chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 31.0
Sex: M
Vaccine: COVID19
Symptoms: SARS-CoV-2 test
Clinical narrative: The morning after I received my vaccine I had the following symptoms which have not gone away till today:  - Slight shortness of breath - Inability to complete a full deep breath in - Coughing - Coughing while sleeping
Age: 23.0
Sex: F
Vaccine: COVID19
Symptoms: Angina pectoris, Blood test normal, Chest pain, Electrocardiogram abnormal
Clinical narrative: Shortly after receiving my vaccine I had heart/chest pain.  In the first few days the pain would come and go and many times throughout the day if felt as if I had run a marathon. I have never experienced any heart pain before. On Saturday August 28th 2021 I went to the emergency room because of the pain. I was told I needed to see a cardiologist because of my EKG. I went to the cardiologist on Friday Sept 3rd and he has requested a echocardiogram and stress test
Age: 69.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Acute respiratory failure, Angiogram pulmonary normal, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal
Clinical narrative: Patient required hospitalization due to breakthrough infection. He received Pfizer vaccine (2nd dose in series) on 04/04/21. Patient was hospitalized from 08/28/21 - 08/31/21. Below is copied from discharge summary:   Hospital Course: Case of 69 yo male w PMHx of Colon CA, COVID vaccinated admitted for hypoxemic resp failure in thje setting of COVID 19 PNA.     Acute hypoxemic respiratory failure secodary to COVID 19 PNA - Today feling better, stable - Currently on nasal canula 4lts osat 96% - CXR reviewed, bilateral infiltrates - D Dimer 18 K, CTA negative for PE - Patient was vaccinetad - Decadron 6mg PO daily to complete 10 days - PRN albuterol - recieved remdesivir -Home oxygen qualification test done -case maangement consulted for home oxygen. -Oxygen at bedside    Hypercoagulable state - D Dimer in the 18 K - CTA negative for PE   Oral trush: resolved - Keep switch and swallow - received Diflucan 200mg IV x 3 days     Hx of colon CA - S/p colon resection and colostomy bag - Keep PRN analgesia   Vitals and labs personally reviewed.   Dispo: Dc home today with hhc and home oxygen. Recs as above.   Patient is discharged in stable condition with stable vital signs. All questions rearding hospital course and plan of care after discharge have been answered to satisfaction. Prescriptions for medications needed to be taken after discharge have been given to patient. Patient has been instructed to follow up with PCP within the next 7 days after discharge. Patient verbalizes understanding all given instructions and has no further doubts regarding discharge.
Age: 69.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Fibrin D dimer, Hypercoagulation, Lung infiltration, Oral candidiasis, SARS-CoV-2 test positive
Clinical narrative: Patient required hospitalization due to breakthrough infection. He received Pfizer vaccine (2nd dose in series) on 04/04/21. Patient was hospitalized from 08/28/21 - 08/31/21. Below is copied from discharge summary:   Hospital Course: Case of 69 yo male w PMHx of Colon CA, COVID vaccinated admitted for hypoxemic resp failure in thje setting of COVID 19 PNA.     Acute hypoxemic respiratory failure secodary to COVID 19 PNA - Today feling better, stable - Currently on nasal canula 4lts osat 96% - CXR reviewed, bilateral infiltrates - D Dimer 18 K, CTA negative for PE - Patient was vaccinetad - Decadron 6mg PO daily to complete 10 days - PRN albuterol - recieved remdesivir -Home oxygen qualification test done -case maangement consulted for home oxygen. -Oxygen at bedside    Hypercoagulable state - D Dimer in the 18 K - CTA negative for PE   Oral trush: resolved - Keep switch and swallow - received Diflucan 200mg IV x 3 days     Hx of colon CA - S/p colon resection and colostomy bag - Keep PRN analgesia   Vitals and labs personally reviewed.   Dispo: Dc home today with hhc and home oxygen. Recs as above.   Patient is discharged in stable condition with stable vital signs. All questions rearding hospital course and plan of care after discharge have been answered to satisfaction. Prescriptions for medications needed to be taken after discharge have been given to patient. Patient has been instructed to follow up with PCP within the next 7 days after discharge. Patient verbalizes understanding all given instructions and has no further doubts regarding discharge.
Age: 69.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Vaccine breakthrough infection
Clinical narrative: Patient required hospitalization due to breakthrough infection. He received Pfizer vaccine (2nd dose in series) on 04/04/21. Patient was hospitalized from 08/28/21 - 08/31/21. Below is copied from discharge summary:   Hospital Course: Case of 69 yo male w PMHx of Colon CA, COVID vaccinated admitted for hypoxemic resp failure in thje setting of COVID 19 PNA.     Acute hypoxemic respiratory failure secodary to COVID 19 PNA - Today feling better, stable - Currently on nasal canula 4lts osat 96% - CXR reviewed, bilateral infiltrates - D Dimer 18 K, CTA negative for PE - Patient was vaccinetad - Decadron 6mg PO daily to complete 10 days - PRN albuterol - recieved remdesivir -Home oxygen qualification test done -case maangement consulted for home oxygen. -Oxygen at bedside    Hypercoagulable state - D Dimer in the 18 K - CTA negative for PE   Oral trush: resolved - Keep switch and swallow - received Diflucan 200mg IV x 3 days     Hx of colon CA - S/p colon resection and colostomy bag - Keep PRN analgesia   Vitals and labs personally reviewed.   Dispo: Dc home today with hhc and home oxygen. Recs as above.   Patient is discharged in stable condition with stable vital signs. All questions rearding hospital course and plan of care after discharge have been answered to satisfaction. Prescriptions for medications needed to be taken after discharge have been given to patient. Patient has been instructed to follow up with PCP within the next 7 days after discharge. Patient verbalizes understanding all given instructions and has no further doubts regarding discharge.
Age: 26.0
Sex: M
Vaccine: COVID19
Symptoms: Flushing, Hyperhidrosis, Hyperventilation
Clinical narrative: Systemic: Flushed / Sweating-Mild, Systemic: Hyperventilation-Mild
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Extra dose administered, Inappropriate schedule of product administration
Clinical narrative: Error: Booster Given Too Early-
Age: 26.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Brain stem stroke, Cerebral haemorrhage, Cerebral thrombosis, Intensive care, Loss of consciousness
Clinical narrative: I went unconscious and went to hospital. I was then taken to the hospital where they found out I had a pontine stroke with vertebral dissection and they tried emergency brain surgery but it was too risky to do anything about it. I want in their ICU from 3/10-3/13. I then went to another hospital (not ICU) from 3/13-3/18. Then to a rehabilitation facility from 3/18-4/9 were I had: Speech, Rec therapy, OT and PT.
Age: 26.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Scan abnormal, Vertebral artery dissection
Clinical narrative: I went unconscious and went to hospital. I was then taken to the hospital where they found out I had a pontine stroke with vertebral dissection and they tried emergency brain surgery but it was too risky to do anything about it. I want in their ICU from 3/10-3/13. I then went to another hospital (not ICU) from 3/13-3/18. Then to a rehabilitation facility from 3/18-4/9 were I had: Speech, Rec therapy, OT and PT.
Age: 28.0
Sex: F
Vaccine: COVID19
Symptoms: Hypoaesthesia
Clinical narrative: I have been having a lot of numbness throughout the area where I received the Pfizer shot. Today, Sunday 9/5/21 by entire left side was numb starting from the left side of my face, down to my left arm all the way through my left leg.
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: Adverse event, Injection site paraesthesia, Paraesthesia, Peripheral swelling
Clinical narrative: Patient was injected in her left deltoid and reported 10 minutes later swelling in her left arm and tingling down from the injection site to her finger tips.  I administered her a 25 mg benadryl and patient reported feeling better in less than 5 minutes.  Was determined that she experienced an adverse event not an allergic reaction as the benadryl would not have had time to work in the time it took for the swelling to subside.  Patient also reported after another 20 minutes that the tingling went away.
Age: 24.0
Sex: M
Vaccine: COVID19
Symptoms: Ear discomfort, Ear disorder, Tinnitus
Clinical narrative: Initial onset of high pitched ringing tinnitus (went away after a few minutes), followed by muffled hearing in left ear. The muffled hearing eased up after around 2 hours, but since the initial Aug 8th onset until now (Sep 5), I've been experiencing sporadic tinnitus attacks, as well as a fullness in my ears that rarely ease up. Not usually muffled hearing, but feeling of pressure and stuffiness that can seems to move from one ear to the other. After around 2 weeks after the initial onset, the intensity of the discomfort lessened somewhat, but all the described symptoms still occur frequently. GP at an after hours clinic did not find any issues with ear canal or ear drum in preliminary screening. Currently waiting for ENT appointment.
Age: 32.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Chills, Headache, Myalgia, Pyrexia
Clinical narrative: Muscle/join paint Fever  Chills Headache Vomiting
Age: 32.0
Sex: F
Vaccine: COVID19
Symptoms: Vomiting
Clinical narrative: Muscle/join paint Fever  Chills Headache Vomiting
Age: 42.0
Sex: F
Vaccine: COVID19
Symptoms: Chest pain, Dizziness, Dyspnoea
Clinical narrative: patient felt dizziness after the vaccine stayed in the store for over 20min for observation. She said she felt fine and went home. She called stating that a few hours after leaving the pharmacy she felt difficulty breathing and chest pain. I informed patient to see a doctor to have her symptoms evaluated by a doctor. she stated she would go to the er after getting off the phone with me but it is unknown if she actually went. Tried calling patient to follow up no answer.
Age: 31.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site pain, Injection site pruritus, Injection site reaction, Injection site swelling, Skin discolouration
Clinical narrative: Skin reaction at injection sight, raised and itchy for the first week. Now it?s not raised or itchy but the discoloration seems to be permanently on my arm. Sometimes it aches in the exact a lot and it hasn?t gone away.  It seems to be a permanent reaction. Second dose has not been taken.
Age: 56.0
Sex: M
Vaccine: DF
Symptoms: Fatigue, Hypoaesthesia, Malaise, Pain in extremity, Paraesthesia
Clinical narrative: Numbness/tingling on right side of body and right side of face as well as soreness in right arm where shot was taken continues three days after shot was given.  Some ill feeling/fatigue a day after the shot but went away after one day.
Age: 75.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Acute kidney injury, Acute respiratory failure, Atrial fibrillation, Breath sounds absent, Bronchoscopy normal
Clinical narrative: Patient required hospitalization due to breakthrough infection. Patient received Pfizer vaccine (2nd dose in series) on 02/19/21. Patient was hospitalized from 08/13/21 - 08/31/21. Below is copied from patients discharge (death) summary:   Hospital Course: Patient is a vaccinated 75 y.o. male with a pmhx of HTN, DM, CAD s/p PCI (10 yrs ago), CKD3 and breast cancer s/p lumpectomy and CT who presented to ED on 8/13/21 c/o SOB in setting of known COVID-19 infection. Patient recieved both doses of his vaccine (2nd dose 2/2021).  Patient was admitted to hospitalist service for acute hypoxic respiratory failure in setting of COVID-19. Throughout course of stay, had increasing oxygenation requirements (requiring FFCPAP after found to have removed mask from face) with pulse ox O2 sats reportedly in 20's, lethargy, and new onset tremor. On pulmonology's evaluation at bedside, patient was A&Ox2 (person/place, thinks year is 2001). Not hypoglycemic on accucheck. Difficult to obtain hx as patient with AMS however shakes head yes when asked if he feels SOB.  Admitted to ICU on 18Aug, now intubated and sedated.  Bronchoscopy performed at bedside, which was unrevealing.  Did not show any mucous plugging. Received solumedrol and lipitor. Toci not given due to depleted supplies.  Episodes of hypoglycemia, NPH 35u TID d/c. S/p D5W drip. Continue with SSI. Oligouric AKI on CKD, requiring CRRT. Nephrology on board. New onset A-fib with RVR, now rate controlled. S/p amiodarone drip & metoprolol. Increasing leukocytosis. Continue Vanc/Aztreonam/Flagyl and empiric Caspo, follow cultures. Episodes of coffee ground emesis. Hgb downtrended. Recevied 1 unit of pRBC. Hgb stable. On Levophed. Continue proning protocol. CRRT better when placed in left position. Keep net even. Wean off Levo as tolerated, start midodrine 10mg tid. DC empiric Abx given negative cultures. Palliative care for goals of care. Shock state of unclear etiology at this time. EV1000 hemodynamics to help guide management. Currently on 40 of levophed and vasopressin. Poor oxygenation. Prone ventilation discontinued. DC'd empiric Abx given negative cultures. Spoke to patient's wife and she wants patient to be DNR with no escalation of care given his overall poor prognosis. Plan to compassionately wean. Confirmed DNR. No further escalation of care.     Death Note  I was called to the room of patient to pronounce that patient had died. Patient was laying motionless and unresponsive to verbal/tactile stimuli. Pupils where fixed and dilated. There were no spontaneous breath sounds. Peripheral pulses were absent. No heartbeat was heard during auscultation. Family was made aware.  Condolences offered. Chaplain and postmortem services offered. Pt was DNR code. Time of death was 1724, confirmed and witnessed by Nurse
Age: 75.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Chronic kidney disease, Culture negative, Death, Dyspnoea
Clinical narrative: Patient required hospitalization due to breakthrough infection. Patient received Pfizer vaccine (2nd dose in series) on 02/19/21. Patient was hospitalized from 08/13/21 - 08/31/21. Below is copied from patients discharge (death) summary:   Hospital Course: Patient is a vaccinated 75 y.o. male with a pmhx of HTN, DM, CAD s/p PCI (10 yrs ago), CKD3 and breast cancer s/p lumpectomy and CT who presented to ED on 8/13/21 c/o SOB in setting of known COVID-19 infection. Patient recieved both doses of his vaccine (2nd dose 2/2021).  Patient was admitted to hospitalist service for acute hypoxic respiratory failure in setting of COVID-19. Throughout course of stay, had increasing oxygenation requirements (requiring FFCPAP after found to have removed mask from face) with pulse ox O2 sats reportedly in 20's, lethargy, and new onset tremor. On pulmonology's evaluation at bedside, patient was A&Ox2 (person/place, thinks year is 2001). Not hypoglycemic on accucheck. Difficult to obtain hx as patient with AMS however shakes head yes when asked if he feels SOB.  Admitted to ICU on 18Aug, now intubated and sedated.  Bronchoscopy performed at bedside, which was unrevealing.  Did not show any mucous plugging. Received solumedrol and lipitor. Toci not given due to depleted supplies.  Episodes of hypoglycemia, NPH 35u TID d/c. S/p D5W drip. Continue with SSI. Oligouric AKI on CKD, requiring CRRT. Nephrology on board. New onset A-fib with RVR, now rate controlled. S/p amiodarone drip & metoprolol. Increasing leukocytosis. Continue Vanc/Aztreonam/Flagyl and empiric Caspo, follow cultures. Episodes of coffee ground emesis. Hgb downtrended. Recevied 1 unit of pRBC. Hgb stable. On Levophed. Continue proning protocol. CRRT better when placed in left position. Keep net even. Wean off Levo as tolerated, start midodrine 10mg tid. DC empiric Abx given negative cultures. Palliative care for goals of care. Shock state of unclear etiology at this time. EV1000 hemodynamics to help guide management. Currently on 40 of levophed and vasopressin. Poor oxygenation. Prone ventilation discontinued. DC'd empiric Abx given negative cultures. Spoke to patient's wife and she wants patient to be DNR with no escalation of care given his overall poor prognosis. Plan to compassionately wean. Confirmed DNR. No further escalation of care.     Death Note  I was called to the room of patient to pronounce that patient had died. Patient was laying motionless and unresponsive to verbal/tactile stimuli. Pupils where fixed and dilated. There were no spontaneous breath sounds. Peripheral pulses were absent. No heartbeat was heard during auscultation. Family was made aware.  Condolences offered. Chaplain and postmortem services offered. Pt was DNR code. Time of death was 1724, confirmed and witnessed by Nurse
Age: 75.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Endotracheal intubation, Haematemesis, Haemoglobin decreased, Hypoglycaemia, Intensive care
Clinical narrative: Patient required hospitalization due to breakthrough infection. Patient received Pfizer vaccine (2nd dose in series) on 02/19/21. Patient was hospitalized from 08/13/21 - 08/31/21. Below is copied from patients discharge (death) summary:   Hospital Course: Patient is a vaccinated 75 y.o. male with a pmhx of HTN, DM, CAD s/p PCI (10 yrs ago), CKD3 and breast cancer s/p lumpectomy and CT who presented to ED on 8/13/21 c/o SOB in setting of known COVID-19 infection. Patient recieved both doses of his vaccine (2nd dose 2/2021).  Patient was admitted to hospitalist service for acute hypoxic respiratory failure in setting of COVID-19. Throughout course of stay, had increasing oxygenation requirements (requiring FFCPAP after found to have removed mask from face) with pulse ox O2 sats reportedly in 20's, lethargy, and new onset tremor. On pulmonology's evaluation at bedside, patient was A&Ox2 (person/place, thinks year is 2001). Not hypoglycemic on accucheck. Difficult to obtain hx as patient with AMS however shakes head yes when asked if he feels SOB.  Admitted to ICU on 18Aug, now intubated and sedated.  Bronchoscopy performed at bedside, which was unrevealing.  Did not show any mucous plugging. Received solumedrol and lipitor. Toci not given due to depleted supplies.  Episodes of hypoglycemia, NPH 35u TID d/c. S/p D5W drip. Continue with SSI. Oligouric AKI on CKD, requiring CRRT. Nephrology on board. New onset A-fib with RVR, now rate controlled. S/p amiodarone drip & metoprolol. Increasing leukocytosis. Continue Vanc/Aztreonam/Flagyl and empiric Caspo, follow cultures. Episodes of coffee ground emesis. Hgb downtrended. Recevied 1 unit of pRBC. Hgb stable. On Levophed. Continue proning protocol. CRRT better when placed in left position. Keep net even. Wean off Levo as tolerated, start midodrine 10mg tid. DC empiric Abx given negative cultures. Palliative care for goals of care. Shock state of unclear etiology at this time. EV1000 hemodynamics to help guide management. Currently on 40 of levophed and vasopressin. Poor oxygenation. Prone ventilation discontinued. DC'd empiric Abx given negative cultures. Spoke to patient's wife and she wants patient to be DNR with no escalation of care given his overall poor prognosis. Plan to compassionately wean. Confirmed DNR. No further escalation of care.     Death Note  I was called to the room of patient to pronounce that patient had died. Patient was laying motionless and unresponsive to verbal/tactile stimuli. Pupils where fixed and dilated. There were no spontaneous breath sounds. Peripheral pulses were absent. No heartbeat was heard during auscultation. Family was made aware.  Condolences offered. Chaplain and postmortem services offered. Pt was DNR code. Time of death was 1724, confirmed and witnessed by Nurse
Age: 75.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Lethargy, Leukocytosis, Mental status changes, Oxygen saturation decreased, Prone position
Clinical narrative: Patient required hospitalization due to breakthrough infection. Patient received Pfizer vaccine (2nd dose in series) on 02/19/21. Patient was hospitalized from 08/13/21 - 08/31/21. Below is copied from patients discharge (death) summary:   Hospital Course: Patient is a vaccinated 75 y.o. male with a pmhx of HTN, DM, CAD s/p PCI (10 yrs ago), CKD3 and breast cancer s/p lumpectomy and CT who presented to ED on 8/13/21 c/o SOB in setting of known COVID-19 infection. Patient recieved both doses of his vaccine (2nd dose 2/2021).  Patient was admitted to hospitalist service for acute hypoxic respiratory failure in setting of COVID-19. Throughout course of stay, had increasing oxygenation requirements (requiring FFCPAP after found to have removed mask from face) with pulse ox O2 sats reportedly in 20's, lethargy, and new onset tremor. On pulmonology's evaluation at bedside, patient was A&Ox2 (person/place, thinks year is 2001). Not hypoglycemic on accucheck. Difficult to obtain hx as patient with AMS however shakes head yes when asked if he feels SOB.  Admitted to ICU on 18Aug, now intubated and sedated.  Bronchoscopy performed at bedside, which was unrevealing.  Did not show any mucous plugging. Received solumedrol and lipitor. Toci not given due to depleted supplies.  Episodes of hypoglycemia, NPH 35u TID d/c. S/p D5W drip. Continue with SSI. Oligouric AKI on CKD, requiring CRRT. Nephrology on board. New onset A-fib with RVR, now rate controlled. S/p amiodarone drip & metoprolol. Increasing leukocytosis. Continue Vanc/Aztreonam/Flagyl and empiric Caspo, follow cultures. Episodes of coffee ground emesis. Hgb downtrended. Recevied 1 unit of pRBC. Hgb stable. On Levophed. Continue proning protocol. CRRT better when placed in left position. Keep net even. Wean off Levo as tolerated, start midodrine 10mg tid. DC empiric Abx given negative cultures. Palliative care for goals of care. Shock state of unclear etiology at this time. EV1000 hemodynamics to help guide management. Currently on 40 of levophed and vasopressin. Poor oxygenation. Prone ventilation discontinued. DC'd empiric Abx given negative cultures. Spoke to patient's wife and she wants patient to be DNR with no escalation of care given his overall poor prognosis. Plan to compassionately wean. Confirmed DNR. No further escalation of care.     Death Note  I was called to the room of patient to pronounce that patient had died. Patient was laying motionless and unresponsive to verbal/tactile stimuli. Pupils where fixed and dilated. There were no spontaneous breath sounds. Peripheral pulses were absent. No heartbeat was heard during auscultation. Family was made aware.  Condolences offered. Chaplain and postmortem services offered. Pt was DNR code. Time of death was 1724, confirmed and witnessed by Nurse
Age: 75.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Pulse absent, Pupil fixed, SARS-CoV-2 test positive, Sedation, Tremor
Clinical narrative: Patient required hospitalization due to breakthrough infection. Patient received Pfizer vaccine (2nd dose in series) on 02/19/21. Patient was hospitalized from 08/13/21 - 08/31/21. Below is copied from patients discharge (death) summary:   Hospital Course: Patient is a vaccinated 75 y.o. male with a pmhx of HTN, DM, CAD s/p PCI (10 yrs ago), CKD3 and breast cancer s/p lumpectomy and CT who presented to ED on 8/13/21 c/o SOB in setting of known COVID-19 infection. Patient recieved both doses of his vaccine (2nd dose 2/2021).  Patient was admitted to hospitalist service for acute hypoxic respiratory failure in setting of COVID-19. Throughout course of stay, had increasing oxygenation requirements (requiring FFCPAP after found to have removed mask from face) with pulse ox O2 sats reportedly in 20's, lethargy, and new onset tremor. On pulmonology's evaluation at bedside, patient was A&Ox2 (person/place, thinks year is 2001). Not hypoglycemic on accucheck. Difficult to obtain hx as patient with AMS however shakes head yes when asked if he feels SOB.  Admitted to ICU on 18Aug, now intubated and sedated.  Bronchoscopy performed at bedside, which was unrevealing.  Did not show any mucous plugging. Received solumedrol and lipitor. Toci not given due to depleted supplies.  Episodes of hypoglycemia, NPH 35u TID d/c. S/p D5W drip. Continue with SSI. Oligouric AKI on CKD, requiring CRRT. Nephrology on board. New onset A-fib with RVR, now rate controlled. S/p amiodarone drip & metoprolol. Increasing leukocytosis. Continue Vanc/Aztreonam/Flagyl and empiric Caspo, follow cultures. Episodes of coffee ground emesis. Hgb downtrended. Recevied 1 unit of pRBC. Hgb stable. On Levophed. Continue proning protocol. CRRT better when placed in left position. Keep net even. Wean off Levo as tolerated, start midodrine 10mg tid. DC empiric Abx given negative cultures. Palliative care for goals of care. Shock state of unclear etiology at this time. EV1000 hemodynamics to help guide management. Currently on 40 of levophed and vasopressin. Poor oxygenation. Prone ventilation discontinued. DC'd empiric Abx given negative cultures. Spoke to patient's wife and she wants patient to be DNR with no escalation of care given his overall poor prognosis. Plan to compassionately wean. Confirmed DNR. No further escalation of care.     Death Note  I was called to the room of patient to pronounce that patient had died. Patient was laying motionless and unresponsive to verbal/tactile stimuli. Pupils where fixed and dilated. There were no spontaneous breath sounds. Peripheral pulses were absent. No heartbeat was heard during auscultation. Family was made aware.  Condolences offered. Chaplain and postmortem services offered. Pt was DNR code. Time of death was 1724, confirmed and witnessed by Nurse
Age: 75.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Unresponsive to stimuli, Vaccine breakthrough infection
Clinical narrative: Patient required hospitalization due to breakthrough infection. Patient received Pfizer vaccine (2nd dose in series) on 02/19/21. Patient was hospitalized from 08/13/21 - 08/31/21. Below is copied from patients discharge (death) summary:   Hospital Course: Patient is a vaccinated 75 y.o. male with a pmhx of HTN, DM, CAD s/p PCI (10 yrs ago), CKD3 and breast cancer s/p lumpectomy and CT who presented to ED on 8/13/21 c/o SOB in setting of known COVID-19 infection. Patient recieved both doses of his vaccine (2nd dose 2/2021).  Patient was admitted to hospitalist service for acute hypoxic respiratory failure in setting of COVID-19. Throughout course of stay, had increasing oxygenation requirements (requiring FFCPAP after found to have removed mask from face) with pulse ox O2 sats reportedly in 20's, lethargy, and new onset tremor. On pulmonology's evaluation at bedside, patient was A&Ox2 (person/place, thinks year is 2001). Not hypoglycemic on accucheck. Difficult to obtain hx as patient with AMS however shakes head yes when asked if he feels SOB.  Admitted to ICU on 18Aug, now intubated and sedated.  Bronchoscopy performed at bedside, which was unrevealing.  Did not show any mucous plugging. Received solumedrol and lipitor. Toci not given due to depleted supplies.  Episodes of hypoglycemia, NPH 35u TID d/c. S/p D5W drip. Continue with SSI. Oligouric AKI on CKD, requiring CRRT. Nephrology on board. New onset A-fib with RVR, now rate controlled. S/p amiodarone drip & metoprolol. Increasing leukocytosis. Continue Vanc/Aztreonam/Flagyl and empiric Caspo, follow cultures. Episodes of coffee ground emesis. Hgb downtrended. Recevied 1 unit of pRBC. Hgb stable. On Levophed. Continue proning protocol. CRRT better when placed in left position. Keep net even. Wean off Levo as tolerated, start midodrine 10mg tid. DC empiric Abx given negative cultures. Palliative care for goals of care. Shock state of unclear etiology at this time. EV1000 hemodynamics to help guide management. Currently on 40 of levophed and vasopressin. Poor oxygenation. Prone ventilation discontinued. DC'd empiric Abx given negative cultures. Spoke to patient's wife and she wants patient to be DNR with no escalation of care given his overall poor prognosis. Plan to compassionately wean. Confirmed DNR. No further escalation of care.     Death Note  I was called to the room of patient to pronounce that patient had died. Patient was laying motionless and unresponsive to verbal/tactile stimuli. Pupils where fixed and dilated. There were no spontaneous breath sounds. Peripheral pulses were absent. No heartbeat was heard during auscultation. Family was made aware.  Condolences offered. Chaplain and postmortem services offered. Pt was DNR code. Time of death was 1724, confirmed and witnessed by Nurse
Age: 61.0
Sex: F
Vaccine: COVID19
Symptoms: Poor quality product administered, Product storage error
Clinical narrative: Error: Improper Storage (temperature)-
Age: 87.0
Sex: F
Vaccine: COVID19
Symptoms: Injected limb mobility decreased, Injection site pain, Pain
Clinical narrative: After receiving the booster Moderna shot I began to feel a crazy pain above and to the left of the original sight. It is quiet annoying but only happens when I move that arm or try to raise it.
Age: 24.0
Sex: M
Vaccine: COVID19
Symptoms: Chills, Headache, Myalgia, Pyrexia
Clinical narrative: Fever started at 2:30 am fever of 103.4 headachea and chills. Muscle aces and soreness.
Age: 67.0
Sex: F
Vaccine: FLU4
Symptoms: Blood glucose decreased, Condition aggravated, Fatigue, Nausea, Seizure
Clinical narrative: Patient reports experiencing extreme fatigue, nausea/vomiting, low blood sugar (diabetic), and seizure (history of seizures) about 2 hours after receiving the vaccine
Age: 67.0
Sex: F
Vaccine: FLU4
Symptoms: Vomiting
Clinical narrative: Patient reports experiencing extreme fatigue, nausea/vomiting, low blood sugar (diabetic), and seizure (history of seizures) about 2 hours after receiving the vaccine
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: Acute kidney injury, Acute respiratory failure, COVID-19 pneumonia, Haemorrhage, Infection
Clinical narrative: Patient required hospitalization due to breakthrough infection. Patient received J&J vaccine on 03/15/21. Patient was hospitalized from 07/29/21 - 08/18/21. Below is copied from discharge summary:   HOSPITAL COURSE  o Acute Hypoxic resp failure due to Covid 19 PNA ,  Completed Decadron for 10 days 7/30 to 8/8  . Pt completed 14 days of Thereuptic AC dose .. changed   to Prophylactic dose. Pt Now on 4L O2 and spo2 95% on 4L . Home o2 arranged      o HTN cont Losartan  o AKI resolved  o DM On Metformin at Home , Now on SSI Only . A1c 7 . o R forearm discoloration sec to Bleeding , . Hb stable .  o Mild Transaminitis elevated but stable      Discharge Diagnoses: Acute Hypoxix resp failure due to Covid 19 PNA  HTN  AKI  Dm  R forearm discoloration sec to Bleeding  Transaminitis
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Skin discolouration, Transaminases increased
Clinical narrative: Patient required hospitalization due to breakthrough infection. Patient received J&J vaccine on 03/15/21. Patient was hospitalized from 07/29/21 - 08/18/21. Below is copied from discharge summary:   HOSPITAL COURSE  o Acute Hypoxic resp failure due to Covid 19 PNA ,  Completed Decadron for 10 days 7/30 to 8/8  . Pt completed 14 days of Thereuptic AC dose .. changed   to Prophylactic dose. Pt Now on 4L O2 and spo2 95% on 4L . Home o2 arranged      o HTN cont Losartan  o AKI resolved  o DM On Metformin at Home , Now on SSI Only . A1c 7 . o R forearm discoloration sec to Bleeding , . Hb stable .  o Mild Transaminitis elevated but stable      Discharge Diagnoses: Acute Hypoxix resp failure due to Covid 19 PNA  HTN  AKI  Dm  R forearm discoloration sec to Bleeding  Transaminitis
Age: 53.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site pain, Pain
Clinical narrative: Injection site (both shots given in left arm) remains painful and feels like muscle mass is impacted. It hurts without lifting when I lay on my side to sleep in the bed -and in a counter clockwise motion.
Age: 47.0
Sex: M
Vaccine: COVID19
Symptoms: Angiogram normal, Cardiac telemetry normal, Dizziness, Echocardiogram normal, Electrocardiogram normal
Clinical narrative: Blurred vision, dizziness,  left arm and leg weakness
Age: 47.0
Sex: M
Vaccine: COVID19
Symptoms: Fibrin D dimer normal, Full blood count normal, Glycosylated haemoglobin, Hemiparesis, Magnetic resonance imaging normal
Clinical narrative: Blurred vision, dizziness,  left arm and leg weakness
Age: 47.0
Sex: M
Vaccine: COVID19
Symptoms: Metabolic function test, Myocardial necrosis marker normal, Scan with contrast normal, Vision blurred
Clinical narrative: Blurred vision, dizziness,  left arm and leg weakness
Age: 21.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Chest discomfort, Chest pain, Dysphagia, Ear infection
Clinical narrative: Day after had sweats and arm pain, then was fine. Tuesday night felt heart a little but didn?t think anything serious of it. Then Wednesday-Friday had immense heart pain. Was only getting 4 hours of sleep because it was hard to sleep as heart would not stop palpitating heavily all throughout the day and had to apply pressure to get that little amount of sleep  on that side. Heavy fatigue. Wheezing. Would feel pain even more when laid down. Chest felt tight and pain on shoulder blade behind heart one day, left side of neck, and then ear infection on left ear by Friday (aug 27th) which I started antibiotics for just recently (sept 1st) as it lingered. Heart pain lingered as well but by that Saturday (aug 28th) slowly got better to stop the nonstop palpitations and sleep properly. A week later heart pain was a lot better, but hurting still slightly at moments. Especially when about to sleep. Now two weeks later I?m okay with heart, ear pain still there at moments though and cautious.
Age: 21.0
Sex: F
Vaccine: COVID19
Symptoms: Electrocardiogram normal, Fatigue, Neck pain, Pain in extremity, Palpitations
Clinical narrative: Day after had sweats and arm pain, then was fine. Tuesday night felt heart a little but didn?t think anything serious of it. Then Wednesday-Friday had immense heart pain. Was only getting 4 hours of sleep because it was hard to sleep as heart would not stop palpitating heavily all throughout the day and had to apply pressure to get that little amount of sleep  on that side. Heavy fatigue. Wheezing. Would feel pain even more when laid down. Chest felt tight and pain on shoulder blade behind heart one day, left side of neck, and then ear infection on left ear by Friday (aug 27th) which I started antibiotics for just recently (sept 1st) as it lingered. Heart pain lingered as well but by that Saturday (aug 28th) slowly got better to stop the nonstop palpitations and sleep properly. A week later heart pain was a lot better, but hurting still slightly at moments. Especially when about to sleep. Now two weeks later I?m okay with heart, ear pain still there at moments though and cautious.
Age: 21.0
Sex: F
Vaccine: COVID19
Symptoms: Wheezing
Clinical narrative: Day after had sweats and arm pain, then was fine. Tuesday night felt heart a little but didn?t think anything serious of it. Then Wednesday-Friday had immense heart pain. Was only getting 4 hours of sleep because it was hard to sleep as heart would not stop palpitating heavily all throughout the day and had to apply pressure to get that little amount of sleep  on that side. Heavy fatigue. Wheezing. Would feel pain even more when laid down. Chest felt tight and pain on shoulder blade behind heart one day, left side of neck, and then ear infection on left ear by Friday (aug 27th) which I started antibiotics for just recently (sept 1st) as it lingered. Heart pain lingered as well but by that Saturday (aug 28th) slowly got better to stop the nonstop palpitations and sleep properly. A week later heart pain was a lot better, but hurting still slightly at moments. Especially when about to sleep. Now two weeks later I?m okay with heart, ear pain still there at moments though and cautious.
Age: 92.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Dementia, Fatigue, Hypophagia, Impaired self-care
Clinical narrative: Patient required hospitalization due to breakthrough infection. Patient received the Pfizer vaccine (2nd dose in series) on 04/13/21. Patient was hospitalized from 07/20/21, then discharged on 07/22/21, readmitted on 07/24/21 and then finally discharged again on 08/04/21. Below is copied from final discharge summary:  The patient presented to the ED with mild fatigue, in no acute distress, and pleasantly demented. Patient was recently admitted for syncope, and was discharged with home healthcare, but returned due to family concern of patient's inability to maintain self care. Patient was noted to have poor nutritional intake in the setting of dementia. Additionally, the patient was tested positive for COVID-19 on 07/20/2021 but remained free of severe symptoms. He has no past history of significant medical problems. He has been followed by case management for placement options, and has been authorized for placement at Nursing and Rehab. He is discharged at this time to this facility in stable condition.   All the above recommendations were discussed with the patient/family. Patient/family agreed with the plan as stated. All questions regarding diagnoses/medications/follow-up were answered. Following appointments already made as below. >30 minutes were spent for the entire discharge process.
Age: 92.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: SARS-CoV-2 test positive, Syncope
Clinical narrative: Patient required hospitalization due to breakthrough infection. Patient received the Pfizer vaccine (2nd dose in series) on 04/13/21. Patient was hospitalized from 07/20/21, then discharged on 07/22/21, readmitted on 07/24/21 and then finally discharged again on 08/04/21. Below is copied from final discharge summary:  The patient presented to the ED with mild fatigue, in no acute distress, and pleasantly demented. Patient was recently admitted for syncope, and was discharged with home healthcare, but returned due to family concern of patient's inability to maintain self care. Patient was noted to have poor nutritional intake in the setting of dementia. Additionally, the patient was tested positive for COVID-19 on 07/20/2021 but remained free of severe symptoms. He has no past history of significant medical problems. He has been followed by case management for placement options, and has been authorized for placement at Nursing and Rehab. He is discharged at this time to this facility in stable condition.   All the above recommendations were discussed with the patient/family. Patient/family agreed with the plan as stated. All questions regarding diagnoses/medications/follow-up were answered. Following appointments already made as below. >30 minutes were spent for the entire discharge process.
Age: 31.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Erythema, Fatigue, Paraesthesia, Pyrexia
Clinical narrative: 9/3/21 Fever 100.9 F. tingling of the extremites, extreme tireness 9/4/21 Joint pain, few red spot on the body (resolved within 4 hours) 9/5/21 Rash on one side of the upper body, tingling sensation on extremities
Age: 31.0
Sex: F
Vaccine: COVID19
Symptoms: Rash
Clinical narrative: 9/3/21 Fever 100.9 F. tingling of the extremites, extreme tireness 9/4/21 Joint pain, few red spot on the body (resolved within 4 hours) 9/5/21 Rash on one side of the upper body, tingling sensation on extremities
Age: 18.0
Sex: M
Vaccine: COVID19
Symptoms: Loss of consciousness
Clinical narrative: Patient claims he blacked out for a second or so. he did not fall off of chair. Regained blood pressure quickly and steadily felt better. Stayed in the rx area for 30 minutes and felt good.
Age: 73.0
Sex: M
Vaccine: COVID19
Symptoms: Joint stiffness, Pain in jaw, Trismus
Clinical narrative: 2 days after injection my right jaw muscles were very stiff and sore, very difficult to open jaw fully.  Onset of symptom was sudden.  It is now 25 days since injection and the issue remains, but significantly reduced. I've never had any symptom like that before.
Age: 45.0
Sex: F
Vaccine: COVID19
Symptoms: Asthma, Condition aggravated, Injection site erythema, Injection site pain, Injection site pruritus
Clinical narrative: Initially, pain, swelling, redness at injection site. Itching at injection site began on 9/4/2021 in the morning. Eased after taking Tagamet for chronic urticaria. Mild asthma symptoms around 3 pm. Itching at injection site returned around 6 pm and spread to entire body (face, ears, arms, legs, back, stomach) with a few small hives. Itching eased after taking Singulair and Tagamet at 8 pm. Itching at injection site, mild itching of face and body, and mild asthma returned about 10 am on 9/5/2021. Eased with administration of Tagamet. Swelling and redness at injection site spread to approximately 2 in in diameter by afternoon on 9/5/2021.
Age: 45.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site swelling, Urticaria, Urticaria chronic
Clinical narrative: Initially, pain, swelling, redness at injection site. Itching at injection site began on 9/4/2021 in the morning. Eased after taking Tagamet for chronic urticaria. Mild asthma symptoms around 3 pm. Itching at injection site returned around 6 pm and spread to entire body (face, ears, arms, legs, back, stomach) with a few small hives. Itching eased after taking Singulair and Tagamet at 8 pm. Itching at injection site, mild itching of face and body, and mild asthma returned about 10 am on 9/5/2021. Eased with administration of Tagamet. Swelling and redness at injection site spread to approximately 2 in in diameter by afternoon on 9/5/2021.
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: Diarrhoea, Fatigue, Injection site pain, Pain, Rash
Clinical narrative: > Day one 9 /3 - sore arm at injection site approximately 6 hours after injection > Day one 9/3 - watery diarrhea, two bouts, approximately 10 hours after injection > Day two 9/4 - general fatigue and body aches, no arm pain or diarrhea  > Day three 9/5 - light rash on chest, some fatigue and body aches, no arm pain or diarrhea
Age: 61.0
Sex: M
Vaccine: COVID19
Symptoms: Death
Clinical narrative: He died , found dead after 24 hours, Closed casket, no foul play.   I  am unable to get an autopsy.
Age: 60.0
Sex: M
Vaccine: COVID19
Symptoms: Rash, Rash erythematous
Clinical narrative: Linear, raised rash down right forearm from elbow to wrist. 1 hour following vaccine administration. Patient stated it lasted for approximately 1 hour. No anaphylaxis.
Age: 12.0
Sex: F
Vaccine: COVID19
Symptoms: Menstruation delayed
Clinical narrative: Menstrual delayed for two weeks
Age: 59.0
Sex: M
Vaccine: COVID19
Symptoms: Dizziness, Headache, Injection site pain, Lethargy
Clinical narrative: Headache injection site pain dizzy lethargic
Age: 49.0
Sex: F
Vaccine: COVID19
Symptoms: Burning sensation, Cellulitis, Neuralgia, Pain, Pain in extremity
Clinical narrative: Patient states that she experienced localized arm pain and a rash shortly after receiving vaccination (8/30 - Monday). She works at a doctor's office and was told by that doctor that a localized rash is a normal reaction "COVID arm" and to not worry.  Towards the end of the week, the rash continued to grow. Her sister outlined the rash on Saturday and by Sunday morning it had continued to progress. She was seen at urgent care on Sunday, 9/5 and prescribed Clindamycin for a Cellulitis diagnosis. The treating doctor advised her to go to the ER to receive IVs if no improvement by Tuesday. At time of presentation at the pharmacy (9/5), the rash covered the majority of patient's right upper arm. Patient also complained of shooting nerve pain ("burning") that travels to her wrist.
Age: 49.0
Sex: F
Vaccine: COVID19
Symptoms: Rash
Clinical narrative: Patient states that she experienced localized arm pain and a rash shortly after receiving vaccination (8/30 - Monday). She works at a doctor's office and was told by that doctor that a localized rash is a normal reaction "COVID arm" and to not worry.  Towards the end of the week, the rash continued to grow. Her sister outlined the rash on Saturday and by Sunday morning it had continued to progress. She was seen at urgent care on Sunday, 9/5 and prescribed Clindamycin for a Cellulitis diagnosis. The treating doctor advised her to go to the ER to receive IVs if no improvement by Tuesday. At time of presentation at the pharmacy (9/5), the rash covered the majority of patient's right upper arm. Patient also complained of shooting nerve pain ("burning") that travels to her wrist.
Age: 17.0
Sex: F
Vaccine: COVID19
Symptoms: Brain natriuretic peptide normal, Chest pain, Dyspnoea, Electrocardiogram normal, Troponin normal
Clinical narrative: chest pain, shortness of breath. normal EKG and cardiac enzymes. Started 12 hours post vaccination, lasted one week.
Age: 69.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Cough, Dyspnoea, Fatigue, Infection
Clinical narrative: Patient required hospitalization due to breakthrough infection. Patient received the Pfizer vaccine (2nd dose in series) on 02/19/21. Patient was hospitalized from 08/30/21 - 09/03/21. Below is copied from discharge summary:   Patient is a 69 y.o. male with PMHx of diabetes, hyperlipidemia, hypertension, BPH who presented to the hospital for shortness or breath.   Patient stated that he tested positive for COVID-19 on 08/24.  Since then he has been experiencing cough, fatigue, and shortness of breath.  He stated that today he woke up and could not catch his breath and hence he called rescue.  On arrival, patient saturations were 80s, and he was placed on 4 liters nasal cannula. Patient stated that he has been on steroids and antibiotics outpatient basis. Admitted to Hospital Medicine.
Age: 69.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: Patient required hospitalization due to breakthrough infection. Patient received the Pfizer vaccine (2nd dose in series) on 02/19/21. Patient was hospitalized from 08/30/21 - 09/03/21. Below is copied from discharge summary:   Patient is a 69 y.o. male with PMHx of diabetes, hyperlipidemia, hypertension, BPH who presented to the hospital for shortness or breath.   Patient stated that he tested positive for COVID-19 on 08/24.  Since then he has been experiencing cough, fatigue, and shortness of breath.  He stated that today he woke up and could not catch his breath and hence he called rescue.  On arrival, patient saturations were 80s, and he was placed on 4 liters nasal cannula. Patient stated that he has been on steroids and antibiotics outpatient basis. Admitted to Hospital Medicine.
Age: 46.0
Sex: M
Vaccine: COVID19
Symptoms: Arthralgia, Muscular weakness
Clinical narrative: Muscle weakness all over. Joint pain
Age: 15.0
Sex: M
Vaccine: COVID19
Symptoms: Syncope
Clinical narrative: syncopal reaction directly after administering vaccine.  patient was seated, did not hit his head, and came to within 30 seconds
Age: 57.0
Sex: M
Vaccine: COVID19
Symptoms: Interchange of vaccine products
Clinical narrative: NO ADVERSE EVENTS- PT PRESENTED FOR 2ND COVID SHOT. HE SCHEDULED HIS APPT ONLINE AND FILLED OUT HIS PAPERWORK ONLINE. HE FILLED EVERYTHING OUT FOR MODERNA. HE PRESENTED AND STATED HE WAS HERE FOR HIS SECOND MODERNA VACCINE. WE BILLED THE INSURANCE AS HIS SECOND DOSE AND IT WAS ACCEPTED. AFTER I GAVE HIM THE VACCINE, I ASKED FOR VACCINATION RECORD CARD. WHEN HE GAVE IT TO ME- IT WAS MARKED AS PFIZER FOR HIS FIRST DOSE. I QUESTIONED HIM AND SAID HE BELIEVED HE RECEIVED MODERNA INITIALLY. I RESEARCHED THIS AND WAS ABLE TO VERIFY THAT HE DID GET PFIZER AS HIS FIRST DOSE. HE WAS GIVEN MODERNA AS HIS SECOND DOSE TODAY. HE REPORTED NO ISSUES AND STATED HE WOULD CALL US IF ANY OCCURRED. I DOCUMENTED THE CORRECT VACCINE INFORMATION ON HIS VACCINATION RECORD CARD.
Age: 56.0
Sex: M
Vaccine: COVID19
Symptoms: Pulmonary embolism
Clinical narrative: Pt presented to ED 3 days later with acute PE
Age: 40.0
Sex: M
Vaccine: COVID19
Symptoms: Blood test, Chest discomfort, Chest pain, Chills, Electrocardiogram normal
Clinical narrative: Fatigue, body aches, chills, chest pain, chest tightness, and chest pressure. I went to my primary care doctor for treatment on Monday, August 30, 2021 and was instructed that if the pain got worse to go to the emergency room. While at my Primary Care doctor they conducted an EKG (good) and drew my blood, results will be given on Tuesday, September 7th. On Tuesday, August 31, 2021 I went to Hospital Emergency Room because the pain became too much to take. They did an X-ray, drew blood, and did an EKG all of which came back good. They recommended me to a Cardiologist of which I will see Tuesday, September 7th as well.