chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 90.0
Sex: M
Vaccine: COVID19-2
Symptoms: Acute respiratory failure, Asthenia, COVID-19, Cough, Echocardiogram abnormal
Clinical narrative: The patient has a history of CHF, brain tumor, and myocardial infarction. He was seen in the ED on 10/20/23 and reported that he tested positive the day before (10/19/23). He reported cold symptoms - cough, weakness, and fever of 102 F - as well as increased weakness. Ultimately the patient was admitted 10/20/23 - 10/25/23 with acute respiratory failure with hypoxia due to COVID-19 infection. He was found to have O2 sats at 88-90% on room air so was initiated on supplemental oxygen. Additionally, he was noted to have an elevated troponin in the ED. The ED provider discussed with cardiology who believed this represented nonischemic myocardial injury likely due to COVID-19 infection. 2D echocardiogram showed an EF of 49% with regional wall motion abnormality involving the mid to distal inferolateral walls that was present in November 2022 as well. During his admission, the patient was able to wean off oxygen.   Of note, the patient has received the Pfizer Monovalent COVID vaccine (administered 1/14/21; 2/4/21; 8/27/21) and the Pfizer Bivalent COVID vaccine (administered 9/18/22; 6/16/23).
Age: 90.0
Sex: M
Vaccine: COVID19-2
Symptoms: Ejection fraction, Hypoxia, Myocardial injury, Nasopharyngitis, Pyrexia
Clinical narrative: The patient has a history of CHF, brain tumor, and myocardial infarction. He was seen in the ED on 10/20/23 and reported that he tested positive the day before (10/19/23). He reported cold symptoms - cough, weakness, and fever of 102 F - as well as increased weakness. Ultimately the patient was admitted 10/20/23 - 10/25/23 with acute respiratory failure with hypoxia due to COVID-19 infection. He was found to have O2 sats at 88-90% on room air so was initiated on supplemental oxygen. Additionally, he was noted to have an elevated troponin in the ED. The ED provider discussed with cardiology who believed this represented nonischemic myocardial injury likely due to COVID-19 infection. 2D echocardiogram showed an EF of 49% with regional wall motion abnormality involving the mid to distal inferolateral walls that was present in November 2022 as well. During his admission, the patient was able to wean off oxygen.   Of note, the patient has received the Pfizer Monovalent COVID vaccine (administered 1/14/21; 2/4/21; 8/27/21) and the Pfizer Bivalent COVID vaccine (administered 9/18/22; 6/16/23).
Age: 90.0
Sex: M
Vaccine: COVID19-2
Symptoms: SARS-CoV-2 test positive, Troponin increased, Wall motion score index abnormal
Clinical narrative: The patient has a history of CHF, brain tumor, and myocardial infarction. He was seen in the ED on 10/20/23 and reported that he tested positive the day before (10/19/23). He reported cold symptoms - cough, weakness, and fever of 102 F - as well as increased weakness. Ultimately the patient was admitted 10/20/23 - 10/25/23 with acute respiratory failure with hypoxia due to COVID-19 infection. He was found to have O2 sats at 88-90% on room air so was initiated on supplemental oxygen. Additionally, he was noted to have an elevated troponin in the ED. The ED provider discussed with cardiology who believed this represented nonischemic myocardial injury likely due to COVID-19 infection. 2D echocardiogram showed an EF of 49% with regional wall motion abnormality involving the mid to distal inferolateral walls that was present in November 2022 as well. During his admission, the patient was able to wean off oxygen.   Of note, the patient has received the Pfizer Monovalent COVID vaccine (administered 1/14/21; 2/4/21; 8/27/21) and the Pfizer Bivalent COVID vaccine (administered 9/18/22; 6/16/23).
Age: 45.0
Sex: M
Vaccine: TD
Symptoms: Guillain-Barre syndrome, Intensive care
Clinical narrative: Pt developed Guillain-Barré syndrome
Age: 63.0
Sex: M
Vaccine: HEP
Symptoms: Underdose
Clinical narrative: Patient was given child dose instead of adult dose of Hepatitis B vaccine
Age: 43.0
Sex: F
Vaccine: COVID19-2
Symptoms: Expired product administered, No adverse event
Clinical narrative: The patient never presented with adverse events from the expired vaccine
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Fatigue, Muscle tightness, Myalgia
Clinical narrative: Significant muscle tightness in left trapezoid muscle.  I have seen the chiropractor twice, with little relief. My muscles and joints all over my body ache. I am fatigued. NONE of these were true before the vaccine on 11/6/23.  All of these symptoms occurred within 48 hours of the vaccine and are not improving.
Age: 65.0
Sex: F
Vaccine: COVID19, VARZOS
Symptoms: Erythema, Nodule, Pain in extremity, Peripheral swelling, Skin warm
Clinical narrative: Shingrix Injection 50/0.5ml - right arm became swollen, painful, red, with hot hard knot about 2" x 3" - wasn't too concerned because I saw that was a fairly normal reaction.  But, it took almost 2 weeks for the swelling and knot to go away.  As of today, 2-1/2 weeks later, there is still about a 2" x 2" pale pink area.   I did not contact my doctor, but I will probably do so because I am wondering if I should have the 2nd shot or not.
Age: 88.0
Sex: M
Vaccine: COVID19-2
Symptoms: Dyspnoea, Pneumonia, Pulmonary thrombosis, Rales
Clinical narrative: Presented with increased difficulty in breathing, crackles.  Admitted to hospital with pneumonia.  Evaluation revealed blood clots in lungs.
Age: 47.0
Sex: M
Vaccine: COVID19-2
Symptoms: Expired product administered, No adverse event
Clinical narrative: The patient never presented with adverse events from the expired vaccine
Age: 71.0
Sex: M
Vaccine: COVID19-2
Symptoms: Rash pruritic
Clinical narrative: diffuse itchy rash developed 2-3d after vaccine. telephone call to office the following day. Rash is already improving. Has not yet taken OTC antihistamines
Age: 45.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site erythema, Injection site induration, Injection site pain, Injection site warmth, Pain in extremity
Clinical narrative: Workforce member reports "Arm of injection site for COVID vaccine was incredibly painful for about 3-4 days after injection and had an area adjacent o vaccine that ran the length of my arm and was red, warm to the touch and firm".
Age: 53.0
Sex: F
Vaccine: FLU4, FLU4
Symptoms: Injected limb mobility decreased, Injection site pain, Joint range of motion decreased, Loss of personal independence in daily activities, Pain
Clinical narrative: Initially, I had the normal shoulder pain after this vaccination. After two days, I was having shooting pain in my shoulder and couldn't lift my arm over my head or behind my back. I had shooting pain when I tried to do things like take my coat on and off. I continue to have pain in my shoulder and have lost much of the range of motion in my left arm. I can not bring my left arm over my head or behind my back. I have seen doctors who have said that the vaccination was incorrectly put into the capsule in my shoulder, which is causing these lingering issues.
Age: 53.0
Sex: F
Vaccine: FLU4, FLU4
Symptoms: Product administered at inappropriate site, X-ray limb normal
Clinical narrative: Initially, I had the normal shoulder pain after this vaccination. After two days, I was having shooting pain in my shoulder and couldn't lift my arm over my head or behind my back. I had shooting pain when I tried to do things like take my coat on and off. I continue to have pain in my shoulder and have lost much of the range of motion in my left arm. I can not bring my left arm over my head or behind my back. I have seen doctors who have said that the vaccination was incorrectly put into the capsule in my shoulder, which is causing these lingering issues.
Age: 53.0
Sex: F
Vaccine: FLU4, FLU4
Symptoms: Periarthritis
Clinical narrative: Initially, I had the normal shoulder pain after this vaccination. After two days, I was having shooting pain in my shoulder and couldn't lift my arm over my head or behind my back. I had shooting pain when I tried to do things like take my coat on and off. I continue to have pain in my shoulder and have lost much of the range of motion in my left arm. I can not bring my left arm over my head or behind my back. I have seen doctors who have said that the vaccination was incorrectly put into the capsule in my shoulder, which is causing these lingering issues.
Age: 78.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, COVID-19, COVID-19 pneumonia, Fall, Hypoxia
Clinical narrative: The patient has a history of emphysema. She presented to the ED via EMS from her assisted living facility after an unwitnessed fall on 10/20/23. EMS reports they were called to the facility after the patient was found lying on the ground, unknown how long she was down for. She additionally was found to be hypoxic en route, O2 sats in the 80's on room air. The patient additionally reported she tested positive for COVID the day prior (10/19) however denied any symptoms. Ultimately, the patient was admitted 10/20/23 - 10/30/23 with discharge diagnoses including acute hypoxic respiratory failure and COVID pneumonia, among other diagnoses. During admission, a COVID PCR test was done (10/24) which was also was positive. She required supplemental oxygen during admission, however by discharge she had been on room air for more than 24 hours.   Of note, the patient has received the Moderan Monovalent COVID vaccine (given 1/30/21; 3/25/21; 11/17/21; 7/28/22). The Vaccine Route and Vaccine site for the most recent vaccine administered on 7/28/22 is unknown.
Age: 78.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: The patient has a history of emphysema. She presented to the ED via EMS from her assisted living facility after an unwitnessed fall on 10/20/23. EMS reports they were called to the facility after the patient was found lying on the ground, unknown how long she was down for. She additionally was found to be hypoxic en route, O2 sats in the 80's on room air. The patient additionally reported she tested positive for COVID the day prior (10/19) however denied any symptoms. Ultimately, the patient was admitted 10/20/23 - 10/30/23 with discharge diagnoses including acute hypoxic respiratory failure and COVID pneumonia, among other diagnoses. During admission, a COVID PCR test was done (10/24) which was also was positive. She required supplemental oxygen during admission, however by discharge she had been on room air for more than 24 hours.   Of note, the patient has received the Moderan Monovalent COVID vaccine (given 1/30/21; 3/25/21; 11/17/21; 7/28/22). The Vaccine Route and Vaccine site for the most recent vaccine administered on 7/28/22 is unknown.
Age: 0.33
Sex: F
Vaccine: DTPPVHBHPB, PNC13, RV5
Symptoms: Expired product administered
Clinical narrative: RotaTeq was given on 11/20/2023 and upon medical assistant documenting the vaccine it was discovered that vaccine expired on 11/17/2023.
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Chest X-ray, Computerised tomogram head, Electrocardiogram, Full blood count, Immunisation reaction
Clinical narrative: syncopal episode within 24 hours of injection
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Influenza A virus test, Influenza B virus test, Metabolic function test, SARS-CoV-2 test, Syncope
Clinical narrative: syncopal episode within 24 hours of injection
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Troponin I, Urine analysis
Clinical narrative: syncopal episode within 24 hours of injection
Age: 59.0
Sex: M
Vaccine: COVID19
Symptoms: Altered state of consciousness, Asthenia, COVID-19, Cough, Influenza like illness
Clinical narrative: The patient has a history of diabetes and PVD s/p bilateral BKA. He was seen in the ED on 10/25/23 for evaluation of weakness and altered level of consciousness. In the ED, his wife reported that the patient has had a cough, weakness, altered LOC, and flu-like symptoms for the past week. He was found to have a fever of 101.7 F. A COVID PCR test resulted positive in the ED. Ultimately, the patient was admitted 10/25/23 - 11/2/23. Discharge diagnoses include COVID-19 infection, among other diagnoses. He did not require oxygen during hospitalization.  Of note, the patient is s/p bilateral BKA, and discharge diagnoses also included left stump wound infection.   Of note, the patient has received the Pfizer Monovalent COVID vaccine (given 5/3/21; 5/22/21; 2/17/22; 7/7/22).
Age: 59.0
Sex: M
Vaccine: COVID19
Symptoms: Postoperative wound infection, Pyrexia, SARS-CoV-2 test positive
Clinical narrative: The patient has a history of diabetes and PVD s/p bilateral BKA. He was seen in the ED on 10/25/23 for evaluation of weakness and altered level of consciousness. In the ED, his wife reported that the patient has had a cough, weakness, altered LOC, and flu-like symptoms for the past week. He was found to have a fever of 101.7 F. A COVID PCR test resulted positive in the ED. Ultimately, the patient was admitted 10/25/23 - 11/2/23. Discharge diagnoses include COVID-19 infection, among other diagnoses. He did not require oxygen during hospitalization.  Of note, the patient is s/p bilateral BKA, and discharge diagnoses also included left stump wound infection.   Of note, the patient has received the Pfizer Monovalent COVID vaccine (given 5/3/21; 5/22/21; 2/17/22; 7/7/22).
Age: 75.0
Sex: F
Vaccine: COVID19
Symptoms: Breakthrough COVID-19
Clinical narrative: Covid 19 Breakthrough Infection
Age: 32.0
Sex: M
Vaccine: HEPA
Symptoms: Underdose
Clinical narrative: Adult patient got administered Hep A pediatric dose.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Contusion, Erythema, Pain, Skin discolouration, Skin exfoliation
Clinical narrative: Patient reports bruising and soreness several days after the vaccine.  Then the area became dark and a red ring formed. Then the skin started to peel around the area.  It has now been 4 weeks, and the dark red skin has gotten better, but the skin was still peeling. It looked like it was healing though.
Age: 71.0
Sex: F
Vaccine: COVID19-2, FLUA4, VARZOS
Symptoms: Angiotensin converting enzyme, Antineutrophil cytoplasmic antibody, Antinuclear antibody, Bell's palsy, Blood culture
Clinical narrative: PER ID MD NOTE IMPRESSION & PLAN 1.  Recent left facial palsy. Secondary to #2? 2.  Recent L auricular rash, possible shingles, concern for Ramsay Hunt syndrome.  Was on prednisone and Valtrex before admission. 3.  Meningitis with CSF lymphocytic pleocytosis 4.  Intractable nausea and vomiting. 5.  Recent COVID-19 (Pfizer) and shingles/Zostavax vaccine 10/30/2023 and Seqirus QV Flu caccine 10/26/23.  Patient is a 71 y.o. female admitted to the hospital 11/20/2023 by MD  . ID service consult for evaluation of CSF pleocytosis, and suspicion for possible meningitis. The patient was admitted to the hospital on November 20, yesterday, presenting with left facial weakness, headache, dizziness nausea photophobia.  Was evaluated by neurology, was found to have Bell's palsy and left facial weakness.  Had an MRI of the brain that shows enhancement of the left facial nerve and the temporal bone.  It would be consistent with a possible inflammatory or infectious related abnormality of the left facial nerve. At the time of admission the patient had no fever but had a mild leukocytosis of 14,000.  She had blood cultures collected on admission which are in progress.  There was a concern for possible associated meningitis, so she had an LP this morning that shows 43 white cells with 96% lymphocytes and 4% monocytes, the protein is 64 mildly elevated glucose is normal at 65.  She has also 8 RBCs.  The Gram stain and in the ankle and the CSF is negative, and therefore meningitis panel is negative for all the pathogens as well.  She was a started empirically on treatment for possible viral or bacterial meningitis with acyclovir ceftriaxone, vancomycin. She has some associated headache, and some concern for possible Rines and Hunt syndrome. I was asked regarding input for possible CNS infection. At this point her main complaint is intractable nausea, with occasional vomiting and headache.  She also has some photophobia. She does not have eye pain.  The possible Ramsay-Hunt syndrome lesions on the ear are at this point dried out.  There is no vesicles. Other pertinent labs include a negative syphilis EIA, normal renal function, normal TSH, negative ENA panel.  Mild leukocytosis of 11,000, normal hemoglobin and platelets.  ESR is normal with a value of 1.   Review of the chart shows that the patient does not take any immunosuppressive therapy at home other than prednisone 20 mg daily.  This was prescribed November 15 by PA.  I reviewed the outpatient ENT note, they apparently suspected Ramsay Hunt of radicular syndrome.  Review of other additional records shows that she was prescribed Valtrex on November 10 for 7 days by her PCP for treatment of shingles involving the left ear. The notes from ENT indicates she had a left facial palsy and also some lesions in the left ear that were sparing the ear canal. She denies history of previous episodes of meningitis. She has a healthy dog, no exotic animals.  No travel to tropical regions.  No other unusual exposures.
Age: 71.0
Sex: F
Vaccine: COVID19-2, FLUA4, VARZOS
Symptoms: CSF protein increased, CSF red blood cell count positive, CSF test, CSF white blood cell count increased, Dizziness
Clinical narrative: PER ID MD NOTE IMPRESSION & PLAN 1.  Recent left facial palsy. Secondary to #2? 2.  Recent L auricular rash, possible shingles, concern for Ramsay Hunt syndrome.  Was on prednisone and Valtrex before admission. 3.  Meningitis with CSF lymphocytic pleocytosis 4.  Intractable nausea and vomiting. 5.  Recent COVID-19 (Pfizer) and shingles/Zostavax vaccine 10/30/2023 and Seqirus QV Flu caccine 10/26/23.  Patient is a 71 y.o. female admitted to the hospital 11/20/2023 by MD  . ID service consult for evaluation of CSF pleocytosis, and suspicion for possible meningitis. The patient was admitted to the hospital on November 20, yesterday, presenting with left facial weakness, headache, dizziness nausea photophobia.  Was evaluated by neurology, was found to have Bell's palsy and left facial weakness.  Had an MRI of the brain that shows enhancement of the left facial nerve and the temporal bone.  It would be consistent with a possible inflammatory or infectious related abnormality of the left facial nerve. At the time of admission the patient had no fever but had a mild leukocytosis of 14,000.  She had blood cultures collected on admission which are in progress.  There was a concern for possible associated meningitis, so she had an LP this morning that shows 43 white cells with 96% lymphocytes and 4% monocytes, the protein is 64 mildly elevated glucose is normal at 65.  She has also 8 RBCs.  The Gram stain and in the ankle and the CSF is negative, and therefore meningitis panel is negative for all the pathogens as well.  She was a started empirically on treatment for possible viral or bacterial meningitis with acyclovir ceftriaxone, vancomycin. She has some associated headache, and some concern for possible Rines and Hunt syndrome. I was asked regarding input for possible CNS infection. At this point her main complaint is intractable nausea, with occasional vomiting and headache.  She also has some photophobia. She does not have eye pain.  The possible Ramsay-Hunt syndrome lesions on the ear are at this point dried out.  There is no vesicles. Other pertinent labs include a negative syphilis EIA, normal renal function, normal TSH, negative ENA panel.  Mild leukocytosis of 11,000, normal hemoglobin and platelets.  ESR is normal with a value of 1.   Review of the chart shows that the patient does not take any immunosuppressive therapy at home other than prednisone 20 mg daily.  This was prescribed November 15 by PA.  I reviewed the outpatient ENT note, they apparently suspected Ramsay Hunt of radicular syndrome.  Review of other additional records shows that she was prescribed Valtrex on November 10 for 7 days by her PCP for treatment of shingles involving the left ear. The notes from ENT indicates she had a left facial palsy and also some lesions in the left ear that were sparing the ear canal. She denies history of previous episodes of meningitis. She has a healthy dog, no exotic animals.  No travel to tropical regions.  No other unusual exposures.
Age: 71.0
Sex: F
Vaccine: COVID19-2, FLUA4, VARZOS
Symptoms: Facial nerve disorder, Facial paralysis, Facial paresis, Gram stain, Haemoglobin normal
Clinical narrative: PER ID MD NOTE IMPRESSION & PLAN 1.  Recent left facial palsy. Secondary to #2? 2.  Recent L auricular rash, possible shingles, concern for Ramsay Hunt syndrome.  Was on prednisone and Valtrex before admission. 3.  Meningitis with CSF lymphocytic pleocytosis 4.  Intractable nausea and vomiting. 5.  Recent COVID-19 (Pfizer) and shingles/Zostavax vaccine 10/30/2023 and Seqirus QV Flu caccine 10/26/23.  Patient is a 71 y.o. female admitted to the hospital 11/20/2023 by MD  . ID service consult for evaluation of CSF pleocytosis, and suspicion for possible meningitis. The patient was admitted to the hospital on November 20, yesterday, presenting with left facial weakness, headache, dizziness nausea photophobia.  Was evaluated by neurology, was found to have Bell's palsy and left facial weakness.  Had an MRI of the brain that shows enhancement of the left facial nerve and the temporal bone.  It would be consistent with a possible inflammatory or infectious related abnormality of the left facial nerve. At the time of admission the patient had no fever but had a mild leukocytosis of 14,000.  She had blood cultures collected on admission which are in progress.  There was a concern for possible associated meningitis, so she had an LP this morning that shows 43 white cells with 96% lymphocytes and 4% monocytes, the protein is 64 mildly elevated glucose is normal at 65.  She has also 8 RBCs.  The Gram stain and in the ankle and the CSF is negative, and therefore meningitis panel is negative for all the pathogens as well.  She was a started empirically on treatment for possible viral or bacterial meningitis with acyclovir ceftriaxone, vancomycin. She has some associated headache, and some concern for possible Rines and Hunt syndrome. I was asked regarding input for possible CNS infection. At this point her main complaint is intractable nausea, with occasional vomiting and headache.  She also has some photophobia. She does not have eye pain.  The possible Ramsay-Hunt syndrome lesions on the ear are at this point dried out.  There is no vesicles. Other pertinent labs include a negative syphilis EIA, normal renal function, normal TSH, negative ENA panel.  Mild leukocytosis of 11,000, normal hemoglobin and platelets.  ESR is normal with a value of 1.   Review of the chart shows that the patient does not take any immunosuppressive therapy at home other than prednisone 20 mg daily.  This was prescribed November 15 by PA.  I reviewed the outpatient ENT note, they apparently suspected Ramsay Hunt of radicular syndrome.  Review of other additional records shows that she was prescribed Valtrex on November 10 for 7 days by her PCP for treatment of shingles involving the left ear. The notes from ENT indicates she had a left facial palsy and also some lesions in the left ear that were sparing the ear canal. She denies history of previous episodes of meningitis. She has a healthy dog, no exotic animals.  No travel to tropical regions.  No other unusual exposures.
Age: 71.0
Sex: F
Vaccine: COVID19-2, FLUA4, VARZOS
Symptoms: Headache, Herpes zoster, Herpes zoster oticus, Leukocytosis, Lymphocytosis
Clinical narrative: PER ID MD NOTE IMPRESSION & PLAN 1.  Recent left facial palsy. Secondary to #2? 2.  Recent L auricular rash, possible shingles, concern for Ramsay Hunt syndrome.  Was on prednisone and Valtrex before admission. 3.  Meningitis with CSF lymphocytic pleocytosis 4.  Intractable nausea and vomiting. 5.  Recent COVID-19 (Pfizer) and shingles/Zostavax vaccine 10/30/2023 and Seqirus QV Flu caccine 10/26/23.  Patient is a 71 y.o. female admitted to the hospital 11/20/2023 by MD  . ID service consult for evaluation of CSF pleocytosis, and suspicion for possible meningitis. The patient was admitted to the hospital on November 20, yesterday, presenting with left facial weakness, headache, dizziness nausea photophobia.  Was evaluated by neurology, was found to have Bell's palsy and left facial weakness.  Had an MRI of the brain that shows enhancement of the left facial nerve and the temporal bone.  It would be consistent with a possible inflammatory or infectious related abnormality of the left facial nerve. At the time of admission the patient had no fever but had a mild leukocytosis of 14,000.  She had blood cultures collected on admission which are in progress.  There was a concern for possible associated meningitis, so she had an LP this morning that shows 43 white cells with 96% lymphocytes and 4% monocytes, the protein is 64 mildly elevated glucose is normal at 65.  She has also 8 RBCs.  The Gram stain and in the ankle and the CSF is negative, and therefore meningitis panel is negative for all the pathogens as well.  She was a started empirically on treatment for possible viral or bacterial meningitis with acyclovir ceftriaxone, vancomycin. She has some associated headache, and some concern for possible Rines and Hunt syndrome. I was asked regarding input for possible CNS infection. At this point her main complaint is intractable nausea, with occasional vomiting and headache.  She also has some photophobia. She does not have eye pain.  The possible Ramsay-Hunt syndrome lesions on the ear are at this point dried out.  There is no vesicles. Other pertinent labs include a negative syphilis EIA, normal renal function, normal TSH, negative ENA panel.  Mild leukocytosis of 11,000, normal hemoglobin and platelets.  ESR is normal with a value of 1.   Review of the chart shows that the patient does not take any immunosuppressive therapy at home other than prednisone 20 mg daily.  This was prescribed November 15 by PA.  I reviewed the outpatient ENT note, they apparently suspected Ramsay Hunt of radicular syndrome.  Review of other additional records shows that she was prescribed Valtrex on November 10 for 7 days by her PCP for treatment of shingles involving the left ear. The notes from ENT indicates she had a left facial palsy and also some lesions in the left ear that were sparing the ear canal. She denies history of previous episodes of meningitis. She has a healthy dog, no exotic animals.  No travel to tropical regions.  No other unusual exposures.
Age: 71.0
Sex: F
Vaccine: COVID19-2, FLUA4, VARZOS
Symptoms: Magnetic resonance imaging head abnormal, Meningitis, Nausea, Photophobia, Platelet count normal
Clinical narrative: PER ID MD NOTE IMPRESSION & PLAN 1.  Recent left facial palsy. Secondary to #2? 2.  Recent L auricular rash, possible shingles, concern for Ramsay Hunt syndrome.  Was on prednisone and Valtrex before admission. 3.  Meningitis with CSF lymphocytic pleocytosis 4.  Intractable nausea and vomiting. 5.  Recent COVID-19 (Pfizer) and shingles/Zostavax vaccine 10/30/2023 and Seqirus QV Flu caccine 10/26/23.  Patient is a 71 y.o. female admitted to the hospital 11/20/2023 by MD  . ID service consult for evaluation of CSF pleocytosis, and suspicion for possible meningitis. The patient was admitted to the hospital on November 20, yesterday, presenting with left facial weakness, headache, dizziness nausea photophobia.  Was evaluated by neurology, was found to have Bell's palsy and left facial weakness.  Had an MRI of the brain that shows enhancement of the left facial nerve and the temporal bone.  It would be consistent with a possible inflammatory or infectious related abnormality of the left facial nerve. At the time of admission the patient had no fever but had a mild leukocytosis of 14,000.  She had blood cultures collected on admission which are in progress.  There was a concern for possible associated meningitis, so she had an LP this morning that shows 43 white cells with 96% lymphocytes and 4% monocytes, the protein is 64 mildly elevated glucose is normal at 65.  She has also 8 RBCs.  The Gram stain and in the ankle and the CSF is negative, and therefore meningitis panel is negative for all the pathogens as well.  She was a started empirically on treatment for possible viral or bacterial meningitis with acyclovir ceftriaxone, vancomycin. She has some associated headache, and some concern for possible Rines and Hunt syndrome. I was asked regarding input for possible CNS infection. At this point her main complaint is intractable nausea, with occasional vomiting and headache.  She also has some photophobia. She does not have eye pain.  The possible Ramsay-Hunt syndrome lesions on the ear are at this point dried out.  There is no vesicles. Other pertinent labs include a negative syphilis EIA, normal renal function, normal TSH, negative ENA panel.  Mild leukocytosis of 11,000, normal hemoglobin and platelets.  ESR is normal with a value of 1.   Review of the chart shows that the patient does not take any immunosuppressive therapy at home other than prednisone 20 mg daily.  This was prescribed November 15 by PA.  I reviewed the outpatient ENT note, they apparently suspected Ramsay Hunt of radicular syndrome.  Review of other additional records shows that she was prescribed Valtrex on November 10 for 7 days by her PCP for treatment of shingles involving the left ear. The notes from ENT indicates she had a left facial palsy and also some lesions in the left ear that were sparing the ear canal. She denies history of previous episodes of meningitis. She has a healthy dog, no exotic animals.  No travel to tropical regions.  No other unusual exposures.
Age: 71.0
Sex: F
Vaccine: COVID19-2, FLUA4, VARZOS
Symptoms: Pleocytosis, Polymerase chain reaction negative, Rash, Red blood cell sedimentation rate normal, Renal function test normal
Clinical narrative: PER ID MD NOTE IMPRESSION & PLAN 1.  Recent left facial palsy. Secondary to #2? 2.  Recent L auricular rash, possible shingles, concern for Ramsay Hunt syndrome.  Was on prednisone and Valtrex before admission. 3.  Meningitis with CSF lymphocytic pleocytosis 4.  Intractable nausea and vomiting. 5.  Recent COVID-19 (Pfizer) and shingles/Zostavax vaccine 10/30/2023 and Seqirus QV Flu caccine 10/26/23.  Patient is a 71 y.o. female admitted to the hospital 11/20/2023 by MD  . ID service consult for evaluation of CSF pleocytosis, and suspicion for possible meningitis. The patient was admitted to the hospital on November 20, yesterday, presenting with left facial weakness, headache, dizziness nausea photophobia.  Was evaluated by neurology, was found to have Bell's palsy and left facial weakness.  Had an MRI of the brain that shows enhancement of the left facial nerve and the temporal bone.  It would be consistent with a possible inflammatory or infectious related abnormality of the left facial nerve. At the time of admission the patient had no fever but had a mild leukocytosis of 14,000.  She had blood cultures collected on admission which are in progress.  There was a concern for possible associated meningitis, so she had an LP this morning that shows 43 white cells with 96% lymphocytes and 4% monocytes, the protein is 64 mildly elevated glucose is normal at 65.  She has also 8 RBCs.  The Gram stain and in the ankle and the CSF is negative, and therefore meningitis panel is negative for all the pathogens as well.  She was a started empirically on treatment for possible viral or bacterial meningitis with acyclovir ceftriaxone, vancomycin. She has some associated headache, and some concern for possible Rines and Hunt syndrome. I was asked regarding input for possible CNS infection. At this point her main complaint is intractable nausea, with occasional vomiting and headache.  She also has some photophobia. She does not have eye pain.  The possible Ramsay-Hunt syndrome lesions on the ear are at this point dried out.  There is no vesicles. Other pertinent labs include a negative syphilis EIA, normal renal function, normal TSH, negative ENA panel.  Mild leukocytosis of 11,000, normal hemoglobin and platelets.  ESR is normal with a value of 1.   Review of the chart shows that the patient does not take any immunosuppressive therapy at home other than prednisone 20 mg daily.  This was prescribed November 15 by PA.  I reviewed the outpatient ENT note, they apparently suspected Ramsay Hunt of radicular syndrome.  Review of other additional records shows that she was prescribed Valtrex on November 10 for 7 days by her PCP for treatment of shingles involving the left ear. The notes from ENT indicates she had a left facial palsy and also some lesions in the left ear that were sparing the ear canal. She denies history of previous episodes of meningitis. She has a healthy dog, no exotic animals.  No travel to tropical regions.  No other unusual exposures.
Age: 71.0
Sex: F
Vaccine: COVID19-2, FLUA4, VARZOS
Symptoms: Treponema test, Treponema test negative, Viral test, Vomiting
Clinical narrative: PER ID MD NOTE IMPRESSION & PLAN 1.  Recent left facial palsy. Secondary to #2? 2.  Recent L auricular rash, possible shingles, concern for Ramsay Hunt syndrome.  Was on prednisone and Valtrex before admission. 3.  Meningitis with CSF lymphocytic pleocytosis 4.  Intractable nausea and vomiting. 5.  Recent COVID-19 (Pfizer) and shingles/Zostavax vaccine 10/30/2023 and Seqirus QV Flu caccine 10/26/23.  Patient is a 71 y.o. female admitted to the hospital 11/20/2023 by MD  . ID service consult for evaluation of CSF pleocytosis, and suspicion for possible meningitis. The patient was admitted to the hospital on November 20, yesterday, presenting with left facial weakness, headache, dizziness nausea photophobia.  Was evaluated by neurology, was found to have Bell's palsy and left facial weakness.  Had an MRI of the brain that shows enhancement of the left facial nerve and the temporal bone.  It would be consistent with a possible inflammatory or infectious related abnormality of the left facial nerve. At the time of admission the patient had no fever but had a mild leukocytosis of 14,000.  She had blood cultures collected on admission which are in progress.  There was a concern for possible associated meningitis, so she had an LP this morning that shows 43 white cells with 96% lymphocytes and 4% monocytes, the protein is 64 mildly elevated glucose is normal at 65.  She has also 8 RBCs.  The Gram stain and in the ankle and the CSF is negative, and therefore meningitis panel is negative for all the pathogens as well.  She was a started empirically on treatment for possible viral or bacterial meningitis with acyclovir ceftriaxone, vancomycin. She has some associated headache, and some concern for possible Rines and Hunt syndrome. I was asked regarding input for possible CNS infection. At this point her main complaint is intractable nausea, with occasional vomiting and headache.  She also has some photophobia. She does not have eye pain.  The possible Ramsay-Hunt syndrome lesions on the ear are at this point dried out.  There is no vesicles. Other pertinent labs include a negative syphilis EIA, normal renal function, normal TSH, negative ENA panel.  Mild leukocytosis of 11,000, normal hemoglobin and platelets.  ESR is normal with a value of 1.   Review of the chart shows that the patient does not take any immunosuppressive therapy at home other than prednisone 20 mg daily.  This was prescribed November 15 by PA.  I reviewed the outpatient ENT note, they apparently suspected Ramsay Hunt of radicular syndrome.  Review of other additional records shows that she was prescribed Valtrex on November 10 for 7 days by her PCP for treatment of shingles involving the left ear. The notes from ENT indicates she had a left facial palsy and also some lesions in the left ear that were sparing the ear canal. She denies history of previous episodes of meningitis. She has a healthy dog, no exotic animals.  No travel to tropical regions.  No other unusual exposures.
Age: 68.0
Sex: F
Vaccine: RSV
Symptoms: Swelling, Vein discolouration
Clinical narrative: Patient received 2 shots. covid had no reaction but patient had swelling 3 days after with veins turning darker tracking toward torso/heart
Age: 0.5
Sex: F
Vaccine: DTAPIPV, PNC20
Symptoms: No adverse event, Product administered to patient of inappropriate age
Clinical narrative: Quadracel was administered to a 6 month old. No adverse reactions reported.
Age: 83.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Cardiac failure congestive, Death, Electrocardiogram abnormal
Clinical narrative: Patient got a abnormal EKG a few months after the covid shot in November, 2021, then got  congestive  heart failure and died 12-22-22
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: Headache, Hypoaesthesia, Migraine, Visual impairment
Clinical narrative: headache that progressed to a migraine with vision disturbances lasting 12 hours.  Next day a feeling of a numb delicate head persisted for another 8 hours or so
Age: 84.0
Sex: M
Vaccine: COVID19-2
Symptoms: Asthenia, Body temperature increased, COVID-19, Cough, Pyrexia
Clinical narrative: The patient has a history of dementia and diabetes. He was seen in the ED on 10/29/23 with weakness and fever. His spouse reported that the patient started a cough the night prior, and was found to have a temperature of 102.9. He had a positive at-home COVID test. A repeat COVID PCR test performed in the ED also resulted positive. Ultimately, the patient was admitted 10/29/23 - 11/2/23.  Discharge diagnoses included COVID-19 infection, among other diagnoses. The provider noted that overall the patient was pretty stable but was physically very weak. He was seen by PT every day during admission and made slow improvements. Outpatient physical therapy was arranged and the patient was discharged home in stable condition.   The patient has received the Pfizer Monovalent COVID vaccine (given 2/23/21; 3/16/21; 8/16/21; 4/12/22) and the Pfizer Bivalent COVID vaccine (given 9/9/22).
Age: 84.0
Sex: M
Vaccine: COVID19-2
Symptoms: SARS-CoV-2 test positive
Clinical narrative: The patient has a history of dementia and diabetes. He was seen in the ED on 10/29/23 with weakness and fever. His spouse reported that the patient started a cough the night prior, and was found to have a temperature of 102.9. He had a positive at-home COVID test. A repeat COVID PCR test performed in the ED also resulted positive. Ultimately, the patient was admitted 10/29/23 - 11/2/23.  Discharge diagnoses included COVID-19 infection, among other diagnoses. The provider noted that overall the patient was pretty stable but was physically very weak. He was seen by PT every day during admission and made slow improvements. Outpatient physical therapy was arranged and the patient was discharged home in stable condition.   The patient has received the Pfizer Monovalent COVID vaccine (given 2/23/21; 3/16/21; 8/16/21; 4/12/22) and the Pfizer Bivalent COVID vaccine (given 9/9/22).
Age: 62.0
Sex: F
Vaccine: FLU4
Symptoms: No adverse event, Product administered to patient of inappropriate age
Clinical narrative: Patient is 62 years and 9 months old, she was given the above vaccine in error. Vaccine is indicated for 65 years of age and up.  Patient has been called but has not returned the call. Patient has been seen in the same clinic 11/03/2023 for RSV vaccine. No notes on chart to indicate any adverse effect from the High dose flu vaccine.
Age: 18.0
Sex: F
Vaccine: COVID19, FLU4, HEP, IPV
Symptoms: Erythema, Skin warm, Swelling face, Urticaria
Clinical narrative: Mom called 3 days after vaccines administered, stating client had a rxn to vaccines.  Mom states client developed hives, facial swelling, RA red and warm to touch.  Mom did not take client to urgent care or ED, and did not state when rxn started.  Mom has not returned calls to follow up on onset time and duration, unsure if client is still having s/sx's.
Age: 100.0
Sex: M
Vaccine: COVID19
Symptoms: Breakthrough COVID-19
Clinical narrative: Covid-19 Breakthrough Infection
Age: 67.0
Sex: M
Vaccine: RSV
Symptoms: Abdominal distension, Axillary pain, Cardiac stress test, Chest pain, Flatulence
Clinical narrative: describes chest pain, waxing/waning, nonexertional, radiating to L axilla, increased abdominal bloating, gas which came on within hours to days after immunization and have persisted x2 months
Age: 67.0
Sex: M
Vaccine: RSV
Symptoms: Pain
Clinical narrative: describes chest pain, waxing/waning, nonexertional, radiating to L axilla, increased abdominal bloating, gas which came on within hours to days after immunization and have persisted x2 months
Age: 71.0
Sex: M
Vaccine: FLU4
Symptoms: Extra dose administered
Clinical narrative: PATIENT RECEIVED A SECOND DOSE OF FLUZONE HD (11/01/2023 AND 11/15/2023)
Age: 51.0
Sex: F
Vaccine: VARZOS
Symptoms: Fatigue, Lymphadenopathy, Mobility decreased, Pain in extremity, Peripheral swelling
Clinical narrative: patient woke up the next day with fever( face and neck very hot, temp unknown), shot arm(Rt Delt) pain & swelling, swollen gland on Rt side of neck, fatigue.  Patient couldl not move her neck upon waking up, but neck became mobile later in the morning. I informed her that these are possible reactions with Shingrix, she can take tylenol for the fever and pain if tolerable, and contact her doctor if symptoms worsen.
Age: 51.0
Sex: F
Vaccine: VARZOS
Symptoms: Pyrexia
Clinical narrative: patient woke up the next day with fever( face and neck very hot, temp unknown), shot arm(Rt Delt) pain & swelling, swollen gland on Rt side of neck, fatigue.  Patient couldl not move her neck upon waking up, but neck became mobile later in the morning. I informed her that these are possible reactions with Shingrix, she can take tylenol for the fever and pain if tolerable, and contact her doctor if symptoms worsen.
Age: 7.0
Sex: M
Vaccine: COVID19, FLU4
Symptoms: Erythema, Induration, Mass, Peripheral swelling, Trismus
Clinical narrative: Mom called 3 days after vaccine appt, stating client had a rxn to vaccines, unsure which.  Mom states client developed hives all over body, LA was swollen, had hard ball, and redness.  Mom stated Friday (11/17/23 day of injections) client took a nap and woke up around 6 or 7 p.m. and had a ?lock jaw,? and no further info was given, unsure how long client had ?lockjaw.?  Mom did not take client to urgent care or ED, and did not state when rxn started.   Mom has not returned calls to follow up on onset and duration, unsure if client is still having s/sx's.
Age: 7.0
Sex: M
Vaccine: COVID19, FLU4
Symptoms: Urticaria
Clinical narrative: Mom called 3 days after vaccine appt, stating client had a rxn to vaccines, unsure which.  Mom states client developed hives all over body, LA was swollen, had hard ball, and redness.  Mom stated Friday (11/17/23 day of injections) client took a nap and woke up around 6 or 7 p.m. and had a ?lock jaw,? and no further info was given, unsure how long client had ?lockjaw.?  Mom did not take client to urgent care or ED, and did not state when rxn started.   Mom has not returned calls to follow up on onset and duration, unsure if client is still having s/sx's.
Age: 82.0
Sex: F
Vaccine: COVID19
Symptoms: Dyskinesia, Lacrimation increased, Moaning, Muscle spasms, Pain
Clinical narrative: 5:56pm - Resident brought back from dining room with arms jerking spasmodically. Initially though it was a seizure but her eyes were tracking and she moved head from side to side when spoken to. Incident times. Jerking stopped at 5:38 (lasted for 5 minutes). A few more arm jerks seen, then stopped. No nonverbal s/s of pain/distress, though she groaned during the incident. Res grip WNL, wanted to hold hands.  6:56pm - VS:100.5-122-16-142/96. 02 sats 94% RM. Given scheduled Tylenol for fever and Oxycodone for pain. Patient teary eyed and having left hand/arm fine small jerks: seizure activity noted. 7:26pm - on-call provider ordered for resident to go to ER for monitoring r/t continued intermittent seizure activity.
Age: 82.0
Sex: F
Vaccine: COVID19
Symptoms: Pyrexia, Seizure
Clinical narrative: 5:56pm - Resident brought back from dining room with arms jerking spasmodically. Initially though it was a seizure but her eyes were tracking and she moved head from side to side when spoken to. Incident times. Jerking stopped at 5:38 (lasted for 5 minutes). A few more arm jerks seen, then stopped. No nonverbal s/s of pain/distress, though she groaned during the incident. Res grip WNL, wanted to hold hands.  6:56pm - VS:100.5-122-16-142/96. 02 sats 94% RM. Given scheduled Tylenol for fever and Oxycodone for pain. Patient teary eyed and having left hand/arm fine small jerks: seizure activity noted. 7:26pm - on-call provider ordered for resident to go to ER for monitoring r/t continued intermittent seizure activity.
Age: 62.0
Sex: F
Vaccine: FLU4, PPV
Symptoms: Erythema, Feeling cold, Lethargy, Pain, Pain in extremity
Clinical narrative: Patient reports lethargy and pain for 3 days, starting the night of the vaccination date. "Everything ached" and patient was freezing the next morning. Arm was painful and red, and needed help getting out of bed.
Age: 62.0
Sex: F
Vaccine: PNC20
Symptoms: Headache, Pallor, Speech disorder, Tremor
Clinical narrative: @ 22:00- Resident had BP 223/105, P 103, O2 95% R18, T 100.6, BG 223. Resident is pale, shaking, keeping her mouth open and moving is around without any words coming out, having a hard time speaking and answering questions. Said her head was hurting.
Age: 0.17
Sex: M
Vaccine: DTAP, HIBV, IPV, PNC20, RV5
Symptoms: Flushing, Irritability, Pyrexia
Clinical narrative: fever 102, flushing and irritability
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Arthralgia, Condition aggravated, Fatigue, Gout, Laboratory test
Clinical narrative: I initially had fatigue that night. I got up the next morning and thought I had a bad round of gout. My right big toe was swollen and painful and I couldn't bend it. I took Tylenol and it helped. By the end of the day my toe was better. After that, All my joints started to hurt all over! It would rotate through my body. Its in my elbow and left knee today, but before that it was in my ankles.
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Mobility decreased, Pain in extremity, Peripheral swelling, Urine analysis
Clinical narrative: I initially had fatigue that night. I got up the next morning and thought I had a bad round of gout. My right big toe was swollen and painful and I couldn't bend it. I took Tylenol and it helped. By the end of the day my toe was better. After that, All my joints started to hurt all over! It would rotate through my body. Its in my elbow and left knee today, but before that it was in my ankles.
Age: 67.0
Sex: M
Vaccine: PNC20
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
Clinical narrative: Patient noted redness, heat, swelling, and pain to injection site on 11/20 and was seen on 11/21.
Age: 10.0
Sex: M
Vaccine: FLUC4, HEP
Symptoms: Wrong patient received product
Clinical narrative: Hep B vaccine was given to wrong patient.  There were 3 male siblings in the same room and the hep b was meant for the middle child and was mistakenly given to the oldest sibling.
Age: 87.0
Sex: F
Vaccine: RSV
Symptoms: Ageusia, Anosmia, Condition aggravated, Gait disturbance, Herpes simplex
Clinical narrative: about 12 hours after administration- knees down to feet were paralyzed for about 4 hours.  she had trouble walking all day and for the following week but paralysis is improving and she is starting to get stronger. she now has no taste or smell with no current improvement. She states herpes simplex was also exacerbated by vaccine and now has an active infection. She may have had a potentially lesser case of guillien barre syndrom per partient's son who is a physician.
Age: 87.0
Sex: F
Vaccine: RSV
Symptoms: Monoplegia
Clinical narrative: about 12 hours after administration- knees down to feet were paralyzed for about 4 hours.  she had trouble walking all day and for the following week but paralysis is improving and she is starting to get stronger. she now has no taste or smell with no current improvement. She states herpes simplex was also exacerbated by vaccine and now has an active infection. She may have had a potentially lesser case of guillien barre syndrom per partient's son who is a physician.
Age: 9.0
Sex: F
Vaccine: UNK
Symptoms: Inappropriate schedule of product administration
Clinical narrative: Gardasil 9 given early MenQuadfi  given early