chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 13.0
Sex: F
Vaccine: HPV4, MNQ, TDAP
Symptoms: Dizziness, Headache, Paralysis, Tremor
Clinical narrative: Information has been received from a physician concerning a 17 year old female who was vaccinated with a dose of GARDASIL. Two years ago, the patient experienced headaches, paralysis, tremors which prevented her from participating in gymnastics. Therapy with GARDASIL was discontinued. The patient sought unspecified medical attention. At the time of this report the patient had not recovered. The reporting physician considered headaches, paralysis, and tremors to be disabling. Follow up information received on 02-SEP-2009 from a physician indicated that the patient had received only 2 doses of GARDASIL. The third dose of GARDASIL was being held because of the possible link between GARDASIL and the events. The physician also indicated that the patient had been referred to a neurologist. Additional Information was also received from the medical assistant of the patient's primary physician; the medical assistant stated that the patient did not had any medical history or known drugs allergies; the patient received a first dose of GARDASIL (lot # 655618/0186U) on 23-FEB-2007. No other vaccines received on this date. At an office visit on 01-JUN-2007 the patient complained of dizziness and tremors in right hand and right foot. The patient was referred to a neurologist. The patient received a second dose of GARDASIL (lot # 659655/1486U) on 06-MAR-2009. Concomitant vaccination given on 06-MAR-2009 included a dose of DTaP (lot# C2775AA) and a dose of MENACTRA (lot # U2549AA), sites of vaccination not recorded. The patient was not seen since 06-MAR-2008. Additional information has been requested.  12/29/09 Neurological consult received for DOS 06/17/07.  Pt c/o nonspecific visual problems and loss of complete vision. Pt was seen by ophthalmologist and diagnosed with migraine. Pt c/o bitemporal headache, tremors in legs, feeling of "pins and needles" in legs, feeling of paralysis, however Pt able to move legs. Neuro exam: wnl. Physician opinion was that Pt's symptoms were likely a psychological/emotional process. Pt r/o Lyme disease and MS.
Age: 27.0
Sex: F
Vaccine: HPV4
Symptoms: Demyelination, Drug administered at inappropriate site, Loss of consciousness, Lumbar puncture, Migraine
Clinical narrative: Information has been received from a health professional concerning a 28 year old female who on 28-AUG-2007 was vaccinated with the first dose of GARDASIL (lot# 658558/1061U) into her left buttocks. Not long after first dose, migraine headache started. On 25-OCT-2007, the patient was vaccinated with the second dose of GARDASIL (lot# 654539/0742U) into her left gluteus and on 25-FEB-2008, was vaccinated with the third dose of GARDASIL (lot# 655327/1287U) into her left gluteus. Concomitant therapy included ALESSE. On 01-MAY-2009, the patient passed out and was hospitalized, a spinal tap was performed. The patient had migraine headache started not long after the first injection. The patient was seeing a neurologist. A MRI performed showed abnormal results. The patient developed demyelination in brain. Questionable Lupus. Upon internal review, questionable lupus was determined to be an other important medical event. Additional information has been requested.  9/16/09 Received vaccine & GYN medical records. Records reveal patient experienced wt loss & fatigue.  On 5/1 had seizure, hospitalized & neuro eval done.  10/6/09 Neurological consult received service dates 5/1/09 to 5/21/09. Assessment: Migraine Presented with c/o severe bifrontal headache and episode of syncope. Transient loss of consciousness. Episodes of weakness associated with headaches, visual disturbance, migraine headaches for past year associated with use of oral contraceptives.
Age: 46.0
Sex: F
Vaccine: FLU3
Symptoms: Aphasia, Blood test, Candidiasis, Computerised tomogram, Condition aggravated
Clinical narrative: 11/27/07 had scratchy throat, coughing, the symptoms went to thrush, fever, high blood pressure, loss/slurred speech, loss of appetite, fatigue. I saw doctor on 12/5/07 gave me IV for dehydration sent me home. 12/6/07 Woke up seeing double vision, saw Ophthalmologist; went to ER - admitted for 6 days - diagnosed with Guillain Barre syndrome at hospital.  11/9/09 DC summary, hospital records recieved service dates 12/6/2007 to 12/12/2007. Assessment: 1. Miller Fisher varient of Guillain-Barre syndrome. 2. Hypertension. 3. Inability to close (L) eye or tear properly, dysarthria with nasal voice. Peripheral facial droop.   Sore throat past 9 days, oral thrush. Fatigue, slurred speech, unsteadiness walking, shuffling gate, and uncoordination. Patient admitted with symptoms of diplopia, palatable dysfunction, ataxia, and areflexia, along with non-reactive pupils. Reflexes absent/decreased. IVIG X 5 days. Tachycardia. Ambulates with walker.
Age: 46.0
Sex: F
Vaccine: FLU3
Symptoms: Cough, Decreased appetite, Dehydration, Diplopia, Dysarthria
Clinical narrative: 11/27/07 had scratchy throat, coughing, the symptoms went to thrush, fever, high blood pressure, loss/slurred speech, loss of appetite, fatigue. I saw doctor on 12/5/07 gave me IV for dehydration sent me home. 12/6/07 Woke up seeing double vision, saw Ophthalmologist; went to ER - admitted for 6 days - diagnosed with Guillain Barre syndrome at hospital.  11/9/09 DC summary, hospital records recieved service dates 12/6/2007 to 12/12/2007. Assessment: 1. Miller Fisher varient of Guillain-Barre syndrome. 2. Hypertension. 3. Inability to close (L) eye or tear properly, dysarthria with nasal voice. Peripheral facial droop.   Sore throat past 9 days, oral thrush. Fatigue, slurred speech, unsteadiness walking, shuffling gate, and uncoordination. Patient admitted with symptoms of diplopia, palatable dysfunction, ataxia, and areflexia, along with non-reactive pupils. Reflexes absent/decreased. IVIG X 5 days. Tachycardia. Ambulates with walker.
Age: 46.0
Sex: F
Vaccine: FLU3
Symptoms: Fatigue, Guillain-Barre syndrome, Hypertension, Lumbar puncture, Nuclear magnetic resonance imaging
Clinical narrative: 11/27/07 had scratchy throat, coughing, the symptoms went to thrush, fever, high blood pressure, loss/slurred speech, loss of appetite, fatigue. I saw doctor on 12/5/07 gave me IV for dehydration sent me home. 12/6/07 Woke up seeing double vision, saw Ophthalmologist; went to ER - admitted for 6 days - diagnosed with Guillain Barre syndrome at hospital.  11/9/09 DC summary, hospital records recieved service dates 12/6/2007 to 12/12/2007. Assessment: 1. Miller Fisher varient of Guillain-Barre syndrome. 2. Hypertension. 3. Inability to close (L) eye or tear properly, dysarthria with nasal voice. Peripheral facial droop.   Sore throat past 9 days, oral thrush. Fatigue, slurred speech, unsteadiness walking, shuffling gate, and uncoordination. Patient admitted with symptoms of diplopia, palatable dysfunction, ataxia, and areflexia, along with non-reactive pupils. Reflexes absent/decreased. IVIG X 5 days. Tachycardia. Ambulates with walker.
Age: 46.0
Sex: F
Vaccine: FLU3
Symptoms: Pyrexia, Throat irritation
Clinical narrative: 11/27/07 had scratchy throat, coughing, the symptoms went to thrush, fever, high blood pressure, loss/slurred speech, loss of appetite, fatigue. I saw doctor on 12/5/07 gave me IV for dehydration sent me home. 12/6/07 Woke up seeing double vision, saw Ophthalmologist; went to ER - admitted for 6 days - diagnosed with Guillain Barre syndrome at hospital.  11/9/09 DC summary, hospital records recieved service dates 12/6/2007 to 12/12/2007. Assessment: 1. Miller Fisher varient of Guillain-Barre syndrome. 2. Hypertension. 3. Inability to close (L) eye or tear properly, dysarthria with nasal voice. Peripheral facial droop.   Sore throat past 9 days, oral thrush. Fatigue, slurred speech, unsteadiness walking, shuffling gate, and uncoordination. Patient admitted with symptoms of diplopia, palatable dysfunction, ataxia, and areflexia, along with non-reactive pupils. Reflexes absent/decreased. IVIG X 5 days. Tachycardia. Ambulates with walker.
Age: 1.3
Sex: M
Vaccine: DTAPIPVHIB, HEP, HEPA, MMR, PNC, VARCEL
Symptoms: Body temperature increased, Convulsion, Hypotonia, Rash
Clinical narrative: 1412 Shots given PENTACEL, MMR, PREVNAR, Hep A, Hep B, Varicella. 1915 parent stated child, limp, rash, convulsions, low temperature. 2000 child taken to ER, admitted to hospital. 9/25/09 Medical records received DOS 9/2/09 to 9/3/09: ER visit presenting SX: unable to walk, became limp in bath. Taken to ER had myoclonic movents/episodes, developed rash. Admit for observation. Admit DX: 780.79   D/C DX: Adverse reaction to immunizations.
Age: 0.3
Sex: F
Vaccine: DTAP, HIBV, IPV, PNC, RV5
Symptoms: Developmental delay, Dyskinesia, Electroencephalogram abnormal, Infantile spasms
Clinical narrative: One week after 4 month check, presented to office with unusual movements for several days. Quickly recognized as infantile spasms in the office. Admitted for treatment. EEG showed hypsarrhythmia. Started on steroids. Remains on anticonvulsants with seizures controlled by significant developmental delay.  9/17/09 PCP records received. In for 4 month WCC. Returned shortly after with c/o muscle tightening, stiffening, shaking, head thrown back with eye deviation. Quiet after.  Episodes noted during PE with horizontal nystagmus, head turns to Left.  In between-normal.  DX: Epilepsy, Infantile Spasms w/o intractable epilepsy. Tx: prednisone. At 6 and 9 month check developmental milestones not being met. Neurodevelopmental consult 4/13/09 with following dx:  Static encephalopathy.  Global developmental delay. Seizure d/o-infantile spasms. Hearing impairment.  Cortical dysplasia-gray matter heterotopia.  Oral defensiveness. Hypotonia. Hypohydrosis and heat intolerance. Adrenal suppression 2' to ACTH and steroids. Increased spasms in 5/2009. Recent cochlear implant. Increase in seizures after meningitis and other vaccines.  9/22/09 Hospital records received, multiple consults, DOS 8/8/09 to 2/9/09 with the following additional information: Assessment: Central Nervous System Heterotopia. Patient spits up formula. Dry cough. Fever. Upper airway congestion. Tachypnea. Upper respiratory infection, pneumonia.   10/13/09 ICD-9 Codes received: 749.22 Cleft lip and palate unilateral incomplete, 381.3 Other chronic nonsuppurative otitis media, 345.60 Infantile Spasms without mention of intractable seizures, 754.0 Congenital deformity of skull face and jaw, 486 Pneumonia unspecified organism, 742.4 Other brain anomaly, 276.51 Dehydration.
Age: 61.0
Sex: F
Vaccine: VARZOS
Symptoms: Blister, Dyspnoea, Local reaction, Pruritus, Pyrexia
Clinical narrative: Local Reaction, blister sore on Rt. thigh, hives on forehead + Rt. eyelid, 101 degree fever, S.O.B. + Pruritus.
Age: 61.0
Sex: F
Vaccine: VARZOS
Symptoms: Urticaria
Clinical narrative: Local Reaction, blister sore on Rt. thigh, hives on forehead + Rt. eyelid, 101 degree fever, S.O.B. + Pruritus.
Age: 61.0
Sex: F
Vaccine: TDAP
Symptoms: Injection site haematoma, Injection site swelling, Tremor
Clinical narrative: Swelling and bruising at injection site.  Pt was shaking.
Sex: F
Vaccine: FLUX
Symptoms: Cough, Swelling, Throat irritation
Clinical narrative: RN here this AM for flu vaccination.  Approximately 2 hrs later (12 noon), pt developed persistent coughing, no wheezy, dyspnea, truritis, mucose swelling.  Irritated throat but no tightness complaints.
Age: 4.0
Sex: M
Vaccine: DTAP, IPV, MMR, VARCEL
Symptoms: Hypersensitivity, Injection site erythema, Injection site nodule, Injection site pain, Injection site warmth
Clinical narrative: Pt woke up day after injections with small red nodule at site of injection, was sent to school and when arrived home, area had gotten bigger with multiple bumps.  On the second day, are was red, firm to touch, warm and he was taken to the ER.  He was diagnosed there with allergic reaction and given PREDNISONE and BENADRYL.  FU in the office on 8-31 showed continued resolution of the area.
Age: 5.0
Sex: F
Vaccine: FLU3, TDAP
Symptoms: Inappropriate schedule of drug administration
Clinical narrative: Mom brought in 2 children for vaccines - baskets/containers were side by side - 5 yr old was kicking & fighting - grabbed the wrong basket & administered Flu & BOOSTRIX which were intended for 12 yr old child, who was also receiving vaccines.
Age: 5.0
Sex: F
Vaccine: DTAP, IPV, MMR, VARCEL
Symptoms: Pyrexia
Clinical narrative: 9-1-09 4 P fever 101.7 temp.  TYLENOL alt. after Ibuprofen per Dr.  9-2-09 no fever.
Age: 5.0
Sex: F
Vaccine: DTAP, IPV, MMR, VARCEL
Symptoms: Decreased activity, Pyrexia
Clinical narrative: 9-1-09 2:30 PM fever 100.9 temp - very quiet - decreased activity - TYLENOL alt. with Ibuprofen per Dr.  9-2-09 no fever - Sx's resolved.
Age: 11.0
Sex: F
Vaccine: FLUN3, HEPA, MNQ, TDAP, VARCEL
Symptoms: Urticaria
Clinical narrative: Generalized urticaria 6 days after receiving vaccines Tx - BENADRYL 25-50mg every 6 hours prn.
Age: 77.0
Sex: F
Vaccine: VARZOS
Symptoms: Pain, Skin burning sensation
Clinical narrative: One year after administration of ZOSTAVAX, I developed burning sensations in skin on left side of back extending into left breast, including sharp burning needle-like pain. My doctor prescribed NEURONTIN which helped relieve the discomfort.
Age: 2.0
Sex: F
Vaccine: DTAP, HEP, IPV, MMR, PNC, VARCEL
Symptoms: Fatigue, Urticaria
Clinical narrative: Mom reported hives over entire body on 8-28-09 which lasted until 9-2-09.  No fever.  States child seemed more tired then usual on day before hives appeared.  Mom states she dosed child with BENADRYL 2 X 1d after hives appeared.
Age: 5.0
Sex: M
Vaccine: DTAP, MMR
Symptoms: Injection site erythema, Injection site swelling
Clinical narrative: DTaP & MMR administered approx 48 hrs ago. 24 hrs ago upper left arm red & swollen now 2x2 inch erythema, no fever child active & playful.
Age: 12.0
Sex: F
Vaccine: HPV4, MNQ, TDAP
Symptoms: Headache, Injection site swelling, Pyrexia, Vomiting
Clinical narrative: - Fever x 2-3 days (102.0). - Alternate TYLENOL/MOTRIN. - Swelling to injection site. - Push fluids. -Headache x 2 days. - Vomiting x 1-2 days.
Age: 4.0
Sex: F
Vaccine: HEPA, IPV, MMR, TDAP
Symptoms: Inappropriate schedule of drug administration
Clinical narrative: None reported.
Age: 1.2
Sex: F
Vaccine: MMR
Symptoms: Convulsion, Developmental delay
Clinical narrative: Onset of seizures and developmental delays. Onset Feb. -12, 2001 9 months after vaccine.  10/6/09 PCP medical records, neurology consult, service dates 2/10/02 to 9/09/09. Assessment: Intractable epilepsy and static encephalopathy. Child presents with hx of generalized tonic-clonic convulsion in setting of high fever in Feb 01 dx febrile seizure. In Feb 02 was found limp and unresponsive, vomited twice, and slept for a period of time. convulsive seizure March 02 when ill with otitis media. Tonic stiffening, loss of consciousness, drooling, clonic movements. Similar seizures have continued to occur. Child has been agitated, aggressive with hitting and biting, hyperactive, mood lability. Sometimes prodrome or aura. Chewing movements, c/o knees hurt, behavioral arrest, blank stare, stiffen and fall to floor. Bilaterally syncronous and symmetric clonic movements. Eyes roll up. Perioral cyanosis. Postictal confusion. Cognitively impaired. Limited speech. Not eating or sleeping as usual. Sore throat. Diarrhea. Bends back while walking.
Age: 30.0
Sex: F
Vaccine: HEP, HEPA, MNQ, TDAP
Symptoms: Injection site pruritus, Injection site swelling, Injection site warmth, Ocular hyperaemia
Clinical narrative: Warmth and swelling up left arm, itchy / redness of eyes. Pt given Benadryl 25mg Po 9/3/09 at 1430.
Age: 8.0
Sex: M
Vaccine: TDAP
Symptoms: Inappropriate schedule of drug administration, Injection site erythema, Injection site induration, Injection site pruritus, Injection site swelling
Clinical narrative: 8/27/09 pt came in this morning c/o hard, red swelling on arm at the site of injection from 2 days ago. Pt says it started yesterday morning, getting worse so they came (him and his mom). He said it is very itchy. Pt had received DTaP in 2006. So booster was preventative. Also, this was given Tdap, not DTaP.
Age: 5.0
Sex: M
Vaccine: DTAPIPV
Symptoms: Dyspnoea, Injection site swelling, Pyrexia
Clinical narrative: Mother states fever of 101 degrees X 3 days beginning 09-01-09.  Also states woke up 2 X on 09-01-09 stating "can't breathe".  Did not take to PMD. "Partner is paramedic so only treated with BENADRYL".  Strongly encouraged to take to MD.  Verbalized understanding arm swollen @ injection site.
Age: 67.0
Sex: F
Vaccine: FLU3, PPV
Symptoms: Erythema, Skin warm, Swelling
Clinical narrative: Red, hot. Tues evening using ice packs. Worse on Wed swelling. Same on Thurs. Redness worse and puffing on Fri.
Age: 19.0
Sex: M
Vaccine: HEPAB, MNQ, TDAP
Symptoms: Rash pruritic, Urticaria
Clinical narrative: see attached SF 600
Age: 4.0
Sex: M
Vaccine: MMR
Symptoms: Herpes zoster, Pyrexia
Clinical narrative: After my son received his booster shot for chicken pox, within 6 months he had got shingles. He also ran a high temp. with the shingles.....
Age: 61.0
Sex: F
Vaccine: VARZOS
Symptoms: Injection site erythema, Injection site inflammation, Injection site pruritus
Clinical narrative: Redness and inflammation at the injection site.  Itching patient is going to apply ice and take antihistamine.
Age: 1.4
Sex: F
Vaccine: DTAP, FLU3, PNC
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth, Pyrexia
Clinical narrative: 8-31-09 @ 7:30 pm - lower right thigh red - dime size, upper right thigh slightly red, low grade fever, pain 9-1-09 PREVENAR @ 7 am - red, nickel size, 12:20 pm, red, raised - warm > lower (R) thigh upper (R) thigh remains red, low grade fever, pain 4:15 - in office : upper (R) thigh 3/4 in x 1 in - red, lower (R) thigh 2in x 1 in warm, raised, red - saw MD gave TYLENOL every 4 hrs since injection 99.2 degrees.
Age: 14.0
Sex: F
Vaccine: HPV4, MNQ
Symptoms: Dizziness, Flushing, Immediate post-injection reaction, Laboratory test normal, Nausea
Clinical narrative: Postural Syncope immediately following vaccine. Recurred again within 24 hrs. Flushed, nausea, dizzy when standing with orthostatic BP changes. No rash, no edema. Labs normal. Given IV fluids with symptom improvement.
Age: 14.0
Sex: F
Vaccine: HPV4, MNQ
Symptoms: Orthostatic hypotension, Syncope
Clinical narrative: Postural Syncope immediately following vaccine. Recurred again within 24 hrs. Flushed, nausea, dizzy when standing with orthostatic BP changes. No rash, no edema. Labs normal. Given IV fluids with symptom improvement.
Age: 39.0
Sex: M
Vaccine: TDAP
Symptoms: Arthralgia, Bilirubin conjugated abnormal, Blood bilirubin increased, Blood creatinine normal, Haemoglobin normal
Clinical narrative: Developed fever to 103.  Painful swelling of arm.  The vaccine was given in H.A., arthralgias, nausea.  No rash no oropharyngeal swelling.  No dyspnea.
Age: 39.0
Sex: M
Vaccine: TDAP
Symptoms: Headache, Liver function test normal, Nausea, Oedema peripheral, Pain in extremity
Clinical narrative: Developed fever to 103.  Painful swelling of arm.  The vaccine was given in H.A., arthralgias, nausea.  No rash no oropharyngeal swelling.  No dyspnea.
Age: 39.0
Sex: M
Vaccine: TDAP
Symptoms: Platelet count normal, Pyrexia, White blood cell count increased
Clinical narrative: Developed fever to 103.  Painful swelling of arm.  The vaccine was given in H.A., arthralgias, nausea.  No rash no oropharyngeal swelling.  No dyspnea.
Age: 14.0
Sex: F
Vaccine: HEPA, HPV4, MNQ
Symptoms: Blood pressure normal, Dyskinesia, Syncope
Clinical narrative: Patient fainted after administering HPV vaccine for about 1-2 mins.  Vital sysm. stable.  Mom witnessed some arching moves.  Blood pressure WNL while she fainted.
Age: 5.0
Sex: M
Vaccine: DTAP, IPV, MMR, VARCEL
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth
Clinical narrative: 12x19 cm, red, swollen, warm to the touch area on L upper arm.  Advised BENADRYL, warm compresses and monitoring.
Age: 15.0
Sex: F
Vaccine: HPV4
Symptoms: Dizziness
Clinical narrative: Patient developed dizziness after administration of GARDASIL (2nd dose).
Age: 0.57
Sex: F
Vaccine: DTAPHEPBIP, FLU3, HIBV, PNC
Symptoms: Hypersensitivity, Local reaction
Clinical narrative: Localized allergic reaction.
Age: 66.0
Sex: F
Vaccine: FLU3
Symptoms: Dizziness, Dyspnoea, Rash
Clinical narrative: Difficulty breathing, rash development, dizziness.
Age: 11.0
Sex: M
Vaccine: TDAP
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth
Clinical narrative: Pt complained of left arm swelling / red/ warm to touch at injection site that measured 18cm x 12cm on 8/26/09. Pt given Benadryl, Motrin and ice.
Age: 18.0
Sex: M
Vaccine: FLU3, HEPA, MNQ, TDAP
Symptoms: Pruritus, Rash, Urticaria
Clinical narrative: See attached.
Age: 58.0
Sex: F
Vaccine: FLU3
Symptoms: Dizziness, Nausea
Clinical narrative: Within 5 mins of receiving flu shot, patient experienced nausea and dizziness.  Symptoms lasted a few minutes & Patient was able to walk out.
Age: 5.0
Sex: F
Vaccine: DTAPIPV, MMR, VARCEL
Symptoms: Erythema
Clinical narrative: (R) arm red 3 X 2 cm.
Age: 66.0
Sex: F
Vaccine: FLUX, PPV
Symptoms: Erythema, Pyrexia
Clinical narrative: 8-29-09 (Mild Fever). 8-30-09 & 8-31-09-(Chills & Fever of 102.5 on & off). 9-01-09-Redness on arm covered all of arm above elbow-9-1-09 saw Dr & was given a pers. For Amox-Clav.
Age: 12.0
Sex: F
Vaccine: HEPA, HPV4
Symptoms: Blood pressure decreased, Immediate post-injection reaction, Syncope
Clinical narrative: Syncopal episode immediately following vaccine administration. Patient was seated, no fall sustained. Blood pressure dropped to 76/48, recovered to 96/56 in 5 minutes.
Age: 14.0
Sex: F
Vaccine: FLU3, HEPA, HPV4
Symptoms: Headache
Clinical narrative: Onset of chronic headaches 21/2 month following HPV #2 Diagnostic w/u (-) .11/30/2009 PCP records 2-9/2009, ENT consult 7/2009 and Neuro consult records 4/2009. Dx tension headaches  Patient with hx of headaches, dizziness, vision changes with headaches. Neuro consult neg, ENT consult dx'd as tension headaches. Tx PT
Age: 55.0
Sex: F
Vaccine: TDAP
Symptoms: Back pain, Musculoskeletal stiffness, Myalgia
Clinical narrative: All my muscles are sore.  My back hurts.  I feel "stiff" all over.
Age: 39.0
Sex: F
Vaccine: TDAP
Symptoms: Fatigue, Injection site pain, Pain
Clinical narrative: Distinct pain @ injection site within 2-3 hours of injection lasting 16-18 hrs. Followed by all over body ache & extreme fatigue.
Age: 12.0
Sex: F
Vaccine: TDAP, VARCEL
Symptoms: Erythema, Oedema peripheral
Clinical narrative: Swelling & Redness 8-6-09 R arm.
Age: 12.0
Sex: F
Vaccine: HPV4
Symptoms: Abdominal discomfort, Chills, Pyrexia, Rash macular, Urticaria
Clinical narrative: Received Wed 8/26/09 fever next day. Friday - rash, splotches 3-4" across, worse, chills spreading.  Saturday & Sunday - hives upset stomach Saturday.
Age: 19.0
Sex: F
Vaccine: DTAP
Symptoms: Lip swelling, Pruritus, Throat irritation
Clinical narrative: -itching of the face, swelling of lips; then 25mg diphenhydramine IV was administered.  When no relief, and additional itching of throat, famotidine 20mg IV and solumedrol 125mg IV were administered
Age: 3.0
Sex: F
Vaccine: MMR
Symptoms: Abdominal pain upper, Abnormal behaviour, Aphasia, Autism, Insomnia
Clinical narrative: 24 hrs after MMR shot, Patient stopped sleeping and complained of sore stomach. First week, major behavior change. On day 10, patient's eyes got a dead look, unresponsive and she lost her speech exibiting autism behavior.  She was quickly removed from dairy, wheat and sugar and continues to be.  On day 14, Pediatrician appointment...possible absence seizures...will need to see a Pediatric Neurologist ASAP.  9/21/09 PCP medical records DOS 8/21/09 to 9/4/09. Assessment: Behavior Changes. Patient is defiant, not sleeping, stomach ache, slurred speech. appears dazed. "Dead eyes". Just got a puppy. Nausea, vomiting, sneezing, bites on skin, drowsiness, 'seizure like'. 12/18/2009 Neuro consult for 9/10/2009, patient seen for behavioral changes, neuro exam wnl. EEG ordered which was wnl, no medication rx'd.
Age: 3.0
Sex: F
Vaccine: MMR
Symptoms: Staring, Unresponsive to stimuli
Clinical narrative: 24 hrs after MMR shot, Patient stopped sleeping and complained of sore stomach. First week, major behavior change. On day 10, patient's eyes got a dead look, unresponsive and she lost her speech exibiting autism behavior.  She was quickly removed from dairy, wheat and sugar and continues to be.  On day 14, Pediatrician appointment...possible absence seizures...will need to see a Pediatric Neurologist ASAP.  9/21/09 PCP medical records DOS 8/21/09 to 9/4/09. Assessment: Behavior Changes. Patient is defiant, not sleeping, stomach ache, slurred speech. appears dazed. "Dead eyes". Just got a puppy. Nausea, vomiting, sneezing, bites on skin, drowsiness, 'seizure like'. 12/18/2009 Neuro consult for 9/10/2009, patient seen for behavioral changes, neuro exam wnl. EEG ordered which was wnl, no medication rx'd.
Age: 4.0
Sex: F
Vaccine: DPP, MMRV, VARCEL
Symptoms: Erythema, Injection site erythema, Injection site swelling, Injection site urticaria, Swelling
Clinical narrative: Red raised welts around injection site.  Approx 1x2cm in size.
Age: 4.0
Sex: F
Vaccine: DPP, MMRV, VARCEL
Symptoms: Urticaria
Clinical narrative: Red raised welts around injection site.  Approx 1x2cm in size.
Age: 14.0
Sex: F
Vaccine: HEPA, HPV4
Symptoms: Dizziness, Loss of consciousness, Syncope
Clinical narrative: Pt fainted at about 3:50pm at the waiting area after blood drawn and vaccination, she felt dizzy then passed out for less than 1 min.  Code blue was called, pt was attended immediately by nursing staff and provider, she was awake by the time provider arrived.  Pt was transferred to Rm 9 for close observation, continuring monitor of vital signs.  Initial accessment by provider was normal, pt was observed for 30 mins with normal vital signs.  Pt was examined again by provider before discharge, normal exam.  Explained to mom that the fainting might be dued to blood drawn or vaccination.  Possible postvaccination reaction to HPV, case is reported for further investigation.   Pt should have f/u in 1 week.
Age: 13.0
Sex: F
Vaccine: HPV4
Symptoms: Injection site mass, Injection site pain, Injection site swelling
Clinical narrative: Pain, swelling, lump on arm at injection site.
Sex: U
Vaccine: FLU3
Symptoms: Erythema, Pruritus
Clinical narrative: REACTION NOTED POST VACCINATION HANDS RED AND ITCHING
Age: 76.0
Sex: F
Vaccine: FLU3
Symptoms: Mobility decreased, No reaction on previous exposure to drug, Oedema peripheral, Pain in extremity, Urticaria
Clinical narrative: After receiving vaccine, pt states her entire upper arm swelled and she was not able to move arm all weekend. The under arm region also broke out in welts. She iced arm and took pain reliever and arm is just now (9/8) starting to go back to normal. However, still sore. No past rxn. per pt.
Age: 2.0
Sex: F
Vaccine: DTAPHEPBIP
Symptoms: Erythema, Induration, Skin warm
Clinical narrative: Parent reported 1 day following vaccination (8/12/09), child's arm (from Shoulder and to just above elbow) increased redness, warmth to touch, and hardness.  Parent stated this lasted about 4-5 days.  Upon viewing today (9/9/09), left arm was back to normal - no adverse effects noted. using both arms equally.
Age: 47.0
Sex: F
Vaccine: FLU3
Symptoms: Dyspnoea, Eye irritation, Throat tightness
Clinical narrative: Employee reported progressively worsening throat tightness after receiving flu vaccine.  Vaccine received at approximately 12:30pm on 9/8/09.  Sought treatment in ED at approx. 19:00 on 9/8/09.  C/o sx beginning approx 3.5hrs earlier, associated with burning eyes.  At time of ED tx sx assoc with difficulty breathing.  Tx with IV Solumedrol 125mg and IV Benadryl 25mg.  D/c home at 23:00 with report of improved sx.  D/c on Prednisone po and benadryl po prn
Age: 42.0
Sex: F
Vaccine: HEP, MMR, TDAP, VARCEL
Symptoms: Lymphadenectomy, Lymphadenopathy
Clinical narrative: Clent stated a few days after receiving Tdap & Varicella in the left arm and MMR and Hep B in the right arm two lymph nodes in the left side of her neck became swollen.  She subsequently had them removed.  Her physician told her it may have been caused by the Tdap.
Age: 86.0
Sex: M
Vaccine: PPV
Symptoms: Injection site cellulitis, Injection site erythema, Injection site rash, Injection site swelling
Clinical narrative: Left upper arm was very swollen, red rash, appearance of cellulitis, and required medical attention. Pt was given vaccine on day of discharge (7/29). Pt went to facility and 7/30 & 7/31 he saw Dr. and received antibiotics and antihistamines. On 8/3 significant improvement.
Age: 4.0
Sex: M
Vaccine: DTAP, IPV, MMR, VARCEL
Symptoms: Injection site erythema, Injection site induration
Clinical narrative: AREA OF ERYTHEMA ON UPPER LEFT ARM APPROX. 3 CM IN DIAMETER WITH MILD INDURATION. NO PUSTULE.  MOM NOTICED AREA OF REDNESS 9/2/09 IN THE MORNING.  OBSERVATION RECOMMENDED AND PATIENT TO POLLOW UP IF SYMPTOMS PERSIST OR WORSEN.
Age: 15.0
Sex: F
Vaccine: MNQ, TDAP
Symptoms: Fall, Feeling cold, Joint stiffness, Pain in extremity, Tremor
Clinical narrative: Received Tdap & MCV4 9/8/2009 @ approx 1500.  Per mother child "Went to bed @ approx 2130 with c/o sore arms.  Woke up @ approx 0200-0300 on 9/9/2009 feeling cold, got up for a blanket, fell to floor, jaw felt clutched shut, and was shaking.  Got back in bed & went back to sleep.  Upon awakening at approx 0500, symptoms no longer present and child returned to school today".  Mother phoned child's physician who told her to monitor today and report even to our facility.
Age: 10.0
Sex: M
Vaccine: HEP, MNQ, TDAP
Symptoms: Dizziness, Fall, Head injury
Clinical narrative: Within 2 minutes of vaccination, Pt c/o dizziness. Dropped to the ground and tapped head on side of plastic chair. Instantly recovered. Drank water & ate breakfast bar. Sat in lobby for 15 minutes before release with Dad. Pt states" little pain @ left forehead". 14:40 called, spoke with Dad,
Age: 12.0
Sex: M
Vaccine: MNQ, TDAP
Symptoms: Injection site inflammation, Injection site pain, Injection site swelling
Clinical narrative: Left arm swelling- inflammation around site- 5" long. Right arm- 4" wide and 3" long swelling and inflammation and tenderness.
Age: 13.0
Sex: M
Vaccine: MNQ, TDAP
Symptoms: Injected limb mobility decreased, Injection site pain, Pain
Clinical narrative: As per client's mother, he started complaining that his left arm was in pain from the moment he received the shots, and that he could not move it because it was sore. Denies any swelling, or rash at the vaccine site. Mom applied ice packs and gave tylenot for pain, but now after 3 weeks the child still complaints of pain to the left arm.
Age: 40.0
Sex: F
Vaccine: FLU3
Symptoms: Pruritus, Urticaria
Clinical narrative: I received the seasonal flu shot around 4 p.m.  I woke up the next morning very itchy and developed hives all over my body.  I took Benadryl every 4 hours and used Caladryl.  It lasted for 48 hours.
Age: 0.17
Sex: F
Vaccine: DTAPIPVHIB, PNC
Symptoms: Crying, Injection site erythema, Urticaria
Clinical narrative: Hives, severe crying and localized Redness to the left thigh. Reaction lasted several hours. Pt was given Zyrtec and Decadron IM.
Age: 42.0
Sex: F
Vaccine: DTAP
Symptoms: Injection site pain, Pain
Clinical narrative: Painful at site when arm moved up high
Age: 1.0
Sex: F
Vaccine: PNC, VARCEL
Symptoms: Allergy test, Immediate post-injection reaction, Injection site swelling, Local swelling, Urticaria
Clinical narrative: Large localized swelling, urticaria (generalized) within two or three minutes of vaccine. 1 tsp children's benedryl given at the time, patient was monitored for twenty minutes.  Symptoms resolved.  Symptoms reappeared one week later after patient ate eggs for the first time, including a large swelling at the vaccine site.
Age: 61.0
Sex: M
Vaccine: FLU3
Symptoms: Injection site pain
Clinical narrative: While there was no pain when shot was given, the next day there was a lot of pain in the arm at the injection location.
Age: 1.0
Sex: M
Vaccine: HEPA
Symptoms: Body temperature increased, Pyrexia
Clinical narrative: developed fever  103  2 days after   vaccination  . resolved without  any  sequelae
Age: 75.0
Sex: F
Vaccine: TD
Symptoms: Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling, Injection site warmth
Clinical narrative: Right arm redness(softball size), swollen, itchy, warm to the touch, sore started on 9-5-09.  Pt used benadryl and calamine lotion starting on 9-6-09 - 9-9-09.  Pt saw family physician on 9-9-09 Rx for a topical cream given, told pt to discontinue putting calamine to the area, also told pt to switch soaps to dove and take cool showers call him in a week(per pt).
Age: 0.15
Sex: M
Vaccine: DTAP, HBHEPB, IPV, PNC
Symptoms: Blood culture negative, CSF culture negative, Chest X-ray abnormal, Convulsion, Culture urine negative
Clinical narrative: 2 days after receiving his scheduled 2 month shots, DTaP, Hep B, Hib, Polio, and Prevnar, patient began having seizures.  After numerous tests, blood work, genetics testing, spinal tap, etc, the doctors still have not been able to diagnose the problem.
Age: 0.15
Sex: M
Vaccine: DTAP, HBHEPB, IPV, PNC
Symptoms: Cyanosis, Cytogenetic analysis, Diarrhoea, Electroencephalogram abnormal, Electroencephalogram normal
Clinical narrative: 2 days after receiving his scheduled 2 month shots, DTaP, Hep B, Hib, Polio, and Prevnar, patient began having seizures.  After numerous tests, blood work, genetics testing, spinal tap, etc, the doctors still have not been able to diagnose the problem.
Age: 0.15
Sex: M
Vaccine: DTAP, HBHEPB, IPV, PNC
Symptoms: Fatigue, Glossodynia, Influenza serology negative, Laboratory test normal, Lumbar puncture
Clinical narrative: 2 days after receiving his scheduled 2 month shots, DTaP, Hep B, Hib, Polio, and Prevnar, patient began having seizures.  After numerous tests, blood work, genetics testing, spinal tap, etc, the doctors still have not been able to diagnose the problem.
Age: 0.15
Sex: M
Vaccine: DTAP, HBHEPB, IPV, PNC
Symptoms: Nuclear magnetic resonance imaging brain normal, Oxygen saturation decreased, Pyrexia, Rash, Respiratory syncytial virus test negative
Clinical narrative: 2 days after receiving his scheduled 2 month shots, DTaP, Hep B, Hib, Polio, and Prevnar, patient began having seizures.  After numerous tests, blood work, genetics testing, spinal tap, etc, the doctors still have not been able to diagnose the problem.
Age: 0.15
Sex: M
Vaccine: DTAP, HBHEPB, IPV, PNC
Symptoms: Vomiting
Clinical narrative: 2 days after receiving his scheduled 2 month shots, DTaP, Hep B, Hib, Polio, and Prevnar, patient began having seizures.  After numerous tests, blood work, genetics testing, spinal tap, etc, the doctors still have not been able to diagnose the problem.
Age: 39.0
Sex: F
Vaccine: FLU3
Symptoms: Throat irritation
Clinical narrative: PT COMPLAINED OF HER THROAT FEELING LIKE IT IS ON "FIRE".
Age: 15.0
Sex: F
Vaccine: HEPA, HPV4, HEPA, HPV4
Symptoms: Anaemia haemolytic autoimmune, Aspiration bone marrow, Blood iron, Blood lactate dehydrogenase, Blood product transfusion
Clinical narrative: Evans Syndrome. Autoimmune hemolitic anemia + idiopathic thrombocytopenic purpura. Coombs positive (warm Ab). Hb=6 & plts. 20,000. Differential Dx and W/U. All negative and comrehensive. Incluging viral studies, lupus serologies and Bone marrow aspirate and biopsy. Cause still unknown. Treated with transfusions, IVIG, steroids and "wait and see" aproach. Ultimately given Rytuxan. Currently on 'remission' 9/28/09 Medical records and DC summary received from date of service 11/1/08 to 11/7/08.  D/C DX:Evans Syndrome. Presented with: malaise x1month,fatigue, fever, sore throat, joint pain/swelling, cough, night sweats, anemia, thrombocytopenia. Insidious onset of symptomatic microcytic hypochromic hyperproliferative anemia with evidence of iron deficiency. TX: IV IG.
Age: 15.0
Sex: F
Vaccine: HEPA, HPV4, HEPA, HPV4
Symptoms: Complement factor, Coombs test positive, Cytomegalovirus serology, Evans syndrome, HIV test
Clinical narrative: Evans Syndrome. Autoimmune hemolitic anemia + idiopathic thrombocytopenic purpura. Coombs positive (warm Ab). Hb=6 & plts. 20,000. Differential Dx and W/U. All negative and comrehensive. Incluging viral studies, lupus serologies and Bone marrow aspirate and biopsy. Cause still unknown. Treated with transfusions, IVIG, steroids and "wait and see" aproach. Ultimately given Rytuxan. Currently on 'remission' 9/28/09 Medical records and DC summary received from date of service 11/1/08 to 11/7/08.  D/C DX:Evans Syndrome. Presented with: malaise x1month,fatigue, fever, sore throat, joint pain/swelling, cough, night sweats, anemia, thrombocytopenia. Insidious onset of symptomatic microcytic hypochromic hyperproliferative anemia with evidence of iron deficiency. TX: IV IG.
Age: 15.0
Sex: F
Vaccine: HEPA, HPV4, HEPA, HPV4
Symptoms: Haemoglobin decreased, Idiopathic thrombocytopenic purpura, Mononucleosis heterophile test, Parvovirus B19 serology, Platelet count decreased
Clinical narrative: Evans Syndrome. Autoimmune hemolitic anemia + idiopathic thrombocytopenic purpura. Coombs positive (warm Ab). Hb=6 & plts. 20,000. Differential Dx and W/U. All negative and comrehensive. Incluging viral studies, lupus serologies and Bone marrow aspirate and biopsy. Cause still unknown. Treated with transfusions, IVIG, steroids and "wait and see" aproach. Ultimately given Rytuxan. Currently on 'remission' 9/28/09 Medical records and DC summary received from date of service 11/1/08 to 11/7/08.  D/C DX:Evans Syndrome. Presented with: malaise x1month,fatigue, fever, sore throat, joint pain/swelling, cough, night sweats, anemia, thrombocytopenia. Insidious onset of symptomatic microcytic hypochromic hyperproliferative anemia with evidence of iron deficiency. TX: IV IG.
Age: 15.0
Sex: F
Vaccine: HEPA, HPV4, HEPA, HPV4
Symptoms: Reticulocyte count
Clinical narrative: Evans Syndrome. Autoimmune hemolitic anemia + idiopathic thrombocytopenic purpura. Coombs positive (warm Ab). Hb=6 & plts. 20,000. Differential Dx and W/U. All negative and comrehensive. Incluging viral studies, lupus serologies and Bone marrow aspirate and biopsy. Cause still unknown. Treated with transfusions, IVIG, steroids and "wait and see" aproach. Ultimately given Rytuxan. Currently on 'remission' 9/28/09 Medical records and DC summary received from date of service 11/1/08 to 11/7/08.  D/C DX:Evans Syndrome. Presented with: malaise x1month,fatigue, fever, sore throat, joint pain/swelling, cough, night sweats, anemia, thrombocytopenia. Insidious onset of symptomatic microcytic hypochromic hyperproliferative anemia with evidence of iron deficiency. TX: IV IG.
Age: 15.0
Sex: F
Vaccine: HEPA, HPV4, HEPA, HPV4
Symptoms: Anaemia, Anaemia haemolytic autoimmune, Antinuclear antibody negative, Arthralgia, Aspiration bone marrow
Clinical narrative: Evans Syndrome. Autoimmune hemolitic anemia + idiopathic thrombocytopenic purpura. Coombs positive (warm Ab). Hb=6 & plts. 20,000. Differential Dx and W/U. All negative and comrehensive. Incluging viral studies, lupus serologies and Bone marrow aspirate and biopsy. Cause still unknown. Treated with transfusions, IVIG, steroids and "wait and see" aproach. Ultimately given Rytuxan. Currently on 'remission' 9/28/09 Medical records and DC summary received from date of service 11/1/08 to 11/7/08.  D/C DX:Evans Syndrome. Presented with: malaise x1month,fatigue, fever, sore throat, joint pain/swelling, cough, night sweats, anemia, thrombocytopenia. Insidious onset of symptomatic microcytic hypochromic hyperproliferative anemia with evidence of iron deficiency. TX: IV IG.
Age: 15.0
Sex: F
Vaccine: HEPA, HPV4, HEPA, HPV4
Symptoms: Biopsy bone marrow normal, Blood iron normal, Blood lactate dehydrogenase, Blood product transfusion, Chest X-ray normal
Clinical narrative: Evans Syndrome. Autoimmune hemolitic anemia + idiopathic thrombocytopenic purpura. Coombs positive (warm Ab). Hb=6 & plts. 20,000. Differential Dx and W/U. All negative and comrehensive. Incluging viral studies, lupus serologies and Bone marrow aspirate and biopsy. Cause still unknown. Treated with transfusions, IVIG, steroids and "wait and see" aproach. Ultimately given Rytuxan. Currently on 'remission' 9/28/09 Medical records and DC summary received from date of service 11/1/08 to 11/7/08.  D/C DX:Evans Syndrome. Presented with: malaise x1month,fatigue, fever, sore throat, joint pain/swelling, cough, night sweats, anemia, thrombocytopenia. Insidious onset of symptomatic microcytic hypochromic hyperproliferative anemia with evidence of iron deficiency. TX: IV IG.
Age: 15.0
Sex: F
Vaccine: HEPA, HPV4, HEPA, HPV4
Symptoms: Chromosome analysis normal, Complement factor normal, Coombs test positive, Cough, Cytomegalovirus serology
Clinical narrative: Evans Syndrome. Autoimmune hemolitic anemia + idiopathic thrombocytopenic purpura. Coombs positive (warm Ab). Hb=6 & plts. 20,000. Differential Dx and W/U. All negative and comrehensive. Incluging viral studies, lupus serologies and Bone marrow aspirate and biopsy. Cause still unknown. Treated with transfusions, IVIG, steroids and "wait and see" aproach. Ultimately given Rytuxan. Currently on 'remission' 9/28/09 Medical records and DC summary received from date of service 11/1/08 to 11/7/08.  D/C DX:Evans Syndrome. Presented with: malaise x1month,fatigue, fever, sore throat, joint pain/swelling, cough, night sweats, anemia, thrombocytopenia. Insidious onset of symptomatic microcytic hypochromic hyperproliferative anemia with evidence of iron deficiency. TX: IV IG.
Age: 15.0
Sex: F
Vaccine: HEPA, HPV4, HEPA, HPV4
Symptoms: Cytomegalovirus test negative, Evans syndrome, Fatigue, HIV test negative, Haemoglobin decreased
Clinical narrative: Evans Syndrome. Autoimmune hemolitic anemia + idiopathic thrombocytopenic purpura. Coombs positive (warm Ab). Hb=6 & plts. 20,000. Differential Dx and W/U. All negative and comrehensive. Incluging viral studies, lupus serologies and Bone marrow aspirate and biopsy. Cause still unknown. Treated with transfusions, IVIG, steroids and "wait and see" aproach. Ultimately given Rytuxan. Currently on 'remission' 9/28/09 Medical records and DC summary received from date of service 11/1/08 to 11/7/08.  D/C DX:Evans Syndrome. Presented with: malaise x1month,fatigue, fever, sore throat, joint pain/swelling, cough, night sweats, anemia, thrombocytopenia. Insidious onset of symptomatic microcytic hypochromic hyperproliferative anemia with evidence of iron deficiency. TX: IV IG.
Age: 15.0
Sex: F
Vaccine: HEPA, HPV4, HEPA, HPV4
Symptoms: Idiopathic thrombocytopenic purpura, Iron deficiency, Joint swelling, Laboratory test abnormal, Malaise
Clinical narrative: Evans Syndrome. Autoimmune hemolitic anemia + idiopathic thrombocytopenic purpura. Coombs positive (warm Ab). Hb=6 & plts. 20,000. Differential Dx and W/U. All negative and comrehensive. Incluging viral studies, lupus serologies and Bone marrow aspirate and biopsy. Cause still unknown. Treated with transfusions, IVIG, steroids and "wait and see" aproach. Ultimately given Rytuxan. Currently on 'remission' 9/28/09 Medical records and DC summary received from date of service 11/1/08 to 11/7/08.  D/C DX:Evans Syndrome. Presented with: malaise x1month,fatigue, fever, sore throat, joint pain/swelling, cough, night sweats, anemia, thrombocytopenia. Insidious onset of symptomatic microcytic hypochromic hyperproliferative anemia with evidence of iron deficiency. TX: IV IG.
Age: 15.0
Sex: F
Vaccine: HEPA, HPV4, HEPA, HPV4
Symptoms: Microcytic anaemia, Mononucleosis heterophile test negative, Night sweats, Oropharyngeal pain, Parvovirus B19 serology negative
Clinical narrative: Evans Syndrome. Autoimmune hemolitic anemia + idiopathic thrombocytopenic purpura. Coombs positive (warm Ab). Hb=6 & plts. 20,000. Differential Dx and W/U. All negative and comrehensive. Incluging viral studies, lupus serologies and Bone marrow aspirate and biopsy. Cause still unknown. Treated with transfusions, IVIG, steroids and "wait and see" aproach. Ultimately given Rytuxan. Currently on 'remission' 9/28/09 Medical records and DC summary received from date of service 11/1/08 to 11/7/08.  D/C DX:Evans Syndrome. Presented with: malaise x1month,fatigue, fever, sore throat, joint pain/swelling, cough, night sweats, anemia, thrombocytopenia. Insidious onset of symptomatic microcytic hypochromic hyperproliferative anemia with evidence of iron deficiency. TX: IV IG.
Age: 15.0
Sex: F
Vaccine: HEPA, HPV4, HEPA, HPV4
Symptoms: Platelet count decreased, Pyrexia, Reticulocyte count normal, Thrombocytopenia
Clinical narrative: Evans Syndrome. Autoimmune hemolitic anemia + idiopathic thrombocytopenic purpura. Coombs positive (warm Ab). Hb=6 & plts. 20,000. Differential Dx and W/U. All negative and comrehensive. Incluging viral studies, lupus serologies and Bone marrow aspirate and biopsy. Cause still unknown. Treated with transfusions, IVIG, steroids and "wait and see" aproach. Ultimately given Rytuxan. Currently on 'remission' 9/28/09 Medical records and DC summary received from date of service 11/1/08 to 11/7/08.  D/C DX:Evans Syndrome. Presented with: malaise x1month,fatigue, fever, sore throat, joint pain/swelling, cough, night sweats, anemia, thrombocytopenia. Insidious onset of symptomatic microcytic hypochromic hyperproliferative anemia with evidence of iron deficiency. TX: IV IG.
Age: 40.0
Sex: F
Vaccine: PPV
Symptoms: Diarrhoea, Pyrexia, Vomiting
Clinical narrative: fevers, tmax 100.6 within 12 hrs of administration responding to tylenol diarrhea, vomiting within 24hrs
Age: 61.0
Sex: M
Vaccine: FLUX, TTOX
Symptoms: Chills, Dyspnoea, Pain
Clinical narrative: Breathing difficulty, body aches, chills apprx 36 hours.
Age: 57.0
Sex: F
Vaccine: TDAP
Symptoms: Erythema, Skin warm
Clinical narrative: Noticed mild redness on Saturday. Each day noted progression down arm further, no fever, redness noticed on inside of bicep down to elbow area, warm to touch is better than before per pt.
Age: 4.0
Sex: F
Vaccine: DTAPIPVHIB, MMR, VARCEL
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth
Clinical narrative: HOT, RED, SWOLLEN AREA FROM SHOULDER TO BELOW DELTOID  MUSCLE.  SEEN BY PHYSICIAN 9/9/09.  ENCOURAGED TO DO ICE COMPRESSES, MOVE ARM 7 SHOULDER JOINT.  TYLENOL FOR DISCOMFORT.    Previously reported under # E-31657  with error on report stating vaccines were purchased with private funds.  These vaccines were sent through the VFC program.    Patient has insurance that does not cover immunizations.
Age: 29.0
Sex: M
Vaccine: SMALL
Symptoms: Albumin globulin ratio abnormal, Erythema multiforme, Full blood count normal, Injection site scab, Laboratory test normal
Clinical narrative: 23 days after vaccination pt. developed 5 red patches on chest and back.  Maximum size 3 cm.  MD noted central flat erythemtous area surrounded by red papules, no vesicles or discharge.  Moderately pruritic. Also 3 white, painful 3-5mm white plaques on mucosa of cheeks and lips.  Vaccination site was still scabbed at this time.  No fever or systemic symptoms.  Lesions resolved without treatment within 3 weeks.
Age: 29.0
Sex: M
Vaccine: SMALL
Symptoms: Oral disorder, Polymerase chain reaction, Rash erythematous, Rash maculo-papular, Rash pruritic
Clinical narrative: 23 days after vaccination pt. developed 5 red patches on chest and back.  Maximum size 3 cm.  MD noted central flat erythemtous area surrounded by red papules, no vesicles or discharge.  Moderately pruritic. Also 3 white, painful 3-5mm white plaques on mucosa of cheeks and lips.  Vaccination site was still scabbed at this time.  No fever or systemic symptoms.  Lesions resolved without treatment within 3 weeks.
Age: 29.0
Sex: M
Vaccine: SMALL
Symptoms: Virus culture negative
Clinical narrative: 23 days after vaccination pt. developed 5 red patches on chest and back.  Maximum size 3 cm.  MD noted central flat erythemtous area surrounded by red papules, no vesicles or discharge.  Moderately pruritic. Also 3 white, painful 3-5mm white plaques on mucosa of cheeks and lips.  Vaccination site was still scabbed at this time.  No fever or systemic symptoms.  Lesions resolved without treatment within 3 weeks.
Age: 5.0
Sex: F
Vaccine: HEPA, IPV, MMR, VARCEL
Symptoms: Injection site erythema, Injection site induration, Injection site warmth
Clinical narrative: Erythema, induration and warmth over right deltoid area, approximately 6cm diameter.