chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 41.0
Sex: F
Vaccine: COVID19
Symptoms: Chest pain, Computerised tomogram abdomen normal, Electrocardiogram normal, Full blood count normal, Intra-abdominal haemorrhage
Clinical narrative: 20 min after receiving vaccine, paresthesia felt in left arm. Spread to left half of face and left leg 3 days later. Two weeks after that, paresthesia spread to whole body. 3 days post-vaccine, chest pain, abdominal pain, nausea, and weakness began. 9 days post vaccine, abdominal bleeding began.   Chest pain resolved in 1 day.  Abdominal bleeding resolved in 2 days. Nausea lasted two weeks.  Weakness and paresthesia continue 3 weeks post vaccine.
Age: 41.0
Sex: F
Vaccine: COVID19
Symptoms: Lymphocyte count decreased, Nausea, Neutrophil count increased, Paraesthesia, Troponin normal
Clinical narrative: 20 min after receiving vaccine, paresthesia felt in left arm. Spread to left half of face and left leg 3 days later. Two weeks after that, paresthesia spread to whole body. 3 days post-vaccine, chest pain, abdominal pain, nausea, and weakness began. 9 days post vaccine, abdominal bleeding began.   Chest pain resolved in 1 day.  Abdominal bleeding resolved in 2 days. Nausea lasted two weeks.  Weakness and paresthesia continue 3 weeks post vaccine.
Age: 41.0
Sex: F
Vaccine: COVID19
Symptoms: Vitamin D deficiency
Clinical narrative: 20 min after receiving vaccine, paresthesia felt in left arm. Spread to left half of face and left leg 3 days later. Two weeks after that, paresthesia spread to whole body. 3 days post-vaccine, chest pain, abdominal pain, nausea, and weakness began. 9 days post vaccine, abdominal bleeding began.   Chest pain resolved in 1 day.  Abdominal bleeding resolved in 2 days. Nausea lasted two weeks.  Weakness and paresthesia continue 3 weeks post vaccine.
Age: 37.0
Sex: F
Vaccine: COVID19
Symptoms: Lymph node pain, Lymphadenopathy
Clinical narrative: Approximately 24 hours after the injection, I developed a swollen lymph node near my collar bone on the same side as my injection (left arm). The swelling is about the size of a golf ball and is very painful to the touch and when not touched at all. It is now 4 full days after the injection and this symptom has not subsided.
Age: 83.0
Sex: M
Vaccine: COVID19
Symptoms: Death
Clinical narrative: Death Narrative: Patient received his first COVID-19 vaccination 2/27/2021 and received his second COVID-19 vaccination 03/27/2021. Patient had not been tested for COVID per chart review and had no contraindications to receiving the vaccine. Patient did not experience any adverse events to the COVID-19 vaccine between time of vaccination and the time of death 12 days later. Of note, patient was receiving home hospice at the time of his death (04/08/2021) for his advanced acute myeloid leukemia.
Age: 100.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Death
Clinical narrative: death Narrative:  Patient received Moderna COVID vaccine #1 on 1/10/21, he was seen by his PCP for a routine 6 month check up on 1/14/21. Notes at that time indicate he had a left great toe, he wound and was receiving home health and IV daptomycin through a PICC line. On 2/7/21, he received vaccine #2. Notes then indicate that on 3/9/21, he was found passed away in his home by family. No autopsy results available. 30 days form date of vaccine #2 to date of death.
Age: 88.0
Sex: M
Vaccine: COVID19
Symptoms: Cardio-respiratory arrest, Cardioversion, Death, Dyspnoea, Endotracheal intubation
Clinical narrative: Death. Narrative: Patient received Moderna COVID vaccine #1 on 3/3/21. He is noted to be a dialysis patient. On 3/24/21, his wife took him to a facility ER due to intermittent shortness of breath over the previous week. He was admitted for fluid overload. On 3/27/21, he was found unresponsive and CPR was initiated and a code blue was called. He received defibrillation, epinephrine, IV calcium, sodium bicarb and amiodarone and was intubated; however he did not survive and time of death is recorded as 3/27/21 at 0138. No autopsy results available. 24 days from time of vaccine to date of death.
Age: 88.0
Sex: M
Vaccine: COVID19
Symptoms: Fluid overload, Resuscitation, Unresponsive to stimuli
Clinical narrative: Death. Narrative: Patient received Moderna COVID vaccine #1 on 3/3/21. He is noted to be a dialysis patient. On 3/24/21, his wife took him to a facility ER due to intermittent shortness of breath over the previous week. He was admitted for fluid overload. On 3/27/21, he was found unresponsive and CPR was initiated and a code blue was called. He received defibrillation, epinephrine, IV calcium, sodium bicarb and amiodarone and was intubated; however he did not survive and time of death is recorded as 3/27/21 at 0138. No autopsy results available. 24 days from time of vaccine to date of death.
Age: 90.0
Sex: M
Vaccine: COVID19
Symptoms: Death
Clinical narrative: death Narrative: Pt received second Moderna COVID vaccine dose on 2/9/21. Pt enrolled in hospice house for end-of-life care 4/8, however, diagnosis was not available in database for enrollment in hospice. Pt's son emailed affairs to report the passing of the patient 4/11/21 with no additional details or reasoning; death has not been verified. Was pt previously covid positive? no Are there any predisposing factors (i.e. PMH, HPI, allergy history etc) for patient experiencing adverse drug event? Yes, CHF potentially a contributing factor to hospice status and death Any occurrence of an ADR at time of administration or during time of observation? No Was there an ADR between observation period and date of death? No Was patient hospitalized prior to vaccination? No Was patient hospitalized prior to death No What are the possible cause of death? unknown, pt enrolled in hospice services outside of the facility.
Age: 100.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Autopsy, Death
Clinical narrative: death Narrative:  Patient received Moderna COVID #1 on 2/4/21 and #2 on 3/4/21. He was seen by his PCP via telephone visit on 3/2/21 for a routine follow up, no acute issues noted and follow up was planned for 6 months. On 3/12/21, he passed away, no notes in medical records or scanned records to indicate what happened. No autopsy results available. 8 days from date of last vaccine and date of death.
Age: 77.0
Sex: M
Vaccine: COVID19
Symptoms: Death
Clinical narrative: Was informed at the time the client was to be seen for booster dose of COVID vaccine that he had recently passed away.  Unable to contact family for more information.
Age: 95.0
Sex: M
Vaccine: COVID19
Symptoms: Death
Clinical narrative: Was informed at the time the client was to be seen for booster dose of COVID vaccine that he had recently passed away. Unable to contact family for more Information.
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Fatigue, Headache, Pain
Clinical narrative: Headache, chills, major body aches , fatigue.  Lasted 36 hours.
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Interchange of vaccine products
Clinical narrative: Pfizer given 1st dose; Moderna given 2nd dose
Age: 44.0
Sex: F
Vaccine: COVID19
Symptoms: Tinnitus
Clinical narrative: Tinnitus: ongoing high pitched sound in left ear.
Age: 17.0
Sex: F
Vaccine: COVID19
Symptoms: Product administered to patient of inappropriate age
Clinical narrative: NO ADVERSE EVENT OCCURED.  PATIENT IS 17 YEARS OF AGE AND WAS ADMINISTERED MODERNA VACCINE AT A OFFSITE CLINIC EVENT.  PER CDC 2ND DOSE SHOULD BE ADMINISTER AS "OFF-LABEL USAGE"
Age: 83.0
Sex: F
Vaccine: COVID19
Symptoms: Body temperature increased, Fatigue, Headache, Malaise, Myalgia
Clinical narrative: Sick feeling ,  tired, 100.4 temperature, headache,  muscle aches in legs and small of the spine,  had to stay in bed 13,14th and am up today the 15th but still feeling tired.
Age: 58.0
Sex: F
Vaccine: COVID19
Symptoms: Cough, Dry mouth, Dysgeusia
Clinical narrative: About 10 days after the vaccine, I started feeling a "cotton mouth" (dry mouth) and a cough that I could not get down. I also wanted to say that I had a metallic taste in my mouth that then developed into the dry mouth. I drank a lot of water and in a couple of hours the taste went away and the dry mouth went away but the cough persisted. Tried the over the counter Dayquil did not work and then decided to do the telehealth visit with a doctor.  They prescribed me some antibiotics and steroids and it solved the problem
Age: 65.0
Sex: M
Vaccine: COVID19
Symptoms: Computerised tomogram thorax abnormal, Echocardiogram, Haemoptysis, Migraine, Pulmonary thrombosis
Clinical narrative: I started having migraine headaches on 3-19-2021 , this lasted for 3 days. On 3-23 started coughing up blood , that progressively became worse. Went to emergency room and was admitted  CAT scan of lungs showed that I had 3 blood clots.
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: Peripheral swelling
Clinical narrative: Swelling and lump in the arm
Age: 81.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Chills, Myalgia, Nausea, Pyrexia
Clinical narrative: I woke up the next morning with bad muscle and joint pain, chills, nausea, threw up and had fever. This was worse than when I had covid.
Age: 81.0
Sex: F
Vaccine: COVID19
Symptoms: Vomiting
Clinical narrative: I woke up the next morning with bad muscle and joint pain, chills, nausea, threw up and had fever. This was worse than when I had covid.
Age: 35.0
Sex: F
Vaccine: COVID19
Symptoms: Diarrhoea, Fatigue, Pyrexia
Clinical narrative: Fever of 102, extreme fatigue, diarrhea,
Age: 65.0
Sex: M
Vaccine: COVID19
Symptoms: Angiogram pulmonary abnormal, Chest X-ray abnormal, Death, Decreased insulin requirement, Dyspnoea
Clinical narrative: He received his first COVID19 shot (Pfizer) reportedly on 3/2/21, then began a new chemotherapy regimen on 3/10/21. On 3/18, he fell to the floor and could not get up. He was admitted to the hospital for sepsis, pneumonia, and chemotherapy-induced neutropenia, treated on IV antibiotics and discharged on PO antibiotics. His home insulin was also decreased but continued to have hypoglycemic to hyperglycemic events. Insulin was decreased in clinic afterward and was compliant on antibiotics. Returned to hospital again a few days later for sepsis and pneumonia/effusion. He later went to a nursing facility / on hospice. He ultimately required supplemental oxygen and breathing increasingly became labored. Patient ultimately died on 4/9/21.
Age: 65.0
Sex: M
Vaccine: COVID19
Symptoms: Fall, Hypoglycaemia, Lung opacity, Mobility decreased, Neutropenia
Clinical narrative: He received his first COVID19 shot (Pfizer) reportedly on 3/2/21, then began a new chemotherapy regimen on 3/10/21. On 3/18, he fell to the floor and could not get up. He was admitted to the hospital for sepsis, pneumonia, and chemotherapy-induced neutropenia, treated on IV antibiotics and discharged on PO antibiotics. His home insulin was also decreased but continued to have hypoglycemic to hyperglycemic events. Insulin was decreased in clinic afterward and was compliant on antibiotics. Returned to hospital again a few days later for sepsis and pneumonia/effusion. He later went to a nursing facility / on hospice. He ultimately required supplemental oxygen and breathing increasingly became labored. Patient ultimately died on 4/9/21.
Age: 65.0
Sex: M
Vaccine: COVID19
Symptoms: Pleural effusion, Pneumonia, Pulmonary mass, Sepsis
Clinical narrative: He received his first COVID19 shot (Pfizer) reportedly on 3/2/21, then began a new chemotherapy regimen on 3/10/21. On 3/18, he fell to the floor and could not get up. He was admitted to the hospital for sepsis, pneumonia, and chemotherapy-induced neutropenia, treated on IV antibiotics and discharged on PO antibiotics. His home insulin was also decreased but continued to have hypoglycemic to hyperglycemic events. Insulin was decreased in clinic afterward and was compliant on antibiotics. Returned to hospital again a few days later for sepsis and pneumonia/effusion. He later went to a nursing facility / on hospice. He ultimately required supplemental oxygen and breathing increasingly became labored. Patient ultimately died on 4/9/21.
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: Computerised tomogram, Electrocardiogram ambulatory, Hemiplegia, Hypertension, Impaired work ability
Clinical narrative: I called a message that patient had experienced a stroke recently and had also rececived the Jansson vaccine. I called patient, who had reported that it happened on 4/2. She had woke up and couldn't put her robe on. Her left arm was not working right. She also noted  that she had drooled. She kept thinking that she was find and got ready and went to work. During work she was typing and found that her left hand was not working still, but still went throughout her day and typed with her right hand. Later that evening when she got home, her husband took her to the ER. There, she reports that her blood pressure was through the roof. She had a CT scan and MRI and labs done and was diagnosed with a TIA. She was started on Plavix, baby aspirin, and was started on a statin drug (couldn't remember the name as that information was at home and she was at work at time of call). She is on a heart monitor for 4 weeks and has follow ups with her outside PCP and cardiologist. Today she states that she is feeling back to normal and has regained function on her left side. She reports that she had a headache at time that had lasted for a while. She also reports that she feels like she was having issues weeks before because her brain felt foggy and just was not thinking right.
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: Laboratory test, Loss of personal independence in daily activities, Magnetic resonance imaging, Transient ischaemic attack
Clinical narrative: I called a message that patient had experienced a stroke recently and had also rececived the Jansson vaccine. I called patient, who had reported that it happened on 4/2. She had woke up and couldn't put her robe on. Her left arm was not working right. She also noted  that she had drooled. She kept thinking that she was find and got ready and went to work. During work she was typing and found that her left hand was not working still, but still went throughout her day and typed with her right hand. Later that evening when she got home, her husband took her to the ER. There, she reports that her blood pressure was through the roof. She had a CT scan and MRI and labs done and was diagnosed with a TIA. She was started on Plavix, baby aspirin, and was started on a statin drug (couldn't remember the name as that information was at home and she was at work at time of call). She is on a heart monitor for 4 weeks and has follow ups with her outside PCP and cardiologist. Today she states that she is feeling back to normal and has regained function on her left side. She reports that she had a headache at time that had lasted for a while. She also reports that she feels like she was having issues weeks before because her brain felt foggy and just was not thinking right.
Age: 62.0
Sex: M
Vaccine: COVID19
Symptoms: Cardiac arrest, Death
Clinical narrative: death Narrative:  Patient received Moderna Covid #1 on 3/11/21 in his home  by nurse. On 3/25/21, a note was entered to indicate that is wife had called EMS the day before as "his heart stopped" and he passed en route to the hospital. No further details available. No autopsy results available. 13 days between date of vaccination and date of death.
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Body temperature decreased, Headache, Nasopharyngitis, Nausea
Clinical narrative: Headache, nausea, very cold - temp was 90.6 degrees.
Age: 64.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Anticoagulant therapy, Biopsy, Blood test, Cerebrovascular accident, Colonoscopy
Clinical narrative: blood clotting in legs, lungs, resulting in hospitalization. Second clotting event resulting in stroke and hospitalization, ongoing treatment and evaluation
Age: 64.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Computerised tomogram, Echocardiogram, Magnetic resonance imaging, Pulmonary thrombosis, Thrombosis
Clinical narrative: blood clotting in legs, lungs, resulting in hospitalization. Second clotting event resulting in stroke and hospitalization, ongoing treatment and evaluation
Age: 64.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Ultrasound scan, X-ray
Clinical narrative: blood clotting in legs, lungs, resulting in hospitalization. Second clotting event resulting in stroke and hospitalization, ongoing treatment and evaluation
Age: 64.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Thrombosis
Clinical narrative: blood clotting in legs, lungs, resulting in hospitalization. Second clotting event resulting in stroke and hospitalization, ongoing treatment and evaluation
Age: 47.0
Sex: M
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Unevaluable event
Clinical narrative: COVID 19 positive  asymptomatic daughter positive also.
Age: 53.0
Sex: M
Vaccine: COVID19
Symptoms: Erythema, Fatigue, Pain in extremity, Rash macular, Skin warm
Clinical narrative: Very tired day of injection with sore arm. The 15th, 3 days after shot arm, is very red and tender with a rash like area about 4? x 6?. Splotchy and warm.
Age: 53.0
Sex: M
Vaccine: COVID19
Symptoms: Tenderness
Clinical narrative: Very tired day of injection with sore arm. The 15th, 3 days after shot arm, is very red and tender with a rash like area about 4? x 6?. Splotchy and warm.
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Arthritis bacterial, Arthritis enteropathic, Arthritis reactive, Aspiration joint
Clinical narrative: Vaccine administered 4.13.21.  ED -- > Hospitalized on 4.14.21.  Septic arthritis vs. reactive arthritis vs. other -  64 y.o. female with a history of Crohn's complicated by multiple small-bowel obstructions requiring bowel resection and lysis of adhesions, chronic hyponatremia, hemochromatosis, iron deficiency anemia. She presented to the emergency department with acute left knee and wrist pain.   # Knee Pain # Wrist Pain Acute, progressive polyarthritis in the setting of recently receiving her 1st COVID vaccine.  Imaging revealed small diffusion in the left knee with concerns for septic arthritis.  Arthrocentesis with WBC count 35,000, no organisms or crystals.  Labs significant for leukocytosis and elevated CRP and ESR. Pain has progressed to involve multiple joints particularly on the left side.  Given polyarticular involvement, reactive arthritis secondary to immunization verses Crohn's disease seems likely, although cannot definitively rule out septic arthritis at this time. Plan: o Monitor off antibiotics for now o Follow blood and fluid cultures o Trend ESR, CRP o Orthopedic surgery following o Pain control with tylenol, oxycodone o Consider GI consult if picture appears consistent with Crohn's related arthropathy   # Acute on Chronic Hypo-osmolar Hyponatremia Sodium 125, baseline appears to be 125-130.  Thought to be SIADH based on past endocrinology evaluation. Plan: o Check serum, urine osm, TSH, cortisol o BMP daily o 2 L fluid restriction o Hold home spironolactone  #  Left knee and wrist pain with swelling.  Likely secondary to reactive arthritis as a side effect of 1st COVID vaccine on 04/13/2021.   White count concerning for septic arthritis of the left knee as well. # leukocytosis with elevated sed rate and CRP, possible reactive arthritis versus septic arthritis -follow-up on cultures from knee arthrocentesis.  So far shows a white blood cell count of 35000, no organisms or crystals -monitor complete blood count -orthopedics following -pain control -trend ESR, CRP -monitor peripheral blood cultures x2 -monitor off antibiotics   ORTHOPAEDIC TRAUMA CONSULT   CC:  Swollen, painful joint    A: 64 y.o. female w/ with acute onset of left pain, swelling after COVID vaccine concerning for septic arthritis vs gout vs pseudogout. Joint was aspirated, and labs are consistent with reactive arthritis. Anterior femoral cortical defect noted on XR. ESR 47, CRP 10.5, WBC 16, afebrile        Recent Labs   04/12/21 1152 04/14/21 0252 WBC 11.32* 16.31*     Recent Labs   04/14/21 0252 CREACTIVEPRO 10.5*     No results for input(s): SEDRATE in the last 72 hours.     P: -CT ordered R/o septic arthritis -Joint arthrocentesis completed in ED               -synovial fluid labs- WBC: 32K, gram stain negative, crystals negative -Plan for admission to medicine vs ED obs to monitor cultures given elevated synovial WBC  -pain control  -ESR/CRP elevated  -WBAT LLE -No abx needed at this time for knee
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Blood sodium decreased, C-reactive protein increased, Fibrous cortical defect, Hyponatraemia, Imaging procedure abnormal
Clinical narrative: Vaccine administered 4.13.21.  ED -- > Hospitalized on 4.14.21.  Septic arthritis vs. reactive arthritis vs. other -  64 y.o. female with a history of Crohn's complicated by multiple small-bowel obstructions requiring bowel resection and lysis of adhesions, chronic hyponatremia, hemochromatosis, iron deficiency anemia. She presented to the emergency department with acute left knee and wrist pain.   # Knee Pain # Wrist Pain Acute, progressive polyarthritis in the setting of recently receiving her 1st COVID vaccine.  Imaging revealed small diffusion in the left knee with concerns for septic arthritis.  Arthrocentesis with WBC count 35,000, no organisms or crystals.  Labs significant for leukocytosis and elevated CRP and ESR. Pain has progressed to involve multiple joints particularly on the left side.  Given polyarticular involvement, reactive arthritis secondary to immunization verses Crohn's disease seems likely, although cannot definitively rule out septic arthritis at this time. Plan: o Monitor off antibiotics for now o Follow blood and fluid cultures o Trend ESR, CRP o Orthopedic surgery following o Pain control with tylenol, oxycodone o Consider GI consult if picture appears consistent with Crohn's related arthropathy   # Acute on Chronic Hypo-osmolar Hyponatremia Sodium 125, baseline appears to be 125-130.  Thought to be SIADH based on past endocrinology evaluation. Plan: o Check serum, urine osm, TSH, cortisol o BMP daily o 2 L fluid restriction o Hold home spironolactone  #  Left knee and wrist pain with swelling.  Likely secondary to reactive arthritis as a side effect of 1st COVID vaccine on 04/13/2021.   White count concerning for septic arthritis of the left knee as well. # leukocytosis with elevated sed rate and CRP, possible reactive arthritis versus septic arthritis -follow-up on cultures from knee arthrocentesis.  So far shows a white blood cell count of 35000, no organisms or crystals -monitor complete blood count -orthopedics following -pain control -trend ESR, CRP -monitor peripheral blood cultures x2 -monitor off antibiotics   ORTHOPAEDIC TRAUMA CONSULT   CC:  Swollen, painful joint    A: 64 y.o. female w/ with acute onset of left pain, swelling after COVID vaccine concerning for septic arthritis vs gout vs pseudogout. Joint was aspirated, and labs are consistent with reactive arthritis. Anterior femoral cortical defect noted on XR. ESR 47, CRP 10.5, WBC 16, afebrile        Recent Labs   04/12/21 1152 04/14/21 0252 WBC 11.32* 16.31*     Recent Labs   04/14/21 0252 CREACTIVEPRO 10.5*     No results for input(s): SEDRATE in the last 72 hours.     P: -CT ordered R/o septic arthritis -Joint arthrocentesis completed in ED               -synovial fluid labs- WBC: 32K, gram stain negative, crystals negative -Plan for admission to medicine vs ED obs to monitor cultures given elevated synovial WBC  -pain control  -ESR/CRP elevated  -WBAT LLE -No abx needed at this time for knee
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Inappropriate antidiuretic hormone secretion, Joint swelling, Leukocytosis, Polyarthritis, Red blood cell sedimentation rate increased
Clinical narrative: Vaccine administered 4.13.21.  ED -- > Hospitalized on 4.14.21.  Septic arthritis vs. reactive arthritis vs. other -  64 y.o. female with a history of Crohn's complicated by multiple small-bowel obstructions requiring bowel resection and lysis of adhesions, chronic hyponatremia, hemochromatosis, iron deficiency anemia. She presented to the emergency department with acute left knee and wrist pain.   # Knee Pain # Wrist Pain Acute, progressive polyarthritis in the setting of recently receiving her 1st COVID vaccine.  Imaging revealed small diffusion in the left knee with concerns for septic arthritis.  Arthrocentesis with WBC count 35,000, no organisms or crystals.  Labs significant for leukocytosis and elevated CRP and ESR. Pain has progressed to involve multiple joints particularly on the left side.  Given polyarticular involvement, reactive arthritis secondary to immunization verses Crohn's disease seems likely, although cannot definitively rule out septic arthritis at this time. Plan: o Monitor off antibiotics for now o Follow blood and fluid cultures o Trend ESR, CRP o Orthopedic surgery following o Pain control with tylenol, oxycodone o Consider GI consult if picture appears consistent with Crohn's related arthropathy   # Acute on Chronic Hypo-osmolar Hyponatremia Sodium 125, baseline appears to be 125-130.  Thought to be SIADH based on past endocrinology evaluation. Plan: o Check serum, urine osm, TSH, cortisol o BMP daily o 2 L fluid restriction o Hold home spironolactone  #  Left knee and wrist pain with swelling.  Likely secondary to reactive arthritis as a side effect of 1st COVID vaccine on 04/13/2021.   White count concerning for septic arthritis of the left knee as well. # leukocytosis with elevated sed rate and CRP, possible reactive arthritis versus septic arthritis -follow-up on cultures from knee arthrocentesis.  So far shows a white blood cell count of 35000, no organisms or crystals -monitor complete blood count -orthopedics following -pain control -trend ESR, CRP -monitor peripheral blood cultures x2 -monitor off antibiotics   ORTHOPAEDIC TRAUMA CONSULT   CC:  Swollen, painful joint    A: 64 y.o. female w/ with acute onset of left pain, swelling after COVID vaccine concerning for septic arthritis vs gout vs pseudogout. Joint was aspirated, and labs are consistent with reactive arthritis. Anterior femoral cortical defect noted on XR. ESR 47, CRP 10.5, WBC 16, afebrile        Recent Labs   04/12/21 1152 04/14/21 0252 WBC 11.32* 16.31*     Recent Labs   04/14/21 0252 CREACTIVEPRO 10.5*     No results for input(s): SEDRATE in the last 72 hours.     P: -CT ordered R/o septic arthritis -Joint arthrocentesis completed in ED               -synovial fluid labs- WBC: 32K, gram stain negative, crystals negative -Plan for admission to medicine vs ED obs to monitor cultures given elevated synovial WBC  -pain control  -ESR/CRP elevated  -WBAT LLE -No abx needed at this time for knee
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Synovial fluid white blood cells positive, White blood cell count increased, X-ray limb abnormal
Clinical narrative: Vaccine administered 4.13.21.  ED -- > Hospitalized on 4.14.21.  Septic arthritis vs. reactive arthritis vs. other -  64 y.o. female with a history of Crohn's complicated by multiple small-bowel obstructions requiring bowel resection and lysis of adhesions, chronic hyponatremia, hemochromatosis, iron deficiency anemia. She presented to the emergency department with acute left knee and wrist pain.   # Knee Pain # Wrist Pain Acute, progressive polyarthritis in the setting of recently receiving her 1st COVID vaccine.  Imaging revealed small diffusion in the left knee with concerns for septic arthritis.  Arthrocentesis with WBC count 35,000, no organisms or crystals.  Labs significant for leukocytosis and elevated CRP and ESR. Pain has progressed to involve multiple joints particularly on the left side.  Given polyarticular involvement, reactive arthritis secondary to immunization verses Crohn's disease seems likely, although cannot definitively rule out septic arthritis at this time. Plan: o Monitor off antibiotics for now o Follow blood and fluid cultures o Trend ESR, CRP o Orthopedic surgery following o Pain control with tylenol, oxycodone o Consider GI consult if picture appears consistent with Crohn's related arthropathy   # Acute on Chronic Hypo-osmolar Hyponatremia Sodium 125, baseline appears to be 125-130.  Thought to be SIADH based on past endocrinology evaluation. Plan: o Check serum, urine osm, TSH, cortisol o BMP daily o 2 L fluid restriction o Hold home spironolactone  #  Left knee and wrist pain with swelling.  Likely secondary to reactive arthritis as a side effect of 1st COVID vaccine on 04/13/2021.   White count concerning for septic arthritis of the left knee as well. # leukocytosis with elevated sed rate and CRP, possible reactive arthritis versus septic arthritis -follow-up on cultures from knee arthrocentesis.  So far shows a white blood cell count of 35000, no organisms or crystals -monitor complete blood count -orthopedics following -pain control -trend ESR, CRP -monitor peripheral blood cultures x2 -monitor off antibiotics   ORTHOPAEDIC TRAUMA CONSULT   CC:  Swollen, painful joint    A: 64 y.o. female w/ with acute onset of left pain, swelling after COVID vaccine concerning for septic arthritis vs gout vs pseudogout. Joint was aspirated, and labs are consistent with reactive arthritis. Anterior femoral cortical defect noted on XR. ESR 47, CRP 10.5, WBC 16, afebrile        Recent Labs   04/12/21 1152 04/14/21 0252 WBC 11.32* 16.31*     Recent Labs   04/14/21 0252 CREACTIVEPRO 10.5*     No results for input(s): SEDRATE in the last 72 hours.     P: -CT ordered R/o septic arthritis -Joint arthrocentesis completed in ED               -synovial fluid labs- WBC: 32K, gram stain negative, crystals negative -Plan for admission to medicine vs ED obs to monitor cultures given elevated synovial WBC  -pain control  -ESR/CRP elevated  -WBAT LLE -No abx needed at this time for knee
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Inappropriate schedule of product administration, Interchange of vaccine products, Malaise, Pyrexia
Clinical narrative: Patient was inadvertently administered a Pfizer vaccine 8 days after receiving a Moderna vaccine at another provider. The patient contacted the clinic one week later and stated that she had been feeling ill since receiving the second vaccine. She reported that she had been having fevers and general malaise.
Age: 81.0
Sex: F
Vaccine: COVID19
Symptoms: Cerebral venous sinus thrombosis, Headache, Platelet count decreased
Clinical narrative: Pt was diagnosed with cerebral venous sinus thrombosis on 3/25/21 after having severe HA x 3 days.  Looing back, she had a cbc for other reasons on 2/24/21 (3 days after her 2nd Covid vaccine) that showed a drop in platelets to 126,000 (although platelets in 2020 were 150,000)
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Haemoptysis
Clinical narrative: Patient reports coughing up small amounts of blood between 10 & 24 hours post-vaccination.  The patient reports that the issue was not present prior to vaccination & resolved after the 24 hour period.  She did not seek further medical treatment at the time & did not report the reaction to the pharmacy until the time of her second dose of the vaccine.  The patient did receive the second vaccine dose & has been instructed to report any issues to the pharmacy promptly.
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Blood test normal, Epistaxis
Clinical narrative: 19 days after receiving vaccine I had a nose bleed that I couldn?t stop and neither could ER until they packed my nose after four hours of continued bleeding. I never had a nosebleed before and have had one weekly since then.
Age: 51.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Amnesia, Asthenia, Dizziness, Electrocardiogram, Headache
Clinical narrative: Dizziness, Nausea, lost feeling in legs, unable to use muscle in left leg for about 4 hours, weakness, headache, brief loss of memory.
Age: 51.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Hypoaesthesia, Mobility decreased, Nausea
Clinical narrative: Dizziness, Nausea, lost feeling in legs, unable to use muscle in left leg for about 4 hours, weakness, headache, brief loss of memory.
Age: 51.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Dizziness, Dyspnoea, Electrocardiogram, Hypoaesthesia, Nausea
Clinical narrative: Dizziness, Nausea, lost feeling in legs, unable to use muscle in left leg for about 4 hours, weakness, headache, brief loss of memory.
Age: 51.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Tremor
Clinical narrative: Dizziness, Nausea, lost feeling in legs, unable to use muscle in left leg for about 4 hours, weakness, headache, brief loss of memory.
Age: 62.0
Sex: F
Vaccine: UNK
Symptoms: Blood glucose normal, COVID-19, Cardio-respiratory arrest, Death, Dyspnoea
Clinical narrative: Patient received Covid vaccine (Jansen) in early March. Patient was diagnosed 7 to 10 days later with Covid. Patient self quarantined for 14 days. One week prior to ED visit patient had exertional dyspnea and SOB. Came to hospital ED and admitted to floor. Twelve hours later patient coded and expired of PE
Age: 62.0
Sex: F
Vaccine: UNK
Symptoms: Dyspnoea exertional, Fibrin D dimer increased, Platelet count normal, SARS-CoV-2 test negative, Ventilation/perfusion scan normal
Clinical narrative: Patient received Covid vaccine (Jansen) in early March. Patient was diagnosed 7 to 10 days later with Covid. Patient self quarantined for 14 days. One week prior to ED visit patient had exertional dyspnea and SOB. Came to hospital ED and admitted to floor. Twelve hours later patient coded and expired of PE
Age: 55.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Hypoaesthesia, Joint injury, Joint range of motion decreased, Muscular weakness
Clinical narrative: Woke up morning after injection with shoulder pain which increased in intensity with evolving decrease in ROM over the course of the following months.  I saw Dr. on March 18 and was diagnosed with L glenohumeral joint injury and had a L shoulder x-ray.  Pain continued to increase upon movement = severe L shoulder joint pain with radiating nerve pain down outside of left arm to elbow and left-hand numbness and weakness.  Waking up several times in the night in excruciating pain from having moved joint in my sleep.  Per Dr.  I went to PT who diagnosed it as frozen shoulder.  I started on a prednisone taper on April 2 and subsequent physical therapy.   I am continuing with pain and decrease ROM although improved after steroid course.  I am also continuing with physical therapy.
Age: 55.0
Sex: F
Vaccine: COVID19
Symptoms: Neuralgia, Pain, Periarthritis, Sleep disorder, X-ray limb normal
Clinical narrative: Woke up morning after injection with shoulder pain which increased in intensity with evolving decrease in ROM over the course of the following months.  I saw Dr. on March 18 and was diagnosed with L glenohumeral joint injury and had a L shoulder x-ray.  Pain continued to increase upon movement = severe L shoulder joint pain with radiating nerve pain down outside of left arm to elbow and left-hand numbness and weakness.  Waking up several times in the night in excruciating pain from having moved joint in my sleep.  Per Dr.  I went to PT who diagnosed it as frozen shoulder.  I started on a prednisone taper on April 2 and subsequent physical therapy.   I am continuing with pain and decrease ROM although improved after steroid course.  I am also continuing with physical therapy.
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Cerebral infarction, Dizziness, Limb discomfort, Vomiting
Clinical narrative: Patient reported to ED with severe dizziness, emesis and left arm heaviness that started at about noon on 4/1/21.  Found to have a cerebral infarct.
Age: 66.0
Sex: F
Vaccine: COVID19
Symptoms: Biopsy, Injection site reaction, Squamous cell carcinoma of skin
Clinical narrative: Patient developed squamous cell carcinoma at injection site.  Patient is scheduled for a consult for excision.
Age: 36.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site erythema, Injection site mass, Injection site pain, Injection site pruritus
Clinical narrative: 8 days after the vaccine I experienced severe itchiness at injection site. The area is extremely red and tender. There is a hard lump there too. Upon researching I learned that it is most likely "Covid arm" and that I should report it.
Age: 23.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Headache, Injection site erythema, Injection site pruritus, Injection site swelling
Clinical narrative: April 12: Woke up with low grade fever, headache and exhaustion.  April 13: Same symptoms. Rapid test for COVID 19 came out negative.  April 14: vomiting but other symptoms gone.  April 15: injection site red, hot, swollen and itchy. Previously had disappeared.
Age: 23.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site warmth, Pyrexia, SARS-CoV-2 test negative, Vomiting
Clinical narrative: April 12: Woke up with low grade fever, headache and exhaustion.  April 13: Same symptoms. Rapid test for COVID 19 came out negative.  April 14: vomiting but other symptoms gone.  April 15: injection site red, hot, swollen and itchy. Previously had disappeared.
Age: 75.0
Sex: F
Vaccine: COVID19
Symptoms: Asthenia, Hypoaesthesia, Immediate post-injection reaction, Paraesthesia
Clinical narrative: Left sided numbness, tingling and weakness immediately after vaccine. Some wax and waning persistent symptoms most localized to left arm/elbow several weeks later.
Age: 39.0
Sex: M
Vaccine: COVID19
Symptoms: Headache, Pyrexia
Clinical narrative: Had extreme headache the night of the shot. Recorded fever 103.4 via ear. Fever reduced to 100 in the late morning next day, and was down to 99 by evening. Headache was also better by the evening. Timeline: Shot: 11:45 am light fever: 11:30 pm (after 12 hours of the shot) recorded high fever, extreme headache: 4 am medium fever, medium headache: 1 pm light fever, light headache: 8 pm (36 hours after shot)
Age: 85.0
Sex: M
Vaccine: COVID19
Symptoms: Arteriogram carotid abnormal, Carotid angioplasty, Carotid artery occlusion, Carotid artery stenosis, Cerebrovascular accident
Clinical narrative: Presented with CVA.   CTA showed large segment occlusion of L ICA,  S/P  thrombectomy and carotid angioplasty by IR. Residual L internal carotid 70% stenosis post procedure
Age: 85.0
Sex: M
Vaccine: COVID19
Symptoms: Condition aggravated, Thrombectomy
Clinical narrative: Presented with CVA.   CTA showed large segment occlusion of L ICA,  S/P  thrombectomy and carotid angioplasty by IR. Residual L internal carotid 70% stenosis post procedure
Age: 46.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Headache, Neck pain, Pain
Clinical narrative: Patient developed headache, body aches, fatigue starting a few hours after the vaccine. Over the next week the headache increased with pulsing pain at temples and back of neck. temp 98.5 HR 66. Sat 98%. No focal neurologic deficits on exam 4/15/21 at 9:30 am.
Age: 93.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Arthralgia, Delirium, Dizziness, Pain in extremity, Proctalgia
Clinical narrative: K62.89 - Rectal pain R42 - Dizziness R41.0 - Delirium R55 - Syncope R77.8 - Elevated troponin M25.552 - Left hip pain Z86.2 - Hx of thrombocytopenia M79.662 - Pain in left lower leg
Age: 93.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Syncope, Troponin increased
Clinical narrative: K62.89 - Rectal pain R42 - Dizziness R41.0 - Delirium R55 - Syncope R77.8 - Elevated troponin M25.552 - Left hip pain Z86.2 - Hx of thrombocytopenia M79.662 - Pain in left lower leg
Age: 45.0
Sex: M
Vaccine: COVID19
Symptoms: Cough
Clinical narrative: Had a dry cough for over 8 weeks
Age: 41.0
Sex: F
Vaccine: COVID19
Symptoms: Asthenia, Blood pressure increased, Diarrhoea, Dizziness, Headache
Clinical narrative: Dizziness, headache, diarrhea, nausea, feeling of weakness. Elevated BP 160/100.
Age: 41.0
Sex: F
Vaccine: COVID19
Symptoms: Nausea
Clinical narrative: Dizziness, headache, diarrhea, nausea, feeling of weakness. Elevated BP 160/100.
Age: 29.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19
Clinical narrative: COVID positive asymptomatic
Age: 20.0
Sex: F
Vaccine: COVID19
Symptoms: Diarrhoea, Dizziness, Headache
Clinical narrative: Slight headache/dizziness, diarhhea
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Adverse reaction, Choking sensation, Swollen tongue
Clinical narrative: ON 4/4/21, THE PATIENT REPORTED THAT HER TONGUE SWELLED TO THE POINT SHE THOUGHT SHE WOULD CHOKE.  SHE WENT TO THE ER AND WAS ADMITTED OVERNIGHT FOR TREATMENT.  SHE STATED THAT HER PCP THOUGHT IT WAS AN ADVERSE REACTION TO HER BP MED (LISINOPRIL).  SHE DID NOT REPORT GETTING THE SECOND DOSE OF MODERNA VACCINE TO HER PCP AT THAT TIME.  SHE SAYS SHE IS PLANNING TO TELL HER PCP AT HER FOLLOW-UP APPT THIS WEEK.
Age: 32.0
Sex: F
Vaccine: COVID19
Symptoms: Confusional state, Dizziness, Nausea
Clinical narrative: Dizziness/lightheadedness, nausea, mild confusion
Age: 53.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Arthralgia, Eye pain, Mobility decreased, Movement disorder, Pain in extremity
Clinical narrative: After first dose, "normal" side effects of extremely sore arm, headache lasting one day.  After second dose, fever to 101.5 at 1:00am after receiving shot at 3:00pm previous day. Extreme arm and shoulder pain. Waking up again at 3:00am experienced FULL BODY paralysis. Estimate fever at 103+ but was unable to move to verify. Eyes were in pain and blurry vision. unable to reach phone to call 911. These symptoms lasted 1 hour and son called to check on me and rushed over. Fever was at 101 but immediate does of motrin and then later tylenol, broke fever. Arm remained immobile for full day. Now it is mobile but still painful to lift overhead. All other symptoms subsided.
Age: 53.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Paralysis, Pyrexia, Vision blurred
Clinical narrative: After first dose, "normal" side effects of extremely sore arm, headache lasting one day.  After second dose, fever to 101.5 at 1:00am after receiving shot at 3:00pm previous day. Extreme arm and shoulder pain. Waking up again at 3:00am experienced FULL BODY paralysis. Estimate fever at 103+ but was unable to move to verify. Eyes were in pain and blurry vision. unable to reach phone to call 911. These symptoms lasted 1 hour and son called to check on me and rushed over. Fever was at 101 but immediate does of motrin and then later tylenol, broke fever. Arm remained immobile for full day. Now it is mobile but still painful to lift overhead. All other symptoms subsided.
Age: 33.0
Sex: M
Vaccine: COVID19
Symptoms: Chills
Clinical narrative: Intense shivering. Temperature in the house was 68 degree F, not an abnormal cold temperature and consistent or higher than previous days/weeks. Intense shivering lasted about 30 minutes. I wrapped myself in blankets and turned on heater but shivering lasted.
Age: 36.0
Sex: M
Vaccine: COVID19
Symptoms: Cold sweat, Electrocardiogram normal, Feeling hot, Laboratory test normal, Nausea
Clinical narrative: Patient had a syncopal episode within 10 minutes of receiving his second Moderna dose. Patient states "I sat down with my phone in my lap and started to feel clammy and hot. The next thing I remember is waking up to the pharmacy staff surrounding me". Patient was seated, alert and oriented while waiting for emergency services. He was taken to the local hospital and received Zofran for his nausea in the ambulence. Patient states that he felt normal within 30 minutes.
Age: 36.0
Sex: M
Vaccine: COVID19
Symptoms: Syncope
Clinical narrative: Patient had a syncopal episode within 10 minutes of receiving his second Moderna dose. Patient states "I sat down with my phone in my lap and started to feel clammy and hot. The next thing I remember is waking up to the pharmacy staff surrounding me". Patient was seated, alert and oriented while waiting for emergency services. He was taken to the local hospital and received Zofran for his nausea in the ambulence. Patient states that he felt normal within 30 minutes.
Age: 39.0
Sex: F
Vaccine: COVID19
Symptoms: Gaze palsy
Clinical narrative: severe headaches on almost daily basis toward end of day, have needed to take my migraine perscription medication to alleviate pain
Age: 57.0
Sex: F
Vaccine: COVID19
Symptoms: Erythema, Injection site erythema, Injection site pruritus, Injection site swelling, Pain
Clinical narrative: She got her vaccine, her side of her leg was sore, but then noticed on the right leg redness that is baseball size, and the lump itself is golfball size, and now it's itching, purple red spotted area. The next day she was achy and slept all day.   Two days later she then on the left leg has a lump on her calf towards the backside, about 1" below the bend of the knee which is another lump, redness around it about the size of a quarter.  This morning when she woke up and the right shoulder at the injection site is itching, redness and lump area is getting bigger about the size of a quarter and hot to touch.  The redness on the leg is getting bigger.   Said that she will take a Benadryl tonight for the reaction.   She did talk to her doctor who told her to contact us.
Age: 57.0
Sex: F
Vaccine: COVID19
Symptoms: Pain in extremity, Peripheral swelling, Pruritus
Clinical narrative: She got her vaccine, her side of her leg was sore, but then noticed on the right leg redness that is baseball size, and the lump itself is golfball size, and now it's itching, purple red spotted area. The next day she was achy and slept all day.   Two days later she then on the left leg has a lump on her calf towards the backside, about 1" below the bend of the knee which is another lump, redness around it about the size of a quarter.  This morning when she woke up and the right shoulder at the injection site is itching, redness and lump area is getting bigger about the size of a quarter and hot to touch.  The redness on the leg is getting bigger.   Said that she will take a Benadryl tonight for the reaction.   She did talk to her doctor who told her to contact us.
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
Clinical narrative: APPROXIMATELY 11 HOURS AFTER RECEIVING VACCINE CLIENT WOKE UP WITH A  RED RAISED , WARM,  PAINFUL SMALL AREA AT SITE OF VACCINATION. THIS AREA HAS GOTTEN BIGGER AND MORE PAINFUL WITH INCREASED REDDNESS AND RAISED AERA. 04/14/2021 CLIENT PRESENTS WITH THESE S/S,  AREA MEASURES 5 INCHES BY 7.25 INCHES.
Age: 28.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Pharyngeal swelling, Swollen tongue, Tonsillar hypertrophy
Clinical narrative: Patient reported throat/tonsils swelling, patient was monitored for 10 minutes.  Then patient reported tongue swelling, patient was talking normal, able to swallow.  Vital signs: HR: 72, O2: 98.  EMS called, 25mg Benadryl IM given.  Patient transferred to  Hospital .
Age: 28.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Blood pressure increased, Dizziness, Dyspnoea, Feeling cold, Paraesthesia
Clinical narrative: Patient reported throat/tonsils swelling, patient was monitored for 10 minutes.  Then patient reported tongue swelling, patient was talking normal, able to swallow.  Vital signs: HR: 72, O2: 98.  EMS called, 25mg Benadryl IM given.  Patient transferred to  Hospital .
Age: 28.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Pharyngeal hypoaesthesia, Pharyngeal paraesthesia, Pharyngeal swelling, Swollen tongue, Urticaria
Clinical narrative: Patient reported throat/tonsils swelling, patient was monitored for 10 minutes.  Then patient reported tongue swelling, patient was talking normal, able to swallow.  Vital signs: HR: 72, O2: 98.  EMS called, 25mg Benadryl IM given.  Patient transferred to  Hospital .
Age: 88.0
Sex: F
Vaccine: COVID19
Symptoms: Erythema, Peripheral swelling
Clinical narrative: covid arm- red and swollen that started 9 days after the dose
Age: 52.0
Sex: M
Vaccine: COVID19
Symptoms: Dyspnoea, Ear pain
Clinical narrative: I experienced two days later bad earaches for some hours. I also had SOB.   Today, I am applying ear drops in my ear due to my ear aches.