chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 18.0
Sex: F
Vaccine: COVID19
Symptoms: No adverse event, Product storage error
Clinical narrative: On the clinic day, the vaccine was transported out from the pharmacy to the facility without a digital data logger. The packing used for transport refrigerated packaging tote to maintain a temperature of 36 F - 46 F.  However, that is not approved by State for COVID-19 vaccine transportation. The total time (from when vaccine left the pharmacy to the clinic completion) was less than 6 hours. There were no adverse events.
Age: 72.0
Sex: M
Vaccine: COVID19
Symptoms: No adverse event, Product storage error
Clinical narrative: On the clinic day, the vaccine was transported out from the pharmacy to the facility without a digital data logger. The packing used for transport was refrigerated packaging tote to maintain a temperature of 36 F - 46 F.  However, that is not approved for COVID-19 vaccine transportation. The total time (from when vaccine left the pharmacy to the clinic completion) was less than 6 hours. There were no adverse events.
Age: 57.0
Sex: F
Vaccine: COVID19
Symptoms: Alanine aminotransferase increased, Aspiration pleural cavity, Blood alkaline phosphatase increased, Blood calcium decreased, Blood potassium decreased
Clinical narrative: COVID Vaccine Breakthrough Case Pfizer Dose 1 5/6/21 (ER8736) Pfizer Dose 2 6/4/21 (EW0164) COVID Positive 12/27/21  12/27/21: Patient is a 57 year old female with metastatic ductal carcinoma, Mets in bones, liver and pleural currently on monthly Faslodex injections and po Ibrance 100 mg every 4 weeks, she is followed by Cancer Center. Patient has been experiencing shortness of breath since September of this year. She was recently seen in ED for bilateral pleural effusions, thoracentesis was performed, however she did not have any improvement in her shortness of breath. She was scheduled for chemotherapy today but has been experiencing fevers since yesterday, TMAX 101.4. She endorses a cough with greenish mucous production. No chest pain. Denies loss of taste or smell. She has fatigue.  She denies any diarrhea, nausea or vomiting.  She has been fully vaccinated for COVID-19 but has yet to receive her booster.  Patient was recently started on Lasix by her Cancer Center secondary to pleural effusions.  She does admit to recent travel by plane.  On arrival to ED the patient was tachycardic 113 and temp 99.3.  She is noted to be hypoxic in ED and 2 L supplemental oxygen was applied with improvement oxygen saturations to 95%.  Laboratory findings were significant for hyponatremia 132. Hypokalemia 3.4.  Transaminitis ALT 65 in ALP 248. Hypocalcemia 8.6.  ProBNP 283. Leukopenia 4.80.  D-dimer 6.82.  CT chest no Regulatory Authority.  Rapid COVID positive.  Chest x-ray small right and moderate left pleural effusions.  Metastatic disease in both lungs, similar to prior.  Patient received acetaminophen, DuoNeb treatment, Solu-Medrol and potassium 40 mEq p.o. in ED.  12/29/21: A 57-year-old lady with generalized metastasis to the lung, liver and bones, presented with history of worsening shortness of breath.  The patient was noted to be positive for COVID-19 infection.  Images show extensive lung metastatic disease.  The patient was treated for hypoxia related to fluid overload and metastatic lung disease. Patient's condition has improved, was given a short course of empiric remdesivir, as well as dexamethasone and empiric antibiotic therapy.  The patient's condition has improved.  She has been advised to follow up with PCP in 2-3 weeks.
Age: 57.0
Sex: F
Vaccine: COVID19
Symptoms: Blood sodium decreased, COVID-19, Chemotherapy, Chest X-ray abnormal, Computerised tomogram thorax normal
Clinical narrative: COVID Vaccine Breakthrough Case Pfizer Dose 1 5/6/21 (ER8736) Pfizer Dose 2 6/4/21 (EW0164) COVID Positive 12/27/21  12/27/21: Patient is a 57 year old female with metastatic ductal carcinoma, Mets in bones, liver and pleural currently on monthly Faslodex injections and po Ibrance 100 mg every 4 weeks, she is followed by Cancer Center. Patient has been experiencing shortness of breath since September of this year. She was recently seen in ED for bilateral pleural effusions, thoracentesis was performed, however she did not have any improvement in her shortness of breath. She was scheduled for chemotherapy today but has been experiencing fevers since yesterday, TMAX 101.4. She endorses a cough with greenish mucous production. No chest pain. Denies loss of taste or smell. She has fatigue.  She denies any diarrhea, nausea or vomiting.  She has been fully vaccinated for COVID-19 but has yet to receive her booster.  Patient was recently started on Lasix by her Cancer Center secondary to pleural effusions.  She does admit to recent travel by plane.  On arrival to ED the patient was tachycardic 113 and temp 99.3.  She is noted to be hypoxic in ED and 2 L supplemental oxygen was applied with improvement oxygen saturations to 95%.  Laboratory findings were significant for hyponatremia 132. Hypokalemia 3.4.  Transaminitis ALT 65 in ALP 248. Hypocalcemia 8.6.  ProBNP 283. Leukopenia 4.80.  D-dimer 6.82.  CT chest no Regulatory Authority.  Rapid COVID positive.  Chest x-ray small right and moderate left pleural effusions.  Metastatic disease in both lungs, similar to prior.  Patient received acetaminophen, DuoNeb treatment, Solu-Medrol and potassium 40 mEq p.o. in ED.  12/29/21: A 57-year-old lady with generalized metastasis to the lung, liver and bones, presented with history of worsening shortness of breath.  The patient was noted to be positive for COVID-19 infection.  Images show extensive lung metastatic disease.  The patient was treated for hypoxia related to fluid overload and metastatic lung disease. Patient's condition has improved, was given a short course of empiric remdesivir, as well as dexamethasone and empiric antibiotic therapy.  The patient's condition has improved.  She has been advised to follow up with PCP in 2-3 weeks.
Age: 57.0
Sex: F
Vaccine: COVID19
Symptoms: Condition aggravated, Dyspnoea, Fatigue, Fibrin D dimer, Hypertransaminasaemia
Clinical narrative: COVID Vaccine Breakthrough Case Pfizer Dose 1 5/6/21 (ER8736) Pfizer Dose 2 6/4/21 (EW0164) COVID Positive 12/27/21  12/27/21: Patient is a 57 year old female with metastatic ductal carcinoma, Mets in bones, liver and pleural currently on monthly Faslodex injections and po Ibrance 100 mg every 4 weeks, she is followed by Cancer Center. Patient has been experiencing shortness of breath since September of this year. She was recently seen in ED for bilateral pleural effusions, thoracentesis was performed, however she did not have any improvement in her shortness of breath. She was scheduled for chemotherapy today but has been experiencing fevers since yesterday, TMAX 101.4. She endorses a cough with greenish mucous production. No chest pain. Denies loss of taste or smell. She has fatigue.  She denies any diarrhea, nausea or vomiting.  She has been fully vaccinated for COVID-19 but has yet to receive her booster.  Patient was recently started on Lasix by her Cancer Center secondary to pleural effusions.  She does admit to recent travel by plane.  On arrival to ED the patient was tachycardic 113 and temp 99.3.  She is noted to be hypoxic in ED and 2 L supplemental oxygen was applied with improvement oxygen saturations to 95%.  Laboratory findings were significant for hyponatremia 132. Hypokalemia 3.4.  Transaminitis ALT 65 in ALP 248. Hypocalcemia 8.6.  ProBNP 283. Leukopenia 4.80.  D-dimer 6.82.  CT chest no Regulatory Authority.  Rapid COVID positive.  Chest x-ray small right and moderate left pleural effusions.  Metastatic disease in both lungs, similar to prior.  Patient received acetaminophen, DuoNeb treatment, Solu-Medrol and potassium 40 mEq p.o. in ED.  12/29/21: A 57-year-old lady with generalized metastasis to the lung, liver and bones, presented with history of worsening shortness of breath.  The patient was noted to be positive for COVID-19 infection.  Images show extensive lung metastatic disease.  The patient was treated for hypoxia related to fluid overload and metastatic lung disease. Patient's condition has improved, was given a short course of empiric remdesivir, as well as dexamethasone and empiric antibiotic therapy.  The patient's condition has improved.  She has been advised to follow up with PCP in 2-3 weeks.
Age: 57.0
Sex: F
Vaccine: COVID19
Symptoms: Hypervolaemia, Hypocalcaemia, Hypokalaemia, Hyponatraemia, Hypoxia
Clinical narrative: COVID Vaccine Breakthrough Case Pfizer Dose 1 5/6/21 (ER8736) Pfizer Dose 2 6/4/21 (EW0164) COVID Positive 12/27/21  12/27/21: Patient is a 57 year old female with metastatic ductal carcinoma, Mets in bones, liver and pleural currently on monthly Faslodex injections and po Ibrance 100 mg every 4 weeks, she is followed by Cancer Center. Patient has been experiencing shortness of breath since September of this year. She was recently seen in ED for bilateral pleural effusions, thoracentesis was performed, however she did not have any improvement in her shortness of breath. She was scheduled for chemotherapy today but has been experiencing fevers since yesterday, TMAX 101.4. She endorses a cough with greenish mucous production. No chest pain. Denies loss of taste or smell. She has fatigue.  She denies any diarrhea, nausea or vomiting.  She has been fully vaccinated for COVID-19 but has yet to receive her booster.  Patient was recently started on Lasix by her Cancer Center secondary to pleural effusions.  She does admit to recent travel by plane.  On arrival to ED the patient was tachycardic 113 and temp 99.3.  She is noted to be hypoxic in ED and 2 L supplemental oxygen was applied with improvement oxygen saturations to 95%.  Laboratory findings were significant for hyponatremia 132. Hypokalemia 3.4.  Transaminitis ALT 65 in ALP 248. Hypocalcemia 8.6.  ProBNP 283. Leukopenia 4.80.  D-dimer 6.82.  CT chest no Regulatory Authority.  Rapid COVID positive.  Chest x-ray small right and moderate left pleural effusions.  Metastatic disease in both lungs, similar to prior.  Patient received acetaminophen, DuoNeb treatment, Solu-Medrol and potassium 40 mEq p.o. in ED.  12/29/21: A 57-year-old lady with generalized metastasis to the lung, liver and bones, presented with history of worsening shortness of breath.  The patient was noted to be positive for COVID-19 infection.  Images show extensive lung metastatic disease.  The patient was treated for hypoxia related to fluid overload and metastatic lung disease. Patient's condition has improved, was given a short course of empiric remdesivir, as well as dexamethasone and empiric antibiotic therapy.  The patient's condition has improved.  She has been advised to follow up with PCP in 2-3 weeks.
Age: 57.0
Sex: F
Vaccine: COVID19
Symptoms: Inappropriate schedule of product administration, Leukopenia, Metastases to lung, Metastatic neoplasm, Pleural effusion
Clinical narrative: COVID Vaccine Breakthrough Case Pfizer Dose 1 5/6/21 (ER8736) Pfizer Dose 2 6/4/21 (EW0164) COVID Positive 12/27/21  12/27/21: Patient is a 57 year old female with metastatic ductal carcinoma, Mets in bones, liver and pleural currently on monthly Faslodex injections and po Ibrance 100 mg every 4 weeks, she is followed by Cancer Center. Patient has been experiencing shortness of breath since September of this year. She was recently seen in ED for bilateral pleural effusions, thoracentesis was performed, however she did not have any improvement in her shortness of breath. She was scheduled for chemotherapy today but has been experiencing fevers since yesterday, TMAX 101.4. She endorses a cough with greenish mucous production. No chest pain. Denies loss of taste or smell. She has fatigue.  She denies any diarrhea, nausea or vomiting.  She has been fully vaccinated for COVID-19 but has yet to receive her booster.  Patient was recently started on Lasix by her Cancer Center secondary to pleural effusions.  She does admit to recent travel by plane.  On arrival to ED the patient was tachycardic 113 and temp 99.3.  She is noted to be hypoxic in ED and 2 L supplemental oxygen was applied with improvement oxygen saturations to 95%.  Laboratory findings were significant for hyponatremia 132. Hypokalemia 3.4.  Transaminitis ALT 65 in ALP 248. Hypocalcemia 8.6.  ProBNP 283. Leukopenia 4.80.  D-dimer 6.82.  CT chest no Regulatory Authority.  Rapid COVID positive.  Chest x-ray small right and moderate left pleural effusions.  Metastatic disease in both lungs, similar to prior.  Patient received acetaminophen, DuoNeb treatment, Solu-Medrol and potassium 40 mEq p.o. in ED.  12/29/21: A 57-year-old lady with generalized metastasis to the lung, liver and bones, presented with history of worsening shortness of breath.  The patient was noted to be positive for COVID-19 infection.  Images show extensive lung metastatic disease.  The patient was treated for hypoxia related to fluid overload and metastatic lung disease. Patient's condition has improved, was given a short course of empiric remdesivir, as well as dexamethasone and empiric antibiotic therapy.  The patient's condition has improved.  She has been advised to follow up with PCP in 2-3 weeks.
Age: 57.0
Sex: F
Vaccine: COVID19
Symptoms: Productive cough, Prohormone brain natriuretic peptide increased, Pyrexia, SARS-CoV-2 test positive, Secretion discharge
Clinical narrative: COVID Vaccine Breakthrough Case Pfizer Dose 1 5/6/21 (ER8736) Pfizer Dose 2 6/4/21 (EW0164) COVID Positive 12/27/21  12/27/21: Patient is a 57 year old female with metastatic ductal carcinoma, Mets in bones, liver and pleural currently on monthly Faslodex injections and po Ibrance 100 mg every 4 weeks, she is followed by Cancer Center. Patient has been experiencing shortness of breath since September of this year. She was recently seen in ED for bilateral pleural effusions, thoracentesis was performed, however she did not have any improvement in her shortness of breath. She was scheduled for chemotherapy today but has been experiencing fevers since yesterday, TMAX 101.4. She endorses a cough with greenish mucous production. No chest pain. Denies loss of taste or smell. She has fatigue.  She denies any diarrhea, nausea or vomiting.  She has been fully vaccinated for COVID-19 but has yet to receive her booster.  Patient was recently started on Lasix by her Cancer Center secondary to pleural effusions.  She does admit to recent travel by plane.  On arrival to ED the patient was tachycardic 113 and temp 99.3.  She is noted to be hypoxic in ED and 2 L supplemental oxygen was applied with improvement oxygen saturations to 95%.  Laboratory findings were significant for hyponatremia 132. Hypokalemia 3.4.  Transaminitis ALT 65 in ALP 248. Hypocalcemia 8.6.  ProBNP 283. Leukopenia 4.80.  D-dimer 6.82.  CT chest no Regulatory Authority.  Rapid COVID positive.  Chest x-ray small right and moderate left pleural effusions.  Metastatic disease in both lungs, similar to prior.  Patient received acetaminophen, DuoNeb treatment, Solu-Medrol and potassium 40 mEq p.o. in ED.  12/29/21: A 57-year-old lady with generalized metastasis to the lung, liver and bones, presented with history of worsening shortness of breath.  The patient was noted to be positive for COVID-19 infection.  Images show extensive lung metastatic disease.  The patient was treated for hypoxia related to fluid overload and metastatic lung disease. Patient's condition has improved, was given a short course of empiric remdesivir, as well as dexamethasone and empiric antibiotic therapy.  The patient's condition has improved.  She has been advised to follow up with PCP in 2-3 weeks.
Age: 57.0
Sex: F
Vaccine: COVID19
Symptoms: Tachycardia, Vaccine breakthrough infection, White blood cell count decreased
Clinical narrative: COVID Vaccine Breakthrough Case Pfizer Dose 1 5/6/21 (ER8736) Pfizer Dose 2 6/4/21 (EW0164) COVID Positive 12/27/21  12/27/21: Patient is a 57 year old female with metastatic ductal carcinoma, Mets in bones, liver and pleural currently on monthly Faslodex injections and po Ibrance 100 mg every 4 weeks, she is followed by Cancer Center. Patient has been experiencing shortness of breath since September of this year. She was recently seen in ED for bilateral pleural effusions, thoracentesis was performed, however she did not have any improvement in her shortness of breath. She was scheduled for chemotherapy today but has been experiencing fevers since yesterday, TMAX 101.4. She endorses a cough with greenish mucous production. No chest pain. Denies loss of taste or smell. She has fatigue.  She denies any diarrhea, nausea or vomiting.  She has been fully vaccinated for COVID-19 but has yet to receive her booster.  Patient was recently started on Lasix by her Cancer Center secondary to pleural effusions.  She does admit to recent travel by plane.  On arrival to ED the patient was tachycardic 113 and temp 99.3.  She is noted to be hypoxic in ED and 2 L supplemental oxygen was applied with improvement oxygen saturations to 95%.  Laboratory findings were significant for hyponatremia 132. Hypokalemia 3.4.  Transaminitis ALT 65 in ALP 248. Hypocalcemia 8.6.  ProBNP 283. Leukopenia 4.80.  D-dimer 6.82.  CT chest no Regulatory Authority.  Rapid COVID positive.  Chest x-ray small right and moderate left pleural effusions.  Metastatic disease in both lungs, similar to prior.  Patient received acetaminophen, DuoNeb treatment, Solu-Medrol and potassium 40 mEq p.o. in ED.  12/29/21: A 57-year-old lady with generalized metastasis to the lung, liver and bones, presented with history of worsening shortness of breath.  The patient was noted to be positive for COVID-19 infection.  Images show extensive lung metastatic disease.  The patient was treated for hypoxia related to fluid overload and metastatic lung disease. Patient's condition has improved, was given a short course of empiric remdesivir, as well as dexamethasone and empiric antibiotic therapy.  The patient's condition has improved.  She has been advised to follow up with PCP in 2-3 weeks.
Age: 58.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Headache, Nausea, Pain, Pyrexia
Clinical narrative: It started 4-5 hours after my shot. I woke in the middle of the night with aches, fever, nausea, headaches, and fatigue. The worst of it lasted about 24 hours, but the headache lasted about a week.
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Cough, Disturbance in attention, Headache, Oropharyngeal pain
Clinical narrative: I started getting symptoms of sore throat, headache, and congestion. I was taking Tylenol. The next day I experienced the worst headache that I've ever had that Tylenol and Ibuprofen would not help. I was also taking decongestion medications. I took a rapid COVID-19 test that was positive. I also did a PCR COVID-19 which was positive. My symptoms progressed to severe congestion and runny nose. After 5 days, I had sneezing, worse runny nose, and occasional chest cough. I did 2 telehealth visits and was prescribed a Z Pak which I did not take due to receiving the positive COVID-19 results. My symptoms lasted for approximately 9 days. I still have concentration and focus issues to this day.
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive, Sneezing
Clinical narrative: I started getting symptoms of sore throat, headache, and congestion. I was taking Tylenol. The next day I experienced the worst headache that I've ever had that Tylenol and Ibuprofen would not help. I was also taking decongestion medications. I took a rapid COVID-19 test that was positive. I also did a PCR COVID-19 which was positive. My symptoms progressed to severe congestion and runny nose. After 5 days, I had sneezing, worse runny nose, and occasional chest cough. I did 2 telehealth visits and was prescribed a Z Pak which I did not take due to receiving the positive COVID-19 results. My symptoms lasted for approximately 9 days. I still have concentration and focus issues to this day.
Age: 9.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Vaccines where stored at incorrect temperature they had been stored in freezer instead of refrigerator.
Age: 36.0
Sex: M
Vaccine: COVID19
Symptoms: Aggression, Agitation, Anion gap, Anticoagulant therapy, Blood glucose increased
Clinical narrative: COVID Vaccine Breakthrough Case  J&J Dose 6/22/21 (203A21A) COVID Positive 12/28/21  12/28/21: Patient is a 37-year-old male with past medical history of diabetes, anxiety, smoking.  He presented on 12/28/2021 with chief complaint of nausea and vomiting. His symptoms started yesterday.  He states that he forgot to take his insulin and ate poorly over the Christmas holiday. His sugars therefore became very high and he started feeling sick.  He currently feels that he is back to his baseline health after receiving fluids and insulin in the ED.  This is not the 1st time that he has been hospitalized with elevated sugars.  He states that he was diagnosed with diabetes last year and has needed insulin since the time of his diagnosis.  He does not know how much insulin he takes at home.   He denies ever taking oral medications for his diabetes.  He does not take any medications otherwise.  He is unaware of any other past medical history.  He denies any illicit drug use.  He had a surgery on his left wrist in the past but otherwise denies surgical history.  Family history is noncontributory.   In the emergency department, his vital signs were in to bed.  Lab work was notable for glucose 941. Other notable findings include anion gap of 17, lactic acid of 3.2, and presence of ketones in urine.  He was diagnosed with DKA. He received LR, Zofran, and insulin drip.  He was admitted for further management.  12/29/21: Received call from nursing the patient was agitated.  He wanted to leave AMA as he "had things to do." When I got to the room, his insulin drip had already been discontinued as he was getting ready to leave.  His GlucoStabilizer was reviewed and he was administered 10 units of Lantus prior to discharge so that at least he would have some long-acting coverage throughout the day. The patient had no idea how much insulin he takes at home regularly.  Patient was also notified that he was COVID-19 positive.  We discussed quarantine you for 10 days.  We discussed returning to care if he develops shortness of breath.  I did not spend much time trying to convince him to stay as he was punching the wall due to lack of patience and wanting to leave.
Age: 36.0
Sex: M
Vaccine: COVID19
Symptoms: Blood lactic acid, COVID-19, Diabetic ketoacidosis, Laboratory test abnormal, Malaise
Clinical narrative: COVID Vaccine Breakthrough Case  J&J Dose 6/22/21 (203A21A) COVID Positive 12/28/21  12/28/21: Patient is a 37-year-old male with past medical history of diabetes, anxiety, smoking.  He presented on 12/28/2021 with chief complaint of nausea and vomiting. His symptoms started yesterday.  He states that he forgot to take his insulin and ate poorly over the Christmas holiday. His sugars therefore became very high and he started feeling sick.  He currently feels that he is back to his baseline health after receiving fluids and insulin in the ED.  This is not the 1st time that he has been hospitalized with elevated sugars.  He states that he was diagnosed with diabetes last year and has needed insulin since the time of his diagnosis.  He does not know how much insulin he takes at home.   He denies ever taking oral medications for his diabetes.  He does not take any medications otherwise.  He is unaware of any other past medical history.  He denies any illicit drug use.  He had a surgery on his left wrist in the past but otherwise denies surgical history.  Family history is noncontributory.   In the emergency department, his vital signs were in to bed.  Lab work was notable for glucose 941. Other notable findings include anion gap of 17, lactic acid of 3.2, and presence of ketones in urine.  He was diagnosed with DKA. He received LR, Zofran, and insulin drip.  He was admitted for further management.  12/29/21: Received call from nursing the patient was agitated.  He wanted to leave AMA as he "had things to do." When I got to the room, his insulin drip had already been discontinued as he was getting ready to leave.  His GlucoStabilizer was reviewed and he was administered 10 units of Lantus prior to discharge so that at least he would have some long-acting coverage throughout the day. The patient had no idea how much insulin he takes at home regularly.  Patient was also notified that he was COVID-19 positive.  We discussed quarantine you for 10 days.  We discussed returning to care if he develops shortness of breath.  I did not spend much time trying to convince him to stay as he was punching the wall due to lack of patience and wanting to leave.
Age: 36.0
Sex: M
Vaccine: COVID19
Symptoms: Nausea, SARS-CoV-2 test positive, Urine ketone body present, Vaccine breakthrough infection, Vomiting
Clinical narrative: COVID Vaccine Breakthrough Case  J&J Dose 6/22/21 (203A21A) COVID Positive 12/28/21  12/28/21: Patient is a 37-year-old male with past medical history of diabetes, anxiety, smoking.  He presented on 12/28/2021 with chief complaint of nausea and vomiting. His symptoms started yesterday.  He states that he forgot to take his insulin and ate poorly over the Christmas holiday. His sugars therefore became very high and he started feeling sick.  He currently feels that he is back to his baseline health after receiving fluids and insulin in the ED.  This is not the 1st time that he has been hospitalized with elevated sugars.  He states that he was diagnosed with diabetes last year and has needed insulin since the time of his diagnosis.  He does not know how much insulin he takes at home.   He denies ever taking oral medications for his diabetes.  He does not take any medications otherwise.  He is unaware of any other past medical history.  He denies any illicit drug use.  He had a surgery on his left wrist in the past but otherwise denies surgical history.  Family history is noncontributory.   In the emergency department, his vital signs were in to bed.  Lab work was notable for glucose 941. Other notable findings include anion gap of 17, lactic acid of 3.2, and presence of ketones in urine.  He was diagnosed with DKA. He received LR, Zofran, and insulin drip.  He was admitted for further management.  12/29/21: Received call from nursing the patient was agitated.  He wanted to leave AMA as he "had things to do." When I got to the room, his insulin drip had already been discontinued as he was getting ready to leave.  His GlucoStabilizer was reviewed and he was administered 10 units of Lantus prior to discharge so that at least he would have some long-acting coverage throughout the day. The patient had no idea how much insulin he takes at home regularly.  Patient was also notified that he was COVID-19 positive.  We discussed quarantine you for 10 days.  We discussed returning to care if he develops shortness of breath.  I did not spend much time trying to convince him to stay as he was punching the wall due to lack of patience and wanting to leave.
Age: 1.0
Sex: F
Vaccine: HEPA, HIBV, MMRV, PNC13
Symptoms: Allergy to vaccine, Hypersensitivity, Injection site rash
Clinical narrative: Allergic reaction to PROQUAD vaccine (rash to left arm), we gave Benadryl. child was observed for 30 min in office. lungs were clear she left with no distress/angioedema. Advise mother to go to ER or call EMS if distressed breathing or swelling to face; follow up  in one day to assess reaction.
Age: 77.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Fatigue, Pyrexia, SARS-CoV-2 test positive
Clinical narrative: I tested positive for COVID-19 on 04/30/2022, I used an at home test. I was very fatigue and had a fever for four days.
Age: 7.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: vaccines where stored at incorrect temperature they had been stored in freezer instead of refrigerator
Age: 59.0
Sex: M
Vaccine: COVID19
Symptoms: Arthralgia, COVID-19, Cough, Diarrhoea, Fatigue
Clinical narrative: I contracted COVID-19 on 05/16/2022 with symptoms of severe headache, dry cough, runny nose, myalgia, joint aches, and fatigue. The next day I developed severe congestion, the headache would not abate, and I had a fever of 102.7, profuse sweating. Wednesday I had diarrhea, and laryngitis develop. On 05/18/2022 I was prescribed Paxlovid and my symptoms began improving. The fever, cough, joint pain, myalgia, diarrhea, and headache have resolved. I am experiencing lingering symptoms of congestion, laryngitis, and fatigue.
Age: 59.0
Sex: M
Vaccine: COVID19
Symptoms: Headache, Hyperhidrosis, Laryngitis, Myalgia, Pyrexia
Clinical narrative: I contracted COVID-19 on 05/16/2022 with symptoms of severe headache, dry cough, runny nose, myalgia, joint aches, and fatigue. The next day I developed severe congestion, the headache would not abate, and I had a fever of 102.7, profuse sweating. Wednesday I had diarrhea, and laryngitis develop. On 05/18/2022 I was prescribed Paxlovid and my symptoms began improving. The fever, cough, joint pain, myalgia, diarrhea, and headache have resolved. I am experiencing lingering symptoms of congestion, laryngitis, and fatigue.
Age: 59.0
Sex: M
Vaccine: COVID19
Symptoms: Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive
Clinical narrative: I contracted COVID-19 on 05/16/2022 with symptoms of severe headache, dry cough, runny nose, myalgia, joint aches, and fatigue. The next day I developed severe congestion, the headache would not abate, and I had a fever of 102.7, profuse sweating. Wednesday I had diarrhea, and laryngitis develop. On 05/18/2022 I was prescribed Paxlovid and my symptoms began improving. The fever, cough, joint pain, myalgia, diarrhea, and headache have resolved. I am experiencing lingering symptoms of congestion, laryngitis, and fatigue.
Age: 46.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: On the clinic day, the vaccine was transported out from the pharmacy to the facility without a digital data logger. The packing used for transport was  refrigerated packaging tote to maintain a temperature of 36 F - 46 F.  However, that is not approved  for COVID-19 vaccine transportation. The total time (from when vaccine left the pharmacy to the clinic completion) was less than 6 hours. There were no adverse events.
Age: 42.0
Sex: M
Vaccine: COVID19
Symptoms: Inappropriate schedule of product administration
Clinical narrative: One day prior to the clinic on 5/18/22, an email was sent to the pharmacy with a list of patients that needed boosters. At the start of the clinic on 5/19/22, copies of vaccine cards for these patients were given to the pharmacy staff. All cards were checked by the pharmacy to ensure eligibility for boosters. Vaccine administration started at 1pm. At approximately 1:20pm, after 14 vaccines were given, the facility alerted the pharmacy that the copies of vaccine cards and emailed list were not up-to-date. After consulting with the facility, who had an updated list of vaccine records, it was determined that six patients were given a booster shot when not eligible. Consulted with the pharmacy team on how to follow-up and proceed with the clinic. Going forward, each patient vaccinated had their records verified on the system and online. Emailed list was cross-checked with the updated list given by the facility. Even with updated list from facility, errors were found with vaccine records not being up-to-date and inconsistencies. Photos of covid vaccination cards were taken for records and vaccination cards were sorted.
Age: 83.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Back pain, Blood culture positive, Blood gases abnormal, COVID-19
Clinical narrative: COVID Vaccine Breakthrough Case  Pfizer Dose 1 2/9/21 (EL1283) Pfizer Dose 2 3/3/21 (EN6200) Pfizer Dose 3 10/16/21 (lot NA) COVID Positive 12/21/21 COVID Positive 12/24/21  12/13/21: Pt is an 83 year-old female with history of nonischemic cardiomyopathy, congestive heart failure, COPD, CKD IIIA, and proteus UTI approximately 1 year ago who presented to the ED this morning with acute right flank pain. Pt states she woke up with right flank pain radiating to her pubic bone at 1 am this morning and was unable to urinate. She then called her son who picked her up and brought her to the ED. Over this time, her pain increased significantly and was severely tachycardic in the 140s and tachypneic in the 40s in the emergency department. CBC revealed a leukocytosis of 16, ABG showed a metabolic acidosis, and abdominal CT showed an obstructing 8mm stone at the right UVJ. She received 2 gm ceftriaxone and 10 mg diltiazem in the ED.  Urology was consulted and the pt was taken to the OR for urgent stent placement of the right ureter. After the procedure, pt was hemodynamically stable and determined to be medically stable for admission to the medicine floor. Pt is currently feeling much better than this morning. She complains of low back pain and shortness of breath that are similar to her baseline. Daughter is requesting voltaren ointment for pt's arthritic low back pain. Pt has a history of tobacco and alcohol use with cessation approximately 1 year ago.  12/31/21: 83-year-old woman who presented with complaints of right flank pain and obstructive lower urinary tract symptoms.  In the emergency department she  was noted  to meet sepsis criteria with leukocytosis, tachycardic and hypertensive.  CT abdomen / pelvis demonstrated right ureteral calculus obstructing the right ureteropelvic junction.   Urology was emergently consulted and she underwent emergent cystoscopy with right ureteral stent placement following initiation of empiric antibiotic therapy.  Post procedural course was complicated by hypotension for which she was admitted to the intensive care unit for pressor support.  Blood cultures were subsequently positive for Proteus mirabilis for which she was appropriately treated with IV Zosyn.  She was also started on stress steroid  which is being tapered down to previous home dose.  Clinical response was favorable with resolution of leukocytosis, tachycardia and  hypotension.  COVID-19 PCR was subsequently noted to be positive during hospital course for which was treated with Decadron and remdesivir with good effect.  She was evaluated by Physical and Occupational therapy and recommended for further rehabilitation.  She has been discharged in stable medical condition to the acute rehab unit today.
Age: 83.0
Sex: F
Vaccine: COVID19
Symptoms: Computerised tomogram abdomen abnormal, Cystoscopy abnormal, Dyspnoea, Flank pain, Full blood count abnormal
Clinical narrative: COVID Vaccine Breakthrough Case  Pfizer Dose 1 2/9/21 (EL1283) Pfizer Dose 2 3/3/21 (EN6200) Pfizer Dose 3 10/16/21 (lot NA) COVID Positive 12/21/21 COVID Positive 12/24/21  12/13/21: Pt is an 83 year-old female with history of nonischemic cardiomyopathy, congestive heart failure, COPD, CKD IIIA, and proteus UTI approximately 1 year ago who presented to the ED this morning with acute right flank pain. Pt states she woke up with right flank pain radiating to her pubic bone at 1 am this morning and was unable to urinate. She then called her son who picked her up and brought her to the ED. Over this time, her pain increased significantly and was severely tachycardic in the 140s and tachypneic in the 40s in the emergency department. CBC revealed a leukocytosis of 16, ABG showed a metabolic acidosis, and abdominal CT showed an obstructing 8mm stone at the right UVJ. She received 2 gm ceftriaxone and 10 mg diltiazem in the ED.  Urology was consulted and the pt was taken to the OR for urgent stent placement of the right ureter. After the procedure, pt was hemodynamically stable and determined to be medically stable for admission to the medicine floor. Pt is currently feeling much better than this morning. She complains of low back pain and shortness of breath that are similar to her baseline. Daughter is requesting voltaren ointment for pt's arthritic low back pain. Pt has a history of tobacco and alcohol use with cessation approximately 1 year ago.  12/31/21: 83-year-old woman who presented with complaints of right flank pain and obstructive lower urinary tract symptoms.  In the emergency department she  was noted  to meet sepsis criteria with leukocytosis, tachycardic and hypertensive.  CT abdomen / pelvis demonstrated right ureteral calculus obstructing the right ureteropelvic junction.   Urology was emergently consulted and she underwent emergent cystoscopy with right ureteral stent placement following initiation of empiric antibiotic therapy.  Post procedural course was complicated by hypotension for which she was admitted to the intensive care unit for pressor support.  Blood cultures were subsequently positive for Proteus mirabilis for which she was appropriately treated with IV Zosyn.  She was also started on stress steroid  which is being tapered down to previous home dose.  Clinical response was favorable with resolution of leukocytosis, tachycardia and  hypotension.  COVID-19 PCR was subsequently noted to be positive during hospital course for which was treated with Decadron and remdesivir with good effect.  She was evaluated by Physical and Occupational therapy and recommended for further rehabilitation.  She has been discharged in stable medical condition to the acute rehab unit today.
Age: 83.0
Sex: F
Vaccine: COVID19
Symptoms: Hypertension, Hypotension, Inappropriate schedule of product administration, Intensive care, Leukocytosis
Clinical narrative: COVID Vaccine Breakthrough Case  Pfizer Dose 1 2/9/21 (EL1283) Pfizer Dose 2 3/3/21 (EN6200) Pfizer Dose 3 10/16/21 (lot NA) COVID Positive 12/21/21 COVID Positive 12/24/21  12/13/21: Pt is an 83 year-old female with history of nonischemic cardiomyopathy, congestive heart failure, COPD, CKD IIIA, and proteus UTI approximately 1 year ago who presented to the ED this morning with acute right flank pain. Pt states she woke up with right flank pain radiating to her pubic bone at 1 am this morning and was unable to urinate. She then called her son who picked her up and brought her to the ED. Over this time, her pain increased significantly and was severely tachycardic in the 140s and tachypneic in the 40s in the emergency department. CBC revealed a leukocytosis of 16, ABG showed a metabolic acidosis, and abdominal CT showed an obstructing 8mm stone at the right UVJ. She received 2 gm ceftriaxone and 10 mg diltiazem in the ED.  Urology was consulted and the pt was taken to the OR for urgent stent placement of the right ureter. After the procedure, pt was hemodynamically stable and determined to be medically stable for admission to the medicine floor. Pt is currently feeling much better than this morning. She complains of low back pain and shortness of breath that are similar to her baseline. Daughter is requesting voltaren ointment for pt's arthritic low back pain. Pt has a history of tobacco and alcohol use with cessation approximately 1 year ago.  12/31/21: 83-year-old woman who presented with complaints of right flank pain and obstructive lower urinary tract symptoms.  In the emergency department she  was noted  to meet sepsis criteria with leukocytosis, tachycardic and hypertensive.  CT abdomen / pelvis demonstrated right ureteral calculus obstructing the right ureteropelvic junction.   Urology was emergently consulted and she underwent emergent cystoscopy with right ureteral stent placement following initiation of empiric antibiotic therapy.  Post procedural course was complicated by hypotension for which she was admitted to the intensive care unit for pressor support.  Blood cultures were subsequently positive for Proteus mirabilis for which she was appropriately treated with IV Zosyn.  She was also started on stress steroid  which is being tapered down to previous home dose.  Clinical response was favorable with resolution of leukocytosis, tachycardia and  hypotension.  COVID-19 PCR was subsequently noted to be positive during hospital course for which was treated with Decadron and remdesivir with good effect.  She was evaluated by Physical and Occupational therapy and recommended for further rehabilitation.  She has been discharged in stable medical condition to the acute rehab unit today.
Age: 83.0
Sex: F
Vaccine: COVID19
Symptoms: Lower urinary tract symptoms, Metabolic acidosis, Nephrolithiasis, Pain, Proteus test positive
Clinical narrative: COVID Vaccine Breakthrough Case  Pfizer Dose 1 2/9/21 (EL1283) Pfizer Dose 2 3/3/21 (EN6200) Pfizer Dose 3 10/16/21 (lot NA) COVID Positive 12/21/21 COVID Positive 12/24/21  12/13/21: Pt is an 83 year-old female with history of nonischemic cardiomyopathy, congestive heart failure, COPD, CKD IIIA, and proteus UTI approximately 1 year ago who presented to the ED this morning with acute right flank pain. Pt states she woke up with right flank pain radiating to her pubic bone at 1 am this morning and was unable to urinate. She then called her son who picked her up and brought her to the ED. Over this time, her pain increased significantly and was severely tachycardic in the 140s and tachypneic in the 40s in the emergency department. CBC revealed a leukocytosis of 16, ABG showed a metabolic acidosis, and abdominal CT showed an obstructing 8mm stone at the right UVJ. She received 2 gm ceftriaxone and 10 mg diltiazem in the ED.  Urology was consulted and the pt was taken to the OR for urgent stent placement of the right ureter. After the procedure, pt was hemodynamically stable and determined to be medically stable for admission to the medicine floor. Pt is currently feeling much better than this morning. She complains of low back pain and shortness of breath that are similar to her baseline. Daughter is requesting voltaren ointment for pt's arthritic low back pain. Pt has a history of tobacco and alcohol use with cessation approximately 1 year ago.  12/31/21: 83-year-old woman who presented with complaints of right flank pain and obstructive lower urinary tract symptoms.  In the emergency department she  was noted  to meet sepsis criteria with leukocytosis, tachycardic and hypertensive.  CT abdomen / pelvis demonstrated right ureteral calculus obstructing the right ureteropelvic junction.   Urology was emergently consulted and she underwent emergent cystoscopy with right ureteral stent placement following initiation of empiric antibiotic therapy.  Post procedural course was complicated by hypotension for which she was admitted to the intensive care unit for pressor support.  Blood cultures were subsequently positive for Proteus mirabilis for which she was appropriately treated with IV Zosyn.  She was also started on stress steroid  which is being tapered down to previous home dose.  Clinical response was favorable with resolution of leukocytosis, tachycardia and  hypotension.  COVID-19 PCR was subsequently noted to be positive during hospital course for which was treated with Decadron and remdesivir with good effect.  She was evaluated by Physical and Occupational therapy and recommended for further rehabilitation.  She has been discharged in stable medical condition to the acute rehab unit today.
Age: 83.0
Sex: F
Vaccine: COVID19
Symptoms: Pubic pain, SARS-CoV-2 test positive, Sepsis, Tachycardia, Tachypnoea
Clinical narrative: COVID Vaccine Breakthrough Case  Pfizer Dose 1 2/9/21 (EL1283) Pfizer Dose 2 3/3/21 (EN6200) Pfizer Dose 3 10/16/21 (lot NA) COVID Positive 12/21/21 COVID Positive 12/24/21  12/13/21: Pt is an 83 year-old female with history of nonischemic cardiomyopathy, congestive heart failure, COPD, CKD IIIA, and proteus UTI approximately 1 year ago who presented to the ED this morning with acute right flank pain. Pt states she woke up with right flank pain radiating to her pubic bone at 1 am this morning and was unable to urinate. She then called her son who picked her up and brought her to the ED. Over this time, her pain increased significantly and was severely tachycardic in the 140s and tachypneic in the 40s in the emergency department. CBC revealed a leukocytosis of 16, ABG showed a metabolic acidosis, and abdominal CT showed an obstructing 8mm stone at the right UVJ. She received 2 gm ceftriaxone and 10 mg diltiazem in the ED.  Urology was consulted and the pt was taken to the OR for urgent stent placement of the right ureter. After the procedure, pt was hemodynamically stable and determined to be medically stable for admission to the medicine floor. Pt is currently feeling much better than this morning. She complains of low back pain and shortness of breath that are similar to her baseline. Daughter is requesting voltaren ointment for pt's arthritic low back pain. Pt has a history of tobacco and alcohol use with cessation approximately 1 year ago.  12/31/21: 83-year-old woman who presented with complaints of right flank pain and obstructive lower urinary tract symptoms.  In the emergency department she  was noted  to meet sepsis criteria with leukocytosis, tachycardic and hypertensive.  CT abdomen / pelvis demonstrated right ureteral calculus obstructing the right ureteropelvic junction.   Urology was emergently consulted and she underwent emergent cystoscopy with right ureteral stent placement following initiation of empiric antibiotic therapy.  Post procedural course was complicated by hypotension for which she was admitted to the intensive care unit for pressor support.  Blood cultures were subsequently positive for Proteus mirabilis for which she was appropriately treated with IV Zosyn.  She was also started on stress steroid  which is being tapered down to previous home dose.  Clinical response was favorable with resolution of leukocytosis, tachycardia and  hypotension.  COVID-19 PCR was subsequently noted to be positive during hospital course for which was treated with Decadron and remdesivir with good effect.  She was evaluated by Physical and Occupational therapy and recommended for further rehabilitation.  She has been discharged in stable medical condition to the acute rehab unit today.