chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 16.0
Sex: M
Vaccine: FLU(H1N1), PPV
Symptoms: Discomfort, Injection site erythema, Injection site pain, Injection site swelling
Clinical narrative: Member received Pneumovax 0.5ml in left deltoid.  Several hours later, mother called to report severe swelling and redness with moderate redness to left deltoid area.  When seen at 3:30, left deltoid area was approximately 3 inches larger in diameter than right, tender to touch, with minor erythema at base of swelling.  Seen by MD, given Benadryl and Ibuprofen, advised to continue this with ice to area.  Spoke with mother 10/30/09 at 9:30 a.m. who stated that left arm is "10% bigger than right arm", less discomfort, and no redness present. They will continue with Benadryl today and ibuprofen as needed, agree to call if other worrisome symptoms arise.
Age: 11.0
Sex: F
Vaccine: FLUN(H1N1)
Symptoms: Abdominal pain, Blood thyroid stimulating hormone, Chest pain, Constipation, Fatigue
Clinical narrative: severe abdominal pain, chest pain, constipation, fatigue, achey, Myalgias, pharygitis  11/17/09 Medical records received for DOS 11/13/09.  Final Dx: Pleuritic chest pain, nausea.  S/P vaccine records show: 11/13 -C/O mid chest/epigastric pressure. Nausea. CXR neg. Pleuritic chest pain.   Records also note h/o suppurative appendicitis 2/4/09. 12/4/09 Medical records received for date 11/13/09.  DX: chest pain Pt c/o sudden onset of chest pain, difficulty breathing, weakness, HA, chills, dizziness, difficulty walking. Assessment: decreased breath sounds bilat bases. OV 11/11 for c/o daily episodes of nosebleeds x9 days. DX: nosebleeds. OV 10/26 DX: myalgias, abd pain, pharyngitis, H1N1 rx. Pt. c/o severe abd pain, chest pain, constipated, fatigue x4 days, had H1N1 vax 4 days ago. Assessment: WNL except (+)tonsils swelling.
Age: 11.0
Sex: F
Vaccine: FLUN(H1N1)
Symptoms: Full blood count, Lipids, Metabolic function test, Myalgia, Pain
Clinical narrative: severe abdominal pain, chest pain, constipation, fatigue, achey, Myalgias, pharygitis  11/17/09 Medical records received for DOS 11/13/09.  Final Dx: Pleuritic chest pain, nausea.  S/P vaccine records show: 11/13 -C/O mid chest/epigastric pressure. Nausea. CXR neg. Pleuritic chest pain.   Records also note h/o suppurative appendicitis 2/4/09. 12/4/09 Medical records received for date 11/13/09.  DX: chest pain Pt c/o sudden onset of chest pain, difficulty breathing, weakness, HA, chills, dizziness, difficulty walking. Assessment: decreased breath sounds bilat bases. OV 11/11 for c/o daily episodes of nosebleeds x9 days. DX: nosebleeds. OV 10/26 DX: myalgias, abd pain, pharyngitis, H1N1 rx. Pt. c/o severe abd pain, chest pain, constipated, fatigue x4 days, had H1N1 vax 4 days ago. Assessment: WNL except (+)tonsils swelling.
Age: 11.0
Sex: F
Vaccine: FLUN(H1N1)
Symptoms: Pharyngitis, Thyroxine
Clinical narrative: severe abdominal pain, chest pain, constipation, fatigue, achey, Myalgias, pharygitis  11/17/09 Medical records received for DOS 11/13/09.  Final Dx: Pleuritic chest pain, nausea.  S/P vaccine records show: 11/13 -C/O mid chest/epigastric pressure. Nausea. CXR neg. Pleuritic chest pain.   Records also note h/o suppurative appendicitis 2/4/09. 12/4/09 Medical records received for date 11/13/09.  DX: chest pain Pt c/o sudden onset of chest pain, difficulty breathing, weakness, HA, chills, dizziness, difficulty walking. Assessment: decreased breath sounds bilat bases. OV 11/11 for c/o daily episodes of nosebleeds x9 days. DX: nosebleeds. OV 10/26 DX: myalgias, abd pain, pharyngitis, H1N1 rx. Pt. c/o severe abd pain, chest pain, constipated, fatigue x4 days, had H1N1 vax 4 days ago. Assessment: WNL except (+)tonsils swelling.
Age: 29.0
Sex: F
Vaccine: FLU(H1N1)
Symptoms: Flushing, Pruritus, Rash macular, Reaction to previous exposure to any vaccine
Clinical narrative: While working with a patient she suddenly started to itch on her face and her eyeballs. She developed some blotch areas on her body. Looks a little flushed. States that she has many allergies and that with previous flu vaccines have made her feel ill. She had a Benydral tablet which she took at 8:20 this morning. I spoke with her at 8:55 a.m. and she is feeling a little better.
Age: 47.0
Sex: F
Vaccine: FLU(H1N1)
Symptoms: Rash
Clinical narrative: right arm rash , Diphenhydramin 25 mg's and zantac 150 mg.
Age: 48.0
Sex: F
Vaccine: FLU(H1N1)
Symptoms: Dyspnoea, Endotracheal intubation, Intensive care, Panic reaction, Throat tightness
Clinical narrative: Complained of shortness of breath, said felt throat was constricted and refused to go to ER.  Due to asthma she has been intubated 18 times previously and she did not want to go to the ER.  Requested and Epipen, which the pharmacy does not carry.  She took a Claritin and used an Albuterol inhaler. When she became panicky she finally went to ER where they intubated her and transferred her to SICU. 11/2/2009 ED records for date 10/29/2009. Patient with c/o's respiratory distress and wheezing post vaccination. Patient given IV Solu Medrol but despite tx, respiratory distress progressed and patient had to be intubated/vented. PTT prolonged and placed on Heparin,  Resp tx's, Telemetry, IV ABX
Age: 2.0
Sex: F
Vaccine: FLU(H1N1)
Symptoms: Pruritus, Rash
Clinical narrative: chest and abd rash ,cont x 2 days -itching
Age: 42.0
Sex: F
Vaccine: FLU(H1N1)
Symptoms: Injection site erythema, Injection site swelling
Clinical narrative: Redness and sl swelling at inj site.
Age: 70.0
Sex: F
Vaccine: FLU(H1N1)
Symptoms: Injection site erythema, Injection site swelling
Clinical narrative: Redness and sl. swelling at inj. site.
Age: 33.0
Sex: F
Vaccine: FLU(H1N1)
Symptoms: Chest discomfort, Dizziness, Drug exposure during pregnancy, Dysphagia, Dyspnoea
Clinical narrative: Throat from vocal folds to clavicle was closing, difficulty breathing, difficulty swallowing, slight dizziness - arrived at ER at approx. 3:30 - was given 50 mg of Benadryl & monitored for approx 1.25 hours - breathing returned to normal - instructed to self administer 25-50 mg of Benadryl as needed at 6 hour intervals - took 25 mg at approx. 10:00 and was fine, then had same severity of onset as initial reaction at approx. 4:00 a.m. (10-29-09) and had to take 50 mg to get breathing back to normal. Went to ob/gyn next morning (10-29-09)for 9:00 a.m. and was given a cortisone shot to help with the recurring reactions, also had baby examined through fetal ultrasound and fetal heartbeat monitor. Had to take 25mg of Bendadryl at approx. 10:00 p.m. that night b/c entire lung area (sternum, ribs & thoracic spine) was under severe pressure and it hurt to breathe. After 1/2 hour, pain subsided - after 45 minutes could lay down to try to sleep. No further reractions so far today (10/30/09 @ 12:10 p.m.) but instructed by ob/gyn to keep the Benadryl with me at all times b/c allergic reactions can last for up to 2 weeks. I HAVE NO ALLERGIES TO EGGS!  11/02/09 and 11/03/09  Medical records received for DOS 10/28/09. Final DX: Adverse reaction to influenza vaccine.  20 week gestation patient developed feeling of throat swelling 1hr s/p vaccine.  PE unremarkable. Benadryl and observation x1hr. Pos fetal heart tones. No change in sx.  Discharged.
Age: 33.0
Sex: F
Vaccine: FLU(H1N1)
Symptoms: Painful respiration, Throat tightness, Vaccination complication
Clinical narrative: Throat from vocal folds to clavicle was closing, difficulty breathing, difficulty swallowing, slight dizziness - arrived at ER at approx. 3:30 - was given 50 mg of Benadryl & monitored for approx 1.25 hours - breathing returned to normal - instructed to self administer 25-50 mg of Benadryl as needed at 6 hour intervals - took 25 mg at approx. 10:00 and was fine, then had same severity of onset as initial reaction at approx. 4:00 a.m. (10-29-09) and had to take 50 mg to get breathing back to normal. Went to ob/gyn next morning (10-29-09)for 9:00 a.m. and was given a cortisone shot to help with the recurring reactions, also had baby examined through fetal ultrasound and fetal heartbeat monitor. Had to take 25mg of Bendadryl at approx. 10:00 p.m. that night b/c entire lung area (sternum, ribs & thoracic spine) was under severe pressure and it hurt to breathe. After 1/2 hour, pain subsided - after 45 minutes could lay down to try to sleep. No further reractions so far today (10/30/09 @ 12:10 p.m.) but instructed by ob/gyn to keep the Benadryl with me at all times b/c allergic reactions can last for up to 2 weeks. I HAVE NO ALLERGIES TO EGGS!  11/02/09 and 11/03/09  Medical records received for DOS 10/28/09. Final DX: Adverse reaction to influenza vaccine.  20 week gestation patient developed feeling of throat swelling 1hr s/p vaccine.  PE unremarkable. Benadryl and observation x1hr. Pos fetal heart tones. No change in sx.  Discharged.
Age: 1.95
Sex: F
Vaccine: FLUX(H1N1), FLU(H1N1)
Symptoms: Crying, Gaze palsy, Hypotonia, Pain in extremity, Pallor
Clinical narrative: Patient started to softly cry that her leg hurt about 1 minute after shot was given...her eyes were gazed over, EXTREMELY PALE, face "fell" and she went limp.  She was out of it for about 15 mins.  She was rushed from the clinic to the ER and they called it a vaso vagal reaction, however, I am certain it was a side effect from the shot!
Age: 1.95
Sex: F
Vaccine: FLUX(H1N1), FLU(H1N1)
Symptoms: Presyncope
Clinical narrative: Patient started to softly cry that her leg hurt about 1 minute after shot was given...her eyes were gazed over, EXTREMELY PALE, face "fell" and she went limp.  She was out of it for about 15 mins.  She was rushed from the clinic to the ER and they called it a vaso vagal reaction, however, I am certain it was a side effect from the shot!
Age: 1.95
Sex: F
Vaccine: FLUX(H1N1), FLU(H1N1)
Symptoms: Blood potassium decreased, Blood test normal, Presyncope
Clinical narrative: Patient started to softly cry that her leg hurt about 1 minute after shot was given...her eyes were gazed over, EXTREMELY PALE, face "fell" and she went limp.  She was out of it for about 15 mins.  She was rushed from the clinic to the ER and they called it a vaso vagal reaction, however, I am certain it was a side effect from the shot!
Age: 73.0
Sex: M
Vaccine: VARZOS
Symptoms: Arthralgia, Blood test abnormal, Musculoskeletal pain, Musculoskeletal stiffness, Polymyalgia rheumatica
Clinical narrative: I hard time getting out of bed, due to extreme pain in my shoulders.  When I did get out of bed my hips were aching and I had pain in my joints.  My Dr. examined me and determined I had polymyalgia rheumatica, and put me on a prednisone pak., and made an appointment for me to see a rheumatologist.  The rheumatologist confirmed PMR., and put me on prednisone.  I still have pain and stiffness, but able to cope.  I firmly believe that the shingles vaccine caused the PMR.
Age: 73.0
Sex: M
Vaccine: VARZOS
Symptoms: X-ray abnormal
Clinical narrative: I hard time getting out of bed, due to extreme pain in my shoulders.  When I did get out of bed my hips were aching and I had pain in my joints.  My Dr. examined me and determined I had polymyalgia rheumatica, and put me on a prednisone pak., and made an appointment for me to see a rheumatologist.  The rheumatologist confirmed PMR., and put me on prednisone.  I still have pain and stiffness, but able to cope.  I firmly believe that the shingles vaccine caused the PMR.
Age: 38.0
Sex: F
Vaccine: FLU(H1N1)
Symptoms: Body temperature increased, Cough, Pyrexia, Throat tightness
Clinical narrative: Developed tightness in throat at approx. 1:30 pm, also cough.  At 3:00 pm, temperature was 104.  Took Benedryl adult dose.  Fever broke at 1:00 am 10/30/09.  No recurrance of symptoms.
Age: 62.0
Sex: M
Vaccine: FLU3
Symptoms: Chest pain, Heart rate increased, Hyperhidrosis, Tachycardia
Clinical narrative: Patient received a flu shot at 3:30pm.  Returned to the flu shot table at 3:45pm complaining of tachycardia.  Asked patient to rest for several minutes.  BP taken for patient at 3:55pm with a reading of 145 or 149/98 at the BP station.  When we checked the patient, he stated his pulse rate was very high and informed us he had an angiogram ~ 2 weeks ago.  Patient returned to the flu shot station to rest again.  Questioned patient if he had any chest pains and if they were radiating?  Patient confirmed yes and stated pain radiating to the left side.  Visible signs of diaphoresis.  Offered to call 911 at least 3 times during the course of events, at which the patient declined.  Patient asked us to wait 5 minutes as he thought the tachycardia will subside.  Patient requested that if the tachycardia does not subside, he would inform us to call 911.  At ~4pm, patient got up and left the flu shot station.  Followed the patient downstairs to the hotel lobby and called 911.  Patient requested aspirin and one Bayer 325mg aspirin was administered at 4:05pm 12/8/09 & 12/11/09:  ED records received for date of service 10/26/09.  Dx:  SVT.  Pt. received flu shot and developed sweating, lightheadedness, and palpotations as well as substernal chest pressure.  BP 140/100 and HR 215.  911 called and pt. chewed an aspirin.  SVT noted by EMS, no resolution with vagal maneuvers.  Adenosine 6 mg. given in the field resulting to conversion to sinus rhythm and resolution of all sx. Seen in the ED, sx. resolved, d/c to home.
Age: 27.0
Sex: M
Vaccine: FLU3
Symptoms: Choking sensation, Chronic inflammatory demyelinating polyradiculoneuropathy, Dizziness, Dyspnoea, Electrocardiogram normal
Clinical narrative: GUILLAIN-BARRE Syndrome - Infusion/Hospitalization. CIPD- Infusions / EMG. -Twitching. Spasms, Numbness, hyperesthesia, Chest pain. Choking/Smothering sensation, hyperventilation, SOB, Tachycardia, Lightheadedness, Paresthesia.
Age: 27.0
Sex: M
Vaccine: FLU3
Symptoms: Electromyogram abnormal, Guillain-Barre syndrome, Hyperaesthesia, Hyperventilation, Muscle spasms
Clinical narrative: GUILLAIN-BARRE Syndrome - Infusion/Hospitalization. CIPD- Infusions / EMG. -Twitching. Spasms, Numbness, hyperesthesia, Chest pain. Choking/Smothering sensation, hyperventilation, SOB, Tachycardia, Lightheadedness, Paresthesia.
Age: 27.0
Sex: M
Vaccine: FLU3
Symptoms: Muscle twitching, Nuclear magnetic resonance imaging normal, Paraesthesia, Tachycardia
Clinical narrative: GUILLAIN-BARRE Syndrome - Infusion/Hospitalization. CIPD- Infusions / EMG. -Twitching. Spasms, Numbness, hyperesthesia, Chest pain. Choking/Smothering sensation, hyperventilation, SOB, Tachycardia, Lightheadedness, Paresthesia.
Age: 27.0
Sex: F
Vaccine: FLU(H1N1)
Symptoms: Anxiety, Drug exposure during pregnancy, Feeling abnormal, Immediate post-injection reaction, Immunisation reaction
Clinical narrative: Immediately after receiving H1N1 immunization the patient c/o "burning of her throat and feeling funny". Pt is 9 wks pregnant. Pt placed in supine position and administered apple juice. BP 106/60 palpable, P 88 and thready, R-22 unlabored. Taken to ED via ambulance. 11/2/09 Emergency Department Records received from date of service 10/30/09. Dx:  Medication Reaction. Assessment:  9 week pregnant woman presented after getting H1N1 vaccine and immediately had some throat irritation and "burning" and became anxious and tachycardic.  There was no syncope or feeling of throat closing, no stridor or urticaria, no SOB or abd. pain.  No evidence of allergic reaction on physical exam.  Pt. discharged to home.   11/16/09 Prenatal records received. Normal prenancy. EDC 6/7/10. No further notation.
Age: 27.0
Sex: F
Vaccine: FLU(H1N1)
Symptoms: Pulse abnormal, Throat irritation
Clinical narrative: Immediately after receiving H1N1 immunization the patient c/o "burning of her throat and feeling funny". Pt is 9 wks pregnant. Pt placed in supine position and administered apple juice. BP 106/60 palpable, P 88 and thready, R-22 unlabored. Taken to ED via ambulance. 11/2/09 Emergency Department Records received from date of service 10/30/09. Dx:  Medication Reaction. Assessment:  9 week pregnant woman presented after getting H1N1 vaccine and immediately had some throat irritation and "burning" and became anxious and tachycardic.  There was no syncope or feeling of throat closing, no stridor or urticaria, no SOB or abd. pain.  No evidence of allergic reaction on physical exam.  Pt. discharged to home.   11/16/09 Prenatal records received. Normal prenancy. EDC 6/7/10. No further notation.
Age: 1.56
Sex: F
Vaccine: FLU3
Symptoms: Cough, Croup infectious, Febrile convulsion, Pyrexia, Respiratory tract congestion
Clinical narrative: On the evening of 10-9-09, child "started having a fever".  100 degree A.  Had developed cough, runny nose & congestion.  Dad says child had a febrile seizure, went to ER & dx with croup - given DECADRON shot.
Age: 1.56
Sex: F
Vaccine: FLU3
Symptoms: Rhinorrhoea
Clinical narrative: On the evening of 10-9-09, child "started having a fever".  100 degree A.  Had developed cough, runny nose & congestion.  Dad says child had a febrile seizure, went to ER & dx with croup - given DECADRON shot.
Age: 60.0
Sex: F
Vaccine: FLU3
Symptoms: Injected limb mobility decreased, Myalgia
Clinical narrative: Pt reports severe muscle pain in left arm which started about 4 days after receiving vaccine.  Pt. states trouble getting dressed & rotating arm.  Pain severe enough to wake during the night.  Pt. denies treatment.
Age: 52.0
Sex: F
Vaccine: FLU3
Symptoms: Injected limb mobility decreased, Pain in extremity
Clinical narrative: Pt reports arm pain that has been present since injection 43 days ago.  Pt. says that pain has been inhibiting her left arm rotation.  Pt says that pain has been steadily decreasing but suddenly was worse in the past two days.  Pt. has taken oral pain relievers (IBN/TYLENOL) but neither has relieved pain completely.
Age: 2.0
Sex: F
Vaccine: HEPA, VARCEL
Symptoms: Urticaria
Clinical narrative: Generalized hives day of and day after Hep A and VARICELLA vaccine 7/2/2009.
Age: 4.0
Sex: F
Vaccine: DTAP, FLUN3, IPV, MMR, VARCEL
Symptoms: Rash erythematous, Skin lesion
Clinical narrative: About 5 minutes after vaccines were administered child presented with 1 small red raised lesion on her right hand. Treating care provider was notified immediately and administered 2 teaspoons of benadryl.  After 30 minutes no new onset of lesions.  Made follow uo appointment for child the next day, parent no showed for appointment.
Age: 46.0
Sex: F
Vaccine: FLU3, FLUX
Symptoms: Arthropod bite, Balance disorder, CSF protein normal, CSF white blood cell count negative, Condition aggravated
Clinical narrative: Pt was in usual state of health until 10/17 when she endorsed upper respiratory tract infection. Pt states that 2 days later she had numbness in her feet bilaterally. Pt states that over the course of a week, the numbness had spread to her proximal lower extremities. Pt denied having bowel or bladder incontinence during that time. Pt went to see PCP the Friday prior to admission and patient had MRI to rule out cauda equina syndrome which was negative. Over course of two to three more days pt endorsed more pronounced numbness of proximal lower extremities with weakness. Pt noted that she was having more trouble with her balance and was constantly tripping on herself; however, she never experienced a traumatic fall. Pt denied fevers, chills, shortness of breath, trouble breathing, upper extremity weakness/numbness, or troubles with speech or swallowing.  Of note, the patient states she had shingles in early October immediately after she had her flu shot distributing from lateral left ankle to lateral knee. Pt was given oral antiviral regimen for this.  Pt also endorses repeated tick exposure and comments that she's always pulling ticks off her body 11/3/2009 ED records for 10/28/2009. patient with c/o's bilateral LE weakness and numbness. Neuro decreased DTR's with patellar and ankle jerks. Tx: LP, Telemetry Patient offered EMG/NCV studies but declined. Patient had just started taking Methotrexate for her Psoriatic arthritis and MD felt this could be the cause of numbness. DC Dx BLE numbness, ? due to Vit B12 or folate deficiency from MTX.
Age: 46.0
Sex: F
Vaccine: FLU3, FLUX
Symptoms: Gait disturbance, Herpes zoster, Hypoaesthesia, Immediate post-injection reaction, Lumbar puncture normal
Clinical narrative: Pt was in usual state of health until 10/17 when she endorsed upper respiratory tract infection. Pt states that 2 days later she had numbness in her feet bilaterally. Pt states that over the course of a week, the numbness had spread to her proximal lower extremities. Pt denied having bowel or bladder incontinence during that time. Pt went to see PCP the Friday prior to admission and patient had MRI to rule out cauda equina syndrome which was negative. Over course of two to three more days pt endorsed more pronounced numbness of proximal lower extremities with weakness. Pt noted that she was having more trouble with her balance and was constantly tripping on herself; however, she never experienced a traumatic fall. Pt denied fevers, chills, shortness of breath, trouble breathing, upper extremity weakness/numbness, or troubles with speech or swallowing.  Of note, the patient states she had shingles in early October immediately after she had her flu shot distributing from lateral left ankle to lateral knee. Pt was given oral antiviral regimen for this.  Pt also endorses repeated tick exposure and comments that she's always pulling ticks off her body 11/3/2009 ED records for 10/28/2009. patient with c/o's bilateral LE weakness and numbness. Neuro decreased DTR's with patellar and ankle jerks. Tx: LP, Telemetry Patient offered EMG/NCV studies but declined. Patient had just started taking Methotrexate for her Psoriatic arthritis and MD felt this could be the cause of numbness. DC Dx BLE numbness, ? due to Vit B12 or folate deficiency from MTX.
Age: 46.0
Sex: F
Vaccine: FLU3, FLUX
Symptoms: Muscular weakness, Nuclear magnetic resonance imaging normal, Upper respiratory tract infection
Clinical narrative: Pt was in usual state of health until 10/17 when she endorsed upper respiratory tract infection. Pt states that 2 days later she had numbness in her feet bilaterally. Pt states that over the course of a week, the numbness had spread to her proximal lower extremities. Pt denied having bowel or bladder incontinence during that time. Pt went to see PCP the Friday prior to admission and patient had MRI to rule out cauda equina syndrome which was negative. Over course of two to three more days pt endorsed more pronounced numbness of proximal lower extremities with weakness. Pt noted that she was having more trouble with her balance and was constantly tripping on herself; however, she never experienced a traumatic fall. Pt denied fevers, chills, shortness of breath, trouble breathing, upper extremity weakness/numbness, or troubles with speech or swallowing.  Of note, the patient states she had shingles in early October immediately after she had her flu shot distributing from lateral left ankle to lateral knee. Pt was given oral antiviral regimen for this.  Pt also endorses repeated tick exposure and comments that she's always pulling ticks off her body 11/3/2009 ED records for 10/28/2009. patient with c/o's bilateral LE weakness and numbness. Neuro decreased DTR's with patellar and ankle jerks. Tx: LP, Telemetry Patient offered EMG/NCV studies but declined. Patient had just started taking Methotrexate for her Psoriatic arthritis and MD felt this could be the cause of numbness. DC Dx BLE numbness, ? due to Vit B12 or folate deficiency from MTX.
Age: 46.0
Sex: F
Vaccine: FLU3, FLUX
Symptoms: Herpes zoster, Hypoaesthesia
Clinical narrative: Pt was in usual state of health until 10/17 when she endorsed upper respiratory tract infection. Pt states that 2 days later she had numbness in her feet bilaterally. Pt states that over the course of a week, the numbness had spread to her proximal lower extremities. Pt denied having bowel or bladder incontinence during that time. Pt went to see PCP the Friday prior to admission and patient had MRI to rule out cauda equina syndrome which was negative. Over course of two to three more days pt endorsed more pronounced numbness of proximal lower extremities with weakness. Pt noted that she was having more trouble with her balance and was constantly tripping on herself; however, she never experienced a traumatic fall. Pt denied fevers, chills, shortness of breath, trouble breathing, upper extremity weakness/numbness, or troubles with speech or swallowing.  Of note, the patient states she had shingles in early October immediately after she had her flu shot distributing from lateral left ankle to lateral knee. Pt was given oral antiviral regimen for this.  Pt also endorses repeated tick exposure and comments that she's always pulling ticks off her body 11/3/2009 ED records for 10/28/2009. patient with c/o's bilateral LE weakness and numbness. Neuro decreased DTR's with patellar and ankle jerks. Tx: LP, Telemetry Patient offered EMG/NCV studies but declined. Patient had just started taking Methotrexate for her Psoriatic arthritis and MD felt this could be the cause of numbness. DC Dx BLE numbness, ? due to Vit B12 or folate deficiency from MTX.
Age: 30.0
Sex: F
Vaccine: FLU(H1N1), FLU3
Symptoms: Feeling hot, Paraesthesia
Clinical narrative: patient describes feeling 'warm and tingling' over entire body starting several minutes after vaccination and lasting several hours. no loss of consciousness, no fever, no weakness, no dizziness
Age: 6.0
Sex: F
Vaccine: FLU(H1N1)
Symptoms: Pyrexia, Vomiting
Clinical narrative: Fever, vomiting.
Age: 17.0
Sex: F
Vaccine: FLU3, PPV
Symptoms: Decreased appetite, Hypoaesthesia, Injection site cellulitis, Injection site erythema, Injection site pain
Clinical narrative: Two vaccines were given in the deltoid of the left arm. Patient subsequently developed severe pain from the injection site to the left elbow; also c/o intermittent numbness of the fingers; red streak noted on the anterior upper arm; c/o also nausea, anorexia, body aches. Dx cellulitis. Cream provided. Plan KEFLEC 500 mgm, PO BID. Heat/sling/Ibruprofen PRN.
Age: 17.0
Sex: F
Vaccine: FLU3, PPV
Symptoms: Injection site streaking, Nausea, Pain
Clinical narrative: Two vaccines were given in the deltoid of the left arm. Patient subsequently developed severe pain from the injection site to the left elbow; also c/o intermittent numbness of the fingers; red streak noted on the anterior upper arm; c/o also nausea, anorexia, body aches. Dx cellulitis. Cream provided. Plan KEFLEC 500 mgm, PO BID. Heat/sling/Ibruprofen PRN.
Age: 17.0
Sex: M
Vaccine: FLU(H1N1), FLUX, FLU(H1N1), FLU3
Symptoms: Blindness, Diarrhoea, Dyspnoea, Fatigue, Immediate post-injection reaction
Clinical narrative: Initial report received 23 October 2009 from a consumer, who is the patient's parent. A 17-year-old male patient with a history of Down's syndrome had received an intramuscular injection of INFLUENZA VACCINE and an intramuscular injection of PANDEMIC INFLUENZA A/H1N1 VACCINE (manufacturers unknown, lot numbers and sites not reported) on 21 October 2009 and immediately after vaccination, he became short of breath, his skin became grey-white, his legs were shaking, and his "eyes went in and he said he could not see". The patient was administered oxygen and ephinephrine, and he recovered in the office within a half hour. The patient had no concurrent illness, no known allergies, no concomitant medication usage and he had not received any other vaccine during the previous four weeks. He had no history of adverse events following prior vaccinations. According to the reporter, the patient had symptoms of achy legs, diarrhea and tiredness at the time of the report (onsets not reported) and he had not recovered. Documents held by sender: None.  11/19/09 PCP medical records received, service dates 10/21/09 and 10/22/09. Assessment: Anaphylactic vaccine reaction. Yesterday post-vaccination hypoxia, limp, eyes rolling, wheezing, pallor clamminess. Diarrhea overnight, 'orange worm appearing objects in stool', restless sleep. Legs feel restless, sore, shaky.
Age: 17.0
Sex: M
Vaccine: FLU(H1N1), FLUX, FLU(H1N1), FLU3
Symptoms: Pain in extremity, Pallor, Tremor
Clinical narrative: Initial report received 23 October 2009 from a consumer, who is the patient's parent. A 17-year-old male patient with a history of Down's syndrome had received an intramuscular injection of INFLUENZA VACCINE and an intramuscular injection of PANDEMIC INFLUENZA A/H1N1 VACCINE (manufacturers unknown, lot numbers and sites not reported) on 21 October 2009 and immediately after vaccination, he became short of breath, his skin became grey-white, his legs were shaking, and his "eyes went in and he said he could not see". The patient was administered oxygen and ephinephrine, and he recovered in the office within a half hour. The patient had no concurrent illness, no known allergies, no concomitant medication usage and he had not received any other vaccine during the previous four weeks. He had no history of adverse events following prior vaccinations. According to the reporter, the patient had symptoms of achy legs, diarrhea and tiredness at the time of the report (onsets not reported) and he had not recovered. Documents held by sender: None.  11/19/09 PCP medical records received, service dates 10/21/09 and 10/22/09. Assessment: Anaphylactic vaccine reaction. Yesterday post-vaccination hypoxia, limp, eyes rolling, wheezing, pallor clamminess. Diarrhea overnight, 'orange worm appearing objects in stool', restless sleep. Legs feel restless, sore, shaky.
Age: 17.0
Sex: M
Vaccine: FLU(H1N1), FLUX, FLU(H1N1), FLU3
Symptoms: Dyspnoea, Hyperhidrosis, Oxygen saturation decreased, Pallor, Wheezing
Clinical narrative: Initial report received 23 October 2009 from a consumer, who is the patient's parent. A 17-year-old male patient with a history of Down's syndrome had received an intramuscular injection of INFLUENZA VACCINE and an intramuscular injection of PANDEMIC INFLUENZA A/H1N1 VACCINE (manufacturers unknown, lot numbers and sites not reported) on 21 October 2009 and immediately after vaccination, he became short of breath, his skin became grey-white, his legs were shaking, and his "eyes went in and he said he could not see". The patient was administered oxygen and ephinephrine, and he recovered in the office within a half hour. The patient had no concurrent illness, no known allergies, no concomitant medication usage and he had not received any other vaccine during the previous four weeks. He had no history of adverse events following prior vaccinations. According to the reporter, the patient had symptoms of achy legs, diarrhea and tiredness at the time of the report (onsets not reported) and he had not recovered. Documents held by sender: None.  11/19/09 PCP medical records received, service dates 10/21/09 and 10/22/09. Assessment: Anaphylactic vaccine reaction. Yesterday post-vaccination hypoxia, limp, eyes rolling, wheezing, pallor clamminess. Diarrhea overnight, 'orange worm appearing objects in stool', restless sleep. Legs feel restless, sore, shaky.
Age: 3.0
Sex: M
Vaccine: FLU(H1N1)
Symptoms: Blepharospasm, Dyskinesia, Dystonia, Electroencephalogram normal, Nuclear magnetic resonance imaging normal
Clinical narrative: Initial case was received on 26 October 2009 from a physician. This was reported as one of a cluster of two patients who experienced adverse events following vaccination with H1N1 2009 Monovalent Vaccine - Preservative (lot number UP001AA). The other patient experienced a non-serious event, which is captured in case number 2009-04481. A three-year-old male patient, with no reported medical history, experienced dystonia after receiving an intramuscular left deltoid first injection of H1N1 2009 Monovalent Vaccine - Preservative (lot number UP001AA) on 14 October 2009. Approximately four days post-vaccination, on 17 or 18 October 2009, the patient's mother noted right eye twitching, jerking of the right arm, and occasional jerking of the right leg. The symptoms occurred daily, particularly when the child was attempting to fall asleep. He was seen by his physician on 21 October 2009 and an exam was normal at that time; however, the physician noted that the patient's mother had videotaped the events and that the videotape was "impressive". He was subsequently seen in the emergency room, and was diagnosed with dystonia. An MRI and EEG were normal. At the time of the report, the event had not recovered. The patient had not received any other vaccines within four weeks of vaccination. Per the reporter, he did receive annual seasonal influenza vaccines. Documents held by sender: None. 11/3/2009 ED records from 10/21/2009. Patient with c/o's eye, mouth and arm twitching, jerky movement of lt arm and rt leg. Neuro exam norm, TX: close observation, no meds. DC DX Dystonia versus focal seizures. 11/9/09 Vaccination record received and updated.    11/3/09 DC summary received for dates 10/21/09 to 10/22/09. DX:Dystonia vs focal seizures. Pt. presented with sudden onset of twitching eyes, mouth, arms muscles lasting a few seconds x4 days prior to admission. 4 days prior to onset of sx, pt had H1N1 vax.
Age: 16.0
Sex: M
Vaccine: FLU3
Symptoms: Influenza, Influenza serology positive, Pyrexia, Respiratory tract congestion
Clinical narrative: Initial report received on 26 Oct 2009 from a health care professional. A 16 year old male patient with a history of allergic rhinitis received FLUZONE on 19 September 2009 and H1N1 on 11 October 2009 (lot number, route and site were not provided). On an unspecified date, reported as "recently", the patient developed a fever and congestion. On 26 October 2009, the patient tested positive for Influenza A. Concomitant therapy included SINGULAIR 10 mg daily and inhalers (not specified). Recovery status was not reported. List of Documents held by Sender: none. 11/4/09 Medical records received for date 10/26/09 DX: fever after vaccine. Pt. presented to OV with fever. Pt received flu vax 9/19/09 and H1N1 vax 10/11/09.
Age: 42.0
Sex: F
Vaccine: FLU(H1N1)
Symptoms: Chest pain, Dyspnoea, Swollen tongue, Throat tightness
Clinical narrative: Initial case was received on 27 October 2009 from a consumer, who is also the patient. A 42-year-old female patient experienced chest pain, shortness of breath, tongue swelling, and felt like her throat was closing after receiving a left deltoid intramuscular injection of Influenza A (H1N1) 2009 Monovalent vaccine - Preservative (lot not reported) on 26 October 2009. The patient had a history of asthma and was allergic to Biaxin, and was taking Albuterol concomitantly. Approximately 15 to 30 minutes post-vaccination, the patient complained of chest pain, shortness of breath, tongue swelling, and felt like her throat was closing. She was treated with Albuterol and Benadryl, and was seen by a physician. At the time of the report on 27 October 2009, all symptoms had resolved except for the tongue swelling. Follow-up information received on 27 October 2009 from a company representative. Number 1-231206115. No other relevant medically significant information was provided. Documents held by sender: None. 11/9/09:  Medical records received from date of service 10/26/09.  Dx: chest tightness. Possible vaccine related adverse event.  Assessment:  Presents 4 hours after receiving H1N1 Flu vaccine with mild throat tightness and chest tightness.  No SOB, no cough.  No swelling of throat.  Pt. to take Zyrtec and seek further attention of sx. worsen.
Age: 49.0
Sex: F
Vaccine: FLU3
Symptoms: Eye swelling, Injection site mass, Injection site vesicles, Lip swelling, Local swelling
Clinical narrative: Initial report received on 19 October 2009 from a consumer. A 49-year-old female patient had received an intramuscular right deltoid injection of FLUZONE SV (lot number not reported) on 13 October 2009 at 17:00 hours from a multi-dose vial. The patient had received flu vaccinations for many years, and reported having a similar reaction (as mentioned below) when she received tetanus (date not reported). The following day after receiving the FLUZONE SV, the patient developed a blister at the injection site. The day after that, the patient developed a lump at the injection site. The next day after that, the patient's arm, face, neck and lips were swollen, as well as her right eye that was swollen shut. She also had blisters on her mouth and tongue. The patient was treated in the emergency room with intravenous steroids and PREDNISONE. When these treatments are stopped the swelling re-occurs. At the time of this report, the patient had not recovered. Documents held by sender: None.
Age: 49.0
Sex: F
Vaccine: FLU3
Symptoms: Oedema peripheral, Oropharyngeal blistering, Swelling face
Clinical narrative: Initial report received on 19 October 2009 from a consumer. A 49-year-old female patient had received an intramuscular right deltoid injection of FLUZONE SV (lot number not reported) on 13 October 2009 at 17:00 hours from a multi-dose vial. The patient had received flu vaccinations for many years, and reported having a similar reaction (as mentioned below) when she received tetanus (date not reported). The following day after receiving the FLUZONE SV, the patient developed a blister at the injection site. The day after that, the patient developed a lump at the injection site. The next day after that, the patient's arm, face, neck and lips were swollen, as well as her right eye that was swollen shut. She also had blisters on her mouth and tongue. The patient was treated in the emergency room with intravenous steroids and PREDNISONE. When these treatments are stopped the swelling re-occurs. At the time of this report, the patient had not recovered. Documents held by sender: None.
Age: 13.0
Sex: F
Vaccine: VARCEL
Symptoms: Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling, Injection site warmth
Clinical narrative: HEAT TO AREA, RED, SWOLLEN, ITCHING SORENESS TO ARM
Age: 1.33
Sex: F
Vaccine: FLUX
Symptoms: Oedema peripheral, Rash generalised, Swelling face
Clinical narrative: Very serious rash all over body, not itchy, later causing swelling on face and feet
Age: 22.0
Sex: F
Vaccine: FLUN(H1N1)
Symptoms: Wheezing
Clinical narrative: expiratory and inspiratory wheezing lasting 30 minutes.  Observed; no treatment necessary as wheezing resolved on its own with no additional symptoms developing
Age: 22.0
Sex: F
Vaccine: FLUN(H1N1)
Symptoms: Asthenia, Confusional state, Dizziness, Malaise, Nasal congestion
Clinical narrative: "confusion, dizziness"; "an hour went by and then I threw up"; did not eat before vaccination or after; reports lack of energy; lasted 2 1/2 hours. When asked how she was feeling, "I stopped taking my allergy medicine for 3 days and don't feel well. My nose and everything is stuffy and runny.
Age: 22.0
Sex: F
Vaccine: FLUN(H1N1)
Symptoms: Rhinorrhoea, Vomiting
Clinical narrative: "confusion, dizziness"; "an hour went by and then I threw up"; did not eat before vaccination or after; reports lack of energy; lasted 2 1/2 hours. When asked how she was feeling, "I stopped taking my allergy medicine for 3 days and don't feel well. My nose and everything is stuffy and runny.
Age: 4.0
Sex: F
Vaccine: FLUX(H1N1)
Symptoms: Cough, Headache, Pyrexia, Vomiting
Clinical narrative: vomiting, fever, cough, headache
Age: 34.0
Sex: F
Vaccine: HEPAB, HEPAB
Symptoms: Arthralgia, Diarrhoea, Foreign travel, Hypoaesthesia, Laboratory test normal
Clinical narrative: presented to the ED with numbness and tingling in the toes on the plantar aspect for the past 4 days. Today the tingling extended to the back of the knees. The tingling is constant and without any pain. No back pain that radiates down in the legs. No problems with walking or gait. No weakness in the lower limbs. Denies any headache, vision changes, speech difficulties. the patient recently returned from Thaiti after a 1 month trip. She did receive hep A, B and typhoid vaccine before her trips. Never had any reactions to any immunizations in the past. Had some diarrhea on her return and now it is improving. No fever or chills. Has been having some achiness in the hips and the wrists. No insect bite. No new medications. Has been trying new foods in Thaiti.  11/13/09 Hospital records, discharge records received, service dates 10/28/09 to 10/29/09. Assessment: Mild distal sensory polyneuropathy with diminished sensation to light touch, temperature and vibration, both feet. History of foreign travel - rule out B12 deficiency, rule out neurotoxicity. Patient presents with 4 day hx of neuropathy. Numbness started in toes and is progressing up legs to calf. Sensation slightly deminished to light touch and temperature noth feet. Recent travel to Haiti. Taking Chloroquin. Diarrhea since returning from Haiti, took Cipro. Dizzy. Achiness in hips and wrist.
Age: 34.0
Sex: F
Vaccine: HEPAB, HEPAB
Symptoms: No reaction on previous exposure to drug, Paraesthesia
Clinical narrative: presented to the ED with numbness and tingling in the toes on the plantar aspect for the past 4 days. Today the tingling extended to the back of the knees. The tingling is constant and without any pain. No back pain that radiates down in the legs. No problems with walking or gait. No weakness in the lower limbs. Denies any headache, vision changes, speech difficulties. the patient recently returned from Thaiti after a 1 month trip. She did receive hep A, B and typhoid vaccine before her trips. Never had any reactions to any immunizations in the past. Had some diarrhea on her return and now it is improving. No fever or chills. Has been having some achiness in the hips and the wrists. No insect bite. No new medications. Has been trying new foods in Thaiti.  11/13/09 Hospital records, discharge records received, service dates 10/28/09 to 10/29/09. Assessment: Mild distal sensory polyneuropathy with diminished sensation to light touch, temperature and vibration, both feet. History of foreign travel - rule out B12 deficiency, rule out neurotoxicity. Patient presents with 4 day hx of neuropathy. Numbness started in toes and is progressing up legs to calf. Sensation slightly deminished to light touch and temperature noth feet. Recent travel to Haiti. Taking Chloroquin. Diarrhea since returning from Haiti, took Cipro. Dizzy. Achiness in hips and wrist.
Age: 34.0
Sex: F
Vaccine: HEPAB, HEPAB
Symptoms: Hypoaesthesia
Clinical narrative: presented to the ED with numbness and tingling in the toes on the plantar aspect for the past 4 days. Today the tingling extended to the back of the knees. The tingling is constant and without any pain. No back pain that radiates down in the legs. No problems with walking or gait. No weakness in the lower limbs. Denies any headache, vision changes, speech difficulties. the patient recently returned from Thaiti after a 1 month trip. She did receive hep A, B and typhoid vaccine before her trips. Never had any reactions to any immunizations in the past. Had some diarrhea on her return and now it is improving. No fever or chills. Has been having some achiness in the hips and the wrists. No insect bite. No new medications. Has been trying new foods in Thaiti.  11/13/09 Hospital records, discharge records received, service dates 10/28/09 to 10/29/09. Assessment: Mild distal sensory polyneuropathy with diminished sensation to light touch, temperature and vibration, both feet. History of foreign travel - rule out B12 deficiency, rule out neurotoxicity. Patient presents with 4 day hx of neuropathy. Numbness started in toes and is progressing up legs to calf. Sensation slightly deminished to light touch and temperature noth feet. Recent travel to Haiti. Taking Chloroquin. Diarrhea since returning from Haiti, took Cipro. Dizzy. Achiness in hips and wrist.
Age: 4.0
Sex: F
Vaccine: FLUN(H1N1)
Symptoms: Fatigue, Malaise, Pyrexia
Clinical narrative: Fever 102-103, fatigue and general malaise for three days and counting.
Age: 19.0
Sex: F
Vaccine: PPV
Symptoms: Erythema, Injection site pain, Oedema, Oedema peripheral
Clinical narrative: Lt arm painful within jection That evening arm was swollen.seen 10/30/09 Lt upper arm shows signs of mild  edama, moderate erthema, ROM Normal and No axillary lympth nodes palp. TX Biaxin 500 mg Bid X 10 days and medrol 4mg dose pack taken as directed.
Age: 53.0
Sex: F
Vaccine: FLU(H1N1)
Symptoms: Rash pruritic
Clinical narrative: Started itching on arms and neck with a fine rash under skin at 4:30 pm and this continued 10/28/09 but was worse at night.  It continued to itch 10/29/09 and is starting to subside today 10/30/09.  Physician was seen and she was prescribed Benadryl-she states that this has helped.
Age: 55.0
Sex: F
Vaccine: FLUX
Symptoms: Injection site erythema, Injection site streaking
Clinical narrative: Erythema tracking from injection site of the left arm deltoid region to the bicep region, measuring 95mmx 45 mm.
Age: 64.0
Sex: F
Vaccine: FLUX
Symptoms: Activities of daily living impaired, Injection site inflammation, Injection site pain, Musculoskeletal pain, Pain in extremity
Clinical narrative: My left arm started hurting where I got the shot but I thought nothing of it.  Within a week it became quite severe so I couldn't dress properly.  Pain radiates down my arm and up into my shoulder.  Went to the doctor 10/29/09 and he said arm is inflamed.  No treatment prescribed except ibuprofen for discomfort.
Age: 3.0
Sex: F
Vaccine: FLU(H1N1)
Symptoms: Influenza serology negative, Pyrexia, Vomiting
Clinical narrative: fever 101 degrees 3 hours after vaccine,  103 degrees following AM and Child vomited x 1
Age: 49.0
Sex: F
Vaccine: FLU3
Symptoms: Urticaria
Clinical narrative: 1 HOUR LATER WELTS ALL OVER BODY. ATARAX GIVEN AND CLARITIN
Age: 57.0
Sex: F
Vaccine: FLU3
Symptoms: Inflammation, Injection site pain, Injection site rash
Clinical narrative: Rash at the injection site with evidence of local inflammatory reaction along with soreness.
Age: 34.0
Sex: F
Vaccine: UNK
Symptoms: Premature labour
Clinical narrative: Patient developed premature labor and delivered a viable male infant at 27 weeks
Age: 16.0
Sex: M
Vaccine: FLU3
Symptoms: Eye oedema, Face oedema, Hypersensitivity, Urticaria
Clinical narrative: Upon awakening on 10/16/09 the resident was noted to have bilateral orbital and mild facial edema with faint hives on face and neck.  The resident had an uncomplicated dental extraction earlier that day and also rec'd one tab of Tylenol #3 (Tylenol 300mg/Codeine 30mg), which he does not recall ever having before.  It is unclear which event lead to the allergic reaction.
Age: 12.0
Sex: M
Vaccine: FLU3, HEPA, MNQ, TDAP, VARCEL
Symptoms: Injection site erythema, Injection site mass, Injection site pruritus, Injection site warmth
Clinical narrative: ITCHING 2 1/2X 1 1/2 INCH REDNESS, WARM TO TOUCH KNOT OR THICKINESS 1 1/2 X 1 INCH WHERE VARICELLA SHOT WAS GIVEN.
Age: 8.0
Sex: M
Vaccine: FLU(H1N1)
Symptoms: Fatigue, Pyrexia
Clinical narrative: Teacher noted fatigue in the AM. Fever checked at noon--103.3.  Student was sent home with family for rest and care.  MD notified and VDH called to inquire if this report was required.  They advised "Yes."
Age: 22.0
Sex: F
Vaccine: HEPA
Symptoms: Incorrect dose administered
Clinical narrative: PATIENT WAS GIVEN A PEDIATRIC DOSE OF HEPATITIS A INSTEAD OF ADULT HEP A.  PATIENT INFORMED.  SHE WILL COME BACK TO GET CORRECT DOSE.
Age: 41.0
Sex: M
Vaccine: FLUX
Symptoms: Injection site pain, Injection site swelling, Musculoskeletal pain
Clinical narrative: SWELLING OF UPPER ARM AROUND INJECTION SITE.  PAIN RADIATING TO SHOULDER FROM INJECTION SITE.
Age: 4.0
Sex: M
Vaccine: FLU3
Symptoms: Pyrexia
Clinical narrative: Fever 104 Taken to Pediatrician, lungs clear no other symptoms, no redness or swelling at injection site
Age: 13.0
Sex: M
Vaccine: HEPA, MNQ, TDAP, VARCEL
Symptoms: Incorrect dose administered
Clinical narrative: PATIENT WAS GIVEN AN EXTRA HEP A PEDIATRIC DOSE.  NO TREATMENT REQUIRED.
Age: 22.0
Sex: F
Vaccine: FLU(H1N1)
Symptoms: Cough, Oropharyngeal pain, Pain, Pyrexia
Clinical narrative: slight fever, coughing, sore throat, soreness/body aches (went to see doctor to get medicine)
Age: 38.0
Sex: F
Vaccine: FLU(H1N1), FLUX(H1N1)
Symptoms: Computerised tomogram, Nuclear magnetic resonance imaging, Paraesthesia, Sensation of heaviness, Sleep disorder
Clinical narrative: Left arm (injection given in left arm) "fell asleep" the night after injection. Arm felt heavy all day. Began to feel heaviness in left leg by the next day. Entire left side of body "feels as if it is heavy or under water". Symptoms decrease but do not go away during the day. Very bothersome at night and affect sleeping.