty orders, Albuterol MDI 2 puffs tid and every 2 hours as needed, Prednisone 40mg daily through 8/17/06, Levaquin 750mg po daily through 8/21/06. Discharge diagnoses: RAD, Pneumonia.
Age: 39.0
Sex: M
Vaccine: SMALL
Symptoms: Hypoxia, Influenza like illness, Odynophagia, Pain, Pharyngolaryngeal pain
Clinical narrative: Presented to Clinic on 8/12/06 with c/o sneezing, ear pain, throat pain, painful swollowing body aches, chills, and sweats x 1 day. Afebrile at time of visit. Diagnoses as smallpox flu like symptoms and allergies. Orders given for quarters x 24 hours, Allegra 180mg po q day, Robitussin prn and push fluids, RTC TMC PRN. Was then seen at ER later that day for Respiratory Distress/difficulty breathing. O2 sats were in the 80's in the ER but improved initially on O2. CXR showed a questionable fluffy infiltrate along the right cardiac border. Patient was admitted for O2 and IV therapy and breathing treatments. Pt. received IV Levaquin 750mg every 24 hours as well as Solumedrol 125mg every 24 hours IV. Patient was maintained on 2L of O2 during hospital stay. O2 sats maintained in the 90's when O2 was removed. Wheeze persisted on discharge. D/C'd 8/13/06 with light duty orders, Albuterol MDI 2 puffs tid and every 2 hours as needed, Prednisone 40mg daily through 8/17/06, Levaquin 750mg po daily through 8/21/06. Discharge diagnoses: RAD, Pneumonia.
Age: 39.0
Sex: M
Vaccine: SMALL
Symptoms: Pneumonia, Respiratory distress, Sneezing, Wheezing
Clinical narrative: Presented to Clinic on 8/12/06 with c/o sneezing, ear pain, throat pain, painful swollowing body aches, chills, and sweats x 1 day. Afebrile at time of visit. Diagnoses as smallpox flu like symptoms and allergies. Orders given for quarters x 24 hours, Allegra 180mg po q day, Robitussin prn and push fluids, RTC TMC PRN. Was then seen at ER later that day for Respiratory Distress/difficulty breathing. O2 sats were in the 80's in the ER but improved initially on O2. CXR showed a questionable fluffy infiltrate along the right cardiac border. Patient was admitted for O2 and IV therapy and breathing treatments. Pt. received IV Levaquin 750mg every 24 hours as well as Solumedrol 125mg every 24 hours IV. Patient was maintained on 2L of O2 during hospital stay. O2 sats maintained in the 90's when O2 was removed. Wheeze persisted on discharge. D/C'd 8/13/06 with light duty orders, Albuterol MDI 2 puffs tid and every 2 hours as needed, Prednisone 40mg daily through 8/17/06, Levaquin 750mg po daily through 8/21/06. Discharge diagnoses: RAD, Pneumonia.
Age: 23.0
Sex: M
Vaccine: HEP, SMALL
Symptoms: Chills, Headache, Pyrexia, Viral infection
Clinical narrative: Presented to clinic on 8/4/06 with c/o HA, fever, and chills. Diagnosed as Smallpox viremia. Toradol 30mg given IM. To push fluids. Discharged with Motrin order and return to clinic prn.
Age: 23.0
Sex: M
Vaccine: SMALL, TTOX
Symptoms: Joint stiffness, Nausea, Pain, Pyrexia, Rash
Clinical narrative: Presented to clinic on 8/4/06 with c/o rash to bilateral hands x 2 days, fever, body aches, stiffness, and nausea. Pustular rash present to hand and arm, non-pruritic. Diagnosed as smallpox viremia vs possible insect bites. Orders given for Motrin 800mg tid with food 10 day supply provided, no refills, Claritin 1 po qd, 30 day supply given, no refills. To follow up at the clinic prn. Returned to duty.
Age: 23.0
Sex: M
Vaccine: SMALL, TTOX
Symptoms: Rash pustular, Viral infection
Clinical narrative: Presented to clinic on 8/4/06 with c/o rash to bilateral hands x 2 days, fever, body aches, stiffness, and nausea. Pustular rash present to hand and arm, non-pruritic. Diagnosed as smallpox viremia vs possible insect bites. Orders given for Motrin 800mg tid with food 10 day supply provided, no refills, Claritin 1 po qd, 30 day supply given, no refills. To follow up at the clinic prn. Returned to duty.
Age: 17.0
Sex: M
Vaccine: MNQ
Symptoms: Influenza like illness, Injection site pain, Injection site swelling
Clinical narrative: Flu like symptoms, axillary pain and fluctuant edema on the side of injection 48 hours after injection. keflex and benadryl.
Age: 35.0
Sex: F
Vaccine: MMR, TDAP
Symptoms: Dysgeusia
Clinical narrative: POST GIVING TDAP AND MMR VACCINES PATIENT COMPLAINED OF STRONG MEDICINE TASTE IN MOUTH.
Age: 30.0
Sex: M
Vaccine: ANTH, SMALL
Symptoms: Alanine aminotransferase increased, Diarrhoea, Injection site erythema, Injection site swelling, Lymphadenopathy
Clinical narrative: Presented to the Clinic on 8/4/06 with c/o HA, swollen lymph nodes under L arm, sore throat, and myalgia. Also experiencing cramping in legs when running. C/o Diarrhea this am as well. Labs done. L upper arm smallpox vaccination site with swelling and erythema. Diagnosed as Smallpox Vaccination Reaction. Quarters x 48 hours given. Push fluids. Ibuprofen 400mg po qid with food.