chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 37.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Axillary pain, Inflammation, Lymphadenopathy, Sciatica
Clinical narrative: A sore left underarm (armpit) - noticeably larger than the right (inflamed). Could feel and see the lymph node. Also, on the left side - the lymph node on the base of my neck - between neck and collarbone was significantly large and inflamed. Nothing on right side (all on the left side.) That subsided in about a week and a half - the armpit one. The one in the neck lasted about 2 weeks. The other thing I noticed was sciatica pain  (both sides) (within a week of the vaccine)- I've never had this before. And I noticed hip pain/tightness of the right side  (I noticed this pain after the second vaccine)- if I sit with my legs crossed,  or sit with one leg underneath, I can only do that a minute or two without  it being really uncomfortable. I had a doctor visit for the swollen lymph node on January 19th. She just did an exam and asked me if I had my vaccine and told me it was a side affect of vaccine.  Have not recovered from the hip pain and sciatica pain yet and that is intermittent. Have recovered from the lymph nodes swollen.
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Gastrointestinal pain, Headache, Injection site pain, Injection site rash, Injection site reaction
Clinical narrative: Fever (100.2), chills, body aches, joint aches, gastrointestinal pain, headache, pain at injection site, skin rash around/within 10" of injection site.
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Pain, Pyrexia
Clinical narrative: Fever (100.2), chills, body aches, joint aches, gastrointestinal pain, headache, pain at injection site, skin rash around/within 10" of injection site.
Age: 41.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: Vial was diluted with less than 1.8ml of diluent.  Pt made aware of the situation.  No adverse effects reported.
Age: 29.0
Sex: F
Vaccine: COVID19
Symptoms: Hyperhidrosis
Clinical narrative: 10 minutes after receiving Pfizer dose patient complained of being Diaphoretic. Onsite EMS was called vitals BP 100/58 HR 56 98% O2. She had test positive for Covid in October 2020. SHe felt better after about 10 minutes & was released to go home.
Age: 23.0
Sex: F
Vaccine: COVID19
Symptoms: Axillary pain, Back pain, Chest pain, Neck pain, Pain
Clinical narrative: Day 1: Sore arm Day 2: Sore arm Day 3: back to normal  Day 4: armpit pain and palpated lump in armpit  Day 5: worse armpit pain radiating into arm, neck, chest and back  Day  6: same pain as day 5  Day 7: extremely severe pain in armpit,  palpated larger lump. The pain is more extreme in my arm and neck.
Age: 23.0
Sex: F
Vaccine: COVID19
Symptoms: Pain in extremity, Swelling
Clinical narrative: Day 1: Sore arm Day 2: Sore arm Day 3: back to normal  Day 4: armpit pain and palpated lump in armpit  Day 5: worse armpit pain radiating into arm, neck, chest and back  Day  6: same pain as day 5  Day 7: extremely severe pain in armpit,  palpated larger lump. The pain is more extreme in my arm and neck.
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness, Dysstasia
Clinical narrative: Pt received vaccine. Pt went to 15 minute waiting room for observation. As Pt was ready to leave facility after 15 minute wait time, Pt reported feeling lightheaded upon standing. Pt sat down in a chair. Cool wet rag placed on Pt's forehead. Pt drank juice and ate crackers. Pt's pulse was checked periodically. Pt received a ride home with a friend approximately 30 minutes after episode. Pt reported feeling well before leaving facility.
Age: 46.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Acute sinusitis, Angiogram cerebral normal, Arteriogram carotid normal, Burning sensation, Echocardiogram abnormal
Clinical narrative: Burning, tingling, numbness on left arm, shoulder, face.   Most symptoms resolved in 36 hours. Resulted in sinus disease left maxillary sinus and swollen lymph glands in neck
Age: 46.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Hypoaesthesia, Injection site hypoaesthesia, Injection site pain, Injection site paraesthesia, Laboratory test
Clinical narrative: Burning, tingling, numbness on left arm, shoulder, face.   Most symptoms resolved in 36 hours. Resulted in sinus disease left maxillary sinus and swollen lymph glands in neck
Age: 46.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Lymphadenopathy, Magnetic resonance imaging head abnormal, Paraesthesia, Sinus disorder, Sinusitis
Clinical narrative: Burning, tingling, numbness on left arm, shoulder, face.   Most symptoms resolved in 36 hours. Resulted in sinus disease left maxillary sinus and swollen lymph glands in neck
Age: 46.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Ventricular hypertrophy
Clinical narrative: Burning, tingling, numbness on left arm, shoulder, face.   Most symptoms resolved in 36 hours. Resulted in sinus disease left maxillary sinus and swollen lymph glands in neck
Age: 46.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Burning sensation, Hypoaesthesia, Paraesthesia, SARS-CoV-2 test
Clinical narrative: Burning, tingling, numbness on left arm, shoulder, face.   Most symptoms resolved in 36 hours. Resulted in sinus disease left maxillary sinus and swollen lymph glands in neck
Age: 32.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Disturbance in attention, Dizziness, Fatigue, Feeling abnormal, Headache
Clinical narrative: Extreme dizziness, lasted for 3 days,  headache, ongoing, so far has lasted 7 days  ibuprofen not helpful, tylenol not helpful  nausea lasting 2-3 days pepto bismol not helpful  severe fatigue lasting around 24-30 hours brain fog, trouble concentrating and thinking clearly, lasting 7 days so far.
Age: 32.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Nausea
Clinical narrative: Extreme dizziness, lasted for 3 days,  headache, ongoing, so far has lasted 7 days  ibuprofen not helpful, tylenol not helpful  nausea lasting 2-3 days pepto bismol not helpful  severe fatigue lasting around 24-30 hours brain fog, trouble concentrating and thinking clearly, lasting 7 days so far.
Age: 94.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Fall, Pelvic fracture, SARS-CoV-2 test positive
Clinical narrative: Received Moderna dose series through the department, with patient's daughter stating series was completed on 2/10/21. No record to verify this date. Patient presented to ED after a fall for a fracture of superior pubic rami on 3/24/21. Was found to be positive for COVID-19 during prescreening prior to transfer to medical floor.  Reported no symptoms of COVID-19 infection during hospital admission.
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Fatigue, Headache, Myalgia, Nausea
Clinical narrative: Chills, fever, nausea, muscle ache, headache, sinus issues, very tired
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Pyrexia, Sinusitis
Clinical narrative: Chills, fever, nausea, muscle ache, headache, sinus issues, very tired
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site erythema, Injection site pruritus, Injection site warmth
Clinical narrative: Redness around the area, it was hot and itchy
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: Diarrhoea, Dyspnoea
Clinical narrative: shortness of breath/diarrhea
Age: 46.0
Sex: M
Vaccine: COVID19
Symptoms: Fatigue
Clinical narrative: Extreme fatigue
Age: 59.0
Sex: M
Vaccine: COVID19
Symptoms: Chills, Fatigue, Pain, Pyrexia
Clinical narrative: 102 fever, totl body aches, chills, extremely tired
Age: 16.0
Sex: F
Vaccine: COVID19
Symptoms: Product administered to patient of inappropriate age
Clinical narrative: None - too young
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site pain, Insomnia, Swelling
Clinical narrative: Local swelling and soreness at injection site Difficulty sleeping following injection for one night
Age: 55.0
Sex: M
Vaccine: COVID19
Symptoms: Lymphadenopathy, Pyrexia
Clinical narrative: Patient called pharmacy Monday morning to report side effects of swollen lymph node under arm and fever of 101 degrees. Suggested patient call his primary care physician and told him I would report side effects.
Age: 24.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Injection site erythema, Injection site mass, Injection site pruritus, Injection site swelling
Clinical narrative: extreme tiredness beginning three hours after injection and lasting for five days total. Fever 24hours after injection and lasting for 2 days. Injection site swelling, redness, hotness, itching and lump beginning 24 hours after injection the redness, and swelling disappeared after seven day but the hotness, lump and itching are persisting and have not fully gone away two weeks after vaccination.  Sever body and muscle aches 24 hours after injection and lasting five days.
Age: 24.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site warmth, Myalgia, Pain, Pyrexia
Clinical narrative: extreme tiredness beginning three hours after injection and lasting for five days total. Fever 24hours after injection and lasting for 2 days. Injection site swelling, redness, hotness, itching and lump beginning 24 hours after injection the redness, and swelling disappeared after seven day but the hotness, lump and itching are persisting and have not fully gone away two weeks after vaccination.  Sever body and muscle aches 24 hours after injection and lasting five days.
Age: 50.0
Sex: M
Vaccine: COVID19
Symptoms: Arthralgia, Chills, Myalgia, Nausea, Pyrexia
Clinical narrative: High fever, joint pain, chills, muscle pain, nausea
Age: 33.0
Sex: M
Vaccine: COVID19
Symptoms: Injection site erythema, Injection site pain, Injection site warmth
Clinical narrative: Flat red area around site of injection, about size in diameter of baseball, no swelling or hardness there, some warmth. Has been tender since receiving vaccine on Friday afternoon. Took ibuprofen on Sat for the pain and did help some. Nothing since then. Not bothering  much. Noticed the redness around the site last night after taking off his shirt, so sometime between morning and evening it developed. He called to notify us this morning about reaction. Instructed him to see Dr or call RN if further concerns arise. RN will follow up with him in 1 week to see how he's recovering. Reminded to go to VSAFE website/app as well. Told him RN would report to VAERS.
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Chest pain, Dyspnoea, Hyperhidrosis
Clinical narrative: 03/23/21: Patient presented and was admitted through ED for chest pain associated with shortness of breath which is worsening from yesterday.  Patient also complains of diaphoresis.  Shortness of breath worse with sitting straight up and better with lying on his side.  In ER patient was found to have blood pressure 119/84 temperature 97.4 heart rate of 101 bpm saturation on 6 L and can supplement therapy via nasal cannula. PMH significant of COPD on 2 L nasal cannula at home.   Per the EUA, hospitalizations are to be reported irrespective of attribution to vaccine.
Age: 34.0
Sex: M
Vaccine: COVID19
Symptoms: Dyspnoea, Throat tightness
Clinical narrative: Subjective Patient is a 34 y.o. male who was seen at Vaccine Clinic today for his first  dose of the COVID 19 vaccination.    He was given the Pfizer vaccination in the left deltoid muscle.   During his 15 minute waiting period after the injection, the patient began to experience difficulty breathing and throat tightness.  He denied rash, hives, welts, difficulty swallowing, throat tightness, hoarseness, stridor, itching, lightheadedness, dizziness, facial swelling, lip swelling and tongue swelling.   This provider was notified of patient reaction and he was then assessed in the emergency area.   Monitored patient for severe reaction symptoms, including but not limited to abdominal pain, blood pressure abnormality , chest pain, collapse, drooling, hypotension, increased swelling, rapid progression of symptoms, respiratory distress, skin changes, tongue swelling and vomiting.   Pt was given a water to drink and he reported the SOB was very mild and the water helped.  He does have a history of childhood asthma but does not use an inhaler for years.     ALLERGY REVIEW OF SYSTEMS:  Patient complains of frequent throat clearing and shortness of breath   CONT negative Eyes negative Skin negative GI negative Musculo negative Neuro negative     Previous Reactions: None    Objective    Vitals Vitals:   03/18/21 1052 03/18/21 1107 03/18/21 1114 BP: 133/86 119/80 129/82 Pulse: 50 53 (!) 49 SpO2: 100% 99% 99%      Pt is a runner and states he runs a lower pulse     Physical Exam Constitutional:      Appearance: He is well-developed.  HENT:     Head: Normocephalic and atraumatic.     Right Ear: External ear normal.     Left Ear: External ear normal.     Nose: Nose normal.  Eyes:     Conjunctiva/sclera: Conjunctivae normal.     Pupils: Pupils are equal, round, and reactive to light.  Cardiovascular:     Rate and Rhythm: Normal rate and regular rhythm.     Heart sounds: Normal heart sounds.  Pulmonary:     Effort: Pulmonary effort is normal.     Breath sounds: Normal breath sounds.  Musculoskeletal:        General: Normal range of motion.     Cervical back: Normal range of motion and neck supple.  Skin:    General: Skin is warm and dry.     Capillary Refill: Capillary refill takes less than 2 seconds.  Neurological:     Mental Status: He is alert and oriented to person, place, and time.        Assessment/Plan  Treatment included: water Follow up response to treatment: excellent. Patient discharge: Stable to go home and follow up with PCP.  Differential Diagnosis: Local reaction (arm pain, bleeding/bruising, mechanical irritation, localized rash) Pt was dismissed at 11:15 to return to work.  No symptoms at time of discharge.  He was told to take an antihistamine before his next appointment.
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site erythema, Injection site pruritus, Pain in extremity, Skin warm
Clinical narrative: Covid arm - red itchy circle on upper arm, has grown 4 x in size from Friday to Sunday. Arm is very hot, and achy.
Age: 39.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Loss of personal independence in daily activities, Pain
Clinical narrative: Severe joint pain in both knees. Pain is constant and radiates down legs; worse when trying to walk. Pain is continuous and progressively getting worse since Saturday, March 20. There is no relief. Taking Aleve makes it tolerable but it is extremely painful to do daily activities.
Age: 32.0
Sex: F
Vaccine: COVID19
Symptoms: Anxiety, Fear of injection, Gait disturbance, Gaze palsy, Hyperhidrosis
Clinical narrative: Patient was wheeled in on a rolling chair(no wheelchair available at time) from nurse that administered vaccine because of anxiety and a needle phobia that put the patient into a kind of shocked state. Patient was sweating profusely, white to the face, and not speaking very much but would answer questions correctly. EMT was speaking with the PT before walking away to continue other monitor duties when he turned back to see patient limp in chair, head back, eyes rolled back, and some twitching movements of the body. EMT called for rapid response  because first thought of seizure and seizure like activity with the twitching movements. EMT got to patient, supported head up straight, and opened jaw to ensure airway was clear. Patient had no response to EMT trying to communicate. Sternum rub was performed where patient came back conscious nearly instantly. PT was unresponsive for roughly 10-15 seconds. Patient was told of what happened and vitals were taken on her, response team was cancelled with most them already on scene. PT was feeling better, sweating stopped, color to the face returned, and PT was speaking and understanding more clearly than before. PT was given a snack and water and was monitored by EMT for an additional 15mins before patient and staff were confident with her leaving.
Age: 32.0
Sex: F
Vaccine: COVID19
Symptoms: Pallor, Seizure
Clinical narrative: Patient was wheeled in on a rolling chair(no wheelchair available at time) from nurse that administered vaccine because of anxiety and a needle phobia that put the patient into a kind of shocked state. Patient was sweating profusely, white to the face, and not speaking very much but would answer questions correctly. EMT was speaking with the PT before walking away to continue other monitor duties when he turned back to see patient limp in chair, head back, eyes rolled back, and some twitching movements of the body. EMT called for rapid response  because first thought of seizure and seizure like activity with the twitching movements. EMT got to patient, supported head up straight, and opened jaw to ensure airway was clear. Patient had no response to EMT trying to communicate. Sternum rub was performed where patient came back conscious nearly instantly. PT was unresponsive for roughly 10-15 seconds. Patient was told of what happened and vitals were taken on her, response team was cancelled with most them already on scene. PT was feeling better, sweating stopped, color to the face returned, and PT was speaking and understanding more clearly than before. PT was given a snack and water and was monitored by EMT for an additional 15mins before patient and staff were confident with her leaving.
Age: 39.0
Sex: M
Vaccine: COVID19
Symptoms: Lip swelling, Swelling face, Urticaria
Clinical narrative: On 3/22/21, I woke up at 6:30a to find the left side of my face and lips completely swollen. I also had a number of large hives acrss my right bicep and elbow, as well as a few smaller hives on my back and underneath my feet.    This reaction was the same reaction I received when I went to the ER on 12/10/2018 for difficulty breathing and an elevated BP.  The ER administered TORODOL and I reacted the same way, ending up in the ER the very next day due to the reaction.    I believe, after much diligent research, the reaction I received to the COVID vaccine was due to the Tromethamine in it, as this ingredient is also in TORODOL.
Age: 57.0
Sex: M
Vaccine: COVID19
Symptoms: Ageusia, Anosmia, COVID-19, Cough, Polymerase chain reaction
Clinical narrative: Received dose 2 of COVID vaccine on 1/21/21.  On 3/25/2021 the patient developed fever, nasal congestion, cough, and loss of taste/smell.  Tested positive for COVID.
Age: 57.0
Sex: M
Vaccine: COVID19
Symptoms: Pyrexia, Respiratory tract congestion, SARS-CoV-2 test positive
Clinical narrative: Received dose 2 of COVID vaccine on 1/21/21.  On 3/25/2021 the patient developed fever, nasal congestion, cough, and loss of taste/smell.  Tested positive for COVID.
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Diagnosed with covid-19 on February 17th and March 18th of 2021
Age: 45.0
Sex: M
Vaccine: COVID19
Symptoms: Arthralgia, Chills, Dyspnoea, Fatigue, Feeling abnormal
Clinical narrative: Mach 24 1700-1730 feeling odd with some joint pain in knees. Injection shot pain normal as most injuections. 1900 achy 2000 chills started 2100 fever of 99.8 March 25 0015 sweaty and hot fever of 102.5 entire body aches, joint pains knees and arms. Musclar aches all over felt slight nausea 0700 aches continued  fever down 100.2, fatigued slept most of the day. Injection site tender. Drank water ate toast.  1300 fever subsided 98.6 (my normal is 98.2) Took motrin for aches. Rest of day and night slightly achy stiff joints fatigued. March 26 Still achy and stiff. No fever. Took Motrin. By midday had more energy and able to get around and walk. Noticed taking deep breaths was hard to do with out slight pain. Was gone by the 28th.
Age: 45.0
Sex: M
Vaccine: COVID19
Symptoms: Hyperhidrosis, Injection site pain, Joint stiffness, Myalgia, Nausea
Clinical narrative: Mach 24 1700-1730 feeling odd with some joint pain in knees. Injection shot pain normal as most injuections. 1900 achy 2000 chills started 2100 fever of 99.8 March 25 0015 sweaty and hot fever of 102.5 entire body aches, joint pains knees and arms. Musclar aches all over felt slight nausea 0700 aches continued  fever down 100.2, fatigued slept most of the day. Injection site tender. Drank water ate toast.  1300 fever subsided 98.6 (my normal is 98.2) Took motrin for aches. Rest of day and night slightly achy stiff joints fatigued. March 26 Still achy and stiff. No fever. Took Motrin. By midday had more energy and able to get around and walk. Noticed taking deep breaths was hard to do with out slight pain. Was gone by the 28th.
Age: 45.0
Sex: M
Vaccine: COVID19
Symptoms: Pain, Pain in extremity, Pyrexia, Somnolence
Clinical narrative: Mach 24 1700-1730 feeling odd with some joint pain in knees. Injection shot pain normal as most injuections. 1900 achy 2000 chills started 2100 fever of 99.8 March 25 0015 sweaty and hot fever of 102.5 entire body aches, joint pains knees and arms. Musclar aches all over felt slight nausea 0700 aches continued  fever down 100.2, fatigued slept most of the day. Injection site tender. Drank water ate toast.  1300 fever subsided 98.6 (my normal is 98.2) Took motrin for aches. Rest of day and night slightly achy stiff joints fatigued. March 26 Still achy and stiff. No fever. Took Motrin. By midday had more energy and able to get around and walk. Noticed taking deep breaths was hard to do with out slight pain. Was gone by the 28th.
Age: 61.0
Sex: U
Vaccine: COVID19
Symptoms: Chest pain, Dyspnoea, Hyperhidrosis, Skin warm
Clinical narrative: at approximately 1310 patient was reporting chest pain at 9/10 on verbal pain scale with pain and heat radiating to lower back. In addition, patient reported SOB on exhalation, HA and diaphoresis. Facility staff EMT called 911 and county fire determined patient should be taken to hospital for a full workup. Facility staff EMT was unaware of what hospital patient was being taken to.
Age: 62.0
Sex: M
Vaccine: COVID19
Symptoms: Interchange of vaccine products
Clinical narrative: First dose received was Moderna
Age: 60.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Pyrexia, Rash pustular, Skin burning sensation, Skin erosion
Clinical narrative: Patient presents to this pharmacy on 03/25/21 for her second dose of covid-19 vaccine. Her first dose was at a clinic. The patient presents back on 03/29/2021 with a complaint of a vaccine-related reaction. Her arm of administration had liquid filled pustules, along with some raw skin, on either side of her arm, but not local to the administration site itself.  She claims it showed up 6 hours after the 03/25/2021 vaccination, along with a fever. The rash had progressively gotten worse from 03/25/2021 to 03/28/2021. She claims it is getting better, that it burns, and that she has only use ibuprofen 800mg q24h for pain relief. I advised the patient be seen by a clinic to confirm diagnosis.
Age: 60.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Blister, Rash
Clinical narrative: Patient presents to this pharmacy on 03/25/21 for her second dose of covid-19 vaccine. Her first dose was at a clinic. The patient presents back on 03/29/2021 with a complaint of a vaccine-related reaction. Her arm of administration had liquid filled pustules, along with some raw skin, on either side of her arm, but not local to the administration site itself.  She claims it showed up 6 hours after the 03/25/2021 vaccination, along with a fever. The rash had progressively gotten worse from 03/25/2021 to 03/28/2021. She claims it is getting better, that it burns, and that she has only use ibuprofen 800mg q24h for pain relief. I advised the patient be seen by a clinic to confirm diagnosis.
Age: 81.0
Sex: M
Vaccine: COVID19
Symptoms: Tinnitus
Clinical narrative: Tinnitus began 3 d day after receiving 1st dose of vaccine.  Continuing through today when I received 2d dose of vaccine, and continues.
Age: 15.0
Sex: M
Vaccine: COVID19
Symptoms: Product administered to patient of inappropriate age
Clinical narrative: Underage administrtion
Age: 53.0
Sex: F
Vaccine: VARZOS
Symptoms: Rash
Clinical narrative: Rash on both hands and wrists and inside of right arm, and ankle
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness, Erythema, Flushing, Heart rate increased, Loss of personal independence in daily activities
Clinical narrative: Immediately had arm pain- lasted about an hour. About 6 hours after injection started trembling - heart rate quickened- dizzy -  pain in the back of the neck and occipital area. Face flushing and mild itching. These symptoms did prevent me from being able to complete regular daily activities. Several days later face had redness.
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: Neck pain, Pain in extremity, Pruritus, Tremor
Clinical narrative: Immediately had arm pain- lasted about an hour. About 6 hours after injection started trembling - heart rate quickened- dizzy -  pain in the back of the neck and occipital area. Face flushing and mild itching. These symptoms did prevent me from being able to complete regular daily activities. Several days later face had redness.
Age: 17.0
Sex: M
Vaccine: COVID19
Symptoms: Dizziness, Immediate post-injection reaction
Clinical narrative: immediately after receiving her vaccination he developed lightheadedness. He  has an aversion to needles.
Age: 43.0
Sex: M
Vaccine: COVID19
Symptoms: Ageusia, Anosmia, Respiratory tract congestion
Clinical narrative: Loss of taste and smell, extreme nasal congestion
Age: 42.0
Sex: F
Vaccine: COVID19
Symptoms: Urinary tract infection
Clinical narrative: A week after the vaccine I developed a UTI which was treated with antibiotics and resolved within 5 days after.
Age: 21.0
Sex: F
Vaccine: IPV, MMR, TDAP, VARCEL
Symptoms: Body temperature increased, Malaise, Pustule, Scab, Varicella
Clinical narrative: Patient states that about 1 week after receiving the vaccines, she started feeling sick with an increased temperature, and pustules started breaking out all over her body and in orifices. Her temp went up to 104 F, and it became bad enough that she went to the ER and was hospitalized from March 19-22. She stated they told her it was chickenpox from the vaccine. When she contacted us on March 26, she said she was feeling better- no longer feverish, and she was scabbing and healing over.
Age: 39.0
Sex: M
Vaccine: COVID19
Symptoms: Muscle spasms, Pain
Clinical narrative: Painful cramping of muscle in upper right back.  Pain 2/10. Pain decreased to 1/10 by the next morning, and was fully resolved approximately 36 hours after onset.
Age: 47.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Cellulitis, SARS-CoV-2 test positive
Clinical narrative: Covid vaccine monitoring documentation. Patient admitted 3/25/21 for cellulitis. SARS-CoV-2 COVID-19 documented positive 03/25/21 21:43, patient documented to be asymptomatic. Patient received both doses of Covid-19 vaccine, of note, documentation stated patient husband not vaccinated. Dose 1, Pfizer 2/26/21 EN6200, Dose 2, Pfizer 3/19/21 EN6204.
Age: 80.0
Sex: M
Vaccine: COVID19
Symptoms: Muscular weakness, Pain in extremity
Clinical narrative: Right arm and left leg pain/ weakness
Age: 46.0
Sex: M
Vaccine: COVID19
Symptoms: Diarrhoea, Fatigue, Pain, Pyrexia
Clinical narrative: Fever, aches, soreness, exhaustion, diarrhea,
Age: 20.0
Sex: M
Vaccine: COVID19
Symptoms: Dizziness
Clinical narrative: 10 minutes after receiving 2nd dose patient complained of being dizzy. Onsite EMS was called vitals BP 108/64 HR 65 100% O2.  He was given Graham Crackers. Monitored for 30 additional minutes. He hadn't eaten since 10 pm last night. He was encouraged to get some food before he gets home. Released to go home.
Age: 51.0
Sex: M
Vaccine: COVID19
Symptoms: Injection site reaction, Rash erythematous
Clinical narrative: A 4-inch long, 2 to 2.5-inch wide, oblong, red rash at injection site appearing approximately nine days after date of injection.
Age: 42.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness, Headache, Hypotension, Injection site swelling, Loss of consciousness
Clinical narrative: Patient states that she woke up at 3am on 3/26, about 12 hours after her injection experiencing nausea. She got out of bed and describes feeling dizzy and passing out. By 12pm on 3/26, she was experiencing dizziness, headache, body aches, and a fever of 101 degrees F. She also describes significant swelling in the arm where she received her injection, with swelling extending towards her chest. She called her PCP and the health department information line, and decided to go to an urgent care facility at 2pm on 3/26. At the urgent care, per patient report she was assessed to have a temperature of 101.8 degrees F, and a "low BP," value uncertain. Per patient, she was referred to ER for further evaluation of the swelling in her arm/chest and hypotension. In the ER, per patient report, she was given IV fluids and toradol and released the same day. The next day, 3/27, she reports that her symptoms began to decrease. She still had a headache, fever (99.8 degrees F) and body aches. The swelling in her arm began to decrease at this point as well. As of 3/29/21, patient describes mild headache, body aches, and no fever. She is taking tylenol and ibuprofen periodically.
Age: 42.0
Sex: F
Vaccine: COVID19
Symptoms: Nausea, Pain, Pyrexia, Swelling face
Clinical narrative: Patient states that she woke up at 3am on 3/26, about 12 hours after her injection experiencing nausea. She got out of bed and describes feeling dizzy and passing out. By 12pm on 3/26, she was experiencing dizziness, headache, body aches, and a fever of 101 degrees F. She also describes significant swelling in the arm where she received her injection, with swelling extending towards her chest. She called her PCP and the health department information line, and decided to go to an urgent care facility at 2pm on 3/26. At the urgent care, per patient report she was assessed to have a temperature of 101.8 degrees F, and a "low BP," value uncertain. Per patient, she was referred to ER for further evaluation of the swelling in her arm/chest and hypotension. In the ER, per patient report, she was given IV fluids and toradol and released the same day. The next day, 3/27, she reports that her symptoms began to decrease. She still had a headache, fever (99.8 degrees F) and body aches. The swelling in her arm began to decrease at this point as well. As of 3/29/21, patient describes mild headache, body aches, and no fever. She is taking tylenol and ibuprofen periodically.
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: Epistaxis
Clinical narrative: On March 3, 2021 at 1:45 PM, I received the first dose of Moderna COVID Vaccine (Lot: 027A21A) via IM injection on my left arm. On March 5, 2021 at approximately 11:45 PM, I had a gushing nose bleed (an event that is extremely rare for me). The bleeding  stopped after 35 minutes following pressure and ice.  On March 7, 2021 at approximately 1 PM, I had a gushing nose bleed. The bleeding stopped after 28 minutes following only pressure. On March 8, 2021 at approximately 1 PM, I had a nose bleed that lasted 17 minutes following only pressure.
Age: 28.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Cough, Dizziness, Fatigue, Headache
Clinical narrative: Sore throat, cough, dizziness, fatigue, body aches, runny nose, throat congestion, headache, nausea, chills   Rested and took medicines
Age: 28.0
Sex: F
Vaccine: COVID19
Symptoms: Nausea, Oropharyngeal pain, Pain, Rhinorrhoea, Throat irritation
Clinical narrative: Sore throat, cough, dizziness, fatigue, body aches, runny nose, throat congestion, headache, nausea, chills   Rested and took medicines
Age: 58.0
Sex: F
Vaccine: COVID19
Symptoms: Inappropriate schedule of product administration, No adverse event
Clinical narrative: pt mistakenly administered second dose 3/23, 20 days after first dose.  second dose lot# 040a21a.  no adverse events reported.
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: Feeling abnormal, Nervousness, Paraesthesia
Clinical narrative: About 15 minutes after receiving shot and having left the shot site. The tip of my tongue was feeling fuzzy, maybe numb.  My face was tingling and I was feeling very shaky.  I had my sister take me to a nearby hospital and we waited in the parking lot just in case my symptoms got worse.  After about 10 minutes or so, the symptoms started to subside and she took me home.
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: Bell's palsy, Blood test, Facial paralysis
Clinical narrative: On 3/28/2021 the left side of my face started drooping and I felt slight paralysis.  I went to the doctor 3/29/2021 and was diagnosed with Bells Palsy
Age: 57.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal pain upper, Fatigue, Injection site pain, Injection site swelling, Muscle spasms
Clinical narrative: Within 4 hours of the Moderna shot I felt injection site pain - a little swelling, then I got very tired.  the pain lasted for around 24 hours. A week after my first injection, I started experiencing stomach pain - from under my breasts to my belly button.  It started around 5pm on Sunday, March 28th. I am still experiencing stomach pain and a little cramping on my right side.  I am waiting it out...
Age: 37.0
Sex: M
Vaccine: COVID19
Symptoms: No adverse event, Underdose
Clinical narrative: Vial was diluted with less than 1.8ml of diluent.  Pt made aware of the situation.  No adverse effects reported.
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: Pain in extremity, Rash erythematous
Clinical narrative: Covid arm about 8" long x 3". Red rash. Not particularly itchy or bothersome. May have appeared earlier, but only noticed because I saw it in mirror
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Anxiety, Cold sweat, Palpitations
Clinical narrative: Racing heart very anxious  Vitals Signs: B/P: 170/74 HR: 142 O2Sat:98 Skin Signs: Clammy Circulation: Delayed  Resp.: Breath sounds clear bilaterally. Denies chest pain. Treatment: controlled breathing with guided imagery. Gave apple juice  Reassessment: @16:12 Vitals: B/P: 138/80 (right arm) HR:134 Reassessment @16:16 B/P 132/70 HR:134 Reassessment @16:20 HR:100 O2Sat:97 Treatment: Patient D/C from triage without incident- Laughing and talking. Husband in parking lot in his own car. Pt d/c home by self.
Age: 44.0
Sex: F
Vaccine: COVID19
Symptoms: Cough
Clinical narrative: Vaccine was administered during a drive through event.  During the waiting period she began to cough almost immediately.  She used her personal albuterol inhaler and was given 50mg of Benadryl.   She did not develop dyspnea, hives, or angioedema.  She was monitored at the location for over an hour after resolution of symptoms.  She was released to home with instructions to monitor carefully for new or worsening symptoms and seek immediate medical care if these occurred.
Age: 23.0
Sex: F
Vaccine: COVID19
Symptoms: Paraesthesia, Paraesthesia oral, Pharyngeal paraesthesia, Pruritus, Wheezing
Clinical narrative: Pt vaccinated @1430. 1436 pt c/o Itching, tingling to mouth and nose and one side of throat, nausea. Pt given Benadryl 50mg PO. Bp 166/81, P 98, SPO2 99%, mild wheezing auscultated. Car seat leaned back, MD consulted. Pt has hx blood clot Oct 2021, currently on Lovenox BID. Pt used her personnal inhailer she had in car. Hx of anaphalaxis with bee stings, Fentanyl, Hydrocodone. EMS called, on site <5min, care transfered, pt being taken to local ER. Pt advised to consult PCP to determine if she should get 2nd dose. RN
Age: 51.0
Sex: M
Vaccine: COVID19
Symptoms: Underdose
Clinical narrative: Immunizer may have hit bone and retracted needle which caused most of the volume of the liquid to be squirted out of patients arm
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: Dyspnoea, Headache, Sinus congestion
Clinical narrative: Started with severe headache and sinus congestion.  Progressed to SOB.  Patient took cold medicine to help with headache and congestion and that seemed to improve the SOB.  No Medical treatment was sought.
Age: 38.0
Sex: M
Vaccine: COVID19
Symptoms: Ageusia, Anosmia, COVID-19, Chills, Cough
Clinical narrative: Patient had dose #2 of COVID vaccine on 1/29/2021.   Patient developed symptoms of COVID on 3/23/2021 with fever, chills, ache, cough, loss of taste/smell, and nasal congestion.  Positive COVID test.
Age: 38.0
Sex: M
Vaccine: COVID19
Symptoms: Nasal congestion, Pain, Pyrexia, SARS-CoV-2 test positive
Clinical narrative: Patient had dose #2 of COVID vaccine on 1/29/2021.   Patient developed symptoms of COVID on 3/23/2021 with fever, chills, ache, cough, loss of taste/smell, and nasal congestion.  Positive COVID test.
Age: 55.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal pain, Fatigue, Heart rate increased, Injection site erythema, Injection site pain
Clinical narrative: 22 hours after injection - muscle aches, fever, fatigue 32 hours after injection - muscle aches, fever, headache, redness and swelling at injection site, rash on chest, nausea, abdominal pain, occasional rapid heartbeat, fatigue 3 days after injection -  muscle aches, fever, headache, redness and swelling at injection site, rash on upper body front and back, nausea, abdominal pain, occasional rapid heartbeat, fatigue 5 days after injection - slight fever, headache, sore arm at injection site, nausea, fatigue
Age: 55.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site swelling, Myalgia, Nausea, Pyrexia, Rash
Clinical narrative: 22 hours after injection - muscle aches, fever, fatigue 32 hours after injection - muscle aches, fever, headache, redness and swelling at injection site, rash on chest, nausea, abdominal pain, occasional rapid heartbeat, fatigue 3 days after injection -  muscle aches, fever, headache, redness and swelling at injection site, rash on upper body front and back, nausea, abdominal pain, occasional rapid heartbeat, fatigue 5 days after injection - slight fever, headache, sore arm at injection site, nausea, fatigue
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: Fatigue, Headache, Neck pain, Photopsia, Vision blurred
Clinical narrative: severe pain back of head near head and neck first 24 hours flashing in both eyes like aura migraine still ongoing. Cloudy vision left eye, still ongoing Fatigue, still ongoing
Age: 42.0
Sex: F
Vaccine: COVID19
Symptoms: Diarrhoea, Dizziness, Fatigue, Nausea
Clinical narrative: Exhaustion, Nausea, Dizziness, Diarrhea
Age: 66.0
Sex: F
Vaccine: COVID19
Symptoms: Inflammation, Injection site pain, Pruritus
Clinical narrative: Inflammation, itchiness, and minor pain at injection site. Began 3/21 and resolved by 3/29
Age: 42.0
Sex: F
Vaccine: COVID19
Symptoms: Migraine, Nausea, Urinary tract infection, Vomiting
Clinical narrative: The next day after the vaccine I developed a severe migrane, nausea and vomiting for about 3 days.  Then the Tues or Wed of the next week another UTI developed but resolved on its on.
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Chest discomfort, Wheezing
Clinical narrative: Patient complained of wheezing & chest tightness. Onsite EMS was called vitals  BP 158/97 HR 75.  EMS took patient to Recieving Hospital.
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Eye pain, Headache, Influenza like illness, Nausea
Clinical narrative: Chills, flu like symptoms. pounding headache, sore eyes, nausea lasting approximately 36 hours.  Hydrated, bed rest and slept most of the time.
Age: 61.0
Sex: M
Vaccine: COVID19
Symptoms: Chest X-ray normal, Computerised tomogram head normal, Confusional state, Full blood count normal, Laboratory test normal
Clinical narrative: UNKNOWN VACCINATION LOCATION. ADMITTED TO CENTER THE DAY AFTER HIS 2ND SHOT FOR CONFUSION, MENTAL STATUS CHANGES, SYNCOPE VS SEIZURE ACTIVITY, LOSS OF CONSCIOUSNESS. NEURO CONSULTED AND THOUGHT POSSIBLE ADVERSE REACTION TO COVID VACCINE #2 AS NO OTHER REASON HAS BEEN FOUND WITH LABS, IMAGING, ETC. NEURO CALLING IT A 2 HOUR FUGUE EVENT.
Age: 61.0
Sex: M
Vaccine: COVID19
Symptoms: Loss of consciousness, Magnetic resonance imaging head normal, Mental status changes, Seizure like phenomena, Syncope
Clinical narrative: UNKNOWN VACCINATION LOCATION. ADMITTED TO CENTER THE DAY AFTER HIS 2ND SHOT FOR CONFUSION, MENTAL STATUS CHANGES, SYNCOPE VS SEIZURE ACTIVITY, LOSS OF CONSCIOUSNESS. NEURO CONSULTED AND THOUGHT POSSIBLE ADVERSE REACTION TO COVID VACCINE #2 AS NO OTHER REASON HAS BEEN FOUND WITH LABS, IMAGING, ETC. NEURO CALLING IT A 2 HOUR FUGUE EVENT.
Age: 61.0
Sex: M
Vaccine: COVID19
Symptoms: X-ray limb normal
Clinical narrative: UNKNOWN VACCINATION LOCATION. ADMITTED TO CENTER THE DAY AFTER HIS 2ND SHOT FOR CONFUSION, MENTAL STATUS CHANGES, SYNCOPE VS SEIZURE ACTIVITY, LOSS OF CONSCIOUSNESS. NEURO CONSULTED AND THOUGHT POSSIBLE ADVERSE REACTION TO COVID VACCINE #2 AS NO OTHER REASON HAS BEEN FOUND WITH LABS, IMAGING, ETC. NEURO CALLING IT A 2 HOUR FUGUE EVENT.
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Pain, Pyrexia, Somnolence
Clinical narrative: Fever and chills began at 11:15 PM on the date of the vaccination continued into the next day at 9:30 AM I took NyQuil and Alka-Seltzer and slept until 8 o?clock in the evening at which time my bones were aching so bad I took more NyQuilAnd slept into the next day finally woke up at 6 o?clock and felt good enough to go for a walk and take a shower and eat something and then by 9 o?clock I went back to bed and slept until 4 AM at which time I woke up and felt good
Age: 59.0
Sex: M
Vaccine: COVID19
Symptoms: Chills, Diarrhoea, Pyrexia, Vomiting
Clinical narrative: 15 hours after injection started with vomiting, diarrhea, fever, and chills. Symptoms lasted 32 hours.
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: Erythema, Injection site induration, Injection site pain, Injection site reaction, Injection site swelling
Clinical narrative: Day 8 injection site reaction--itchy rash over upper arm, burning, splotchy red skin like a sunburn, injection site hard and swollen, deltoid muscle pain from top of shoulder down to elbow. Used over the counter antihistamine (dipenhydramine 25 mg) once, anti-itch cream twice. Symptoms better in 2 days but still present
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: Rash macular, Rash pruritic, Skin burning sensation
Clinical narrative: Day 8 injection site reaction--itchy rash over upper arm, burning, splotchy red skin like a sunburn, injection site hard and swollen, deltoid muscle pain from top of shoulder down to elbow. Used over the counter antihistamine (dipenhydramine 25 mg) once, anti-itch cream twice. Symptoms better in 2 days but still present
Age: 84.0
Sex: F
Vaccine: COVID19
Symptoms: Bacteraemia, Blood culture positive, Cardiac telemetry, Chest X-ray, Computerised tomogram abdomen
Clinical narrative: Bacteremia - strep epidermidis, developed respiratory distress required intubation for hypercapnic respiratory failure. Developed PEA on 3/28 died.
Age: 84.0
Sex: F
Vaccine: COVID19
Symptoms: Computerised tomogram abnormal, Computerised tomogram head, Computerised tomogram thorax, Death, Endotracheal intubation
Clinical narrative: Bacteremia - strep epidermidis, developed respiratory distress required intubation for hypercapnic respiratory failure. Developed PEA on 3/28 died.
Age: 84.0
Sex: F
Vaccine: COVID19
Symptoms: Full blood count, Metabolic function test, Pulseless electrical activity, Respiratory distress, Respiratory failure
Clinical narrative: Bacteremia - strep epidermidis, developed respiratory distress required intubation for hypercapnic respiratory failure. Developed PEA on 3/28 died.
Age: 84.0
Sex: F
Vaccine: COVID19
Symptoms: Streptococcal sepsis, Streptococcus test positive, Ultrasound Doppler, Ultrasound abdomen
Clinical narrative: Bacteremia - strep epidermidis, developed respiratory distress required intubation for hypercapnic respiratory failure. Developed PEA on 3/28 died.
Age: 64.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Arthralgia, Mobility decreased
Clinical narrative: I had the Pfizer vaccine, 1st and 2nd. The first one gave me the reaction most people say the 2nd one gives, although not quite as bad as what others have described. HOWEVER, the 2nd dose in my case, cause a severe flare-up of arthritic type symptoms in my joints, mostly both knees but no feverish reactions. When I say severe arthritic flare up, I mean debilitating to the point where it almost hurts too much to walk. I had the shot on a Friday, the arthritic pain began late that night and became worse on Saturday. It is now Monday and the pain has only subsided a little bit. It's still difficult to get up from a sitting position and to walk or stand for longer periods of time.
Age: 64.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Arthralgia, Joint swelling, Pain
Clinical narrative: I had the Pfizer vaccine, 1st and 2nd. The first one gave me the reaction most people say the 2nd one gives, although not quite as bad as what others have described. HOWEVER, the 2nd dose in my case, cause a severe flare-up of arthritic type symptoms in my joints, mostly both knees but no feverish reactions. When I say severe arthritic flare up, I mean debilitating to the point where it almost hurts too much to walk. I had the shot on a Friday, the arthritic pain began late that night and became worse on Saturday. It is now Monday and the pain has only subsided a little bit. It's still difficult to get up from a sitting position and to walk or stand for longer periods of time.
Age: 27.0
Sex: F
Vaccine: COVID19
Symptoms: Haemorrhage, Injection site induration, Injection site reaction, Menstruation irregular, Premenstrual syndrome
Clinical narrative: -Hard raised red lump at the injection site that became present a week following injection -Early menstruation cycle: The previous bleeding part of the cycle concluded 03/07/2021.  Patient began experiencing PMS symptoms around 03/23/2021, and bleeding began again 03/26/2021. Patient's period is almost always regular. Patient's periods typically last between 2-3 days, but at the time of this report has been going on for 4 days now.
Age: 36.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Contusion, Fatigue, Flushing, Oropharyngeal pain
Clinical narrative: Body aches, mild sore throat, and night chills within 24 hours of vaccine. Took acetaminophen as needed to manage. On day 4, had extreme fatigue, aches, chills, with a "puffy-flushed face and neck sensation," which later in the evening, developed a full body rash resembling hives. Went to ER and took prednisone 50mg, Benadryl 50mg, and famotidine 40mg. On day 5, the rash had progressed in color (brighter red) from head down to my ankles. Had a doctor tell me it was a maculopapular rash which was blanchable on my abdomen/back. My legs were covered down to my ankles with red dots that became purple non-blanchable small bruises the next day (day 6), resembling petechiae.
Age: 36.0
Sex: F
Vaccine: COVID19
Symptoms: Pain, Pallor, Rash, Rash erythematous, Rash macular
Clinical narrative: Body aches, mild sore throat, and night chills within 24 hours of vaccine. Took acetaminophen as needed to manage. On day 4, had extreme fatigue, aches, chills, with a "puffy-flushed face and neck sensation," which later in the evening, developed a full body rash resembling hives. Went to ER and took prednisone 50mg, Benadryl 50mg, and famotidine 40mg. On day 5, the rash had progressed in color (brighter red) from head down to my ankles. Had a doctor tell me it was a maculopapular rash which was blanchable on my abdomen/back. My legs were covered down to my ankles with red dots that became purple non-blanchable small bruises the next day (day 6), resembling petechiae.
Age: 36.0
Sex: F
Vaccine: COVID19
Symptoms: Rash maculo-papular, Swelling face, Urticaria
Clinical narrative: Body aches, mild sore throat, and night chills within 24 hours of vaccine. Took acetaminophen as needed to manage. On day 4, had extreme fatigue, aches, chills, with a "puffy-flushed face and neck sensation," which later in the evening, developed a full body rash resembling hives. Went to ER and took prednisone 50mg, Benadryl 50mg, and famotidine 40mg. On day 5, the rash had progressed in color (brighter red) from head down to my ankles. Had a doctor tell me it was a maculopapular rash which was blanchable on my abdomen/back. My legs were covered down to my ankles with red dots that became purple non-blanchable small bruises the next day (day 6), resembling petechiae.
Age: 46.0
Sex: F
Vaccine: COVID19
Symptoms: Nodule, Pain in extremity, Pruritus, Skin warm
Clinical narrative: Large red knot growing daily since shot. The red know is hot, itchy, sore, and is not directly on injection site. The knot started slightly above the injection site.
Age: 84.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, Dysphonia, Nausea, Productive cough, Vomiting
Clinical narrative: Weakness, nausea, vomiting, unable to hold food down, hoarse voice, productive cough