chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 1.1
Sex: F
Vaccine: PNC
Symptoms: Pyrexia, Sepsis, Tachypnoea
Clinical narrative: Information regarding PREVNAR was received from a pediatrician regarding a 16-month-old female patient who experienced Invasive Pneumococcal Disease - drug ineffective, pneumococcal bacteremia and sepsis. The patient died. The patient received the fourth dose on 16-Apr-2008.  No significant medical history. Concomitant medications were not reported. The patient was seen at the doctor's office on 17-Aug-2008. She was fussy and clingy and had a temperature. The child returned to the office on 19-Aug-2008, at which time, she was afebrile and tachypnic. The physician sent her to the ER for diagnostic tests (see test results) and treatment. The child died in the ER. It was determined that the patient experienced Invasive Pneumococcal Disease - drug ineffective on 17-Aug-2008, pneumococcal bacteremia, and sepsis on 19-Aug-2008. The physician stated that IPD was due to serotype 33F, which was not covered by PREVNAR. An autopsy was performed, however results were not available. No additional information was available at the time of this report. The cause of death was reported as sepsis and pneumococcal infection and the autopsy cause of death was not reported. Body temperature (results: fever) was done on 17-Aug-2008. On 19-Aug-2008 test results were: body temperature (results: afebrile); chest x-ray (results: revealed pneumonia); and blood culture (results: revealed S. pneumoniae; Serotype 33F).  10/17/08 Autopsy report states COD as acute lobar pneumonia complicating CHF following viral myocarditis.  10/17/08 Reviewed autopsy report, death certificate & extensive hospital & PCP medical records received for coroner.  Records reveal patient experienced fever & difficulty breathing x 2 days.  Seen by PCP & sent for admission.  Tx w/IV antibiotics.  Became tachypneic, tachycardic & intubated for impending respiratory failure.  Developed bradycardia.  CPR & transcutaneous pacing initiated.  Transported to higher level of care for PICU.  Upon arrival, had blood in ETT & was acidotic & despite continued resuscitative efforts expired. FINDINGS at Autopsy: severe viral myocarditis w/marked patchy myofibrillar nectosis; chronic lymphocytic bronchitis; acute bilateral pan-lobar pneumonia; acute passive visceral congestion; pleural & pericardial effusions; ascites; mild focal lymphocytic meningeal infiltrates; early neuronal anoxic changes; acute splenitis.
Age: 25.0
Sex: F
Vaccine: ANTH, TBE
Symptoms: Blood creatine phosphokinase normal, Blood magnesium normal, Blood phosphorus increased, Blood thyroid stimulating hormone normal, Bundle branch block left
Clinical narrative: SM referred to Healthcare Center by her Cardiologist. She reports while swimming she noted "heart flipping, pounding and skipping beats". She immediately got out of the pool and noted "some dizziness". She reports the dizziness improved with rest, but the palpitations lasted for "several days". On 21 Sep (11 days later) the palpitations became stronger and she began experiencing sharp, anterior chest pains (7/10). She was seen at medical center and admitted for observation.  12/11/08 Reviewed medical records of cardio & neuro consults. FINAL DX: syncope, palpitations, frequent PVCs Records reveal patient experienced heart racing, SOB & pre-syncope while swimming 9/08.  Palpitations persisted.  Later episode of chest pain & SOB resulted in hospitalization.  Tx w/meds.  Continued w/presyncope episodes that included lightheadedness, vision darkening, weak legs w/unsteady gait
Age: 25.0
Sex: F
Vaccine: ANTH, TBE
Symptoms: Cardiac flutter, Chest X-ray normal, Chest pain, Computerised tomogram normal, Dizziness
Clinical narrative: SM referred to Healthcare Center by her Cardiologist. She reports while swimming she noted "heart flipping, pounding and skipping beats". She immediately got out of the pool and noted "some dizziness". She reports the dizziness improved with rest, but the palpitations lasted for "several days". On 21 Sep (11 days later) the palpitations became stronger and she began experiencing sharp, anterior chest pains (7/10). She was seen at medical center and admitted for observation.  12/11/08 Reviewed medical records of cardio & neuro consults. FINAL DX: syncope, palpitations, frequent PVCs Records reveal patient experienced heart racing, SOB & pre-syncope while swimming 9/08.  Palpitations persisted.  Later episode of chest pain & SOB resulted in hospitalization.  Tx w/meds.  Continued w/presyncope episodes that included lightheadedness, vision darkening, weak legs w/unsteady gait
Age: 25.0
Sex: F
Vaccine: ANTH, TBE
Symptoms: Echocardiogram normal, Electrocardiogram abnormal, Electrocardiogram ambulatory abnormal, Extrasystoles, Full blood count normal
Clinical narrative: SM referred to Healthcare Center by her Cardiologist. She reports while swimming she noted "heart flipping, pounding and skipping beats". She immediately got out of the pool and noted "some dizziness". She reports the dizziness improved with rest, but the palpitations lasted for "several days". On 21 Sep (11 days later) the palpitations became stronger and she began experiencing sharp, anterior chest pains (7/10). She was seen at medical center and admitted for observation.  12/11/08 Reviewed medical records of cardio & neuro consults. FINAL DX: syncope, palpitations, frequent PVCs Records reveal patient experienced heart racing, SOB & pre-syncope while swimming 9/08.  Palpitations persisted.  Later episode of chest pain & SOB resulted in hospitalization.  Tx w/meds.  Continued w/presyncope episodes that included lightheadedness, vision darkening, weak legs w/unsteady gait
Age: 25.0
Sex: F
Vaccine: ANTH, TBE
Symptoms: Palpitations, Troponin T, Urine analysis normal
Clinical narrative: SM referred to Healthcare Center by her Cardiologist. She reports while swimming she noted "heart flipping, pounding and skipping beats". She immediately got out of the pool and noted "some dizziness". She reports the dizziness improved with rest, but the palpitations lasted for "several days". On 21 Sep (11 days later) the palpitations became stronger and she began experiencing sharp, anterior chest pains (7/10). She was seen at medical center and admitted for observation.  12/11/08 Reviewed medical records of cardio & neuro consults. FINAL DX: syncope, palpitations, frequent PVCs Records reveal patient experienced heart racing, SOB & pre-syncope while swimming 9/08.  Palpitations persisted.  Later episode of chest pain & SOB resulted in hospitalization.  Tx w/meds.  Continued w/presyncope episodes that included lightheadedness, vision darkening, weak legs w/unsteady gait
Age: 48.0
Sex: F
Vaccine: TDAP
Symptoms: Erythema, Lymphadenopathy
Clinical narrative: 9/26/08 in AM, noticed swelling of lymph nodes under left axila.  This was same arm that  ADACEL was administrated. Pt states she commonly will have inflammated lymph nodes with systemic infections. Left axilla also slightly reddened
Age: 60.0
Sex: F
Vaccine: TDAP
Symptoms: Chills, Erythema, Musculoskeletal pain, Pain in extremity, Pyrexia
Clinical narrative: Erythema, pain extending from shoulder past elbow, shoulder pain, fevers, chills. Rx AUGMENTIN/ADVIL
Age: 0.2
Sex: F
Vaccine: DTAPHEPBIP, HIBV, PPV, RV5
Symptoms: Breath holding, Foaming at mouth, Opisthotonus, Staring
Clinical narrative: Mom states that approximately 48 hours after immunization the child had a blank stare, arched her back, held her breath, and had a "frothy' saliva from mouth. This lasted just a few seconds.
Age: 58.0
Sex: F
Vaccine: FLU3
Symptoms: Erythema, Pain in extremity
Clinical narrative: Sore arm - redness
Age: 73.0
Sex: F
Vaccine: VARZOS
Symptoms: Rash, Urticaria
Clinical narrative: Per home conversation, developed "Welts on both arms and rash in the area between her knees and ankles on both legs. She saw a dermatologist on 9/18/08 and he prescribed some medication, she doesn't know the name. Rash is getting better.
Age: 46.0
Sex: M
Vaccine: YF
Symptoms: Rash erythematous
Clinical narrative: Red rash on arms and legs - no fever
Age: 58.0
Sex: F
Vaccine: FLU3
Symptoms: Injection site swelling, Injection site warmth
Clinical narrative: Pt had a 2 inch swelled are at injection site. Area warm to touch. Ice applied and area getting better.
Age: 15.0
Sex: F
Vaccine: HPV4
Symptoms: Syncope
Clinical narrative: Pt reported having syncope episode 3 days after receiving vaccine
Age: 14.0
Sex: M
Vaccine: HEPA, MNQ, VARCEL
Symptoms: Body temperature increased, Rash, Rash erythematous
Clinical narrative: Temp 101 degrees and broke out with a rash on his back and chest - little pinkish red spots as if he were bitten by bugs.
Age: 41.0
Sex: F
Vaccine: FLUX
Symptoms: Erythema, Skin warm, Swelling
Clinical narrative: Red hot swollen lump
Age: 49.0
Sex: F
Vaccine: FLU3
Symptoms: Asthenia, Chills, Cough, Dizziness, Headache
Clinical narrative: Within 4 hours experienced dizziness, nausea, weakness, headache, fever and chills, coughing. Symptoms lasted for approx. 16 hours.
Age: 49.0
Sex: F
Vaccine: FLU3
Symptoms: Nausea, Pyrexia
Clinical narrative: Within 4 hours experienced dizziness, nausea, weakness, headache, fever and chills, coughing. Symptoms lasted for approx. 16 hours.
Age: 19.0
Sex: F
Vaccine: TDAP
Symptoms: Balance disorder, Dizziness, Feeling abnormal, Vision blurred
Clinical narrative: Sense of unbalance, light headedness, dizziness -brain feels like its being jostled in head, can't focus
Age: 38.0
Sex: F
Vaccine: RAB
Symptoms: Abdominal pain upper, Nausea, Pyrexia
Clinical narrative: Client reported experience nausea, severe stomach cramps and fever that occurred approx 4 hours after administration of previous RABIES vaccination. Highest temp of 103 degrees F was reported by client after dose #2 on 9-19-08. Client stated stomach cramps lasted approx 2 days then resolved. Recommended client consult with medical provider Re: stomach cramps and to prophylactically self treat with ibuprofen 24-48 hrs after additional RABIES vaccinations to minimize fever side effect.
Age: 84.0
Sex: M
Vaccine: TD
Symptoms: Chills, Injection site erythema, Injection site induration, Injection site pain, Injection site swelling
Clinical narrative: Approximately 26 hours after injection pt experienced chills and fever of 101.5, painful swelling at site with 13 x 20 cm induration and 10 x 15 cm erythema. Tx with ice. Rechecked by MD several times. Complete resolution.
Age: 84.0
Sex: M
Vaccine: TD
Symptoms: Pyrexia
Clinical narrative: Approximately 26 hours after injection pt experienced chills and fever of 101.5, painful swelling at site with 13 x 20 cm induration and 10 x 15 cm erythema. Tx with ice. Rechecked by MD several times. Complete resolution.
Age: 4.0
Sex: F
Vaccine: DTAP, IPV
Symptoms: Injection site erythema, Injection site swelling
Clinical narrative: One day after vaccine administration redness and swelling around injection site
Age: 0.3
Sex: M
Vaccine: DTAP, IPV, PNC, RV5
Symptoms: Diarrhoea, Vomiting
Clinical narrative: Loose stools started 24 hrs after vaccines. Vomited for 1 day - started 24 hrs. No fever.
Age: 18.0
Sex: F
Vaccine: HPV4
Symptoms: Dizziness, Nausea, Palpitations, Tachycardia, Vaccine positive rechallenge
Clinical narrative: dizziness/palpatations/nausea x 48 hours. Tachycardia - pt had symptoms after 1st injection but did not report until same thing after 2nd injection.
Age: 32.0
Sex: F
Vaccine: FLU3
Symptoms: Chest discomfort, Chills, Crying, Injection site pain, Muscle spasms
Clinical narrative: Received FLUZONE 0.5 ml dose L deltoid at 2:30 pm on 10/1/08. Began to experience severe body aches with muscle spasms of trunk and back 5 hours post injection. Discomfort was so severe it caused pt to cry. Positive chills, no temperature, positive chest tightness. L deltoid site had positive soreness, no swelling, no redness. Advil - tablet 9 pm. Feeling better in am. Symptoms improved. Advised to notify PCP of event.
Age: 32.0
Sex: F
Vaccine: FLU3
Symptoms: Pain
Clinical narrative: Received FLUZONE 0.5 ml dose L deltoid at 2:30 pm on 10/1/08. Began to experience severe body aches with muscle spasms of trunk and back 5 hours post injection. Discomfort was so severe it caused pt to cry. Positive chills, no temperature, positive chest tightness. L deltoid site had positive soreness, no swelling, no redness. Advil - tablet 9 pm. Feeling better in am. Symptoms improved. Advised to notify PCP of event.
Age: 42.0
Sex: M
Vaccine: PPV
Symptoms: Chills, Induration, Pyrexia
Clinical narrative: Induration 4 1/4 x 3 1/2 with fever 99 to 103 degrees and chills.
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMR, VARCEL
Symptoms: Inappropriate schedule of drug administration
Clinical narrative: None stated
Age: 1.0
Sex: F
Vaccine: HEPA, MMR, VARCEL
Symptoms: Injection site erythema, Injection site mass, Injection site urticaria
Clinical narrative: 20 mm / 20 mm - red knot at varicella inj point. (Hive) Treatment: no Rx, cool compress.
Age: 46.0
Sex: F
Vaccine: PPV
Symptoms: Erythema, Induration, Oedema peripheral
Clinical narrative: 1 1/2 x 3 1/2 induration, 4 x 3 cm redness. 2 red streaks toward axillia. 10 cm and 4 cm. Gen'l swelling upper arm. Benadryl, ice to area
Age: 21.0
Sex: M
Vaccine: ANTH, TYP
Symptoms: Immediate post-injection reaction, Loss of consciousness
Clinical narrative: Patient passed out briefly after receiving Typhoid and "Anthrax vaccinations.  Transported via wheelchair to Acute Care for evaluation and treatment.
Age: 54.0
Sex: F
Vaccine: IPV, TYP
Symptoms: Pruritus, Rash
Clinical narrative: Pt states rash and itching to lower extremeties 1 day after vaccination.  Continued to have symptoms for 2 weeks up until she used hydrocortisone cream 2 days ago which gave relief.
Age: 26.0
Sex: F
Vaccine: FLU3
Symptoms: Pyrexia, Rash, Urticaria
Clinical narrative: THE PATIENT BROKE OUT IN HIVES.
Age: 7.0
Sex: F
Vaccine: FLUN3
Symptoms: Herpes zoster
Clinical narrative: Patient received the intranasal flu vaccine on 25Sep08. On the same day, her Brother received both the FluMist and a Varicella vaccine. 2 days later, patient developed shingles.
Age: 27.0
Sex: F
Vaccine: FLUX
Symptoms: Bowel movement irregularity, Dysstasia, Pain, Urinary retention
Clinical narrative: Patient initially presented with generalized body aches and was admitted by medicine service.  She had paresthesias and numbness from the wrist down.  she also had problems with urinary retention, bowel movements and difficulty standing.  she was worked up by neurology and thought to have some sort of Guillian-Barre Syndrome related to receiving a Flu Vaccine.  10/24/08 Reviewed hospita medical records of 11/28-12/06/2007. FINAL DX: transverse myelitis& urinary retention secondary to flu vacccine Records reveal patient experienced generalized body aching esp from lower torso up to mid back, chills, urinary retention, difficulty standing, abnormal gait, constipation, worsening numbness & tingling from waist down. Neuro & uro consults done.  Tx w/IV steroids & I/O caths.
Age: 18.0
Sex: F
Vaccine: MNQ, TDAP
Symptoms: Immediate post-injection reaction, Syncope
Clinical narrative: Administered Menactra and TDAP to Left Deltoid, after TDAP inj. Student had syncopal episode for approx. 5-10 seconds. Student came to, states was feeling a bit dazed. Assisted to infirmary to lie down and to monitor. Monitored for 1 hour, had no other signs of syncope, VSS.
Age: 1.83
Sex: M
Vaccine: DTAP, IPV
Symptoms: Injection site erythema, Injection site swelling
Clinical narrative: Redness and swelling of injection site.
Age: 7.0
Sex: M
Vaccine: VARCEL
Symptoms: Varicella
Clinical narrative: Pt with chiken pox after two dose of vaccine received 11/3/2000 and 6/22/07
Age: 4.0
Sex: F
Vaccine: DTAP, IPV
Symptoms: Injection site erythema, Injection site swelling
Clinical narrative: Redness and swelling of injection site.
Age: 14.0
Sex: M
Vaccine: HEPA, MNQ, TDAP
Symptoms: Dizziness, Nausea, Pyrexia, Vomiting
Clinical narrative: Mother called Hlth. Dept. this AM (10-2-08) stating her son experienced fever of 102, Nausea, Vomiting, & Dizziness beginning evening of 10-1-08 post vaccine administration and was still experiencing N,V,& Dizziness with fever reduced as a result of Tylenol admnistration. Advised mother if child was still experiencing same problems he should see a physician to determine if symptoms were resultant of vaccine or another cause. Requested mother to advise me of the outcome.
Age: 1.75
Sex: F
Vaccine: DTAP, PNC
Symptoms: Inappropriate schedule of drug administration, No adverse event
Clinical narrative: misadministration.  no adverse reaction. after administering Dtap #4 and Prevnar #4 on 9-30-08. Found out client already recieved Dtap #4 and Prevnar #4 in May 2008. Client recieved extra
Age: 1.42
Sex: F
Vaccine: HEPA, MMR, PNC, VARCEL
Symptoms: Injection site erythema
Clinical narrative: Red area right anterior thigh at site of prevnar.
Age: 0.15
Sex: M
Vaccine: DPP, HEP, PNC, RV5
Symptoms: Inappropriate schedule of drug administration
Clinical narrative: Our Electronic Record system was down on 9/26/08.  Dr. ordered 2 month vaccines for this 2 month old that morning.  I administered them.  Later when the electronic system came back up, I noticed that the patient received the same vaccines on September 12, 2008 at around 6 weeks old by another nurse.            The provider had not written a note in the record for that day 9/12/08.   The patient was scheduled for that day and per mother was here on 9/12/08 and was vaccinated.  I asked our operations manager to pull the encounter form, which she did.  The encounter form was filled out by Dr. with orders for pentacel, hep b, hib and rototeg.       Called the mother again on 10/1/08 to see how the baby was doing.  The mother said the baby was fine.
Sex: M
Vaccine: FLU3
Symptoms: Chills, Cold sweat, Feeling cold, Pruritus generalised, Tachycardia
Clinical narrative: Tachycardia, cold, clamy, generalized itching, chattering of teeth 2.5 hours after administering Fluarix.
Age: 24.0
Sex: M
Vaccine: FLU3
Symptoms: Chest discomfort, Flushing, Nausea, Paraesthesia, Vomiting
Clinical narrative: Nausea, vomitting, chest tightness, tingling hands, flushed 15 minutes after receiving Fluarix.  Treated with IV fluids, epinephrine, benadryl, zofran, albuterol neb, benadryl in the ED, then admitted into hospital. 10/31/08 Reviewed ER medical records of 10/02/2008. FINAL DX: no d/c summary available.  H&P states: anaphylactic reaction to flu shot Records reveal patient experienced chest tightness, nausea, emesis, flushed, heart rate increased, redness, skin warmth, itching, blood pressure elevated.  1st time flu shot.  Tx w/epi, nebs, benadryl & steroids.  Had recurrence of symptoms.  Admitted for overnight observation.  Developed HA next day & seen in ER again, tx w/pain meds & steroids.
Age: 1.42
Sex: M
Vaccine: DTAP, MMR, PNC, VARCEL
Symptoms: Inappropriate schedule of drug administration, No adverse event
Clinical narrative: No adverse event was reported.  Vaccines were administered ahead of recommended schedule.
Age: 87.0
Sex: F
Vaccine: FLU3
Symptoms: Dyskinesia, Mouth injury
Clinical narrative: Resident received flu vaccination at 1:30 pm on September 30,2008. The morning of October 2,2008,6:00 am, resident had seizure like activity lasting 10 seconds. She had jerky movement of upper and lower extremity and had small bite mark on her lower lip.
Age: 63.0
Sex: F
Vaccine: FLU3
Symptoms: Heart rate increased, Hyperventilation
Clinical narrative: bp 187/88, HR 100+ ~30 MIN AFTER VACINE.        6-7 HOURS LATER, BP 176/88 TO 182/87, HR 97 TO 88OXYGEN SATS 98.  PATIENT WAS RANDOMLY TAKING VERY LARGE BREATHS.  NO SITE REDNESS AND SWELLING
Age: 25.0
Sex: M
Vaccine: FLUN3
Symptoms: Bronchospasm, Chest pain, Dehydration, Dyspnoea
Clinical narrative: Patient reported to and was treated at local ER. Pt complained of shortness of breath and chest pain following Flumist administration. Symptoms started shortly after inhalation of Flumist and continued to progress. Local ER evaluated as dehydration and brochospasm secondary to Flumist. Treated with nebulizers and steroids and released.
Age: 29.0
Sex: M
Vaccine: ANTH
Symptoms: Aggression, Cerebral haemorrhage, Disorientation, Dizziness
Clinical narrative: Donor received an anthrax vaccine after plasma donation.  While waiting to be released, he started to feel light-headed.  He was escorted to an exam table to lie down.  While on the exam bed, he became disoriented and combative.  He never fell or struck his head.  His vitals were as follows:  BP- 90/68, pulse- 74bpm.  Dr. was notified and he recommended calling 911. Donor was released to ambulance service at 10:45am en route to hospital.  From there he was transferred to another hospital for evaluation.  He was discharged 10-1-08.  Staff was notified on 10-2-08 that he was being airlifted to another hospital because of a brain hemorrhage.  11/7/08 Reviewed hospital medical records of 10/2-10/3/2008. FINAL DX: bilateral frontal hemorrhagic contusion; bronchitis; tobacco abuse. Records reveal patient experienced confusion, hallucination, HA, dizziness x 4 days.  Had been transferred from outlying hospital.  Neuro & ID consults done.  11/4/08 Reviewed hospital medical records of 9/29-10/1/2008. FINAL DX: psychosis & depression Records reveal patient experienced psychosis, disorientation, confusion, delerium, HA after plasma donation followed by vaccine.  In ER was uncooperative, babbling, bizarre affect, responding inappropriately to questions.
Sex: F
Vaccine: FLU3
Symptoms: Cold sweat, Cough, Pruritus
Clinical narrative: Experienced coughing, clammy, itching.  Treated with IV fluids, claritin.  Patient went back to work in the hospital and was fine in the AM of 10/2/08.
Sex: M
Vaccine: FLU3
Symptoms: Flushing, Headache, Rash
Clinical narrative: Experienced rash, bumps, flushing, headache.  Symptoms started one hour after vaccination.  Treatment included benadryl IV, solumedrol IV.  Left work to go home after being seen in the ED.
Age: 25.0
Sex: F
Vaccine: FLU3
Symptoms: Blood test normal, Dyspnoea, Electrocardiogram normal, Flushing, Palpitations
Clinical narrative: Paresthesia to L side of face, L arm, and L leg.  Led to flushing, palpitations and dyspnea.
Age: 25.0
Sex: F
Vaccine: FLU3
Symptoms: Paraesthesia
Clinical narrative: Paresthesia to L side of face, L arm, and L leg.  Led to flushing, palpitations and dyspnea.
Age: 12.0
Sex: M
Vaccine: TDAP
Symptoms: Oedema peripheral
Clinical narrative: L arm red, swollen 1/2 inch x 2 inches
Age: 10.0
Sex: M
Vaccine: VARCEL
Symptoms: Facial palsy, Nuclear magnetic resonance imaging normal
Clinical narrative: two weeks after the vaccine my son developed bells paulsy, i was told it came from a form of herpes which is the chicken pox vacine. My ten year old child has no feeling or ability to move the left side of his face.  10/17/08 Reviewed PCP office records of 8/13-10/2/2008. FINAL DX: left side Bell's palsy Records reveal patient experienced usual state of health on 8/13/08.  RTC 9/29 s/p ER visit where dx w/Bell's palsy, left side.  RTC 10/2 w/nosebleeds, HA & congestion x 3 days, dx w/allergic rhinitis & given flu shot.
Sex: M
Vaccine: FLU3
Symptoms: Chills, Cold sweat, Pruritus, Rash
Clinical narrative: Experienced claminess, itching, teeth/jaw shaking.  Symptom onset approximately 3.5 hrs after vaccination.  Rash developed at 0115 on 10/2/08 and employee went to ED.  Treatment included saline, benadryl, solumedrol, tagmet.  Employee sent home after ED visit.
Sex: F
Vaccine: FLUX
Symptoms: Back pain, Chest discomfort, Dyspnoea, Fibrin D dimer increased, Hyperventilation
Clinical narrative: 9am vaccine for influenza and received depo-provera injection. 2 hours later got pleurisy pain in right chest and back with short of breath. no itching or hives but felt throat and chest tightness. VS were ok except hyperventilation. treated with benadryl,solumedrol ativan and nubain. stable in er for over 2 hours so released, thorasic back pain only.
Sex: F
Vaccine: FLUX
Symptoms: Neutrophil count, Pleuritic pain, Throat tightness, White blood cell count increased
Clinical narrative: 9am vaccine for influenza and received depo-provera injection. 2 hours later got pleurisy pain in right chest and back with short of breath. no itching or hives but felt throat and chest tightness. VS were ok except hyperventilation. treated with benadryl,solumedrol ativan and nubain. stable in er for over 2 hours so released, thorasic back pain only.
Sex: F
Vaccine: FLU3
Symptoms: Chest pain, Nausea
Clinical narrative: Inpatient administered vaccine at 1700, developed nausea and chest pain at 2300.  Patient given zofran and tylenol - symptoms abated.  Patient with afib, copd, DM, HTN, CRF, UTI.  Beta-blocker stopped on 9/30/08.
Age: 40.0
Sex: F
Vaccine: FLU3
Symptoms: Erythema, Eye swelling
Clinical narrative: Aprrox 90 min after Flu shot pt called in stating she was red in face arms and chest. No SOB but eyes slightly swollen. She drove herself to the ER locally.
Age: 28.0
Sex: F
Vaccine: FLUX
Symptoms: Chills, Fatigue, Hyperhidrosis, Hypersomnia, Limb discomfort
Clinical narrative: I received the vaccination at work, from health care providers where administering the shot there. The shot was given to me in my left arm at about 8:40 a.m. on Oct. 1, 2008. Immediately after receiving the shot, my arm was sore. As the day went on, I began to feel aches in my back and legs. These aches intensified throughout the night, and were accompanied by fever, sweats and chills. The worst of my symptoms seem to have abated by about 8 a.m. on Oct. 2, 2008. I did not go into work, however, as I have been exceptionally tired all day. I have slept most of the day, and only my upper back remains a little stiff. I took NyQuil and Ibuprofen to help reduce the fever and aches. I did not see a doctor, as I read on the CDC Web site that my symptoms sometimes do occur after getting a flu shot. I also have felt gradually better throughout the day. If I had not improved, I would have seen a physician.
Age: 28.0
Sex: F
Vaccine: FLUX
Symptoms: Musculoskeletal stiffness, Pain, Pyrexia
Clinical narrative: I received the vaccination at work, from health care providers where administering the shot there. The shot was given to me in my left arm at about 8:40 a.m. on Oct. 1, 2008. Immediately after receiving the shot, my arm was sore. As the day went on, I began to feel aches in my back and legs. These aches intensified throughout the night, and were accompanied by fever, sweats and chills. The worst of my symptoms seem to have abated by about 8 a.m. on Oct. 2, 2008. I did not go into work, however, as I have been exceptionally tired all day. I have slept most of the day, and only my upper back remains a little stiff. I took NyQuil and Ibuprofen to help reduce the fever and aches. I did not see a doctor, as I read on the CDC Web site that my symptoms sometimes do occur after getting a flu shot. I also have felt gradually better throughout the day. If I had not improved, I would have seen a physician.
Age: 16.0
Sex: F
Vaccine: MNQ
Symptoms: Dizziness, Induration, Malaise, Pain, Pruritus
Clinical narrative: Swelling, induration, pain and itching LDT  Induration approximately 10cm by 10cm  Swelling and pain started approximately 2 hours after administation of the vaccine.  Patient also felt dizzy last night and feeling general malaise today.  Afebrile Tried Naproxen for pain with minimal results. Tried Benadryl for itch-helped for approximately 2 hours.  Has also tried ice.
Age: 16.0
Sex: F
Vaccine: MNQ
Symptoms: Swelling
Clinical narrative: Swelling, induration, pain and itching LDT  Induration approximately 10cm by 10cm  Swelling and pain started approximately 2 hours after administation of the vaccine.  Patient also felt dizzy last night and feeling general malaise today.  Afebrile Tried Naproxen for pain with minimal results. Tried Benadryl for itch-helped for approximately 2 hours.  Has also tried ice.
Age: 0.3
Sex: M
Vaccine: DTAP, HIBV, IPV, PNC, RV5
Symptoms: Autopsy, Electroencephalogram abnormal, Epilepsy, Nuclear magnetic resonance imaging brain normal
Clinical narrative: Patient had likely seizure 8 days after 2 month imms that included DTaP, Hep B, PCV, Hib & rotavirus vaccines (on 6/20/08).  Death possibly secondary to seizure, autopsy in progress.  11/07/08 Autopsy report states COD as sudden death & manner of death as undetermined.  Report also states patient was in crib in supine position w/vomitus stains around head but no aspiration on autopsy.   10/21/08 Reviewed PCP medical records of 5/1-7/21/2008 including birth records & vaccination records. FINAL DX:  Records reveal patient experienced seizure activity x 1 on 6/28/08 during sleep when stiffened & shook arms/legs, unresponsive w/eyes open & deviated.  Episode lasted approx 1 min, then pt cried out, had bowel movement & went to sleep  Tx w/diastat but not routine antiseizure meds unless had 2nd seizure. .
Age: 19.0
Sex: M
Vaccine: MNQ, MNQ
Symptoms: CSF test abnormal, Headache, Leukoencephalomyelitis, Pyrexia
Clinical narrative: Acute onset of fever, headache 3 wks post vaccination- Hospitalized 9.8.08. Rx with IV antibiotics. antivirals + IV steroids. Diagnosis- acute disseminated encephalomyelitis.   11/21/08 Reviewed hospital medical records of 9/11-9/18/2008. FINAL DX:acute disseminated encephalomyelitis; right side hemiparesis; elevated blood sugars secondary to steroids. Records reveal patient experienced fever, chills, HA, blurred vision & altered sensorium starting 9/7/08.  Seen in ER where LP revealed abnormal CSF & CT/MRI scan of brain abnormal.  Tx w/IV antibiotics/antivirals & steroids.  Admitted 9/7/08 to ICU but continued to worsen, developed right side weakness & was transferred to higher level of care on 9/11/08.  Repeat LP & MRI abnormal.  D/C antibiotics/antivirals & changed steroids.  ID & rehab consults done.  Patient improved significantly but had right sided weakness, dysmetria, double vision resolved, blood sugars elevated due to steroids.  Transferred to inpatient rehab.  Seen in clinic 11/13/2008 where complete recovery noted & recommended not to receive flu shot.  12/12/2008 Reviewed hospital recorces of 9/8-9/11/2008. FINAL DX: ADEM Records reveal patient experienced severe HA, chills, sweats, fever x 1 day.  Seen in PCP office & sent to ER.  Became unresponsive & transferred to ICU.  Tx w/antivirals, antibiotics, steroids.  Consults done by ID, Neuro & Cardiology.  Improved w/steroids & transferred to higher level of care.
Age: 19.0
Sex: M
Vaccine: MNQ, MNQ
Symptoms: CSF test abnormal, Headache, Leukoencephalomyelitis, Nuclear magnetic resonance imaging abnormal, Pyrexia
Clinical narrative: Acute onset of fever, headache 3 wks post vaccination- Hospitalized 9.8.08. Rx with IV antibiotics. antivirals + IV steroids. Diagnosis- acute disseminated encephalomyelitis.   11/21/08 Reviewed hospital medical records of 9/11-9/18/2008. FINAL DX:acute disseminated encephalomyelitis; right side hemiparesis; elevated blood sugars secondary to steroids. Records reveal patient experienced fever, chills, HA, blurred vision & altered sensorium starting 9/7/08.  Seen in ER where LP revealed abnormal CSF & CT/MRI scan of brain abnormal.  Tx w/IV antibiotics/antivirals & steroids.  Admitted 9/7/08 to ICU but continued to worsen, developed right side weakness & was transferred to higher level of care on 9/11/08.  Repeat LP & MRI abnormal.  D/C antibiotics/antivirals & changed steroids.  ID & rehab consults done.  Patient improved significantly but had right sided weakness, dysmetria, double vision resolved, blood sugars elevated due to steroids.  Transferred to inpatient rehab.  Seen in clinic 11/13/2008 where complete recovery noted & recommended not to receive flu shot.  12/12/2008 Reviewed hospital recorces of 9/8-9/11/2008. FINAL DX: ADEM Records reveal patient experienced severe HA, chills, sweats, fever x 1 day.  Seen in PCP office & sent to ER.  Became unresponsive & transferred to ICU.  Tx w/antivirals, antibiotics, steroids.  Consults done by ID, Neuro & Cardiology.  Improved w/steroids & transferred to higher level of care.
Age: 0.2
Sex: M
Vaccine: DTAPIPVHIB, HEP, PNC, RV5
Symptoms: Gastrointestinal sounds abnormal, Irritability, Vomiting
Clinical narrative: Extreme fussiness with hyperactive bowel sounds: vomiting x 2.
Age: 0.5
Sex: M
Vaccine: DTAPIPVHIB, PNC
Symptoms: Hypersensitivity, Injection site erythema, Injection site induration, Injection site warmth
Clinical narrative: RTIM 1" x 1" Red knot, warm to touch, allergic reaction. Dx. Pt will call if redness spreads. Next time Prevnar is given, it will be given by itself.
Age: 12.0
Sex: F
Vaccine: HEPA, HPV4
Symptoms: Concussion, Differential white blood cell count, Dizziness, Echocardiogram, Electroencephalogram
Clinical narrative: 2/28/06 - Unconscious episode - Dx s/p concussion. 3/30/06 - Evaluated lightheadedness. 5/24/07 - Evaluated with syncope episode. 8/22/07, 10/22/07, 2/21/08 received GARDASIL. 8/22/07 - 2/21/08 received HEP A. 7/3/08 Evaluate syncope. 9/11/08 Mom states seizure disorder - requests form.  10/06/2008 PCP records received. Pt with several year hx of intermittant dizziness, lightheadedness, headaches and tunnel vision s/p concussion. W/u have been (-) thus far except iron deficiency anemia-treated. Most recent recorded incident 5/07 with low blood sugar. Seen 7/3/08 in F/U of ER visit for syncopal episode. Pt reported feeling weak prior to incident then pt's eyes rolled back and had jerking movements. Pt remained semi-conscious.  Likely dx: Vasovagal  Syncope. Referred for Echo and EEG.  1/16/2009 MR received for DOS 6/26/2008 with DX: Syncope. Pt presented after episode of dizziness and syncope with loss of consciousness while having an abrasion from a fall cleaned.  Pt has appeared pale x several days. PE WNL exept for superficial abrasions. Assessment:  Spell, 2' to vasovagal from pain.
Age: 12.0
Sex: F
Vaccine: HEPA, HPV4
Symptoms: Full blood count, Nuclear magnetic resonance imaging, Syncope
Clinical narrative: 2/28/06 - Unconscious episode - Dx s/p concussion. 3/30/06 - Evaluated lightheadedness. 5/24/07 - Evaluated with syncope episode. 8/22/07, 10/22/07, 2/21/08 received GARDASIL. 8/22/07 - 2/21/08 received HEP A. 7/3/08 Evaluate syncope. 9/11/08 Mom states seizure disorder - requests form.  10/06/2008 PCP records received. Pt with several year hx of intermittant dizziness, lightheadedness, headaches and tunnel vision s/p concussion. W/u have been (-) thus far except iron deficiency anemia-treated. Most recent recorded incident 5/07 with low blood sugar. Seen 7/3/08 in F/U of ER visit for syncopal episode. Pt reported feeling weak prior to incident then pt's eyes rolled back and had jerking movements. Pt remained semi-conscious.  Likely dx: Vasovagal  Syncope. Referred for Echo and EEG.  1/16/2009 MR received for DOS 6/26/2008 with DX: Syncope. Pt presented after episode of dizziness and syncope with loss of consciousness while having an abrasion from a fall cleaned.  Pt has appeared pale x several days. PE WNL exept for superficial abrasions. Assessment:  Spell, 2' to vasovagal from pain.
Age: 22.0
Sex: M
Vaccine: MNQ, TDAP
Symptoms: Headache, Pain, Pyrexia
Clinical narrative: Fever of 103 Tue and Wed 9/31-10/1/08, headache, body aches. Man requested symptoms be reported.
Age: 3.0
Sex: M
Vaccine: FLU3
Symptoms: Crying, Injection site pain, Injection site swelling
Clinical narrative: FLU vaccine given yesterday (10/1/08) at approx 1540. Last night awoke crying with pain at injection site. Today thigh swollen from site to knee and buldase over knee. Slightly afebrile, able to walk without difficulty.
Age: 61.0
Sex: F
Vaccine: TDAP
Symptoms: Abdominal pain upper, Influenza like illness, Injection site erythema, Injection site induration, Injection site swelling
Clinical narrative: Pt received ADACEL on 9-8-08 in LA - We received a TC from Pt's husband on 9-11-08 AM. With  Pt c/o local Rx at inject site - warm red swollen - also pt with mild fever and stomach hurting. Pt subsequently came in for O.V. on 9-12-08 and was diagnosed with severe reaction to ADACEL 10+ cm of Erythema, central induration, blister, flu like Sx. - Rx Pred-
Age: 61.0
Sex: F
Vaccine: TDAP
Symptoms: Injection site vesicles, Injection site warmth, Pyrexia
Clinical narrative: Pt received ADACEL on 9-8-08 in LA - We received a TC from Pt's husband on 9-11-08 AM. With  Pt c/o local Rx at inject site - warm red swollen - also pt with mild fever and stomach hurting. Pt subsequently came in for O.V. on 9-12-08 and was diagnosed with severe reaction to ADACEL 10+ cm of Erythema, central induration, blister, flu like Sx. - Rx Pred-
Age: 12.0
Sex: F
Vaccine: MNQ, TDAP, VARCEL
Symptoms: Injection site erythema, Injection site swelling
Clinical narrative: C/o redness and swelling at vaccine site Rx BENADRYL 25 mg cap tid - KEFLEX 500 mg tab 1 tid X 10 days
Age: 16.0
Sex: F
Vaccine: HPV4
Symptoms: Asthenia, Dizziness, Nausea
Clinical narrative: Vaccine administered 7/31/08, pt presented to local ER 8/1/08 with dizziness, nausea, weakness after physical activity; mother phone MERCK to be advised of side effects; physicians office notified on 9/29/08 if immunization services should be continued
Age: 52.0
Sex: F
Vaccine: FLU3
Symptoms: Conjunctivitis, Cough, Dyspnoea, Lacrimation increased, Ocular hyperaemia
Clinical narrative: Oculo- Respiratory syndrome symptoms, sore throat, cough, tightness of breath, bilateral red/tearing eyes with conjunctivitis like characteristics plus fever (100.6 -101) occurred starting one hour after injection and braking 6 hours after injection. Overview faxed to VAERS. She quoted the Guillain-Barre Syndrome.
Age: 52.0
Sex: F
Vaccine: FLU3
Symptoms: Oculorespiratory syndrome, Pharyngolaryngeal pain, Pyrexia
Clinical narrative: Oculo- Respiratory syndrome symptoms, sore throat, cough, tightness of breath, bilateral red/tearing eyes with conjunctivitis like characteristics plus fever (100.6 -101) occurred starting one hour after injection and braking 6 hours after injection. Overview faxed to VAERS. She quoted the Guillain-Barre Syndrome.
Age: 15.0
Sex: M
Vaccine: MNQ, TDAP
Symptoms: Dizziness, Hypoaesthesia, Paraesthesia
Clinical narrative: Tingling of arms/legs - Numbness body - Dizziness
Age: 71.0
Sex: F
Vaccine: FLU3, PPV
Symptoms: Injection site erythema, Injection site oedema, Injection site warmth
Clinical narrative: Redness, warmth, mild edema to site/upper arm.
Age: 11.0
Sex: F
Vaccine: TDAP, VARCEL
Symptoms: Erythema, Induration, Oedema, Tenderness
Clinical narrative: Left triceps - 4x4 cm red, edema - 2x2 cm induration and tender (-) oozing
Age: 2.0
Sex: F
Vaccine: HEPA
Symptoms: Dysphemia, Expressive language disorder, Sleep disorder, Somnambulism
Clinical narrative: Concern with sleep walking - For 2 weeks - restless sleep. Stuttering day after immunization 9/5 and also difficult verbalizing - after Rx improving as of 9/22/08
Age: 5.0
Sex: F
Vaccine: DTAP, IPV, MMR, VARCEL
Symptoms: Injection site erythema, Injection site swelling
Clinical narrative: Pt c/o of vaccine lump and redness -ATARAZ 10 mg 1 tsp tid  4 oz - KEFLEX 280 1 1/2 tsp tid
Age: 17.0
Sex: F
Vaccine: VARCEL
Symptoms: Injection site erythema, Injection site swelling
Clinical narrative: Swelling and redness at injection site - right arm for 4 days, No treatment given
Age: 12.0
Sex: F
Vaccine: MNQ, MNQ
Symptoms: Chills, Headache, Neck pain, Pain in extremity
Clinical narrative: 3 hrs after shot left arm started to hurt from fingers to the neck/ear - sharp shooting, tingling sensations, headache and chills also, next day neck pain, 2 days later right arm pain, 4 days back pain followed by left leg pain. Worst pain was in head, neck and back, still continuing 1 month later Per follow up: As of 2/2/09, (5 months later) patient is still having hip and back pain, sharp headaches (frequent) and is only back to school for 2 1/2 hrs. per day. She is taking NEUROTIN, doing physical therapy, and has extreme fatigue daily.
Age: 12.0
Sex: F
Vaccine: MNQ, MNQ
Symptoms: Activities of daily living impaired, Arthralgia, Back pain, Chills, Ear pain
Clinical narrative: 3 hrs after shot left arm started to hurt from fingers to the neck/ear - sharp shooting, tingling sensations, headache and chills also, next day neck pain, 2 days later right arm pain, 4 days back pain followed by left leg pain. Worst pain was in head, neck and back, still continuing 1 month later Per follow up: As of 2/2/09, (5 months later) patient is still having hip and back pain, sharp headaches (frequent) and is only back to school for 2 1/2 hrs. per day. She is taking NEUROTIN, doing physical therapy, and has extreme fatigue daily.
Age: 12.0
Sex: F
Vaccine: MNQ, MNQ
Symptoms: Fatigue, Headache, Lumbar puncture, Neck pain, Nuclear magnetic resonance imaging
Clinical narrative: 3 hrs after shot left arm started to hurt from fingers to the neck/ear - sharp shooting, tingling sensations, headache and chills also, next day neck pain, 2 days later right arm pain, 4 days back pain followed by left leg pain. Worst pain was in head, neck and back, still continuing 1 month later Per follow up: As of 2/2/09, (5 months later) patient is still having hip and back pain, sharp headaches (frequent) and is only back to school for 2 1/2 hrs. per day. She is taking NEUROTIN, doing physical therapy, and has extreme fatigue daily.
Age: 12.0
Sex: F
Vaccine: MNQ, MNQ
Symptoms: Nuclear magnetic resonance imaging brain, Pain, Pain in extremity, Paraesthesia
Clinical narrative: 3 hrs after shot left arm started to hurt from fingers to the neck/ear - sharp shooting, tingling sensations, headache and chills also, next day neck pain, 2 days later right arm pain, 4 days back pain followed by left leg pain. Worst pain was in head, neck and back, still continuing 1 month later Per follow up: As of 2/2/09, (5 months later) patient is still having hip and back pain, sharp headaches (frequent) and is only back to school for 2 1/2 hrs. per day. She is taking NEUROTIN, doing physical therapy, and has extreme fatigue daily.
Age: 3.0
Sex: M
Vaccine: FLUN3, MMR, FLUN3, MMR
Symptoms: Blister, Conjunctival hyperaemia, Depressed level of consciousness, Erythema, Urticaria
Clinical narrative: A serious, spontaneous report of CHANGE IN SENSORIUM, EYES BECAME GLAZED OVER, ERYTHEMA and HIVES has been received from a nurse concerning a three-year-old male, subsequent to FLUMIST. The patient's medical history was not reported. On 18-Sep-2008, the patient concurrently received FLUMIST and MMR vaccines. Approximately ten minutes after receipt of FLUMIST and MMR vaccines, the patient experienced a change in sensorium, eyes became glazed over, erythema on neck and chest, and hives on trunk. An injection site reaction on the MMR site of administration was also noted. The patient was treated with epinephrine and BENADRYL. He was transported to the emergency room where he was monitored for four hours and then released. The outcome of the events was not reported. The sponsor considered the events medically important.
Age: 3.0
Sex: M
Vaccine: FLUN3, MMR, FLUN3, MMR
Symptoms: Depressed level of consciousness, Erythema, Injection site reaction, Staring, Urticaria
Clinical narrative: A serious, spontaneous report of CHANGE IN SENSORIUM, EYES BECAME GLAZED OVER, ERYTHEMA and HIVES has been received from a nurse concerning a three-year-old male, subsequent to FLUMIST. The patient's medical history was not reported. On 18-Sep-2008, the patient concurrently received FLUMIST and MMR vaccines. Approximately ten minutes after receipt of FLUMIST and MMR vaccines, the patient experienced a change in sensorium, eyes became glazed over, erythema on neck and chest, and hives on trunk. An injection site reaction on the MMR site of administration was also noted. The patient was treated with epinephrine and BENADRYL. He was transported to the emergency room where he was monitored for four hours and then released. The outcome of the events was not reported. The sponsor considered the events medically important.
Age: 44.0
Sex: M
Vaccine: HPV4
Symptoms: Mobility decreased, Myalgia, Off label use, Pain in extremity
Clinical narrative: Subject reported the following to this study RN today. He had been experiencing muscle pain equally in both arms and had been seeing his PCP for this problem. The pain is worse in the mornings upon rising to where it is painful to raise his arms up. He is able to continue with his ADLs and does not take pain meds. He stated that the pain began over a month after his first GARDASIL injection (Day 1=3/12/2008) and after his doctor had changed his ARV regimen, and before his second GARDASIL injection. He started new HIV medication regimen on 3/25/08. His doctor (PCP) told him that his arm pain was a side effect of one of his new HIV medications such as TRUVADA and did not think it was caused by the GARDASIL vaccine. The pain did not subside so his physician switched the TRUVADA out for INTELENCE one month ago to see if his arm pain will subside. The arm pain continues, so one of the other HIV medications will be switched out to see if the symptoms improve. The subject states that he is otherwise well and that it is "not a big deal," yet agrees that it will be good to be rid of the arm pain. (The subject never reported this arm muscle pain on his report cards and stated that he tolerated the injections well without problem.)
Age: 17.0
Sex: F
Vaccine: HPV4
Symptoms: Abdominal pain lower, Activities of daily living impaired, Arthralgia, Electrocardiogram, Erythema
Clinical narrative: My daughter had the first GARDASIL shot on 7/7/08.  7 to 10 days later she began having severe pains and cramping in her pelvic area along with redness, fever, vomiting, and joint pains.  Her doctor said it was just a reaction to the shot and after examining her told her to go home and take TYLENOL for headaches, pains, etc because she was the first case he had seen this severe and didn't know what to do other than to examine her once a month. Every week she has experienced severe joint pains, cramps, not feeling well enough to eat, etc.  She lost 10 lbs.  Since she is 17 years old and only weighed 105 lbs that didn't set well with me.  She is naturally skinny.  The gynecologist still doesn't know what to do with my daughter's pains.  He did an EKG, ultrasound, urine test and they all came back ok. The ultrasound showed an enlarged cyst on one of her ovaries.  This is getting ridiculous in the fact that she can no longer lead a normal life due to weekly pains and not feeling well.  Isn't there anything she can take to reverse the medicine's side effects as I see this as being a lifetime adventure for her.  PLEASE ADVISE on what I as a parent can do next.  I feel this is all the medicine's fault because my daughter Never had anything wrong with her until after having this shot.  I don't like reading all the articles about this shot and seeing that the company tries to blame every day life events or happenings for causing the bad things to happen to these girls.  It is definitely the GARDASIL Shot that has caused the adverse health of these young girls having problems.  12/29/2008 PCP records received for several OVs between 9/29/08 and 11/10/2008. Pt initially presented with c/o painful joints, cramping chest pain. ROS (+) for fever, chills, fatigue, 10 lb weight loss, abdominal pain, nausea, vomiting, H/A, eye pain, ear pain, sore throat, congestion, runny nose and Flu-like sx since Gardasil vax in July. Pt also reports sleep disturbance, joint pain and swelling, morning stiffness, myalgias, anxiety and depression.  Missed 5 days of school. PE (+) for joint tenderness and ache.  Assessment:  Joint disease-multiple joints.  Pain in Limb.  Loss of Weight.  AC Maxillary sinusitis.  Nausea with vomiting. F/U 10/13/08 with no improvement.  furthe heartburn, abdominal pain and bloating note with loss of appetite. Assess:  Esophagela Reflux.  Abdominal Pain-Epigastric. Bloating. F/U 11/10/08 Abdominal pain, nausea and vomiting improved on meds. Assess:  Esophageal leukoplakia.  Nausea with vomiting.  Irregular menstruation.