chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 63.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Dizziness, Nausea, Oral herpes
Clinical narrative: Slight dizziness and mild nausea about 20 mins in length,  I sat down and waited for it to pass. That evening I noticed fever sores erupting all around my mouth. I'm trying home remedies for discomfort. No medical attention at this time. Very painful.
Age: 59.0
Sex: M
Vaccine: COVID19
Symptoms: Nausea, Somnolence, Vomiting
Clinical narrative: Felt very nauseous and began to vomit 3 to 4 times, also felt like I couldn't wake up very drogy lasted about 15 hr this all started about 4am on the 14th
Age: 33.0
Sex: F
Vaccine: COVID19
Symptoms: Central nervous system lesion, Headache, Magnetic resonance imaging head abnormal, Malaise, Musculoskeletal stiffness
Clinical narrative: Fever after 24 HRS, sick and in bed all day. From Tuesday to date - leg stiffness and some headaches.  Admitted to Hospital for testing, found lesion on brain.
Age: 33.0
Sex: F
Vaccine: COVID19
Symptoms: Pyrexia
Clinical narrative: Fever after 24 HRS, sick and in bed all day. From Tuesday to date - leg stiffness and some headaches.  Admitted to Hospital for testing, found lesion on brain.
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Cough, Dyspnoea, Headache, Myalgia
Clinical narrative: Presented to ED 4/5.  Fever 102 on 4/3.  Headache, myalgias, chills, cough, shortness of breath.
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Pyrexia
Clinical narrative: Presented to ED 4/5.  Fever 102 on 4/3.  Headache, myalgias, chills, cough, shortness of breath.
Age: 61.0
Sex: M
Vaccine: COVID19
Symptoms: Death
Clinical narrative: Patient passed away on April 4 2021
Age: 22.0
Sex: F
Vaccine: COVID19
Symptoms: Heavy menstrual bleeding, Oligomenorrhoea
Clinical narrative: My menstrual cycleafter the vaccine is prolonged and is causing large bloodclots.
Age: 49.0
Sex: F
Vaccine: COVID19
Symptoms: Oropharyngeal discomfort, Paraesthesia oral, Pharyngeal paraesthesia
Clinical narrative: Pt reported 40 min after the covid vaccine, she had tongue and throat tingling and odd sensation like she had to swallow. She took benadryl, with improvement. 2 hours later, she still had symptoms, so she repeated the dose, and then the symptoms went away.
Age: 17.0
Sex: F
Vaccine: COVID19
Symptoms: Cold sweat, Dizziness, Hyperhidrosis, Lip discolouration, Pallor
Clinical narrative: pt looked pale 10 minutes after vaccine went out to check on him he was getting faint and lips looked purple, was NOT having breathing problems and BP was normal at 104/54, called 911 patient was very clammy and sweaty, stayed with patient until paramedics arrived, patient was feeling much better a little before paramedics arrived, but they decided to take him to hospital
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Burning sensation, Headache, Neck pain, Neuralgia
Clinical narrative: Headache. Severe , burning, nerve pain in neck shoulders and both arms . Right arm swollen from elbow to wrists. Went to Dr.  on 3-19-21 . Told to return in 3 days if not better. They said pulse was ok so prob not a clot. I had pain for two weeks but did not return. At end of two weeks swelling gone . Still some residual pain in right arm, but not constant.
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Pain in extremity, Peripheral swelling
Clinical narrative: Headache. Severe , burning, nerve pain in neck shoulders and both arms . Right arm swollen from elbow to wrists. Went to Dr.  on 3-19-21 . Told to return in 3 days if not better. They said pulse was ok so prob not a clot. I had pain for two weeks but did not return. At end of two weeks swelling gone . Still some residual pain in right arm, but not constant.
Age: 34.0
Sex: M
Vaccine: COVID19
Symptoms: Chills, Hyperhidrosis, Tremor
Clinical narrative: Around 11:30 pm, began experiencing symptoms. By 12:30am,  had extremely severe/uncontrollable  chills and shakes.  I took Advil and the shakes lasted approx another 20 minutes.  Tried to take temperature, but had to physically hold my mouth shut , which was unsuccessful.  The thermometer registered 95°.  Cycles of chills/sweats/shakes continued throughout the night.
Age: 45.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness, Dysphagia, Malaise, Oropharyngeal discomfort, Oropharyngeal pain
Clinical narrative: Patient was treated with Benadryl 50mg liquid at 2:50 pm for dizziness and throat sensation described as trouble swallowing or feeling the need to swallow twice.  BP, HR, O2sats, and temp all wnl.  She did start to complain of more throat pain and described a history of anaphylaxis in the past with the same feeling in her throat; therefore I administered 0.3 mg epinephrine per auto-injector at 3pm and called 911.  Vital signs remained stable including O2 levels, EMS arrived at 3:20 pm, she was starting to feel ill again, they took her to the ER.
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Acute myocardial infarction, Arterial stent insertion, Cardiac arrest, Catheterisation cardiac, Culture urine negative
Clinical narrative: 50 yo female with no medical history known to our system presents with Inferior STEMI with ventricular fibrillation cardiac arrest.  Unknown initial downtime without CPR. Arrived by rescue squad and taken emergently to Cardiac Catheterization Lab, required mid-LAD stenting.  Therapeutic temperature management (TTM), now rewarmed. Currently intubated on mechanical ventilation, on norepinephrine, poor neurological responses, consider neurology consult for brain evaluation/prognostic recommendations.  There is a progress note written by ED RN on 4/12/21 that states family reports she had "her 2nd COVID shot 1 week ago," but per Immunization Registry, only 1 COVID vaccine is recorded.
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Endotracheal intubation, Fibrin D dimer increased, Mechanical ventilation, Neurological symptom, Platelet count normal
Clinical narrative: 50 yo female with no medical history known to our system presents with Inferior STEMI with ventricular fibrillation cardiac arrest.  Unknown initial downtime without CPR. Arrived by rescue squad and taken emergently to Cardiac Catheterization Lab, required mid-LAD stenting.  Therapeutic temperature management (TTM), now rewarmed. Currently intubated on mechanical ventilation, on norepinephrine, poor neurological responses, consider neurology consult for brain evaluation/prognostic recommendations.  There is a progress note written by ED RN on 4/12/21 that states family reports she had "her 2nd COVID shot 1 week ago," but per Immunization Registry, only 1 COVID vaccine is recorded.
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test negative, Troponin I increased, Ventricular fibrillation, White blood cell count increased
Clinical narrative: 50 yo female with no medical history known to our system presents with Inferior STEMI with ventricular fibrillation cardiac arrest.  Unknown initial downtime without CPR. Arrived by rescue squad and taken emergently to Cardiac Catheterization Lab, required mid-LAD stenting.  Therapeutic temperature management (TTM), now rewarmed. Currently intubated on mechanical ventilation, on norepinephrine, poor neurological responses, consider neurology consult for brain evaluation/prognostic recommendations.  There is a progress note written by ED RN on 4/12/21 that states family reports she had "her 2nd COVID shot 1 week ago," but per Immunization Registry, only 1 COVID vaccine is recorded.
Age: 21.0
Sex: F
Vaccine: COVID19
Symptoms: Computerised tomogram, Electrocardiogram, Headache, Injection site rash, Injection site reaction
Clinical narrative: Severe headache continuing for 7 days and rash red 2 in circle near vaccine site started on day 5.
Age: 21.0
Sex: F
Vaccine: COVID19
Symptoms: Laboratory test, Rash erythematous, Scan with contrast
Clinical narrative: Severe headache continuing for 7 days and rash red 2 in circle near vaccine site started on day 5.
Age: 32.0
Sex: F
Vaccine: COVID19
Symptoms: Blood glucose normal, Dizziness, Fall, Tonic clonic movements, Vomiting
Clinical narrative: Patient received Covid vaccine at 10:17am. Left exam room to wait for 15 minutes. At 10:20 am patient felt light headed and began to fall. Medical Assistant and help lowered patient to the floor. Head was protected . Patient began to have tonic clonic posturing for about 30 seconds that stopped. Emesis x2 yellow in coloring. Blood pressure 121/78, Blood glucose 90, and pulse oximetry was 95%. Doctor assessed and paramedics were called. Paramedics arrived  at 1030 am and transported patient to the ER.
Age: 34.0
Sex: F
Vaccine: COVID19
Symptoms: Diarrhoea, Fatigue, Nausea, Vomiting
Clinical narrative: Tiredness, extreme nausea, diarrhea and vomiting.
Age: 28.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Headache, Malaise, Pain, Somnolence
Clinical narrative: She received the second dose of the Pfizer Covid19 vaccine yesterday morning. Yesterday mid-day she was hit with a wave of sleepiness. She slept a full night's sleep, and woke up feeling really bad.: Overall body 'aches and pains'. Headache that comes and goes. Then, throughout the day she's been hit with sever tiredness. She's been sleeping most of the entire day, and it's 3:40pm currently.  No fever or nausea, currently.
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Injection site pain, Myalgia, Pyrexia
Clinical narrative: Fever 12 hours after shot of 104.2-Fever lasted 2 days.  Fever could not be broken by tyenol or motrin.   Fatigue  for 2 days,   muscle aches for 2 days Soreness at injection site for 1 day.
Age: 35.0
Sex: F
Vaccine: COVID19
Symptoms: Eye swelling, Feeling hot, Inflammation, Swelling face
Clinical narrative: The next evening following the vaccine, my right eye swelled (the white of the eye) and my cheek and above my eyebrow became inflamed on the right side only. I visited the ER the next morning and they told me it looked like an unrelated allergic reaction. She said it looked almost like the pattern of shingles but said that was unlikely. Visited another dr who said it looked like the possible beginnings of shingles based on the affected areas and that I should monitor. Face feels hot, eye swelling went away after Benadryl use the first night but cheek and eyebrow are still inflamed.
Age: 86.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Biopsy, Pruritus, Rash
Clinical narrative: Rash and itching that started on fingers of right hand, rash then progressed to chest/back and eventually most of her body. Patient prescribed a steroid cream to relieve itching but rash has never went away.
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Wrong product administered
Clinical narrative: First dose given 3/25/2021 was Pfizer EN6207. Inadvertently gave Moderna vaccine when doing a clinic. No reaction noted at this time.
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Ageusia, Bell's palsy, Facial paralysis, Hypoaesthesia oral
Clinical narrative: Patient presented to my office for a routine visit (as her family doctor) the very next day after she started noticing symptoms. First it started with some numbness of her tongue on the left and accompanying decrease in taste. The next morning (day of my appointment with her) she woke up with left side facial drooping involving the entire left face. I diagnosed her with Bell's Palsy today and discussed the case with a neurologist at the academic center nearby and started treatment of prednisone  for 7 days. Also instructed other conservative measures such as eye wetting drops and eye patch.
Age: 65.0
Sex: M
Vaccine: COVID19
Symptoms: Acute myocardial infarction, Acute respiratory failure, Bilevel positive airway pressure, Blood bicarbonate normal, Blood pH decreased
Clinical narrative: Emergency Department Note (Verified) Visit Date:  04/13/2021  CHIEF COMPLAINT: Shortness of breath.  HISTORY OF PRESENT ILLNESS: The patient is a 65-year-old male with a history of hypertension and congestive heart failure, presents with shortness of breath that started on Friday and worsened significantly this morning.  He does have some chest discomfort with this.  No fevers, chills, or other complaints.  Discharge Diagnoses   1. Hypertensive emergency, 04/13/2021  2. Chest discomfort, 04/14/2021  3. Heart failure, systolic, 04/13/2021  Assessment and Plan 65M w/ HTN and HFrEF p/w hypoxic respiratory failure i/s/o a hypertensive emergency. BP and respiratory status much improved, admitted to CCU for acute BP management and medication titration.   #HTN Emergency Likely precipitated by lack of medication non-adherence since 04/11, when he ran out of his medications. SBP approx 220 at time of presentation, good response to enalapril and nitro gtt. Decreased work of breathing with Bi-pap. MAP 130-140 on presentation, will attempt to lower by 20-25% in first 2-6hrs w/ MAP goal of approx 100, while aiming towards normotensive in next 24-48 hrs while transitioning from IV to PO meds. -TTE ordered -cont incremental BP mgmt:  -goal MAP < 110    -prn hydralazine  -gradual goal towards normotensive over next 24-48hrs thereafter -cardiac monitor -will ensure that patient has anti-hypertensives prior to DC -q4hr neuro checks  #Acute Hypoxic and Hypercapnic respiratory failure  Decreased work of breathing with Bi-pap. Likely related to HTN emergency as above in addition to moderate-severe volume overload as seen on CXR. VBG in am of 4/13 showed pH 7.17, pCO2 64, pO2 58, bicarb 24. -cont Bi-pap, will wean as tolerable  -repeat VBG this am for resp acidosis  #HFrEF w/ acute exacerbation Last echo 04/14/2017, LVEF 38%, cxr on admission shows moderate-severe volume overload. -TTE ordered on 4/13 -may consider additional diuresis, given furosemide in ED on presentation, mindful of BP -goal net negative 1-2L/24hrs as pressures permit -daily standing weights -fluid and sodium restriction when off Bi-Pap  #NSTEMI Likely type II given HTN emergency, did have chest pain on presentation which was relieved with BP control. -trend trops until flat, next at 08:00  #type II DM Hgb A1c 7.5% on 4/13, mild hyperglycemia on presentation -SSI  #polycythemia Could be indicative of undiagnosed OSA vs manifestation of heart failure. Additionally, hemoconcentration from CHF i/s/o HTN emergency is another possibility. -TTE as above -ctm w/ am labs  #lymphocytosis Afebrile, no urinary symptoms. Hypoxic on presentation, likely related to edema i/s/o HTN emergency as above. No suspicion for infectious etiology at this time, no white count. -ctm w/ am labs  #HLD -cont statin  #QTC prolongation 561 on 4/13/2021 -avoid QTc prolonging medications
Age: 65.0
Sex: M
Vaccine: COVID19
Symptoms: Cardiac failure congestive, Cardiac monitoring, Chest X-ray abnormal, Chest discomfort, Condition aggravated
Clinical narrative: Emergency Department Note (Verified) Visit Date:  04/13/2021  CHIEF COMPLAINT: Shortness of breath.  HISTORY OF PRESENT ILLNESS: The patient is a 65-year-old male with a history of hypertension and congestive heart failure, presents with shortness of breath that started on Friday and worsened significantly this morning.  He does have some chest discomfort with this.  No fevers, chills, or other complaints.  Discharge Diagnoses   1. Hypertensive emergency, 04/13/2021  2. Chest discomfort, 04/14/2021  3. Heart failure, systolic, 04/13/2021  Assessment and Plan 65M w/ HTN and HFrEF p/w hypoxic respiratory failure i/s/o a hypertensive emergency. BP and respiratory status much improved, admitted to CCU for acute BP management and medication titration.   #HTN Emergency Likely precipitated by lack of medication non-adherence since 04/11, when he ran out of his medications. SBP approx 220 at time of presentation, good response to enalapril and nitro gtt. Decreased work of breathing with Bi-pap. MAP 130-140 on presentation, will attempt to lower by 20-25% in first 2-6hrs w/ MAP goal of approx 100, while aiming towards normotensive in next 24-48 hrs while transitioning from IV to PO meds. -TTE ordered -cont incremental BP mgmt:  -goal MAP < 110    -prn hydralazine  -gradual goal towards normotensive over next 24-48hrs thereafter -cardiac monitor -will ensure that patient has anti-hypertensives prior to DC -q4hr neuro checks  #Acute Hypoxic and Hypercapnic respiratory failure  Decreased work of breathing with Bi-pap. Likely related to HTN emergency as above in addition to moderate-severe volume overload as seen on CXR. VBG in am of 4/13 showed pH 7.17, pCO2 64, pO2 58, bicarb 24. -cont Bi-pap, will wean as tolerable  -repeat VBG this am for resp acidosis  #HFrEF w/ acute exacerbation Last echo 04/14/2017, LVEF 38%, cxr on admission shows moderate-severe volume overload. -TTE ordered on 4/13 -may consider additional diuresis, given furosemide in ED on presentation, mindful of BP -goal net negative 1-2L/24hrs as pressures permit -daily standing weights -fluid and sodium restriction when off Bi-Pap  #NSTEMI Likely type II given HTN emergency, did have chest pain on presentation which was relieved with BP control. -trend trops until flat, next at 08:00  #type II DM Hgb A1c 7.5% on 4/13, mild hyperglycemia on presentation -SSI  #polycythemia Could be indicative of undiagnosed OSA vs manifestation of heart failure. Additionally, hemoconcentration from CHF i/s/o HTN emergency is another possibility. -TTE as above -ctm w/ am labs  #lymphocytosis Afebrile, no urinary symptoms. Hypoxic on presentation, likely related to edema i/s/o HTN emergency as above. No suspicion for infectious etiology at this time, no white count. -ctm w/ am labs  #HLD -cont statin  #QTC prolongation 561 on 4/13/2021 -avoid QTc prolonging medications
Age: 65.0
Sex: M
Vaccine: COVID19
Symptoms: Dyspnoea, Echocardiogram abnormal, Electrocardiogram QT prolonged, Fluid overload, Hyperglycaemia
Clinical narrative: Emergency Department Note (Verified) Visit Date:  04/13/2021  CHIEF COMPLAINT: Shortness of breath.  HISTORY OF PRESENT ILLNESS: The patient is a 65-year-old male with a history of hypertension and congestive heart failure, presents with shortness of breath that started on Friday and worsened significantly this morning.  He does have some chest discomfort with this.  No fevers, chills, or other complaints.  Discharge Diagnoses   1. Hypertensive emergency, 04/13/2021  2. Chest discomfort, 04/14/2021  3. Heart failure, systolic, 04/13/2021  Assessment and Plan 65M w/ HTN and HFrEF p/w hypoxic respiratory failure i/s/o a hypertensive emergency. BP and respiratory status much improved, admitted to CCU for acute BP management and medication titration.   #HTN Emergency Likely precipitated by lack of medication non-adherence since 04/11, when he ran out of his medications. SBP approx 220 at time of presentation, good response to enalapril and nitro gtt. Decreased work of breathing with Bi-pap. MAP 130-140 on presentation, will attempt to lower by 20-25% in first 2-6hrs w/ MAP goal of approx 100, while aiming towards normotensive in next 24-48 hrs while transitioning from IV to PO meds. -TTE ordered -cont incremental BP mgmt:  -goal MAP < 110    -prn hydralazine  -gradual goal towards normotensive over next 24-48hrs thereafter -cardiac monitor -will ensure that patient has anti-hypertensives prior to DC -q4hr neuro checks  #Acute Hypoxic and Hypercapnic respiratory failure  Decreased work of breathing with Bi-pap. Likely related to HTN emergency as above in addition to moderate-severe volume overload as seen on CXR. VBG in am of 4/13 showed pH 7.17, pCO2 64, pO2 58, bicarb 24. -cont Bi-pap, will wean as tolerable  -repeat VBG this am for resp acidosis  #HFrEF w/ acute exacerbation Last echo 04/14/2017, LVEF 38%, cxr on admission shows moderate-severe volume overload. -TTE ordered on 4/13 -may consider additional diuresis, given furosemide in ED on presentation, mindful of BP -goal net negative 1-2L/24hrs as pressures permit -daily standing weights -fluid and sodium restriction when off Bi-Pap  #NSTEMI Likely type II given HTN emergency, did have chest pain on presentation which was relieved with BP control. -trend trops until flat, next at 08:00  #type II DM Hgb A1c 7.5% on 4/13, mild hyperglycemia on presentation -SSI  #polycythemia Could be indicative of undiagnosed OSA vs manifestation of heart failure. Additionally, hemoconcentration from CHF i/s/o HTN emergency is another possibility. -TTE as above -ctm w/ am labs  #lymphocytosis Afebrile, no urinary symptoms. Hypoxic on presentation, likely related to edema i/s/o HTN emergency as above. No suspicion for infectious etiology at this time, no white count. -ctm w/ am labs  #HLD -cont statin  #QTC prolongation 561 on 4/13/2021 -avoid QTc prolonging medications
Age: 65.0
Sex: M
Vaccine: COVID19
Symptoms: Hyperlipidaemia, Hypertensive emergency, Intensive care, Left ventricular failure, Lymphocytosis
Clinical narrative: Emergency Department Note (Verified) Visit Date:  04/13/2021  CHIEF COMPLAINT: Shortness of breath.  HISTORY OF PRESENT ILLNESS: The patient is a 65-year-old male with a history of hypertension and congestive heart failure, presents with shortness of breath that started on Friday and worsened significantly this morning.  He does have some chest discomfort with this.  No fevers, chills, or other complaints.  Discharge Diagnoses   1. Hypertensive emergency, 04/13/2021  2. Chest discomfort, 04/14/2021  3. Heart failure, systolic, 04/13/2021  Assessment and Plan 65M w/ HTN and HFrEF p/w hypoxic respiratory failure i/s/o a hypertensive emergency. BP and respiratory status much improved, admitted to CCU for acute BP management and medication titration.   #HTN Emergency Likely precipitated by lack of medication non-adherence since 04/11, when he ran out of his medications. SBP approx 220 at time of presentation, good response to enalapril and nitro gtt. Decreased work of breathing with Bi-pap. MAP 130-140 on presentation, will attempt to lower by 20-25% in first 2-6hrs w/ MAP goal of approx 100, while aiming towards normotensive in next 24-48 hrs while transitioning from IV to PO meds. -TTE ordered -cont incremental BP mgmt:  -goal MAP < 110    -prn hydralazine  -gradual goal towards normotensive over next 24-48hrs thereafter -cardiac monitor -will ensure that patient has anti-hypertensives prior to DC -q4hr neuro checks  #Acute Hypoxic and Hypercapnic respiratory failure  Decreased work of breathing with Bi-pap. Likely related to HTN emergency as above in addition to moderate-severe volume overload as seen on CXR. VBG in am of 4/13 showed pH 7.17, pCO2 64, pO2 58, bicarb 24. -cont Bi-pap, will wean as tolerable  -repeat VBG this am for resp acidosis  #HFrEF w/ acute exacerbation Last echo 04/14/2017, LVEF 38%, cxr on admission shows moderate-severe volume overload. -TTE ordered on 4/13 -may consider additional diuresis, given furosemide in ED on presentation, mindful of BP -goal net negative 1-2L/24hrs as pressures permit -daily standing weights -fluid and sodium restriction when off Bi-Pap  #NSTEMI Likely type II given HTN emergency, did have chest pain on presentation which was relieved with BP control. -trend trops until flat, next at 08:00  #type II DM Hgb A1c 7.5% on 4/13, mild hyperglycemia on presentation -SSI  #polycythemia Could be indicative of undiagnosed OSA vs manifestation of heart failure. Additionally, hemoconcentration from CHF i/s/o HTN emergency is another possibility. -TTE as above -ctm w/ am labs  #lymphocytosis Afebrile, no urinary symptoms. Hypoxic on presentation, likely related to edema i/s/o HTN emergency as above. No suspicion for infectious etiology at this time, no white count. -ctm w/ am labs  #HLD -cont statin  #QTC prolongation 561 on 4/13/2021 -avoid QTc prolonging medications
Age: 65.0
Sex: M
Vaccine: COVID19
Symptoms: PCO2 increased, Polycythaemia, Polyuria, Respiratory failure
Clinical narrative: Emergency Department Note (Verified) Visit Date:  04/13/2021  CHIEF COMPLAINT: Shortness of breath.  HISTORY OF PRESENT ILLNESS: The patient is a 65-year-old male with a history of hypertension and congestive heart failure, presents with shortness of breath that started on Friday and worsened significantly this morning.  He does have some chest discomfort with this.  No fevers, chills, or other complaints.  Discharge Diagnoses   1. Hypertensive emergency, 04/13/2021  2. Chest discomfort, 04/14/2021  3. Heart failure, systolic, 04/13/2021  Assessment and Plan 65M w/ HTN and HFrEF p/w hypoxic respiratory failure i/s/o a hypertensive emergency. BP and respiratory status much improved, admitted to CCU for acute BP management and medication titration.   #HTN Emergency Likely precipitated by lack of medication non-adherence since 04/11, when he ran out of his medications. SBP approx 220 at time of presentation, good response to enalapril and nitro gtt. Decreased work of breathing with Bi-pap. MAP 130-140 on presentation, will attempt to lower by 20-25% in first 2-6hrs w/ MAP goal of approx 100, while aiming towards normotensive in next 24-48 hrs while transitioning from IV to PO meds. -TTE ordered -cont incremental BP mgmt:  -goal MAP < 110    -prn hydralazine  -gradual goal towards normotensive over next 24-48hrs thereafter -cardiac monitor -will ensure that patient has anti-hypertensives prior to DC -q4hr neuro checks  #Acute Hypoxic and Hypercapnic respiratory failure  Decreased work of breathing with Bi-pap. Likely related to HTN emergency as above in addition to moderate-severe volume overload as seen on CXR. VBG in am of 4/13 showed pH 7.17, pCO2 64, pO2 58, bicarb 24. -cont Bi-pap, will wean as tolerable  -repeat VBG this am for resp acidosis  #HFrEF w/ acute exacerbation Last echo 04/14/2017, LVEF 38%, cxr on admission shows moderate-severe volume overload. -TTE ordered on 4/13 -may consider additional diuresis, given furosemide in ED on presentation, mindful of BP -goal net negative 1-2L/24hrs as pressures permit -daily standing weights -fluid and sodium restriction when off Bi-Pap  #NSTEMI Likely type II given HTN emergency, did have chest pain on presentation which was relieved with BP control. -trend trops until flat, next at 08:00  #type II DM Hgb A1c 7.5% on 4/13, mild hyperglycemia on presentation -SSI  #polycythemia Could be indicative of undiagnosed OSA vs manifestation of heart failure. Additionally, hemoconcentration from CHF i/s/o HTN emergency is another possibility. -TTE as above -ctm w/ am labs  #lymphocytosis Afebrile, no urinary symptoms. Hypoxic on presentation, likely related to edema i/s/o HTN emergency as above. No suspicion for infectious etiology at this time, no white count. -ctm w/ am labs  #HLD -cont statin  #QTC prolongation 561 on 4/13/2021 -avoid QTc prolonging medications
Age: 31.0
Sex: M
Vaccine: COVID19
Symptoms: Interchange of vaccine products, No adverse event
Clinical narrative: Patient previously got COVID vaccine 017B21A on 3/26/21. Patient was inadvertently given P ER8733 on 4/14/21.  He thought he was receiving the second dose of M.  Mistake was realized after looking at patient's vaccination card.  Patient continues to be asymptomatic as of today's date.
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: Bell's palsy
Clinical narrative: Onset of Bells Palsey
Age: 51.0
Sex: M
Vaccine: COVID19
Symptoms: Blood creatine phosphokinase increased, Rhabdomyolysis
Clinical narrative: Rhabdomyolysis
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: Pruritus, Rash, Vaccine positive rechallenge
Clinical narrative: 56 y/o female, with history of Adult Onset Diabetes, presents with left arm itching and faint rash post vaccination administration. Patient vaccination site was the left deltoid. NP and Paramedics at patient side. Patient denies sore throat, difficulty breathing or chest pain. Patient states that she had the same reaction with the initial vaccination and Benadryl was given. Patient given Benadryl 25 mg PO x1 and patient was observed and within 20 minutes symptoms resolved. Patient felt better, rash resolved and was discharged home in stable condition. ------------------------------------------------------------------------------------------------------END
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal discomfort, Abdominal pain, Back pain, Dyspnoea, Headache
Clinical narrative: Severe headache neck pain after 2 days of vaccination. The migraine-like headache lasted 3 days, still have mild neck pain now (day 17 from vaccination).  After 11 days of vaccination, had abdominal pain, lasted about 12 hours. After that developed leg and back pain, which lasted one day. After 2 weeks, noticed shortness of breath and feeling like something stuck between my stomach and chest. Still have this symptom now (day 17).
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: Neck pain, Pain in extremity
Clinical narrative: Severe headache neck pain after 2 days of vaccination. The migraine-like headache lasted 3 days, still have mild neck pain now (day 17 from vaccination).  After 11 days of vaccination, had abdominal pain, lasted about 12 hours. After that developed leg and back pain, which lasted one day. After 2 weeks, noticed shortness of breath and feeling like something stuck between my stomach and chest. Still have this symptom now (day 17).
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Blindness unilateral, Cerebrovascular accident, Eye pain
Clinical narrative: Patient reports that she had pain behind her eye. Went to hospital and was diagnosed with having a stroke. Patient states she lost sight in her left eye and is still blind in her left eye. Optometrist states patient will not regain her vision in her left eye.
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site pain
Clinical narrative: muscle pain in the arm /shoulder  where vaccine was administered after 1st shot
Age: 36.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Computerised tomogram, Facial paralysis, Headache, Hemiparesis, Magnetic resonance imaging
Clinical narrative: Patient received Janssen vaccine on 3/26/21.  States she had a headache on day one of receiving vaccine and progressive neuro symptoms afterwards.  Went to UC 4/14/21 with facial drooping, left side weakness.  Sent to ED and airlifted to hospital.
Age: 36.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Neurological symptom
Clinical narrative: Patient received Janssen vaccine on 3/26/21.  States she had a headache on day one of receiving vaccine and progressive neuro symptoms afterwards.  Went to UC 4/14/21 with facial drooping, left side weakness.  Sent to ED and airlifted to hospital.
Age: 36.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Anticoagulant therapy, Blood test, Cerebrovascular accident, Computerised tomogram head abnormal, Fatigue
Clinical narrative: Patient received Janssen vaccine on 3/26/21.  States she had a headache on day one of receiving vaccine and progressive neuro symptoms afterwards.  Went to UC 4/14/21 with facial drooping, left side weakness.  Sent to ED and airlifted to hospital.
Age: 36.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Headache, Magnetic resonance imaging head abnormal, Nausea, Pain in extremity, Photophobia
Clinical narrative: Patient received Janssen vaccine on 3/26/21.  States she had a headache on day one of receiving vaccine and progressive neuro symptoms afterwards.  Went to UC 4/14/21 with facial drooping, left side weakness.  Sent to ED and airlifted to hospital.
Age: 36.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Thrombosis, Ultrasound Doppler abnormal
Clinical narrative: Patient received Janssen vaccine on 3/26/21.  States she had a headache on day one of receiving vaccine and progressive neuro symptoms afterwards.  Went to UC 4/14/21 with facial drooping, left side weakness.  Sent to ED and airlifted to hospital.
Age: 64.0
Sex: M
Vaccine: COVID19
Symptoms: No adverse event
Clinical narrative: None stated.
Age: 32.0
Sex: M
Vaccine: COVID19
Symptoms: Syncope
Clinical narrative: syncope.  collapsed from sitting position.   emergency services called and arrived.  administered aid.  stabilized patient but he and wife refused further emergency services.  left on his own recognizance
Age: 43.0
Sex: M
Vaccine: COVID19
Symptoms: Dizziness, Malaise, Pain in extremity, Paraesthesia, Pyrexia
Clinical narrative: Malaise, sinus congestion, dizziness, mild fever (99.4 degrees F), increasing in severity since waking at 5:45 am April 15  Sore left arm, including some tingling along left forearm and back of left hand (diminished within a few minutes of waking)
Age: 43.0
Sex: M
Vaccine: COVID19
Symptoms: Sinus congestion
Clinical narrative: Malaise, sinus congestion, dizziness, mild fever (99.4 degrees F), increasing in severity since waking at 5:45 am April 15  Sore left arm, including some tingling along left forearm and back of left hand (diminished within a few minutes of waking)
Age: 43.0
Sex: F
Vaccine: COVID19
Symptoms: Cerebrovascular accident, Magnetic resonance imaging abnormal, Thrombosis
Clinical narrative: I had the the vaccine on Friday then Monday i had a stroke from a blood clot
Age: 18.0
Sex: M
Vaccine: COVID19
Symptoms: Dysarthria, Fatigue, Hyperhidrosis, Pallor, Photophobia
Clinical narrative: Patient received the Pfizer COVID vaccine (Lot EW0150, exp 7/2021) dose 1 at 1400. At 1405, EMT approached patient who appeared pale and diaphoretic with his eyes closed. PHN approached to assess, patient had slow speech and pulse felt thready. Vital signs: O2 99%, pulse 56, respirations 24. Patient had thick sweatshirt on EMT had difficulty obtaining blood pressure. Paramedic approached to assist. At 1410, PHN, EMT, and paramedic transfered patient to zero gravity chair and placed in reclining position. Patient was offered water and he verbalized feeling better. Patient denied allergies, medical conditions, or medications. PHN assisted patient in removing sweatshirt partially to obtain blood pressure. Vital signs: O2 99%, pulse 51, blood pressure 92/60, respirations 24. PHN offered Benadryl but patient declined. PHN advised on when to call 911. At 1422, patient reported light sensitivity and blurry vision. At 1425, vital signs: pulse 52, respirations 18, O2 99%, blood pressure 118/84. At 1535, vital signs: O2 99%, pulse 58, respirations 18, blood pressure 110/66. Patient reported continued improvement in symptoms, only feeling tired. Patient reported working out, only sleeping 2 hours that night, and not eating before coming in. PHN called family member at patient's request to drive patient home. At 1439, patient assisted to seated position in zero-gravity chair by PHN and EMT. Patient reported symptoms had resolved and he felt back to baseline. At 1445, patient stood up, monitored closely by PHN and EMT. At 1449, patient left walking with steady gait to parking lot where family member was waiting to drive patient home.
Age: 18.0
Sex: M
Vaccine: COVID19
Symptoms: Pulse abnormal
Clinical narrative: Patient received the Pfizer COVID vaccine (Lot EW0150, exp 7/2021) dose 1 at 1400. At 1405, EMT approached patient who appeared pale and diaphoretic with his eyes closed. PHN approached to assess, patient had slow speech and pulse felt thready. Vital signs: O2 99%, pulse 56, respirations 24. Patient had thick sweatshirt on EMT had difficulty obtaining blood pressure. Paramedic approached to assist. At 1410, PHN, EMT, and paramedic transfered patient to zero gravity chair and placed in reclining position. Patient was offered water and he verbalized feeling better. Patient denied allergies, medical conditions, or medications. PHN assisted patient in removing sweatshirt partially to obtain blood pressure. Vital signs: O2 99%, pulse 51, blood pressure 92/60, respirations 24. PHN offered Benadryl but patient declined. PHN advised on when to call 911. At 1422, patient reported light sensitivity and blurry vision. At 1425, vital signs: pulse 52, respirations 18, O2 99%, blood pressure 118/84. At 1535, vital signs: O2 99%, pulse 58, respirations 18, blood pressure 110/66. Patient reported continued improvement in symptoms, only feeling tired. Patient reported working out, only sleeping 2 hours that night, and not eating before coming in. PHN called family member at patient's request to drive patient home. At 1439, patient assisted to seated position in zero-gravity chair by PHN and EMT. Patient reported symptoms had resolved and he felt back to baseline. At 1445, patient stood up, monitored closely by PHN and EMT. At 1449, patient left walking with steady gait to parking lot where family member was waiting to drive patient home.
Age: 68.0
Sex: M
Vaccine: VARZOS
Symptoms: Injection site pain, Injection site reaction, Injection site swelling, Injection site warmth, Macule
Clinical narrative: 1. First 24 hours, local site hot, tender and swollen 2. First 36 hours, malaise 3. After 48 hours, slightly tender slightly raised red macule , lateral side of left arm, distal to vaccine site, 12cm x 6 cm horizontally positioned
Age: 68.0
Sex: M
Vaccine: VARZOS
Symptoms: Malaise
Clinical narrative: 1. First 24 hours, local site hot, tender and swollen 2. First 36 hours, malaise 3. After 48 hours, slightly tender slightly raised red macule , lateral side of left arm, distal to vaccine site, 12cm x 6 cm horizontally positioned
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, Balance disorder, Chest X-ray, Dehydration, Gait disturbance
Clinical narrative: 04/09/2021 Patient became very week and unable to balance or walk, was dehydrated. Called 911 who transported to Hospital ER, was kept for 6 hours, did chest X-Ray and administered IV fluids, was discharged to home in much better condition.
Age: 18.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Patient was administered a dose that was beyond the known stability of 6 hours for the vaccine; it was likely 15 to 18 hours beyond known stability period.
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Muscle spasms, Muscular weakness
Clinical narrative: 4/13/21 in the morning felt ok, afternoon felt both thighs were tight and crampy, later left thigh  feeling  moved to below knee. about 5 pm my legs felt weak and I had a difficult time to bend down/squat to oven, I could not get up unless I held on to something sturdy. I never had this before as day before I was able to bake and bend/squat down with no problem.
Age: 21.0
Sex: F
Vaccine: COVID19
Symptoms: Chest X-ray normal, Chest discomfort, Dyspnoea, Electrocardiogram normal, Fibrin D dimer normal
Clinical narrative: 3 days post vaccine short of breath on exertion and chest tightness
Age: 21.0
Sex: F
Vaccine: COVID19
Symptoms: Full blood count normal, Metabolic function test
Clinical narrative: 3 days post vaccine short of breath on exertion and chest tightness
Age: 63.0
Sex: F
Vaccine: VARZOS
Symptoms: Asthenia, Axillary pain, Chills, Decreased appetite, Fatigue
Clinical narrative: Injection site swelling, pain. Armpit swelling & pain. Chills, fatigue, weakness, total body aches, loss of appetite. This all lasted about 2 days. Very similar effects after first injection but didn?t last as long & much more severe with second injection. I was pretty much incapacitated for 2 days.
Age: 63.0
Sex: F
Vaccine: VARZOS
Symptoms: Injection site pain, Injection site swelling, Oedema peripheral, Pain, Vaccine positive rechallenge
Clinical narrative: Injection site swelling, pain. Armpit swelling & pain. Chills, fatigue, weakness, total body aches, loss of appetite. This all lasted about 2 days. Very similar effects after first injection but didn?t last as long & much more severe with second injection. I was pretty much incapacitated for 2 days.
Age: 31.0
Sex: M
Vaccine: COVID19
Symptoms: Inappropriate schedule of product administration, Interchange of vaccine products, No adverse event
Clinical narrative: There were no actual physical events, This was a medication error. Patient had reported that he had received the Pfizer vaccine for his 1st dose to the person registering him for his 2nd dose of vaccine, Therefore he was registered for a Pfizer clinic. When he presented to the clinic, the staff administering the vaccine did not observe on his vaccine card he had received Moderna for his first dose and gave him the Pfizer vaccine as his second dose in error.
Age: 31.0
Sex: F
Vaccine: COVID19
Symptoms: Hypersensitivity, Pharyngeal swelling, Swelling face, Swollen tongue
Clinical narrative: Allergic reaction - face, throat, and tongue swelling
Age: 33.0
Sex: M
Vaccine: COVID19
Symptoms: Chills, Fatigue, Nausea, Pain, Pyrexia
Clinical narrative: Severe chills 8 hours after injection. Fever of 102, body aches, 8-16 hours after. Fever of 100, body aches, nausea, fatigue 16-30 hours after injection.
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Labyrinthitis, Vertigo
Clinical narrative: vertigo due to peripheral labyrinthitis
Age: 41.0
Sex: F
Vaccine: COVID19
Symptoms: Pain in extremity, Paraesthesia
Clinical narrative: tingling or "pins and needles" in fingers for weeks after the vaccine injection (this is unusual and not something I've had after a vaccine or shot before), still ongoing local soreness (normal for vaccines including flu shots I've had before), this resolved after 48 hours
Age: 30.0
Sex: F
Vaccine: COVID19
Symptoms: Erythema, Flushing, Paraesthesia
Clinical narrative: Left arm tingling and the feeling of being flushed with redness on  upper chest.
Age: 65.0
Sex: M
Vaccine: COVID19
Symptoms: Deep vein thrombosis, Full blood count, Glycosylated haemoglobin, Metabolic function test
Clinical narrative: DVT
Age: 62.0
Sex: M
Vaccine: COVID19
Symptoms: Eye pain, Halo vision, Ocular hyperaemia, Ophthalmological examination, Uveitis
Clinical narrative: I personally began developing left eye symptoms (eye pain, redness, decreased vision and seeing halos around lights in my left eye only)  on February 21 and was subsequently diagnosed with pretty severe, acute left eye anterior uveitis on February 23. (Thankfully, it appears to have fully resolved with a course of ocular steroid eyedrops.) I received my initial Moderna vaccine on January 4, with my second dose on January 27.   I have never had anterior uveitis before, and of course I have no idea if it is related to my vaccination. I am at increased risk for anterior uveitis as I have psoriasis and I am HLA B27 positive.
Age: 62.0
Sex: M
Vaccine: COVID19
Symptoms: Visual impairment
Clinical narrative: I personally began developing left eye symptoms (eye pain, redness, decreased vision and seeing halos around lights in my left eye only)  on February 21 and was subsequently diagnosed with pretty severe, acute left eye anterior uveitis on February 23. (Thankfully, it appears to have fully resolved with a course of ocular steroid eyedrops.) I received my initial Moderna vaccine on January 4, with my second dose on January 27.   I have never had anterior uveitis before, and of course I have no idea if it is related to my vaccination. I am at increased risk for anterior uveitis as I have psoriasis and I am HLA B27 positive.
Age: 33.0
Sex: M
Vaccine: COVID19
Symptoms: Dizziness, Nausea, Somnolence, Tachycardia, Tremor
Clinical narrative: Rec'd covid vaccine dose 1 @ 1430. c/o nausea, dizzy, tachy @1440. taken from theater chair to gurney@1443 HR 114 Left BP 134/94 sats 94% on RA. 1446 given apple juice box, fruit snacks and water LEFT BP 136/94 HR 104 sats 94%increased drowsiness, bilateral arm tremor, nauseous, able to answer all questions, aaox3 however drifting to sleep eyes closed often during conversation. pt stated takes depakote, chart review revealed depakote, cogen, plenate with h/o schizophrenia. 1459 BP LEFT while sitting up on gurneu 129/94 HR 120 RA 96% no longer dizzy or nauseous. 1502 sitting up, talking, recovered. 1504 LEFT BP 113/100 RA 94% ambulated to parking lot without assistance to depart in handivan.
Age: 58.0
Sex: F
Vaccine: COVID19
Symptoms: Chest X-ray, Chest pain, Dyspnoea, Fatigue, Pruritus
Clinical narrative: Per patient she began to feel tired and out of breath, and as if something was stuck in her throat on 3/19/21. Patient states she went to Hospital freestanding emergency room around 4:30pm, she says she was given medication, but not sure what medication she was given and chest x-ray was taken due to chest pain. Patient was released on same day without any prescriptions and told to take Motrin or Tylenol for pain. Patient states she began having occasional mild itching to entire body on 3/31/21 and went to see Doctor and was not prescribed medication, states itching  has since increased in frequency and intensity. On 4/6/21 hives began to appear throughout body, went to see Doctor and was not prescribed anything. Patient denies change in dietary habits, detergents or household cleaning products, states she has a follow up appointment on 4/21/21 to discuss itching and hives. Patient states hives randomly appear and disappear, but itching is now constant. Patient in clinic to give report, she was noticed to be scratching most of the time she was with nurse
Age: 58.0
Sex: F
Vaccine: COVID19
Symptoms: Urticaria
Clinical narrative: Per patient she began to feel tired and out of breath, and as if something was stuck in her throat on 3/19/21. Patient states she went to Hospital freestanding emergency room around 4:30pm, she says she was given medication, but not sure what medication she was given and chest x-ray was taken due to chest pain. Patient was released on same day without any prescriptions and told to take Motrin or Tylenol for pain. Patient states she began having occasional mild itching to entire body on 3/31/21 and went to see Doctor and was not prescribed medication, states itching  has since increased in frequency and intensity. On 4/6/21 hives began to appear throughout body, went to see Doctor and was not prescribed anything. Patient denies change in dietary habits, detergents or household cleaning products, states she has a follow up appointment on 4/21/21 to discuss itching and hives. Patient states hives randomly appear and disappear, but itching is now constant. Patient in clinic to give report, she was noticed to be scratching most of the time she was with nurse
Age: 38.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Guillain-Barre syndrome
Clinical narrative: Per neurologist "agree with dx of Guillain-Barre Syndrome secondary to COVID vaccine"
Age: 38.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Gait inability, Hypoaesthesia, Nerve injury
Clinical narrative: Per neurologist "agree with dx of Guillain-Barre Syndrome secondary to COVID vaccine"
Age: 54.0
Sex: M
Vaccine: COVID19
Symptoms: Blood test, Chest X-ray, Joint swelling, Muscle spasms, Pain
Clinical narrative: Pain, swelling left knee found to be a blood clot when he went to the Emergency Room at hospital. Visit was on 3/31/2021 Treatment with rivaroxaban and bed rest.  Pain and muscle spasms persist as of 4/15/2021
Age: 54.0
Sex: M
Vaccine: COVID19
Symptoms: Thrombosis, Ultrasound scan
Clinical narrative: Pain, swelling left knee found to be a blood clot when he went to the Emergency Room at hospital. Visit was on 3/31/2021 Treatment with rivaroxaban and bed rest.  Pain and muscle spasms persist as of 4/15/2021
Age: 45.0
Sex: M
Vaccine: COVID19
Symptoms: Interchange of vaccine products
Clinical narrative: pts had the first vaccine moderna was given pfizer
Age: 40.0
Sex: F
Vaccine: COVID19
Symptoms: Headache, Hypoaesthesia, Paraesthesia
Clinical narrative: Severe headache about 7 hours after getting vaccine which I think was normal but about a week later my feet and hands started tingling and I?m experiencing numbness in them, almost the same sensation as when your foot falls asleep but it doesn?t go away and it?s both feet and both hands. I met with my doctor regarding something else and mentioned it and she suggested I report it and I have an upcoming appointment  to be seen for just that soon.
Age: 50.0
Sex: M
Vaccine: COVID19
Symptoms: Arthralgia, Asthenia, Fatigue, Headache, Night sweats
Clinical narrative: 36-48 hours from the start of first effect  were the worst side effects severe body aches and multiple joint pain wrists ,knees ankles elbows headaches, and total weakness  very tired the next day and weak and 2nd night 24  march in bed at 830 pm low grade fever and sweated it out throughout the night.  wrists are still in pain with left arm wrist worse and today is 4-15-21. overall most joints are in dull pain
Age: 50.0
Sex: M
Vaccine: COVID19
Symptoms: Pain, Pyrexia
Clinical narrative: 36-48 hours from the start of first effect  were the worst side effects severe body aches and multiple joint pain wrists ,knees ankles elbows headaches, and total weakness  very tired the next day and weak and 2nd night 24  march in bed at 830 pm low grade fever and sweated it out throughout the night.  wrists are still in pain with left arm wrist worse and today is 4-15-21. overall most joints are in dull pain
Age: 41.0
Sex: M
Vaccine: COVID19
Symptoms: Injection site induration, Injection site mass, Injection site pruritus, Injection site vesicles
Clinical narrative: Covid-Arm:  Red lesion around injection site, redness on upper arm, itchiness, hardness/lump on upper arm