chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 1.0
Sex: F
Vaccine: HBHEPB, MMR, PNC
Symptoms: Pruritus, Rash, Rash maculo-papular, Rash papular
Clinical narrative: Rash for 1 day, mild itching, raised blanching papules of different shape and size, all over her body.
Age: 4.0
Sex: M
Vaccine: DTAP, IPV, MMR
Symptoms: Injection site erythema, Injection site inflammation, Injection site oedema
Clinical narrative: Redness, swelling, inflammation.
Age: 1.17
Sex: M
Vaccine: DTAP, HEPA, HIBV, MMR, PNC, VARCEL
Symptoms: Medication error
Clinical narrative: Adult Hap A given to 14 MO. No treatment required.
Age: 5.0
Sex: F
Vaccine: DTAP, HEPA, IPV, MMRV
Symptoms: Erythema, Lymphadenopathy, Pain, Swelling, Tenderness
Clinical narrative: C/O swelling, redness tenderness, pain in R delt. Parent reports no fever, no NVD. Parent states, "She is normal except her arm is sore." Client examined by RN. One palpable R axillary lymph node approx 8mm: client reports slight pain to touch. Submandibular and submental lymph nodes nonpalpable. Advised cool pack and suggested Tylenol per manufacturers direction and to seek immediate tx at hospital if S/S worsen. All questions answered.
Age: 25.0
Sex: F
Vaccine: MMR
Symptoms: Arthralgia, Joint stiffness, Joint swelling
Clinical narrative: Rt knee pain on 10/16; lt knee pain 11/10/06. Bilateral knees swollen and stiff. Pain in AM; decreases during day with activity.
Age: 6.0
Sex: M
Vaccine: FLU3
Symptoms: Injection site erythema, Injection site hypersensitivity, Injection site induration, Injection site pain, Injection site warmth
Clinical narrative: The flu vaccine was given at about 3pm 11-14-06. The following morning complained about his arm hurting.  The arm was itchy, hard, hot, and red about 3 inches around the site of the injection.  This lasted for about 48 hours, during which time the parent took the child to the doctor and the doctor asked for a report to be filed.
Age: 6.0
Sex: M
Vaccine: FLU3
Symptoms: Pruritus
Clinical narrative: The flu vaccine was given at about 3pm 11-14-06. The following morning complained about his arm hurting.  The arm was itchy, hard, hot, and red about 3 inches around the site of the injection.  This lasted for about 48 hours, during which time the parent took the child to the doctor and the doctor asked for a report to be filed.
Age: 43.0
Sex: F
Vaccine: PPV
Symptoms: Injection site pain, Injection site swelling, Lethargy
Clinical narrative: Left arm pain and swelling at vaccine site. Thought to be allergic. She was treated with antihistamines and antibiotics
Age: 28.0
Sex: F
Vaccine: FLU3
Symptoms: Erythema, Feeling hot, Headache, Hyperhidrosis, Throat tightness
Clinical narrative: Approximately 90 minutes after vaccine given, Reported headache, feeling hot, diaphoretic, denied difficulty breathing, skin appeared sl red, denied itching, Patient reports took 50 mg benadryl, 10 minutes later "jaw felt tight, tongue swelling, and throat started to swell". Went to ER.
Age: 28.0
Sex: F
Vaccine: FLU3
Symptoms: Tongue oedema
Clinical narrative: Approximately 90 minutes after vaccine given, Reported headache, feeling hot, diaphoretic, denied difficulty breathing, skin appeared sl red, denied itching, Patient reports took 50 mg benadryl, 10 minutes later "jaw felt tight, tongue swelling, and throat started to swell". Went to ER.
Age: 41.0
Sex: F
Vaccine: HEP
Symptoms: Dyspnoea, Pruritus
Clinical narrative: Itching, difficulty breathing. Epinephrine & Prednisone.
Age: 0.33
Sex: F
Vaccine: DTAPHEPBIP, HIBV, PNC, RV5, DTAPHEPBIP, HIBV, PNC, RV5
Symptoms: Colitis, Gastroenteritis, Gastrooesophageal reflux disease, Haematochezia, Intussusception
Clinical narrative: 7/13/06: WELL CHILD VISIT. PAST WEEK SPITTY & GAGGY. NO VOMITING, NON BILIOUS, NON BLOODY. STOOLS GREEN JELLY LIKE WITH BLOOD STREAKS, NO FEVER, FEEDING WELL. DX: APPEARS TO BE GERD POSSIBLY WITH VIRAL ENTERITIS OR BREAT MILK COLITIS.  PLAN: CBC & STOOL O AND P. HOLD VACCINES UNTIL LAB RESULTS 7/20/06: NO RECURRENCE OF BLOOD IN STOOL.  OK FOR IMMS.  2M IMMS ADMIN. 9/14/06: 3M WELL CHILD VISIT. BORN W/ASSYMETRIC FACES SYNDROME. NO GROWTH CONCERNS.  4M IMMS ADMIN. 10/25/06: MOC CALLED STATING BABY GAGS AND SPITTING AFTER FEEDING.  TRIED ZANTAC IN PAST WITHOUT RELIEF SO STOPPED.  LAST VOID IN AM. 10/26/06, 10:15AM: FOC STATES CHILD VOMITING 4X DAY FOR PAST 2 DAYS MOSTLY AFTER BREASTFEEDING FORMULA.  BROUGHT CHILD INTO ED. 2 DAYS AGO HAD X1 LARGE STOOL.  INTERMITTENT FUSSINESS. AM X 1 BLOODY STOOL.  NO FEVER OR URI SXS. DX: INTUSSUSCEPTION, INCOMPLETE REDUCTION BY AIR ENEMA. PLAN: ADMIT OR FOR INTUSSUSCEPTION REDUCTION PROCEDURE: RQL LIMITED LAPAROTOMY W/ILEOCOLIC INSTUSSUSCEPTION REDUCTION.  APPENDECTOMY.  NO COMPLICATIONS.  DISCHARGED. 11/16/06: 6M WELL CHILD VISIT.  HAD INTUSSUCEPTION, BUT DOING WELL.  EATING SOLIDS, NO CHRONIC DIARRHEA OR CONSTIPATION.  IMMS ADMIN, BUT ROTAVIRUS HELD. 12/12/06 Received medical records from hospital which reveal patient presented to ER s/p 36 hours of vomiting, fussiness & then 1 bloody diaper on 10/26/06. Air enema revealed incomplete reduction of ileocolic IS which was initially present at the sigmoid level & reduced to the hepatic flexure.  Taken to OR & findings revealed distal ileum & appendix intussuscepted within right colon extending to mid transverse level which was reduced w/o difficulty & appendix removed.  D/C to home on 10/28/06. Final DX: Intussusception, surgically reduced.
Age: 0.33
Sex: F
Vaccine: DTAPHEPBIP, HIBV, PNC, RV5, DTAPHEPBIP, HIBV, PNC, RV5
Symptoms: Irritability, Vomiting, White blood cell count increased
Clinical narrative: 7/13/06: WELL CHILD VISIT. PAST WEEK SPITTY & GAGGY. NO VOMITING, NON BILIOUS, NON BLOODY. STOOLS GREEN JELLY LIKE WITH BLOOD STREAKS, NO FEVER, FEEDING WELL. DX: APPEARS TO BE GERD POSSIBLY WITH VIRAL ENTERITIS OR BREAT MILK COLITIS.  PLAN: CBC & STOOL O AND P. HOLD VACCINES UNTIL LAB RESULTS 7/20/06: NO RECURRENCE OF BLOOD IN STOOL.  OK FOR IMMS.  2M IMMS ADMIN. 9/14/06: 3M WELL CHILD VISIT. BORN W/ASSYMETRIC FACES SYNDROME. NO GROWTH CONCERNS.  4M IMMS ADMIN. 10/25/06: MOC CALLED STATING BABY GAGS AND SPITTING AFTER FEEDING.  TRIED ZANTAC IN PAST WITHOUT RELIEF SO STOPPED.  LAST VOID IN AM. 10/26/06, 10:15AM: FOC STATES CHILD VOMITING 4X DAY FOR PAST 2 DAYS MOSTLY AFTER BREASTFEEDING FORMULA.  BROUGHT CHILD INTO ED. 2 DAYS AGO HAD X1 LARGE STOOL.  INTERMITTENT FUSSINESS. AM X 1 BLOODY STOOL.  NO FEVER OR URI SXS. DX: INTUSSUSCEPTION, INCOMPLETE REDUCTION BY AIR ENEMA. PLAN: ADMIT OR FOR INTUSSUSCEPTION REDUCTION PROCEDURE: RQL LIMITED LAPAROTOMY W/ILEOCOLIC INSTUSSUSCEPTION REDUCTION.  APPENDECTOMY.  NO COMPLICATIONS.  DISCHARGED. 11/16/06: 6M WELL CHILD VISIT.  HAD INTUSSUCEPTION, BUT DOING WELL.  EATING SOLIDS, NO CHRONIC DIARRHEA OR CONSTIPATION.  IMMS ADMIN, BUT ROTAVIRUS HELD. 12/12/06 Received medical records from hospital which reveal patient presented to ER s/p 36 hours of vomiting, fussiness & then 1 bloody diaper on 10/26/06. Air enema revealed incomplete reduction of ileocolic IS which was initially present at the sigmoid level & reduced to the hepatic flexure.  Taken to OR & findings revealed distal ileum & appendix intussuscepted within right colon extending to mid transverse level which was reduced w/o difficulty & appendix removed.  D/C to home on 10/28/06. Final DX: Intussusception, surgically reduced.
Age: 0.33
Sex: F
Vaccine: DTAPHEPBIP, HIBV, PNC, RV5, DTAPHEPBIP, HIBV, PNC, RV5
Symptoms: Constipation, Haematochezia, Intussusception, Retching, Salivary hypersecretion
Clinical narrative: 7/13/06: WELL CHILD VISIT. PAST WEEK SPITTY & GAGGY. NO VOMITING, NON BILIOUS, NON BLOODY. STOOLS GREEN JELLY LIKE WITH BLOOD STREAKS, NO FEVER, FEEDING WELL. DX: APPEARS TO BE GERD POSSIBLY WITH VIRAL ENTERITIS OR BREAT MILK COLITIS.  PLAN: CBC & STOOL O AND P. HOLD VACCINES UNTIL LAB RESULTS 7/20/06: NO RECURRENCE OF BLOOD IN STOOL.  OK FOR IMMS.  2M IMMS ADMIN. 9/14/06: 3M WELL CHILD VISIT. BORN W/ASSYMETRIC FACES SYNDROME. NO GROWTH CONCERNS.  4M IMMS ADMIN. 10/25/06: MOC CALLED STATING BABY GAGS AND SPITTING AFTER FEEDING.  TRIED ZANTAC IN PAST WITHOUT RELIEF SO STOPPED.  LAST VOID IN AM. 10/26/06, 10:15AM: FOC STATES CHILD VOMITING 4X DAY FOR PAST 2 DAYS MOSTLY AFTER BREASTFEEDING FORMULA.  BROUGHT CHILD INTO ED. 2 DAYS AGO HAD X1 LARGE STOOL.  INTERMITTENT FUSSINESS. AM X 1 BLOODY STOOL.  NO FEVER OR URI SXS. DX: INTUSSUSCEPTION, INCOMPLETE REDUCTION BY AIR ENEMA. PLAN: ADMIT OR FOR INTUSSUSCEPTION REDUCTION PROCEDURE: RQL LIMITED LAPAROTOMY W/ILEOCOLIC INSTUSSUSCEPTION REDUCTION.  APPENDECTOMY.  NO COMPLICATIONS.  DISCHARGED. 11/16/06: 6M WELL CHILD VISIT.  HAD INTUSSUCEPTION, BUT DOING WELL.  EATING SOLIDS, NO CHRONIC DIARRHEA OR CONSTIPATION.  IMMS ADMIN, BUT ROTAVIRUS HELD. 12/12/06 Received medical records from hospital which reveal patient presented to ER s/p 36 hours of vomiting, fussiness & then 1 bloody diaper on 10/26/06. Air enema revealed incomplete reduction of ileocolic IS which was initially present at the sigmoid level & reduced to the hepatic flexure.  Taken to OR & findings revealed distal ileum & appendix intussuscepted within right colon extending to mid transverse level which was reduced w/o difficulty & appendix removed.  D/C to home on 10/28/06. Final DX: Intussusception, surgically reduced.
Age: 0.33
Sex: F
Vaccine: DTAPHEPBIP, HIBV, PNC, RV5, DTAPHEPBIP, HIBV, PNC, RV5
Symptoms: Vomiting
Clinical narrative: 7/13/06: WELL CHILD VISIT. PAST WEEK SPITTY & GAGGY. NO VOMITING, NON BILIOUS, NON BLOODY. STOOLS GREEN JELLY LIKE WITH BLOOD STREAKS, NO FEVER, FEEDING WELL. DX: APPEARS TO BE GERD POSSIBLY WITH VIRAL ENTERITIS OR BREAT MILK COLITIS.  PLAN: CBC & STOOL O AND P. HOLD VACCINES UNTIL LAB RESULTS 7/20/06: NO RECURRENCE OF BLOOD IN STOOL.  OK FOR IMMS.  2M IMMS ADMIN. 9/14/06: 3M WELL CHILD VISIT. BORN W/ASSYMETRIC FACES SYNDROME. NO GROWTH CONCERNS.  4M IMMS ADMIN. 10/25/06: MOC CALLED STATING BABY GAGS AND SPITTING AFTER FEEDING.  TRIED ZANTAC IN PAST WITHOUT RELIEF SO STOPPED.  LAST VOID IN AM. 10/26/06, 10:15AM: FOC STATES CHILD VOMITING 4X DAY FOR PAST 2 DAYS MOSTLY AFTER BREASTFEEDING FORMULA.  BROUGHT CHILD INTO ED. 2 DAYS AGO HAD X1 LARGE STOOL.  INTERMITTENT FUSSINESS. AM X 1 BLOODY STOOL.  NO FEVER OR URI SXS. DX: INTUSSUSCEPTION, INCOMPLETE REDUCTION BY AIR ENEMA. PLAN: ADMIT OR FOR INTUSSUSCEPTION REDUCTION PROCEDURE: RQL LIMITED LAPAROTOMY W/ILEOCOLIC INSTUSSUSCEPTION REDUCTION.  APPENDECTOMY.  NO COMPLICATIONS.  DISCHARGED. 11/16/06: 6M WELL CHILD VISIT.  HAD INTUSSUCEPTION, BUT DOING WELL.  EATING SOLIDS, NO CHRONIC DIARRHEA OR CONSTIPATION.  IMMS ADMIN, BUT ROTAVIRUS HELD. 12/12/06 Received medical records from hospital which reveal patient presented to ER s/p 36 hours of vomiting, fussiness & then 1 bloody diaper on 10/26/06. Air enema revealed incomplete reduction of ileocolic IS which was initially present at the sigmoid level & reduced to the hepatic flexure.  Taken to OR & findings revealed distal ileum & appendix intussuscepted within right colon extending to mid transverse level which was reduced w/o difficulty & appendix removed.  D/C to home on 10/28/06. Final DX: Intussusception, surgically reduced.
Age: 62.0
Sex: F
Vaccine: FLU3
Symptoms: Abdominal discomfort, Cold sweat, Hyperhidrosis, Hypoaesthesia, Vomiting
Clinical narrative: 11:15am burning in stomach, clammy/sweaty, vomiting x3, numbness on arms and hands (all within 20 minutes).
Age: 0.56
Sex: M
Vaccine: DTAPHEPBIP, HIBV, PNC, RV5
Symptoms: Diarrhoea, Gastroenteritis, Irritability, Pyrexia
Clinical narrative: The patient received rotateq vaccine(first dose) at age 7 months. One day later he was seen in our office with fever and fussiness.  He was admitted to the hospital for 3 days to rule out bacteremia.  All cultures were negative and the only source of fever was felt to be his immunizations.  On the day he received Pediarix Prevnar and Acthib.  He had never had an adverse reaction with any of the other immunizations.  11/30/06 Received medical records from PCP which reveal patient was well on day of vax.  Seen following day with temp 103.6 & very fussy & long period of crying inconsolably.  Also found to be constipated.  Admitted to hospital w/Dx: fever, irritability, r/o sepsis. 12/8/06 Received medical records from hospital which reveal patient seen by PCP on day of vax & was well.  Then became fussy & ran fever up to 103.5 at home. Patient admitted on 9/13/06 to r/o sepsis.  Started on IV antibiotics.  Day after admission, began w/diarrhea & continued with fever.  Improved & was d/c to home on 9/16/06 still febrile & was to complete antibiotics course at home. Final Dx: gastroenteritis & febrile illness related to RotaTeq vax.
Age: 1.02
Sex: F
Vaccine: FLU3, HIBV, MMR, PNC, VARCEL
Symptoms: Injection site erythema, Injection site reaction
Clinical narrative: local reaction, erythema.
Age: 5.0
Sex: F
Vaccine: IPV, MMR, TDAP
Symptoms: Unevaluable event
Clinical narrative: NONE
Age: 0.2
Sex: M
Vaccine: DTAPHEPBIP, HIBV, PNC, RV5
Symptoms: Haematochezia, Pyrexia, Retching
Clinical narrative: Patient has a (one) blood-streaked mucousy stool by report of mother.  He had 3 loose stools/day for  3 days.   See attached email:  "Has  survived his first set of immunizations.  Low grade temps all weekend.  One episode of blood/ mucus in his stool.  Inc in spit up / dry heaves...all that to say that rotavirus vaccine is "wicked".  I hope the next dose is better. See you soon.
Age: 24.0
Sex: F
Vaccine: FLUN3
Symptoms: Pruritus, Rash papular, Swelling
Clinical narrative: Severe facial itching and swelling around the mouth. 12/22/06 Received medical records from hospital which reveal patient seen 11/20/06 with complaints of swollen itchy lips & painful chin day after flu vax 11/15/06.  Patient had taken Benadryl w/o relief.  Lips were noted to be reddened, had papules & were swollen.  No respiratory distress.   FInal DX: allergy to FluMist vaccine.
Age: 60.0
Sex: M
Vaccine: FLU3
Symptoms: Chills, Ocular hyperaemia, Pyrexia, Tremor
Clinical narrative: Shaking chills, fever up to 101F, blood shot eyes, arm capillaries seemed to be raised on bilteral arms only.  Took benadryl 50 mg at 5:30, Symptoms reduced by 11:30 pm, resolved by 11/22 AM.
Age: 15.0
Sex: F
Vaccine: FLU3
Symptoms: Pruritus, Rash
Clinical narrative: Student developed a rash and had some complaints of itching.
Age: 35.0
Sex: M
Vaccine: FLU3
Symptoms: Pruritus, Swelling
Clinical narrative: Intermittent swelling and itching.
Age: 49.0
Sex: F
Vaccine: PPV
Symptoms: Arthralgia, Cellulitis, Injection site pain, Injection site swelling, Injection site warmth
Clinical narrative: Later in the evening after receiving her third pneumovax, she developed severe pain, swelling, and warmth at the injection site.  She also developed diffuse arthralgias and fever.  She was initially treated by another physican for possible cellulitis but when I saw her the next day I treated for inflammation and arthralgias with prednisone.
Age: 49.0
Sex: F
Vaccine: PPV
Symptoms: Pyrexia
Clinical narrative: Later in the evening after receiving her third pneumovax, she developed severe pain, swelling, and warmth at the injection site.  She also developed diffuse arthralgias and fever.  She was initially treated by another physican for possible cellulitis but when I saw her the next day I treated for inflammation and arthralgias with prednisone.
Age: 33.0
Sex: F
Vaccine: FLU3, PPV
Symptoms: Diabetes mellitus, Impaired gastric emptying, Injection site erythema, Injection site pain, Loss of consciousness
Clinical narrative: Increased temperature (101 F), Increased WBC (22.7), pain/redness at injection site. Both vaccines were administered at the same site.  12/4/06 Received medical records from hospital which reveal patient admitted 11/8/05 for uncontrolled IDDM (on insulin pump), transient loss of consciousness, gastroparesis & history of closed head injury(CHI).  Neuro consult done but not included with records received.  Had at least 2 other episodes of transient LOC due to hypoglycemia unawareness. New dx of pineal cyst which Neuro did not feel was contributory.  No further episodes & was d/c to home 11/12/05   Final Dx: IDDM, uncontrolled; transient loss of consciousness secondary to hypoglycemia; pineal cyst.
Age: 33.0
Sex: F
Vaccine: FLU3, PPV
Symptoms: Nuclear magnetic resonance imaging brain abnormal, Pyrexia, White blood cell count increased
Clinical narrative: Increased temperature (101 F), Increased WBC (22.7), pain/redness at injection site. Both vaccines were administered at the same site.  12/4/06 Received medical records from hospital which reveal patient admitted 11/8/05 for uncontrolled IDDM (on insulin pump), transient loss of consciousness, gastroparesis & history of closed head injury(CHI).  Neuro consult done but not included with records received.  Had at least 2 other episodes of transient LOC due to hypoglycemia unawareness. New dx of pineal cyst which Neuro did not feel was contributory.  No further episodes & was d/c to home 11/12/05   Final Dx: IDDM, uncontrolled; transient loss of consciousness secondary to hypoglycemia; pineal cyst.
Age: 0.0
Sex: F
Vaccine: FLU3
Symptoms: Pruritus
Clinical narrative: Began itching approximatly 5 minutes after receiving the flu shot.
Age: 42.0
Sex: F
Vaccine: YF
Symptoms: Arthralgia, Myalgia, Pyrexia, White blood cell count increased
Clinical narrative: Fever up to 103F developed approx 5 days after vaccine administered. Myalgias and arthralgias started 2-3 days after injection.
Age: 0.26
Sex: F
Vaccine: FLU3
Symptoms: Medication error
Clinical narrative: Medical Assistant administered influenza vaccine to 3 month old.
Age: 1.35
Sex: F
Vaccine: DTAP, HIBV, IPV, PNC
Symptoms: Convulsion
Clinical narrative: CLIENT HAD A SEIZURE AND WAS SEEN IN THE ER AT HOSPITAL BY DR PER MOTHER.
Age: 62.0
Sex: F
Vaccine: FLU3, PPV, TDAP
Symptoms: Cellulitis, Injection site reaction, Injection site vesicles, Skin ulcer
Clinical narrative: The patient developed a 3x5cm area on her upper right arm that appeared to look like a blister after receiving a pneumococcal vaccine on 10/26/06.  It was debrided and diagnosed as a cellulitis and given an Rx for Augmentin 1000 mg bid x 10 days on 10/30/06. The wound did not improve much, so she was then given Rocephin 1 gm IM x 1 on 10/31/06. She was seen again on 11/01/06 and had improved somewhat, so no additional treatment was done at that visit.  She was then seen again on 11/09/06 and given an Rx for Augmentin 875 mg bid x 10 more days.  She was seen again on 11/21/06 for a follow up and there was not much improvement.  There was no redness or enduration but the area was a large open wound with crust down to the adipose tissue.  She was diagnosed with an open wound, diabetic ulcer and we were able to get her in that day to a general surgeon for evaluation and treatment.
Age: 3.0
Sex: M
Vaccine: DTAP, FLUX
Symptoms: Agitation, Injection site erythema, Injection site swelling, Injection site warmth, Irritability
Clinical narrative: Marked swelling of R thigh (site of injection)with erythema and warmth.  Marked irritability and agitation.
Age: 50.0
Sex: F
Vaccine: TYP
Symptoms: Abdominal pain, Diarrhoea, Feeling hot, Headache, Nausea
Clinical narrative: Patient completed the oral typhoid vaccine on November 13, 2006.  (She started it on November 7th.)  She describes GI upset (nausea, diarrhea and stomach cramping) that started with taking the first pill and has gradually improved up until today's date.  She has also felt hot but has not had any temps over 99 degrees.  She also describes daily frontal headaches.
Age: 32.0
Sex: M
Vaccine: FLUX
Symptoms: Chills, Fatigue, Hyperhidrosis, Pyrexia
Clinical narrative: Fever at night (flu vaccine administered at 9am that day). Chills, sweating.  Felt very tired.
Age: 50.0
Sex: F
Vaccine: PPV, PPV
Symptoms: Anaphylactic reaction, Bronchial obstruction, Face oedema, Flushing, Hypersensitivity
Clinical narrative: Severe anaphylactic reaction with flushing, hypotension, tongue and facial swelling, airway obstruction and respiratory distress. Shock with SAO2 of 78, BP palpalble at 80 systolic and HR of 184.  Given 02 per mask at 8l/min, 2 xopenex inhalation treatments and benadryl 50 mg IM. No epi was given as pt. has carcinoid syndrome. As pt. remained unstable, she was transported via ambulance to the hospital where fluids, tagamet and prednisone were given.. Pt. stabilized and was sent home on prednisone and benadryl.  HPI:  Immediately after receiving the Pneumovax she began to experience anaphylactic symptoms of flushing through her face and body, and her throat beginning to swell. Tx'd with O2, Benadryl 50mg IM, and Xopenex nebs. O2 sats dropped to 87% on 6L of O2, but rose to 98% on room air prior to being sent via ambulance to the hospital. Pulse was 124 initially after the incident began but dropped to the 70's with treatment. Upon arrival in th ER, symptoms had improved, but still c/o a sensation of swelling in the back of her throat.  Discharged to home after several hours on steroids and benadryl.   Differential DX: anaphylaxis, allergic reaction, airway compromise.
Age: 50.0
Sex: F
Vaccine: PPV, PPV
Symptoms: Hypotension, Respiratory distress, Shock, Tachycardia, Tongue oedema
Clinical narrative: Severe anaphylactic reaction with flushing, hypotension, tongue and facial swelling, airway obstruction and respiratory distress. Shock with SAO2 of 78, BP palpalble at 80 systolic and HR of 184.  Given 02 per mask at 8l/min, 2 xopenex inhalation treatments and benadryl 50 mg IM. No epi was given as pt. has carcinoid syndrome. As pt. remained unstable, she was transported via ambulance to the hospital where fluids, tagamet and prednisone were given.. Pt. stabilized and was sent home on prednisone and benadryl.  HPI:  Immediately after receiving the Pneumovax she began to experience anaphylactic symptoms of flushing through her face and body, and her throat beginning to swell. Tx'd with O2, Benadryl 50mg IM, and Xopenex nebs. O2 sats dropped to 87% on 6L of O2, but rose to 98% on room air prior to being sent via ambulance to the hospital. Pulse was 124 initially after the incident began but dropped to the 70's with treatment. Upon arrival in th ER, symptoms had improved, but still c/o a sensation of swelling in the back of her throat.  Discharged to home after several hours on steroids and benadryl.   Differential DX: anaphylaxis, allergic reaction, airway compromise.
Age: 50.0
Sex: F
Vaccine: PPV, PPV
Symptoms: Dizziness, Dyspnoea, Erythema, Hypoxia
Clinical narrative: Severe anaphylactic reaction with flushing, hypotension, tongue and facial swelling, airway obstruction and respiratory distress. Shock with SAO2 of 78, BP palpalble at 80 systolic and HR of 184.  Given 02 per mask at 8l/min, 2 xopenex inhalation treatments and benadryl 50 mg IM. No epi was given as pt. has carcinoid syndrome. As pt. remained unstable, she was transported via ambulance to the hospital where fluids, tagamet and prednisone were given.. Pt. stabilized and was sent home on prednisone and benadryl.  HPI:  Immediately after receiving the Pneumovax she began to experience anaphylactic symptoms of flushing through her face and body, and her throat beginning to swell. Tx'd with O2, Benadryl 50mg IM, and Xopenex nebs. O2 sats dropped to 87% on 6L of O2, but rose to 98% on room air prior to being sent via ambulance to the hospital. Pulse was 124 initially after the incident began but dropped to the 70's with treatment. Upon arrival in th ER, symptoms had improved, but still c/o a sensation of swelling in the back of her throat.  Discharged to home after several hours on steroids and benadryl.   Differential DX: anaphylaxis, allergic reaction, airway compromise.
Age: 59.0
Sex: M
Vaccine: FLU3
Symptoms: Abdominal pain, Anaemia, Arrhythmia, Asthenia, Atrial fibrillation
Clinical narrative: Recent history of end stage renal disease. On dialysis for last 3 weeks. Discharged from hospital 10/24/06. 3-4 days ago, developed gradual increase in weakness, fatigue. Not able to get up without assistance. 11/08 intubated. 11/14 trache placed.  1/2/07 Received medical records from hospital which reveal patient admitted 3 times: 10/13/06-10/19/06 -- Final Dx: renal failure, secondary to acute tubular necrosis; hx of DVT & PE; & Wolff-Parkins-White syndrome; anemia; metabolic acidosis & hyperkalemia, resolved. Procedures during that hospitalization included: US guided percutaneous biopsy or right kidney 10/13/06; MRA of abdomen 10/17; placement of dialysis cath & initiation of dialysis 10/18/06. LABS: creatinine 7.3 (up from 2.9 2 wks prior during hospitalization for chest pain). 10/21/06-10/25/06 -- Final Dx: Abdominal & back pain; tachyarrhythmia tx w/ablation.  10/31/06-11/30/06.  Intubated on 11/8/06 due to resp muscle weakness.  Numerous episodes of plasmapheresis; numerous courses of IV immunoglobulin.  Feeding tube & trach placed 11/14/06. FINAL DX: Guillain Barre Syndrome believed to be due to flu vax; renal failure, dialysis dependent; fevers, secondary to vancomycin; profound weakness; & history of DVT & PE.  Information received from annual follow up indicates patient has not recovered. Only able to move eyes & jaw. Vent dependent. Patient died 1/26/07. Developed multiple myeloma. Had renal failure prior to this. In chronic atrial fibrillation. Per 60 day follow up: Continued to have minor improvements in neurologic function, including some neck flexion and some purposeful function of leg muscles, prior to his death due to other complications, on 1/26/07. He was a dialysis pt. who had bouts of C. difficile, dysrhythmia and ventricular tachycardia during the last days of life.
Age: 59.0
Sex: M
Vaccine: FLU3
Symptoms: Back pain, Biopsy, Biopsy kidney, Blood creatinine increased, Blood product transfusion
Clinical narrative: Recent history of end stage renal disease. On dialysis for last 3 weeks. Discharged from hospital 10/24/06. 3-4 days ago, developed gradual increase in weakness, fatigue. Not able to get up without assistance. 11/08 intubated. 11/14 trache placed.  1/2/07 Received medical records from hospital which reveal patient admitted 3 times: 10/13/06-10/19/06 -- Final Dx: renal failure, secondary to acute tubular necrosis; hx of DVT & PE; & Wolff-Parkins-White syndrome; anemia; metabolic acidosis & hyperkalemia, resolved. Procedures during that hospitalization included: US guided percutaneous biopsy or right kidney 10/13/06; MRA of abdomen 10/17; placement of dialysis cath & initiation of dialysis 10/18/06. LABS: creatinine 7.3 (up from 2.9 2 wks prior during hospitalization for chest pain). 10/21/06-10/25/06 -- Final Dx: Abdominal & back pain; tachyarrhythmia tx w/ablation.  10/31/06-11/30/06.  Intubated on 11/8/06 due to resp muscle weakness.  Numerous episodes of plasmapheresis; numerous courses of IV immunoglobulin.  Feeding tube & trach placed 11/14/06. FINAL DX: Guillain Barre Syndrome believed to be due to flu vax; renal failure, dialysis dependent; fevers, secondary to vancomycin; profound weakness; & history of DVT & PE.  Information received from annual follow up indicates patient has not recovered. Only able to move eyes & jaw. Vent dependent. Patient died 1/26/07. Developed multiple myeloma. Had renal failure prior to this. In chronic atrial fibrillation. Per 60 day follow up: Continued to have minor improvements in neurologic function, including some neck flexion and some purposeful function of leg muscles, prior to his death due to other complications, on 1/26/07. He was a dialysis pt. who had bouts of C. difficile, dysrhythmia and ventricular tachycardia during the last days of life.
Age: 59.0
Sex: M
Vaccine: FLU3
Symptoms: Bronchoscopy, Catheter placement, Chest pain, Clostridial infection, Computerised tomogram
Clinical narrative: Recent history of end stage renal disease. On dialysis for last 3 weeks. Discharged from hospital 10/24/06. 3-4 days ago, developed gradual increase in weakness, fatigue. Not able to get up without assistance. 11/08 intubated. 11/14 trache placed.  1/2/07 Received medical records from hospital which reveal patient admitted 3 times: 10/13/06-10/19/06 -- Final Dx: renal failure, secondary to acute tubular necrosis; hx of DVT & PE; & Wolff-Parkins-White syndrome; anemia; metabolic acidosis & hyperkalemia, resolved. Procedures during that hospitalization included: US guided percutaneous biopsy or right kidney 10/13/06; MRA of abdomen 10/17; placement of dialysis cath & initiation of dialysis 10/18/06. LABS: creatinine 7.3 (up from 2.9 2 wks prior during hospitalization for chest pain). 10/21/06-10/25/06 -- Final Dx: Abdominal & back pain; tachyarrhythmia tx w/ablation.  10/31/06-11/30/06.  Intubated on 11/8/06 due to resp muscle weakness.  Numerous episodes of plasmapheresis; numerous courses of IV immunoglobulin.  Feeding tube & trach placed 11/14/06. FINAL DX: Guillain Barre Syndrome believed to be due to flu vax; renal failure, dialysis dependent; fevers, secondary to vancomycin; profound weakness; & history of DVT & PE.  Information received from annual follow up indicates patient has not recovered. Only able to move eyes & jaw. Vent dependent. Patient died 1/26/07. Developed multiple myeloma. Had renal failure prior to this. In chronic atrial fibrillation. Per 60 day follow up: Continued to have minor improvements in neurologic function, including some neck flexion and some purposeful function of leg muscles, prior to his death due to other complications, on 1/26/07. He was a dialysis pt. who had bouts of C. difficile, dysrhythmia and ventricular tachycardia during the last days of life.
Age: 59.0
Sex: M
Vaccine: FLU3
Symptoms: Death, Dependence on respirator, Dysstasia, Endotracheal intubation, Fatigue
Clinical narrative: Recent history of end stage renal disease. On dialysis for last 3 weeks. Discharged from hospital 10/24/06. 3-4 days ago, developed gradual increase in weakness, fatigue. Not able to get up without assistance. 11/08 intubated. 11/14 trache placed.  1/2/07 Received medical records from hospital which reveal patient admitted 3 times: 10/13/06-10/19/06 -- Final Dx: renal failure, secondary to acute tubular necrosis; hx of DVT & PE; & Wolff-Parkins-White syndrome; anemia; metabolic acidosis & hyperkalemia, resolved. Procedures during that hospitalization included: US guided percutaneous biopsy or right kidney 10/13/06; MRA of abdomen 10/17; placement of dialysis cath & initiation of dialysis 10/18/06. LABS: creatinine 7.3 (up from 2.9 2 wks prior during hospitalization for chest pain). 10/21/06-10/25/06 -- Final Dx: Abdominal & back pain; tachyarrhythmia tx w/ablation.  10/31/06-11/30/06.  Intubated on 11/8/06 due to resp muscle weakness.  Numerous episodes of plasmapheresis; numerous courses of IV immunoglobulin.  Feeding tube & trach placed 11/14/06. FINAL DX: Guillain Barre Syndrome believed to be due to flu vax; renal failure, dialysis dependent; fevers, secondary to vancomycin; profound weakness; & history of DVT & PE.  Information received from annual follow up indicates patient has not recovered. Only able to move eyes & jaw. Vent dependent. Patient died 1/26/07. Developed multiple myeloma. Had renal failure prior to this. In chronic atrial fibrillation. Per 60 day follow up: Continued to have minor improvements in neurologic function, including some neck flexion and some purposeful function of leg muscles, prior to his death due to other complications, on 1/26/07. He was a dialysis pt. who had bouts of C. difficile, dysrhythmia and ventricular tachycardia during the last days of life.
Age: 59.0
Sex: M
Vaccine: FLU3
Symptoms: Haemoglobin decreased, Hyperkalaemia, Hypokinesia, Laboratory test, Metabolic acidosis
Clinical narrative: Recent history of end stage renal disease. On dialysis for last 3 weeks. Discharged from hospital 10/24/06. 3-4 days ago, developed gradual increase in weakness, fatigue. Not able to get up without assistance. 11/08 intubated. 11/14 trache placed.  1/2/07 Received medical records from hospital which reveal patient admitted 3 times: 10/13/06-10/19/06 -- Final Dx: renal failure, secondary to acute tubular necrosis; hx of DVT & PE; & Wolff-Parkins-White syndrome; anemia; metabolic acidosis & hyperkalemia, resolved. Procedures during that hospitalization included: US guided percutaneous biopsy or right kidney 10/13/06; MRA of abdomen 10/17; placement of dialysis cath & initiation of dialysis 10/18/06. LABS: creatinine 7.3 (up from 2.9 2 wks prior during hospitalization for chest pain). 10/21/06-10/25/06 -- Final Dx: Abdominal & back pain; tachyarrhythmia tx w/ablation.  10/31/06-11/30/06.  Intubated on 11/8/06 due to resp muscle weakness.  Numerous episodes of plasmapheresis; numerous courses of IV immunoglobulin.  Feeding tube & trach placed 11/14/06. FINAL DX: Guillain Barre Syndrome believed to be due to flu vax; renal failure, dialysis dependent; fevers, secondary to vancomycin; profound weakness; & history of DVT & PE.  Information received from annual follow up indicates patient has not recovered. Only able to move eyes & jaw. Vent dependent. Patient died 1/26/07. Developed multiple myeloma. Had renal failure prior to this. In chronic atrial fibrillation. Per 60 day follow up: Continued to have minor improvements in neurologic function, including some neck flexion and some purposeful function of leg muscles, prior to his death due to other complications, on 1/26/07. He was a dialysis pt. who had bouts of C. difficile, dysrhythmia and ventricular tachycardia during the last days of life.
Age: 59.0
Sex: M
Vaccine: FLU3
Symptoms: Multiple myeloma, Muscular weakness, Plasmapheresis, Platelet count normal, Prothrombin time normal
Clinical narrative: Recent history of end stage renal disease. On dialysis for last 3 weeks. Discharged from hospital 10/24/06. 3-4 days ago, developed gradual increase in weakness, fatigue. Not able to get up without assistance. 11/08 intubated. 11/14 trache placed.  1/2/07 Received medical records from hospital which reveal patient admitted 3 times: 10/13/06-10/19/06 -- Final Dx: renal failure, secondary to acute tubular necrosis; hx of DVT & PE; & Wolff-Parkins-White syndrome; anemia; metabolic acidosis & hyperkalemia, resolved. Procedures during that hospitalization included: US guided percutaneous biopsy or right kidney 10/13/06; MRA of abdomen 10/17; placement of dialysis cath & initiation of dialysis 10/18/06. LABS: creatinine 7.3 (up from 2.9 2 wks prior during hospitalization for chest pain). 10/21/06-10/25/06 -- Final Dx: Abdominal & back pain; tachyarrhythmia tx w/ablation.  10/31/06-11/30/06.  Intubated on 11/8/06 due to resp muscle weakness.  Numerous episodes of plasmapheresis; numerous courses of IV immunoglobulin.  Feeding tube & trach placed 11/14/06. FINAL DX: Guillain Barre Syndrome believed to be due to flu vax; renal failure, dialysis dependent; fevers, secondary to vancomycin; profound weakness; & history of DVT & PE.  Information received from annual follow up indicates patient has not recovered. Only able to move eyes & jaw. Vent dependent. Patient died 1/26/07. Developed multiple myeloma. Had renal failure prior to this. In chronic atrial fibrillation. Per 60 day follow up: Continued to have minor improvements in neurologic function, including some neck flexion and some purposeful function of leg muscles, prior to his death due to other complications, on 1/26/07. He was a dialysis pt. who had bouts of C. difficile, dysrhythmia and ventricular tachycardia during the last days of life.
Age: 59.0
Sex: M
Vaccine: FLU3
Symptoms: Pyrexia, Renal failure, Renal tubular necrosis, Surgery, Tachyarrhythmia
Clinical narrative: Recent history of end stage renal disease. On dialysis for last 3 weeks. Discharged from hospital 10/24/06. 3-4 days ago, developed gradual increase in weakness, fatigue. Not able to get up without assistance. 11/08 intubated. 11/14 trache placed.  1/2/07 Received medical records from hospital which reveal patient admitted 3 times: 10/13/06-10/19/06 -- Final Dx: renal failure, secondary to acute tubular necrosis; hx of DVT & PE; & Wolff-Parkins-White syndrome; anemia; metabolic acidosis & hyperkalemia, resolved. Procedures during that hospitalization included: US guided percutaneous biopsy or right kidney 10/13/06; MRA of abdomen 10/17; placement of dialysis cath & initiation of dialysis 10/18/06. LABS: creatinine 7.3 (up from 2.9 2 wks prior during hospitalization for chest pain). 10/21/06-10/25/06 -- Final Dx: Abdominal & back pain; tachyarrhythmia tx w/ablation.  10/31/06-11/30/06.  Intubated on 11/8/06 due to resp muscle weakness.  Numerous episodes of plasmapheresis; numerous courses of IV immunoglobulin.  Feeding tube & trach placed 11/14/06. FINAL DX: Guillain Barre Syndrome believed to be due to flu vax; renal failure, dialysis dependent; fevers, secondary to vancomycin; profound weakness; & history of DVT & PE.  Information received from annual follow up indicates patient has not recovered. Only able to move eyes & jaw. Vent dependent. Patient died 1/26/07. Developed multiple myeloma. Had renal failure prior to this. In chronic atrial fibrillation. Per 60 day follow up: Continued to have minor improvements in neurologic function, including some neck flexion and some purposeful function of leg muscles, prior to his death due to other complications, on 1/26/07. He was a dialysis pt. who had bouts of C. difficile, dysrhythmia and ventricular tachycardia during the last days of life.
Age: 59.0
Sex: M
Vaccine: FLU3
Symptoms: Tracheostomy, Ventricular tachycardia, Wolff-Parkinson-White syndrome
Clinical narrative: Recent history of end stage renal disease. On dialysis for last 3 weeks. Discharged from hospital 10/24/06. 3-4 days ago, developed gradual increase in weakness, fatigue. Not able to get up without assistance. 11/08 intubated. 11/14 trache placed.  1/2/07 Received medical records from hospital which reveal patient admitted 3 times: 10/13/06-10/19/06 -- Final Dx: renal failure, secondary to acute tubular necrosis; hx of DVT & PE; & Wolff-Parkins-White syndrome; anemia; metabolic acidosis & hyperkalemia, resolved. Procedures during that hospitalization included: US guided percutaneous biopsy or right kidney 10/13/06; MRA of abdomen 10/17; placement of dialysis cath & initiation of dialysis 10/18/06. LABS: creatinine 7.3 (up from 2.9 2 wks prior during hospitalization for chest pain). 10/21/06-10/25/06 -- Final Dx: Abdominal & back pain; tachyarrhythmia tx w/ablation.  10/31/06-11/30/06.  Intubated on 11/8/06 due to resp muscle weakness.  Numerous episodes of plasmapheresis; numerous courses of IV immunoglobulin.  Feeding tube & trach placed 11/14/06. FINAL DX: Guillain Barre Syndrome believed to be due to flu vax; renal failure, dialysis dependent; fevers, secondary to vancomycin; profound weakness; & history of DVT & PE.  Information received from annual follow up indicates patient has not recovered. Only able to move eyes & jaw. Vent dependent. Patient died 1/26/07. Developed multiple myeloma. Had renal failure prior to this. In chronic atrial fibrillation. Per 60 day follow up: Continued to have minor improvements in neurologic function, including some neck flexion and some purposeful function of leg muscles, prior to his death due to other complications, on 1/26/07. He was a dialysis pt. who had bouts of C. difficile, dysrhythmia and ventricular tachycardia during the last days of life.
Age: 10.0
Sex: M
Vaccine: FLUN3
Symptoms: Feeling hot, Henoch-Schonlein purpura, Neck pain, Rash, Rhinorrhoea
Clinical narrative: 11/14/06 FluMist given, 11/16 c/o right neck ache, felt hot to mom, PE examination tender right posterior cervical. T/C neg. 11/19 expresses yellow nasal discharge (hx recurrent sinusitis), Rx given. 11/20 developed rash. 11/21  admitted to hosp DX HSP.   3/15/07 Received medical records from hospital which reveal patient admitted 11/21/06-11/22/07 after experienced rash & HTN 8 days s/p flu vax.  Exam revealed fatigue, swollen left foot, shotty cervical lymph nodes in neck, diffuse peripuric rash & torticollis.  Had mild abdominal pain.  Admitted renal consult done. Rheum consult recommended & renal f/u scheduled as outpatient. FINAL DX: Vasculitis, likely Henoch-Schonlein Purpura (HSP); nephritis; HTN. Per 60 day follow up: Dx with HENOCH-SCHONLEIN purpura doing well.
Age: 10.0
Sex: M
Vaccine: FLUN3
Symptoms: Sinusitis, Tenderness
Clinical narrative: 11/14/06 FluMist given, 11/16 c/o right neck ache, felt hot to mom, PE examination tender right posterior cervical. T/C neg. 11/19 expresses yellow nasal discharge (hx recurrent sinusitis), Rx given. 11/20 developed rash. 11/21  admitted to hosp DX HSP.   3/15/07 Received medical records from hospital which reveal patient admitted 11/21/06-11/22/07 after experienced rash & HTN 8 days s/p flu vax.  Exam revealed fatigue, swollen left foot, shotty cervical lymph nodes in neck, diffuse peripuric rash & torticollis.  Had mild abdominal pain.  Admitted renal consult done. Rheum consult recommended & renal f/u scheduled as outpatient. FINAL DX: Vasculitis, likely Henoch-Schonlein Purpura (HSP); nephritis; HTN. Per 60 day follow up: Dx with HENOCH-SCHONLEIN purpura doing well.
Age: 51.0
Sex: F
Vaccine: FLU3
Symptoms: Unevaluable event
Clinical narrative: None Stated.
Age: 2.0
Sex: F
Vaccine: FLUN3
Symptoms: Medication error
Clinical narrative: No adverse event, pt given FluMist, should have had vaccine. Had Flu vaccine 1yr ago no Adverse effect.
Age: 60.0
Sex: F
Vaccine: TDAP
Symptoms: Injection site erythema, Injection site oedema, Injection site pain
Clinical narrative: Local site reaction with redness and swelling at the site. Also painful.
Age: 52.0
Sex: F
Vaccine: TDAP
Symptoms: Unevaluable event
Clinical narrative: None Stated
Age: 67.0
Sex: F
Vaccine: PPV
Symptoms: Injection site erythema, Injection site oedema, Injection site pain, Injection site warmth, Tenderness
Clinical narrative: Within 4-5 hours after injection noticed soreness, slight swollen, tender to touch. 24-30 hours later obvious redness, warm to touch, remains sl swollen, but less soreness.
Age: 24.0
Sex: F
Vaccine: HEP, TD
Symptoms: Blood glucose increased, Hypertonia, Hypotonia, Pallor
Clinical narrative: Pt became pale and had tonic/clonic movement which subsided and recurred over 7 minutes, pt.
Sex: M
Vaccine: TDAP
Symptoms: Injection site erythema, Injection site warmth, Myalgia
Clinical narrative: w/i 24 hrs after admin. of Tdap, had large, erythematous area  distal to vaccine site which was hot to touch.  Also had erythema around vaccine injection site. + achy muscle
Age: 70.0
Sex: M
Vaccine: FLUX, PPV
Symptoms: Arthralgia, Asthenia, Atrioventricular block, Chills, Dizziness
Clinical narrative: Patient received Influenza and Pneumococcal vaccinations in left shoulder at 9am. At 5pm he developed weakness, dizziness and fever to 102F. He had terrible pain in the shoulder not so much at the injection site but in the joint itself. He had shakes and chills. He continued to feel faint after lying down and continued to have fever. He had pain in the left shoulder and also in both knees. Paramedics were called. Blood pressure in the field was as low as 52/40 but improved with fluid bolus to 118/58. He was brought to the ED and given Tylenol, Motrin, Stress-dose steroids, Morphine and Dilaudid.He became hypotensive again in the hospital and was transferred to intermediate care on dopamine. All symptoms improved within 48 hours. Sepsis was ruled out.  Hospital MR received revealing  70 yr old male admitted to the hospital for sudden onset of fever, weakness, dizziness, and shoulder pain approximately 8 hours after his Pneumovax and Flu vax.  PE: Febrile with rectal temp. up to 104'F.  Initially hypotensive then improved with bolus IV fluids.  Decreased ROM in left shoulder.  Pain in left shoulder and knees. Otherwise normal exam.  Treated with dopamine for BP support, Rocephin, Zosyn,and stress dose steroids. Discharged feeling well and asymptomatic after 48 hours. Impression: Resolved hypotension, arthralgias, fever 2' to AE from pneumococcal/influenza immunizations (serum-sickness like).
Age: 70.0
Sex: M
Vaccine: FLUX, PPV
Symptoms: Hypotension, Pyrexia, Serum sickness, Shoulder pain, Tremor
Clinical narrative: Patient received Influenza and Pneumococcal vaccinations in left shoulder at 9am. At 5pm he developed weakness, dizziness and fever to 102F. He had terrible pain in the shoulder not so much at the injection site but in the joint itself. He had shakes and chills. He continued to feel faint after lying down and continued to have fever. He had pain in the left shoulder and also in both knees. Paramedics were called. Blood pressure in the field was as low as 52/40 but improved with fluid bolus to 118/58. He was brought to the ED and given Tylenol, Motrin, Stress-dose steroids, Morphine and Dilaudid.He became hypotensive again in the hospital and was transferred to intermediate care on dopamine. All symptoms improved within 48 hours. Sepsis was ruled out.  Hospital MR received revealing  70 yr old male admitted to the hospital for sudden onset of fever, weakness, dizziness, and shoulder pain approximately 8 hours after his Pneumovax and Flu vax.  PE: Febrile with rectal temp. up to 104'F.  Initially hypotensive then improved with bolus IV fluids.  Decreased ROM in left shoulder.  Pain in left shoulder and knees. Otherwise normal exam.  Treated with dopamine for BP support, Rocephin, Zosyn,and stress dose steroids. Discharged feeling well and asymptomatic after 48 hours. Impression: Resolved hypotension, arthralgias, fever 2' to AE from pneumococcal/influenza immunizations (serum-sickness like).
Age: 70.0
Sex: M
Vaccine: FLUX, PPV
Symptoms: Urine abnormality, White blood cell count increased
Clinical narrative: Patient received Influenza and Pneumococcal vaccinations in left shoulder at 9am. At 5pm he developed weakness, dizziness and fever to 102F. He had terrible pain in the shoulder not so much at the injection site but in the joint itself. He had shakes and chills. He continued to feel faint after lying down and continued to have fever. He had pain in the left shoulder and also in both knees. Paramedics were called. Blood pressure in the field was as low as 52/40 but improved with fluid bolus to 118/58. He was brought to the ED and given Tylenol, Motrin, Stress-dose steroids, Morphine and Dilaudid.He became hypotensive again in the hospital and was transferred to intermediate care on dopamine. All symptoms improved within 48 hours. Sepsis was ruled out.  Hospital MR received revealing  70 yr old male admitted to the hospital for sudden onset of fever, weakness, dizziness, and shoulder pain approximately 8 hours after his Pneumovax and Flu vax.  PE: Febrile with rectal temp. up to 104'F.  Initially hypotensive then improved with bolus IV fluids.  Decreased ROM in left shoulder.  Pain in left shoulder and knees. Otherwise normal exam.  Treated with dopamine for BP support, Rocephin, Zosyn,and stress dose steroids. Discharged feeling well and asymptomatic after 48 hours. Impression: Resolved hypotension, arthralgias, fever 2' to AE from pneumococcal/influenza immunizations (serum-sickness like).
Age: 77.0
Sex: M
Vaccine: PPV
Symptoms: Injection site erythema, Injection site pain
Clinical narrative: REDNESS AND PAIN AT INJECTION SITE 24 HOURS AFTER INJECTION.
Age: 77.0
Sex: F
Vaccine: PPV
Symptoms: Injection site erythema, Injection site pain
Clinical narrative: REDNESS AND PAIN AT INJECTION SITE 24 HOURS AFTER RECIEVING INJECTION.
Age: 46.0
Sex: F
Vaccine: FLU3
Symptoms: Injection site erythema, Injection site pain, Injection site swelling
Clinical narrative: Patient vaccinated on 11/15/06.  Returned to clinic two days later (11/17/06) with pain, swelling, erythema, and tenderness.  She stated the pain started immediately after receiving the vaccine, and the other symptoms were noticed once she had returned home.  She reported a history of numerous flu shots without problems and denies any allergies including to eggs.  The patient was directed to use ice packs and was given a five day course of dicloxicillin 500mg QID due to the severe tenderness and erythema.  The patient was called the following morning (11/18/06) and reported the erythema, redness, and swelling had all improved.  She was told to complete the course of antibiotic and to follow up in clinic on 11/20/06 (Monday) if she still had problems, which she did not need to do.
Age: 8.0
Sex: F
Vaccine: FLUN3
Symptoms: Cold sweat, Dyspnoea, Heart rate increased, Nasopharyngitis
Clinical narrative: Unsure if any relation to vaccine, but in case. . . Since the night of 10/23/06, the day she got Flumist, she has had sparse episodes of heart-racing associated with clammy skin and shortness of breath.  We are now working her up for SVT.  No such problems before then.