chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 70.0
Sex: M
Vaccine: COVID19
Symptoms: Electrocardiogram ST-T segment abnormal, Endotracheal intubation, Haematoma, Haemorrhage, Heparin-induced thrombocytopenia
Clinical narrative: note from 11/23/21 had pfizer covid vaccines 2/24/21, 3/19/21, and 10/5/2021, i do not have lot number for the 10/5/2021 dose  A/P: Pt is a 70 y.o. male with PMH of HTN, gerd, BPH who is transferred from a HCF with massive PE s/p ROSC and tPA. Placed on eliquis and developed right anterior chest and arm hematoma and need IVC filter placement. Now w/ e/o HIT, suspect classic HIT, w/in 5-10 days of heparin exposure, plt count nadir at 130 (>50% decline from 283) w/ h/o thrombosis and HIT Ab >2 OD (2.765) 4Ts of at least 5 or intermed, and w/ elev OD c/w and diagnostic for HIT. Suspect covid vaccine booster on 5 October 2021 could have been a risk factor for his initial presentation with PE and DVT however as the HIT is greater than 30 days post Covid vaccine and not present at initial presentation, this is not consistent with VITT at this point in time.   1. Massive PE s/p ROSC; acute LLE DVT and HIT -HCF CTA of chest which revealed acute bilateral PE with large clot burden and evidence of pulmonary hypertension and right heart strain -Echo from 11/15/2021 revealed EF of 70%, moderate diastolic dysfunction, right ventricular systolic pressure of 34.6 mmhg -Became pulseless while going to the restroom, was given tPA, intubated, required levophed  -Received heparin and then eliquis @ HCF- last dose 11/14/21 2/2 bleeding -11/16/21 BLE U/S: 1. Acute-appearing, occlusive and nonocclusive thrombus in the left low femoral vein, as well as occlusive thrombus in the left popliteal vein. No right lower extremity DVT. -AC back on, apix 2.5 bid, ok to go to 5 mg bid -rec avoiding further covid shots due to poss contribution to clot -avoid heparin, it is an allergy now, w/ dx of HIT -plt already improving, currently on DOAC   2. Acute blood loss anemia -2/2 right anterior chest and arm hematoma while on Eliquis  -Patient had right upper extremity arterial Doppler which did not reveal significant stenosis.  He also had right upper extremity venous Doppler which revealed large hematoma involving the anterior chest and extending down the medial aspect of the right arm. -Hgb stable/improved -back on AC, ok to go to full dose   3. AKI -Cr 0.9 @ HCF admit, currently 0.82 -Renal ultrasound at HCF revealed renal cortical atrophy bilaterally.  Enlarged prostate with palpable trabeculation.  Questionable nonobstructing left renal stone.   Recommendations: -resume eliquis 5 mg po bid  -avoid heparin products -f/u w/ Dr at HCF next wk
Age: 70.0
Sex: M
Vaccine: COVID19
Symptoms: Plasminogen activator inhibitor, Prostatomegaly, Pulmonary embolism, Pulmonary hypertension, Pulse absent
Clinical narrative: note from 11/23/21 had pfizer covid vaccines 2/24/21, 3/19/21, and 10/5/2021, i do not have lot number for the 10/5/2021 dose  A/P: Pt is a 70 y.o. male with PMH of HTN, gerd, BPH who is transferred from a HCF with massive PE s/p ROSC and tPA. Placed on eliquis and developed right anterior chest and arm hematoma and need IVC filter placement. Now w/ e/o HIT, suspect classic HIT, w/in 5-10 days of heparin exposure, plt count nadir at 130 (>50% decline from 283) w/ h/o thrombosis and HIT Ab >2 OD (2.765) 4Ts of at least 5 or intermed, and w/ elev OD c/w and diagnostic for HIT. Suspect covid vaccine booster on 5 October 2021 could have been a risk factor for his initial presentation with PE and DVT however as the HIT is greater than 30 days post Covid vaccine and not present at initial presentation, this is not consistent with VITT at this point in time.   1. Massive PE s/p ROSC; acute LLE DVT and HIT -HCF CTA of chest which revealed acute bilateral PE with large clot burden and evidence of pulmonary hypertension and right heart strain -Echo from 11/15/2021 revealed EF of 70%, moderate diastolic dysfunction, right ventricular systolic pressure of 34.6 mmhg -Became pulseless while going to the restroom, was given tPA, intubated, required levophed  -Received heparin and then eliquis @ HCF- last dose 11/14/21 2/2 bleeding -11/16/21 BLE U/S: 1. Acute-appearing, occlusive and nonocclusive thrombus in the left low femoral vein, as well as occlusive thrombus in the left popliteal vein. No right lower extremity DVT. -AC back on, apix 2.5 bid, ok to go to 5 mg bid -rec avoiding further covid shots due to poss contribution to clot -avoid heparin, it is an allergy now, w/ dx of HIT -plt already improving, currently on DOAC   2. Acute blood loss anemia -2/2 right anterior chest and arm hematoma while on Eliquis  -Patient had right upper extremity arterial Doppler which did not reveal significant stenosis.  He also had right upper extremity venous Doppler which revealed large hematoma involving the anterior chest and extending down the medial aspect of the right arm. -Hgb stable/improved -back on AC, ok to go to full dose   3. AKI -Cr 0.9 @ HCF admit, currently 0.82 -Renal ultrasound at HCF revealed renal cortical atrophy bilaterally.  Enlarged prostate with palpable trabeculation.  Questionable nonobstructing left renal stone.   Recommendations: -resume eliquis 5 mg po bid  -avoid heparin products -f/u w/ Dr at HCF next wk
Age: 70.0
Sex: M
Vaccine: COVID19
Symptoms: Renal atrophy, Right ventricular systolic pressure, Thrombosis, Ultrasound Doppler abnormal, Ultrasound kidney abnormal
Clinical narrative: note from 11/23/21 had pfizer covid vaccines 2/24/21, 3/19/21, and 10/5/2021, i do not have lot number for the 10/5/2021 dose  A/P: Pt is a 70 y.o. male with PMH of HTN, gerd, BPH who is transferred from a HCF with massive PE s/p ROSC and tPA. Placed on eliquis and developed right anterior chest and arm hematoma and need IVC filter placement. Now w/ e/o HIT, suspect classic HIT, w/in 5-10 days of heparin exposure, plt count nadir at 130 (>50% decline from 283) w/ h/o thrombosis and HIT Ab >2 OD (2.765) 4Ts of at least 5 or intermed, and w/ elev OD c/w and diagnostic for HIT. Suspect covid vaccine booster on 5 October 2021 could have been a risk factor for his initial presentation with PE and DVT however as the HIT is greater than 30 days post Covid vaccine and not present at initial presentation, this is not consistent with VITT at this point in time.   1. Massive PE s/p ROSC; acute LLE DVT and HIT -HCF CTA of chest which revealed acute bilateral PE with large clot burden and evidence of pulmonary hypertension and right heart strain -Echo from 11/15/2021 revealed EF of 70%, moderate diastolic dysfunction, right ventricular systolic pressure of 34.6 mmhg -Became pulseless while going to the restroom, was given tPA, intubated, required levophed  -Received heparin and then eliquis @ HCF- last dose 11/14/21 2/2 bleeding -11/16/21 BLE U/S: 1. Acute-appearing, occlusive and nonocclusive thrombus in the left low femoral vein, as well as occlusive thrombus in the left popliteal vein. No right lower extremity DVT. -AC back on, apix 2.5 bid, ok to go to 5 mg bid -rec avoiding further covid shots due to poss contribution to clot -avoid heparin, it is an allergy now, w/ dx of HIT -plt already improving, currently on DOAC   2. Acute blood loss anemia -2/2 right anterior chest and arm hematoma while on Eliquis  -Patient had right upper extremity arterial Doppler which did not reveal significant stenosis.  He also had right upper extremity venous Doppler which revealed large hematoma involving the anterior chest and extending down the medial aspect of the right arm. -Hgb stable/improved -back on AC, ok to go to full dose   3. AKI -Cr 0.9 @ HCF admit, currently 0.82 -Renal ultrasound at HCF revealed renal cortical atrophy bilaterally.  Enlarged prostate with palpable trabeculation.  Questionable nonobstructing left renal stone.   Recommendations: -resume eliquis 5 mg po bid  -avoid heparin products -f/u w/ Dr at HCF next wk
Age: 70.0
Sex: M
Vaccine: COVID19
Symptoms: Vena cava filter insertion
Clinical narrative: note from 11/23/21 had pfizer covid vaccines 2/24/21, 3/19/21, and 10/5/2021, i do not have lot number for the 10/5/2021 dose  A/P: Pt is a 70 y.o. male with PMH of HTN, gerd, BPH who is transferred from a HCF with massive PE s/p ROSC and tPA. Placed on eliquis and developed right anterior chest and arm hematoma and need IVC filter placement. Now w/ e/o HIT, suspect classic HIT, w/in 5-10 days of heparin exposure, plt count nadir at 130 (>50% decline from 283) w/ h/o thrombosis and HIT Ab >2 OD (2.765) 4Ts of at least 5 or intermed, and w/ elev OD c/w and diagnostic for HIT. Suspect covid vaccine booster on 5 October 2021 could have been a risk factor for his initial presentation with PE and DVT however as the HIT is greater than 30 days post Covid vaccine and not present at initial presentation, this is not consistent with VITT at this point in time.   1. Massive PE s/p ROSC; acute LLE DVT and HIT -HCF CTA of chest which revealed acute bilateral PE with large clot burden and evidence of pulmonary hypertension and right heart strain -Echo from 11/15/2021 revealed EF of 70%, moderate diastolic dysfunction, right ventricular systolic pressure of 34.6 mmhg -Became pulseless while going to the restroom, was given tPA, intubated, required levophed  -Received heparin and then eliquis @ HCF- last dose 11/14/21 2/2 bleeding -11/16/21 BLE U/S: 1. Acute-appearing, occlusive and nonocclusive thrombus in the left low femoral vein, as well as occlusive thrombus in the left popliteal vein. No right lower extremity DVT. -AC back on, apix 2.5 bid, ok to go to 5 mg bid -rec avoiding further covid shots due to poss contribution to clot -avoid heparin, it is an allergy now, w/ dx of HIT -plt already improving, currently on DOAC   2. Acute blood loss anemia -2/2 right anterior chest and arm hematoma while on Eliquis  -Patient had right upper extremity arterial Doppler which did not reveal significant stenosis.  He also had right upper extremity venous Doppler which revealed large hematoma involving the anterior chest and extending down the medial aspect of the right arm. -Hgb stable/improved -back on AC, ok to go to full dose   3. AKI -Cr 0.9 @ HCF admit, currently 0.82 -Renal ultrasound at HCF revealed renal cortical atrophy bilaterally.  Enlarged prostate with palpable trabeculation.  Questionable nonobstructing left renal stone.   Recommendations: -resume eliquis 5 mg po bid  -avoid heparin products -f/u w/ Dr at HCF next wk
Age: 43.0
Sex: F
Vaccine: COVID19
Symptoms: Blood test normal, Erythema, Neck pain, Skin discolouration, X-ray
Clinical narrative: Shoulder had a large red and purple patch and neck started hurting and kept on hurting. So I visited my Doctor on 11/18 for a checkup and prior blood work discovery. It came back clean. After I told him about my neck, he ordered X-Ray of my neck that was done today 12/10. Follow-up is to be done on 11/15. I have not been issued any treatment yet.
Age: 12.0
Sex: M
Vaccine: COVID19
Symptoms: Inappropriate schedule of product administration, No adverse event
Clinical narrative: The event was that the patient received a COVID vaccine on 12/3/2021, and then mistakenly received another vaccine today, 12/10/21. There were no observable signs or symptoms. Provider was not aware until parent called the clinic to inform provider that patient had received a dose on 12/3/21 and did not inform the provider at the time of the injection.
Age: 29.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Asthenia, Chills, Diarrhoea, Headache
Clinical narrative: Swollen lymph in left arm, headache, fever (101.5F), joint pain, muscle pain, chills, nausea, diarrhea, weakness
Age: 29.0
Sex: F
Vaccine: COVID19
Symptoms: Lymphadenopathy, Myalgia, Nausea, Pyrexia
Clinical narrative: Swollen lymph in left arm, headache, fever (101.5F), joint pain, muscle pain, chills, nausea, diarrhea, weakness
Age: 16.0
Sex: F
Vaccine: FLU4
Symptoms: Rash, Urticaria
Clinical narrative: Patient developed hives/rash on arms and back post vaccination. Patient was given benadryl 25 mg and Epi pen was administered 0.3 mg. Patient's hives improved, denied any shortness of breath or difficulty breathing. Patient's vitals were checked Q10 mins, remained stable throughout encounter. SpO2 remained in the 98-99% range.
Age: 85.0
Sex: F
Vaccine: COVID19
Symptoms: Anxiety, COVID-19 pneumonia, Cough, Tearfulness
Clinical narrative: 86 year old female with COPD, HTN, hx hep C, and fibromyalgia with crhonic pain admitted from facility with covid pneumonia. Patient with progression to 16 L O2 needs and was given dose of tocilizumab, as well as decadron and remdesivir. However, on day 4 of admission elected to transition to comfort care. All covid treatment and non comfort drive medications were stopped. She remained stable for 24 hours on 6 L NC and was discharged back to custodial facility with hospice. Using prn roxanol for discomfort.    Subjective: Tearful this am and anxious about transfer home. Breathing stable. Some cough.    Objective: BP 164/78  | Pulse 74  | Temp 97.9 °F (36.6 °C)  | Resp 17  | Ht 5'  | Wt 52.2 kg (115 lb)  | SpO2 90%  | Breastfeeding Yes  | BMI 22.46 kg/m²    Physical Exam at Discharge: Comfort care, full exam deferred Anxious but no acute distress Non labored breathing   Selected Results: Recent Labs No results found for this or any previous visit (from the past 24 hour(s)).    Primary Procedures:  None   Secondary Procedures: None   Reason for Hospital Admission (Admitting Diagnosis):  covid pneumonia
Age: 58.0
Sex: M
Vaccine: COVID19
Symptoms: Swelling face
Clinical narrative: Facial swelling on cheek developed the next day. Started on left cheek, then switched to right cheek. No swelling of lips, tongue, or throat. No difficulty breathing
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Immunodeficiency, Interchange of vaccine products, Wrong product administered
Clinical narrative: PT HAD APPT FOR COVID VACCINE. PRIMARY SERIES WAS PFIZER. PT REPORTED SHE HAD AUTO IMMUNE DISEASE AND WAS IMMUNOCOMPROMISED. PHARMACIST ADMINISTERED FULL DOSE MODERNA 0.5 ML BUT PT SHOULD RECEIVE PFIZER 0.3 ML
Age: 38.0
Sex: M
Vaccine: COVID19, FLU4
Symptoms: Loss of consciousness, Pallor, Syncope
Clinical narrative: Patient fainted after receiving both vaccinations. He went pale and lost consciousness for about 30 seconds -1 minute.
Age: 58.0
Sex: M
Vaccine: COVID19
Symptoms: Anxiety, Chills, Condition aggravated, Gait disturbance, Impaired work ability
Clinical narrative: The patient reports still feeling unwell from his covid booster he received on 12/7/2021.  He is worried about having to miss another day of work.  He says his symptoms started Wednesday morning at 5am and he was in so much pain, he could hardly walk until about 1pm that day.  He had a fever of 103.1 but has since gone down to 100.4.  He is still having chills but overall is improving from the worst of his syptoms. He is self treating with otc meds.  He reports experiencing a similiar reaction to his first COVID shot, which was Johnson and Johnson.  Pfizer was a booster for him.
Age: 58.0
Sex: M
Vaccine: COVID19
Symptoms: Interchange of vaccine products, Malaise, Pain, Pyrexia
Clinical narrative: The patient reports still feeling unwell from his covid booster he received on 12/7/2021.  He is worried about having to miss another day of work.  He says his symptoms started Wednesday morning at 5am and he was in so much pain, he could hardly walk until about 1pm that day.  He had a fever of 103.1 but has since gone down to 100.4.  He is still having chills but overall is improving from the worst of his syptoms. He is self treating with otc meds.  He reports experiencing a similiar reaction to his first COVID shot, which was Johnson and Johnson.  Pfizer was a booster for him.
Age: 44.0
Sex: F
Vaccine: COVID19
Symptoms: Dysmenorrhoea, Hypomenorrhoea, Intermenstrual bleeding
Clinical narrative: Unexpected Menstral cramping and spotting, mid-cycle, for just 1 day.  Very light flow.
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Blood test normal, Erythema, Rash, Urticaria
Clinical narrative: No issues with shot upon receiving. Two weeks after shot I began having hive like symptoms but no itching. Skin is red and bumpy. Has not gone away at all. Actually seems to be spreading.
Age: 23.0
Sex: F
Vaccine: COVID19
Symptoms: Pyrexia, Rash
Clinical narrative: patient recieved a dose of Janssen and later experienced fever and a skin breakout on the face and neck
Age: 25.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness postural, Hypoaesthesia, Loss of consciousness, Nausea
Clinical narrative: 12/2/21 @6:33 LOC while seated at post-vaccine table for < 1min.  No head impact. Patient reported hand numbness, nausea.  Laid flat and elevated legs.  Vitals WNL : 104/70, HR 78, Pulse ox 99%. Patient accompanied with partner who reports this type of thing happens about every 2 weeks. Patient is alert and oriented x 3.   Patient reports hx of dissociative seizures, POTS, and notes she had increased anxiety prior in the day. She reports she may have had a seizure earlier in the day.  She notes she had very little to eat or drink today.  She appears extremely thin - she states she has ongoing issues with nausea that prevent her from eating well. She is followed by a neurologist.   Carpopedal symptoms resolved within 15 minutes. Offered patient sips of water, she tolerated this well. Vitals remained stable throughout observation.  Took laying/sitting readings as follows: 100/72, HR 60 o2 99%; 102/70 HR 62 O2 99%.  Patient denied dizziness with position changes.  She left the clinic by 7:15 pm, accompanied by her partner who drove her home. They were advised to call 911 with any concerns. Advised f/u with neurologist to discuss recent seizures and work with a provider regarding nausea issues.
Age: 82.0
Sex: F
Vaccine: FLU4
Symptoms: Abdominal discomfort, Back pain, Burning sensation, Dizziness, Immediate post-injection reaction
Clinical narrative: patient began to fill severely ill immediately after receiving the vaccine. Symptoms included nausea, severe back pain, burning sensation from neck to stomach, and dizziness. We called 911, and ems took the patient to the ER.
Age: 82.0
Sex: F
Vaccine: FLU4
Symptoms: Malaise, Nausea
Clinical narrative: patient began to fill severely ill immediately after receiving the vaccine. Symptoms included nausea, severe back pain, burning sensation from neck to stomach, and dizziness. We called 911, and ems took the patient to the ER.
Age: 21.0
Sex: F
Vaccine: COVID19
Symptoms: Blood folate, Blood iron normal, Cholelithiasis, Computerised tomogram thorax abnormal, Condition aggravated
Clinical narrative: pfizer vaccine 11/7/2021, and she had u/s on 11/11/21 showing RUE DVT, Near the elbow at the site of a previously placed peripheral IV there is a a short segment acute appearing occlusive DVT within the more anterior of  the paired brachial veins.   Note from 30 Nov 2021: 21 yo female with PMH of SSA, avascular necrosis R hip s/p arthroplasty, hx acute chest, LE DVT on Xarelto admitted for acute pain.  She has had a prolonged hospitalization and been treated with high doses of oral and parenteral opioids.  She has had multiple local interventions to attempt to control the pain including trigger point injection.  She declined exchange transfusion after discussion   1. SSA -follows with Dr. -discharge 11/7/21 after admission for pain crisis -Hgb 9.1, MCV 113 on Hydrea 1000mg po daily, folic acid 1mg po daily  -PTA tylenol 650mg prn, neurontin 400mg 4 times daily, motrin 600mg prn q6hrs, oxycodone 15mg q4hr prn -retic much better- 120 -TB 0.5 -B12 296, folate >22 -ferritin 609, TIBC 332, % sat 46, iron 152 -CT Chest per #3 -We discussed outpatient management of sickle cell disease including the possibility of pulmonary transplant, which she would be willing to reconsider   2. LLE DVT/RUE DVT -9/5/21 LLE U/S: Thrombosed calf veins without femoral-popliteal deep venous thrombosis.  -covid + 8/23/21 -PTA Xarelto-admits to compliance -covid vaccine 7 Nov 2021 -11/11/21 RUE U/S: Near the elbow at the site of a previously placed peripheral IV there is a a short segment acute appearing occlusive DVT within the more anterior of the paired brachial veins.    3. ID -11/11/21 CT Chest: No evidence of acute central or major segmental pulmonary embolism. Evaluation of the pulmonary arteries limited despite repeated attempts. Development of clustered nodular and groundglass opacities in the left upper lobe consistent with pneumonia. Trace left pleural effusion, likely reactive. Development of mild right axillary lymphadenopathy, likely reactive from reported recent COVID-19 vaccination in the right arm. Cholelithiasis. Stable osseous findings of sickle cell disease.  -normal WBC, afebrile, no cough/SOB or hypoxia   -pulmonary consulted, completed 5 day course of doxycycline    4.  Avascular necrosis -MRI 11/25/2021: Evidence of prior bone infarctions, with no new bone infarctions identified -Appreciate orthopedic surgery evaluation, she will have outpatient follow-up     Recommendations: -Appreciate pain service assistance, agree with current pain management -Will continue Hydrea at 1000mg po daily at d'c, to be adjusted outpatient -Continue Xarelto -B12 298, continue replacement 1000mcg po daily -continue folic acid 1 mg po daily
Age: 21.0
Sex: F
Vaccine: COVID19
Symptoms: Deep vein thrombosis, Haemoglobin decreased, Iron binding capacity total normal, Lung opacity, Lymphadenopathy
Clinical narrative: pfizer vaccine 11/7/2021, and she had u/s on 11/11/21 showing RUE DVT, Near the elbow at the site of a previously placed peripheral IV there is a a short segment acute appearing occlusive DVT within the more anterior of  the paired brachial veins.   Note from 30 Nov 2021: 21 yo female with PMH of SSA, avascular necrosis R hip s/p arthroplasty, hx acute chest, LE DVT on Xarelto admitted for acute pain.  She has had a prolonged hospitalization and been treated with high doses of oral and parenteral opioids.  She has had multiple local interventions to attempt to control the pain including trigger point injection.  She declined exchange transfusion after discussion   1. SSA -follows with Dr. -discharge 11/7/21 after admission for pain crisis -Hgb 9.1, MCV 113 on Hydrea 1000mg po daily, folic acid 1mg po daily  -PTA tylenol 650mg prn, neurontin 400mg 4 times daily, motrin 600mg prn q6hrs, oxycodone 15mg q4hr prn -retic much better- 120 -TB 0.5 -B12 296, folate >22 -ferritin 609, TIBC 332, % sat 46, iron 152 -CT Chest per #3 -We discussed outpatient management of sickle cell disease including the possibility of pulmonary transplant, which she would be willing to reconsider   2. LLE DVT/RUE DVT -9/5/21 LLE U/S: Thrombosed calf veins without femoral-popliteal deep venous thrombosis.  -covid + 8/23/21 -PTA Xarelto-admits to compliance -covid vaccine 7 Nov 2021 -11/11/21 RUE U/S: Near the elbow at the site of a previously placed peripheral IV there is a a short segment acute appearing occlusive DVT within the more anterior of the paired brachial veins.    3. ID -11/11/21 CT Chest: No evidence of acute central or major segmental pulmonary embolism. Evaluation of the pulmonary arteries limited despite repeated attempts. Development of clustered nodular and groundglass opacities in the left upper lobe consistent with pneumonia. Trace left pleural effusion, likely reactive. Development of mild right axillary lymphadenopathy, likely reactive from reported recent COVID-19 vaccination in the right arm. Cholelithiasis. Stable osseous findings of sickle cell disease.  -normal WBC, afebrile, no cough/SOB or hypoxia   -pulmonary consulted, completed 5 day course of doxycycline    4.  Avascular necrosis -MRI 11/25/2021: Evidence of prior bone infarctions, with no new bone infarctions identified -Appreciate orthopedic surgery evaluation, she will have outpatient follow-up     Recommendations: -Appreciate pain service assistance, agree with current pain management -Will continue Hydrea at 1000mg po daily at d'c, to be adjusted outpatient -Continue Xarelto -B12 298, continue replacement 1000mcg po daily -continue folic acid 1 mg po daily
Age: 21.0
Sex: F
Vaccine: COVID19
Symptoms: Magnetic resonance imaging normal, Mean cell volume increased, Mycobacterium tuberculosis complex test, Pain, Pleural effusion
Clinical narrative: pfizer vaccine 11/7/2021, and she had u/s on 11/11/21 showing RUE DVT, Near the elbow at the site of a previously placed peripheral IV there is a a short segment acute appearing occlusive DVT within the more anterior of  the paired brachial veins.   Note from 30 Nov 2021: 21 yo female with PMH of SSA, avascular necrosis R hip s/p arthroplasty, hx acute chest, LE DVT on Xarelto admitted for acute pain.  She has had a prolonged hospitalization and been treated with high doses of oral and parenteral opioids.  She has had multiple local interventions to attempt to control the pain including trigger point injection.  She declined exchange transfusion after discussion   1. SSA -follows with Dr. -discharge 11/7/21 after admission for pain crisis -Hgb 9.1, MCV 113 on Hydrea 1000mg po daily, folic acid 1mg po daily  -PTA tylenol 650mg prn, neurontin 400mg 4 times daily, motrin 600mg prn q6hrs, oxycodone 15mg q4hr prn -retic much better- 120 -TB 0.5 -B12 296, folate >22 -ferritin 609, TIBC 332, % sat 46, iron 152 -CT Chest per #3 -We discussed outpatient management of sickle cell disease including the possibility of pulmonary transplant, which she would be willing to reconsider   2. LLE DVT/RUE DVT -9/5/21 LLE U/S: Thrombosed calf veins without femoral-popliteal deep venous thrombosis.  -covid + 8/23/21 -PTA Xarelto-admits to compliance -covid vaccine 7 Nov 2021 -11/11/21 RUE U/S: Near the elbow at the site of a previously placed peripheral IV there is a a short segment acute appearing occlusive DVT within the more anterior of the paired brachial veins.    3. ID -11/11/21 CT Chest: No evidence of acute central or major segmental pulmonary embolism. Evaluation of the pulmonary arteries limited despite repeated attempts. Development of clustered nodular and groundglass opacities in the left upper lobe consistent with pneumonia. Trace left pleural effusion, likely reactive. Development of mild right axillary lymphadenopathy, likely reactive from reported recent COVID-19 vaccination in the right arm. Cholelithiasis. Stable osseous findings of sickle cell disease.  -normal WBC, afebrile, no cough/SOB or hypoxia   -pulmonary consulted, completed 5 day course of doxycycline    4.  Avascular necrosis -MRI 11/25/2021: Evidence of prior bone infarctions, with no new bone infarctions identified -Appreciate orthopedic surgery evaluation, she will have outpatient follow-up     Recommendations: -Appreciate pain service assistance, agree with current pain management -Will continue Hydrea at 1000mg po daily at d'c, to be adjusted outpatient -Continue Xarelto -B12 298, continue replacement 1000mcg po daily -continue folic acid 1 mg po daily
Age: 21.0
Sex: F
Vaccine: COVID19
Symptoms: Pneumonia, Pulmonary mass, Serum ferritin increased, Sickle cell disease, Ultrasound Doppler abnormal
Clinical narrative: pfizer vaccine 11/7/2021, and she had u/s on 11/11/21 showing RUE DVT, Near the elbow at the site of a previously placed peripheral IV there is a a short segment acute appearing occlusive DVT within the more anterior of  the paired brachial veins.   Note from 30 Nov 2021: 21 yo female with PMH of SSA, avascular necrosis R hip s/p arthroplasty, hx acute chest, LE DVT on Xarelto admitted for acute pain.  She has had a prolonged hospitalization and been treated with high doses of oral and parenteral opioids.  She has had multiple local interventions to attempt to control the pain including trigger point injection.  She declined exchange transfusion after discussion   1. SSA -follows with Dr. -discharge 11/7/21 after admission for pain crisis -Hgb 9.1, MCV 113 on Hydrea 1000mg po daily, folic acid 1mg po daily  -PTA tylenol 650mg prn, neurontin 400mg 4 times daily, motrin 600mg prn q6hrs, oxycodone 15mg q4hr prn -retic much better- 120 -TB 0.5 -B12 296, folate >22 -ferritin 609, TIBC 332, % sat 46, iron 152 -CT Chest per #3 -We discussed outpatient management of sickle cell disease including the possibility of pulmonary transplant, which she would be willing to reconsider   2. LLE DVT/RUE DVT -9/5/21 LLE U/S: Thrombosed calf veins without femoral-popliteal deep venous thrombosis.  -covid + 8/23/21 -PTA Xarelto-admits to compliance -covid vaccine 7 Nov 2021 -11/11/21 RUE U/S: Near the elbow at the site of a previously placed peripheral IV there is a a short segment acute appearing occlusive DVT within the more anterior of the paired brachial veins.    3. ID -11/11/21 CT Chest: No evidence of acute central or major segmental pulmonary embolism. Evaluation of the pulmonary arteries limited despite repeated attempts. Development of clustered nodular and groundglass opacities in the left upper lobe consistent with pneumonia. Trace left pleural effusion, likely reactive. Development of mild right axillary lymphadenopathy, likely reactive from reported recent COVID-19 vaccination in the right arm. Cholelithiasis. Stable osseous findings of sickle cell disease.  -normal WBC, afebrile, no cough/SOB or hypoxia   -pulmonary consulted, completed 5 day course of doxycycline    4.  Avascular necrosis -MRI 11/25/2021: Evidence of prior bone infarctions, with no new bone infarctions identified -Appreciate orthopedic surgery evaluation, she will have outpatient follow-up     Recommendations: -Appreciate pain service assistance, agree with current pain management -Will continue Hydrea at 1000mg po daily at d'c, to be adjusted outpatient -Continue Xarelto -B12 298, continue replacement 1000mcg po daily -continue folic acid 1 mg po daily
Age: 21.0
Sex: F
Vaccine: COVID19
Symptoms: Venous occlusion, Vitamin B12 normal, White blood cell count normal
Clinical narrative: pfizer vaccine 11/7/2021, and she had u/s on 11/11/21 showing RUE DVT, Near the elbow at the site of a previously placed peripheral IV there is a a short segment acute appearing occlusive DVT within the more anterior of  the paired brachial veins.   Note from 30 Nov 2021: 21 yo female with PMH of SSA, avascular necrosis R hip s/p arthroplasty, hx acute chest, LE DVT on Xarelto admitted for acute pain.  She has had a prolonged hospitalization and been treated with high doses of oral and parenteral opioids.  She has had multiple local interventions to attempt to control the pain including trigger point injection.  She declined exchange transfusion after discussion   1. SSA -follows with Dr. -discharge 11/7/21 after admission for pain crisis -Hgb 9.1, MCV 113 on Hydrea 1000mg po daily, folic acid 1mg po daily  -PTA tylenol 650mg prn, neurontin 400mg 4 times daily, motrin 600mg prn q6hrs, oxycodone 15mg q4hr prn -retic much better- 120 -TB 0.5 -B12 296, folate >22 -ferritin 609, TIBC 332, % sat 46, iron 152 -CT Chest per #3 -We discussed outpatient management of sickle cell disease including the possibility of pulmonary transplant, which she would be willing to reconsider   2. LLE DVT/RUE DVT -9/5/21 LLE U/S: Thrombosed calf veins without femoral-popliteal deep venous thrombosis.  -covid + 8/23/21 -PTA Xarelto-admits to compliance -covid vaccine 7 Nov 2021 -11/11/21 RUE U/S: Near the elbow at the site of a previously placed peripheral IV there is a a short segment acute appearing occlusive DVT within the more anterior of the paired brachial veins.    3. ID -11/11/21 CT Chest: No evidence of acute central or major segmental pulmonary embolism. Evaluation of the pulmonary arteries limited despite repeated attempts. Development of clustered nodular and groundglass opacities in the left upper lobe consistent with pneumonia. Trace left pleural effusion, likely reactive. Development of mild right axillary lymphadenopathy, likely reactive from reported recent COVID-19 vaccination in the right arm. Cholelithiasis. Stable osseous findings of sickle cell disease.  -normal WBC, afebrile, no cough/SOB or hypoxia   -pulmonary consulted, completed 5 day course of doxycycline    4.  Avascular necrosis -MRI 11/25/2021: Evidence of prior bone infarctions, with no new bone infarctions identified -Appreciate orthopedic surgery evaluation, she will have outpatient follow-up     Recommendations: -Appreciate pain service assistance, agree with current pain management -Will continue Hydrea at 1000mg po daily at d'c, to be adjusted outpatient -Continue Xarelto -B12 298, continue replacement 1000mcg po daily -continue folic acid 1 mg po daily
Age: 40.0
Sex: M
Vaccine: COVID19
Symptoms: Inflammation, Mechanical urticaria, Urticaria physical
Clinical narrative: About 10-13 days after receiving my 3rd dose, I began to have dispersed dermatographism over my entire body. At first I thought it was just physical urticaria from some environmental cause, but it continued for the past 10 days or so. I have not had any other changes in diet, environmental exposure, changes of soap/laundry detergent, bug bites or any such events. I have narrowed it down to likely as a result of a likely increased hyperactive inflammatory response due to vaccine.  Of course with all dermatographism, it's hard to say the cause, but I figured I should document it here. If it doesn't resolve in another week, I shall seek assistance from my physician.
Age: 12.0
Sex: M
Vaccine: COVID19
Symptoms: Underdose
Clinical narrative: Patient was 12 years old and given Pfizer 5 to 11Year old vaccine.
Age: 51.0
Sex: M
Vaccine: COVID19
Symptoms: Anticoagulant therapy, Chest pain, Colonoscopy, Cough, Device occlusion
Clinical narrative: note 24 Nov 2021 Patient is a 51 y.o. male who had left foot and mid calf pain mid August after initial moderna Covid vaccination on 26 July, he had his second dose of Covid vaccination on 23 August and the left mid calf pain that persisted did get worse, it had only been associated with some mild swelling however 3 weeks after his second dose it extended all the way up to his lower thigh and by early October he had groin pain and chest pain of the left lower lobe that was pleuritic associated with cough but it was improved with NSAIDs which he took for about a month until 11 November when he was noticing foot problems and significant swelling and came to the ER, he had TPA for extensive left lower extremity thrombosis with stent and was noted to have left lower lobe PE and segmental and subsegmental bilateral PE with some evidence of right heart strain, he was sent home on Eliquis 10 mg twice daily for a week and about as soon as he went to the 5 mg twice daily dosing left lower extremity symptoms worsened prompting current admission noting extensive clot to the left lower extremity with occlusion of recently placed stent.  He is currently on heparin drip and TPA.  This clot was exacerbated by Covid vaccination and other than being a man who is 51 years old he has no family history or other risk factors for thrombosis.  We can check a hyper coag work-up but I would avoid any future Covid vaccinations due to his history.   ?He will continue TPA and heparin drip, appreciate IR assistance ?When transitioning to anticoagulant once TPA is complete would give Lovenox 1 mg/kg twice daily while admitted and then 1.5 mg/kg daily (133 mg) upon discharge for likely at least 6 months, could use 150 mg dose, plus aspirin 81 mg daily ?Recommend starting aspirin 81 mg daily as soon as TPA has been completed and he transitions to his Lovenox  ?Hypercoagulable work-up that can be checked at this time includes factor V Leiden, prothrombin gene, beta-2 glycoprotein antibodies, anticardiolipin antibodies  ?Antithrombin cannot be checked while on heparin and will avoid checking DRVVT, and hexagonal lupus anticoagulant on heparin ?Protein S can be affected by acute clot, thus can check later ?He has had a colonoscopy and can keep these up-to-date through primary care, and PSA in August was 0.56 ?We discussed follow-up with me after discharge, they have information to arrange this as needed
Age: 51.0
Sex: M
Vaccine: COVID19
Symptoms: Groin pain, Muscle strain, Myocardial strain imaging abnormal, Pain, Pain in extremity
Clinical narrative: note 24 Nov 2021 Patient is a 51 y.o. male who had left foot and mid calf pain mid August after initial moderna Covid vaccination on 26 July, he had his second dose of Covid vaccination on 23 August and the left mid calf pain that persisted did get worse, it had only been associated with some mild swelling however 3 weeks after his second dose it extended all the way up to his lower thigh and by early October he had groin pain and chest pain of the left lower lobe that was pleuritic associated with cough but it was improved with NSAIDs which he took for about a month until 11 November when he was noticing foot problems and significant swelling and came to the ER, he had TPA for extensive left lower extremity thrombosis with stent and was noted to have left lower lobe PE and segmental and subsegmental bilateral PE with some evidence of right heart strain, he was sent home on Eliquis 10 mg twice daily for a week and about as soon as he went to the 5 mg twice daily dosing left lower extremity symptoms worsened prompting current admission noting extensive clot to the left lower extremity with occlusion of recently placed stent.  He is currently on heparin drip and TPA.  This clot was exacerbated by Covid vaccination and other than being a man who is 51 years old he has no family history or other risk factors for thrombosis.  We can check a hyper coag work-up but I would avoid any future Covid vaccinations due to his history.   ?He will continue TPA and heparin drip, appreciate IR assistance ?When transitioning to anticoagulant once TPA is complete would give Lovenox 1 mg/kg twice daily while admitted and then 1.5 mg/kg daily (133 mg) upon discharge for likely at least 6 months, could use 150 mg dose, plus aspirin 81 mg daily ?Recommend starting aspirin 81 mg daily as soon as TPA has been completed and he transitions to his Lovenox  ?Hypercoagulable work-up that can be checked at this time includes factor V Leiden, prothrombin gene, beta-2 glycoprotein antibodies, anticardiolipin antibodies  ?Antithrombin cannot be checked while on heparin and will avoid checking DRVVT, and hexagonal lupus anticoagulant on heparin ?Protein S can be affected by acute clot, thus can check later ?He has had a colonoscopy and can keep these up-to-date through primary care, and PSA in August was 0.56 ?We discussed follow-up with me after discharge, they have information to arrange this as needed
Age: 51.0
Sex: M
Vaccine: COVID19
Symptoms: Peripheral swelling, Pleuritic pain, Prostatic specific antigen normal, Pulmonary embolism, Stent placement
Clinical narrative: note 24 Nov 2021 Patient is a 51 y.o. male who had left foot and mid calf pain mid August after initial moderna Covid vaccination on 26 July, he had his second dose of Covid vaccination on 23 August and the left mid calf pain that persisted did get worse, it had only been associated with some mild swelling however 3 weeks after his second dose it extended all the way up to his lower thigh and by early October he had groin pain and chest pain of the left lower lobe that was pleuritic associated with cough but it was improved with NSAIDs which he took for about a month until 11 November when he was noticing foot problems and significant swelling and came to the ER, he had TPA for extensive left lower extremity thrombosis with stent and was noted to have left lower lobe PE and segmental and subsegmental bilateral PE with some evidence of right heart strain, he was sent home on Eliquis 10 mg twice daily for a week and about as soon as he went to the 5 mg twice daily dosing left lower extremity symptoms worsened prompting current admission noting extensive clot to the left lower extremity with occlusion of recently placed stent.  He is currently on heparin drip and TPA.  This clot was exacerbated by Covid vaccination and other than being a man who is 51 years old he has no family history or other risk factors for thrombosis.  We can check a hyper coag work-up but I would avoid any future Covid vaccinations due to his history.   ?He will continue TPA and heparin drip, appreciate IR assistance ?When transitioning to anticoagulant once TPA is complete would give Lovenox 1 mg/kg twice daily while admitted and then 1.5 mg/kg daily (133 mg) upon discharge for likely at least 6 months, could use 150 mg dose, plus aspirin 81 mg daily ?Recommend starting aspirin 81 mg daily as soon as TPA has been completed and he transitions to his Lovenox  ?Hypercoagulable work-up that can be checked at this time includes factor V Leiden, prothrombin gene, beta-2 glycoprotein antibodies, anticardiolipin antibodies  ?Antithrombin cannot be checked while on heparin and will avoid checking DRVVT, and hexagonal lupus anticoagulant on heparin ?Protein S can be affected by acute clot, thus can check later ?He has had a colonoscopy and can keep these up-to-date through primary care, and PSA in August was 0.56 ?We discussed follow-up with me after discharge, they have information to arrange this as needed
Age: 51.0
Sex: M
Vaccine: COVID19
Symptoms: Thrombosis
Clinical narrative: note 24 Nov 2021 Patient is a 51 y.o. male who had left foot and mid calf pain mid August after initial moderna Covid vaccination on 26 July, he had his second dose of Covid vaccination on 23 August and the left mid calf pain that persisted did get worse, it had only been associated with some mild swelling however 3 weeks after his second dose it extended all the way up to his lower thigh and by early October he had groin pain and chest pain of the left lower lobe that was pleuritic associated with cough but it was improved with NSAIDs which he took for about a month until 11 November when he was noticing foot problems and significant swelling and came to the ER, he had TPA for extensive left lower extremity thrombosis with stent and was noted to have left lower lobe PE and segmental and subsegmental bilateral PE with some evidence of right heart strain, he was sent home on Eliquis 10 mg twice daily for a week and about as soon as he went to the 5 mg twice daily dosing left lower extremity symptoms worsened prompting current admission noting extensive clot to the left lower extremity with occlusion of recently placed stent.  He is currently on heparin drip and TPA.  This clot was exacerbated by Covid vaccination and other than being a man who is 51 years old he has no family history or other risk factors for thrombosis.  We can check a hyper coag work-up but I would avoid any future Covid vaccinations due to his history.   ?He will continue TPA and heparin drip, appreciate IR assistance ?When transitioning to anticoagulant once TPA is complete would give Lovenox 1 mg/kg twice daily while admitted and then 1.5 mg/kg daily (133 mg) upon discharge for likely at least 6 months, could use 150 mg dose, plus aspirin 81 mg daily ?Recommend starting aspirin 81 mg daily as soon as TPA has been completed and he transitions to his Lovenox  ?Hypercoagulable work-up that can be checked at this time includes factor V Leiden, prothrombin gene, beta-2 glycoprotein antibodies, anticardiolipin antibodies  ?Antithrombin cannot be checked while on heparin and will avoid checking DRVVT, and hexagonal lupus anticoagulant on heparin ?Protein S can be affected by acute clot, thus can check later ?He has had a colonoscopy and can keep these up-to-date through primary care, and PSA in August was 0.56 ?We discussed follow-up with me after discharge, they have information to arrange this as needed
Age: 30.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Thursday (12/9/21) 1. the Public Health nurse, while preparing for the days COVID-19 Moderna vaccination, found a Moderna via in the nurses station vaccine fridge mistakenly labeled being punctured at ?12/10/21 at 2pm? when it should have be labelled ?12/9/21 at 2pm?**.  **In the local HCF when nursing staff puncture a Moderna vial, they will write the date and time that they punctured the vial on the vial. Once a vial is punctured, the staff has 12 hrs to use all of the contents of the vial before it expires. In this case the vial would have expired on 12/10/21 at 2am.  Friday (12/10/21)  1. A day later (12/10/21), the same public health nurses noticed the same vial labelled as ?12/10/21 at 2pm? was still in the nurses vaccine fridge when it should have expired on 12/10/21 at 2am.  2. The nursing team discovered that one dose was provided to a patient  at 10:44am on 12/10/21. That means this patient's dose was technically given 8 hrs and 44 minutes after it had expired.
Age: 25.0
Sex: U
Vaccine: COVID19
Symptoms: Chills, Heavy menstrual bleeding, Injection site swelling, Lymphadenopathy, Menstruation irregular
Clinical narrative: About 24 hours after the vaccination I experienced swelling at the injection site as well as swelling in my left armpit. About 36 hours after the vaccination I experienced uncontrollable chills and shaking. My menstrual bleeding cycle had just ended before taking the vaccination.  I started experiencing returned, heavy menstrual bleeding within 24 hours of vaccination. And I've now been experiencing 21 straight days of menstrual bleeding, which is highly irregular.
Age: 25.0
Sex: U
Vaccine: COVID19
Symptoms: Oligomenorrhoea, Tremor
Clinical narrative: About 24 hours after the vaccination I experienced swelling at the injection site as well as swelling in my left armpit. About 36 hours after the vaccination I experienced uncontrollable chills and shaking. My menstrual bleeding cycle had just ended before taking the vaccination.  I started experiencing returned, heavy menstrual bleeding within 24 hours of vaccination. And I've now been experiencing 21 straight days of menstrual bleeding, which is highly irregular.
Age: 32.0
Sex: F
Vaccine: COVID19
Symptoms: Vomiting
Clinical narrative: Vomiting
Age: 61.0
Sex: F
Vaccine: COVID19
Symptoms: Bone pain, Bone swelling, Neck pain, Swelling
Clinical narrative: patient said next morning her arm was fine and could move it but near her collarbone and neck area very swollen and painful on left side
Age: 0.33
Sex: F
Vaccine: DTAPIPVHIB, HIBV
Symptoms: Body temperature increased, Extra dose administered, Feeling abnormal, Lethargy
Clinical narrative: pt was given 2 doses of the HIB by mistake due to combo vaccine. pt develped high temperature, lethargy and increased fussiness