chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 3.0
Sex: F
Vaccine: FLUN3
Symptoms: Expired drug administered
Clinical narrative: A non-serious report of administered expired FLUMIST was received from a medical assistant concerning a 36-month-old female. FLUMIST, which expired on 25-Dec-2008, was administered on 26-Dec-2008. There was no adverse event associated with this medication error; therefore, treatment and reporter/sponsor causality assessments are not applicable, and the event is considered resolved. This case is submitted in accordance with a post-marketing commitment on accelerated reporting of 2 years to 59 months of age for FLUMIST. Based on the results on the investigation, the root cause for the medication errors were caused by 1) customers not discarding product from previous season and 2) product expiring during the peak of flu season resulting in some medication errors that occurred shortly after the prouduct expired. Additional information received on 03-Feb-2009 included Product Complaint Investigation results.
Age: 3.4
Sex: M
Vaccine: FLUN3
Symptoms: Expired drug administered
Clinical narrative: A non-serious spontaneous report of expired FLUMIST given to this child was received from a certified medical assistant in a physician's office concerning a 48-month-old male. Neither medical history nor concomitant medications were reported. On 26-Dec-2008, two siblings, including this patient, received expired FLUMIST vaccine. The vaccine had an expiration date of 25-Dec-2008. There was no adverse event associated with this medication error; therefore, treatment and reporter/sponsor causality assessments are not applicable, and the event is considered resolved. This case is submitted in accordance with a post-marketing commitment on accelerated reporting for the newly population of 2 years to 59 months of age for FLUMIST. Based on the results of the investigation, the root cause for the medication errors were caused by 1) customers not discarding product from the previous season and 2) product expiring during the peak of the flu season resulting in some medications errors that occurred shortly after the product expired. Additional information was received on 03-Feb-2009: The reporter confirmed there were no delayed occurring adverse events. Follow-up information received on 24-Mar-2009 included Product Complaint Investigation results.
Sex: U
Vaccine: DTAPIPV
Symptoms: Discomfort, Injection site erythema, Oedema peripheral
Clinical narrative: This case was reported by a healthcare professional via sales representative and described the occurrence of swelling arm in a subject of unspecified age and gender who was vaccinated with KINRIX. On an unspecified date, the subject received unspecified dose of KINRIX. At an unspecified time after vaccination with KINRIX, the subject experienced swelling arm, discomfort and injection site redness. On 11 November 2008, the sales representative was contacted by the healthcare professional office that completed a Vaccine Adverse Event Report and inquired where to send
Age: 61.0
Sex: M
Vaccine: VARZOS
Symptoms: Injection site erythema, Injection site haematoma, Injection site pain, Injection site pruritus, Injection site swelling
Clinical narrative: Redness, swelling, itching, pain and tenderness and slight bruising at and around injection site on second day after vaccination lasting about five days;about two weeks later, runny nose and sneezing plus about three weeks later, numerous small red, itchy splotches.  These latter effects have lasted about two weeks--the splotches remain after about four days.
Age: 61.0
Sex: M
Vaccine: VARZOS
Symptoms: Rash erythematous, Rash macular, Rash pruritic, Rhinorrhoea, Sneezing
Clinical narrative: Redness, swelling, itching, pain and tenderness and slight bruising at and around injection site on second day after vaccination lasting about five days;about two weeks later, runny nose and sneezing plus about three weeks later, numerous small red, itchy splotches.  These latter effects have lasted about two weeks--the splotches remain after about four days.
Age: 1.0
Sex: F
Vaccine: MMR, PPV
Symptoms: Condition aggravated, Convulsion
Clinical narrative: Patient has history of seizures. She had been seizure free for over 3 months after switching drugs. She had two seizures 3 days after vaccination.
Age: 59.0
Sex: U
Vaccine: VARZOS
Symptoms: Blister, Pruritus, Rash erythematous, Skin discolouration
Clinical narrative: Raised bubble 2 inches by 4 inches surrounded by a flame red 3 inch in circumfance rash.  1/17/2009, 2 weeks after the injection, a flat redish brown discoloration about 2 inches by 4 inches remains. Itching subsided in 10 days and the buble or bliseter went flat.  No scab
Age: 4.0
Sex: M
Vaccine: DTAP, MMR, PPV, VARCEL
Symptoms: Erythema, Skin warm
Clinical narrative: 8cm wide x 10cm long, redness, warm to touch (L) upper arm.
Age: 60.0
Sex: M
Vaccine: FLU3
Symptoms: Dizziness, Headache, Incorrect dose administered
Clinical narrative: This case was reported by a pharmacist (also the subject) and described the occurrence of feeling woozy in a 60-year-old male subject who was vaccinated with FLULAVAL. On 9 October 2008 at 12:50 the subject received a dose of FLULAVAL (1 ml, unknown, left arm). On 9 October 2008, 1 hour after vaccination with FLULAVAL the subject experienced feeling woozy, headache and overdose. The pharmacist reported that he received FLULAVAL at work and was given 1 ml instead of 0.5 ml. At the time of reporting the events were unresolved. Follow-up received on 31 October 2008 indicated that the events were just temporary and passed soon. The events were resolved at the time of follow-up. No additional information was reported.
Age: 48.0
Sex: F
Vaccine: FLU3
Symptoms: Back pain, Balance disorder, Bladder disorder, Blood product transfusion, Breast cancer
Clinical narrative: Patient suffered Severe back pain, Tingling of lower extremities, Loss of sensation, Band like feeling around torsoe, Unable to stand, resulted in permanent paralysis, Bladder disfunction, Bowel disfunction, Loss of balance, Motor Skills and has since been diagnosed with breast cancer and diabetes. Final discharge diagnosis as Transverse Myelitis at the T-4 - T-6 level. Treatment included Prednisone, full course IVIG.  2/2/09 MR received for DOS 12/19-30/2005 with D/C DX:  Transverse Myelitis.  Mild depression.  Anxiety.  Hx of breast cyst.  Hx of removal of L facial cyst.  DM Type II.  Pt presented to ER with c/o decreasing sensation in the lower extremities with inability to walk. Neuro exam (+) for decreased sensation from the waist down, decreased strength-0/5 in both legs, decreased reflexes and (+) Babinski.  Unable to move legs  due to ascending motor paralysis. Tx with IVIG.  Transferred to rehab.
Age: 48.0
Sex: F
Vaccine: FLU3
Symptoms: Diabetes mellitus, Dysstasia, Intestinal functional disorder, Motor dysfunction, Myelitis transverse
Clinical narrative: Patient suffered Severe back pain, Tingling of lower extremities, Loss of sensation, Band like feeling around torsoe, Unable to stand, resulted in permanent paralysis, Bladder disfunction, Bowel disfunction, Loss of balance, Motor Skills and has since been diagnosed with breast cancer and diabetes. Final discharge diagnosis as Transverse Myelitis at the T-4 - T-6 level. Treatment included Prednisone, full course IVIG.  2/2/09 MR received for DOS 12/19-30/2005 with D/C DX:  Transverse Myelitis.  Mild depression.  Anxiety.  Hx of breast cyst.  Hx of removal of L facial cyst.  DM Type II.  Pt presented to ER with c/o decreasing sensation in the lower extremities with inability to walk. Neuro exam (+) for decreased sensation from the waist down, decreased strength-0/5 in both legs, decreased reflexes and (+) Babinski.  Unable to move legs  due to ascending motor paralysis. Tx with IVIG.  Transferred to rehab.
Age: 48.0
Sex: F
Vaccine: FLU3
Symptoms: Paraesthesia, Paralysis, Sensory loss
Clinical narrative: Patient suffered Severe back pain, Tingling of lower extremities, Loss of sensation, Band like feeling around torsoe, Unable to stand, resulted in permanent paralysis, Bladder disfunction, Bowel disfunction, Loss of balance, Motor Skills and has since been diagnosed with breast cancer and diabetes. Final discharge diagnosis as Transverse Myelitis at the T-4 - T-6 level. Treatment included Prednisone, full course IVIG.  2/2/09 MR received for DOS 12/19-30/2005 with D/C DX:  Transverse Myelitis.  Mild depression.  Anxiety.  Hx of breast cyst.  Hx of removal of L facial cyst.  DM Type II.  Pt presented to ER with c/o decreasing sensation in the lower extremities with inability to walk. Neuro exam (+) for decreased sensation from the waist down, decreased strength-0/5 in both legs, decreased reflexes and (+) Babinski.  Unable to move legs  due to ascending motor paralysis. Tx with IVIG.  Transferred to rehab.
Age: 66.0
Sex: F
Vaccine: FLU3
Symptoms: Back pain, Gait disturbance, Insomnia, Muscle spasms, Oedema peripheral
Clinical narrative: lower leg,ankle,and foot were swollen. Painful hives on ankle, and on top of foot. smaller hives across lower back,on back of neck,and top of head.the muscles in my foot and leg were in a tight cramp,the big toe was to painful to even lay on the bed. it is still extremly painful when I try to sleep at night.  the muscles in my leg are still tight and painfull that also makes it hard for me to get sleep.   my back started hurting so bad it was hard to walk.   I guess that may have been because of no sleep.     I did not go to the Doctor because I was in to much pain to even move around my house and when I called the clinic to see if there was something I could do the nurse acted like I was crazy,she said I could,t have hives unless they were all over my body,well I still have the marks from them, they were like burns on my skin.    It seemes like what ever gave me the bad reaction just went after the arthritis in my body.
Age: 66.0
Sex: F
Vaccine: FLU3
Symptoms: Pain, Urticaria
Clinical narrative: lower leg,ankle,and foot were swollen. Painful hives on ankle, and on top of foot. smaller hives across lower back,on back of neck,and top of head.the muscles in my foot and leg were in a tight cramp,the big toe was to painful to even lay on the bed. it is still extremly painful when I try to sleep at night.  the muscles in my leg are still tight and painfull that also makes it hard for me to get sleep.   my back started hurting so bad it was hard to walk.   I guess that may have been because of no sleep.     I did not go to the Doctor because I was in to much pain to even move around my house and when I called the clinic to see if there was something I could do the nurse acted like I was crazy,she said I could,t have hives unless they were all over my body,well I still have the marks from them, they were like burns on my skin.    It seemes like what ever gave me the bad reaction just went after the arthritis in my body.
Age: 15.0
Sex: F
Vaccine: HEPA, HPV4, MNQ, HPV4
Symptoms: Alopecia, Arthralgia, Chest pain, Disturbance in attention, Dizziness
Clinical narrative: Seizure activity, lower paralysis, exhaustion, nausea and vomiting, brain fog, difficulty concetrating, low blood pressure, Painful periods and off cycle, chest pain, joint pain, muscle pain and weakness, blurred vision, tremors, weight loss, personality change, dizziness, difficuly breathing, oxygen deprived, hair loss, Skin pale.  2/25/09 Received PCP medical records of 10/25/07-12/24/2008. FINAL DX: none provided Records reveal patient experienced good health on 10/25/07.  RTC 11/15 w/sore throat, left ear pain & nausea x 1 wk.  Dx w/viral URI.  RTC 11/23/07 w/left knee pain/swelling x 5 yrs.  Dx w/patellofemoral syndrome, tx w/meds & referred to PT.  RTC 1/8/08 w/neck & throat discomfort.  Dx w/voice weakness, probable strained cricopharyngial nerve.  Tx w/meds & referred to ENT who dx w/dysphonia following likely vocal misuse.  RTC 2/8/08 w/fatigue, upset stomach, weight loss, polydipsia & nausea x 1 wk.  RTC 2/12/08 s/p fainting in school, lightheaded x 1 wk.  Dx w/syncopal episode & possible dehydration, weight loss & fatigue.  Tx w/IVF & meds.  DM w/u neg.  RTC 2/28 s/p ER visit for generalized pain.  Had been hospitalized previous wk, dx w/pseudoseizure & followed by neuro.  3/27/09 Received Neuro consult medical records of 2/25-3/7/2008. FINAL DX: none provided.  Consult states excessive tiredness, nausea & weight loss likely secondary to viral illness; intermittent weakness of legs posssibly due to dehydration vs presyncope; & recent onset of nonepileptic shaking events. Records reveal patient experienced fatigue during vacation out of state approx 3 wks prior to eval.  Saw PCP after vacation for nausea, weakness.  Hospitalized x 3 days.  Eval by peds neuro at that time & dx w/syncope vs near syncope.  Improved & d/c to home.  Was able to return to school f/t & traveled out of state.  Collapsed & had to be brought back home w/trembling of extremities.  Admitted to hospital for further neuro eval.  Exam & testing all WNL.  D/C to home.  Seen in ER x 2 for recurrence of shaking & aggressive behavior.  Seen in Neuro clinic 3/7/08 where exam WNL.  Dx spells of nonepileptic events.  Referred to psych.
Age: 15.0
Sex: F
Vaccine: HEPA, HPV4, MNQ, HPV4
Symptoms: Dysmenorrhoea, Dyspnoea, Fatigue, Feeling abnormal, Hypotension
Clinical narrative: Seizure activity, lower paralysis, exhaustion, nausea and vomiting, brain fog, difficulty concetrating, low blood pressure, Painful periods and off cycle, chest pain, joint pain, muscle pain and weakness, blurred vision, tremors, weight loss, personality change, dizziness, difficuly breathing, oxygen deprived, hair loss, Skin pale.  2/25/09 Received PCP medical records of 10/25/07-12/24/2008. FINAL DX: none provided Records reveal patient experienced good health on 10/25/07.  RTC 11/15 w/sore throat, left ear pain & nausea x 1 wk.  Dx w/viral URI.  RTC 11/23/07 w/left knee pain/swelling x 5 yrs.  Dx w/patellofemoral syndrome, tx w/meds & referred to PT.  RTC 1/8/08 w/neck & throat discomfort.  Dx w/voice weakness, probable strained cricopharyngial nerve.  Tx w/meds & referred to ENT who dx w/dysphonia following likely vocal misuse.  RTC 2/8/08 w/fatigue, upset stomach, weight loss, polydipsia & nausea x 1 wk.  RTC 2/12/08 s/p fainting in school, lightheaded x 1 wk.  Dx w/syncopal episode & possible dehydration, weight loss & fatigue.  Tx w/IVF & meds.  DM w/u neg.  RTC 2/28 s/p ER visit for generalized pain.  Had been hospitalized previous wk, dx w/pseudoseizure & followed by neuro.  3/27/09 Received Neuro consult medical records of 2/25-3/7/2008. FINAL DX: none provided.  Consult states excessive tiredness, nausea & weight loss likely secondary to viral illness; intermittent weakness of legs posssibly due to dehydration vs presyncope; & recent onset of nonepileptic shaking events. Records reveal patient experienced fatigue during vacation out of state approx 3 wks prior to eval.  Saw PCP after vacation for nausea, weakness.  Hospitalized x 3 days.  Eval by peds neuro at that time & dx w/syncope vs near syncope.  Improved & d/c to home.  Was able to return to school f/t & traveled out of state.  Collapsed & had to be brought back home w/trembling of extremities.  Admitted to hospital for further neuro eval.  Exam & testing all WNL.  D/C to home.  Seen in ER x 2 for recurrence of shaking & aggressive behavior.  Seen in Neuro clinic 3/7/08 where exam WNL.  Dx spells of nonepileptic events.  Referred to psych.
Age: 15.0
Sex: F
Vaccine: HEPA, HPV4, MNQ, HPV4
Symptoms: Menstruation irregular, Muscular weakness, Myalgia, Nausea, Oxygen consumption decreased
Clinical narrative: Seizure activity, lower paralysis, exhaustion, nausea and vomiting, brain fog, difficulty concetrating, low blood pressure, Painful periods and off cycle, chest pain, joint pain, muscle pain and weakness, blurred vision, tremors, weight loss, personality change, dizziness, difficuly breathing, oxygen deprived, hair loss, Skin pale.  2/25/09 Received PCP medical records of 10/25/07-12/24/2008. FINAL DX: none provided Records reveal patient experienced good health on 10/25/07.  RTC 11/15 w/sore throat, left ear pain & nausea x 1 wk.  Dx w/viral URI.  RTC 11/23/07 w/left knee pain/swelling x 5 yrs.  Dx w/patellofemoral syndrome, tx w/meds & referred to PT.  RTC 1/8/08 w/neck & throat discomfort.  Dx w/voice weakness, probable strained cricopharyngial nerve.  Tx w/meds & referred to ENT who dx w/dysphonia following likely vocal misuse.  RTC 2/8/08 w/fatigue, upset stomach, weight loss, polydipsia & nausea x 1 wk.  RTC 2/12/08 s/p fainting in school, lightheaded x 1 wk.  Dx w/syncopal episode & possible dehydration, weight loss & fatigue.  Tx w/IVF & meds.  DM w/u neg.  RTC 2/28 s/p ER visit for generalized pain.  Had been hospitalized previous wk, dx w/pseudoseizure & followed by neuro.  3/27/09 Received Neuro consult medical records of 2/25-3/7/2008. FINAL DX: none provided.  Consult states excessive tiredness, nausea & weight loss likely secondary to viral illness; intermittent weakness of legs posssibly due to dehydration vs presyncope; & recent onset of nonepileptic shaking events. Records reveal patient experienced fatigue during vacation out of state approx 3 wks prior to eval.  Saw PCP after vacation for nausea, weakness.  Hospitalized x 3 days.  Eval by peds neuro at that time & dx w/syncope vs near syncope.  Improved & d/c to home.  Was able to return to school f/t & traveled out of state.  Collapsed & had to be brought back home w/trembling of extremities.  Admitted to hospital for further neuro eval.  Exam & testing all WNL.  D/C to home.  Seen in ER x 2 for recurrence of shaking & aggressive behavior.  Seen in Neuro clinic 3/7/08 where exam WNL.  Dx spells of nonepileptic events.  Referred to psych.
Age: 15.0
Sex: F
Vaccine: HEPA, HPV4, MNQ, HPV4
Symptoms: Pallor, Personality change, Polycystic ovaries, Tremor, Vision blurred
Clinical narrative: Seizure activity, lower paralysis, exhaustion, nausea and vomiting, brain fog, difficulty concetrating, low blood pressure, Painful periods and off cycle, chest pain, joint pain, muscle pain and weakness, blurred vision, tremors, weight loss, personality change, dizziness, difficuly breathing, oxygen deprived, hair loss, Skin pale.  2/25/09 Received PCP medical records of 10/25/07-12/24/2008. FINAL DX: none provided Records reveal patient experienced good health on 10/25/07.  RTC 11/15 w/sore throat, left ear pain & nausea x 1 wk.  Dx w/viral URI.  RTC 11/23/07 w/left knee pain/swelling x 5 yrs.  Dx w/patellofemoral syndrome, tx w/meds & referred to PT.  RTC 1/8/08 w/neck & throat discomfort.  Dx w/voice weakness, probable strained cricopharyngial nerve.  Tx w/meds & referred to ENT who dx w/dysphonia following likely vocal misuse.  RTC 2/8/08 w/fatigue, upset stomach, weight loss, polydipsia & nausea x 1 wk.  RTC 2/12/08 s/p fainting in school, lightheaded x 1 wk.  Dx w/syncopal episode & possible dehydration, weight loss & fatigue.  Tx w/IVF & meds.  DM w/u neg.  RTC 2/28 s/p ER visit for generalized pain.  Had been hospitalized previous wk, dx w/pseudoseizure & followed by neuro.  3/27/09 Received Neuro consult medical records of 2/25-3/7/2008. FINAL DX: none provided.  Consult states excessive tiredness, nausea & weight loss likely secondary to viral illness; intermittent weakness of legs posssibly due to dehydration vs presyncope; & recent onset of nonepileptic shaking events. Records reveal patient experienced fatigue during vacation out of state approx 3 wks prior to eval.  Saw PCP after vacation for nausea, weakness.  Hospitalized x 3 days.  Eval by peds neuro at that time & dx w/syncope vs near syncope.  Improved & d/c to home.  Was able to return to school f/t & traveled out of state.  Collapsed & had to be brought back home w/trembling of extremities.  Admitted to hospital for further neuro eval.  Exam & testing all WNL.  D/C to home.  Seen in ER x 2 for recurrence of shaking & aggressive behavior.  Seen in Neuro clinic 3/7/08 where exam WNL.  Dx spells of nonepileptic events.  Referred to psych.
Age: 15.0
Sex: F
Vaccine: HEPA, HPV4, MNQ, HPV4
Symptoms: Vomiting, Weight decreased
Clinical narrative: Seizure activity, lower paralysis, exhaustion, nausea and vomiting, brain fog, difficulty concetrating, low blood pressure, Painful periods and off cycle, chest pain, joint pain, muscle pain and weakness, blurred vision, tremors, weight loss, personality change, dizziness, difficuly breathing, oxygen deprived, hair loss, Skin pale.  2/25/09 Received PCP medical records of 10/25/07-12/24/2008. FINAL DX: none provided Records reveal patient experienced good health on 10/25/07.  RTC 11/15 w/sore throat, left ear pain & nausea x 1 wk.  Dx w/viral URI.  RTC 11/23/07 w/left knee pain/swelling x 5 yrs.  Dx w/patellofemoral syndrome, tx w/meds & referred to PT.  RTC 1/8/08 w/neck & throat discomfort.  Dx w/voice weakness, probable strained cricopharyngial nerve.  Tx w/meds & referred to ENT who dx w/dysphonia following likely vocal misuse.  RTC 2/8/08 w/fatigue, upset stomach, weight loss, polydipsia & nausea x 1 wk.  RTC 2/12/08 s/p fainting in school, lightheaded x 1 wk.  Dx w/syncopal episode & possible dehydration, weight loss & fatigue.  Tx w/IVF & meds.  DM w/u neg.  RTC 2/28 s/p ER visit for generalized pain.  Had been hospitalized previous wk, dx w/pseudoseizure & followed by neuro.  3/27/09 Received Neuro consult medical records of 2/25-3/7/2008. FINAL DX: none provided.  Consult states excessive tiredness, nausea & weight loss likely secondary to viral illness; intermittent weakness of legs posssibly due to dehydration vs presyncope; & recent onset of nonepileptic shaking events. Records reveal patient experienced fatigue during vacation out of state approx 3 wks prior to eval.  Saw PCP after vacation for nausea, weakness.  Hospitalized x 3 days.  Eval by peds neuro at that time & dx w/syncope vs near syncope.  Improved & d/c to home.  Was able to return to school f/t & traveled out of state.  Collapsed & had to be brought back home w/trembling of extremities.  Admitted to hospital for further neuro eval.  Exam & testing all WNL.  D/C to home.  Seen in ER x 2 for recurrence of shaking & aggressive behavior.  Seen in Neuro clinic 3/7/08 where exam WNL.  Dx spells of nonepileptic events.  Referred to psych.
Age: 15.0
Sex: F
Vaccine: HEPA, HPV4, MNQ, HPV4
Symptoms: Abasia, Alopecia, Amnesia, Blood pressure decreased, Dyspnoea
Clinical narrative: Seizure activity, lower paralysis, exhaustion, nausea and vomiting, brain fog, difficulty concetrating, low blood pressure, Painful periods and off cycle, chest pain, joint pain, muscle pain and weakness, blurred vision, tremors, weight loss, personality change, dizziness, difficuly breathing, oxygen deprived, hair loss, Skin pale.  2/25/09 Received PCP medical records of 10/25/07-12/24/2008. FINAL DX: none provided Records reveal patient experienced good health on 10/25/07.  RTC 11/15 w/sore throat, left ear pain & nausea x 1 wk.  Dx w/viral URI.  RTC 11/23/07 w/left knee pain/swelling x 5 yrs.  Dx w/patellofemoral syndrome, tx w/meds & referred to PT.  RTC 1/8/08 w/neck & throat discomfort.  Dx w/voice weakness, probable strained cricopharyngial nerve.  Tx w/meds & referred to ENT who dx w/dysphonia following likely vocal misuse.  RTC 2/8/08 w/fatigue, upset stomach, weight loss, polydipsia & nausea x 1 wk.  RTC 2/12/08 s/p fainting in school, lightheaded x 1 wk.  Dx w/syncopal episode & possible dehydration, weight loss & fatigue.  Tx w/IVF & meds.  DM w/u neg.  RTC 2/28 s/p ER visit for generalized pain.  Had been hospitalized previous wk, dx w/pseudoseizure & followed by neuro.  3/27/09 Received Neuro consult medical records of 2/25-3/7/2008. FINAL DX: none provided.  Consult states excessive tiredness, nausea & weight loss likely secondary to viral illness; intermittent weakness of legs posssibly due to dehydration vs presyncope; & recent onset of nonepileptic shaking events. Records reveal patient experienced fatigue during vacation out of state approx 3 wks prior to eval.  Saw PCP after vacation for nausea, weakness.  Hospitalized x 3 days.  Eval by peds neuro at that time & dx w/syncope vs near syncope.  Improved & d/c to home.  Was able to return to school f/t & traveled out of state.  Collapsed & had to be brought back home w/trembling of extremities.  Admitted to hospital for further neuro eval.  Exam & testing all WNL.  D/C to home.  Seen in ER x 2 for recurrence of shaking & aggressive behavior.  Seen in Neuro clinic 3/7/08 where exam WNL.  Dx spells of nonepileptic events.  Referred to psych.
Age: 15.0
Sex: F
Vaccine: HEPA, HPV4, MNQ, HPV4
Symptoms: Fatigue, Hypoaesthesia, Loss of consciousness, Malaise, Muscle spasms
Clinical narrative: Seizure activity, lower paralysis, exhaustion, nausea and vomiting, brain fog, difficulty concetrating, low blood pressure, Painful periods and off cycle, chest pain, joint pain, muscle pain and weakness, blurred vision, tremors, weight loss, personality change, dizziness, difficuly breathing, oxygen deprived, hair loss, Skin pale.  2/25/09 Received PCP medical records of 10/25/07-12/24/2008. FINAL DX: none provided Records reveal patient experienced good health on 10/25/07.  RTC 11/15 w/sore throat, left ear pain & nausea x 1 wk.  Dx w/viral URI.  RTC 11/23/07 w/left knee pain/swelling x 5 yrs.  Dx w/patellofemoral syndrome, tx w/meds & referred to PT.  RTC 1/8/08 w/neck & throat discomfort.  Dx w/voice weakness, probable strained cricopharyngial nerve.  Tx w/meds & referred to ENT who dx w/dysphonia following likely vocal misuse.  RTC 2/8/08 w/fatigue, upset stomach, weight loss, polydipsia & nausea x 1 wk.  RTC 2/12/08 s/p fainting in school, lightheaded x 1 wk.  Dx w/syncopal episode & possible dehydration, weight loss & fatigue.  Tx w/IVF & meds.  DM w/u neg.  RTC 2/28 s/p ER visit for generalized pain.  Had been hospitalized previous wk, dx w/pseudoseizure & followed by neuro.  3/27/09 Received Neuro consult medical records of 2/25-3/7/2008. FINAL DX: none provided.  Consult states excessive tiredness, nausea & weight loss likely secondary to viral illness; intermittent weakness of legs posssibly due to dehydration vs presyncope; & recent onset of nonepileptic shaking events. Records reveal patient experienced fatigue during vacation out of state approx 3 wks prior to eval.  Saw PCP after vacation for nausea, weakness.  Hospitalized x 3 days.  Eval by peds neuro at that time & dx w/syncope vs near syncope.  Improved & d/c to home.  Was able to return to school f/t & traveled out of state.  Collapsed & had to be brought back home w/trembling of extremities.  Admitted to hospital for further neuro eval.  Exam & testing all WNL.  D/C to home.  Seen in ER x 2 for recurrence of shaking & aggressive behavior.  Seen in Neuro clinic 3/7/08 where exam WNL.  Dx spells of nonepileptic events.  Referred to psych.
Age: 15.0
Sex: F
Vaccine: HEPA, HPV4, MNQ, HPV4
Symptoms: Muscle twitching, Nausea, Paralysis, Tremor
Clinical narrative: Seizure activity, lower paralysis, exhaustion, nausea and vomiting, brain fog, difficulty concetrating, low blood pressure, Painful periods and off cycle, chest pain, joint pain, muscle pain and weakness, blurred vision, tremors, weight loss, personality change, dizziness, difficuly breathing, oxygen deprived, hair loss, Skin pale.  2/25/09 Received PCP medical records of 10/25/07-12/24/2008. FINAL DX: none provided Records reveal patient experienced good health on 10/25/07.  RTC 11/15 w/sore throat, left ear pain & nausea x 1 wk.  Dx w/viral URI.  RTC 11/23/07 w/left knee pain/swelling x 5 yrs.  Dx w/patellofemoral syndrome, tx w/meds & referred to PT.  RTC 1/8/08 w/neck & throat discomfort.  Dx w/voice weakness, probable strained cricopharyngial nerve.  Tx w/meds & referred to ENT who dx w/dysphonia following likely vocal misuse.  RTC 2/8/08 w/fatigue, upset stomach, weight loss, polydipsia & nausea x 1 wk.  RTC 2/12/08 s/p fainting in school, lightheaded x 1 wk.  Dx w/syncopal episode & possible dehydration, weight loss & fatigue.  Tx w/IVF & meds.  DM w/u neg.  RTC 2/28 s/p ER visit for generalized pain.  Had been hospitalized previous wk, dx w/pseudoseizure & followed by neuro.  3/27/09 Received Neuro consult medical records of 2/25-3/7/2008. FINAL DX: none provided.  Consult states excessive tiredness, nausea & weight loss likely secondary to viral illness; intermittent weakness of legs posssibly due to dehydration vs presyncope; & recent onset of nonepileptic shaking events. Records reveal patient experienced fatigue during vacation out of state approx 3 wks prior to eval.  Saw PCP after vacation for nausea, weakness.  Hospitalized x 3 days.  Eval by peds neuro at that time & dx w/syncope vs near syncope.  Improved & d/c to home.  Was able to return to school f/t & traveled out of state.  Collapsed & had to be brought back home w/trembling of extremities.  Admitted to hospital for further neuro eval.  Exam & testing all WNL.  D/C to home.  Seen in ER x 2 for recurrence of shaking & aggressive behavior.  Seen in Neuro clinic 3/7/08 where exam WNL.  Dx spells of nonepileptic events.  Referred to psych.
Age: 19.0
Sex: F
Vaccine: HPV4
Symptoms: Back pain, Blood test normal, Chest pain, Headache, Immediate post-injection reaction
Clinical narrative: Immediately after receiving shot,severe pain in injection arm.Had to rest for 10mins in office.Beginning the next day, had a painful knot in back, pain in left lung if deep breath is drawn, muscle weakness on left side from shoulder to fingertips all the way down to toes, muscle weakness, nausea, headache,rash on neck and itchiness on chest.These symptoms progressed and got worse and by Friday. Call Dr's office. Was told the symptoms I described had nothing to do with the Gardasil Shot. After I pressed the issue, the doctor returned my call, stated their office could do nothing and suggested I should see my primary care physician. The primary care doctor was booked solid so went to urgent care center. The doctor on duty did not know much about gardasil and suggested we go to the emergency room at another hospital if symptoms got worse. I took my daughter home and watched over her. She did begin to feel better and as of today the symptoms have subsided. This was her 2nd gardasil shot, the first was given 7/2008. She is scheduled to receive the 3rd shot on 2/3/2009. I am very afraid to have the 3rd shot administered because of the difficulty she experienced with the 2nd shot and the lack of support she received from her doctor and the urgent care doctor.
Age: 19.0
Sex: F
Vaccine: HPV4
Symptoms: Muscular weakness, Nausea, Nodule, Pain in extremity, Pruritus
Clinical narrative: Immediately after receiving shot,severe pain in injection arm.Had to rest for 10mins in office.Beginning the next day, had a painful knot in back, pain in left lung if deep breath is drawn, muscle weakness on left side from shoulder to fingertips all the way down to toes, muscle weakness, nausea, headache,rash on neck and itchiness on chest.These symptoms progressed and got worse and by Friday. Call Dr's office. Was told the symptoms I described had nothing to do with the Gardasil Shot. After I pressed the issue, the doctor returned my call, stated their office could do nothing and suggested I should see my primary care physician. The primary care doctor was booked solid so went to urgent care center. The doctor on duty did not know much about gardasil and suggested we go to the emergency room at another hospital if symptoms got worse. I took my daughter home and watched over her. She did begin to feel better and as of today the symptoms have subsided. This was her 2nd gardasil shot, the first was given 7/2008. She is scheduled to receive the 3rd shot on 2/3/2009. I am very afraid to have the 3rd shot administered because of the difficulty she experienced with the 2nd shot and the lack of support she received from her doctor and the urgent care doctor.
Age: 19.0
Sex: F
Vaccine: HPV4
Symptoms: Rash
Clinical narrative: Immediately after receiving shot,severe pain in injection arm.Had to rest for 10mins in office.Beginning the next day, had a painful knot in back, pain in left lung if deep breath is drawn, muscle weakness on left side from shoulder to fingertips all the way down to toes, muscle weakness, nausea, headache,rash on neck and itchiness on chest.These symptoms progressed and got worse and by Friday. Call Dr's office. Was told the symptoms I described had nothing to do with the Gardasil Shot. After I pressed the issue, the doctor returned my call, stated their office could do nothing and suggested I should see my primary care physician. The primary care doctor was booked solid so went to urgent care center. The doctor on duty did not know much about gardasil and suggested we go to the emergency room at another hospital if symptoms got worse. I took my daughter home and watched over her. She did begin to feel better and as of today the symptoms have subsided. This was her 2nd gardasil shot, the first was given 7/2008. She is scheduled to receive the 3rd shot on 2/3/2009. I am very afraid to have the 3rd shot administered because of the difficulty she experienced with the 2nd shot and the lack of support she received from her doctor and the urgent care doctor.
Age: 0.5
Sex: F
Vaccine: DTAPHEPBIP, HIBV, PNC
Symptoms: Crying, Irritability
Clinical narrative: Prolonged crying spell for hours after vaccine.  Has remained more fussy and easily cries for several days.  Wakes at night more often.
Age: 60.0
Sex: F
Vaccine: VARZOS
Symptoms: Rash erythematous, Rash pruritic
Clinical narrative: Slight, itchy red rash area across belly
Age: 17.0
Sex: F
Vaccine: HPV4
Symptoms: Syncope
Clinical narrative: SYNCOPE
Age: 63.0
Sex: F
Vaccine: VARZOS
Symptoms: Injection site erythema, Injection site swelling, Palpitations
Clinical narrative: PATIENT FELT LIKE HER HEART WAS RACING. SHE HAD A MINOR LOCAL REACTION TO NEOMYCIN IN THE PAST. BASCIALLY, WE CALMED HER, TOOK HER PULSE (56BPM) AND OBSERVED RESPIRATION. HER BREATHING WAS FINE. WE CHECKED THE INJECTION SITE. IT WAS SLIGHTLY RED AND NO SWELLING. IT WAS A TYPICAL FLARE REACTION. TO ERR ON THE SIDE OF CAUTION, WE OBSERVED HER FOR A TOTAL OF 45 MINUTES. SHE WAS RELAXED AND HER PULSE RETURNED TO NORMAL. THREEFORE, WE SENT HER HOME AND ADVISED HER TO TAKE SOME BENADRYL JUST TO BE ON THE SAFE SIDE.
Age: 70.0
Sex: F
Vaccine: VARZOS
Symptoms: Rash
Clinical narrative: Patient reported slight rash across back following a shingle vaccination.
Age: 31.0
Sex: F
Vaccine: TYP, YF
Symptoms: Urticaria, Vaccine positive rechallenge
Clinical narrative: Approximately 6-8 hrs after taking third pill of Vivotif on 1/12/09, pt had generalized whelps/hives.  Pt works in an ER, was seen by a fellow physician and given Benadryl, Pepcid, and 5 day course of Prednisone.  Pt took 4th pill on 1/14/09 and had same reaction exactly.  Time course for both reactions to resolve was until 1/17.
Age: 41.0
Sex: M
Vaccine: FLU3
Symptoms: Blood pressure increased, Chills, Heart rate increased, Hypoaesthesia, Paraesthesia
Clinical narrative: 30 minutes after vaccine developed chills, progressed to numbness, tingling of lips and palate, increased BP and heart rate.
Age: 2.0
Sex: M
Vaccine: MMR
Symptoms: Body temperature increased, Grand mal convulsion, Rash macular
Clinical narrative: Pt received MMR on 1/10/09.  On 1/18/09 at 2am, Pt noted with 103F temp at home, with tonic clonic seizure and macular body rash.  Taken to ER, evaluated and released.  Pt now stable at home.
Age: 0.45
Sex: M
Vaccine: HIBV
Symptoms: Ischaemic stroke, Nuclear magnetic resonance imaging brain abnormal
Clinical narrative: Acute onset right hemisphere ischemic stroke within 12 hours of vaccine administration.  3/11/2009 Received vaccine records & PCP medical records which consisted of hospital records x 2.  Admit 1/15-1/17/2009. FINAL DX: new onset seizure; late onset HTN w/decreased left side movement Records reveal patient experienced seizures.  Tx w/antiseizure meds, antivirals & antibiotics.  Developed fever & OM.  Condition deteriorated & transferred to higher level of care.    Admit 1/17-1/19/2009. FINAL DX: arterial ischemic stroke; focal onset seizures; hypoxia, resolved; and left hemiparesis. Records reveal patient transferred from outlying hospital.  Had experienced left side facial & arm seizures when found by parent.  Had persistent left hemiparesis.  Neuro consults done.  Sick sibling w/viral syndrome.  On d/c had left facial droop, right conjugate gaze, left hemiparesis, left side decreased tone, reflexes 1/4.  Improved & d/c to home w/Neuro, PMR, hearing, ophtho & early intervention referrals.
Age: 43.0
Sex: M
Vaccine: ANTH, HEP
Symptoms: Catheterisation cardiac abnormal, Computerised tomogram coronary artery, Coronary arterial stent insertion, Coronary artery occlusion, Myocardial infarction
Clinical narrative: Pt developed Myocardial infarction and MI a week after administration of Anthrax vaccination. Pt did not have any coronary risk factors (no family history of CAD/MI, No HTN, No HLP). Pt is healthy and active. 1/27/09-records received-Acute myocardial infarction.
Age: 1.25
Sex: M
Vaccine: HIBV, MMR
Symptoms: Autism, Blood immunoglobulin E, Blood immunoglobulin G, Dehydration, Diarrhoea
Clinical narrative: On 04/13/07, my son was treated in the Emergency Room.  He had recently developed a high fever (103. 2) along with repeated projectile vomiting and diarrhea, and the beginnings of dehydration.  He was taken to the emergency room after repeatedly regurgitating the small amounts of Pedialyte we were trying to administer by spoon to prevent dehydration.  In the days immediately prior he had been lethargic and was running a low grade fever that had developed since receiving his MMR and Hib vaccines nine days earlier. Patient was treated with an anti-nausea suppository.  This allowed him to begin to consume small amounts of Pedialyte without vomiting.  He continued to suffer from frequent diarrhea for the next several days. Patient then had a loss of all vocabulary learned to that point. He became withdrawn and no longer made eye contact. He was diagnosed with Autism and is still fighting to recover.  1/27/09 Developmental eval dated 9/18-19/2007 received.  Pt presented for eval of developmental delays, specifically in areas of speech and language as well as concerns for social interaction and safety.   Parents report at approx age 16 months child lost vocab, began having staring spells and zoning out and developed some behavioral concerns.  DX:  Autism Spectrum Disorder.
Age: 1.25
Sex: M
Vaccine: HIBV, MMR
Symptoms: Food allergy, Lethargy, Pyrexia, Regurgitation, Social avoidant behaviour
Clinical narrative: On 04/13/07, my son was treated in the Emergency Room.  He had recently developed a high fever (103. 2) along with repeated projectile vomiting and diarrhea, and the beginnings of dehydration.  He was taken to the emergency room after repeatedly regurgitating the small amounts of Pedialyte we were trying to administer by spoon to prevent dehydration.  In the days immediately prior he had been lethargic and was running a low grade fever that had developed since receiving his MMR and Hib vaccines nine days earlier. Patient was treated with an anti-nausea suppository.  This allowed him to begin to consume small amounts of Pedialyte without vomiting.  He continued to suffer from frequent diarrhea for the next several days. Patient then had a loss of all vocabulary learned to that point. He became withdrawn and no longer made eye contact. He was diagnosed with Autism and is still fighting to recover.  1/27/09 Developmental eval dated 9/18-19/2007 received.  Pt presented for eval of developmental delays, specifically in areas of speech and language as well as concerns for social interaction and safety.   Parents report at approx age 16 months child lost vocab, began having staring spells and zoning out and developed some behavioral concerns.  DX:  Autism Spectrum Disorder.
Age: 1.25
Sex: M
Vaccine: HIBV, MMR
Symptoms: Speech disorder developmental, Vomiting projectile
Clinical narrative: On 04/13/07, my son was treated in the Emergency Room.  He had recently developed a high fever (103. 2) along with repeated projectile vomiting and diarrhea, and the beginnings of dehydration.  He was taken to the emergency room after repeatedly regurgitating the small amounts of Pedialyte we were trying to administer by spoon to prevent dehydration.  In the days immediately prior he had been lethargic and was running a low grade fever that had developed since receiving his MMR and Hib vaccines nine days earlier. Patient was treated with an anti-nausea suppository.  This allowed him to begin to consume small amounts of Pedialyte without vomiting.  He continued to suffer from frequent diarrhea for the next several days. Patient then had a loss of all vocabulary learned to that point. He became withdrawn and no longer made eye contact. He was diagnosed with Autism and is still fighting to recover.  1/27/09 Developmental eval dated 9/18-19/2007 received.  Pt presented for eval of developmental delays, specifically in areas of speech and language as well as concerns for social interaction and safety.   Parents report at approx age 16 months child lost vocab, began having staring spells and zoning out and developed some behavioral concerns.  DX:  Autism Spectrum Disorder.
Age: 5.0
Sex: F
Vaccine: FLUX, HEPA, VARCEL
Symptoms: Chills, Cough, Flushing, Hyperhidrosis, Pyrexia
Clinical narrative: Temperature 104.1, heavy chest congestion, wet hacking cough, chills, sweaty. 3:00 AM 5 ml Childrens tylenol 7:00 AM temp 103.9 7.5 ml childrens motrim. broke the fever, low grade fever persisted the next 12 hours. Flushed skin tiny red dots from 7:00 Am for 12 hours. Cough went away Monday AM
Age: 5.0
Sex: F
Vaccine: FLUX, HEPA, VARCEL
Symptoms: Rash erythematous, Upper respiratory tract congestion
Clinical narrative: Temperature 104.1, heavy chest congestion, wet hacking cough, chills, sweaty. 3:00 AM 5 ml Childrens tylenol 7:00 AM temp 103.9 7.5 ml childrens motrim. broke the fever, low grade fever persisted the next 12 hours. Flushed skin tiny red dots from 7:00 Am for 12 hours. Cough went away Monday AM
Age: 40.0
Sex: M
Vaccine: FLUN3, HEPA, SMALL, TYP
Symptoms: Agitation, Amnesia, Balance disorder, CSF culture negative, CSF lymphocyte count increased
Clinical narrative: This serious case was received via a search of the scientific literature on 12 January 2009. A 40-year-old male serviceman received the following vaccinations on an unknown day in 2005 in preparation for active military duty: smallpox vaccine, typhoid vaccine, hepatitis A vaccine, (manufacturers not reported) and FLUMIST (MedImmune Vaccines). Lot numbers, and site of administration were not reported. The patient had received a primary smallpox vaccination in 1986, 19 years earlier, when he joined the military. He had no reported medical history. Five days post-vaccination, the patient developed photophobia. He was hospitalized eight days post-vaccination, and upon admission was noted to be confused and agitated. Physical examination showed a temperature of 38.2 degrees Celsius, increased upper extremity tone, low-frequency tremor, and a Glasgow coma score of 10. A rash was noted at the site of vaccination. Lumbar puncture revealed an opening pressure of 15 cm of water, a protein concentration of 122 mg/dL, and a WBC count of 294 cells/uL, with 76% lymphocytes and 24% neutrophils. An electroencephalogram revealed diffuse theta-frequency slowing without epileptiform discharges; brain MRI showed no significant abnormalities. The patient was initially treated with ACYCLOVIR, and then PHENYTOIN when he developed generalized seizures. A repeat lumbar puncture 11 days post-vaccination showed an opening pressure of 19 cm of water, a protein concentration of 95 mg/dL, and a WBC count of 137 cell/uL, with 89% lymphocytes, 1% neutrophils, and 10% monocytes. His status improved gradually, and he was discharged 16 days post-vaccination. At the time of discharge, he exhibited residual deficits in short-term memory, coordination, and balance. Serum and CSF samples sent to the Poxvirus Program at the CDC were negative for orthopox virus DNA, and IgM antibody was undetectable. Vaccinia-specific IgG antibody was detected in both serum and CSF. Results of extensive testing for infectious agents were negative. According to the authors, "the five-day lapse to onset of neurological symptoms after secondary smallpox vaccination and lack of evidence of direct CNS infection suggest an autoimmune response to vaccination". In conclusion, it was noted that "the patient in this report meets the surveillance case definition for probably PVE(postvaccinia encephalitis)."
Age: 40.0
Sex: M
Vaccine: FLUN3, HEPA, SMALL, TYP
Symptoms: CSF monocyte count decreased, CSF neutrophil count increased, CSF protein increased, CSF white blood cell count increased, Confusional state
Clinical narrative: This serious case was received via a search of the scientific literature on 12 January 2009. A 40-year-old male serviceman received the following vaccinations on an unknown day in 2005 in preparation for active military duty: smallpox vaccine, typhoid vaccine, hepatitis A vaccine, (manufacturers not reported) and FLUMIST (MedImmune Vaccines). Lot numbers, and site of administration were not reported. The patient had received a primary smallpox vaccination in 1986, 19 years earlier, when he joined the military. He had no reported medical history. Five days post-vaccination, the patient developed photophobia. He was hospitalized eight days post-vaccination, and upon admission was noted to be confused and agitated. Physical examination showed a temperature of 38.2 degrees Celsius, increased upper extremity tone, low-frequency tremor, and a Glasgow coma score of 10. A rash was noted at the site of vaccination. Lumbar puncture revealed an opening pressure of 15 cm of water, a protein concentration of 122 mg/dL, and a WBC count of 294 cells/uL, with 76% lymphocytes and 24% neutrophils. An electroencephalogram revealed diffuse theta-frequency slowing without epileptiform discharges; brain MRI showed no significant abnormalities. The patient was initially treated with ACYCLOVIR, and then PHENYTOIN when he developed generalized seizures. A repeat lumbar puncture 11 days post-vaccination showed an opening pressure of 19 cm of water, a protein concentration of 95 mg/dL, and a WBC count of 137 cell/uL, with 89% lymphocytes, 1% neutrophils, and 10% monocytes. His status improved gradually, and he was discharged 16 days post-vaccination. At the time of discharge, he exhibited residual deficits in short-term memory, coordination, and balance. Serum and CSF samples sent to the Poxvirus Program at the CDC were negative for orthopox virus DNA, and IgM antibody was undetectable. Vaccinia-specific IgG antibody was detected in both serum and CSF. Results of extensive testing for infectious agents were negative. According to the authors, "the five-day lapse to onset of neurological symptoms after secondary smallpox vaccination and lack of evidence of direct CNS infection suggest an autoimmune response to vaccination". In conclusion, it was noted that "the patient in this report meets the surveillance case definition for probably PVE(postvaccinia encephalitis)."