chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 24.0
Sex: F
Vaccine: HPV4, HPV4
Symptoms: Hypoaesthesia, Injected limb mobility decreased, Injection site erythema, Injection site swelling, Muscular weakness
Clinical narrative: Pt experienced right arm pain, she received her second GARDASIL injection on June 17, 2008.  Pain continues to get worse, can't move arm to much.  Pain originates in deltoid and travels down her arm.  She has numbness and tingling in hands.  A lot of swelling and redness at the injection site.  Weakness is present in entire arm.  She is also having nausea and vomiting, beginning 5 days ago.  24 year old female with adverse reaction to IM GARDASIL injection.  Exam is unremarkable.  Will treat her symptoms aggressively and have her follow-up in 1-2 days as needed.  PHENERGAN 25 MG OR TABS, LORTAB 7.5 7.5-500 MG OR TABS, ZYRTEC 10 MG OR TABS, given to pt. 7/21/08-records received for DOS 6/17/08-received gardasil vaccine. 6/23/08 C/O pain right arm can't move arm much, travels down arm with numbness and tingling. Weakness in entire arm. Nausea and vomiting. Impressions:adverse reaction to vaccine. 7/1/08-received depo provera. 7/11/08-depression, decreased libido, angry, mood outbursts, pulling own hair, stress due to premature baby and recent marriage.
Age: 24.0
Sex: F
Vaccine: HPV4, HPV4
Symptoms: Nausea, Pain in extremity, Paraesthesia, Vomiting
Clinical narrative: Pt experienced right arm pain, she received her second GARDASIL injection on June 17, 2008.  Pain continues to get worse, can't move arm to much.  Pain originates in deltoid and travels down her arm.  She has numbness and tingling in hands.  A lot of swelling and redness at the injection site.  Weakness is present in entire arm.  She is also having nausea and vomiting, beginning 5 days ago.  24 year old female with adverse reaction to IM GARDASIL injection.  Exam is unremarkable.  Will treat her symptoms aggressively and have her follow-up in 1-2 days as needed.  PHENERGAN 25 MG OR TABS, LORTAB 7.5 7.5-500 MG OR TABS, ZYRTEC 10 MG OR TABS, given to pt. 7/21/08-records received for DOS 6/17/08-received gardasil vaccine. 6/23/08 C/O pain right arm can't move arm much, travels down arm with numbness and tingling. Weakness in entire arm. Nausea and vomiting. Impressions:adverse reaction to vaccine. 7/1/08-received depo provera. 7/11/08-depression, decreased libido, angry, mood outbursts, pulling own hair, stress due to premature baby and recent marriage.
Age: 24.0
Sex: F
Vaccine: HPV4, HPV4
Symptoms: Hypoaesthesia, Injected limb mobility decreased, Injection site erythema, Injection site swelling, Nausea
Clinical narrative: Pt experienced right arm pain, she received her second GARDASIL injection on June 17, 2008.  Pain continues to get worse, can't move arm to much.  Pain originates in deltoid and travels down her arm.  She has numbness and tingling in hands.  A lot of swelling and redness at the injection site.  Weakness is present in entire arm.  She is also having nausea and vomiting, beginning 5 days ago.  24 year old female with adverse reaction to IM GARDASIL injection.  Exam is unremarkable.  Will treat her symptoms aggressively and have her follow-up in 1-2 days as needed.  PHENERGAN 25 MG OR TABS, LORTAB 7.5 7.5-500 MG OR TABS, ZYRTEC 10 MG OR TABS, given to pt. 7/21/08-records received for DOS 6/17/08-received gardasil vaccine. 6/23/08 C/O pain right arm can't move arm much, travels down arm with numbness and tingling. Weakness in entire arm. Nausea and vomiting. Impressions:adverse reaction to vaccine. 7/1/08-received depo provera. 7/11/08-depression, decreased libido, angry, mood outbursts, pulling own hair, stress due to premature baby and recent marriage.
Age: 24.0
Sex: F
Vaccine: HPV4, HPV4
Symptoms: Pain in extremity, Paraesthesia, Vomiting
Clinical narrative: Pt experienced right arm pain, she received her second GARDASIL injection on June 17, 2008.  Pain continues to get worse, can't move arm to much.  Pain originates in deltoid and travels down her arm.  She has numbness and tingling in hands.  A lot of swelling and redness at the injection site.  Weakness is present in entire arm.  She is also having nausea and vomiting, beginning 5 days ago.  24 year old female with adverse reaction to IM GARDASIL injection.  Exam is unremarkable.  Will treat her symptoms aggressively and have her follow-up in 1-2 days as needed.  PHENERGAN 25 MG OR TABS, LORTAB 7.5 7.5-500 MG OR TABS, ZYRTEC 10 MG OR TABS, given to pt. 7/21/08-records received for DOS 6/17/08-received gardasil vaccine. 6/23/08 C/O pain right arm can't move arm much, travels down arm with numbness and tingling. Weakness in entire arm. Nausea and vomiting. Impressions:adverse reaction to vaccine. 7/1/08-received depo provera. 7/11/08-depression, decreased libido, angry, mood outbursts, pulling own hair, stress due to premature baby and recent marriage.
Age: 24.0
Sex: F
Vaccine: HPV4, HPV4
Symptoms: Hypoaesthesia, Injected limb mobility decreased, Injection site erythema, Injection site swelling, Muscular weakness
Clinical narrative: Patient experienced right arm pain, after receiving her second gardasil injection on 06/17/2008.  Pain continues to get owrse, can't move arm easily.  Pain originates in deltoid and travels down her arm.  She has numbness and tingling in hands.  Swelling and redness at injection site.  Also having nausea and vomiting which began 5 days ago.  Date seen 07/05/2008. 7/21/08-records received for DOS 6/23/08-presented with right arm pain, can not move arm much. Numbness and tingling weakness in entire arm. Nausea and vomiting. Assessment:adverse reaction to Gardasil. office visit 7/1/08-received Depo-provera injection. Office visit 7/11/08-C/O feels angry, mood outbursts, does not like self worried baby does not like her. Pulling own hair. Stress, premature baby, new married.
Age: 24.0
Sex: F
Vaccine: HPV4, HPV4
Symptoms: Nausea, Pain in extremity, Paraesthesia, Vomiting
Clinical narrative: Patient experienced right arm pain, after receiving her second gardasil injection on 06/17/2008.  Pain continues to get owrse, can't move arm easily.  Pain originates in deltoid and travels down her arm.  She has numbness and tingling in hands.  Swelling and redness at injection site.  Also having nausea and vomiting which began 5 days ago.  Date seen 07/05/2008. 7/21/08-records received for DOS 6/23/08-presented with right arm pain, can not move arm much. Numbness and tingling weakness in entire arm. Nausea and vomiting. Assessment:adverse reaction to Gardasil. office visit 7/1/08-received Depo-provera injection. Office visit 7/11/08-C/O feels angry, mood outbursts, does not like self worried baby does not like her. Pulling own hair. Stress, premature baby, new married.
Age: 24.0
Sex: F
Vaccine: HPV4, HPV4
Symptoms: Hypoaesthesia, Injected limb mobility decreased, Injection site erythema, Injection site swelling, Nausea
Clinical narrative: Patient experienced right arm pain, after receiving her second gardasil injection on 06/17/2008.  Pain continues to get owrse, can't move arm easily.  Pain originates in deltoid and travels down her arm.  She has numbness and tingling in hands.  Swelling and redness at injection site.  Also having nausea and vomiting which began 5 days ago.  Date seen 07/05/2008. 7/21/08-records received for DOS 6/23/08-presented with right arm pain, can not move arm much. Numbness and tingling weakness in entire arm. Nausea and vomiting. Assessment:adverse reaction to Gardasil. office visit 7/1/08-received Depo-provera injection. Office visit 7/11/08-C/O feels angry, mood outbursts, does not like self worried baby does not like her. Pulling own hair. Stress, premature baby, new married.
Age: 24.0
Sex: F
Vaccine: HPV4, HPV4
Symptoms: Pain in extremity, Paraesthesia, Vomiting
Clinical narrative: Patient experienced right arm pain, after receiving her second gardasil injection on 06/17/2008.  Pain continues to get owrse, can't move arm easily.  Pain originates in deltoid and travels down her arm.  She has numbness and tingling in hands.  Swelling and redness at injection site.  Also having nausea and vomiting which began 5 days ago.  Date seen 07/05/2008. 7/21/08-records received for DOS 6/23/08-presented with right arm pain, can not move arm much. Numbness and tingling weakness in entire arm. Nausea and vomiting. Assessment:adverse reaction to Gardasil. office visit 7/1/08-received Depo-provera injection. Office visit 7/11/08-C/O feels angry, mood outbursts, does not like self worried baby does not like her. Pulling own hair. Stress, premature baby, new married.
Age: 22.0
Sex: M
Vaccine: HEPAB, SMALL
Symptoms: Blood creatine phosphokinase MB, Blood creatine phosphokinase increased, Chest pain, Dyspnoea, Troponin
Clinical narrative: 22 y/o male ADSM is referred from the Smallpox study with complaint of a single episode of chest pain on yesterday evening.  Possible adverse reaction to Smallpox vaccine.  Symptoms: Chest Pain, Dyspnea (shortness of breath).
Age: 14.0
Sex: M
Vaccine: MNQ, TDAP
Symptoms: Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling, Injection site warmth
Clinical narrative: Mom calling 2nd day red, raised, warm to touch.  Swollen size of "1/2 baseball", + itching, + tenderness at site.
Age: 17.0
Sex: F
Vaccine: MNQ
Symptoms: Tenderness
Clinical narrative: Tenderness x 25 hours at left arm (deltoid).
Age: 71.0
Sex: F
Vaccine: TDAP
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Neck pain, Palpitations
Clinical narrative: Redness, swelling, & pain at the injection site, neck pain, bouncing heart rate.
Age: 1.5
Sex: M
Vaccine: DTAP, HEPA, VARCEL
Symptoms: Injection site erythema, Injection site pruritus, Injection site swelling
Clinical narrative: Raised red itchy area on patients injection site rt upper thigh.
Age: 1.4
Sex: M
Vaccine: DTAP, HIBV, PNC
Symptoms: Injection site erythema, Injection site pain, Injection site swelling
Clinical narrative: Swelling, redness, pain at site >5 cm.
Age: 5.0
Sex: M
Vaccine: DTAP, HEPA, IPV
Symptoms: Skin warm, Urticaria
Clinical narrative: Patients arm was warm to touch, had hives, but they were not itchy.  Patient was given BENADRYL.
Age: 66.0
Sex: F
Vaccine: TD
Symptoms: Injection site erythema, Injection site induration, Injection site pain, Injection site warmth
Clinical narrative: Injection given 6/23/08.  That evening patient reports soreness, redness, warmth.  Area also felt hard.  Worsening symptoms of redness, soreness, warmth over next few days.  Physician appt 6/26/08.  Given prednisone 20 mg BID x 5 days.
Age: 5.0
Sex: F
Vaccine: DTAP, HEPA, IPV, MMR, VARCEL
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth
Clinical narrative: 4 1/2" x 5" erythematous, edematous, warm area around dtap injection site, right lateral thigh.
Age: 5.0
Sex: M
Vaccine: HEPA, VARCEL
Symptoms: Cough, Eye discharge, Pallor, Rhinorrhoea, Wheezing
Clinical narrative: Child given 2nd varicella & 1st Hep A. Approx 20 mins after getting imms mom returned to our office with "the patient" wheezing (audible in room without stethoscope), tight cough, eyes running, nose running & pallor. Taken immediately to pediatrician across street - eppi, albuterol reb treatment & steroids given. Sent home on Medrol dose pack. Recovered within 1 hour
Age: 1.02
Sex: F
Vaccine: HEPA, MMR, PNC, VARCEL
Symptoms: Erythema, Rash maculo-papular, Skin lesion
Clinical narrative: Pt had onset of red maculopapular rash 6 days after vaccine given. No fever. No other symptoms. Some lesions coalesced on back. No treatment needed.
Age: 1.0
Sex: M
Vaccine: MMR, VARCEL
Symptoms: Rash
Clinical narrative: Broke out in rash consistent with vaccine assc. varicella
Age: 1.1
Sex: F
Vaccine: HEPA, MMR, VARCEL
Symptoms: Rash
Clinical narrative: Rash noted one day after immunizations given.
Age: 67.0
Sex: M
Vaccine: PPV
Symptoms: Congenital joint malformation, Contusion, Erythema, Eye pain, Headache
Clinical narrative: Vaccination given in upper left arm - area below injection (crook of elbow up, on top of arm both very hot and pinkish red). Over several days swelling - bruised look - rash around both thighs - nausea - difficulty sleeping - increased pain and snapping/popping in joints - pain under arm and swelling in lymph glands - stiff neck plus - plus - head - eye pain.
Age: 67.0
Sex: M
Vaccine: PPV
Symptoms: Lymphadenopathy, Musculoskeletal stiffness, Nausea, Pain, Pain in extremity
Clinical narrative: Vaccination given in upper left arm - area below injection (crook of elbow up, on top of arm both very hot and pinkish red). Over several days swelling - bruised look - rash around both thighs - nausea - difficulty sleeping - increased pain and snapping/popping in joints - pain under arm and swelling in lymph glands - stiff neck plus - plus - head - eye pain.
Age: 67.0
Sex: M
Vaccine: PPV
Symptoms: Rash, Skin warm, Sleep disorder
Clinical narrative: Vaccination given in upper left arm - area below injection (crook of elbow up, on top of arm both very hot and pinkish red). Over several days swelling - bruised look - rash around both thighs - nausea - difficulty sleeping - increased pain and snapping/popping in joints - pain under arm and swelling in lymph glands - stiff neck plus - plus - head - eye pain.
Age: 5.0
Sex: M
Vaccine: DTAPHEPBIP, MMR
Symptoms: Erythema, Pallor, Pruritus
Clinical narrative: MMR given (R) VL. 6/27/08. 6/28/08- Mild redness. 6/29/08-Quarter sized area of redness. 6/30/08 approx 4 cm diameter area of redness. (+) itchy (+) blanches
Age: 1.6
Sex: M
Vaccine: DTAP, HEPA, VARCEL
Symptoms: Erythema, Skin warm
Clinical narrative: Onset erythema/warmth on left; anterior -> medial thigh in evening after vaccines administered. No fever N/D/SOB/Pain. Walking well and active
Age: 39.0
Sex: F
Vaccine: HEPA
Symptoms: Rash, Urticaria
Clinical narrative: Received Hepatitis A vaccination on Fri 6/29 am. Began around 3pm Sat. with rash on ankles and extending up legs. Had hives on right ankle and left upper thigh
Age: 0.2
Sex: F
Vaccine: DTAP, HIBV, IPV, PNC
Symptoms: Diarrhoea
Clinical narrative: Three hours after ROTATEQ the patient started with diarrhea and it continued for 3 weeks with 4 to 6 watery stools per day.
Age: 35.0
Sex: F
Vaccine: TD
Symptoms: Erythema, Hyperaesthesia, Paraesthesia, Skin warm, Swelling
Clinical narrative: Day 2- Red, swollen, hot, size of tennis ball. Day 4- same as day 2, with addition of sharp prickly sticks feeling Day arm not as hot, but hot very sensitive to touch. Left ear and throat sore.
Age: 5.0
Sex: F
Vaccine: DTAP, IPV, MMR, VARCEL
Symptoms: Injection site mass
Clinical narrative: "Baseball" size knot (R) buttock. "Golf ball" size knot bilateral thighs.
Age: 52.0
Sex: F
Vaccine: UNK
Symptoms: Injection site induration, Oedema peripheral, Pain in extremity, Pruritus generalised
Clinical narrative: Patient experienced swelling and pain in right arm 24 hours after vaccine.  Patient now has hard knot at vaccine site and has all over itching.
Age: 45.0
Sex: F
Vaccine: TD
Symptoms: Injection site erythema
Clinical narrative: Local erythema area on (L) upper forearm 5x6" circular area where pt. received vaccine (TD tetanus) on 6-25 - Tx with 10mg IM DEXAMETHASONE on 7-1-08 and BENADRYL 25 mg po Q4-6 hrs. No urticaria, edema, difficulty breathing
Age: 8.0
Sex: M
Vaccine: VARCEL
Symptoms: Abdominal pain upper, Cough, Flushing, Increased upper airway secretion, Nausea
Clinical narrative: Within 3-4 minutes of getting varicella vaccine pt began to c/o tummy ache & became flushed in face & cheeks.  Although no pain persisted he felt like he was going to throw up. He did not.  He coughed up a little bit of phlegm.  No wheezing exam remained stable - lungs clear.  Heart rate reg. rhythm reg. faint macular erythematous rash in the periumbilical area.  That was not there before.  Given 1 tsp. BENADRYL - flushing resolved.  Pt felt better.
Age: 9.0
Sex: F
Vaccine: HEPA, JEV, TYP
Symptoms: Dyspnoea, Fatigue, Tongue disorder
Clinical narrative: Feeling of difficulty breathing with no increased RR. The evening of getting shots. Also fatigue and feeling of her tongue being thicker. All reported no visible enlargement when seen by mother. Reported to nurse on 6/5/08 no intervention ok
Age: 5.0
Sex: M
Vaccine: DTAP, IPV, MMR, VARCEL
Symptoms: Erythema, Oedema peripheral, Skin warm
Clinical narrative: R upper arm, red, swelling, entire upper arm, warm.
Sex: U
Vaccine: DTAP, MMR
Symptoms: Erythema, Oedema peripheral, Pruritus
Clinical narrative: Mom states yesterday 6/25/08 after shower noticed Lt upper red swollen and itchy arm
Sex: M
Vaccine: HEP
Symptoms: Ear infection, Hypersensitivity, Respiratory tract congestion, Rhinorrhoea
Clinical narrative: Severe allergies that lasted over 2 years.  Constant mucous in the nose, chest.  Reoccurring ear infections.
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMR, VARCEL
Symptoms: Skin warm, Tenderness
Clinical narrative: Within 24 hr of VZV there is warmth and tenderness <2cm. This reaction seems to be with our booster VZV. No reaction seen with primary VZV.
Age: 7.0
Sex: F
Vaccine: HEP, HEPA, VARCEL
Symptoms: Injection site erythema, Injection site pruritus
Clinical narrative: Slight redness, itching at injection site on R arm.
Age: 27.0
Sex: F
Vaccine: MMR, VARCEL
Symptoms: Erythema, Induration, Oedema peripheral, Pruritus
Clinical narrative: Received vaccinations for immigration process.  Noted Lt arm evening of 6/11/08 to becoming swollen and itching.  Swelling has continued & become more so.  Rt arm sl. swollen with sl. redness.  Parts of circle are indurated.
Age: 20.0
Sex: F
Vaccine: HEPA
Symptoms: Hypoaesthesia, Injection site erythema, Injection site warmth, Local reaction, Paraesthesia
Clinical narrative: Gave patient 2nd Hep A shot at 2:00pm (6/16/08).  Patient complained of numbness in left arm and tingling in left fingers.  Observations of injection site showed localized reaction with hot, red areas.  Dr interviewed patient and released patient with instructions to call if symptoms worsened.  Vital signs were taken and were normal.
Age: 16.0
Sex: F
Vaccine: VARCEL
Symptoms: Injection site erythema, Injection site swelling
Clinical narrative: Increased redness, swelling, erythema at site - Left arm
Age: 9.0
Sex: F
Vaccine: VARCEL
Symptoms: Injection site erythema, Injection site swelling, Pyrexia
Clinical narrative: Increased redness, swelling over the site, fever.
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMR
Symptoms: Erythema
Clinical narrative: 12 cm x 10 cm area of redness on left arm onset date 6-24-08. Treatment: BENADRYL prn, cold compresses
Age: 10.0
Sex: M
Vaccine: HEPA, VARCEL
Symptoms: Erythema
Clinical narrative: 6mm x 5mm L arm redness with darker red area 1-15cm.  OMNICEF 250/5 1 tsp BID x10 days.
Age: 15.0
Sex: F
Vaccine: VARCEL
Symptoms: Erythema
Clinical narrative: 6 cm x 4 cm (L) arm redness. ATARAX 25 mg one to two tabs po q 6-8 hrs. AUGMENTIN 875 mg 1 tab po bid as prophylaxis.
Age: 34.0
Sex: M
Vaccine: TTOX
Symptoms: Chills, Musculoskeletal stiffness, Pyrexia
Clinical narrative: Patient states that he had chills, fever, stiffness in neck and lower back that he noticed on 6/28/08 around 7am.
Age: 1.3
Sex: F
Vaccine: DTAP, HEP
Symptoms: Injection site erythema, Injection site urticaria, Urticaria
Clinical narrative: Patient received DTaP dose in (L) thigh. Developed redness at injection site earlier today. Following day developed urticaria at injection site, which progressed to generalized urticarial rash.
Age: 0.2
Sex: F
Vaccine: DTAP, HIBV, IPV, PNC
Symptoms: Body temperature increased, Crying
Clinical narrative: Excessive crying, unable to calm down, temp 100.2 rectally
Age: 0.2
Sex: F
Vaccine: DTAP, HEP, HIBV, IPV, PNC, RV5, DTAP, HEP, HIBV, IPV, PNC, RV5
Symptoms: Eye movement disorder, Irritability, Postictal state, Tonic convulsion
Clinical narrative: 2 episodes of 2 second tonic appearance of both arms with slight eye deviation.  (+) Immediate recovery with postictal state - no other neurologic symptoms - pt irritable during period of time as well.
Age: 0.2
Sex: F
Vaccine: DTAP, HEP, HIBV, IPV, PNC, RV5, DTAP, HEP, HIBV, IPV, PNC, RV5
Symptoms: Gaze palsy, Irritability, Postictal state, Tonic clonic movements
Clinical narrative: 2 episodes of 2 second tonic appearance of both arms with slight eye deviation.  (+) Immediate recovery with postictal state - no other neurologic symptoms - pt irritable during period of time as well.
Age: 1.2
Sex: F
Vaccine: DTAPHEPBIP, HIBV, MMR, PNC, VARCEL
Symptoms: Blister, Erythema, Lethargy, Pyrexia, Rash
Clinical narrative: Broke out 7/4/08 with rash-started on stomach and back -were large red and many small red raised. Did not stop for next couple days- Went to ambucare 4/6/08- Had fever in 100's, lethargic- Became blisters-all little bumps also today has only red raised rash and no fever.
Age: 65.0
Sex: F
Vaccine: PNC
Symptoms: Dyspepsia, Headache, Malaise, Neck pain, Pain
Clinical narrative: Arm & neck pain starting one day post-vaccine - progressing to headache body ache, heartburn, general malaise.
Age: 65.0
Sex: F
Vaccine: PNC
Symptoms: Pain in extremity
Clinical narrative: Arm & neck pain starting one day post-vaccine - progressing to headache body ache, heartburn, general malaise.
Age: 23.0
Sex: M
Vaccine: ANTH, SMALL
Symptoms: Blood culture, Blood pressure increased, C-reactive protein increased, Chills, Diarrhoea
Clinical narrative: The following information gathered from patient on 4 July while in hospital:  Patient reported to HC on 2 July/ Day #8 after receiving SPX Vaccination on 24 June complaining of chills and tunnel vision, feeling 'off', sweating profusely temp was 102 degrees with BP of 160/120.  Patient also revealed prior sun exposure on 1 July with some reddened areas.  Physician sent to Hospital. Patient stated that the vaccination on his arm appeared about the Day #10 picture when shown pictures of normal reaction timeline and described, "bruised yellow on perimeter...continued oozing... sunken a bit...too yellow to be a scab".  Spoke with house Doctor.  During hospitalization CRPs elevated to 5-6, patient had diarrhea, received fever reducing medications, blood cultures and SPX vaccination site was removed by surgeon.  When asked if tissue samples were taken it was unknown.  Per patient the skin area around the vaccination site was cleansed with rivanol 0.1%.  10/27/2008 MR received for OV 7/8/2008 with Dx:  Cellulitis. Pt seen in f/u for foreign hospital visit for viral fever and smallpox vaccination site infection. Tx-antibiotics. Pt is now well
Age: 23.0
Sex: M
Vaccine: ANTH, SMALL
Symptoms: Hyperhidrosis, Injection site bruising, Malaise, Pyrexia, Sunburn
Clinical narrative: The following information gathered from patient on 4 July while in hospital:  Patient reported to HC on 2 July/ Day #8 after receiving SPX Vaccination on 24 June complaining of chills and tunnel vision, feeling 'off', sweating profusely temp was 102 degrees with BP of 160/120.  Patient also revealed prior sun exposure on 1 July with some reddened areas.  Physician sent to Hospital. Patient stated that the vaccination on his arm appeared about the Day #10 picture when shown pictures of normal reaction timeline and described, "bruised yellow on perimeter...continued oozing... sunken a bit...too yellow to be a scab".  Spoke with house Doctor.  During hospitalization CRPs elevated to 5-6, patient had diarrhea, received fever reducing medications, blood cultures and SPX vaccination site was removed by surgeon.  When asked if tissue samples were taken it was unknown.  Per patient the skin area around the vaccination site was cleansed with rivanol 0.1%.  10/27/2008 MR received for OV 7/8/2008 with Dx:  Cellulitis. Pt seen in f/u for foreign hospital visit for viral fever and smallpox vaccination site infection. Tx-antibiotics. Pt is now well
Age: 23.0
Sex: M
Vaccine: ANTH, SMALL
Symptoms: Tunnel vision
Clinical narrative: The following information gathered from patient on 4 July while in hospital:  Patient reported to HC on 2 July/ Day #8 after receiving SPX Vaccination on 24 June complaining of chills and tunnel vision, feeling 'off', sweating profusely temp was 102 degrees with BP of 160/120.  Patient also revealed prior sun exposure on 1 July with some reddened areas.  Physician sent to Hospital. Patient stated that the vaccination on his arm appeared about the Day #10 picture when shown pictures of normal reaction timeline and described, "bruised yellow on perimeter...continued oozing... sunken a bit...too yellow to be a scab".  Spoke with house Doctor.  During hospitalization CRPs elevated to 5-6, patient had diarrhea, received fever reducing medications, blood cultures and SPX vaccination site was removed by surgeon.  When asked if tissue samples were taken it was unknown.  Per patient the skin area around the vaccination site was cleansed with rivanol 0.1%.  10/27/2008 MR received for OV 7/8/2008 with Dx:  Cellulitis. Pt seen in f/u for foreign hospital visit for viral fever and smallpox vaccination site infection. Tx-antibiotics. Pt is now well
Age: 16.0
Sex: F
Vaccine: HPV4
Symptoms: Back pain, Computerised tomogram, Menorrhagia, Menstruation irregular, Migraine
Clinical narrative: heavy bleeding- menstrual(7-11 days ////// more often migraines ( double the occurances//relpax//////////degenerated muscles on the left side of her spine - recently diagnosed by her chiropracter and claims her spine has shifted as result causing her to be 14cm unevenly carrying her weight requesting to see her mandatory for at least a year causing extereme back pain  - abnormal periods of which havent been able to steady without stopping them alltogether with birth controls //depo- & ortho
Age: 16.0
Sex: F
Vaccine: HPV4
Symptoms: Muscle atrophy, Spine malformation, X-ray
Clinical narrative: heavy bleeding- menstrual(7-11 days ////// more often migraines ( double the occurances//relpax//////////degenerated muscles on the left side of her spine - recently diagnosed by her chiropracter and claims her spine has shifted as result causing her to be 14cm unevenly carrying her weight requesting to see her mandatory for at least a year causing extereme back pain  - abnormal periods of which havent been able to steady without stopping them alltogether with birth controls //depo- & ortho
Age: 84.0
Sex: F
Vaccine: PPV
Symptoms: Body temperature increased, Erythema, Myalgia, Pain in extremity, Skin necrosis
Clinical narrative: Low grade temperature (101F); Mylagia (aches); upper arm soreness; Large indintation; localized with large erythematous area. Benadryl 50mg iv administered. Discharged home follwoing day - do not believe that the discharge was delayed.
Age: 83.0
Sex: M
Vaccine: PPV
Symptoms: Erythema, Oedema peripheral, Pain in extremity
Clinical narrative: Left upper arm: red, swollen 4 inch puffy circle. Sore per patient.
Age: 15.0
Sex: U
Vaccine: HPV4
Symptoms: Dizziness, Hyperhidrosis, Pallor
Clinical narrative: Light headedness, diaphoresis, and pale skin color after HPV vaccination. These symptoms resolved within 5 minutes after patient was assisted to a seated position and a cool compress applied to her forehead.
Age: 0.33
Sex: M
Vaccine: HIBV, IPV, PNC, RV5, TDAP
Symptoms: Wrong drug administered
Clinical narrative: Pt given Tdap vs DTaP.
Age: 4.0
Sex: F
Vaccine: DTAP, HEPA, IPV, MMR
Symptoms: Dyspnoea, Injection site mass, Injection site rash, Pain in extremity, Pyrexia
Clinical narrative: Rash started 6 hours after immunizations given on the left arm where DTAP and Polio injections were given. Mom states patient was sluggish the next morning and at approximately 2:10 p.m. on 7/3/08 patient had fever of 101F, with rash of 2-1/2" around front of arm and a hard lump on the top side of arm. Mom gave child tylenol at approximately 2:10 p.m. Mom put ice pack on patient's arm and then child had trouble breathing. Patient has controlled asthma with Flovent daily. Patient has seasonal allergies. Patient was taken to ER at approx. 4:00 p.m. and given Cephalexin 5ml four times a day for 7 days, benadryl (mom unsure how much given, thinks it was tsp), and a breathing treatment. Patient felt better after ER visit but arm still hurt. ER told her to call physician office immmediately if rash got to elbow, which it did the next morning on 7/4/08. Mom took patient to urgent care to make sure she was not dehydrated or constipated, and child checked out ok. Child was tired rest of 7/4/08 and felt better next day, on 7/5/08.
Age: 4.0
Sex: F
Vaccine: DTAP, HEPA, IPV, MMR
Symptoms: Sluggishness
Clinical narrative: Rash started 6 hours after immunizations given on the left arm where DTAP and Polio injections were given. Mom states patient was sluggish the next morning and at approximately 2:10 p.m. on 7/3/08 patient had fever of 101F, with rash of 2-1/2" around front of arm and a hard lump on the top side of arm. Mom gave child tylenol at approximately 2:10 p.m. Mom put ice pack on patient's arm and then child had trouble breathing. Patient has controlled asthma with Flovent daily. Patient has seasonal allergies. Patient was taken to ER at approx. 4:00 p.m. and given Cephalexin 5ml four times a day for 7 days, benadryl (mom unsure how much given, thinks it was tsp), and a breathing treatment. Patient felt better after ER visit but arm still hurt. ER told her to call physician office immmediately if rash got to elbow, which it did the next morning on 7/4/08. Mom took patient to urgent care to make sure she was not dehydrated or constipated, and child checked out ok. Child was tired rest of 7/4/08 and felt better next day, on 7/5/08.
Age: 18.0
Sex: F
Vaccine: FLU3, HPV4, TDAP
Symptoms: Abdominal pain upper, Activities of daily living impaired, Colonoscopy, Electrocardiogram, Electroencephalogram
Clinical narrative: stomach spasms, which have been diagnosed as abdominal myoclonus.  has led to spasms in back, legs, face.  Is on klonzapen daily, cymbalta.  was on other medications but have since been taken off them.  had to sit out semester of college. 8/14/08-records received for DOS 12/14-12/16/07-DC DX: Gastroenteritis now improved. Developed nausea, vomiting, diarrhea and abdominal crampy pains, presented to ED.  1/25/2010 Follow up: Diagnosed with "myclonus". Takes 7-8 medications daily, maybe for life.
Age: 18.0
Sex: F
Vaccine: FLU3, HPV4, TDAP
Symptoms: Endoscopy, Lumbar puncture, Muscle spasms, Myoclonus, Nuclear magnetic resonance imaging
Clinical narrative: stomach spasms, which have been diagnosed as abdominal myoclonus.  has led to spasms in back, legs, face.  Is on klonzapen daily, cymbalta.  was on other medications but have since been taken off them.  had to sit out semester of college. 8/14/08-records received for DOS 12/14-12/16/07-DC DX: Gastroenteritis now improved. Developed nausea, vomiting, diarrhea and abdominal crampy pains, presented to ED.  1/25/2010 Follow up: Diagnosed with "myclonus". Takes 7-8 medications daily, maybe for life.
Age: 9.0
Sex: F
Vaccine: HEPA, VARCEL
Symptoms: Injection site reaction
Clinical narrative: localized reaction observed on varicella injection site on 6/4/08. The area was 68mm x 92mm red with 27mm x 41mm indurated. On 6/5/08, the measurements were 35mm x 37mm indurated and 40mm x 43mm reddness. Cool pack to area adviced.
Age: 8.0
Sex: F
Vaccine: HEPA, VARCEL
Symptoms: Body temperature increased, Injection site erythema, Injection site induration, Injection site reaction
Clinical narrative: Localized reaction observed on 6/4/05 where varicella vaccine was given. Measurement of  induration of 27mm x 52mm and reddness of 80mm x 65mm. Temp=100 F (oral). 6/5/08 measurements were 36mm x 54mm induration and 44mm x 54mm reddness. temp= 100 F (oral).
Age: 14.0
Sex: F
Vaccine: HPV4
Symptoms: Abdominal pain, Activities of daily living impaired, Fatigue, Nausea, Ovarian cyst
Clinical narrative: After first dosage, within 24 hours developed severe admoninal pain, fever, fatigue.   We thought she had the flu.  Improved.  After second dose, again adominal pain, fever, nauseau, fatigue.  Treated in ER for possible kidney infectin.   Extreme pain continued and peditrician ordered a  CT Scan performed revealing the development of two ovarian cysts.   She missed 7 weeks of school after the second dose.   Pain medication was provided while we waited for the cysts to dissolve on their own. 7/16/08-records received for DOS 9/6/07-presented to ED with C.O left lumbar pain, chills and fever. DX: UTI.
Age: 14.0
Sex: F
Vaccine: HPV4
Symptoms: Pyrexia, Ultrasound scan abnormal
Clinical narrative: After first dosage, within 24 hours developed severe admoninal pain, fever, fatigue.   We thought she had the flu.  Improved.  After second dose, again adominal pain, fever, nauseau, fatigue.  Treated in ER for possible kidney infectin.   Extreme pain continued and peditrician ordered a  CT Scan performed revealing the development of two ovarian cysts.   She missed 7 weeks of school after the second dose.   Pain medication was provided while we waited for the cysts to dissolve on their own. 7/16/08-records received for DOS 9/6/07-presented to ED with C.O left lumbar pain, chills and fever. DX: UTI.
Age: 0.5
Sex: F
Vaccine: HIBV
Symptoms: Body temperature increased, Diarrhoea, Injection site erythema, Injection site swelling, Screaming
Clinical narrative: 4 hours after shot was received my daughter started screaming (she had NEVER done this before).  The injection site was red and raised in a 4 inch diameter.  She had diarrea for about 16 hours after the shot was administered and a low grade fever for several hours.  Her sleep schedule was off for the next few days.
Age: 0.5
Sex: F
Vaccine: HIBV
Symptoms: Sleep disorder
Clinical narrative: 4 hours after shot was received my daughter started screaming (she had NEVER done this before).  The injection site was red and raised in a 4 inch diameter.  She had diarrea for about 16 hours after the shot was administered and a low grade fever for several hours.  Her sleep schedule was off for the next few days.
Age: 14.0
Sex: F
Vaccine: HEPA, HPV4, MNQ, TDAP
Symptoms: Facial palsy, Urticaria
Clinical narrative: Urticaria 2 days post vaccine. Left facial palsy  9 days post vaccine. 8/4/08-records received-office visit 7/5/08-C/O hives started 2 days after injection coming and going for 1 week. Left eye lid drrops since 6/29/08-partial facial nerve palsy. 7/7/08-left side of face droops and tingles. no further visits.
Age: 58.0
Sex: F
Vaccine: TDAP
Symptoms: Chills, Fatigue, Headache, Pain, Pain of skin
Clinical narrative: Fever of 102 degrees, headache, chills, aches, skin hurt, tired.  Hard time doing anything.  Took Ibuprofen all day.  Lasted approx. 36 hours.  Was okay by Friday, Jul 4.
Age: 58.0
Sex: F
Vaccine: TDAP
Symptoms: Pyrexia
Clinical narrative: Fever of 102 degrees, headache, chills, aches, skin hurt, tired.  Hard time doing anything.  Took Ibuprofen all day.  Lasted approx. 36 hours.  Was okay by Friday, Jul 4.
Age: 4.0
Sex: M
Vaccine: FLU3
Symptoms: Convulsion, Dyskinesia, Fall, Musculoskeletal stiffness
Clinical narrative: My son had what I believe to be a seizure on the day after he received a flu shot. He fell out of his chair (as if something had scared him) and he started to convulse on the floor for about ten seconds and then stood up, sat down and continued to play while his body was stiff and still jerking a bit.
Age: 48.0
Sex: F
Vaccine: HEP
Symptoms: Cryoglobulinaemia, Electromyogram, Fatigue, Hyperventilation, Lymphoma
Clinical narrative: Peripheral neuropathy requiring ongoing medication in fingers, mouth, tongue and feet. Sensitivity to cold, tinnitus, fatigue, blurred vision, elevated liver enzymes. Non-response to vaccine. Dates of HepB Vaccinations: 8/08/07, 9/11/07, 2/5/08. 7/14/08-records received-Hepatitis received interferon October through December 2007. Developed intermittent tingling of fingers, feet and tongue, loss of pain sensation in extremities. Neurological exam WNL. Symptoms are greatly exacerbated by hyperventilation. 01/25/2010 Ongoing perpheral neuropathy enormous- corpal tunnel ulnar nerve entrapment. tarsal tunnel syndrome documented, in addition the vaccine did not work.
Age: 48.0
Sex: F
Vaccine: HEP
Symptoms: Neurological examination, Paraesthesia, Paraesthesia oral, Sensory disturbance, Tarsal tunnel syndrome
Clinical narrative: Peripheral neuropathy requiring ongoing medication in fingers, mouth, tongue and feet. Sensitivity to cold, tinnitus, fatigue, blurred vision, elevated liver enzymes. Non-response to vaccine. Dates of HepB Vaccinations: 8/08/07, 9/11/07, 2/5/08. 7/14/08-records received-Hepatitis received interferon October through December 2007. Developed intermittent tingling of fingers, feet and tongue, loss of pain sensation in extremities. Neurological exam WNL. Symptoms are greatly exacerbated by hyperventilation. 01/25/2010 Ongoing perpheral neuropathy enormous- corpal tunnel ulnar nerve entrapment. tarsal tunnel syndrome documented, in addition the vaccine did not work.
Age: 48.0
Sex: F
Vaccine: HEP
Symptoms: Tinnitus, Ulnar nerve injury, Vision blurred
Clinical narrative: Peripheral neuropathy requiring ongoing medication in fingers, mouth, tongue and feet. Sensitivity to cold, tinnitus, fatigue, blurred vision, elevated liver enzymes. Non-response to vaccine. Dates of HepB Vaccinations: 8/08/07, 9/11/07, 2/5/08. 7/14/08-records received-Hepatitis received interferon October through December 2007. Developed intermittent tingling of fingers, feet and tongue, loss of pain sensation in extremities. Neurological exam WNL. Symptoms are greatly exacerbated by hyperventilation. 01/25/2010 Ongoing perpheral neuropathy enormous- corpal tunnel ulnar nerve entrapment. tarsal tunnel syndrome documented, in addition the vaccine did not work.
Age: 62.0
Sex: F
Vaccine: VARZOS
Symptoms: Hypoaesthesia facial, Hypoaesthesia oral
Clinical narrative: Zostovax was administered at approx. 1:30 pm on 07/03/2008.  Client states that by early evening on 07/03/2008, she was experiencing left sided facial numbness from left eye, to cheek, to nose, all of maxillary area and base of tongue. These symptoms were only on left side.  Client states that the symptoms persisted all Thursday evening and all day Friday (07/04/2008) and then gradually subsided.  Client called the Public Health Office on 07/07/2008 to report reaction.
Age: 1.17
Sex: M
Vaccine: DTAPHEPBIP, HIBV, MMR
Symptoms: Erythema, Hypersensitivity, Injection site bruising, Injection site erythema, Injection site rash
Clinical narrative: Mother states: child began to develop a red raised rash on entire body within 1 hour of vaccinations. Red raised area to left leg where shot was given started like a bite and was dime sized the same day but progressed to silver dollar sized the next day. Fever was 99 on day of shots and went to 102 during the night. Mom had given Tylenol during the night. Saw MD on day one approximately 2 hours post shots and was sent home to use Tylenol.  Went to ER 24 hours post vaccinations and Mom was told it was an allergic reaction to pertussis.  She was to give Benadryl and Tylenol q 6 hours prn. On 7-7-08 child has so far recieved one dose of Benadryl. Child still has slight rash and Left leg looks a bit bruised.
Age: 1.17
Sex: M
Vaccine: DTAPHEPBIP, HIBV, MMR
Symptoms: Pyrexia, Rash generalised
Clinical narrative: Mother states: child began to develop a red raised rash on entire body within 1 hour of vaccinations. Red raised area to left leg where shot was given started like a bite and was dime sized the same day but progressed to silver dollar sized the next day. Fever was 99 on day of shots and went to 102 during the night. Mom had given Tylenol during the night. Saw MD on day one approximately 2 hours post shots and was sent home to use Tylenol.  Went to ER 24 hours post vaccinations and Mom was told it was an allergic reaction to pertussis.  She was to give Benadryl and Tylenol q 6 hours prn. On 7-7-08 child has so far recieved one dose of Benadryl. Child still has slight rash and Left leg looks a bit bruised.
Age: 34.0
Sex: F
Vaccine: HEPAB, TDAP, TYP
Symptoms: Rash
Clinical narrative: PT. TRAVELING 7/18/08. PT. RECEIVED THE FOLLOWING TRAVEL VACCINATIONS ON 7/2/08:        TWIN RIX # 1 - GSKB EXP. 5/15/10 LOT# AHABB116AA 1 CC IM LEFT DELTOID                                            TDAP - SANOFI PASTEUR EXP. 07/25/10 LOT# C2966AA  0.5 CC IM RIGHT DELTOID         TYPHIM VI - SANOFI PASTEUR  ESP. 10/02/09 LOT# A0923 0.5 CC IM RIGHT DELTOID.    PT. CALLED 7/7/08 @ APPROX. 4:00 PM TO SAY SHE HAD A RASH ON HER ABDOMEN AND LEGS THAT STARTED ON SAT. 7/5/08. PT. DENIES ANY OTHER REACTION. PT. ADVISED TO TAKE ORAL BENADRYL. PT. STATES SHE HAS BEEN APPLYING TOPICAL BENADRYL. ADVISED TO STOP TOPICAL AND BEGIN ORAL. IF RASH DOES NOT IMPROVE IN 48 HOURS TO SEE PCP.  PT. VERBALLY AGREED VIA PHONE.
Age: 26.0
Sex: F
Vaccine: TDAP
Symptoms: Blister, Malaise, Pain, Pyrexia
Clinical narrative: c/o feeling sore and achy night of shot.  Fever of >100 started 07/03/2008, ill for 2-3 nights with fever and body aches.  Painful blisters on hands and feet at points of contact developed on 07/05/2008 and have not resolved.  Achyness and fever resolved on 07/06/2008
Age: 22.0
Sex: M
Vaccine: YF
Symptoms: Paraesthesia
Clinical narrative: Tingling sensation in penis.
Age: 18.0
Sex: F
Vaccine: HPVX, TDAP
Symptoms: Asthma, Blood immunoglobulin E increased, Chest X-ray normal, Myalgia, Pulmonary function test abnormal
Clinical narrative: After recieving the 1st injection at approximately 0900 on 5/2/08 patient had low grade fever of 100.6, myalgias, upper respiratory system symptoms that rapidly progressed to exacerbation of asthma by 4pm which required being evaluated by pulmonologist within 24 hours of injection.  Patient received antibiotics, initiation of Advair Diskus prescription, burst of steroids, Veramist, change of nebulizer meds to Xopenex and increase in frequency of inhaled nebs.  Patient had to be re-treated less than 3 weeks later after relapse after completing antibiotic and steroid therapy.  Patient is now on maintenance doses of Advair diskus, Veramist and back to using Albuterol for rescue inhaler use.
Age: 18.0
Sex: F
Vaccine: HPVX, TDAP
Symptoms: Pyrexia, Upper respiratory tract infection
Clinical narrative: After recieving the 1st injection at approximately 0900 on 5/2/08 patient had low grade fever of 100.6, myalgias, upper respiratory system symptoms that rapidly progressed to exacerbation of asthma by 4pm which required being evaluated by pulmonologist within 24 hours of injection.  Patient received antibiotics, initiation of Advair Diskus prescription, burst of steroids, Veramist, change of nebulizer meds to Xopenex and increase in frequency of inhaled nebs.  Patient had to be re-treated less than 3 weeks later after relapse after completing antibiotic and steroid therapy.  Patient is now on maintenance doses of Advair diskus, Veramist and back to using Albuterol for rescue inhaler use.
Age: 11.0
Sex: F
Vaccine: MEN
Symptoms: Condition aggravated, Convulsion
Clinical narrative: My child already has seizures.  The evening of the first dosage, she had a seizure, worse than usual.  I thought maybe it was a fluke, however the same thing happened again after the second dose.  THe medicine I'm refering to is Gardasil.
Age: 38.0
Sex: F
Vaccine: TDAP
Symptoms: Arthralgia, Discomfort, Fatigue, Malaise, Myalgia
Clinical narrative: Received Tdap in the afternoon on 7/3/08. Experienced mild Lt deltoid pain, swelling and discomfort. Woke the following morning feeling generally unwell: fatigue, myalgias, arthralgias, tender lump Lt side of neck. Symptoms persisted x 3 days, with mild improvement thereafter.
Age: 38.0
Sex: F
Vaccine: TDAP
Symptoms: Neck mass, Oedema peripheral, Pain in extremity, Tenderness
Clinical narrative: Received Tdap in the afternoon on 7/3/08. Experienced mild Lt deltoid pain, swelling and discomfort. Woke the following morning feeling generally unwell: fatigue, myalgias, arthralgias, tender lump Lt side of neck. Symptoms persisted x 3 days, with mild improvement thereafter.
Age: 17.0
Sex: F
Vaccine: HPV4, HPV4
Symptoms: Anaemia, Autoimmune disorder, Biopsy muscle abnormal, C-reactive protein increased, Computerised tomogram normal
Clinical narrative: autoimmune myositis, fasciitis, anemia, chronic autoimmune disease.  Patient developed symptoms in ipsilateral arm about 3 weeks postvaccination, progressed to severe inflammatory autoimmune disease that has lasted for 1 year and is ongoing.  07/09/2008 Office notes received from Rheumatologist from 9/7/2007 to 4/03/2008 with DX: Myositis/Fasciitis L arm.   Pt developed L shoulder pain and decreased ROM in 8/2007 which has persisted. Pt then developed forearm pain and swelling, elbow pain and pain upon extending fingers and wrist. PE (+) for TMJ pain and inability to fully open mandible, tenderness of the anterior humeral head, upper inner aspect of the arm below the humeral head, and the lateral aspect of the L forearm. Pain upon dorsiflexion of L wrist. Swelling noted on L forearm. Started on Pred.  Much improved by 10/11/07 with Pred taper scheduled. Increased pain with decreased pred. Dose increased and Methotrexate started. Episode of inflammation L leg (ankle and shin pain) 4/2008.
Age: 17.0
Sex: F
Vaccine: HPV4, HPV4
Symptoms: Fasciitis, Myositis, Red blood cell sedimentation rate increased, Serology normal
Clinical narrative: autoimmune myositis, fasciitis, anemia, chronic autoimmune disease.  Patient developed symptoms in ipsilateral arm about 3 weeks postvaccination, progressed to severe inflammatory autoimmune disease that has lasted for 1 year and is ongoing.  07/09/2008 Office notes received from Rheumatologist from 9/7/2007 to 4/03/2008 with DX: Myositis/Fasciitis L arm.   Pt developed L shoulder pain and decreased ROM in 8/2007 which has persisted. Pt then developed forearm pain and swelling, elbow pain and pain upon extending fingers and wrist. PE (+) for TMJ pain and inability to fully open mandible, tenderness of the anterior humeral head, upper inner aspect of the arm below the humeral head, and the lateral aspect of the L forearm. Pain upon dorsiflexion of L wrist. Swelling noted on L forearm. Started on Pred.  Much improved by 10/11/07 with Pred taper scheduled. Increased pain with decreased pred. Dose increased and Methotrexate started. Episode of inflammation L leg (ankle and shin pain) 4/2008.
Age: 17.0
Sex: F
Vaccine: HPV4, HPV4
Symptoms: Anaemia, Arthralgia, Autoimmune disorder, Biopsy bone marrow normal, Biopsy muscle abnormal
Clinical narrative: autoimmune myositis, fasciitis, anemia, chronic autoimmune disease.  Patient developed symptoms in ipsilateral arm about 3 weeks postvaccination, progressed to severe inflammatory autoimmune disease that has lasted for 1 year and is ongoing.  07/09/2008 Office notes received from Rheumatologist from 9/7/2007 to 4/03/2008 with DX: Myositis/Fasciitis L arm.   Pt developed L shoulder pain and decreased ROM in 8/2007 which has persisted. Pt then developed forearm pain and swelling, elbow pain and pain upon extending fingers and wrist. PE (+) for TMJ pain and inability to fully open mandible, tenderness of the anterior humeral head, upper inner aspect of the arm below the humeral head, and the lateral aspect of the L forearm. Pain upon dorsiflexion of L wrist. Swelling noted on L forearm. Started on Pred.  Much improved by 10/11/07 with Pred taper scheduled. Increased pain with decreased pred. Dose increased and Methotrexate started. Episode of inflammation L leg (ankle and shin pain) 4/2008.
Age: 17.0
Sex: F
Vaccine: HPV4, HPV4
Symptoms: C-reactive protein increased, Computerised tomogram abnormal, Dyskinesia, Fasciitis, Haematocrit decreased
Clinical narrative: autoimmune myositis, fasciitis, anemia, chronic autoimmune disease.  Patient developed symptoms in ipsilateral arm about 3 weeks postvaccination, progressed to severe inflammatory autoimmune disease that has lasted for 1 year and is ongoing.  07/09/2008 Office notes received from Rheumatologist from 9/7/2007 to 4/03/2008 with DX: Myositis/Fasciitis L arm.   Pt developed L shoulder pain and decreased ROM in 8/2007 which has persisted. Pt then developed forearm pain and swelling, elbow pain and pain upon extending fingers and wrist. PE (+) for TMJ pain and inability to fully open mandible, tenderness of the anterior humeral head, upper inner aspect of the arm below the humeral head, and the lateral aspect of the L forearm. Pain upon dorsiflexion of L wrist. Swelling noted on L forearm. Started on Pred.  Much improved by 10/11/07 with Pred taper scheduled. Increased pain with decreased pred. Dose increased and Methotrexate started. Episode of inflammation L leg (ankle and shin pain) 4/2008.