chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 35.0
Sex: M
Vaccine: HEP
Symptoms: Abdominal distension, Arthralgia, Diarrhoea, Flatulence, Loss of consciousness
Clinical narrative: Acute pain in shoulder for a month where shot was administered.  Furthermore, after the third shot, within a couple weeks patient developed severe joint pain all across body.  However, at this time the worst reaction has been gastro-intestinal with bloating, cramps, and gas that developed within two weeks.  The onset of the gastro-intestinal problems required immediate healthcare attention as patient was losing consciousness over the severe abdominal conditions.  Note that after each of the first two shots there was extended pain and gastro problems though not to the extent after the third shot.   On a different note, there has been muscle/fat loss in certain places on body that have occurred since the first shot.  It is not known at this time whether this is gasto-related, a neuro-muscular problem, or other cause.  Lastly, note that none of the above symptons had ever been seen in prior 35 years.  An "auto-immune"-like mechanism is suspected as both the direct and indirect cause of the above symptons.  Tests are being done to baseline the patient and track whether or not health further declines. Nausea/Diarrhea. Follow Up: Pt still has chronic problems with stomach and muscles (weakness, etc.). The patient was lied to with respect to taking the vaccination. Pt was told that it was a state law, however the patient, as a gruaduate student, was not required to take the vaccination. The law goes into effect for 2005; patient vaccinations began in 2002. Furthermore, patient has very low/non existent risk for acquiring Hep B. There need to be a better way of doing this: someone who is 35 and at no risk should not be lied to and then told to take a vaccination. the policy is dicriminatory as well as non-student aged 35 are not forced to take the vaccination.
Age: 35.0
Sex: M
Vaccine: HEP
Symptoms: Muscle spasms, Muscular weakness, Nausea, Pain
Clinical narrative: Acute pain in shoulder for a month where shot was administered.  Furthermore, after the third shot, within a couple weeks patient developed severe joint pain all across body.  However, at this time the worst reaction has been gastro-intestinal with bloating, cramps, and gas that developed within two weeks.  The onset of the gastro-intestinal problems required immediate healthcare attention as patient was losing consciousness over the severe abdominal conditions.  Note that after each of the first two shots there was extended pain and gastro problems though not to the extent after the third shot.   On a different note, there has been muscle/fat loss in certain places on body that have occurred since the first shot.  It is not known at this time whether this is gasto-related, a neuro-muscular problem, or other cause.  Lastly, note that none of the above symptons had ever been seen in prior 35 years.  An "auto-immune"-like mechanism is suspected as both the direct and indirect cause of the above symptons.  Tests are being done to baseline the patient and track whether or not health further declines. Nausea/Diarrhea. Follow Up: Pt still has chronic problems with stomach and muscles (weakness, etc.). The patient was lied to with respect to taking the vaccination. Pt was told that it was a state law, however the patient, as a gruaduate student, was not required to take the vaccination. The law goes into effect for 2005; patient vaccinations began in 2002. Furthermore, patient has very low/non existent risk for acquiring Hep B. There need to be a better way of doing this: someone who is 35 and at no risk should not be lied to and then told to take a vaccination. the policy is dicriminatory as well as non-student aged 35 are not forced to take the vaccination.
Age: 23.0
Sex: F
Vaccine: SMALL
Symptoms: Erythema, Oedema, Post vaccination autoinoculation, Pruritus, Rash vesicular
Clinical narrative: Possible inadvertant autoinoculation of right hand. Development of itching, erythema, and swelling around DIP and PIP joint on palmar surface of 5th finger (little finger) of right hand on day 4 post-vaccination. Development of two additional lesions on medial side of right hand near MP joint. Lesions progreesing; now with vesicles. No fever. No other similar lesions except at left deltoid vaccination site. No ocular or peri-ocular lesions. No fever or other systemic symptoms reported.
Age: 23.0
Sex: F
Vaccine: SMALL
Symptoms: Vaccination complication
Clinical narrative: Possible inadvertant autoinoculation of right hand. Development of itching, erythema, and swelling around DIP and PIP joint on palmar surface of 5th finger (little finger) of right hand on day 4 post-vaccination. Development of two additional lesions on medial side of right hand near MP joint. Lesions progreesing; now with vesicles. No fever. No other similar lesions except at left deltoid vaccination site. No ocular or peri-ocular lesions. No fever or other systemic symptoms reported.
Age: 1.0
Sex: M
Vaccine: MMR, VARCEL
Symptoms: Abnormal behaviour, Anorexia, Faecal incontinence, Pyrexia, Restlessness
Clinical narrative: Son was immunized on 4/28/03 with the MMR and Varivax vaccinations.  At approximately 11 p.m. of Tuesday, 4/29/03 -- baby began to run a high fever (never had a fever before in his life) of 102 to 103 degrees.  Treated the fever with Tylenol and Motrin (alternately).  Stared alot into space and was at time very restless.  Temperature would not go down to normal, with Tylenol/Motrin would go down to 100 degrees.  Fever continued entire day of Wednesday, and Thursday - took him to doctor on Thursday -- ran bloodwork and everything came back normal. ONLY Nursed him to keep him hydrated -- would not eat (my son has a tremendous appetite and this is very unusual as he loves to eat everything he sees).  Fever dissipated on Friday morning, May 2nd, 2003 and began to have profuse bowel movements -- very runny and smelly. Appetite still not normal. Saturday, May 3rd -- baby began to cry inconsolably at about 11 p.m. - would not nurse and there is nothing we could do to make him feel better.  Our baby is not the baby that we knew prior to the vaccinations.  His behavior is completely different and he is not the happy baby he used to be.  He is very miserable.  My husband just left with him to the Hospital emergency room at midnight.
Age: 1.0
Sex: M
Vaccine: MMR, VARCEL
Symptoms: Staring
Clinical narrative: Son was immunized on 4/28/03 with the MMR and Varivax vaccinations.  At approximately 11 p.m. of Tuesday, 4/29/03 -- baby began to run a high fever (never had a fever before in his life) of 102 to 103 degrees.  Treated the fever with Tylenol and Motrin (alternately).  Stared alot into space and was at time very restless.  Temperature would not go down to normal, with Tylenol/Motrin would go down to 100 degrees.  Fever continued entire day of Wednesday, and Thursday - took him to doctor on Thursday -- ran bloodwork and everything came back normal. ONLY Nursed him to keep him hydrated -- would not eat (my son has a tremendous appetite and this is very unusual as he loves to eat everything he sees).  Fever dissipated on Friday morning, May 2nd, 2003 and began to have profuse bowel movements -- very runny and smelly. Appetite still not normal. Saturday, May 3rd -- baby began to cry inconsolably at about 11 p.m. - would not nurse and there is nothing we could do to make him feel better.  Our baby is not the baby that we knew prior to the vaccinations.  His behavior is completely different and he is not the happy baby he used to be.  He is very miserable.  My husband just left with him to the Hospital emergency room at midnight.
Age: 21.0
Sex: U
Vaccine: VARCEL
Symptoms: Unevaluable event
Clinical narrative: Vaccination given prior to or during first two weeks of pregnancy. Registration for tracking purpose
Age: 0.3
Sex: M
Vaccine: DTAP, HEP, IPV, PNC, DTAP, HEP, IPV, PNC, DTAP, HEP, IPV, PNC
Symptoms: Autopsy, Sudden infant death syndrome
Clinical narrative: Information received at manufacturer on 3/3/03 (HQWYE172204FEB03) regarding an event that happened concerning a 4 month old male pt who received IPOL on 9/5/02. The lot number and site/route for the vaccination was not reported. The pt died on 9/26/02 from sudden infant death syndrome. From additional info received on 4/24/03, it was reported that the pt also received Prevnar, DTaP and Hep B vaccine on 9/5/02. The manufacturer, lot number and route/site were all not reported for hep B vaccine and DTaP. Prevnar was given IM. Autopsy results showed sudden infant death syndrome as reported as cause of death.
Age: 0.3
Sex: M
Vaccine: DTAP, HEP, IPV, PNC, DTAP, HEP, IPV, PNC, DTAP, HEP, IPV, PNC
Symptoms: Sudden infant death syndrome
Clinical narrative: Information received at manufacturer on 3/3/03 (HQWYE172204FEB03) regarding an event that happened concerning a 4 month old male pt who received IPOL on 9/5/02. The lot number and site/route for the vaccination was not reported. The pt died on 9/26/02 from sudden infant death syndrome. From additional info received on 4/24/03, it was reported that the pt also received Prevnar, DTaP and Hep B vaccine on 9/5/02. The manufacturer, lot number and route/site were all not reported for hep B vaccine and DTaP. Prevnar was given IM. Autopsy results showed sudden infant death syndrome as reported as cause of death.
Age: 1.08
Sex: M
Vaccine: VARCEL, HIBV, MMR, VARCEL
Symptoms: Febrile convulsion, Pyrexia, Viral infection
Clinical narrative: Information has been received from research (manuf control #HQWYE740318APR03) concerning a 13 month old male who on 10/9/02 was vaccinated with a dose of varicella virus vaccine live. On 10/18/02 the pt developed viral syndrome and febrile seizures. Upon internal review, it has been determined that viral syndrome and febrile seizures were considered to be other important medical events (OMIC). Additional info has been requested.  A 15-day follow up report received 7/3/2003 adds: Follow up info from a health professional indicated that the pt is enrolled in a Wyeth IND study (study title not provided). Therefore, this is not a spontaneous report and only limited info is available. Additionally, the investigator felt that the adverse events were related to the vaccination with varicella virus vaccine live and measles virus vaccine live (+) mumps virus vaccine live (+) rubella virus vaccine live (second generation) (MSD). Upon internal review, it has been determined that viral syndrome and febrile seizures were considered to be other important medical events. The case is closed.
Age: 1.08
Sex: M
Vaccine: VARCEL, HIBV, MMR, VARCEL
Symptoms: Febrile convulsion, Viral infection
Clinical narrative: Information has been received from research (manuf control #HQWYE740318APR03) concerning a 13 month old male who on 10/9/02 was vaccinated with a dose of varicella virus vaccine live. On 10/18/02 the pt developed viral syndrome and febrile seizures. Upon internal review, it has been determined that viral syndrome and febrile seizures were considered to be other important medical events (OMIC). Additional info has been requested.  A 15-day follow up report received 7/3/2003 adds: Follow up info from a health professional indicated that the pt is enrolled in a Wyeth IND study (study title not provided). Therefore, this is not a spontaneous report and only limited info is available. Additionally, the investigator felt that the adverse events were related to the vaccination with varicella virus vaccine live and measles virus vaccine live (+) mumps virus vaccine live (+) rubella virus vaccine live (second generation) (MSD). Upon internal review, it has been determined that viral syndrome and febrile seizures were considered to be other important medical events. The case is closed.
Age: 22.0
Sex: M
Vaccine: IPV, RAB, YF
Symptoms: Haematocrit decreased, Platelet count decreased, Pyrexia
Clinical narrative: Pt hospitalized with fever of unknown origin, drop in platelets and hematocrit. Probable diagnosis was ? but subsequent ? testing negative. Serums (acute-convalescent) sent to lab. Acute: o convalescent: 1:1600.
Age: 0.3
Sex: M
Vaccine: DTAP, HIBV, IPV, PNC
Symptoms: Convulsion, Pyrexia
Clinical narrative: Prolonged generalized seizure following administration of DTaP, IPV, Prevnar, HIB requiring admission to PICU for intubation/ventilation, seizure medication.
Age: 1.0
Sex: F
Vaccine: MMR, VARCEL
Symptoms: Pyrexia, Viral infection, Vomiting, Wheezing
Clinical narrative: Fever to 103.6 at home 39.7 ion Er (41.7) after receiving x 1 day. emesis. No rash no resp. distress initially. In hospital, developed slight wheeze (resolved and albuterol nebs and po prednisone). Continued febrile until started ceftiocoreal abd + DXR fils neg for ? and c/w viral illness.
Age: 10.0
Sex: F
Vaccine: HEP
Symptoms: Anorexia, Apnoea, Atelectasis, CSF test abnormal, Dyspnoea
Clinical narrative: About one month after vaccination, mountain viral illness/strep 1 day later with peripheral neurologic symptoms. GBS severe. A 60-day follow up report received 7/31/2003 adds: Severe Guillain-Barre still with considerable defects both motor and respiratory. Are there any other similar occurrences? Please advise. The discharge summary received on 12/31/03 states respiratory distress, and atelectasis. Follow up in 2004: No information reported. Severe pain. Medical records state hypertension, respiratory failure, pancreatitis, neurogenic bowel, failure to thrive, nausea, vomiting and left-sided weakness. msv
Age: 10.0
Sex: F
Vaccine: HEP
Symptoms: Guillain-Barre syndrome, Hemiparesis, Hypertension, Nausea, Neuropathy
Clinical narrative: About one month after vaccination, mountain viral illness/strep 1 day later with peripheral neurologic symptoms. GBS severe. A 60-day follow up report received 7/31/2003 adds: Severe Guillain-Barre still with considerable defects both motor and respiratory. Are there any other similar occurrences? Please advise. The discharge summary received on 12/31/03 states respiratory distress, and atelectasis. Follow up in 2004: No information reported. Severe pain. Medical records state hypertension, respiratory failure, pancreatitis, neurogenic bowel, failure to thrive, nausea, vomiting and left-sided weakness. msv
Age: 10.0
Sex: F
Vaccine: HEP
Symptoms: Neuropathy peripheral, Pain, Pancreatitis, Viral infection, Vomiting
Clinical narrative: About one month after vaccination, mountain viral illness/strep 1 day later with peripheral neurologic symptoms. GBS severe. A 60-day follow up report received 7/31/2003 adds: Severe Guillain-Barre still with considerable defects both motor and respiratory. Are there any other similar occurrences? Please advise. The discharge summary received on 12/31/03 states respiratory distress, and atelectasis. Follow up in 2004: No information reported. Severe pain. Medical records state hypertension, respiratory failure, pancreatitis, neurogenic bowel, failure to thrive, nausea, vomiting and left-sided weakness. msv
Age: 2.5
Sex: M
Vaccine: PNC
Symptoms: Guillain-Barre syndrome, Nervous system disorder
Clinical narrative: Progressive neurologic deterioration within 24 on vaccine. In ICU. Guillain Barre. A 60-day follow up report received 7/29/2003 adds: pt recovered. Follow up on 6/9/04: states unknown whether pt recovered. "Pt transferred secondary to moving".
Age: 46.0
Sex: F
Vaccine: ANTH
Symptoms: Dermatitis, Sinus bradycardia
Clinical narrative: Dermatitis under breast left axilla and posterior left knee. Worse following vaccine. The follow up received on 5/27/03 states this vaccine was provided at a facility. I do not have access to that information.
Age: 26.0
Sex: M
Vaccine: ANTH
Symptoms: Injection site erythema, Injection site oedema
Clinical narrative: 20 x 24cm red and swollen at vaccine site right arm
Age: 1.0
Sex: M
Vaccine: MMR, VARCEL
Symptoms: Rash
Clinical narrative: Small rashes on trunk today . Some on extremities.
Age: 5.0
Sex: M
Vaccine: DTAP
Symptoms: Injection site erythema, Injection site oedema, Injection site pain, Injection site warmth
Clinical narrative: Right arm deltoid area, red, swollen, warm to touch, painful.
Age: 1.2
Sex: M
Vaccine: DTAP, HEP, HIBV
Symptoms: Injection site erythema, Injection site oedema
Clinical narrative: Swelling to left thigh and redness 9 1/2 cm x 5 cm
Age: 46.0
Sex: M
Vaccine: TTOX
Symptoms: Gingival bleeding
Clinical narrative: Vaccine administered at 11:00. Pt returned to office at 3 PM with gums bleeding. Examined by MD. Dx: bleeding spontaneous, etiology undetermined.
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMR
Symptoms: Erythema, Oedema
Clinical narrative: Left upper thigh, large area of edema and erythema. No evidence of infection at site
Age: 20.0
Sex: M
Vaccine: ANTH
Symptoms: Joint range of motion decreased, Oedema
Clinical narrative: Received anthrax vaccine left arm on 25 April. Started having problem 25 April - 27 April. Inability to move left arm.  Had alot of swelling.
Age: 4.0
Sex: M
Vaccine: DTAP, IPV, MMR
Symptoms: Body temperature increased, Injection site erythema, Injection site pain
Clinical narrative: 3/26/03: Mom phoned clinic - 40 redness/tenderness left upper arm, elevated temp in child. Tx: apply Neosporin to area and wrap with plastic wrap for several hours - bring child in to clinic for nurse to assess. Mother did not bring child in - ct on 3/28/03  Mom stated. Redness/tenderness resolved by 3/26/03 PM.
Age: 69.0
Sex: F
Vaccine: TTOX
Symptoms: Discomfort, Injection site hypersensitivity, Injection site pain, Injection site warmth, Pruritus
Clinical narrative: Some twinge of discomfort first 1-2 days after shot. One week after injection. Red raised, itching from site to elbow , hot tender- no other symptoms. Woke up pt with itching. Pt does not really any recent injection but has had before.
Age: 69.0
Sex: F
Vaccine: TTOX
Symptoms: Rash erythematous
Clinical narrative: Some twinge of discomfort first 1-2 days after shot. One week after injection. Red raised, itching from site to elbow , hot tender- no other symptoms. Woke up pt with itching. Pt does not really any recent injection but has had before.
Age: 5.0
Sex: M
Vaccine: DTAP, IPV, MMR
Symptoms: Swelling
Clinical narrative: 03/19/2003 @ 08:00 mother noticed RA was swollen while giving child a bath.  Giving child motrin-advised cold compresses and warm compresses tomorrow.
Age: 39.0
Sex: F
Vaccine: TD
Symptoms: Injection site oedema, Injection site pain
Clinical narrative: 03/18/2003 @ 07:00:  Woke up complained of swelling and soreness in left arm at site of injection - advised to apply cold compresses x24hrs - then warm compresses - Tylenol prescribed for pain.
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMR
Symptoms: Agitation, Pain, Swelling
Clinical narrative: 03/20/2003 @ 21:00:  Child started crying with pain in left arm-arm swollen-Mother called PMD, advised to give child Tylenol and apply ice-child feeling a little better today-advised to now applay warm compresses.
Age: 27.0
Sex: F
Vaccine: TD
Symptoms: Feeling hot, Injection site erythema, Injection site pain, Injection site swelling
Clinical narrative: Right arm swollen & tender to touch @ injection site; warm and red in color.  Instructed to use cold compresses 24 hr, then warm as needed.  Take Tylenol as needed.
Age: 4.0
Sex: M
Vaccine: DTAP, IPV, MMR
Symptoms: Feeling cold, Injection site hypersensitivity, Injection site oedema, Pruritus
Clinical narrative: Mother called states that left arm swollen and child c/o itching around injection site no fever.  Advised her to put cool compress on arm.  Bring child in if not better.  03/06/2003: mother called back stated child is fine.  Swelling down itching stopped.
Age: 33.0
Sex: M
Vaccine: PPV, VARCEL
Symptoms: Injection site rash, Injection site swelling, Pruritus, Rash
Clinical narrative: Severe swelling and rash at site in left arm.  Rash moved upward in arm and chest area.  Also complained of itching of nose and throat area.  Reaction occur 10-12 hr after injection.  Client treatment with IM and oral antibiotics.
Age: 38.0
Sex: M
Vaccine: HEP, HEPA, TD, TYP
Symptoms: Blister, Erythema, Pain
Clinical narrative: 04/05/2003 am:  Woke up complained of a "fever blister".  On 04/07/2003 pm: noticed 3 "red spots" on right arm.  Also soreness in right arm.  Advised to take Tylenol and apply cold compresses to right today.
Age: 4.0
Sex: M
Vaccine: DTAP, HEP, IPV, MMR
Symptoms: Injection site erythema, Injection site oedema, Injection site pain
Clinical narrative: Mother states child started having swollen, tender, sherry right arm.  Shot site problem 08/28/2002 am-Stated history similiar problem. 03/15/99-after receiving DTAP at Doctors office.  After next and compression-resolved.
Age: 3.0
Sex: M
Vaccine: DTAP, HEP
Symptoms: Injection site erythema, Injection site oedema
Clinical narrative: 12/04/2002:  Mother noticed child's right arm was red-child was scratching area.  Arm became swollen later in the day.  No fever.  Advised Tylenol, cold compresses today and warm compresses tomorrow.
Age: 5.6
Sex: F
Vaccine: DTAP, MMR
Symptoms: Injection site erythema, Injection site swelling
Clinical narrative: Redness, swelling to injection site.  Rb approximately 3in diameter on 04/04/2003-worse 04/06 per mother.
Age: 5.0
Sex: F
Vaccine: DTAP
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
Clinical narrative: Recurrent episodes of swelling, redness, soreness & warmth at site since 03/14/2003.
Age: 7.0
Sex: F
Vaccine: VARCEL
Symptoms: Drug ineffective, Infection
Clinical narrative: Varicella disease diagnosed: 04/29/2003, mild
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMR
Symptoms: Cellulitis, Erythema, Feeling hot, Tenderness
Clinical narrative: Redness, warmth, tender, left shoulder suggestive of cellulitis.
Age: 12.0
Sex: F
Vaccine: DT
Symptoms: Pruritus, Urticaria
Clinical narrative: Patient states that the next day she started to feel itchy and notice hives on the back both arms, abdomen and the back of the right leg.  Mother was notified and brought patient to the clinic on 08/26/2003.  No medication given at home.  MD prescribed atarax 10mg 1tsp by mouth of 6 hr x3 days.  04/26/2003
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMR
Symptoms: Cellulitis, Pain
Clinical narrative: Cellulitis LAT complained of leg pain 3-4in swelling
Age: 4.0
Sex: F
Vaccine: DTAP, DTPPHIB, MMR
Symptoms: Feeling hot, Pyrexia, Swelling, Vomiting
Clinical narrative: Received vaccine at Health Dept on 01/24/2003 see in office 04/25/2003.  Temperature 103 degrees.  Right arm swollen.  Warm to touch.  Vomiting.  Treatment with compress supp.
Age: 65.0
Sex: F
Vaccine: PPV
Symptoms: Erythema, Hypoaesthesia, Hypokinesia, Joint range of motion decreased, Pain
Clinical narrative: Redness and swelling of arm.  Numbness of arm and fingers.  Very sore and painful arm.  Lack of mobility.
Age: 65.0
Sex: F
Vaccine: PPV
Symptoms: Swelling
Clinical narrative: Redness and swelling of arm.  Numbness of arm and fingers.  Very sore and painful arm.  Lack of mobility.
Age: 2.0
Sex: F
Vaccine: DTAP, HEPA, IPV, PNC
Symptoms: Urticaria
Clinical narrative: Urticaria the day after immunization.
Age: 12.5
Sex: F
Vaccine: TD
Symptoms: Fracture, Injection site erythema, Injection site pain
Clinical narrative: Soreness over upper extremity with no remarkable swelling, erythema at site; tersearerexia.
Age: 38.0
Sex: F
Vaccine: TD
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Pain, Pyrexia
Clinical narrative: Fever, 3in redness and swelling around site.  Left arm sore/stiff, painful.
Age: 55.0
Sex: M
Vaccine: PPV
Symptoms: Feeling hot, Injection site erythema, Injection site swelling, Pain, Tenderness
Clinical narrative: Pain began hours after injection.  Morning after site was red, swollen, 24 hrs after red swollen area spread.  36 hrs entire upper arm swollen, red, tender, and skin hot.
Age: 7.0
Sex: M
Vaccine: HEPA
Symptoms: Abdominal pain upper, Pyrexia
Clinical narrative: Temp 104, stomach ache, no vommiting @ 04:00 on 04/17/2003.  Temp down to 100 by noon with Tylenol and stomach ache down.  No steady state as of 04/18/2002.
Age: 0.74
Sex: M
Vaccine: DTAP, HIBV, IPV, PNC
Symptoms: Pyrexia
Clinical narrative: Patient developed high fever (103 degrees 24 degrees) after receiving injections.  Clinical exam suspect oral herpangina.
Age: 1.11
Sex: F
Vaccine: DTAP, PPV
Symptoms: Injection site erythema, Injection site swelling
Clinical narrative: Swelling at site, redness, right arm received call from parent. 04/30/2003
Age: 32.0
Sex: F
Vaccine: SMALL
Symptoms: Cellulitis, Injection site hypersensitivity, Pain
Clinical narrative: Patient (Pt) vaccinated on 4/21/03 and seen in employee health at Hospital for TAKE Check on 4/28/03. TAKE recorded and no problems were noted at that time.  Subsequently, Pt returned to employee health on 4/30/03 in the afternoon with complaints of pain in left arm.  Skin at vaccination site on left are was reported to be red, raised and warm to touch. This affected site was reported at about a 3 by 3 inch area. At 3 PM that same afternoon saw Dr. and was diagnosed with cellulitis.  Given prescription for doxycycline.  The Pt continued not to feel well and went to the ER.  There the Pt was given Cefaolin IV ans discharged home. State Health Department was contacted on Friday, May 2, 2003 by the Employee Health Department.  The patient was being admitted to the hospital at that time for cellulitis.
Age: 49.0
Sex: F
Vaccine: SMALL, SMALL
Symptoms: Blister, Dermatitis bullous, Rash
Clinical narrative: Pt had small vaccine 2weeks ago 4/15/03.  Scab fell off 2wks after.  Began rash this am 5/1/03, some of rash has blisters.  Pt states resembles chickenpox, no c/o itchin & has scratched.  Rash on arms, back, legs and face.
Age: 49.0
Sex: F
Vaccine: SMALL, SMALL
Symptoms: Pruritus, Rash, Rash maculo-papular
Clinical narrative: Pt had small vaccine 2weeks ago 4/15/03.  Scab fell off 2wks after.  Began rash this am 5/1/03, some of rash has blisters.  Pt states resembles chickenpox, no c/o itchin & has scratched.  Rash on arms, back, legs and face.
Age: 59.0
Sex: F
Vaccine: SMALL
Symptoms: Chest discomfort, Hypertension
Clinical narrative: 34 hours post-vaccination, made visit to dr's office, bp was 200/110.  on 10th day post-vaccination, was treated in ER.  bp 200/110, complains of some chest tightness, has been treated in past for hypertension.
Age: 5.0
Sex: M
Vaccine: DTAP, HEPA, IPV, MMR
Symptoms: Erythema, Feeling hot, Rash
Clinical narrative: RED, HOT TO TOUCH RASH
Age: 2.0
Sex: F
Vaccine: DTAP, HEPA, PNC
Symptoms: Erythema, Feeling hot, Injection site induration, Rash
Clinical narrative: RED, HOT TO TOUCH, INDURATED RASH
Age: 57.0
Sex: F
Vaccine: SMALL
Symptoms: Extrasystoles, Palpitations
Clinical narrative: 3/6 - slight palpitations 3/7-3/18 - worsening palpitations; had EKG that revealed bigeminal PVCs; on 3/11, had a cardiac workup (ECHO, stress ECHO) - all normal; elevated ALT to 80 but other labs normal; 3/14 - palpitations resolved 4/18 repeated labs - ALT now elevated to 139 & AST elevated to 56; u/s of liver & gallbladder normal
Age: 27.0
Sex: M
Vaccine: SMALL
Symptoms: Erythema, Rash papular
Clinical narrative: Diffuse papules, red, non-puritic trunk and thighs
Age: 0.2
Sex: M
Vaccine: DTAP, HBHEPB, IPV, PNC
Symptoms: Respiratory distress, Sudden infant death syndrome
Clinical narrative: infant death reported 3 days after 2 mos immunizations; autopsy revealed no etiology for death; reported as SIDS; child a 34 wk preemy growing up with history of respiratory distress; prescribed apnea monitor but unaware of its use at home
Age: 1.3
Sex: F
Vaccine: DTAP, MMR, PNC
Symptoms: Injection site erythema, Injection site swelling
Clinical narrative: 4/24/03 am mom reported redness & swelling at site.  Advised with standard comfort measures to use & call back PRN.  On 4/25/03 pm mom reports more pain @ site, more redness & "bullseye" configuration at site.  Mom says she called PMD (Primary Care Center) advised to go to hospital ER.  child treated at ER with po prednisone, RX given for Amoxil 250mg/5ml & motrin & Benedryl every 6 hours.
Age: 4.0
Sex: M
Vaccine: DTAP, HEPA, IPV, MMR
Symptoms: Injection site rash, Tenderness
Clinical narrative: RASH, TENDERNESS LEFT THIGH SURROUNDING IMMUNIZATION SITE
Age: 5.0
Sex: F
Vaccine: DTAP, HEPA, MMR
Symptoms: Injection site erythema, Injection site oedema
Clinical narrative: REDNESS SWELLING LEFT THIGH AROUND INJECTION SITE
Age: 5.0
Sex: F
Vaccine: DTAP, HEPA, IPV, MMR
Symptoms: Erythema
Clinical narrative: LEFT ANTERIOR THIGH WITH 5CM RED, INDURATED AREA. INDISITINCITVE BORDER
Age: 5.0
Sex: M
Vaccine: DTAP, HEPA, IPV, MMR
Symptoms: Erythema, Feeling hot, Swelling
Clinical narrative: LEFT THIGH RED SWOLLEN WARM TO TOUCH
Age: 1.3
Sex: M
Vaccine: DTAP, MMR, PNC, VARCEL
Symptoms: Erythema, Feeling hot, Swelling
Clinical narrative: On 4/29/03 @ 5:55 pm patients mother called reporting patient has moderate amount of redness and swelling to RAT.  Hot to touch.  Mother states pating acting fine, no fever, no N/v.  Mother was told to apply warm compresses and keep an eye on swelling, redness
Age: 0.3
Sex: F
Vaccine: DTAP, HIBV, IPV, PNC
Symptoms: Erythema, Swelling
Clinical narrative: REDNESS, SWELLING LEFT THIGH
Age: 47.0
Sex: M
Vaccine: SMALL, SMALL
Symptoms: Dizziness, Vertigo, Vomiting
Clinical narrative: patient became lightheaded on 5/3/03, woke up with vertigo on 5/4/03, also had episodes of vomiting.  Final diagnosis:  benign positional vertigo.  patient received 5 mg of valium IV and one liter of 0.9 normal saline
Age: 43.0
Sex: F
Vaccine: SMALL
Symptoms: Fatigue, Malaise
Clinical narrative: within 24 hours post vaccination patient developed extreme malaise and fatigue.  No rash.  No documented fever.  Gradual improvement, however as of report date patient still reporting symptoms.  Note:  Patient did not leave country due to reaction.
Age: 33.0
Sex: M
Vaccine: SMALL
Symptoms: Headache, Myalgia, Rash erythematous, Rash vesicular, Tenderness
Clinical narrative: 33 yo male s/p day 8 vaccination reports onset that date of approx 6 0.3-0.4 cm erythematous vesicles on his back; lesions non-tender, non-pruritic.  Pt otherwise reports (+) major take at vax site, occasional frontal HA relieved with Tylenol, mild generalized myalgias and mild (L) axillary tenderness.
Age: 50.0
Sex: F
Vaccine: SMALL
Symptoms: Headache, Musculoskeletal stiffness, Neck pain
Clinical narrative: 50 yo WF day 16-17 onset of "dull headache/neck pain" described as dull ache at the occiput/nape of neck.  Pt described neck as "stiff/sore" but has FROM, no N/V/F/change in vision although states "my eyes feel strange" but when she looked in the mirror, stated that her eyes "looked normal".  Vaccine site clean and dry.  No paresthesias/neuropathies.  Pt went home from work w/instructions to seek assistance if sx worsened. 4/22/03: pt still at home - no change in sx, unrelieved with ibuprofen but states more comfortable resting at home.  4/23/03: improved sx but still at home.   4/24/03:  pt states sx resolved - back at work.
Age: 0.2
Sex: F
Vaccine: DTAP, HBHEPB, IPV, PNC
Symptoms: Sudden infant death syndrome
Clinical narrative: Probable SIDS.
Age: 0.2
Sex: F
Vaccine: DTAP, HBHEPB, IPV, PNC
Symptoms: Hypertension, Lung disorder, Respiratory distress
Clinical narrative: Pt admitted 01/10/2003 with respiratory distress, eventually diagnosed with primary pulmonary hypertension.
Sex: F
Vaccine: DTAP, HEP, OPV
Symptoms: Drug toxicity, Nervous system disorder
Clinical narrative: Information has been received concerning a case in litigation regarding a female minor child who, during the period of May 1994 through June 1995, was subjected to very high doses of mercury contained in thimerosal by being inoculated during the first two years of her life with thimerosal adulterated infant injections. It is alleged that as a result of the cumulative doses of mercury contained in the thimerosal that the patient now suffers from and in the future will continue to suffer from the toxic neurological effects of mercury poisoning. An immunization history record was received and reported that the patient was vaccinated with the first, second, and third doses of hepatitis B virus vaccine rHBsAg on 3/10/94, 5/11/94, and 9/14/94. Other vaccinations received included the first, second, third, and fourth doses of diphtheria toxoid (+) haemophilus B conjugate vaccine (+) pertussis vaccine (+) tetanus toxoid vaccine and the first, second, and third doses of oral polio vaccine on 5/11/94, 7/13/94, 9/14/94, and 6/28/95; MMR (second generation) received on 3/22/95, and tuberculin purified protein derivative received on 12/17/94. Upon internal review, the mercury poisoning and its toxic neurological effects were considered to be other important medical events. No further information is available. A copy of the patient's complete medical records is available up on request.
Sex: M
Vaccine: HEP
Symptoms: Autism, Drug toxicity, Nervous system disorder
Clinical narrative: Information has been received concerning a case litigation regarding a male minor child who starting in July of 1998 through November 1999 was inoculated with his infant vaccinations and through these vaccinations was subjected to high doses of mercury contained in the preservative Thimerosal. Immunization information was received and reported that the patient was vaccinated with the first, second, and third doses of hepatitis B virus vaccine rHBsAg on 7/21/98, 9/28/98, and 2/15/99. Other vaccinations included diphtheria toxoid (+) pertussis vaccine (+) tetanus toxoid received on 7/21/98, 9/28/98, 11/16/98, 11/19/99; poliovirus vaccine received on 9/30/99; and varicella virus vaccine live received on 9/30/99. It was also noted that the patient was diagnosed with Autistic Spectrum Disorder. It is alleged that the patient was poisoned by the cumulative doses of mercury in thimerosal and as a result now suffers and in the future will continue to suffer from the toxic neurological effects of mercury poisoning. Upon internal review, mercury poisoning, it's toxic neurological effects, and Autistic Spectrum Disorder were considered to be other important medical events. No further information is available. A copy of the patient's complete medical records is available upon request.
Sex: M
Vaccine: HEP
Symptoms: Drug toxicity
Clinical narrative: This report describes the occurrence of mercury poisoning in a male child of unspecified age who was vaccinated with Hep B vaccine recombinant (Engerix B) for prophylaxis. This report was received as part of litigation proceedings and has not has not been verified by a physician or other healthcare professional. The subject's medical history, concurrent conditions, and concurrent medications were not reported. the subject received injections of Engerix-B on 03 Feb 1998 (lot ENG2368A2) and 19 Nov 1998 (lot ENG2795A2). He also received combination Haemophilus influenza type B conjugate/hepatitis B vaccine (Comax, Merck: 03 March 1998): diphtheria and tetanus toxoids and acellular pertussis vaccine (Acel-Imune, Lederle Labs: 03 March 1998 and Tripedia:08 May 1998, 23 July 1998, and 06 april 1999): Haemophilus Influenza type b conjugate vaccine (Hib Titer, Lederle Labs: 08 May 1998 and 23 July 1998 and Act Hib, Aventis Pasteur: 06 April 1999): inactivated poliomyelitis virus vaccine (IPOL: 03 March 1998 and 08 May 1998) : oral poliomyelitis virus vaccine (Orimune, Lederle Labs: 06 July 1998):MMR II 06 April 1999: and varicella virus vaccine (Varivax 05Jan. 1999). He also received an injection of tubeculin purified derivative (TB Mantoux 05 Jan 1999). The subject's attorney alleged that as a result of the vaccines administered, the subject "suffers from the effects of mercury poisoning". The mercury poisoning in this report is considered GSK medically serious.
Sex: F
Vaccine: DTPHIB, HEP, OPV
Symptoms: Drug toxicity
Clinical narrative: This report describes the occurrence of mercury poisoning in a female child of unspecified age who was vaccinated with hepatitis B vaccine for prophylaxis. This report was received as part of litigation proceedings and has not been verified by a physician or other healthcare professional. The subject's medical history, concurrent conditions, and concurrent medications were not reported. This subject received injections of hepatitis B vaccine on 3/10/94, 5/11/94, and 9/14/94. She also received combination diphtheria and tetanus toxoids and pertussis/Haemophilus influenzae type B conjugate vaccine, oral poliomyelitis virus vaccine, and MMR. She also received a tuberculin skin test. The subject's attorney alleged that, as a result of the vaccines administered, the subject suffers from the effects of mercury poisoning. The mercury poisoning in this report is considered medically serious (OMIC).
Sex: M
Vaccine: DTAP, HEP, HIBV
Symptoms: Drug toxicity
Clinical narrative: This report describes the occurrence of mercury poisoning in a male child of unspecified age who was vaccinated with hepatitis B vaccine recombinant for prophylaxis. This report was received as part of litigation proceedings and has not been verified by a physician or other healthcare professional. The subject's medical history, concurrent conditions, and concurrent medications were not reported. The subject received injections of Engerix B on 5/1/98, 6/12/98, and 10/20/98. He also received diphtheria and tetanus toxoids and acellular pertussis vaccine, Haemophilus influenzae type B conjugate vaccine, inactivated poliomyelitis virus vaccine, oral poliomyelitis virus vaccine, and MMR. He also received a tuberculin test. The subject's attorney alleged that, as a result of the vaccines administered, the subject suffers from the effects of mercury poisoning. The mercury poisoning in this report is considered medically serious.
Sex: M
Vaccine: HEP
Symptoms: Drug toxicity
Clinical narrative: This report describes the occurrence of mercury poisoning in a male child of unspecified age who was vaccinated with Hep B vaccine recombinant (Engerix-B0 for prophylaxis. This report was received as part of litigation proceedings and has not been verified by a physician or other healthcare professional. The subject's medical history concurrent conditions, and concurrent medications were not  reported. the subject received injections of Engerix B on 06 April 1995 (Lot ENG 1512B2), 16 May 1995 (lot ENG1742A2), and 08 Jan 1996 (lot ENG1816A2). He also received combination diphtheria and tetanus toxoids and pertussis/Haemophilus influenza type B conjugate vaccine (Tetramune: 16 May 1995, 18 July 1995, and 20 Sept 1995), diphtheria and tetanus and acellular pertussis vaccine (Acel Immune 18 Sept 1996), Haempohilus influenza type b conjugate vaccine (Act HIB, 28 March 1996), oral poliomyelitis virus vaccine (Orimune 16 May 1995, 18 July 1995, and 20 Sept 1995), MMRII 17 June 1996), and varicella virus vaccine (Varivax 11 April 1997). He also received an injection of tuberculin purified protein derivative (TB Mantoux 08 Jan 1996). The subject's attorney alleged that, as a result of the vaccines administered, the subjects suffers from the effects of mercury poisoning. The mercury poisoning in this report is considered medically serious.
Sex: M
Vaccine: DTP, IPV
Symptoms: Autism, Drug toxicity
Clinical narrative: This report describes the occurrence of autism spectrum disorder and mercury poisoning in a male child of unspecified age who was vaccinated with diphtheria and tetanus toxoids and pertussis vaccine and hepatitis B vaccine for prophylaxis. This report was received as part of litigation proceedings, with forwarding of limited medical records. The subject's medical history, concurrent conditions, and concurrent medications were not reported. The subject received injections of diphtheria and tetanus toxoids and pertussis vaccine on 7/21/98, 9/28/98, 11/16/98, and 11/19/99. He also received injections of hepatitis B vaccine, haemophilus influenzae type B conjugate vaccine, inactivated poliomyelitis virus vaccine, MMR, and varicella virus vaccine. The subject's attorney alleged that, as a result of the vaccines administered, the subject suffers from the effects of mercury poisoning. The attorney forwarded a form used by the pediatrician to certify that the subject could participate in physical education. In the general comments section of the form, the pediatrician wrote, Autistic Spectrum Disorder. The autism spectrum disorder and mercury poisoning in this report are considered medically serious.
Sex: M
Vaccine: DTAP, HEP, HIBV, IPV
Symptoms: Drug toxicity
Clinical narrative: This report describes the occurrence of mercury poisoning in a male child of unspecified age who was vaccinated with Hep B vaccine recombinant (Engerix B) for prophylaxis. This report was received as part of a litigation proceeding and has not been verified by a physician or other healthcare professional. The subject's medical history, concurrent conditions, and concurrent medications were not reported. The subject received injections of Engerix B on 19 Dec 1997 (lot ENG2424A2), 16 Feb 1998 (lot ENG2357A2), and 20 APril 1998(lot ENG2427A2), the third injection was administered four months after the first injection, rather than the recommended interval of six months. He also received diptheria and tetanus toxoids and acellular pertussis vaccine (Acel Immune 16 Feb 1998, 20 April 1998, and 19 Nov 2000, and Tripedia 22 Feb 1998, and 22 June 1998. Haemophilus influenza type B conjugate vaccine (Hib Titer 16 Feb 1998, 20 April 1998, 22 June 1998, and 08 April 1999) inactivated poliomyelitis virus vaccine (IPOL 16 Feb 1998, 20 June 1998) MMR II 08 April 1999), and varicella virus vaccine (Varivax 05 Jan 1999) The subjects attorney alleged that, as a result of the vaccines administered, the subject suffers from the effects of mercury poisoning. The mercury in this report is considered medically serious.
Sex: M
Vaccine: HEP
Symptoms: Drug toxicity
Clinical narrative: This report describes the occurrence of mercury poisoning in a male child of unspecified age who was vaccinated with Hep B vaccine recombinant (Engerix B) for prophylaxis. This report was received as part of litigation proceedings and has not been verified by a physician or other healthcare professional. The subject's medical history concurrent conditions, and concurrent medications were not reported. The subject received injections of hepatitis b vaccine on 09 Jan 1995, 24 March 1995, and 23 Aug 1995. He also received diphtheria and tetanus toxoids and pertussis vaccine 09 Jan 1995, 24 March 1995, and 16 May 1995). diptheria and tetanus toxoids and acellular pertussis vaccine (Acel Immune 15 July 1996), Haemophilus influenza type B conjugate vaccine 09 Jan 1995, 24 March 1995, and 16 May 1995, and Hib Titier 05 April 1996), oral poliomyelitis virus vaccine (Orimune 09 Jan 1995, 24 March 1995, 15 July 1996), MMRII 26 Dec 1995), and varicella virus vaccine (Varivax 11 Jan 1995). He also received a tuberculin skin test 23 Dec 1995). The subject's attorney alleged that, as a result of the vaccines administered, the subject suffers from the effects of mercury poisoning. The mercury poisoning in this report is considered medically serious.
Age: 2.0
Sex: F
Vaccine: PPV
Symptoms: Cellulitis, Gait disturbance, Laboratory test abnormal, Oedema peripheral, Pain
Clinical narrative: 04/30/2003 at 09:30pm : limping, pain and swelling at leg: no fever: Tylenol for pain, heat/ice for comfort    05/01/2003 at 05:45 increase pain, swelling at leg: Temp of 38.5, to CD, labs and blood cultures drawn: IV  , Cellulitis  05/2/2003o/c impatient on 8 days of Keflex for cellulitis. 05/05/2003 Anticipated full recovery after antibiotic course.
Age: 49.0
Sex: M
Vaccine: ANTH
Symptoms: Arthritis
Clinical narrative: 7-10 days after 1st vaccination of anthrax, joints small and large got inflammed.  Have history of psoriatic arthritis, controlled on methotrexote will then.
Age: 47.0
Sex: U
Vaccine: PPV
Symptoms: Influenza like illness, Injection site erythema, Injection site pain
Clinical narrative: Local erythema.  Pain at injection site.  Flu like symptoms.
Age: 71.0
Sex: F
Vaccine: PPV
Symptoms: Chills, Injection site erythema, Injection site pain, Injection site swelling, Muscular weakness
Clinical narrative: Pain at injection site with swelling and redness.  chills and very weak legs.
Age: 0.2
Sex: F
Vaccine: DTAP, HEP, HIBV, IPV, PNC
Symptoms: Convulsion, Pyrexia
Clinical narrative: Approximately 18 hours after vaccinations, developed fever that led to brief generalized seizure. Evaluated at ER and admitted for observation and 48 hours antibiotics. The discharge summary received on 1/6/04 confirms the diagnosis of febrile seizure.
Age: 0.08
Sex: M
Vaccine: HEP
Symptoms: Autism
Clinical narrative: Developed signs of autism by 5 months of age. Unknown if newborn dose of Hep B contained Thimersol. A 60-day follow up report received 7/29/2003 adds: Not recovered. Has autism. The medical record received on 1/6/04 confirms the diagnosis of autism.
Age: 31.0
Sex: M
Vaccine: FLUX
Symptoms: Dizziness, Dyspnoea, Hypoxia, Syncope, Wheezing
Clinical narrative: Received flu shot as an outpatient 12/12. Came to ER at 21:26 with SOB, wheezing, severe hypoxia. Received 6 respiratory treatments with albuterol, solumedrol, and Alocort. Almost required intubation. Severe hypoxia with asthma attack. Felt dizzy, fainting/no seizure disorder. Wheezing. Continue corticosteroids at high dosage for treatment.
Age: 0.5
Sex: M
Vaccine: DTAP, IPV, PNC
Symptoms: Convulsion
Clinical narrative: Pt was being changed by g'ma on changing table. Had tonic seizure x 5 min. EMS arrived. Pt post ictal afebrile. Sent to ER for eval.
Age: 0.2
Sex: M
Vaccine: 6VAX-F, DTAP, HIBV, PNC
Symptoms: Agitation, Irritability
Clinical narrative: Approximately 1 hour after receiving vaccine, became very irritable; unconsolable.  Given Tylenol.  Wouldn't take bottle.  Symptoms persisted about 3 hours.
Age: 0.33
Sex: M
Vaccine: DTAP, HIBV, IPV, PNC
Symptoms: Dyskinesia, Feeling jittery, Muscle twitching, Pyrexia, Sleep disorder
Clinical narrative: Fever 101-102 degrees F; associated with poor sleep.  Jitterness and tongue fasiculations occational sudden arm and leg movements syptoms resolved within 48 hrs.
Age: 1.3
Sex: F
Vaccine: DTAP, PNC, VARCEL
Symptoms: Crying, Pyrexia
Clinical narrative: Temperature of 104 degrees rectal since last evening.  With crying for 24 hrs (since 6pm on 04/28/2003).  Tylenol and or motrin as needed.
Sex: M
Vaccine: HIBV, PNC
Symptoms: Injection site swelling, Injection site warmth, Tenderness
Clinical narrative: Left upper arm swollen, warm and tender in area of injection.  No fever, good appetite, and active.  Treatment: atarax 10mg/5m 1/2 tsp with 8lt, motrin.  Cool compresses to area.  Return date in 3 mos.
Age: 61.0
Sex: F
Vaccine: FLU3
Symptoms: Hypokinesia, Injection site pain, Joint range of motion decreased, Pain, Shoulder pain
Clinical narrative: Client came to clinic on 01/29/2003-complaining pain in left upper arm.  Client states that after she received flu vaccine her arm hurt x1 week.  After 3 mnths the arm hurts to move up and down and backwards.  She can't disconnect bra without hurting.  No redness seen, no lung felt, no visible signs or distress.  Soreness in deltoid following flu vaccine 10/29/2002.  Copy of immunization record given to client along with Influenza VIS form.  See PMD for evaluation.  Will let clinic know outcome.  04/02/2003: Returned to clinic for some pain in left shoulder-has not improved-did not see PMD in 01/03.  No visible changes to arm-moderate to sever pain in left arm when she raises her arm or reaches toward back-pain at injection site when she does these things.  Continued pain in left arm after Influenza.  Will send a copy of this report to client.  Follow up evaluation by MD. 04/15/2003:  Client called to let nurse know she saw Dr. at left shoulder and uppoer arm pain.  He referred her to another Dr. who did x-rays and tests and determined she has bursitis of left shoulder and gave her injection in shoulder and medications.  She will return to him for follow-up.
Age: 0.75
Sex: F
Vaccine: IPV, PNC
Symptoms: Injection site erythema, Injection site induration
Clinical narrative: Morning of 4/24/03, mother noticed injection site of left vastus laterus (thigh muscle) to be red and hard to touch. Child is without fever, active and in no acute distress. Left upper limb with area 2 cm x 4 cm of induration and erythema.
Age: 1.25
Sex: F
Vaccine: HBHEPB, MMR, PNC
Symptoms: Rash
Clinical narrative: Rash on and near after immunization.
Age: 5.0
Sex: F
Vaccine: DTAP, MMR
Symptoms: Injection site erythema, Injection site induration, Injection site swelling, Pruritus
Clinical narrative: 24 hours later - arm red, swollen and hard from shoulder down to midway to elbow, outside. Only complained of itching.