chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 55.0
Sex: F
Vaccine: SMALL
Symptoms: Chest pain, Dizziness, Dyspnoea, Hyperhidrosis, Neck pain
Clinical narrative: Admitted to ICU from ER. Ntg drip relived C/P. Stress test-negative. Lovenox. Admitted on 3/31/03. DC 4/2/03. C/O CP at stenum that radiates into L shoulder and L side of neck approximately 2 hr PTA. Pt states it feels like pressure, and a sensation that she "couldn't get enough air." She is a 55 year old female. The pt has been under a little bit more stress than usual today. She worked a 24-hour shift the day before she got ill. Yesterday while she was walking around the hospital she had chest pain, it bothered her, made her a little bit dizzy and she got diaphoretic with it. It was midsternal, progressive and associated with some shortness of breath and some aching in her shoulder and neck. She got to thinking about all the people she had seen with chest pain that she had warned to come to the hospital because of it and finally went to the ER. They did EKGs and started a nitrodrip on her and she got almost immediate relief of the chest pain with the nitro drip. The heaviness and shortness of breath were also resolved. She became hypotensive and they had to drop her off of the nitrates and the chest pain returned. They started the nitrates and the chest pain was resolved again.
Age: 55.0
Sex: F
Vaccine: SMALL
Symptoms: Pain
Clinical narrative: Admitted to ICU from ER. Ntg drip relived C/P. Stress test-negative. Lovenox. Admitted on 3/31/03. DC 4/2/03. C/O CP at stenum that radiates into L shoulder and L side of neck approximately 2 hr PTA. Pt states it feels like pressure, and a sensation that she "couldn't get enough air." She is a 55 year old female. The pt has been under a little bit more stress than usual today. She worked a 24-hour shift the day before she got ill. Yesterday while she was walking around the hospital she had chest pain, it bothered her, made her a little bit dizzy and she got diaphoretic with it. It was midsternal, progressive and associated with some shortness of breath and some aching in her shoulder and neck. She got to thinking about all the people she had seen with chest pain that she had warned to come to the hospital because of it and finally went to the ER. They did EKGs and started a nitrodrip on her and she got almost immediate relief of the chest pain with the nitro drip. The heaviness and shortness of breath were also resolved. She became hypotensive and they had to drop her off of the nitrates and the chest pain returned. They started the nitrates and the chest pain was resolved again.
Age: 43.0
Sex: F
Vaccine: SMALL
Symptoms: Dyspnoea, Thyroid disorder
Clinical narrative: Started waking up with tachydysrhythmias and S.O.B. at night.  Placed on Toprol XL.
Age: 34.0
Sex: F
Vaccine: SMALL
Symptoms: Chest pain, Dizziness, Dyspnoea, Oedema peripheral, Periorbital oedema
Clinical narrative: 1+ bilateral pitting edema in legs noted PM of 4/3/03.  Facial swelling and preorbital edema noted morning of 4/4/03.  Weight 109 pounds.  4/7/03 weight 110 pounds, temp 99.6.  4/9/03 110 pounds. 4/10/03 111 pounds.  Episodes of frequent sharp chest pain.  2 FB increased L breast nipple short durations began 4/7/03 at approx. 5PM arriving home from work.  SOB and dizziness noted 4/7/03.  Did not seek MD evaluation.
Age: 34.0
Sex: F
Vaccine: SMALL
Symptoms: Swelling face, Weight increased
Clinical narrative: 1+ bilateral pitting edema in legs noted PM of 4/3/03.  Facial swelling and preorbital edema noted morning of 4/4/03.  Weight 109 pounds.  4/7/03 weight 110 pounds, temp 99.6.  4/9/03 110 pounds. 4/10/03 111 pounds.  Episodes of frequent sharp chest pain.  2 FB increased L breast nipple short durations began 4/7/03 at approx. 5PM arriving home from work.  SOB and dizziness noted 4/7/03.  Did not seek MD evaluation.
Age: 45.0
Sex: F
Vaccine: SMALL
Symptoms: Chest pain, Dyspnoea, Pain
Clinical narrative: Received vaccination on 3/28/03.  On 4/1/03 I had left arm pain with some pain that went across my chest for approximately 2-3 hours.  Also some shortness of breath noted during that time.  No symptoms since.
Age: 24.0
Sex: F
Vaccine: SMALL
Symptoms: Arthralgia, Chills, Headache, Musculoskeletal stiffness, Myalgia
Clinical narrative: Severe H/A since vaccination. Seen in ER x 2 on 3/25/03 and 3/28/03 then admitted with stiff neck, H/A's, N/V fever of 101.0, myalgia and arthralgia. Still sick today 4/3/03 with H/A and N/V still sick with H/A's with vomiting. Pt is a 24 year old female who received the small pox vaccination 9 days ago. Every since she got vaccinated she has had severe headache. Three days ago she began to experience a stiff neck and worsening of her headaches. She has associated nausea, vomiting, photophobia, and phonophobis. She had a fever at home to 101.0. She has had shaking and chills at home with associated myalgias and arthralgias. She denies a rash. Pt was seen in the ER last night and was started on Mepergan and Cipro.
Age: 24.0
Sex: F
Vaccine: SMALL
Symptoms: Nausea, Photophobia, Pyrexia, Tremor, Vomiting
Clinical narrative: Severe H/A since vaccination. Seen in ER x 2 on 3/25/03 and 3/28/03 then admitted with stiff neck, H/A's, N/V fever of 101.0, myalgia and arthralgia. Still sick today 4/3/03 with H/A and N/V still sick with H/A's with vomiting. Pt is a 24 year old female who received the small pox vaccination 9 days ago. Every since she got vaccinated she has had severe headache. Three days ago she began to experience a stiff neck and worsening of her headaches. She has associated nausea, vomiting, photophobia, and phonophobis. She had a fever at home to 101.0. She has had shaking and chills at home with associated myalgias and arthralgias. She denies a rash. Pt was seen in the ER last night and was started on Mepergan and Cipro.
Age: 43.0
Sex: F
Vaccine: SMALL
Symptoms: Headache, Migraine, Nausea, Pain
Clinical narrative: 3/24/03 went to dr's office with severe H/A, N and V=had Teradol Im 3/28/03 severe H/A "worst ever"- had nublain and Phen. in office without relief,-admitted for IV flds, IV and IM pain management hx of migraines. Pt is a 43 year old female with a histoy of migraine headaches who presented to the clinic after having sudden onset of a severe headache while at work in the hospital. The pt took her normal medication, which was Frova x 2, without any relief, with continued escalation. The pt was the worst she had ever had. She was unable to sit still, was crying and nauseated. She was seen in the office and given a shot of Nubain and Phenergan, but continued to have severe pain and was, therefore, admitted to the hospital for further treatment. Complication factors included recent immunization against small pox approximately ten to eleven days ago which may have induced some headacches and she has had two headaches since that time requiring narcotic analgesics.
Age: 27.0
Sex: F
Vaccine: SMALL
Symptoms: Headache, Myalgia, Neck pain, Photophobia, Pyrexia
Clinical narrative: 3/26/02 Headache, myalgia, low grade fever. 3/27/03 Felt better. 4/2/03 Fever 101.4, severe headache, myalgia. 4/3/03 ER visit - received medicine for severe headache; went home with PO Lortab. 4/8/03 Severe headache, neck pain, head pounding, photophobia; ER visit - admitted to hospital.
Age: 51.0
Sex: M
Vaccine: SMALL
Symptoms: Fatigue, Joint swelling
Clinical narrative: Generalized fatigue 1 day after vaccination and continuing for 21 days post vaccination. Also, patient complained of joint swelling in wrist and back of knees. Patient came to ER complaining of the above symptoms and concerned about reports of post smallpox cardiac complications.
Age: 40.0
Sex: F
Vaccine: SMALL
Symptoms: Chills, Fatigue, Headache, Lymphadenopathy, Neck pain
Clinical narrative: The patient has experienced persistent dull headaches, a sore neck (onset 3/30/03), swollen lymph nodes in the armpits and neck, chills and nightsweats (3/31/03-4/1/03; no fever), and considerable fatigue (at times, it has been difficult for the patient to stay awake for more that 2-3 hours).  She was evaluated by her primary care physician (4/10/03), and the physician determined that the patient did not have encephalitis.  Ultracet was prescribed for the patient's headaches, but the medication did not help.  The patient was seen again by her physician on 4/15/03 and naprosen was prescribed for the patient's sore neck.  As of 4/18/03 the patient's neck was feeling much better, but she was still experiencing dull headaches and fatigue.  She has been referred to a neurologist, but no appointment date has been set.  The patient has already missed 10 days of work due to this illness.  NOTE: The patient has a history of migraines, but she indicated that her current headaches do not feel like migraines.
Age: 40.0
Sex: F
Vaccine: SMALL
Symptoms: Night sweats
Clinical narrative: The patient has experienced persistent dull headaches, a sore neck (onset 3/30/03), swollen lymph nodes in the armpits and neck, chills and nightsweats (3/31/03-4/1/03; no fever), and considerable fatigue (at times, it has been difficult for the patient to stay awake for more that 2-3 hours).  She was evaluated by her primary care physician (4/10/03), and the physician determined that the patient did not have encephalitis.  Ultracet was prescribed for the patient's headaches, but the medication did not help.  The patient was seen again by her physician on 4/15/03 and naprosen was prescribed for the patient's sore neck.  As of 4/18/03 the patient's neck was feeling much better, but she was still experiencing dull headaches and fatigue.  She has been referred to a neurologist, but no appointment date has been set.  The patient has already missed 10 days of work due to this illness.  NOTE: The patient has a history of migraines, but she indicated that her current headaches do not feel like migraines.
Age: 25.0
Sex: F
Vaccine: SMALL
Symptoms: Injection site swelling, Lymphadenopathy, Tenderness
Clinical narrative: 4/16 noted lymphadenopathy; 4/17 increased swelling and tenderness; 4/18 cont. swelling less tenderness.
Age: 57.0
Sex: F
Vaccine: SMALL
Symptoms: Arthralgia, Dizziness, Fatigue, Joint stiffness, Pain
Clinical narrative: The patient has experienced fatigue, light-headedness, body aches, and sore and stiff joints.  The light-headedness resolved shortly after the patient resumed taking her prescription of allegra.  She presented to a physician on 4/9/03 and was given a 6-day medrol pack (4mg; 4/11/03-4/16/03).  The patient experienced no change in the severity of symptoms after finishing the medrol prescription.  Dr. with CDC was consulted on 4/17/03, and it was decided that the patient should be followed for 2 more weeks--at which point the patient would be advised to see a rheumatologist if the symptoms persisted. NOTE: When the patient originally became ill on 4/5/03, several of the patient's co-workers who had not received the smallpox vaccination were also ill with similar symptoms.  However, those co-workers' symptoms resolved after a few days, where as the patient's symptoms have now persisted for 2 weeks.
Age: 50.0
Sex: F
Vaccine: ANTH
Symptoms: Injection site erythema, Injection site hypersensitivity, Injection site oedema, Injection site pain, Injection site reaction
Clinical narrative: Moderate to severe localized reaction right arm anterior half armpit to two inches below elbow- Red, hot, swollen itchy, tender
Age: 50.0
Sex: F
Vaccine: ANTH
Symptoms: Injection site warmth, Pruritus
Clinical narrative: Moderate to severe localized reaction right arm anterior half armpit to two inches below elbow- Red, hot, swollen itchy, tender
Age: 44.0
Sex: M
Vaccine: SMALL
Symptoms: Headache, Pruritus, Rash, Rash erythematous
Clinical narrative: Pin point rash progressed to cover most of body in 7 days. Began to resolve 3/27/03. Almost completely resolved by 3/31/03. Accompanied by H/A, extreme itching, no fever. 3/18/03, 10am approximately 29 hrs after vaccination, pt presented with diffuse rash extending primarily over face, neck, trunk and thighs. Rash was very red, fine (pin point) and itchy and progressed over the next several days to the arms, axillae, legs, ankles and genitalia. He did not have fever, respiratory symptoms, or myalgia at any time. Pt noted a cropping aspect to the rash where it improved in the evenings, then was worse the next day when tiny painful scabs formed over the pin-point rash (no notable vesicular or pustular stage). Rash was accompanied by persistent headache lasting throughout the period of rash. Pt was treated in the ER on 3/18 with 150mg Prednisone and 150mg Benadryl immediately after rash was noticed. A closer review of medical history included the following: past allergies to "-zines," such as Compazine, dust, mild and guinea pigs. His TST always displayed erythema without induration; he can eat seafood (saltwater) but can't eat fresh fish (freshwater). Freshwater fish causes systemic anaphylaxis with the following symptoms: itching, tongue,  lip and pharyngeal swelling. Pt had been taking antibiotic Clindomycin until 3/19 or 3/20 ro cervical lymphadenitis. A TST was administered at same time as the vaccinia vaccination (3/17/03). The rash first appeared and first cleared in the face, neck and chest. The rash last appeared and last cleared from his axillae. He received limited relief from diphenhydramine, hydroxyzine and cimetidine. On 3/25/03 pt was given Doxapin x 1 for extreme itching and related distress. On 3/26/03 pt felt much better and seemed to "turn a corner" and get better over the next few days. His rash was 99% resolved by 3/31/03 per pt. Residual skin discoloration/scarring on trunk (4/18/03).
Age: 64.0
Sex: M
Vaccine: SMALL
Symptoms: Chest discomfort, Dizziness, Myocardial infarction
Clinical narrative: Heart-attack 3/23/03. Vaccinated 3/21/03. No known history of cardiac problems. Severe indication of some hx of chest discomfort. MMWR weekly April 4, 2003/52 (13); 278-282. Case #3. An active man aged 64 years with a history of dyspnea on exertion and productive cough for 3 months and eight previous smallpox vaccinations was revaccinated on 3/21. On 3/23, he sought medical care for chest "fullness" and dizziness. Blood tests indicated elevated troponin I and CK-MB levels. ECG demonstrated inferior ST segment depression and T wave inversion. Echocardiography indicated moderate inferior wall hypokenesis with a normal ejection fraction. Coronary arteriography showed three vessel atherosclertic disease with development of some collateral circulation. THe pt underwent cardiac catheterization with ballon arthrotomy, and two coronary artery stents were placed. The clinical course and laboratory findings are consistent with acute myocardial infarction in a pt with chronic coronary artery disease. He returned to work on 3/31.
Age: 0.2
Sex: M
Vaccine: DTAP, PNC
Symptoms: Apnoea, Bradycardia, Condition aggravated, White blood cell count increased
Clinical narrative: Patient developed recurrent episodes of apnea, bradycardia, and desaturations in blood oxygenation.  He eventually had to be intubated and placed on a ventilator to control his apnea.  He currently remains on ventilator support.   He is an ex 27 week premie with chronic lung disease who had been weaned down to 0.2L of oxygen prior to his vaccinations, and then he developed the listed symptoms the next day.
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMR
Symptoms: Erythema, Feeling hot, Oedema
Clinical narrative: Area of swelling  2 inches wide by 3-4 inches long on upper left outer arm below but not including aea where DTaP administered.  But does involve area where IPV given.  Area red, warm to the touch temp 98.1 orally.  Seen by Dr @ Health deaprtment
Age: 4.0
Sex: M
Vaccine: DTAP, IPV, MMR
Symptoms: Erythema, Feeling hot, Oedema, Pyrexia
Clinical narrative: Developed redness, swelling, heat lt upper arm to shoulder.  Has had fever since  100-101 degrees.  Saw Dr. at Clinic on 4/16/03
Age: 32.0
Sex: F
Vaccine: SMALL
Symptoms: Back pain, Headache, Musculoskeletal stiffness, Pain, Pyrexia
Clinical narrative: On 3/16/03, (day 5), vaccinee complained of a "slight headache and sore Rt.axillary node".  On 3/21/03, (day 10), vaccinee was admitted to Hospital, with fever (103.4F), HA, backache and stiff neck.  She was treated with IV Zithromax X 3days.  Liver function tests were elevated slightly therefore INH prophylaxis discontinued. Blood cultures were pending (later returned negative) when she was transferred to the regional medical center, for further evaluation.  All medications were discontinued.  LP was performed - mild elevated glucose and protein were only findings.  Sample of CSF and 1 red top tube of serum were sent to CDC as requested. CT and MRI were negative.  She received neurological supportive care while hospitalized.  Vaccinee was discharged on 3/26/03 with diagnosis of "Adverse reaction to Smallpox Vaccine, Headache".  On 3/28/03, vaccinee was re-admitted to with Headache and vomiting according to her mother.  Mother did not know is she had fever at the time of this admission.  Have been unable to obtain the records of this admission but she was hospitalized for either 1 or 2 days.  She did return to work on 4/1/03.  The vaccinee was unable to be interviewed after last hospitalization due to another unrelated but elective hospitalization within 2 weeks of returning to work.
Age: 32.0
Sex: F
Vaccine: SMALL
Symptoms: Vomiting
Clinical narrative: On 3/16/03, (day 5), vaccinee complained of a "slight headache and sore Rt.axillary node".  On 3/21/03, (day 10), vaccinee was admitted to Hospital, with fever (103.4F), HA, backache and stiff neck.  She was treated with IV Zithromax X 3days.  Liver function tests were elevated slightly therefore INH prophylaxis discontinued. Blood cultures were pending (later returned negative) when she was transferred to the regional medical center, for further evaluation.  All medications were discontinued.  LP was performed - mild elevated glucose and protein were only findings.  Sample of CSF and 1 red top tube of serum were sent to CDC as requested. CT and MRI were negative.  She received neurological supportive care while hospitalized.  Vaccinee was discharged on 3/26/03 with diagnosis of "Adverse reaction to Smallpox Vaccine, Headache".  On 3/28/03, vaccinee was re-admitted to with Headache and vomiting according to her mother.  Mother did not know is she had fever at the time of this admission.  Have been unable to obtain the records of this admission but she was hospitalized for either 1 or 2 days.  She did return to work on 4/1/03.  The vaccinee was unable to be interviewed after last hospitalization due to another unrelated but elective hospitalization within 2 weeks of returning to work.
Age: 20.0
Sex: M
Vaccine: ANTH, HEP, ANTH
Symptoms: Abdominal pain, Anorexia, Dehydration, Fatigue, Pain
Clinical narrative: Developed GI symptoms after AVA #3 continues with intermittent pain. Suspected irritable bowel syndrome, new onset, temporally associated to anthrax vaccine #3. Pt experiences episodes of nausea, vomiting, and abdominal pain after anthrax #3. He was later hospitalized and treated for dehydration and subsequently had a gastrointestinal evaluation. Despite ongoing therapeutic intervention, he continues to have intermittent episodes of abdominal pain. Pt is in today, he was referred for possible Crohn's disease. I reviewed his records. He had not really had any diarrhea. He had abdominal pain, thought initially to have appendicitis. Cat scan was non-specific findings and initially suggested Crohn's disease. He subsequently underwent a colonoscopy including they said 20cm and a terminal ileum with biopsies which did not show nay granulomas or see any changes. He subsequently had a small bowel follow through that showed some possible thickening with very soft findings. He also had vaccinations as well with the military as well. He had an anthrax shot on 1/25 and he has felt pale and tired since that time. He had more fatigue on 2/9 and he had some nausea and regurgitation. He subsequently wen on 2-12 to student health service but they thought he was dehydrated, gave him IV fluids and gave him some pain killers he said. He had a WBC elevated at that time. He then went to hospital and that was where the further work up was done as above. The pt was given antibiotics and had the colonoscopy. He since that time the last 3 d he has been doing very well. He has occasionally some heart burn and reflex but he has not been on any cheese or milk products and he has had less gas and bloating. He sounds like he clearly has had some lactose deficiency as well. At present today he is not having any further nausea, vomiting, or abdominal pain. He has absolutely no extra bowel manifestations of inflammatory bowel disease. Reviewing his records, they are not consistent in that the small bowel involvement with effecting the terminal ileum but not in the distal ileum but not having any involvement there on colonoscopy including with biopsies. The follow up received on 12/23/03 states pt took Entocort-EC until 11/13/03. He was weaned off of the medication and up to this time he remains symptom-free. He was activated and is performing all duties. He continues with a permanent exemption to the anthrax vaccine.
Age: 20.0
Sex: M
Vaccine: ANTH, HEP, ANTH
Symptoms: Pallor, Pyrexia, Somnolence, Vomiting
Clinical narrative: Developed GI symptoms after AVA #3 continues with intermittent pain. Suspected irritable bowel syndrome, new onset, temporally associated to anthrax vaccine #3. Pt experiences episodes of nausea, vomiting, and abdominal pain after anthrax #3. He was later hospitalized and treated for dehydration and subsequently had a gastrointestinal evaluation. Despite ongoing therapeutic intervention, he continues to have intermittent episodes of abdominal pain. Pt is in today, he was referred for possible Crohn's disease. I reviewed his records. He had not really had any diarrhea. He had abdominal pain, thought initially to have appendicitis. Cat scan was non-specific findings and initially suggested Crohn's disease. He subsequently underwent a colonoscopy including they said 20cm and a terminal ileum with biopsies which did not show nay granulomas or see any changes. He subsequently had a small bowel follow through that showed some possible thickening with very soft findings. He also had vaccinations as well with the military as well. He had an anthrax shot on 1/25 and he has felt pale and tired since that time. He had more fatigue on 2/9 and he had some nausea and regurgitation. He subsequently wen on 2-12 to student health service but they thought he was dehydrated, gave him IV fluids and gave him some pain killers he said. He had a WBC elevated at that time. He then went to hospital and that was where the further work up was done as above. The pt was given antibiotics and had the colonoscopy. He since that time the last 3 d he has been doing very well. He has occasionally some heart burn and reflex but he has not been on any cheese or milk products and he has had less gas and bloating. He sounds like he clearly has had some lactose deficiency as well. At present today he is not having any further nausea, vomiting, or abdominal pain. He has absolutely no extra bowel manifestations of inflammatory bowel disease. Reviewing his records, they are not consistent in that the small bowel involvement with effecting the terminal ileum but not in the distal ileum but not having any involvement there on colonoscopy including with biopsies. The follow up received on 12/23/03 states pt took Entocort-EC until 11/13/03. He was weaned off of the medication and up to this time he remains symptom-free. He was activated and is performing all duties. He continues with a permanent exemption to the anthrax vaccine.
Age: 20.0
Sex: M
Vaccine: ANTH, HEP, ANTH
Symptoms: Abdominal pain, Dehydration, Gastrointestinal disorder, Nausea, Pain
Clinical narrative: Developed GI symptoms after AVA #3 continues with intermittent pain. Suspected irritable bowel syndrome, new onset, temporally associated to anthrax vaccine #3. Pt experiences episodes of nausea, vomiting, and abdominal pain after anthrax #3. He was later hospitalized and treated for dehydration and subsequently had a gastrointestinal evaluation. Despite ongoing therapeutic intervention, he continues to have intermittent episodes of abdominal pain. Pt is in today, he was referred for possible Crohn's disease. I reviewed his records. He had not really had any diarrhea. He had abdominal pain, thought initially to have appendicitis. Cat scan was non-specific findings and initially suggested Crohn's disease. He subsequently underwent a colonoscopy including they said 20cm and a terminal ileum with biopsies which did not show nay granulomas or see any changes. He subsequently had a small bowel follow through that showed some possible thickening with very soft findings. He also had vaccinations as well with the military as well. He had an anthrax shot on 1/25 and he has felt pale and tired since that time. He had more fatigue on 2/9 and he had some nausea and regurgitation. He subsequently wen on 2-12 to student health service but they thought he was dehydrated, gave him IV fluids and gave him some pain killers he said. He had a WBC elevated at that time. He then went to hospital and that was where the further work up was done as above. The pt was given antibiotics and had the colonoscopy. He since that time the last 3 d he has been doing very well. He has occasionally some heart burn and reflex but he has not been on any cheese or milk products and he has had less gas and bloating. He sounds like he clearly has had some lactose deficiency as well. At present today he is not having any further nausea, vomiting, or abdominal pain. He has absolutely no extra bowel manifestations of inflammatory bowel disease. Reviewing his records, they are not consistent in that the small bowel involvement with effecting the terminal ileum but not in the distal ileum but not having any involvement there on colonoscopy including with biopsies. The follow up received on 12/23/03 states pt took Entocort-EC until 11/13/03. He was weaned off of the medication and up to this time he remains symptom-free. He was activated and is performing all duties. He continues with a permanent exemption to the anthrax vaccine.
Age: 20.0
Sex: M
Vaccine: ANTH, HEP, ANTH
Symptoms: Vomiting
Clinical narrative: Developed GI symptoms after AVA #3 continues with intermittent pain. Suspected irritable bowel syndrome, new onset, temporally associated to anthrax vaccine #3. Pt experiences episodes of nausea, vomiting, and abdominal pain after anthrax #3. He was later hospitalized and treated for dehydration and subsequently had a gastrointestinal evaluation. Despite ongoing therapeutic intervention, he continues to have intermittent episodes of abdominal pain. Pt is in today, he was referred for possible Crohn's disease. I reviewed his records. He had not really had any diarrhea. He had abdominal pain, thought initially to have appendicitis. Cat scan was non-specific findings and initially suggested Crohn's disease. He subsequently underwent a colonoscopy including they said 20cm and a terminal ileum with biopsies which did not show nay granulomas or see any changes. He subsequently had a small bowel follow through that showed some possible thickening with very soft findings. He also had vaccinations as well with the military as well. He had an anthrax shot on 1/25 and he has felt pale and tired since that time. He had more fatigue on 2/9 and he had some nausea and regurgitation. He subsequently wen on 2-12 to student health service but they thought he was dehydrated, gave him IV fluids and gave him some pain killers he said. He had a WBC elevated at that time. He then went to hospital and that was where the further work up was done as above. The pt was given antibiotics and had the colonoscopy. He since that time the last 3 d he has been doing very well. He has occasionally some heart burn and reflex but he has not been on any cheese or milk products and he has had less gas and bloating. He sounds like he clearly has had some lactose deficiency as well. At present today he is not having any further nausea, vomiting, or abdominal pain. He has absolutely no extra bowel manifestations of inflammatory bowel disease. Reviewing his records, they are not consistent in that the small bowel involvement with effecting the terminal ileum but not in the distal ileum but not having any involvement there on colonoscopy including with biopsies. The follow up received on 12/23/03 states pt took Entocort-EC until 11/13/03. He was weaned off of the medication and up to this time he remains symptom-free. He was activated and is performing all duties. He continues with a permanent exemption to the anthrax vaccine.
Sex: U
Vaccine: MMR
Symptoms: Lymphadenitis
Clinical narrative: It was reported in a published article that a patient with a history of familial cellular immunodeficiency was vaccinated with a dose of MMR. Subsequently, the patient developed necrotizing measles lymphadenitis. Upon internal review, necrotizing measles lymphadenitis was considered to be an important medical event. Additional information has been requested. It was also reported that a second patient developed autism after being treated with MMR.
Age: 12.0
Sex: M
Vaccine: HEP
Symptoms: Dizziness, Hydronephrosis, Hyperaesthesia, Nausea, Pyrexia
Clinical narrative: Information has been received from a registered nurse concerning a 12 year old male patient who on 10/18/02 was vaccinated with a first dose of hepatitis B vaccine recombinant 10mcg. Concomitant medication was unknown. It was noted that the patient developed back pain, a low grade fever, nausea, dizziness, hypersensitivity to touch and had surgery to clear blocked ureter shortly after vaccination. Unspecified medical attention was sought. The outcome was unknown. Follow up information revealed that the mother of the child reported to the nurse manager that the child was continuing to run intermittant fevers but does not have them documented. The nurse reported that she instructed the mother of the child to maintain a log of the child's temperature's at 8am, 4pm and 8pm daily. Around the same time the child was vaccinated (date unknown but sometime in October 2002) the child was diagnosed with a UTI, and since that time was also diagnosed with hydronephrosis of the kidney and had surgery to clear a blocked ureter in December 2002. It was reported that the child no longer had a UTI and that the nurse had done balance tests on the child and they were all normal. The physicians did not feel that there was any connection between the symptoms, surgery and the hepatitis B recombinant, however, the mother is looking for a reason for her sons condition. Upon internal medical review, the blocked ureter and hydronephrosis were considered an other important medical event. No further information was provided.
Age: 12.0
Sex: M
Vaccine: HEP
Symptoms: Upper respiratory tract infection
Clinical narrative: Information has been received from a registered nurse concerning a 12 year old male patient who on 10/18/02 was vaccinated with a first dose of hepatitis B vaccine recombinant 10mcg. Concomitant medication was unknown. It was noted that the patient developed back pain, a low grade fever, nausea, dizziness, hypersensitivity to touch and had surgery to clear blocked ureter shortly after vaccination. Unspecified medical attention was sought. The outcome was unknown. Follow up information revealed that the mother of the child reported to the nurse manager that the child was continuing to run intermittant fevers but does not have them documented. The nurse reported that she instructed the mother of the child to maintain a log of the child's temperature's at 8am, 4pm and 8pm daily. Around the same time the child was vaccinated (date unknown but sometime in October 2002) the child was diagnosed with a UTI, and since that time was also diagnosed with hydronephrosis of the kidney and had surgery to clear a blocked ureter in December 2002. It was reported that the child no longer had a UTI and that the nurse had done balance tests on the child and they were all normal. The physicians did not feel that there was any connection between the symptoms, surgery and the hepatitis B recombinant, however, the mother is looking for a reason for her sons condition. Upon internal medical review, the blocked ureter and hydronephrosis were considered an other important medical event. No further information was provided.
Age: 0.57
Sex: M
Vaccine: HEPA
Symptoms: Contusion, Neutropenia, Petechiae, Thrombocytopenic purpura
Clinical narrative: Bruising, petichae-ITP 1 wk after hep A #1 in 9/02 and #2 in 4/03. Tx with IVIG.  Discharge Summary received on 9/10/2003 states neutropenia.
Age: 0.5
Sex: M
Vaccine: DTAP, IPV, PNC
Symptoms: Contusion, Hypersensitivity, Oedema peripheral, Otitis media, Petechiae
Clinical narrative: Atypical HSP-fever, bruising/petichiae/edema of legs. The hospital discharge summary states bilateral OM.  A follow up report received 8/26/03 adds: Atypical HSP - fever, bruising, peticular, edema of legs. Diagnosed with allergic reaction
Age: 0.5
Sex: M
Vaccine: DTAP, IPV, PNC
Symptoms: Pyrexia
Clinical narrative: Atypical HSP-fever, bruising/petichiae/edema of legs. The hospital discharge summary states bilateral OM.  A follow up report received 8/26/03 adds: Atypical HSP - fever, bruising, peticular, edema of legs. Diagnosed with allergic reaction
Age: 28.0
Sex: M
Vaccine: ANTH
Symptoms: Injection site erythema, Injection site oedema
Clinical narrative: 12cm area of redness and swelling around vaccination site.
Age: 25.0
Sex: F
Vaccine: ANTH
Symptoms: Injection site erythema, Injection site pain, Injection site warmth
Clinical narrative: 10cm area of redness, warmth, tenderness around vaccination site.
Age: 21.0
Sex: M
Vaccine: ANTH
Symptoms: Injection site erythema, Injection site pain, Rash
Clinical narrative: Erythema with tenderness at R tricep-where anthrax administered. Pink rash to arms/trunk.
Age: 23.0
Sex: M
Vaccine: ANTH
Symptoms: Cellulitis, Injection site erythema, Injection site reaction
Clinical narrative: Erythema to entire upper extremity tx=cellulitis. Rx Nafcillin.
Age: 21.0
Sex: F
Vaccine: ANTH
Symptoms: Injection site abscess sterile, Injection site oedema
Clinical narrative: Small, sterile abscess two days immunization arm swollen.
Age: 22.0
Sex: F
Vaccine: ANTH
Symptoms: Skin ulcer
Clinical narrative: Scattered tiny lesions on trunk and extremities no SOB.
Age: 34.0
Sex: F
Vaccine: ANTH
Symptoms: Injection site erythema, Injection site oedema
Clinical narrative: Swelling of arm, redness.
Age: 23.0
Sex: F
Vaccine: ANTH
Symptoms: Injection site erythema
Clinical narrative: Redness R upper arm around vaccine site, now on inside of arm.
Age: 55.0
Sex: F
Vaccine: SMALL, SMALL
Symptoms: Myocarditis, Pericardial effusion, Pericarditis, Ventricular extrasystoles
Clinical narrative: PVC's-started 4/9/03. Saw cardiologist 4/11 and 4/14. Echocardiogram-pericarditis, pericardial effusion and myocarditis.
Age: 55.0
Sex: F
Vaccine: SMALL, SMALL
Symptoms: Palpitations, Pericardial effusion, Pericarditis
Clinical narrative: PVC's-started 4/9/03. Saw cardiologist 4/11 and 4/14. Echocardiogram-pericarditis, pericardial effusion and myocarditis.
Age: 0.3
Sex: F
Vaccine: DTAP, HBHEPB, IPV, PNC
Symptoms: Pyrexia
Clinical narrative: 4/16/03 after hairs message rec'd, fever 102.5. Using Tylenol since 8a, 12n, 8pm. Vaccines 4/15/03.
Age: 4.3
Sex: M
Vaccine: DTAP
Symptoms: Injection site induration, Injection site warmth
Clinical narrative: Large area induration/warmth L upper arm approximately 7x6cm.
Age: 1.6
Sex: F
Vaccine: DTAP, HBHEPB, IPV, MMR
Symptoms: Lymphadenopathy, Pyrexia, Rash
Clinical narrative: Temp 104, day 11-day 12. Rash day 14. Swelled lymph nodes (groin) day 13. Visited local ER-treatment only for symptoms.
Age: 1.0
Sex: F
Vaccine: HBHEPB, MMR, VARCEL
Symptoms: Cellulitis, Injection site erythema, Injection site induration, Injection site pain, Injection site reaction
Clinical narrative: Right thigh site, red, indurated, tender 2x3cm size x 7 days. Fever x 1 day. (7 day course) dx cellulitis Rx ? then post ? Keflex 250-3.5mL tid x 10 days.
Age: 1.0
Sex: F
Vaccine: HBHEPB, MMR, VARCEL
Symptoms: Pyrexia
Clinical narrative: Right thigh site, red, indurated, tender 2x3cm size x 7 days. Fever x 1 day. (7 day course) dx cellulitis Rx ? then post ? Keflex 250-3.5mL tid x 10 days.
Age: 43.0
Sex: F
Vaccine: TD
Symptoms: Injection site erythema, Injection site induration
Clinical narrative: 8cc induration, (+) erythema L arm. Seen by PCR local care to arm and NSaids given.
Age: 53.0
Sex: F
Vaccine: TD
Symptoms: Rash maculo-papular, Vasodilation procedure
Clinical narrative: Came in 4 days later with red warm indurated area extended to under axilla. Seen by MD Rx'd with ibuprofen and advised to use wet compresses.
Age: 34.0
Sex: M
Vaccine: ANTH
Symptoms: Injection site hypersensitivity, Pruritus
Clinical narrative: Large area of erythema from vax site. Itchy. No fever. No N/V
Age: 21.0
Sex: M
Vaccine: ANTH
Symptoms: Cellulitis, Erythema, Oedema
Clinical narrative: Anthrax 3 days prior - erythema extending beyond elbow w/swelling - possible cellulitis.
Age: 26.0
Sex: M
Vaccine: ANTH
Symptoms: Cellulitis, Erythema
Clinical narrative: Erythema posterior UE. Cellulitis.
Age: 24.0
Sex: M
Vaccine: ANTH
Symptoms: Injection site hypersensitivity, Injection site rash
Clinical narrative: Red zone at site of injection. Skin rash at inject site.
Age: 21.0
Sex: F
Vaccine: ANTH
Symptoms: Paraesthesia
Clinical narrative: c/o hand numbness 15 mins post receiving anthrax shot.
Age: 28.0
Sex: M
Vaccine: ANTH
Symptoms: Asthenia, Erythema, Headache, Myalgia, Pain
Clinical narrative: c/o body aches, fever, headache. Feeling weak. Increased redness with streaking to axilla; tender node.
Age: 28.0
Sex: M
Vaccine: ANTH
Symptoms: Pyrexia, Skin striae
Clinical narrative: c/o body aches, fever, headache. Feeling weak. Increased redness with streaking to axilla; tender node.
Age: 23.0
Sex: F
Vaccine: ANTH
Symptoms: Erythema, Injection site oedema, Injection site pain
Clinical narrative: + redness and induration to posterior right upper arm, no lesions, no streaking. Swelling / pain at site.
Age: 42.0
Sex: M
Vaccine: ANTH
Symptoms: Cellulitis, Injection site hypersensitivity, Injection site inflammation
Clinical narrative: Cellulitis. Redness / heat at site.
Age: 37.0
Sex: M
Vaccine: ANTH
Symptoms: Pyrexia
Clinical narrative: Fever 100.9 deg F
Age: 23.0
Sex: M
Vaccine: ANTH
Symptoms: Rash, Skin ulcer
Clinical narrative: Flesh colored lesion raised, circular to elbows.
Age: 56.0
Sex: M
Vaccine: ANTH
Symptoms: Erythema, Oedema
Clinical narrative: Approx 90 mm diameter area of erythema, posterior arm over tricep with extension down to elbow. Slight edema.
Age: 38.0
Sex: M
Vaccine: ANTH
Symptoms: Pain
Clinical narrative: Mild tenderness + tender axillary lymph node.
Age: 32.0
Sex: M
Vaccine: ANTH
Symptoms: Erythema, Oedema, Tenderness
Clinical narrative: Left arm - mild erythema with tenderness to posterior upper arm to elbow + edema.
Age: 29.0
Sex: F
Vaccine: ANTH
Symptoms: Anorexia, Asthenia, Chills, Headache, Myalgia
Clinical narrative: Bad headaches, muscle aches, tiredness, loss of appetite, chills, fever.
Age: 29.0
Sex: F
Vaccine: ANTH
Symptoms: Pyrexia
Clinical narrative: Bad headaches, muscle aches, tiredness, loss of appetite, chills, fever.
Age: 4.0
Sex: M
Vaccine: DTAP, IPV, MMR
Symptoms: Injection site inflammation, Injection site mass, Injection site oedema, Injection site reaction
Clinical narrative: Child went for well child check up - MD office notified clinic that left arm - swollen, red, hot, firm to touch, MD sending child back to the reporting clinic for observation. 3/18/03 - PT never came to clinic for follow-up.
Age: 0.2
Sex: M
Vaccine: PPV
Symptoms: Pyrexia
Clinical narrative: Fever 2 hrs pediatric immunizations. INER = 100.1 deg F. Home = 100.6 deg F.
Age: 0.3
Sex: M
Vaccine: DTAP, HIBV, IPV, PNC
Symptoms: Agitation, Pyrexia, Screaming
Clinical narrative: "Tactile" fever and fussiness the evening of 4/7/03. 4/8/03 a.m. extremely fussy, them crying inconsolably for 3-4 hrs. His behavior and physical exam were normal. When PT seen at 16:00 4/8/03.
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMR
Symptoms: Injection site hypersensitivity, Injection site oedema
Clinical narrative: PT c/o swelling with erythema and inject site to knee - left side where received DTaP.
Age: 3.0
Sex: M
Vaccine: HEPA
Symptoms: Arthralgia, Erythema, Oedema peripheral, Osteoarthritis, Pyrexia
Clinical narrative: Swollen hands and foot, bilateral; Swollen and tender joints (with erythema) ankle, wrist and elbow; low grade fever x 1 day. Erythema macular rash hip area, lower back. Sign and SXs tested(?) for ??, guia Atarax / Restrin. (inject site normal)
Age: 3.0
Sex: M
Vaccine: HEPA
Symptoms: Rash maculo-papular
Clinical narrative: Swollen hands and foot, bilateral; Swollen and tender joints (with erythema) ankle, wrist and elbow; low grade fever x 1 day. Erythema macular rash hip area, lower back. Sign and SXs tested(?) for ??, guia Atarax / Restrin. (inject site normal)
Age: 4.0
Sex: M
Vaccine: DTAP, IPV
Symptoms: Erythema, Oedema
Clinical narrative: Erythema, edema, warmt, L triceps region.  Also had inject sore area day prior.  Took Keflex and Benadryl.
Age: 4.5
Sex: F
Vaccine: DTAP, IPV, MMR
Symptoms: Application site oedema, Feeling hot, Injection site erythema
Clinical narrative: Erythema, edema, warmth at injection site R deltoid. Treated with Keflex.
Age: 2.0
Sex: M
Vaccine: DTAP
Symptoms: Erythema, Feeling hot, Swelling
Clinical narrative: Mother states the redness and swelling happened "all at once" about 9:00 PM the next night after the vaccine.  Pt was seen at ER.  Pt's shoulder and L arm down to the elbow is red, warm to touch and is swollen tight.  No fever noted at this time.  MD ordered cold and warm packs, Tylenol and Benadryl and followup.
Sex: F
Vaccine: HEP
Symptoms: Pyrexia
Clinical narrative: Received Hep. B vaccination 3/4/03.  Approx 11:30 AM - went back to school and began feeling sick round 2 PM  - complaints of feeling "bad" and has fever.  Missed school 3/5 and 3/6 due to illness.  Temp 99 degrees today.  Mom states that child has received Tylenol for temp.  Also has cough.
Age: 1.0
Sex: F
Vaccine: DTAP, HIBV, MMR, PNC, VARCEL
Symptoms: Erythema, Rash
Clinical narrative: Mother states she noticed a red scattered rash on most of body starting on Monday 3/10/03.  Pt saw Dr. on 3/11/03.  Pt received an injection and was instructed to take Benadryl at home. Infant still has a fading red scattered rash on most of body.
Age: 1.0
Sex: M
Vaccine: MMR, VARCEL
Symptoms: Skin ulcer
Clinical narrative: Developed varicella lesions on 4/9/03.
Age: 1.2
Sex: M
Vaccine: DTAP, UNK
Symptoms: Erythema, Swelling
Clinical narrative: Swelling L thigh noted the night of vaccination.  Non tender, erythematous swelling.  Afebrile; gait N1.
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMR
Symptoms: Injection site erythema, Injection site swelling
Clinical narrative: Marked redness/swelling R upper arm - developed 1 day after IZ's.
Age: 1.9
Sex: M
Vaccine: DTAPHEPBIP, HIBV, MMR, PNC, VARCEL
Symptoms: Herpes zoster, Infection, Pyrexia
Clinical narrative: 3 x 6 area on R flank (rash).  Shingles - prescribed Zovirax for treatment.  Fever 100.00 degrees in office 4/13/03 - child first came in office on 4/10/03 with first onset of rash. Pt is still on Rx and still has rash as of 4/14/03.
Age: 73.0
Sex: M
Vaccine: PPV
Symptoms: Feeling hot, Injection site erythema, Injection site oedema
Clinical narrative: 4 degrees post vaccine notable redness edema and warmth at injection site.  Persistent unhl observation 4/11/03 12 noon. Reported a previous dose of vaccine fall 1999.
Age: 47.0
Sex: F
Vaccine: TYP
Symptoms: Body temperature increased, Erythema, Pruritus, Tenderness
Clinical narrative: 4" x 7" area with redness, increased skin temp and tenderness (raised) on right shoulder for 3 days.  Subjective fever.  Pruritis. Treatment:  cold compress, Advil or Tylenol and Atarax 25 mg P.O.  QID P/N.
Age: 4.0
Sex: M
Vaccine: DTAP, IPV, MMR
Symptoms: Feeling hot, Injection site hypersensitivity, Injection site induration, Injection site swelling, Pruritus
Clinical narrative: Day after vaccinated child's right arm, area of vaccination swollen, hot, hardened, no pain, does complain of some itching.  IZ received in this arm (DTaP and IPV) on 4/9/03.  No fever.
Age: 83.0
Sex: F
Vaccine: PPV
Symptoms: Erythema, Pain, Swelling
Clinical narrative: Had 2nd pneumococcal vaccine at 2200. Developed exquisite pain, swelling, erythema, couldn't lift objects.  Swelling, extended to elbow.  Last pneumococcal shot 9/14/93.
Age: 35.0
Sex: M
Vaccine: HEP, HEPA, MEN, TD
Symptoms: Blister, Chills, Cough, Erythema, Myalgia
Clinical narrative: 6 hours after immunizations had increased swelling R shoulder to elbow, 12 hours later skin turned bright red, developed pupules and vesicles and itching.  Also had myalgias, fever, cough, chills.  Developed the lesion in area where shots had been given.  Will have patch testing to preservatives in vaccines themselves.
Age: 35.0
Sex: M
Vaccine: HEP, HEPA, MEN, TD
Symptoms: Pruritus, Pyrexia, Skin ulcer, Swelling
Clinical narrative: 6 hours after immunizations had increased swelling R shoulder to elbow, 12 hours later skin turned bright red, developed pupules and vesicles and itching.  Also had myalgias, fever, cough, chills.  Developed the lesion in area where shots had been given.  Will have patch testing to preservatives in vaccines themselves.
Age: 29.0
Sex: F
Vaccine: TTOX
Symptoms: Pain
Clinical narrative: Pain in left shoulder
Age: 23.0
Sex: F
Vaccine: HEP
Symptoms: Hypoaesthesia, Paraesthesia
Clinical narrative: Pt states she developed numbness in feet and perineum on 3/26/03, subsequently got paresthesias on trunk 3/28/03 and hands, no symptoms of muscle weakness or pain, no problems with walking, talking or eating or shortness of breath.
Age: 1.08
Sex: M
Vaccine: HIBV, IPV, MMR, VARCEL
Symptoms: Urticaria
Clinical narrative: Patient received immunizations.  5 minutes afterwards developed hives on face and chest.  No trouble breathing.  15 minutes later only hives on chin.
Age: 29.0
Sex: F
Vaccine: TD
Symptoms: Chills, Hypoaesthesia, Muscular weakness, Myalgia, Pyrexia
Clinical narrative: Chills, fever, myalgias 12 hours after receiving Td.  Then weakness of muscles in thighs and shoulders, numbness in little and ring fingers of hands and medial surfaces of forearms. Referred to neuro.
Age: 1.9
Sex: M
Vaccine: DTAP, IPV, PNC
Symptoms: Injection site swelling, Pain, Pruritus
Clinical narrative: Complained of pain, increased swelling of L thigh, itching since day of immunization.   Benadryl liquid 1 tsp stat to 1/2 tsp TID until decrease in swelling/itching.
Age: 6.0
Sex: F
Vaccine: DTAP
Symptoms: Injection site erythema, Injection site pain, Injection site swelling
Clinical narrative: Pain, swelling and redness on site of shot started 4/15/03 and got worse after 24 hours.  Mom insisted that it is a bruise and was upset.  Instructed to apply warm compress 5 minutes every hour.
Age: 49.0
Sex: M
Vaccine: TTOX
Symptoms: Speech disorder
Clinical narrative: I received a Tetnaus vaccine in the latter part of October, 2002 after stepping on a nail.  2 days later I completely lost my singing voice! My speaking voice was okay except when I tried to raise my pitch...It wouldn't go there!  I went to 2 different ENT Doctors and after complete testing  they told me nothing was wrong with my throat structurally (no nodules, tumors etc.)  the vocal folds were fuctioning properly.   I am a musician/singer so you can imagine how devastating this was to me.   The symptons are FINALLY subsiding.  I almost have all of my singing voice back!   I AM CONVINCED A NERVE IN MY THROAT WAS PARALYZED BY THE TETNAUS VACCINE
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMR, VARCEL
Symptoms: Injection site erythema, Injection site vesicles, Rash erythematous
Clinical narrative: Received Dtap, IPV, MMR, Varicella at 10:15 AM-erythema around neck with patchy reddness with raised papules developed at approx. 11:00 am- no dyspnea, SOB other anaphylactic Rxs - instructed sister/caregiver to administer Benedryal PO and actuate EMS if any resperatory problems developed.
Age: 1.4
Sex: F
Vaccine: HIBV, PNC, VARCEL
Symptoms: Rash maculo-papular, Urticaria
Clinical narrative: 4/11/03 Parent called about 9:30am-stated child had rash yesterday-discription was macpular papular- this morning woke up with large area of confluent rash and whelps.  Advised to take to see her doctor.  Dr's office called back-Put on Ped pred. not to have any Varicella, Hib, or PCV-7 again.