chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 65.0
Sex: F
Vaccine: FLU3, PPV
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth, Nausea
Clinical narrative: Received PPV23 (SC) and TIV (IM) into left arm 10-21-98.  The patient called the office on 10-23-08 to report that her left arm  was red, hot, swollen with  pain and pressure from the elbow to the arm pit.  She relayed that the site was better on the 23rd than the 22nd.  A status call on 10-24-08 indicated that she had inproved since the 23rd and that she did not report that she was  nauseated with the other symptoms also.
Age: 1.0
Sex: F
Vaccine: FLU3, MMR, PNC, VARCEL
Symptoms: Decreased appetite, Irritability, Pyrexia, Rash, Rhinorrhoea
Clinical narrative: MMR vaccine administered on 10/13/08.  Fever 101.7 beginning 10/19/08. Runny nose 10/22/08-present.  Rash on trunk, face, back and arms beginning 10/23/08. Decreased apppetite and increased fussiness 10/23/08.
Age: 60.0
Sex: M
Vaccine: FLU3
Symptoms: Cough, Influenza like illness, Nasopharyngitis, Sinus congestion
Clinical narrative: Within an hour after receiving the shot at 12:17 P.M. on October 11, 2008, I began to feel as though something was wrong. I continued to get more physically uncomfortable for the next 36 hours. By Monday morning the 13th I felt as though I had a mild case of the flu, but went to work anyway. By Tuesday morning the 14th, I was too ill with flu-like symptoms to go to work and stayed home. Wednesday morning the 15th, I went to work again, but was still ill. I feel as though I had a low-grade flu the rest of that week. Between the weekend (October 18) thru today's date (October 24), I continue to have bad cold symptoms including sinus, congestion, and coughing problems, but the flu symptoms are gone.
Age: 14.0
Sex: F
Vaccine: TDAP
Symptoms: Activities of daily living impaired, Blood test, Dehydration, Influenza like illness, Nausea
Clinical narrative: Two weeks ago my daughter had the updated Tdap as school required even though she had it ten years ago as small child. She was out of school two days last week with flu like symptoms and three days this week with nausea that wont subside, and very sleepy. All I have given her so far is Equate over the counter anti-nausea liquid, seems to help only little. My daughter has allergies to small bug bites and is on Loratadine for them. I related this to a flu nausea that my Aunt had last week and was hospitalized for it, only being dehydrated as she is an alcoholic, so I thought this was what my daughter had as she gets every flu that the school has going around at any given time, yet she doesnt have that severe of nausea. Doctor took blood sample last week, I havent heard back yet. I contacted CDC with this info also, being a concerned parent.
Age: 14.0
Sex: F
Vaccine: TDAP
Symptoms: Somnolence
Clinical narrative: Two weeks ago my daughter had the updated Tdap as school required even though she had it ten years ago as small child. She was out of school two days last week with flu like symptoms and three days this week with nausea that wont subside, and very sleepy. All I have given her so far is Equate over the counter anti-nausea liquid, seems to help only little. My daughter has allergies to small bug bites and is on Loratadine for them. I related this to a flu nausea that my Aunt had last week and was hospitalized for it, only being dehydrated as she is an alcoholic, so I thought this was what my daughter had as she gets every flu that the school has going around at any given time, yet she doesnt have that severe of nausea. Doctor took blood sample last week, I havent heard back yet. I contacted CDC with this info also, being a concerned parent.
Age: 36.0
Sex: F
Vaccine: TTOX
Symptoms: Arthralgia, Back pain, Lymphadenopathy
Clinical narrative: Pain in the left hip constant for the most part. Pain is moving around- not constantly in one particular place-   in the lower part of the body-mostly in joints- in knee,ankles and back-around waist line. Swollen lymph nods in both groins - left is very pronounced - about the size of an egg.Blood ( directed by gynochologist )test didn't show an infection and no problems gynochologicly.
Age: 65.0
Sex: M
Vaccine: FLU3, PPV
Symptoms: Erythema, Oedema peripheral, Pain, Pain in extremity, Pyrexia
Clinical narrative: Fever and body aches for 48 hours.  Pain, swelling, heat and redness of deltoid area, gravitating distally to elbow, one week until resolution.
Age: 65.0
Sex: M
Vaccine: FLU3, PPV
Symptoms: Skin warm
Clinical narrative: Fever and body aches for 48 hours.  Pain, swelling, heat and redness of deltoid area, gravitating distally to elbow, one week until resolution.
Age: 2.0
Sex: M
Vaccine: FLU3
Symptoms: Cold sweat, Lethargy, Oxygen supplementation, Syncope vasovagal
Clinical narrative: Client received intramuscular injection of 0.25 ml Fluzone influenza vaccine at 1145. Client observed his mother receiving flu vaccination at 1157. Client laid down on clinic floor. Nurse completed the mother's vaccination and immediately attended to client who appeared to have a vasovagal reaction. Clerical was directed to call 9-1-1, related to client's father's history of reactions to immunizations; though client had received two doses of influenza vaccine in the previous flu season. Oxygen was administered in a blow-by fashion while pulse and blood pressure were taken. Client began arousing at 1158, skin was cold and clammy. When emergency personnel arrived at 1200 client was alert and oriented, though continued to be lethargic. When client's father arrived at 1202 client was alert and oriented X3 and greeted father with a smile. Apical pulse at 1201 was 114 beats per minute. Blood pressure using pediatric cuff was 84/50 and pulse was 120 beats per minute. By 1207 client was talking clearly and walking steady. Emergency personnel and nurse concurred that patient experienced syncopy and did not need to be transferred to hospital. At 1230 client went home with mother and father, smiling and talking as they went.
Age: 35.0
Sex: F
Vaccine: FLU3
Symptoms: Dyspnoea, Wheezing
Clinical narrative: Wheezing, gasping for air.  Went to local Emergency Room and treated with IV Prednisone and nebulizer treatment
Age: 61.0
Sex: F
Vaccine: FLU3
Symptoms: Asthma, Dry skin, Feeling abnormal, Skin warm, Throat tightness
Clinical narrative: 7 min. after flu shot was given, c/o feeling bad.  Heart rate-76/minand regular, respirations 16/min and regular.  C/o slight tightness in her throat.  At 10:00 a.m., c/o increased throat tightening.  Resp-16/min and regular, pulse-76 and reg.  No shortness of breath noted.  Color pink, skin warm and dry.  Taken to ER by government vehicle, accompanied by 2 fellow employees.
Age: 0.17
Sex: M
Vaccine: DTAPIPVHIB, PNC, RV5
Symptoms: Body temperature increased, Crying, Injection site swelling
Clinical narrative: temp 99.6 F (axillary) swelling of thigh, cried for 4-5 hours after shot
Age: 61.0
Sex: F
Vaccine: FLU3, PPV
Symptoms: Erythema, Injection site pain, Oedema peripheral, Pain in extremity
Clinical narrative: CLIENT COMPLAINED OF PAIN AT INJECTION SITE SOON AFTER INJECTION.  CLIENT STATED THAT LATER IN THE EVENING HER LEFT ARM BEGAN SWELLING, TURNING RED AND WAS PAINFUL TO MOVE.  CLIENT STATES THAT SHE TOOK BENADRYL TO RELIEVE SWELLING AND IRRITATION AND TYLENOL FOR PAIN.  THE NEXT MORNING, CLIENT STATES THAT THE SWELLING AND REDNESS WAS BETTER, BUT IT WAS STILL PAINFUL.  CLIENT WAS INSTRUCTED TO CONTINUE TAKING TYLENOL AND BENADRYL FOR PAIN AND IRRITATION AND TO CALL HER DOCTOR IF IT DID NOT GET ANY BETTER OR IF IT GOT WORSE.
Age: 11.0
Sex: M
Vaccine: FLUN3, MNQ, TDAP, VARCEL
Symptoms: Muscular weakness, Paraesthesia
Clinical narrative: tingling and weakness in lower legs and feet 2 days after receiving MCV, Tdap, INF (nasal) and VZV.  11/14/08 Reviewed PCP medical records or 10/3-11/3/08. FINAL DX: none provided Records reveal patient in usual state of good health on day of vaccination. Seen in ER 10/23 w/numbness feet & legs & had low grade fever.  No treatment provided, observation.
Age: 51.0
Sex: F
Vaccine: FLUX
Symptoms: Asthenia, Chills, Fatigue, Impaired work ability, Myalgia
Clinical narrative: Very high fever, shaking chills, muscle aches, began at about 12 hours after the flu vaccine, left exhausted and debilitated the next two days.  Missed two days of work.  Never happened previously
Age: 51.0
Sex: F
Vaccine: FLUX
Symptoms: No reaction on previous exposure to drug, Pyrexia
Clinical narrative: Very high fever, shaking chills, muscle aches, began at about 12 hours after the flu vaccine, left exhausted and debilitated the next two days.  Missed two days of work.  Never happened previously
Age: 39.0
Sex: F
Vaccine: FLU3
Symptoms: Chest pain, Dysphagia, Dyspnoea, Palpitations
Clinical narrative: Pt was given TIV fku vaccine 10-3-08.That night she had chest pain, dyspnea,dysphagia.  Went to ER and was given breathing treatment,IV's and injections.In ER again with heart pounding dysphagia and dyspnea on 10-06-08.  Okay after breathing treatment.  Sent home with epi pen and albuterol inhaler.  Office visit 10-17-08 pt doing well.  She was instructed to continue with prednisone tapering dose.  Also given Rx for benadryl and cimetidine.  She is instructed to not have the flu vaccine again and to follow in office prn.
Age: 37.0
Sex: F
Vaccine: FLUX
Symptoms: Rash
Clinical narrative: Breaking out in rash on both arms from sholder and down entire arm.  Taking benedryl for treatment.
Age: 13.0
Sex: M
Vaccine: FLUN3
Symptoms: Facial palsy, Full blood count normal, Red blood cell sedimentation rate normal
Clinical narrative: PATIENT RECEIVED FLUMIST ON 10/13/2008.  DEVELOPED FACIAL NERVE PALSY (BELL'S PALSY) ON 10/21/2008.  12/2/08 Reviewed PCP medical records of 10/4-10/13/08. FINAL DX: none provided Records reveal pt seen 10/4 for removal of sutures from right leg laceration.  Received flumist on 10/13.  1/21/09 Reviewed PCP medical record of 10/22/08. FINAL DX: Bell's palsy Records reveal patient experienced right facial paresis, unable to completely close right eye, eye watery. Tx w/eye protection, no meds.
Age: 60.0
Sex: F
Vaccine: FLU3
Symptoms: Blood potassium decreased, Diarrhoea, Full blood count normal, Haematemesis, Occult blood negative
Clinical narrative: Eight hours after I had my flu vaccine, I developed diarrehea followed by vomiting for the next 18 hours.  The last vomit was entirely blood.  I fainted and was transported to Mt Nittany Medical Center's ER where I recieved 3000cc of glucose solution, was tested negative for common intestinal deseases and bleeding.  the next two days I followed a clear liquid diet until I met with Kartrana Lutz, PA who advised me to resume eating a regular diet and return for a CBC in a week to be sure I am in good health again.
Age: 60.0
Sex: F
Vaccine: FLU3
Symptoms: Stool analysis normal, Syncope, Vomiting
Clinical narrative: Eight hours after I had my flu vaccine, I developed diarrehea followed by vomiting for the next 18 hours.  The last vomit was entirely blood.  I fainted and was transported to Mt Nittany Medical Center's ER where I recieved 3000cc of glucose solution, was tested negative for common intestinal deseases and bleeding.  the next two days I followed a clear liquid diet until I met with Kartrana Lutz, PA who advised me to resume eating a regular diet and return for a CBC in a week to be sure I am in good health again.
Age: 23.0
Sex: M
Vaccine: FLU3
Symptoms: Headache, Ocular hyperaemia, Upper respiratory tract congestion
Clinical narrative: Headaches - until 2 days after vaccination - Tx = Acetaminophen, Blood Shot Eyes - until 5 days after vaccination - Tx = Visine, Naphcon-A, Chest Congestion - until 2 days after vaccination - Tx = DayQuil
Age: 10.0
Sex: F
Vaccine: DTAP, MMR, VARCEL
Symptoms: Cough, Eyelid oedema, Local swelling, Rash, Swelling
Clinical narrative: Swelling of head, neck and eye-lids, facial rash, coughing.
Age: 49.0
Sex: F
Vaccine: FLU3
Symptoms: Erythema, Injection site induration, Injection site nodule, Injection site pruritus, Musculoskeletal pain
Clinical narrative: IW states she rcvd flu shot at 2300ish.  She developed a hard knot at injection site.   At 0100 she states she had pain that went into her shoulder and neck.   At 0300 she began itcing around shoulder, neck and injection site.   At 0330 she noticed hives.  She had an ER doc she was working with look at it and he suggested Benadryl.   At 0430 she took some Benadryl (25 mg).  The hives went away but the itching continued.   At 0900 itching and hives were gone but knot was still there. At 2049 the next night she still had a small knot, but itching, redness, heat, and hives were gone.  No medical treatment required.
Age: 49.0
Sex: F
Vaccine: FLU3
Symptoms: Neck pain, Skin warm, Urticaria
Clinical narrative: IW states she rcvd flu shot at 2300ish.  She developed a hard knot at injection site.   At 0100 she states she had pain that went into her shoulder and neck.   At 0300 she began itcing around shoulder, neck and injection site.   At 0330 she noticed hives.  She had an ER doc she was working with look at it and he suggested Benadryl.   At 0430 she took some Benadryl (25 mg).  The hives went away but the itching continued.   At 0900 itching and hives were gone but knot was still there. At 2049 the next night she still had a small knot, but itching, redness, heat, and hives were gone.  No medical treatment required.
Age: 73.0
Sex: F
Vaccine: FLU3
Symptoms: Erythema, Pruritus
Clinical narrative: Vaccine administered about 10am  on 11/20/2008. Itching,redness commenced in pubic area, inner thighs, around waist and under arms about 9pm.  Took 25mg  benadryl and repeated about 11pm.  Also applied 2.5% hydrocortisone ointment to red areas. Took benadryl once again about 8am. Itching occured again about 6pm.  By the time I had access to benedryl and hydrocortisone ointment at 7pm, the areas affected were much larger including a good portion of my back and around my bra line.  Repeated medications about 9:30pm and once again at 8am.  At this time I am waiting to see if this reoccurs late this afternoon/evening.
Age: 54.0
Sex: F
Vaccine: TDAP
Symptoms: Dysphonia, Dyspnoea, Pruritus
Clinical narrative: Employee came to office on 09/22 at 1530 to rcv Tdap shot.  At 1540 she developed difficulty breathing, itching, and hoarse throat.  She spoke to her office coordinator and they sent her to the ED.  She was treated with IM Benadryl, monitored and sent home.
Age: 48.0
Sex: F
Vaccine: FLU3
Symptoms: Chills, Cough, Dry throat, Respiratory tract congestion, Throat irritation
Clinical narrative: Dry,itchy throat, congestion, cough, chills
Age: 49.0
Sex: F
Vaccine: FLU3
Symptoms: Eye pruritus, Pruritus generalised
Clinical narrative: Received flu shot at 1540 and began itching all over body, mostly in ear canals and eyes.
Age: 57.0
Sex: F
Vaccine: FLUX
Symptoms: Chills, Cough, Diarrhoea, Dizziness, Pyrexia
Clinical narrative: Four hours after receiving my "drive up" flu vaccine, I had fever, chills, dizziness, runny nose, cough, raspy throat and diahhria.  I self-medicated with Immodium, benedryl, aspirin and cough drops.  My cough developed first.  When I called the Public Health Dep't, they said cough was not related to the vaccine.  I did not call back once the other symptoms set in.  As to the manufacturer of the vaccine, I don't know it.
Age: 57.0
Sex: F
Vaccine: FLUX
Symptoms: Rhinorrhoea, Throat irritation
Clinical narrative: Four hours after receiving my "drive up" flu vaccine, I had fever, chills, dizziness, runny nose, cough, raspy throat and diahhria.  I self-medicated with Immodium, benedryl, aspirin and cough drops.  My cough developed first.  When I called the Public Health Dep't, they said cough was not related to the vaccine.  I did not call back once the other symptoms set in.  As to the manufacturer of the vaccine, I don't know it.
Age: 65.0
Sex: F
Vaccine: VARZOS
Symptoms: Injection site erythema, Injection site induration, Injection site streaking
Clinical narrative: Pt. called to report that site of shingles vaccine has a large red knot with red streaks around it and about the size of a small orange. States that has had reactions to flu vaccine this year but did not report this to CCHD at this time of vaccine. Takes Allegra Q 24 /hr daily and Benadryl at HS. Instructed to use Benadryl or Cortaid type cream to area and apply a cool compress to area today. May take her Benadryl this afternoon and at bedtime but to not exceed 4 tabs (25 mg) at a time due to icreased sleepiness. Told if condition worsens with edema to elbow or below site of injection and /or has red streaks going down the arm toward fingertips to seek prompt medical treatment at the ER this weekend. RN will call to recheck on pt. on 10/27/08. Copy of VAERS report to be sent to pt. per mail today. 10/24/08. DN 10/24/08 12:45 pm CST
Age: 46.0
Sex: F
Vaccine: PPV
Symptoms: Chills, Injection site pain, Malaise, Pain, Pyrexia
Clinical narrative: Beginning 2nd day, symptoms were sever pain at injection site, fever, chills, body aches, general ill feeling.
Age: 59.0
Sex: F
Vaccine: FLU3
Symptoms: Dyspnoea, Pain, Pain in extremity, Pyrexia
Clinical narrative: Mild arm soreness followed by generalized aching, unable to catch full breath, fever.  Had mild achiness day following vaccine.
Age: 57.0
Sex: F
Vaccine: FLU3
Symptoms: Chest discomfort, Cough, Dyspnoea, Fatigue, Feeling cold
Clinical narrative: Shot receive 11:40. 15:40 coughing, white of eye turning red.  18:40 white of eyes very red, difficulty breathing, skin in pain 22:30 body in a lot of pain.  Felt like an ice pick stabbing mid section all over 03:20 heart reacting, chest tightening, felt like the ice pick was stabbing the heart and felt very cold, terrible headache, face swollen, top of head itching, sinus area full of pressure 06:20 symptoms starting to go away 13:00 still had headache but able to breath better and feel recovery coming 18:00 able to consume food, 10/23 & 10/24 able to attend to business but feel tired and like my organs and muscles have been through a spin cycle.
Age: 57.0
Sex: F
Vaccine: FLU3
Symptoms: Headache, Ocular hyperaemia, Pain, Palpitations, Pruritus
Clinical narrative: Shot receive 11:40. 15:40 coughing, white of eye turning red.  18:40 white of eyes very red, difficulty breathing, skin in pain 22:30 body in a lot of pain.  Felt like an ice pick stabbing mid section all over 03:20 heart reacting, chest tightening, felt like the ice pick was stabbing the heart and felt very cold, terrible headache, face swollen, top of head itching, sinus area full of pressure 06:20 symptoms starting to go away 13:00 still had headache but able to breath better and feel recovery coming 18:00 able to consume food, 10/23 & 10/24 able to attend to business but feel tired and like my organs and muscles have been through a spin cycle.
Age: 57.0
Sex: F
Vaccine: FLU3
Symptoms: Sinus headache, Swelling face
Clinical narrative: Shot receive 11:40. 15:40 coughing, white of eye turning red.  18:40 white of eyes very red, difficulty breathing, skin in pain 22:30 body in a lot of pain.  Felt like an ice pick stabbing mid section all over 03:20 heart reacting, chest tightening, felt like the ice pick was stabbing the heart and felt very cold, terrible headache, face swollen, top of head itching, sinus area full of pressure 06:20 symptoms starting to go away 13:00 still had headache but able to breath better and feel recovery coming 18:00 able to consume food, 10/23 & 10/24 able to attend to business but feel tired and like my organs and muscles have been through a spin cycle.
Age: 84.0
Sex: M
Vaccine: PPV
Symptoms: Discomfort, Erythema, Full blood count abnormal, Oedema peripheral, Pyrexia
Clinical narrative: Pt was seen in local ER on 10/21/08 about 36 hours after shot complaining of redness, swelling, and discomfort of right arm, temp of 100 F
Age: 39.0
Sex: F
Vaccine: FLU3
Symptoms: Chills, Diarrhoea, Nausea, Pain, Pyrexia
Clinical narrative: Vaccine admninsitered at 1604 on 10/22/08 and individual began with nausea, fever ( 101) , chills, diarrhea, generalized body aches.  Symptoms lasted through 1600 on 10/23/08
Age: 9.0
Sex: M
Vaccine: FLUN3
Symptoms: Rash
Clinical narrative: 2 1/2 hours after the flu mist was given my son broken out in a severe rash on this legs and feet. I called the covering doctor and was told "it is totally unrelated".  I gave my son benadryl and put 1% hydrocortisone cream all over his rash.  In the morning it has spread to his buttocks and his arms. I took him back to the doctor who told me it may or may not be a reaction to the flu mist. I was told to purchase Clarinex and 1% hydrocortisone ointment and it would take about a week to clear up.
Age: 62.0
Sex: F
Vaccine: FLU3
Symptoms: Cold sweat, Dysphonia, Eye burns, Eye pruritus, Headache
Clinical narrative: 10/22/08 6:30PM c/o eyes itching & burning and hoarse voice 10/23/08 4:30AM c/o headache got up to medication for headache, c/o nausea, became sweaty and skin felt clammy then passed out Reported did not seek medical attention.
Age: 62.0
Sex: F
Vaccine: FLU3
Symptoms: Hyperhidrosis, Loss of consciousness, Nausea
Clinical narrative: 10/22/08 6:30PM c/o eyes itching & burning and hoarse voice 10/23/08 4:30AM c/o headache got up to medication for headache, c/o nausea, became sweaty and skin felt clammy then passed out Reported did not seek medical attention.
Age: 30.0
Sex: F
Vaccine: FLU3
Symptoms: Chills, Diarrhoea, Vomiting
Clinical narrative: within 24 hours had diarrhea, vomiting, and chills lasting approx. 24 hours.
Sex: M
Vaccine: FLU3
Symptoms: Pruritus, Rash, Urticaria
Clinical narrative: Developed itching and hive-like rash 24 hours after receiving flu shot at public  clinic         Taking Benedryl PO every 4-8 hrs with relief       Referred to primary MD
Age: 28.0
Sex: F
Vaccine: FLUX
Symptoms: Anorexia, Asthenia, Chills, Fatigue, Headache
Clinical narrative: 6 hours after administration of vaccine, developed fever (101F), severe chills, aches, headache, weakness, exhaustion, and loss of appetite.  Symptoms lasted for 60 hours.
Age: 28.0
Sex: F
Vaccine: FLUX
Symptoms: Pain, Pyrexia
Clinical narrative: 6 hours after administration of vaccine, developed fever (101F), severe chills, aches, headache, weakness, exhaustion, and loss of appetite.  Symptoms lasted for 60 hours.
Age: 65.0
Sex: F
Vaccine: FLU3, PPV
Symptoms: Erythema, Oedema peripheral, Pruritus, Skin discolouration, Tenderness
Clinical narrative: patient came to clinic second day after vaccination. stated upper right arm swollen and itchy day before. at visit arm was no longer red and swollen but had a purplish discoloration at elbow,only slightly tender.
Age: 36.0
Sex: M
Vaccine: FLU3
Symptoms: Chills, Diarrhoea, Pyrexia, Vomiting
Clinical narrative: diarrhea, vomiting, chills, fever of 103 degrees F.  Went to ER for IV fluids and antipyretic.
Age: 0.92
Sex: U
Vaccine: DTAPHEPBIP
Symptoms: Pyrexia, Rhinorrhoea, Wrong drug administered
Clinical narrative: Pediarix dose #4 given to baby instead of intended flu vaccine. Grandmother reports child experienced mild fever the evening after the vaccination.  Today, child has a runny nose.
Age: 54.0
Sex: F
Vaccine: FLU3
Symptoms: Pyrexia
Clinical narrative: Within a couple hours aches, fever rose to 101.5 within first 12 hours.  Came down below 100 within 24 hours with no other symptoms. Used Tylonal as treatment
Age: 87.0
Sex: F
Vaccine: FLU3
Symptoms: Convulsion, Grand mal convulsion
Clinical narrative: Resident was given Afluria 0.5ml Im at 11am on 10/22/08.  At 9:05PM on 10/22/08, resident was observed with grand mal seizure activity. Resident was transferred to Saint Luke's Hospital in Bethlehem, Pa where she was admitted with a diagnosis of seizures.  The resident did not have a history or diagnosis of seizures prior to this event.  12/5/08 Reviewed hospital medical records of 10/22-10/31/2008. FINAL DX: status epilipticus w/prolonged encephalopathy. Records reveal nursing home patient experienced seizures x 2 with the last one lasting approx 40 min.  Lethargic, unresponsive & respiratory distress.  Intubated overnight & loaded w/antiseizure meds.  Neuro consult done.  D/C back to nursing home on pureed diet w/assist.  Coumadin d/c due to falls risk & tx w/ASA.
Sex: M
Vaccine: HEP
Symptoms: Crying, Diarrhoea, Failure to thrive, Hepatomegaly, Metabolic acidosis
Clinical narrative: Failure to thrive, suck on nipple, inconsolable screaming, crying, diarrhea, yellow skin, enlarged liver, urinary tract infection, metabolic acidosis  2/20/09 Received PCP medical records of 10/28/05-12/1/2005. FINAL DX: UTI, hepatomegaly, direct hyperbilirubinemia, all resolved Records reveal patient experienced hepatomegaly & increased bilirubin of 15 on 10/28/05.  RTC 10/29 & bili 13.6.  RTC 11/6/05 w/feeding difficulties & crying.  Dx w/GERD & formula changed.  RTC 11/15 w/continued poor feeding, poor suck & excessive crying, jaundice.  Dx w/FTT, formula changed again.  WBC increased & referred to hospital.  RTC 11/26 w/irritability & oral intake reduced.  Had been hospitalized for E. coli UTI & skin infection on buttock.  Was on oral antibiotics.  Was to f/u w/ GI & metabolic clinic.
Sex: M
Vaccine: HEP
Symptoms: Poor sucking reflex, Screaming, Urinary tract infection
Clinical narrative: Failure to thrive, suck on nipple, inconsolable screaming, crying, diarrhea, yellow skin, enlarged liver, urinary tract infection, metabolic acidosis  2/20/09 Received PCP medical records of 10/28/05-12/1/2005. FINAL DX: UTI, hepatomegaly, direct hyperbilirubinemia, all resolved Records reveal patient experienced hepatomegaly & increased bilirubin of 15 on 10/28/05.  RTC 10/29 & bili 13.6.  RTC 11/6/05 w/feeding difficulties & crying.  Dx w/GERD & formula changed.  RTC 11/15 w/continued poor feeding, poor suck & excessive crying, jaundice.  Dx w/FTT, formula changed again.  WBC increased & referred to hospital.  RTC 11/26 w/irritability & oral intake reduced.  Had been hospitalized for E. coli UTI & skin infection on buttock.  Was on oral antibiotics.  Was to f/u w/ GI & metabolic clinic.
Age: 30.0
Sex: F
Vaccine: FLU3, PPV
Symptoms: Injection site swelling, Pneumonia, Pyrexia
Clinical narrative: Patient experienced pneumonia-like sypmtoms and swelling on the arm of the injection site. She also had a fever.
Age: 66.0
Sex: M
Vaccine: VARZOS
Symptoms: Injection site erythema, Injection site haematoma, Injection site induration, Local reaction
Clinical narrative: Came in to show RN localized reaction to left upper arm after receiving the Zoster vaccine on 09/22/2008. Noted a hard reddened knot approximately 50 cent size on 09/24. Denies shortness of breathe, trouble swallowing etc. Encouraged to treat area with Tylenol and Benadryl for discomfort.Can use cool compress to area and anit-itch cream to site. Pt. states on blood thinners- ASA and a bruise at site also noted this day. Called daughter an RN for advise also today. DN
Age: 4.0
Sex: M
Vaccine: DTAP, IPV, MMR, VARCEL
Symptoms: Computerised tomogram normal, Condition aggravated, Febrile convulsion
Clinical narrative: Patient received vaccines (IPV #4, MMR #2, VZV #2, DTaP #5, ppd test) on 10/17/08.  He had a febrile seizure on 10/18/08, was taken to the ER and kept for 2 days.  He has a VP shunt since 2005 and a history of other febrile seizures.  CT scan revealed the shunt was working properly.  01/26/2009 MR received for DOS 10/18-20/2008 with D/C DX: Acute symptomatic seizure, h/o febrile seizure, macrocephaly, expressive speech delay, s/p SDH evacuation 2005, h/o subdural peritoneal shunt placement 2005, URI. Pt presented after episode of shaking, followed by sleep, then trembling in sleep. One episode of shaking in ER. Neuro consult-no clinical signs of shunt malformation. Concurrent URI, likely tactile fever noted by EMS. D/C for outpt f/u by PMD.
Age: 47.0
Sex: F
Vaccine: FLU3
Symptoms: Angioedema, Erythema, Pruritus, Swelling
Clinical narrative: Approx 26hrs after dose administered in L deltoid, pt developed red, itchy swollen area medial aspect of L elbow.  Pt developed angioedema of lips 30hrs after dose os vaccine.  Pt treated with diphenhydramine and hydroxyzine after E.R. visit.
Age: 9.0
Sex: M
Vaccine: FLU3
Symptoms: Dizziness, Paraesthesia, Syncope, Visual impairment
Clinical narrative: PATIENT WAS "WOOZY" AND FEINTED APPROXIMATELY 30 MINUTES AFTER ADMINISTRATION OF FLU SHOT.  PATIENT REPORTED SPOTS IN HIS VISION, TINGLY FINGERS, AND DIZZY FEELING.  PATIENT DID NOT LOSE CONSCIOUSNESS.  PATIENT WAS NOT TREATED BY US--911 WAS CALLED, PARAMEDICS GAVE OXYGEN AND TOOK HIM TO ER FOR OBSERVATION.
Age: 17.0
Sex: F
Vaccine: HEPA, MNQ, TDAP
Symptoms: Blood pressure increased, Dizziness, Dyskinesia, Loss of consciousness
Clinical narrative: Had immunizations.  Immediately after last one given (MCV4). Complained of dizziness and passed out. Lowered to floor regained consciousness, but did make a few jerky movements and snorting sound before regaining consciousness.
Age: 59.0
Sex: F
Vaccine: FLU3
Symptoms: Blood pressure increased, Eye irritation, Ocular hyperaemia, Throat irritation
Clinical narrative: At 12:10 PM th patient reported back to the area where the flu clinic was being held compalaining of throat being scratchy and eyes "sandy".  Her eyes were totally injected and her BP was 180/102.  She was given Benedryl 25 mg po and monitored for 1 hour.  Her BP went down to 146/70.  She was sent to her primary care physician who put her on a medrol dose pack.
Age: 43.0
Sex: F
Vaccine: FLU3
Symptoms: Chest pain, Cough, Eye pruritus, Postnasal drip
Clinical narrative: Chest Pain, PND, cough, itchy eyes Benadryl 25 mg feeling better (less cough) 1 hr after benadryl. Has Epi pen will call if used.
Age: 43.0
Sex: F
Vaccine: FLU3
Symptoms: Injected limb mobility decreased, Musculoskeletal pain, No reaction on previous exposure to drug, Pain in extremity, X-ray
Clinical narrative: The patient reports that a couple of minutes after receiving the shot her left "shoulder/arm" was very painful.  This pain has remained "excruciating" when her arm is in motion after two weeks, although it is not as painful when not in motion as it was initially.  There was not a local reaction noted at the site of injection.  The patient saw the physician's assistant at her regular physician's office on October 16, 2008, ten days after the shot, and she was prescribed Mobic/Meloxicam for the pain, which does help.  She has had an xray subsequently, but does not have the result.  She may be referred to an orthopedic specialist if the pain continues to bother her.  She states that she has not previously had problems with flu shots.
Age: 42.0
Sex: F
Vaccine: FLUX
Symptoms: Asthenia, Pain, Pyrexia
Clinical narrative: Fever of 103 degrees, severe weakness and body aches approximately four hours after receiving the inactivated influenza vaccine.  Took two Tylenol PMs and went to bed.  Woke up the next morning with no signs of illness.  Called physician's office and was told that it was couldn't be a reaction to the flu shot.  I was told that my white blood count on that day was "normal," but that maybe something was coming on when I received the shot. I replied that by the next morning, I was perfectly fine.  They then told me, "Well, maybe you just shouldn't get the shot, then." I have Multiple Sclerosis, and I am advised by my neurologist to get the shot!  No effort was made to make a report, therefore I am doing it myself...  (after getting online and finding the vaccine information paper from the CDC website.) I was reading the CDC information page on the influeza vaccine again, and I noticed that "hoarseness" was also a potential reaction. I have been very hoarse since the shot, but, at first thought it was due to the weather. However, even when I drink something hot, the hoarseness does not go away, as normal hoarseness usually does. So, I would like to add this to my report. I received the vaccination last Tuesday, and I have been hoarse since.  When can I expec t this to stop? Are the reaction sI experienced from the shot considered an allergy to it? With Multiple Sclerosis, I am supposed to be vaccinated every year, because contracting influenza can be extremely harmful to me. Would this reaction make me unable to be vaccinated, or do the benefits outweigh the risks? (I can handle fever the night of the shot because I can take medication  to alleviate the discomfort and lower the fever, and the hoarseness is only a minor nuisance.) Please respond, because I have four school-aged children who frequently bring illnesses home from school, and I feel more protected being immunized. If I should avoid the flu shot, is there another vaccination I could take that would offer me protection from the flu that is perhaps made up of different components than the one I have been receiving? Any information and advice would be most appreciated. Thank you!
Age: 43.0
Sex: M
Vaccine: TDAP
Symptoms: Dermatitis
Clinical narrative: dermatitis
Age: 55.0
Sex: F
Vaccine: FLUX
Symptoms: Asthenia, Cough, Dizziness, Dysphonia, Dyspnoea
Clinical narrative: Flu shot @ 4:00 - Coughing at 7:00 - difficulty breathing 7:45 - hoarseness, hives, weakness, dizziness, lips and  gums stinging - lips, eyes swollen
Age: 55.0
Sex: F
Vaccine: FLUX
Symptoms: Eye swelling, Lip swelling, Pain, Urticaria
Clinical narrative: Flu shot @ 4:00 - Coughing at 7:00 - difficulty breathing 7:45 - hoarseness, hives, weakness, dizziness, lips and  gums stinging - lips, eyes swollen
Age: 45.0
Sex: F
Vaccine: TDAP
Symptoms: Cellulitis
Clinical narrative: pt was diagnosed with cellulitis of the Left deltoid two days after Adacel was administered.  pt was started on Keflex.
Age: 1.42
Sex: F
Vaccine: DTAPHEPBIP, HEPA, HIBV, MMR, PNC
Symptoms: Convulsion, Laboratory test normal, Pyrexia, White blood cell count
Clinical narrative: Patient received Pediarix, MMR, ActHib, Hepatitis A, and Prevnar vaccines on 10/9/08.  Her mother called the nurse on 10/20/08, stated that child had a low grade temperature on 10/17, but fever climbed to 104 on 10/18, and child developed seizures.  She was evaluated in the emergency department of Rosebud Indian Health Service on 10/18/08.  Mother states that although the ER provider was unable to find any other reason for the child's high fever and seizures, she was prescribed Keflex at that time.  When mother called on 10/20/08, child was well and had had no further seizures since 10/18.
Age: 62.0
Sex: M
Vaccine: FLU3
Symptoms: Ecchymosis, Full blood count normal
Clinical narrative: Eccymosis to Left forearm/upper arm, approx 3 inches below site of vaccine administration.  Noted 24 hours after vaccine was given.  CBC was drawn that was within normal limits.
Age: 35.0
Sex: F
Vaccine: FLU3
Symptoms: Chills, Erythema, Immediate post-injection reaction, Malaise, Nasal congestion
Clinical narrative: Developed itching, rash, facial redness, throat swelling, rhinorrhea, nasal congestion, chills and malaise starting approximately 10 minutes after intramuscular influenza vaccine--FluZone
Age: 35.0
Sex: F
Vaccine: FLU3
Symptoms: Pharyngeal oedema, Pruritus, Rash, Rhinorrhoea
Clinical narrative: Developed itching, rash, facial redness, throat swelling, rhinorrhea, nasal congestion, chills and malaise starting approximately 10 minutes after intramuscular influenza vaccine--FluZone
Age: 43.0
Sex: M
Vaccine: FLUX
Symptoms: Chest discomfort, Dizziness, Headache, Lymph node pain, Malaise
Clinical narrative: Flu shot administered in the AM on 10/24/2006 at NIOSH by the facility nurse. Around 2:30 pm patient felt light headed, tightness in chest, sore ribs, lymph node soreness, stiffness in neck, tightness of throat and headache. As of 7:20 PM patient is lying down and still complaining of chest tightness. States does not feel well at all.
Age: 43.0
Sex: M
Vaccine: FLUX
Symptoms: Musculoskeletal chest pain, Musculoskeletal stiffness, Throat tightness
Clinical narrative: Flu shot administered in the AM on 10/24/2006 at NIOSH by the facility nurse. Around 2:30 pm patient felt light headed, tightness in chest, sore ribs, lymph node soreness, stiffness in neck, tightness of throat and headache. As of 7:20 PM patient is lying down and still complaining of chest tightness. States does not feel well at all.
Age: 39.0
Sex: F
Vaccine: FLU3
Symptoms: Cough, Eye discharge, Eye pruritus, Eye swelling, Fatigue
Clinical narrative: Heaviness in injection arm one hour after vaccine followed by cough, swelling and itching eyes, eye redness and discharge, fever, fatigue, head pressure.
Age: 39.0
Sex: F
Vaccine: FLU3
Symptoms: Headache, Ocular hyperaemia, Pyrexia, Sensation of heaviness
Clinical narrative: Heaviness in injection arm one hour after vaccine followed by cough, swelling and itching eyes, eye redness and discharge, fever, fatigue, head pressure.
Age: 47.0
Sex: F
Vaccine: FLUX
Symptoms: Neck pain, Pain in extremity
Clinical narrative: Severe,debilitating pain in arm that received injection.  Pain concentrated in neck and down arm ending just below elbow joint.  Treated with heat and Vicodin (Ibuprophen offered no pain relief).  Pain still mild/moderate at time of submission of this report (9 hrs post injection)
Age: 33.0
Sex: F
Vaccine: FLUN3
Symptoms: Chest X-ray normal, Condition aggravated, Electrocardiogram abnormal, Heart rate increased, Laboratory test normal
Clinical narrative: A serious report of supraventricular ventricular tachycardia (SVT) with heart rate greater than 160 has been received from a Registered Nurse and an office manager concerning a 33-year-old female employee in a pediatric office subsequent to FLUMIST. Medical history included tachycardia. The patient was not on any concomitant medications. The patient received FLUMIST, intranasal administration as an influenza vaccine at 11:00am at work on 09-Oct-2008. At approximately 4:00pm on the same day, the patient started having a very fast heart rate. She was transported to the emergency room (ER). While in the ER, her heart rate increased as high as 250 beats per minute (bpm). An electrocardiogram confirmed SVT, a chest X-ray was negative and unspecified lab work was done and all results were within normal limits. The patient was treated with unspecified intravenous medication to decrease her heart rate. The patient was discharged from the ER at around 9:00pm. The outcome of the SVT was unknown. The sponsor considered the SVT to be serious (important medical event).
Age: 33.0
Sex: F
Vaccine: FLUN3
Symptoms: Supraventricular tachycardia
Clinical narrative: A serious report of supraventricular ventricular tachycardia (SVT) with heart rate greater than 160 has been received from a Registered Nurse and an office manager concerning a 33-year-old female employee in a pediatric office subsequent to FLUMIST. Medical history included tachycardia. The patient was not on any concomitant medications. The patient received FLUMIST, intranasal administration as an influenza vaccine at 11:00am at work on 09-Oct-2008. At approximately 4:00pm on the same day, the patient started having a very fast heart rate. She was transported to the emergency room (ER). While in the ER, her heart rate increased as high as 250 beats per minute (bpm). An electrocardiogram confirmed SVT, a chest X-ray was negative and unspecified lab work was done and all results were within normal limits. The patient was treated with unspecified intravenous medication to decrease her heart rate. The patient was discharged from the ER at around 9:00pm. The outcome of the SVT was unknown. The sponsor considered the SVT to be serious (important medical event).
Age: 48.0
Sex: F
Vaccine: FLU3
Symptoms: Paraesthesia oral, Throat tightness
Clinical narrative: After receiving influenza - FLUZONE vaccine for 1st time pt. was asked to remain in area x 15 min, after approximately 15 min pt. reported tingling of lips and some thickening in the throat. Heart Rate was Normal. No outward symptoms, no visual swelling, no clammy skin. Pt reported no difficulty breathing or swallowing. Pt. refused epinephrine and EMS. Pt. requested husband to pick her up. Pt instructed by RN to monitor symptoms. Pt. left clinic not in distress approx 1/2 hr after injection. Pt. to seek emergency care if worsening of symptoms. Pt verbalized understanding.
Age: 62.0
Sex: M
Vaccine: FLU3
Symptoms: Condition aggravated, Diarrhoea, Dizziness, Hypotension, Myalgia
Clinical narrative: Patient developed hypotension x 1 day along with 2 day h/o myalgias, lightheadedness, subjective fever, and increased diarrhea.
Age: 62.0
Sex: M
Vaccine: FLU3
Symptoms: Pyrexia
Clinical narrative: Patient developed hypotension x 1 day along with 2 day h/o myalgias, lightheadedness, subjective fever, and increased diarrhea.
Age: 10.0
Sex: M
Vaccine: FLUN3
Symptoms: Dizziness
Clinical narrative: Mom called RN @ about 1210 to report that started complaining of being light headed about bedtime and again this morning.
Age: 4.0
Sex: F
Vaccine: FLU3
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
Clinical narrative: Had vaccine on Oct 21. On Oct 22 patient complained of pain and swelling. On Oct 23 there was a 3 inch area of redness, heat, swelling below the vaccine site.
Age: 59.0
Sex: F
Vaccine: FLU3
Symptoms: Feeling hot, Pruritus generalised, Swollen tongue
Clinical narrative: 10/23 member started with warm hands and itching all over approx 1 Hr after Flu vaccine, took BENADRYL. Then about 10  AM 10/24 tongue swells
Age: 9.0
Sex: F
Vaccine: FLUN3
Symptoms: Grip strength decreased, Hypoaesthesia
Clinical narrative: Numbness of hands, feet, distal extremities LUE 1st, then all 4. As of 10/24 all but LUE recovered. Grip weak LUE.  11/4/08 Reviewed ER medical records of 10/12/08. FINAL DX: extremity numbness of unknown etiology Records reveal patient experienced inability to feel legs/arms.  Walked into ER.      11/4/08 Reviewed PCP medical records of 10/15-10/24/2008. FINAL DX: transient numbness of extremities, improving.  High suspicion of reaction to flumist. Records reveal patient experienced numbness & had been seen in ER.  Feeling better but still numb in distal extremities, fall while running in school, dropping things, anorexic for a few days, 8# weight loss, diarrhea that had resolved.  Exam revealed slight decreased grip strength on left, decreased sensation from knees down & from elbows down,  areflexia in UE's.  RTC 10/24 improved but with left arm numbness persisting, difficulty writing, occasional HA, palpitations, SOB.
Age: 1.3
Sex: M
Vaccine: FLU3, MMR
Symptoms: Injection site urticaria, Vomiting
Clinical narrative: About 3 min. after vaccines given, pt. vomited and hive noted to (L) thigh under MMR injection site. No resp. distress. BENADRYL given as ordered (12.5 mg po). Pt observed 20 min, no distress, no further hives.
Age: 62.0
Sex: F
Vaccine: FLU3
Symptoms: Erythema, Eye swelling, Oedema peripheral, Swelling face
Clinical narrative: Red, swollen face, eyes, fingers next day after vaccination - given BENADRYL EVERY 6 hrs
Age: 76.0
Sex: M
Vaccine: FLU3, PPV
Symptoms: Arthralgia, Pain in extremity
Clinical narrative: Right arm extremely painful. Extreme pain in joint and deltoid. No redness or swelling.
Age: 58.0
Sex: F
Vaccine: FLU3
Symptoms: Dizziness, Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling
Clinical narrative: Pruritis at the injection site at 5:15 p.m. - put Eucerin Calming once - no relief - intense redness and swelling at injection site. About 3 cm - talked with doctor and told to use Zyrtec and hydrocortisone and have Albuterol inhaler on hand - at 6:00 pm, felt dizzy and didn't feel so good barely made it to  e chair and passed out for about 20 seconds - pulse 6, B/P 135/95 - recovered. Speech was slow - went home after 30 minutes with my husband - took Zyrtec - used HC on injection site - on 10-11-08, the injection site was about 5 cm and very sore and hot to the touch. By 10-12-08, the swelling had decreased and redness had decreased.
Age: 58.0
Sex: F
Vaccine: FLU3
Symptoms: Injection site warmth, Loss of consciousness, Malaise, Speech disorder
Clinical narrative: Pruritis at the injection site at 5:15 p.m. - put Eucerin Calming once - no relief - intense redness and swelling at injection site. About 3 cm - talked with doctor and told to use Zyrtec and hydrocortisone and have Albuterol inhaler on hand - at 6:00 pm, felt dizzy and didn't feel so good barely made it to  e chair and passed out for about 20 seconds - pulse 6, B/P 135/95 - recovered. Speech was slow - went home after 30 minutes with my husband - took Zyrtec - used HC on injection site - on 10-11-08, the injection site was about 5 cm and very sore and hot to the touch. By 10-12-08, the swelling had decreased and redness had decreased.
Age: 7.0
Sex: M
Vaccine: FLU3
Symptoms: Injection site erythema, Injection site pain, Injection site swelling
Clinical narrative: (+) erythema, (+) swelling, mild tenderness to site
Age: 5.0
Sex: M
Vaccine: FLU3, HEPA, VARCEL
Symptoms: Injection site erythema, Injection site haemorrhage, Injection site swelling, Injection site warmth
Clinical narrative: Had flu vaccine in right arm 10/23/08, 10/24 noticed redness -> pinpoint eccynosis at site of injection, no erythema in immediate area but diffuse confluent mild erythema/ warmth/ fullness around sides and back of entire upper arm. No induration, noi tenderness.
Age: 50.0
Sex: F
Vaccine: FLU3
Symptoms: Activities of daily living impaired, Chills, Cough, Headache, Throat tightness
Clinical narrative: Pt called 10/21/08, states received Flu vaccine at 10:12 AM (Never had one before), approx. 2 1/2 hr after received, developed a cough, throat felt tight, HA, chills and vomited. Lasted several hrs no intervention.  Much better today. Stayed hm from work 10/21/08 - but still some residual
Age: 50.0
Sex: F
Vaccine: FLU3
Symptoms: Vomiting
Clinical narrative: Pt called 10/21/08, states received Flu vaccine at 10:12 AM (Never had one before), approx. 2 1/2 hr after received, developed a cough, throat felt tight, HA, chills and vomited. Lasted several hrs no intervention.  Much better today. Stayed hm from work 10/21/08 - but still some residual
Age: 5.0
Sex: F
Vaccine: DTAP, IPV, MMR, VARCEL
Symptoms: Injection site erythema, Injection site swelling, Pharmaceutical product complaint
Clinical narrative: This case was reported by a healthcare professional and described the occurrence of swollen thigh (injection site) in a 5-year-old female subject who was vaccinated with INFANRIX (GlaxoSmithKline). Concurrent vaccinations given on 21 August 2008 included the 4th dose of IPV; Sanofi; the 2nd dose of MMR II (Merck); and the 2nd dose of VARIVAX; Merck. On 21 August 2008, the subject received the 5th dose of INFANRIX (.5 ml, unknown, left thigh). On the evening of 24 August 2008, three days after vaccination with INFANRIX, the subject experienced a swollen thigh (injection site) and injection site redness. The reporting nurse stated that the subject presented to the emergency room on 24 August 2008, and was also seen in the physician's office on 25 August 2008 with entire thigh swelling and redness. A product complaint was lodged for this report, as the nurse inquired if GSK had changed the formulation or if there were "hot" lots with the company's DTaP vaccines. At the time of reporting the events were resolved. The healthcare professional considered the events were probably related to vaccination with INFANRIX. Follow-up information received on 21 October 2008 indicated that events began 1 day following vaccination with INFANRIX on 22 August 2008. Additional events of cellulitis versus hypersensitivity reaction were reported. INFANRIX was reportedly administered intramuscularly. The events resolved and were considered by the reporter, possibly related to treatment with INFANRIX. It was additionally stated that all four previous DTaP shots were Aventis brand.
Age: 17.0
Sex: F
Vaccine: HPV4, HPV4
Symptoms: Activities of daily living impaired, Fatigue, Headache, Malaise, Nausea
Clinical narrative: my daughter had GARDASIL.  The next day became very sick with headache and nausea and very tired.  This is going on 3 weeks she is still sick from this.  has seen two doctors and can't find anything causing this.  They won't say it was the shot.  but she was very healthy when I took her for her yearly check up.  She has missed 3 weeks of school so far.11/5/2008 PCP records received OV 10/3/08 with c/o low back pain, abdominal pain, nausea, tiredness and feeling cold x 1 week. Abd pain is epigastric-(+) tenderness. Bland diet suggested. TC from parent re: nausea-phnergan prescribed. Pt extremely tired unable to attend school x 2 days. OV 10/10/08 F/U for stomach pain, queezy, night sweats. Assessment: Nausea, H/A, fatigue-possible viral etiology, doubts 2' to Gardasil. ER visit 10/15/08 for above sx-prescribed Nexium.