chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 1.28
Sex: F
Vaccine: MMR
Symptoms: Abasia, Abnormal behaviour, Aphasia, Gait disturbance, Irritability
Clinical narrative: Information has been received from a registered nurse concerning a 15 month old female with no drug reactions allergies and a history of low birth weight and failure to thrive (starting at 6 months) who on  4/25/2006 was vaccinated SC with a 0.5ml dose of MMR II (lot 650104/0828R). there was no concomitant medication. On 4/30/06 the pt developed some behavior changes. The mother reported to the nurse that the child appeared panic stricken, clingy, lost verbal communication, and was irritated with anything too close to her face. She also stopped walking. The child was seen by a neurologist and developmental pediatrician. An EEG and MRI were normal. The pt recovered on 8/28/06. There was no product quality complaint. The reporter considered the events to be other important medical events (OMIC). Additional information has been requested.
Age: 1.28
Sex: F
Vaccine: MMR
Symptoms: Panic reaction
Clinical narrative: Information has been received from a registered nurse concerning a 15 month old female with no drug reactions allergies and a history of low birth weight and failure to thrive (starting at 6 months) who on  4/25/2006 was vaccinated SC with a 0.5ml dose of MMR II (lot 650104/0828R). there was no concomitant medication. On 4/30/06 the pt developed some behavior changes. The mother reported to the nurse that the child appeared panic stricken, clingy, lost verbal communication, and was irritated with anything too close to her face. She also stopped walking. The child was seen by a neurologist and developmental pediatrician. An EEG and MRI were normal. The pt recovered on 8/28/06. There was no product quality complaint. The reporter considered the events to be other important medical events (OMIC). Additional information has been requested.
Age: 4.0
Sex: F
Vaccine: MMRV
Symptoms: Bradycardia, Coma, Hypoxia, Pallor
Clinical narrative: Information has been received from a registered nurse concerning a 4 year old female with a history of dyspnea, lethargy and pyrexia following vaccination with MMR II/Varicella on 9/24/03 (WAES0609USA01195), who on 9/1/06 was vaccinated SC with a 0.5ml dose of MMR II/Varicella (upgrade process) ( lot 653834/0521F). There were no concomitant vaccinations. It was reported that when the mother took the child out to their car to go home the child became unresponsive. Medical attention was sought and the child was taken back to the physicians office. It was reported that the child was pale in color and her heart rate was about 50 bpm. She was started on oxygen and IV fluids and was stabilized within 30 minutes. She was sent to the local ER for evaluation. At the time of the report she was reported to be recovering. The reporter considered the pts pallor, decreased heart rate and unresponsiveness to be other important medical events (OMIC). Additional information has been requested.
Age: 0.41
Sex: M
Vaccine: DTAP, HEP, HIBV, IPV, PNC, RV5, RV5, DTAP, HEP, HIBV, IPV, PNC, RV5
Symptoms: Constipation, Haematochezia, Intussusception, Irritability, Laboratory test abnormal
Clinical narrative: Rotateq given 5/23/06 and 8/4/06 developed intussusception Sept 5th requiring surgical reduction. 99/19/06-received office note for DOS 8/1-9/5/06- note for 9/5/06-vomiting/possible dehydration. vomiting times 2 days, constipated 2 days ago, blood in diaper today, small amount of stool. PE: awake alert responsive, unsmiling. Abdomen soft non-tender, transfer to hospital. Operative Report received from Southwest Texas Methodist Hospital: 9/7/06-Pre operative DX: Intussusception Postoperative DX and DC DX/: Ileo ileocolic intussusception. Procedure: open reduction of intussusception. Incidental appendectomy. Preoperative Note: admitted to hospital with bilious emesis approximately 36 hours ago. Upper GI normal, US failed to disclose a suspected intussusception. Underwent trial of feeds which were unsuccessful. Follow up CT scan disclosed intussusception in right lower quadrant which was masked by overlying small bowel. Open reduction recommended due to failure of hydrostatic reduction in radiology. HX of Present Illness: admitted 9/5/06 with emesis which progressed to bilious and fussiness and dry heaves. Seen in office after 2 hours of emesis and a normal BM. No diarrhea and no fever.  PMH: Bronchitis. PE: Temp 99.5, HR 131, resp rate 32. Slightly lethargic, dry lips and mucous membranes. Mild tachycardia. Lungs clear. ABD: very supple without guarding, soft, nontender and nondistended. Normal bowel sounds.   2 trials of feeds failed with bilious emesis and started to have mucosy bloody stools.  Attempted hydrostatic reduction was unsuccessful.  Surgery 9/7/06 open reduction and intussusception and internal appendectomy. He did not require a bowel resection. Uncomplicated postoperative course with gradual resumption of p.o. feeds. Post op day #3 tolerating goal calorie and fluid diet. Afebrile, vital signs stable.  DC to home follow up in 3-4 weeks.
Age: 0.41
Sex: M
Vaccine: DTAP, HEP, HIBV, IPV, PNC, RV5, RV5, DTAP, HEP, HIBV, IPV, PNC, RV5
Symptoms: Vomiting
Clinical narrative: Rotateq given 5/23/06 and 8/4/06 developed intussusception Sept 5th requiring surgical reduction. 99/19/06-received office note for DOS 8/1-9/5/06- note for 9/5/06-vomiting/possible dehydration. vomiting times 2 days, constipated 2 days ago, blood in diaper today, small amount of stool. PE: awake alert responsive, unsmiling. Abdomen soft non-tender, transfer to hospital. Operative Report received from Southwest Texas Methodist Hospital: 9/7/06-Pre operative DX: Intussusception Postoperative DX and DC DX/: Ileo ileocolic intussusception. Procedure: open reduction of intussusception. Incidental appendectomy. Preoperative Note: admitted to hospital with bilious emesis approximately 36 hours ago. Upper GI normal, US failed to disclose a suspected intussusception. Underwent trial of feeds which were unsuccessful. Follow up CT scan disclosed intussusception in right lower quadrant which was masked by overlying small bowel. Open reduction recommended due to failure of hydrostatic reduction in radiology. HX of Present Illness: admitted 9/5/06 with emesis which progressed to bilious and fussiness and dry heaves. Seen in office after 2 hours of emesis and a normal BM. No diarrhea and no fever.  PMH: Bronchitis. PE: Temp 99.5, HR 131, resp rate 32. Slightly lethargic, dry lips and mucous membranes. Mild tachycardia. Lungs clear. ABD: very supple without guarding, soft, nontender and nondistended. Normal bowel sounds.   2 trials of feeds failed with bilious emesis and started to have mucosy bloody stools.  Attempted hydrostatic reduction was unsuccessful.  Surgery 9/7/06 open reduction and intussusception and internal appendectomy. He did not require a bowel resection. Uncomplicated postoperative course with gradual resumption of p.o. feeds. Post op day #3 tolerating goal calorie and fluid diet. Afebrile, vital signs stable.  DC to home follow up in 3-4 weeks.
Age: 0.41
Sex: M
Vaccine: DTAP, HEP, HIBV, IPV, PNC, RV5, RV5, DTAP, HEP, HIBV, IPV, PNC, RV5
Symptoms: Bronchiolitis, Intussusception, Vomiting
Clinical narrative: Rotateq given 5/23/06 and 8/4/06 developed intussusception Sept 5th requiring surgical reduction. 99/19/06-received office note for DOS 8/1-9/5/06- note for 9/5/06-vomiting/possible dehydration. vomiting times 2 days, constipated 2 days ago, blood in diaper today, small amount of stool. PE: awake alert responsive, unsmiling. Abdomen soft non-tender, transfer to hospital. Operative Report received from Southwest Texas Methodist Hospital: 9/7/06-Pre operative DX: Intussusception Postoperative DX and DC DX/: Ileo ileocolic intussusception. Procedure: open reduction of intussusception. Incidental appendectomy. Preoperative Note: admitted to hospital with bilious emesis approximately 36 hours ago. Upper GI normal, US failed to disclose a suspected intussusception. Underwent trial of feeds which were unsuccessful. Follow up CT scan disclosed intussusception in right lower quadrant which was masked by overlying small bowel. Open reduction recommended due to failure of hydrostatic reduction in radiology. HX of Present Illness: admitted 9/5/06 with emesis which progressed to bilious and fussiness and dry heaves. Seen in office after 2 hours of emesis and a normal BM. No diarrhea and no fever.  PMH: Bronchitis. PE: Temp 99.5, HR 131, resp rate 32. Slightly lethargic, dry lips and mucous membranes. Mild tachycardia. Lungs clear. ABD: very supple without guarding, soft, nontender and nondistended. Normal bowel sounds.   2 trials of feeds failed with bilious emesis and started to have mucosy bloody stools.  Attempted hydrostatic reduction was unsuccessful.  Surgery 9/7/06 open reduction and intussusception and internal appendectomy. He did not require a bowel resection. Uncomplicated postoperative course with gradual resumption of p.o. feeds. Post op day #3 tolerating goal calorie and fluid diet. Afebrile, vital signs stable.  DC to home follow up in 3-4 weeks.
Age: 0.41
Sex: M
Vaccine: DTAP, HEP, HIBV, IPV, PNC, RV5, RV5, DTAP, HEP, HIBV, IPV, PNC, RV5
Symptoms: Intussusception, Vomiting
Clinical narrative: Rotateq given 5/23/06 and 8/4/06 developed intussusception Sept 5th requiring surgical reduction. 99/19/06-received office note for DOS 8/1-9/5/06- note for 9/5/06-vomiting/possible dehydration. vomiting times 2 days, constipated 2 days ago, blood in diaper today, small amount of stool. PE: awake alert responsive, unsmiling. Abdomen soft non-tender, transfer to hospital. Operative Report received from Southwest Texas Methodist Hospital: 9/7/06-Pre operative DX: Intussusception Postoperative DX and DC DX/: Ileo ileocolic intussusception. Procedure: open reduction of intussusception. Incidental appendectomy. Preoperative Note: admitted to hospital with bilious emesis approximately 36 hours ago. Upper GI normal, US failed to disclose a suspected intussusception. Underwent trial of feeds which were unsuccessful. Follow up CT scan disclosed intussusception in right lower quadrant which was masked by overlying small bowel. Open reduction recommended due to failure of hydrostatic reduction in radiology. HX of Present Illness: admitted 9/5/06 with emesis which progressed to bilious and fussiness and dry heaves. Seen in office after 2 hours of emesis and a normal BM. No diarrhea and no fever.  PMH: Bronchitis. PE: Temp 99.5, HR 131, resp rate 32. Slightly lethargic, dry lips and mucous membranes. Mild tachycardia. Lungs clear. ABD: very supple without guarding, soft, nontender and nondistended. Normal bowel sounds.   2 trials of feeds failed with bilious emesis and started to have mucosy bloody stools.  Attempted hydrostatic reduction was unsuccessful.  Surgery 9/7/06 open reduction and intussusception and internal appendectomy. He did not require a bowel resection. Uncomplicated postoperative course with gradual resumption of p.o. feeds. Post op day #3 tolerating goal calorie and fluid diet. Afebrile, vital signs stable.  DC to home follow up in 3-4 weeks.
Age: 10.0
Sex: M
Vaccine: MNQ
Symptoms: Erythema, Pain, Swelling
Clinical narrative: Patient attended clinic for PPD reading.  Alerted staff to his right deltoid area which was red and slightly swollen.  Per patient area slightly painful.  Seen by provider, diagnose with mild inflammatory reaction to vaccine.
Age: 20.0
Sex: M
Vaccine: ANTH, HEPA, SMALL
Symptoms: Pain, Rash, Rash pruritic, Tenderness
Clinical narrative: 20 y/o male SM with c/o painful rash developing on his left ribcage and back about two weeks after primary SPV, anthrax, and Hep A vaccines. Symptoms rash, diffuse start 8/28/06 rash started on the left ribcage and extended posteriorly with rash at the left mid back area. Rash pruritic start 8/28/05 same rash at left ribcage and back has been pruritic. Tenderness start 8/28/06 the skin rash has been painful at times off and on.
Age: 11.0
Sex: F
Vaccine: MNQ
Symptoms: Dizziness, Fatigue
Clinical narrative: Several minutes after Menactra was given pt felt dizzy and Tired. Pt was monitored for 1 hour and had juice.
Age: 10.0
Sex: M
Vaccine: MMR, TDAP
Symptoms: Dizziness, Pruritus, Rash, Rash maculo-papular
Clinical narrative: Within several hours of receiving vaccine patient fell "sleepy, dizzy, like I wanted to throw up", denies fever.  Three days later developed fluid filled itchy rash on right arm.( Public health department noted on 9/5-scaly area on right arm) on 9/4 rash spread to chest. Public health department noted few maculopapular areas on right arm-antecubital area and on upper right side of chest.  Public health department advised to see medical doctor for rash.
Age: 42.0
Sex: M
Vaccine: ANTH
Symptoms: Unevaluable event
Clinical narrative: NONE
Age: 1.01
Sex: F
Vaccine: HBHEPB
Symptoms: Blister, Pyrexia, Rash, Viral infection
Clinical narrative: Blister like bumps with low grade fever Dx by MD as chickenpox.
Age: 31.0
Sex: F
Vaccine: MMR
Symptoms: Eye disorder, Facial palsy, Headache, Hypoaesthesia, Tongue oedema
Clinical narrative: MMR vaccine given 8/29/06 about 1400, that evening noted numbness of right mouth and tongue swollen, 8/30 am, right eye unable to close and less movement. Right side of face, also headache back of head, blurred vision, 8/31 ER 1400 CT scan, lab tests, RX prednisone and referred to PCP and neurologist with diagnosis of Bells palsy.
Age: 31.0
Sex: F
Vaccine: MMR
Symptoms: Vision blurred
Clinical narrative: MMR vaccine given 8/29/06 about 1400, that evening noted numbness of right mouth and tongue swollen, 8/30 am, right eye unable to close and less movement. Right side of face, also headache back of head, blurred vision, 8/31 ER 1400 CT scan, lab tests, RX prednisone and referred to PCP and neurologist with diagnosis of Bells palsy.
Age: 6.0
Sex: F
Vaccine: DTAP, IPV, MMR
Symptoms: Injection site erythema, Pyrexia
Clinical narrative: Severe redness around injection site, fever.
Age: 5.0
Sex: F
Vaccine: DTAP, IPV, MMR
Symptoms: Injection site erythema, Pyrexia
Clinical narrative: Severe Redness around injection site, fever.
Age: 4.0
Sex: M
Vaccine: DTAP, IPV, MMR
Symptoms: Injection site oedema, Injection site warmth
Clinical narrative: Mother described left arm as being hot and swollen on 9/6/06. Ice applied and Tylenol given per conversation with mom.
Age: 13.0
Sex: F
Vaccine: VARCEL
Symptoms: Blister, Headache, Rash, Rash pruritic, Skin ulcer
Clinical narrative: Received Varivax 8/22/06 developed severe headache 9/7 and 9/8 followed by blister rash 9/9 15 days after vaccine. Mom stated rash was generalized with possibly up to 55 lesions. Still new crops. Extremely itchy saw PCP who confirmed rash as chickenpox. Question vaccine induced, possibly incubating disease when immunized or adverse event. Discussed with supervisor, chief of 10 9 state. Enter into NEPPS as chickenpox. re immunize.
Age: 13.0
Sex: F
Vaccine: VARCEL
Symptoms: Viral infection
Clinical narrative: Received Varivax 8/22/06 developed severe headache 9/7 and 9/8 followed by blister rash 9/9 15 days after vaccine. Mom stated rash was generalized with possibly up to 55 lesions. Still new crops. Extremely itchy saw PCP who confirmed rash as chickenpox. Question vaccine induced, possibly incubating disease when immunized or adverse event. Discussed with supervisor, chief of 10 9 state. Enter into NEPPS as chickenpox. re immunize.
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMRV
Symptoms: Discomfort, Injection site erythema, Injection site induration, Injection site oedema
Clinical narrative: LA red, swollen, non tender, mildly indurated almost entire upper arm 10x12cm warm compresses to area Tylenol for discomfort.
Age: 12.0
Sex: M
Vaccine: UNK
Symptoms: Blister, Injection site erythema, Injection site vesicles, Viral infection
Clinical narrative: 1-2 days after vaccination pt c/o vesicle on back and 3 vesicles with redness and around injection site.
Age: 0.2
Sex: F
Vaccine: DTPIHI
Symptoms: Agitation, Diarrhoea, Dyspnoea, Erythema, High-pitched crying
Clinical narrative: She was vaccinated, that I recall, twice after being born. The first was at the Health Dept. and the second was at the doctor's office.   She had a reaction to the first set given at the Health Dept. of vomiting and diarrhea, fever and inconsolable crying. So the doctor suggested we have the second set done in the office.   The evening of the second set she started running a high fever, her body was covered in a red rash and she was screaming a high pitched scream and had projectile vomiting and she would not nurse.  As the evening progressed she became very lethargic. She laid in my lap very limp and in like a daze and seemed to have labored breathing.  We had no insurance or money at that time and I kept calling the ER for direction through the night. I was waiting for the doctor when the office opened the next morning and he took her immediately in and said that she had experienced an allergic reaction to the vaccination. We monitored her and she recovered.   She has not had any other vaccinations to this day  and will not have any!   Not sure of the date and time but it was around the end of '95. She was born in October so however long after it would have been for a second series of shots. She was between 8-10 weeks old I would say.  And not sure of exactly what they gave back then. It was a series for newborns whatever that would have entailed. I had to enter something on line 13  but not sure of what all was given. Sorry.   I just heard about this website and felt I needed to convey this information even at this late date because it was a very scary incident with extreme adverse affects. It has affected my child in not being able to have any updated vaccinations and causes problems for school records, etc.
Age: 0.2
Sex: F
Vaccine: DTPIHI
Symptoms: Hypersensitivity, Hypotonia, Lethargy, Pyrexia, Rash
Clinical narrative: She was vaccinated, that I recall, twice after being born. The first was at the Health Dept. and the second was at the doctor's office.   She had a reaction to the first set given at the Health Dept. of vomiting and diarrhea, fever and inconsolable crying. So the doctor suggested we have the second set done in the office.   The evening of the second set she started running a high fever, her body was covered in a red rash and she was screaming a high pitched scream and had projectile vomiting and she would not nurse.  As the evening progressed she became very lethargic. She laid in my lap very limp and in like a daze and seemed to have labored breathing.  We had no insurance or money at that time and I kept calling the ER for direction through the night. I was waiting for the doctor when the office opened the next morning and he took her immediately in and said that she had experienced an allergic reaction to the vaccination. We monitored her and she recovered.   She has not had any other vaccinations to this day  and will not have any!   Not sure of the date and time but it was around the end of '95. She was born in October so however long after it would have been for a second series of shots. She was between 8-10 weeks old I would say.  And not sure of exactly what they gave back then. It was a series for newborns whatever that would have entailed. I had to enter something on line 13  but not sure of what all was given. Sorry.   I just heard about this website and felt I needed to convey this information even at this late date because it was a very scary incident with extreme adverse affects. It has affected my child in not being able to have any updated vaccinations and causes problems for school records, etc.
Age: 0.2
Sex: F
Vaccine: DTPIHI
Symptoms: Somnolence, Vomiting, Vomiting projectile
Clinical narrative: She was vaccinated, that I recall, twice after being born. The first was at the Health Dept. and the second was at the doctor's office.   She had a reaction to the first set given at the Health Dept. of vomiting and diarrhea, fever and inconsolable crying. So the doctor suggested we have the second set done in the office.   The evening of the second set she started running a high fever, her body was covered in a red rash and she was screaming a high pitched scream and had projectile vomiting and she would not nurse.  As the evening progressed she became very lethargic. She laid in my lap very limp and in like a daze and seemed to have labored breathing.  We had no insurance or money at that time and I kept calling the ER for direction through the night. I was waiting for the doctor when the office opened the next morning and he took her immediately in and said that she had experienced an allergic reaction to the vaccination. We monitored her and she recovered.   She has not had any other vaccinations to this day  and will not have any!   Not sure of the date and time but it was around the end of '95. She was born in October so however long after it would have been for a second series of shots. She was between 8-10 weeks old I would say.  And not sure of exactly what they gave back then. It was a series for newborns whatever that would have entailed. I had to enter something on line 13  but not sure of what all was given. Sorry.   I just heard about this website and felt I needed to convey this information even at this late date because it was a very scary incident with extreme adverse affects. It has affected my child in not being able to have any updated vaccinations and causes problems for school records, etc.
Age: 54.0
Sex: M
Vaccine: TD
Symptoms: Diarrhoea, Nausea, Vomiting
Clinical narrative: Patient report nausea, vomiting and diarrhea that started approx 5 hours after immunization administered.
Age: 42.0
Sex: F
Vaccine: TDAP
Symptoms: Headache, Injection site erythema, Injection site pain, Injection site swelling, Malaise
Clinical narrative: Swelling, redness and pain on arm about 2 days after injection. Also experienced malaise and headache. Still has some swelling and redness along with mailaise 7 days after injection, but better. Treated with NSAID's.
Age: 0.18
Sex: M
Vaccine: DTAPHEPBIP, HIBV, PNC, RV5
Symptoms: Contusion, Injection site erythema, Injection site pain, Injection site swelling
Clinical narrative: Redness, swelling, pain and bruising at the right thigh injection site x3-4days (per parents' report)
Age: 71.0
Sex: M
Vaccine: TD
Symptoms: Balance disorder, Muscle spasms, Muscular weakness, Pain in jaw
Clinical narrative: Two - three hours after receiving Td injection, noted muscle weakness in both arms and legs and left jaw pain (right at mandibular joint) and an increased loss of balance that have persisted for 48 + hours.  This weakness has decreased his ability to do his physical therapy exercises at the medical center by at least 50%.  No soreness at injection site noted.  Also reports large increase in number of muscle cramps in back, arms and legs.
Age: 47.0
Sex: M
Vaccine: HEP, HEPA
Symptoms: Abdominal pain, Diarrhoea, Fatigue
Clinical narrative: Pt. complained of abdominal cramps, diarrhea, tiredness x 2 days.
Age: 19.0
Sex: F
Vaccine: RUB
Symptoms: Blood glucose decreased, Convulsion
Clinical narrative: Patient received vaccine at 12:15 pm on 9/13/06 at 13:05 patient found on floor having a seizure. Post-partum patient - delivered on 09/11/06 1929. History and Physical Report, Neuro Consultation and MRI of brain received. Two day post partum, generalized seizure. Scheduled for DC and 35-40 minutes prior to DC received Rubella vaccination. Found on the floor having a generalized seizure. She had dropped the baby but the baby is fine. Seizure lasted a couple of minutes and patient was confused for 20 minutes or so thereafter. That evening during consultation she felt fine but also tired, does not remember packing up her belongings and the next thing she remembers is waking up in her bed. No HX of seizures or syncope. No warning to this episode. Mother has epilepsy but seizures related to head injury in MVA. Neuro exam WNL. Lab results WNL, however, MRI of brain normal. EEG report pending. Impression: isolated generalized seizure. Circumstances suggest it might have been related to Rubella vaccination 35-40 minutes earlier. Doubt related to epidural anesthetic 2 days earlier since she had no sequelae from procedure. -DC Summary received: DC DX Term Pregnancy-Delivered.
Age: 13.0
Sex: F
Vaccine: TDAP, VARCEL
Symptoms: Acute abdomen, Gastrointestinal disorder, Laboratory test abnormal, Lymphadenopathy, Ovarian cyst
Clinical narrative: Child developed signs and symptoms of acute appendicitis on the day after the vaccinations. She underwent an appendectomy. DC DX for DOS 08/23-8/24/06:acute appendicitis without rupture and Ovarian cyst. Procedure performed:Laparoscopic appendectomy, aspiration of left ovarian cyst.
Age: 9.0
Sex: M
Vaccine: DT, PNC
Symptoms: Face oedema, Headache, Nausea, Pyrexia, Urticaria
Clinical narrative: Received vaccines 9/12/06, experienced hives, headache and nausea this AM associated with Tmax 101.5F. Facial swelling with no face hives, hives on arms and legs. No Shortness of breath, wheeze or diarrhea.
Age: 5.0
Sex: M
Vaccine: DTAP, IPV, MMRV
Symptoms: Hypoxia, Syncope
Clinical narrative: Syncopal episode immediately after immunizations.  Recovered over period of 30 minutes.  Oxygen saturations normal.
Age: 37.0
Sex: F
Vaccine: TDAP
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth
Clinical narrative: SHOT SITE 50MMX60MM SWOLLEN AREA AND REDDENED. SITE WARM TO TOUCH. DR. OBSERVED REACTION AND RECOMMENDED ORAL BENADRYL AND ICE TO SITE. PT INSTRUCTED TO FOLLOW UP IF ANY CHANGES.
Age: 16.0
Sex: F
Vaccine: MNQ
Symptoms: Headache, Migraine, Sinusitis
Clinical narrative: Severe headache onset 5/12/2006 pm.  Patient treated for presumed sinusitis based on clinical symptoms with no improvement in 72hrs.  Migraine suspected and confirmed by neurologist 5/18/2006.  Positive family history of migraines, but no prior migraine in this patient.
Age: 6.0
Sex: F
Vaccine: DTAP
Symptoms: Injection site reaction, Injection site warmth, Pain, Tenderness
Clinical narrative: Large local reaction measuring 20 cm in length, arm circumferance 34.5; other arm circumference 29.5. arm warm, tender to touch and painful at rest.
Age: 11.0
Sex: F
Vaccine: MNQ
Symptoms: Headache, Vision blurred
Clinical narrative: "Blurry" vision at left lateral visual field brief and onset of headache in school 9/13/2006 am.  Visual changes resolved spontaneously, but headache intensified.  Headache resolved after treatment with ibuprofen.  Positive family history of migraines but no prior headache history in this patient.
Age: 35.0
Sex: M
Vaccine: MMR
Symptoms: Injection site erythema, Injection site swelling, Pain
Clinical narrative: Patient was administered MMR vaccine subdermally instead of subcutaneously and suffered  immediate swelling, redness, mild pain.  All symptoms were gone by the next morning and have not recurred.
Age: 5.0
Sex: F
Vaccine: DTAP, HEPA, IPV, MMRV
Symptoms: Unevaluable event
Clinical narrative: 25.4mm x 13.5mm, oral steroids Benadryl PO Keflex.
Age: 1.51
Sex: M
Vaccine: DTAP, HPV4, PNC
Clinical narrative: Wrong vaccine was given Gardasil was given instead of Hep A by mistake.
Age: 28.0
Sex: F
Vaccine: TD
Symptoms: Lymphadenopathy, Pain, Pyrexia
Clinical narrative: Enlarged node, generalized achiness, fever, relief after aspirin, pain not worsening.
Age: 0.17
Sex: F
Vaccine: DTAP, HIBV, IPV, MMRV
Symptoms: Medication error
Clinical narrative: At 2 month visit pt was given ProQuad instead of Prevnar. Discovered at 4 month visit. No known side effect yet no fever, rash, irritability with immunizations.
Age: 13.0
Sex: M
Vaccine: TDAP
Symptoms: Injection site oedema, Pharyngolaryngeal pain, Pyrexia, Rash maculo-papular
Clinical narrative: Fever, sore throat, swelling at injection site, diffuse maculo papular rash.
Age: 0.15
Sex: F
Vaccine: DTAP, HBHEPB, IPV, PNC
Symptoms: Crying, Rash, Screaming, Tremor
Clinical narrative: After administration of DTaP 1, IVP 1, Prevnar 1, Comvax ! on 6/28/06 at 2 months the child developed uncontrollable shaking of whole body about 1 min, rash lower extremities lasted 2 days, no fever, uncontrollable crying for about 5 hours.
Age: 47.0
Sex: M
Vaccine: ANTH, ANTH
Symptoms: Arthralgia, Asthenia, Fatigue, Hypoaesthesia, Sexual dysfunction
Clinical narrative: Pain in hips and knees within 10 hours of receiving fifth anthrax vaccine. Within 1 week of vaccine receipt, onset of paresthesias in hands and feet.
Age: 47.0
Sex: M
Vaccine: ANTH, ANTH
Symptoms: Arthralgia, Laboratory test abnormal, Paraesthesia
Clinical narrative: Pain in hips and knees within 10 hours of receiving fifth anthrax vaccine. Within 1 week of vaccine receipt, onset of paresthesias in hands and feet.
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMR
Symptoms: Erythema multiforme
Clinical narrative: 1 week after vaccination, developed erythema multiforme.
Age: 3.0
Sex: M
Vaccine: VARCEL, VARCEL
Symptoms: Bacterial infection, Cellulitis, Dermatitis bullous
Clinical narrative: 5 chicken pox sores on torso 6 days after injection.  Told was normal by doctor office over the phone and could last 7-10 days.  I started noticing all minor cuts, scrapes ,wounds etc and pox not healing as normal.  Still never a fever.  9/6 diagnosed with cellulitis and impetigo.  Started on KEFLEX, BACTRIM, Bactroban cream and bleach baths.
Age: 3.0
Sex: M
Vaccine: VARCEL, VARCEL
Symptoms: Bacterial infection, Cellulitis, Dermatitis bullous, Rash, Skin disorder
Clinical narrative: 5 chicken pox sores on torso 6 days after injection.  Told was normal by doctor office over the phone and could last 7-10 days.  I started noticing all minor cuts, scrapes ,wounds etc and pox not healing as normal.  Still never a fever.  9/6 diagnosed with cellulitis and impetigo.  Started on KEFLEX, BACTRIM, Bactroban cream and bleach baths.
Age: 3.0
Sex: M
Vaccine: VARCEL, VARCEL
Symptoms: Skin ulcer, Viral infection
Clinical narrative: 5 chicken pox sores on torso 6 days after injection.  Told was normal by doctor office over the phone and could last 7-10 days.  I started noticing all minor cuts, scrapes ,wounds etc and pox not healing as normal.  Still never a fever.  9/6 diagnosed with cellulitis and impetigo.  Started on KEFLEX, BACTRIM, Bactroban cream and bleach baths.
Age: 11.0
Sex: M
Vaccine: TDAP, VARCEL
Symptoms: Pyrexia
Clinical narrative: Patient temperature rose to 103.5 approximately midnight as reported by mother.  Per mother patient temperature dropped to 99 later the same day.  No time given when temperature dropped.
Age: 15.0
Sex: F
Vaccine: HPV4, MNQ, HPV4, MNQ
Symptoms: Asthenia, Dehydration, Difficulty in walking, Gait disturbance, Guillain-Barre syndrome
Clinical narrative: Guillain Barre. She was well on day of immunization but later said she was weak and several months this was not objectively noticed then, but shortly after the vaccine. 9/28/06 Received medical records from neurologists which reveal patient seen by PCP 7/31/06 with complaint of loss of strength over past 3 mos.  Labs were done by PCP & showed mild dehydration & elevated neutrophils, eos were absent.  Patient referred to neuro & initial eval on 8/3 reveals patient noted weakness beginning in June which had progressively worsened.  Symptoms included tingling sensation at tip of fingers & significant weakness to the point she could not do her own hair.  Birth history was WNL & only PMH is of ADD & has been on Adderall for about 1 year as well as BCP.  Exam showed definite weakness of all extremities, esp upper extremities, & neck.  Reflexes were absent in legs.  Gait was normal but had difficulty taking steps w/o support & could not rise from sitting w/o help.  Normal CPK made dx difficult & EMG/NCS was done on 8/4 which was strongly positive for GBS & copy of test included with records.  Treated with IVIG x 2 days & placed in rehab facility on 8/5/06 for eval & therapy then received home PT.  Seen by neuro next on 8/24 which showed improvement but still with weakness especially in the hands.  Now able to rise from sitting on floor w/o support.  Still no reflexes in legs.  Complete but slow recovery was expected at that time/ss 9/28/06 Received medical records from hospital which reveal patient admitted 8/4/-8/6/06 for IVIG & PT./ss
Age: 15.0
Sex: F
Vaccine: HPV4, MNQ, HPV4, MNQ
Symptoms: Laboratory test abnormal, Paraesthesia, Psychomotor hyperactivity
Clinical narrative: Guillain Barre. She was well on day of immunization but later said she was weak and several months this was not objectively noticed then, but shortly after the vaccine. 9/28/06 Received medical records from neurologists which reveal patient seen by PCP 7/31/06 with complaint of loss of strength over past 3 mos.  Labs were done by PCP & showed mild dehydration & elevated neutrophils, eos were absent.  Patient referred to neuro & initial eval on 8/3 reveals patient noted weakness beginning in June which had progressively worsened.  Symptoms included tingling sensation at tip of fingers & significant weakness to the point she could not do her own hair.  Birth history was WNL & only PMH is of ADD & has been on Adderall for about 1 year as well as BCP.  Exam showed definite weakness of all extremities, esp upper extremities, & neck.  Reflexes were absent in legs.  Gait was normal but had difficulty taking steps w/o support & could not rise from sitting w/o help.  Normal CPK made dx difficult & EMG/NCS was done on 8/4 which was strongly positive for GBS & copy of test included with records.  Treated with IVIG x 2 days & placed in rehab facility on 8/5/06 for eval & therapy then received home PT.  Seen by neuro next on 8/24 which showed improvement but still with weakness especially in the hands.  Now able to rise from sitting on floor w/o support.  Still no reflexes in legs.  Complete but slow recovery was expected at that time/ss 9/28/06 Received medical records from hospital which reveal patient admitted 8/4/-8/6/06 for IVIG & PT./ss
Age: 15.0
Sex: F
Vaccine: HPV4, MNQ, HPV4, MNQ
Symptoms: Asthenia, Guillain-Barre syndrome
Clinical narrative: Guillain Barre. She was well on day of immunization but later said she was weak and several months this was not objectively noticed then, but shortly after the vaccine. 9/28/06 Received medical records from neurologists which reveal patient seen by PCP 7/31/06 with complaint of loss of strength over past 3 mos.  Labs were done by PCP & showed mild dehydration & elevated neutrophils, eos were absent.  Patient referred to neuro & initial eval on 8/3 reveals patient noted weakness beginning in June which had progressively worsened.  Symptoms included tingling sensation at tip of fingers & significant weakness to the point she could not do her own hair.  Birth history was WNL & only PMH is of ADD & has been on Adderall for about 1 year as well as BCP.  Exam showed definite weakness of all extremities, esp upper extremities, & neck.  Reflexes were absent in legs.  Gait was normal but had difficulty taking steps w/o support & could not rise from sitting w/o help.  Normal CPK made dx difficult & EMG/NCS was done on 8/4 which was strongly positive for GBS & copy of test included with records.  Treated with IVIG x 2 days & placed in rehab facility on 8/5/06 for eval & therapy then received home PT.  Seen by neuro next on 8/24 which showed improvement but still with weakness especially in the hands.  Now able to rise from sitting on floor w/o support.  Still no reflexes in legs.  Complete but slow recovery was expected at that time/ss 9/28/06 Received medical records from hospital which reveal patient admitted 8/4/-8/6/06 for IVIG & PT./ss
Age: 13.0
Sex: F
Vaccine: HEPA, MNQ
Symptoms: Injection site erythema, Injection site oedema, Pruritus, Tenderness
Clinical narrative: Right deltoid 3 inch redness, tenderness, swelling itching at injection site, warm compress Claritin 10 mg daily Recheck 9/15/06.
Age: 28.0
Sex: F
Vaccine: TYP
Symptoms: Erythema, Headache, Myalgia, Pyrexia, Rash
Clinical narrative: Subjective fever for 12 hours, erythematous rash anterior neck, myalgias, bilat retro orbital HA with gradual onset, Treated with Midrin and Motrin.
Age: 0.42
Sex: M
Vaccine: DTAP, HIBV, IPV, PNC
Symptoms: Hyperaemia, Injection site erythema, Injection site oedema, Tenderness
Clinical narrative: Redness, hyperemic, swollen, tenderness area of admin right thigh.
Age: 1.03
Sex: M
Vaccine: MMR, VARCEL
Symptoms: Blister, Erythema, Rash, Skin ulcer, Upper respiratory tract infection
Clinical narrative: Rash x 2 days, non itchy skin with vesicle upper forehead and red base 2 lesions, on each part; 2 lesions on trunk and left hand - URI.
Age: 28.0
Sex: F
Vaccine: TD
Symptoms: Chest pain, Chills, Dyspnoea, Headache, Influenza like illness
Clinical narrative: 8/16/06 about 11:00 TD given. That evening began with chills and very sore deltoid. While working 11-7 sore neck, increasing chills, headache, 8/17 at 0500 felt like I had flu, like I was hit by a truck. Chest began to get sore hurt to breath. 1100 muscle cramps in legs. Fever 101.3F headache worse, blurred vision. Consulted family doctor. Went to ER. CXR, Labs, EKG WNL.
Age: 28.0
Sex: F
Vaccine: TD
Symptoms: Injection site pain, Malaise, Muscle spasms, Neck pain, Pyrexia
Clinical narrative: 8/16/06 about 11:00 TD given. That evening began with chills and very sore deltoid. While working 11-7 sore neck, increasing chills, headache, 8/17 at 0500 felt like I had flu, like I was hit by a truck. Chest began to get sore hurt to breath. 1100 muscle cramps in legs. Fever 101.3F headache worse, blurred vision. Consulted family doctor. Went to ER. CXR, Labs, EKG WNL.
Age: 28.0
Sex: F
Vaccine: TD
Symptoms: Vision blurred
Clinical narrative: 8/16/06 about 11:00 TD given. That evening began with chills and very sore deltoid. While working 11-7 sore neck, increasing chills, headache, 8/17 at 0500 felt like I had flu, like I was hit by a truck. Chest began to get sore hurt to breath. 1100 muscle cramps in legs. Fever 101.3F headache worse, blurred vision. Consulted family doctor. Went to ER. CXR, Labs, EKG WNL.
Age: 30.0
Sex: F
Vaccine: HEP
Symptoms: Rash, Urticaria
Clinical narrative: Was given shot at approximately 2p on mon.9/11/2006. Rash hives 20min after shot adminstered. Called emergency on call dr, that night and was told to come in only if started to effect airway. Called the following day tues. and was told the same thing. Continued to progress went to ER on wed. 2 days later and was given claritin 10mg and Prednisone 20mg as treatment.
Age: 0.0
Sex: F
Vaccine: TD
Symptoms: Erythema, Injection site induration, Injection site warmth, Malaise, Pyrexia
Clinical narrative: Patient reported 6/21/06 developing fever of 101F orally, malaise and redness on left arm distal from injection site with hardness and feeling hot. treatment included warm compress, tylenol or aspirin and follow-up the following day to assess.
Age: 25.0
Sex: F
Vaccine: TD
Symptoms: Injection site erythema, Injection site pain, Injection site warmth
Clinical narrative: Sore hot reddened area at injection site of Td booster.
Age: 0.0
Sex: F
Vaccine: TD
Symptoms: Erythema, Pain
Clinical narrative: LOCAL REDNESS AND SORENESS.
Age: 0.0
Sex: F
Vaccine: TD
Symptoms: Injection site erythema, Injection site induration
Clinical narrative: HARD RED AREA 24 HRS AFTER VACCINATION MEASURED 70MM LATERALLY. TREATMENT WARM COMPRESS AND TYLENOL.
Age: 0.0
Sex: M
Vaccine: TD
Symptoms: Neuritis
Clinical narrative: Right brachial neuritis beginning 24 hours after a tetanus immunization.
Age: 1.02
Sex: M
Vaccine: HBHEPB, HEPA, PNC
Symptoms: Urticaria
Clinical narrative: Mom came back after vaccination of Comvax, Prevnar and Hepatitis A were given.  Child had hives on face and legs.  No respiratory distress noted.  Child evaluated by doctor. No signs of anaphylaxis noted. Child found to be well.  Hives diminished after 5 minutes.  Mom informed to stay for 20 more minutes.  Mandatory # 2 Hepatitis A will not be given due to reaction.
Age: 1.03
Sex: F
Vaccine: HEPA, MMRV, PNC
Symptoms: Blister, Rash papular
Clinical narrative: 3 pink papules and 1 vesicle on skin.
Age: 32.0
Sex: M
Vaccine: ANTH
Symptoms: Diarrhoea, Gastrointestinal disorder, Insomnia, Paraesthesia, Rash
Clinical narrative: Feburary 2006 Gastrointestinal, diarrhea/loose stool treatment in June Dicyclomine 20mg 3x a day. March 2006 Rash on top of both hands, treatment steroid cream. 14 May 2006 Insomnia, treatment June 2006 Ambien 10mg. May 2006 Tingling in hands and feet. May-July 2006 20lb weight loss/Acute adjustment disorder.
Age: 32.0
Sex: M
Vaccine: ANTH
Symptoms: Weight decreased
Clinical narrative: Feburary 2006 Gastrointestinal, diarrhea/loose stool treatment in June Dicyclomine 20mg 3x a day. March 2006 Rash on top of both hands, treatment steroid cream. 14 May 2006 Insomnia, treatment June 2006 Ambien 10mg. May 2006 Tingling in hands and feet. May-July 2006 20lb weight loss/Acute adjustment disorder.
Age: 65.0
Sex: F
Vaccine: PPV
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
Clinical narrative: pt received pneumovax 0.5cc IM in the R deltoid muscle on 09/13/2006. The patient states that in the evening she noticed redness, swelling, heat, and pain in the right upper arm. She has been applying cold packs to this area.
Age: 0.18
Sex: M
Vaccine: DTAPHEPBIP, HIBV, MNQ, PNC
Symptoms: Medication error
Clinical narrative: 1100- Menactra 0.5cc given in error. Immunization Program contacted; discussion ensued regarding the fact that expected reactions would be the same as those noted with other inactivated vaccines; Discussed this with parents; VIS given. Advised to call if any further questions or concerns.
Age: 1.33
Sex: F
Vaccine: DTAP, MMRV
Symptoms: Pyrexia, Urticaria
Clinical narrative: Fever followed by Urticaria.
Age: 1.3
Sex: F
Vaccine: DTAP, IPV, MMR
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth, Tenderness
Clinical narrative: Warm, tender, swelling, and erythematous left arm.
Age: 32.0
Sex: F
Vaccine: TD
Symptoms: Injection site erythema, Injection site pain, Injection site swelling
Clinical narrative: Employee C/O red, swollen, and pain right arm 9/14/2006.
Age: 13.0
Sex: F
Vaccine: TDAP
Symptoms: Injection site erythema, Injection site pain, Injection site warmth
Clinical narrative: 50 cent piece size red, hot it hurts to touch. Motrin as directed and warm pack to injection site.
Age: 1.13
Sex: M
Vaccine: VARCEL
Symptoms: Rash, Viral infection
Clinical narrative: Varicella (Mild) rash (<50 lesions) without fever or complications.
Age: 65.0
Sex: F
Vaccine: TD
Symptoms: Asthenia, Myalgia, Pain
Clinical narrative: Myalgias, proximal LE weakness and pain. Onset 5-6 hours after injection. TX Medrol DP 24 mg Taper to 0 over 7day.
Age: 1.91
Sex: F
Vaccine: DTAP
Symptoms: Injection site erythema, Injection site pain, Injection site warmth, Urticaria
Clinical narrative: 50 cent piece size welts, redness, hot and hurts to touch. Motrin as directed and warm pack to site injection.
Age: 0.41
Sex: F
Vaccine: DTAP, HIBV, IPV, PNC
Symptoms: Flushing, Pyrexia
Clinical narrative: Parent c/o high fever of 102.2, flushed face.
Age: 4.0
Sex: F
Vaccine: DTAP
Symptoms: Injection site erythema, Tenderness, Urticaria
Clinical narrative: 50 cent piece size welp, redness tender to touch. Motrin as directed and warm pack to injection site.
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMR
Symptoms: Injection site erythema, Injection site induration
Clinical narrative: Area of induration and Erythema in left thigh at site of injection. Area is 3x5 inches approx. Non tender to palpation, Gave Atarax syrup 1/2 tsp TIO and Prelone syrup.
Age: 47.0
Sex: M
Vaccine: HEPA, HEPA
Symptoms: Rash
Clinical narrative: Patient describes breaking out in hives five (5) days following HAVRIX injection.  Treated by primary provider with BENADYRL and steroids orally.  Advised by primary care provider no further hepatitis A vaccine.
Age: 47.0
Sex: M
Vaccine: HEPA, HEPA
Symptoms: Urticaria
Clinical narrative: Patient describes breaking out in hives five (5) days following HAVRIX injection.  Treated by primary provider with BENADYRL and steroids orally.  Advised by primary care provider no further hepatitis A vaccine.
Age: 1.25
Sex: M
Vaccine: HBHEPB, MMRV
Symptoms: Febrile convulsion, Pneumonia, Viral infection, White blood cell count decreased
Clinical narrative: Pt had MMR II/Varicella, Hib-Hep B on 8/15/06. Had febrile seizure on 9/2/06 with viral pneumonia. Hosp 9/2/06-9/4/06 with rapid improvement, RX'd with Rocephin (have on Amox). Normal exam on 9/8/06. 10/20/06 Received medical records from hospital which reveal patient admitted with fever & seizure activity lasting approx 5 min.  Patient was nonresponsive & while in ER had lateral gaze of right eye.  Temp 101.4 in ER.  Received Pb & Tylenol & symptoms resolved.  Admitted for further eval & observation from 9/2-9/4/-6.  Received IV antibiotics.  No further seizure activity noted & remained afebrile.  Dx: viral pneumonia & prolonged seizure.  D/C home on oral antibiotics./ss
Age: 23.0
Sex: M
Vaccine: SMALL
Symptoms: Acne, Hypersensitivity, Infection, Rash, Vaccination complication
Clinical narrative: 10 days after shot pimples like bumps came up all over chest, stomach, arms, and few on thighs area. Went to ER due to possible infection of vaccine. 10/2/06 Received medical records from patient for hospitalization 8/12-8/13/06 with final Dx: reaction to small pox vaccine (pustular nonviral pustulosis vs eczema vaccinatum vs disseminated cowpox).  ID & DOD were consulted.  Photos were taken & mailed to DOD for diagnosis.  Patient was initially placed in strict isolation while hospitalized but DOD recommended not needed & patient was d/c home to be followed at AFB next day.
Age: 55.0
Sex: F
Vaccine: PPV, TD
Symptoms: Cellulitis, Chills, Injection site rash, Pyrexia, White blood cell count increased
Clinical narrative: Pt presented to ER complaining of rash in her left deltoid after receiving a diphtheria and Pneumovax vaccination shot. 5 days prior, she developed a fever and worsening of rash. She had also been taking some anti cancer medication since Jan 05 for her breast cancer (unclear as to what it was). Because she has SX consistent with an infection (fever, increase WBC, chills), she was DX with cellulitis. She was treated with ABX and her symptoms resolved. 11/7/06 Received medical records from VAMC which reveal patient admitted 4/12-4/16/06 for rash on right shoulder w/fever & chills x 2 days.  Received tet tox vax 4/8 for finger cut in kitchen accident.  Then received pneumo vax in same region on 4/10.  After 1 day developed rash, pain & fever to 101.   Final DX: cellulitis right arm, hypotension, bipolar affective disorder, breast cancer & anemia. D/C to home on oral antibiotics w/rash almost resolved & pain & fever gone.
Age: 61.0
Sex: F
Vaccine: VARZOS
Symptoms: Headache, Injection site erythema, Injection site induration, Injection site oedema, Pyrexia
Clinical narrative: Left arm at injection site erythema, swelling same hardness. Client states reaction started 9/12/06. She also states HA and temperature.
Age: 5.0
Sex: F
Vaccine: MMRV
Symptoms: Gait disturbance, Injection site erythema, Injection site warmth, Skin discolouration, Skin ulcer
Clinical narrative: Had ProQuad on 9/12, within 24 hrs developed redness at the site. 9/14/06 developed limp 4 1/2 by 4 inch area of pinkness, warm to touch with central area, 1 x 1 1/2 inch marked redness and warmth, mild to moderate tenderness over interior aspect of lesion, no Fluctuance.
Age: 5.0
Sex: F
Vaccine: MMRV
Symptoms: Tenderness
Clinical narrative: Had ProQuad on 9/12, within 24 hrs developed redness at the site. 9/14/06 developed limp 4 1/2 by 4 inch area of pinkness, warm to touch with central area, 1 x 1 1/2 inch marked redness and warmth, mild to moderate tenderness over interior aspect of lesion, no Fluctuance.
Age: 7.0
Sex: F
Vaccine: FLUN3
Symptoms: Eye pain, Headache, Lethargy, Nasal congestion, Pyrexia
Clinical narrative: Developed fever 104.7 about 24 hours after FluMist vaccine. Also c/o lethargy and congestion, headache, and eye hurting. Seen in office 9/8/06 T 98.1. Symptoms resolved 24 hours later.
Age: 15.0
Sex: F
Vaccine: TDAP
Symptoms: Pyrexia
Clinical narrative: Began on 9/10/06 with temp of 99.0. Tylenol given temp at 0630 103.4. Temp at 0800 102.5.
Age: 61.0
Sex: F
Vaccine: TDAP
Symptoms: Injection site erythema, Injection site warmth
Clinical narrative: Redness and warmness, redness 16cm x 17cm up and down arm and around arm.