chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Sex: U
Vaccine: VARCEL
Symptoms: No adverse event, Product storage error
Clinical narrative: This spontaneous report was received from a registered nurse concerning an unspecified patient of unknown age and gender. The patient's concurrent conditions and medical history were not provided. On an unknown date, the patient was vaccinated with an improperly stored dose of VARIVAX (lot # N017698; expiration date: 09-JUN-2019) or (lot # N017701; expiration date: 09-JUN-2019) for prophylaxis, which had a temperature excursion of 6F to 14F for 2 hours 12 minutes on an unknown date. Previous temperature excursions included the same previous temperature for 2 hours 48 minutes and 15F to 46F for 1 hour 59 minutes. The digital data logger was involved in recording the temperature excursion. The vaccine was reconstituted with properly stored dose of Merck sterile diluent. No adverse effect was reported. No product quality complaint was involved. This is one of the several reports from the same source. Sender's Comments: US-009507513-1801USA005992.
Sex: U
Vaccine: VARCEL
Symptoms: No adverse event, Product storage error
Clinical narrative: This spontaneous report was received from a registered nurse concerning an unspecified patient of unknown age and gender. The patient's concurrent conditions and medical history were not provided.  On an unknown date, the patient was vaccinated with an improperly stored dose of VARIVAX (lot # N017698; expiration date: 09-JUN-2019)  or  (lot # N017701; expiration date: 09-JUN-2019) for prophylaxis, which had a temperature excursion of 6F to 14F for 2 hours 12 minutes on an unknown date. Previous temperature excursions included the same previous temperature for 2 hours 48 minutes and 15F to 46F for 1 hour 59 minutes. The digital data logger was involved in recording the temperature excursion. The vaccine was reconstituted with properly stored dose of sterile diluent (MERCK STERILE DILUENT). No adverse effect was reported. No product quality complaint was involved. This is one of the several reports from the same source.; Sender's Comments: US-009507513-1801USA005992:
Sex: U
Vaccine: VARCEL
Symptoms: Liquid product physical issue, No adverse event
Clinical narrative: This spontaneous report as received from a physician refers to a patient of unknown age and gender. On an unknown date, the patient had to reschedule a visit to receive a dose of VARIVAX due to the cloudy appearance of the vaccine (Product appearance cloudy, product quality issue). PQC (product quality complaint) was filed. No adverse effects were reported.
Sex: F
Vaccine: HPV9
Symptoms: Fatigue, Pyrexia
Clinical narrative: This spontaneous report as received from a nurse practitioner via a company representative refers to a 17 year old female patient. The patient's pertinent medical history, drug reaction or allergies and concomitant therapies were not reported. On an unknown date, the patient was vaccinated with the first dose of GARDASIL 9 (dosing details, lot # and expiry date unknown) for prophylaxis. On an unknown date, the patient developed a fever and fatigue. The outcome of fatigue and pyrexia was unknown. Causality assessment was not provided by the reporter. Product quality complaint (PQC) was not involved.
Age: 18.0
Sex: F
Vaccine: MENB
Symptoms: Erythema, Pain, Rash macular
Clinical narrative: Splotchy, red, and painful.
Age: 14.0
Sex: F
Vaccine: HPV4
Symptoms: Acupuncture, Blood test, Depression, Electroencephalogram, Nuclear magnetic resonance imaging
Clinical narrative: Depression, suicide, seizures ( after second dose).
Age: 14.0
Sex: F
Vaccine: HPV4
Symptoms: Seizure, Suicidal ideation
Clinical narrative: Depression, suicide, seizures ( after second dose).
Age: 60.0
Sex: F
Vaccine: VARZOS, VARZOS
Symptoms: Abnormal dreams, Influenza virus test negative, Middle insomnia, Pyrexia, Tachycardia
Clinical narrative: Woke up in middle of night (midnight) with tachycardia, weird dreams, and felt feverish. Patient's temperature on Sunday morning was 101.8 (F). Went to urgent care to get tested for influenza, but test came back negative.
Age: 60.0
Sex: F
Vaccine: VARZOS, VARZOS
Symptoms: Abnormal dreams, Asthenia, Bone pain, Feeling abnormal, Influenza virus test negative
Clinical narrative: Woke up in middle of night (midnight) with tachycardia, weird dreams, and felt feverish. Patient's temperature on Sunday morning was 101.8 (F). Went to urgent care to get tested for influenza, but test came back negative.
Age: 60.0
Sex: F
Vaccine: VARZOS, VARZOS
Symptoms: Musculoskeletal pain, Pain in extremity, Pruritus, Pyrexia, Tachycardia
Clinical narrative: Woke up in middle of night (midnight) with tachycardia, weird dreams, and felt feverish. Patient's temperature on Sunday morning was 101.8 (F). Went to urgent care to get tested for influenza, but test came back negative.
Age: 60.0
Sex: F
Vaccine: VARZOS, VARZOS
Symptoms: Vision blurred
Clinical narrative: Woke up in middle of night (midnight) with tachycardia, weird dreams, and felt feverish. Patient's temperature on Sunday morning was 101.8 (F). Went to urgent care to get tested for influenza, but test came back negative.
Age: 60.0
Sex: F
Vaccine: VARZOS, VARZOS
Symptoms: Abnormal dreams, Influenza virus test negative, Middle insomnia, Pyrexia, Tachycardia
Clinical narrative: Fever of 102 degrees F, weakness, blurred vision, fogginess, tachycardia, pain in arm radiating into collarbone and shoulder, hives covering entire upper arm with pain and itching, vivid bizarre dreams.
Age: 60.0
Sex: F
Vaccine: VARZOS, VARZOS
Symptoms: Abnormal dreams, Asthenia, Bone pain, Feeling abnormal, Influenza virus test negative
Clinical narrative: Fever of 102 degrees F, weakness, blurred vision, fogginess, tachycardia, pain in arm radiating into collarbone and shoulder, hives covering entire upper arm with pain and itching, vivid bizarre dreams.
Age: 60.0
Sex: F
Vaccine: VARZOS, VARZOS
Symptoms: Musculoskeletal pain, Pain in extremity, Pruritus, Pyrexia, Tachycardia
Clinical narrative: Fever of 102 degrees F, weakness, blurred vision, fogginess, tachycardia, pain in arm radiating into collarbone and shoulder, hives covering entire upper arm with pain and itching, vivid bizarre dreams.
Age: 60.0
Sex: F
Vaccine: VARZOS, VARZOS
Symptoms: Vision blurred
Clinical narrative: Fever of 102 degrees F, weakness, blurred vision, fogginess, tachycardia, pain in arm radiating into collarbone and shoulder, hives covering entire upper arm with pain and itching, vivid bizarre dreams.
Age: 59.0
Sex: F
Vaccine: FLU3
Symptoms: Injected limb mobility decreased, Insomnia, Pain in extremity, X-ray
Clinical narrative: Had flu shot on 1/19/2018 that evening arm really hurt and could not lift left arm I waited for 3 days and still hurting went back to doctor office on 1-22-2018 was told to take aleve and put heating pad, I did that another week and at this point i could not sleep or lift arm at all went back to doctor and she refered me to a ortho doctor he done xrays and could not say it was from shot he prescribed Prednisone for 7 days and that I should have been using ice not heat and if that did not work that i may need a cordizone shot  and possible physical therapy.
Age: 0.5
Sex: F
Vaccine: DTAPIPVHIB, FLU4, PNC13, RV5
Symptoms: Body temperature increased
Clinical narrative: Per Mom, patient developed temp of 100.3 the morning after the vaccinations were administered. Denies other symptoms. Advised to give tylenol every 4-6hr PRN and to call back with new/worsening symptoms/questions.
Age: 4.0
Sex: F
Vaccine: DTAPIPV, FLU4
Symptoms: Injection site bruising, Injection site erythema, Injection site swelling
Clinical narrative: Two days after vaccine administration, patient developed redness, swelling and bruising to her left arm. Advised to use ice and otc pain relievers prn. Patient seen for sick visit that day and was cleared by MD.
Age: 72.0
Sex: M
Vaccine: PPV
Symptoms: Erythema, Swelling
Clinical narrative: Pt returned to pharmacy on 2-24 and rph advised patient to apply ice pack to lessen swelling. Pt returned on 2-27 and stated that he had gone hiking and the arm continued to get worse and redness spread down his arm. He went to the hospital and was given IV antibiotics, then oral Bactrim DS (per record). He stated on 2-27 that it was beginning to resolve. I observed for the first time and redness was throughout lower arm starting at the elbow. Patient had been to PCP and she said it was getting better.
Age: 71.0
Sex: F
Vaccine: VARZOS
Symptoms: Headache, Pruritus, Rash, Swelling
Clinical narrative: The patient stated the reaction occurred the following day. Stated under her neck became swollen, developed bumps under her neck, severe itching under her neck and developed a headache. She stated she took BENADRYL to stop the itching and help decrease the swelling. She stated that under her neck is still swollen a little today.
Age: 22.0
Sex: F
Vaccine: MMR
Symptoms: Injection site pain, Injection site warmth, Pain in extremity, Peripheral swelling
Clinical narrative: PT RETURNED TO CLINIC ON 02/27/2018 WITH COMPLAINTS OF SWELLING AND PAIN IN LEFT ARM. PT HAS A SMALL CIRCLE AROUND APPROXIMATE INJECTION SITE, WARM TO TOUCH.  PT STATES IT IS PAINFUL AND UNABLE TO LAY ON THAT SIDE AT NIGHT. SYMPTOMS STARTED 2-3 DAYS BEFORE RETURNING BACK TO CLINIC. PT DENIES ANY INJURIES TO THE ARM OR ANY OTHER VACCINES. PT HAS NOT SEEN AN MD. REFERRED HER TO THE PMC CLINIC OR THE AFTER HOURS CLINIC.
Age: 18.0
Sex: M
Vaccine: MNQ
Symptoms: Balance disorder, Body temperature increased, Cardiovascular evaluation, Dermatologic examination, Fatigue
Clinical narrative: Received MENACTRA vaccine on Thursday and he felt fine on Thursday and Friday. Then Saturday felt like lungs were sore, 100.0 Temp alternately cold and hot, and felt drained. Had intermittent off balance. Currently in exam room without fever, VSS, Pulse Ox 98% room air.
Age: 18.0
Sex: M
Vaccine: MNQ
Symptoms: Feeling of body temperature change, Neurological examination, Pulmonary pain
Clinical narrative: Received MENACTRA vaccine on Thursday and he felt fine on Thursday and Friday. Then Saturday felt like lungs were sore, 100.0 Temp alternately cold and hot, and felt drained. Had intermittent off balance. Currently in exam room without fever, VSS, Pulse Ox 98% room air.
Age: 60.0
Sex: M
Vaccine: PPV
Symptoms: Injection site bruising, Injection site pain
Clinical narrative: Bruise on site of injection very bad pain on the underside of left arm. Not at all like my past Flu shots! pain lasted two days.
Age: 82.0
Sex: F
Vaccine: VARZOS, VARZOS
Symptoms: Biopsy skin abnormal, Hypersensitivity vasculitis, Macule, Pallor, Rash
Clinical narrative: Developed pruritic rash on bilateral lower extremities. Rash evaluated on 2/15, blanchiry, erythematous macules. Increasing area of legs involved on 2/16 so patient returned to office for revaluation, had nonblanchiry macules. Biopsy done on 2/16. Patch report showed leukocytoclastic vasculitis. Rash resolved over following 5 days.
Age: 82.0
Sex: F
Vaccine: VARZOS, VARZOS
Symptoms: Rash macular, Rash pruritic
Clinical narrative: Developed pruritic rash on bilateral lower extremities. Rash evaluated on 2/15, blanchiry, erythematous macules. Increasing area of legs involved on 2/16 so patient returned to office for revaluation, had nonblanchiry macules. Biopsy done on 2/16. Patch report showed leukocytoclastic vasculitis. Rash resolved over following 5 days.
Age: 82.0
Sex: F
Vaccine: VARZOS, VARZOS
Symptoms: Biopsy skin abnormal, Erythema, Hypersensitivity vasculitis, Macule, Pallor
Clinical narrative: Developed pruritic rash on bilateral lower extremities. Rash evaluated on 2/15, blanchiry, erythematous macules. Increasing area of legs involved on 2/16 so patient returned to office for revaluation, had nonblanchiry macules. Biopsy done on 2/16. Patch report showed leukocytoclastic vasculitis. Rash resolved over following 5 days.
Age: 82.0
Sex: F
Vaccine: VARZOS, VARZOS
Symptoms: Rash, Rash macular, Rash pruritic, Skin test negative
Clinical narrative: Developed pruritic rash on bilateral lower extremities. Rash evaluated on 2/15, blanchiry, erythematous macules. Increasing area of legs involved on 2/16 so patient returned to office for revaluation, had nonblanchiry macules. Biopsy done on 2/16. Patch report showed leukocytoclastic vasculitis. Rash resolved over following 5 days.
Age: 16.0
Sex: F
Vaccine: HPV9, MENB, MNQ
Symptoms: Fall, Head injury, Headache, Immediate post-injection reaction, Intensive care
Clinical narrative: Patient with a history of syncope, anxiety, and depression received vaccines at approximately 0900. Immediately after receiving last vaccine HPV patient fell forward hitting her forehead on the ground from a 3 feet fall. She was "out cold" ashen color, cool extremities. Never lost pulse, vital signs WNL times taken 0906, 0910, 0919. Patient did not have breakfast this morning. Rapid response was called and patient transferred to PICU. Loss of consciousness reported to be less than 30 seconds. Patient was alert and oriented but with headache. She was monitored in the PICU with every hour neurochecks. All of which were normal. She was on telemetry with showed no abnormalities. TYLENOL was given for pain. C-collar was cleared and patient was able to eat and drink without difficultly. She walked throughout the unit without any dizziness. Patient was released mid afternoon that same day. With instructions to follow up with PCP to determine need for concussion clinic.
Age: 16.0
Sex: F
Vaccine: HPV9, MENB, MNQ
Symptoms: Loss of consciousness, Pain, Pallor, Peripheral coldness
Clinical narrative: Patient with a history of syncope, anxiety, and depression received vaccines at approximately 0900. Immediately after receiving last vaccine HPV patient fell forward hitting her forehead on the ground from a 3 feet fall. She was "out cold" ashen color, cool extremities. Never lost pulse, vital signs WNL times taken 0906, 0910, 0919. Patient did not have breakfast this morning. Rapid response was called and patient transferred to PICU. Loss of consciousness reported to be less than 30 seconds. Patient was alert and oriented but with headache. She was monitored in the PICU with every hour neurochecks. All of which were normal. She was on telemetry with showed no abnormalities. TYLENOL was given for pain. C-collar was cleared and patient was able to eat and drink without difficultly. She walked throughout the unit without any dizziness. Patient was released mid afternoon that same day. With instructions to follow up with PCP to determine need for concussion clinic.
Age: 29.0
Sex: F
Vaccine: FLUC4
Symptoms: Rash, Skin warm, Swelling
Clinical narrative: Rash spreading across arm, swelling, hot.
Age: 23.0
Sex: M
Vaccine: HPV9, HPV9
Symptoms: Influenza, Pyrexia
Clinical narrative: Subject is enrolled on a clinical trial that is evaluating the nonavalent HPV vaccine in cancer survivor and received HPV Vaccine Dose #3 on 2/14/18. On 2/18/18, subject developed a severe fever (to 103.5degreesF) and took TYLENOL. On 2/19/18, subject saw their doctor and was diagnosed with the flu and treated with TAMIFLU. Symptoms have since resolved.
Age: 23.0
Sex: M
Vaccine: HPV9, HPV9
Symptoms: Acute myeloid leukaemia, Death, Second primary malignancy
Clinical narrative: Subject is enrolled on a clinical trial that is evaluating the nonavalent HPV vaccine in cancer survivor and received HPV Vaccine Dose #3 on 2/14/18. On 2/18/18, subject developed a severe fever (to 103.5degreesF) and took TYLENOL. On 2/19/18, subject saw their doctor and was diagnosed with the flu and treated with TAMIFLU. Symptoms have since resolved.
Age: 16.0
Sex: M
Vaccine: MNQ
Symptoms: Dizziness, Hyperhidrosis, Pallor
Clinical narrative: Patient felt faint, was diaphoretic, and pale 10:15 AM Blood Pressure 82/45 Pulse 52. Patient given juice and water. Patient's Mother was called 10:35 AM Patient Blood Pressure 84/63 Pulse 60.
Age: 1.08
Sex: M
Vaccine: MMR
Symptoms: Rash generalised
Clinical narrative: Patient presented to the office 10 days after receiving MMR vaccine with c/o head-toe rash. Patient was also currently being treated for AOM and taking Amox. It is unknown whether a reaction form vaccine or Amox.
Age: 16.0
Sex: F
Vaccine: MNQ
Symptoms: Presyncope
Clinical narrative: Patient nearly fainted, first Blood Pressure 62/48 Pulse 47. Given apple juice and Patient's mother was called. Second Blood Pressure 93/50 Pulse 60.
Age: 60.0
Sex: M
Vaccine: VARZOS
Symptoms: Immediate post-injection reaction, Myalgia, Pyrexia
Clinical narrative: Immediate musuclar pain down entire left arm radiating to the shoulder and the neck, continuing 3 days later. Low grade fever upon awakening the next morning.
Sex: F
Vaccine: VARZOS
Symptoms: Burning sensation, Chest pain, Erythema, Induration, Malaise
Clinical narrative: This spontaneous report as received from a physician via a field representative refers to a female patient of unknown age. The patient's medical history, concurrent condition and concomitant medications were not reported. On an unknown date (also reported as "many years ago"), the patient was vaccinated with ZOSTAVAX (lot # and expiry date were unknown), intramuscular for immunisation. Other suspect therapies included SHINGRIX (lot # and expiry date were unknown) which the patient was administered on 19-FEB-2018. Approximately on an unknown date in February 2018 (also reported as soon as she got the vaccine), the patient had severe burning that was going up and down the left arm, that went across the chest and the sternum. It was reported that the patient also felt sick the next day with general malaise. The patient also had a hard induration that was red and very painful. The patient was still in severe pain. The outcome of malaise, pain, erythema, induration, chest pain and burning sensation was reported as not recovered. Causality assessment was not provided by reporter.
Sex: F
Vaccine: VARZOS
Symptoms: Pain
Clinical narrative: This spontaneous report as received from a physician via a field representative refers to a female patient of unknown age. The patient's medical history, concurrent condition and concomitant medications were not reported. On an unknown date (also reported as "many years ago"), the patient was vaccinated with ZOSTAVAX (lot # and expiry date were unknown), intramuscular for immunisation. Other suspect therapies included SHINGRIX (lot # and expiry date were unknown) which the patient was administered on 19-FEB-2018. Approximately on an unknown date in February 2018 (also reported as soon as she got the vaccine), the patient had severe burning that was going up and down the left arm, that went across the chest and the sternum. It was reported that the patient also felt sick the next day with general malaise. The patient also had a hard induration that was red and very painful. The patient was still in severe pain. The outcome of malaise, pain, erythema, induration, chest pain and burning sensation was reported as not recovered. Causality assessment was not provided by reporter.
Sex: U
Vaccine: HPV4
Symptoms: No adverse event
Clinical narrative: This spontaneous report as received from a pharmacist refers to a adult patient of unknown age and gender. The patient's medical history, concurrent condition and concomitant medications were not reported. Pharmacist reported that the patient received the first dose of GARDASIL on 04-JUN-2007 and received the second dose of GARDASIL on 09-JUL-2007, at an unspecified healthcare provider. Pharmacist reported patient was 21 years of age, when patient received the first two doses of GARDASIL (inappropriate schedule of drug administration). No adverse effects were reported. No further information was provided.
Age: 11.0
Sex: F
Vaccine: HPV9, MNQ, TDAP
Symptoms: Dizziness, Muscle twitching, Nausea, Pallor, Syncope
Clinical narrative: After receiving vaccines, patient walked about 15 feet when she suddenly felt nauseated and dizzy. She sat down and appeared pale. She was provided with water and a lollipop. After 2 minutes, she stated she felt better. She walked another 15 feet to the front office desk when she then collapsed into her mother's arms. She was carried to an exam room and laid on an exam table with her legs elevated She was alert and oriented. She was provided with more water. About 10 minutes later, it was noticed that the muscles in her arms were twitching. She stated her legs muscles were also twitching. Patient denied feeling cold, but was covered with a sweater anyways. After 20 minutes, she felt well enough to sit up and that her twitching was getting better. Denied nausea or dizziness. After 10 minutes of sitting, patient felt well enough to stand and stated that her twitching was mostly gone. She was able to walk around exam room without difficulty and felt well enough to leave.
Age: 50.0
Sex: F
Vaccine: FLU3
Symptoms: Musculoskeletal pain, Pain in extremity, X-ray limb
Clinical narrative: Left arm/ shoulder pain.
Age: 59.0
Sex: F
Vaccine: PNC13
Symptoms: Injection site erythema, Injection site pain, Injection site warmth, Pain in extremity
Clinical narrative: I was fine day of injection just normal soreness to left arm after it. Site fine next morning and afternoon. About 7 PM on Feb 15, dime size redness started and continued to enlarge and feel warm and painful, like cellulitis. Redness had increased to 1/3 of upper arm in an hr. Even family member said yes it is growing in redness. Never itched. Took TYLENOL for pain. I am an RN. Called MD next day and made appt. Dr marked it and said delayed reaction of redness SE to vaccine. I continued to take TYLENOL and than applied a lot of OTC cortisone for 2 days before it went away.
Age: 46.0
Sex: F
Vaccine: PPV
Symptoms: Erythema, Pain, Swelling
Clinical narrative: Swelling, pain, redness.
Age: 70.0
Sex: F
Vaccine: PNC13, TDAP
Symptoms: Headache, Injection site erythema, Injection site swelling, Injection site warmth, Pain
Clinical narrative: PATIENT REPORTED SWELLING AND REDNESS AT BOTH SITES, HOWEVER, TDAP SITE LOOKED OK UPON EXAM TODAY. PCV13 SITE TO RIGHT ARM WAS SWOLLEN WITH ERYTHEMA APPROXIMATELY 10CMX10CM AND WARM TO TOUCH. PATIENT HAS KEPT A HEADACHE INTERMITTENTLY WITH BODY ACHES AND LOW GRADE FEVER OF 100 INTERMITTENTLY AS WELL.
Age: 70.0
Sex: F
Vaccine: PNC13, TDAP
Symptoms: Pyrexia
Clinical narrative: PATIENT REPORTED SWELLING AND REDNESS AT BOTH SITES, HOWEVER, TDAP SITE LOOKED OK UPON EXAM TODAY. PCV13 SITE TO RIGHT ARM WAS SWOLLEN WITH ERYTHEMA APPROXIMATELY 10CMX10CM AND WARM TO TOUCH. PATIENT HAS KEPT A HEADACHE INTERMITTENTLY WITH BODY ACHES AND LOW GRADE FEVER OF 100 INTERMITTENTLY AS WELL.
Age: 69.0
Sex: F
Vaccine: FLU3
Symptoms: Axillary pain, Myalgia, Pain in extremity
Clinical narrative: Soreness continuing in right arm muscle and in underarm and all the way down arm into hand at times after 2 weeks. Motion and use not limited except being careful because of aggravating soreness.
Age: 1.92
Sex: M
Vaccine: FLU4, HEPA
Symptoms: Abdominal pain, Acute disseminated encephalomyelitis, Ataxia, Bruxism, Chills
Clinical narrative: Hepatitis A vaccine Influenza vaccine Developed likely ADEM (acute disseminated meningoencephalitis) From Admission Note: Patient was in his usual state of health until the evening of 2/21 when he started with retching, abdominal pain, back arching, NBNB vomiting, diarrhea. Yesterday, 2/22, he continued to have a few episodes of NBNB emesis and diarrhea. The family called the PCP, who recommended supportive care at home. This morning at 7:30am (2/23) he woke up from sleep and was crying, had a small mucous vomit, then had a 15min seizure (bruxism and teeth chattering, eye deviation up and right, whole body shivering/shaking, minimally responsive). Otherwise he was recently well, fully vaccinated, no sick contacts, no fevers. No toxin exposures. Had vaccines a few weeks ago, had an elevated lead level of 9 planned to follow with the PCP. No recent traumas. He recently spent the last 5 months away from home and returned a few weeks ago. No FH of seizures or neurologic conditions. The family called EMS, per report the shaking seemed to have subsided by EMS arrival however patient was post-ictal. He was transported to hospital. There he had stable VS, irritable. He had a non-con CT that was reportedly normal. Labs with WBC 18, otherwise CBC normal, BMP normal, LFTs normal, no blood culture. Received 20cc/kg of NS. He was transferred to another hospital for ongoing care. In the ED, he was slightly post-ictal and not encephalopathy, responsive, apprehensive with caregivers, nonfocal neuro exam except for mild ataxia (vs peripheral IV in foot). He was tolerating PO. Abdominal US in ED was also negative. He also had a spot EEG which showed some possible L temporal slowing, non-epileptogenic. He was admitted to the floor for monitoring for unprovoked seizure. On the floor this afternoon, he has been slightly "sleepy" but interactive and arousable with a non-focal exam. Around 5:30pm today, he had a 15 min seizure (R eye deviation, unresponsive, intermittent whining sounds, bruxism, shaking, lip tremulousness). He had emesis with desat to 87% placed on the non-rebreather. Treated with 0.1mg/kg ativan with resolution of the seizures. Afterwards was post-ictal with some upper extremity posturing and overall rigidity and hypertonicity. He gradually recovered. By 6:30pm had R gaze preference but minimal residual rigidity. He had a full brain MRI which showed multiple areas of T2 hyperintense signal encephalitis/meningitis. He was admitted to PICU for monitoring and ongoing care, LP, acyclovir, antibiotics, and workup as per plan. His infectious studies including HSV PCR have been negative to date. He is receiving treatment with high dose IV steroids for presumed ADEM.
Age: 1.92
Sex: M
Vaccine: FLU4, HEPA
Symptoms: Crying, Diarrhoea, Electroencephalogram abnormal, Full blood count normal, Gaze palsy
Clinical narrative: Hepatitis A vaccine Influenza vaccine Developed likely ADEM (acute disseminated meningoencephalitis) From Admission Note: Patient was in his usual state of health until the evening of 2/21 when he started with retching, abdominal pain, back arching, NBNB vomiting, diarrhea. Yesterday, 2/22, he continued to have a few episodes of NBNB emesis and diarrhea. The family called the PCP, who recommended supportive care at home. This morning at 7:30am (2/23) he woke up from sleep and was crying, had a small mucous vomit, then had a 15min seizure (bruxism and teeth chattering, eye deviation up and right, whole body shivering/shaking, minimally responsive). Otherwise he was recently well, fully vaccinated, no sick contacts, no fevers. No toxin exposures. Had vaccines a few weeks ago, had an elevated lead level of 9 planned to follow with the PCP. No recent traumas. He recently spent the last 5 months away from home and returned a few weeks ago. No FH of seizures or neurologic conditions. The family called EMS, per report the shaking seemed to have subsided by EMS arrival however patient was post-ictal. He was transported to hospital. There he had stable VS, irritable. He had a non-con CT that was reportedly normal. Labs with WBC 18, otherwise CBC normal, BMP normal, LFTs normal, no blood culture. Received 20cc/kg of NS. He was transferred to another hospital for ongoing care. In the ED, he was slightly post-ictal and not encephalopathy, responsive, apprehensive with caregivers, nonfocal neuro exam except for mild ataxia (vs peripheral IV in foot). He was tolerating PO. Abdominal US in ED was also negative. He also had a spot EEG which showed some possible L temporal slowing, non-epileptogenic. He was admitted to the floor for monitoring for unprovoked seizure. On the floor this afternoon, he has been slightly "sleepy" but interactive and arousable with a non-focal exam. Around 5:30pm today, he had a 15 min seizure (R eye deviation, unresponsive, intermittent whining sounds, bruxism, shaking, lip tremulousness). He had emesis with desat to 87% placed on the non-rebreather. Treated with 0.1mg/kg ativan with resolution of the seizures. Afterwards was post-ictal with some upper extremity posturing and overall rigidity and hypertonicity. He gradually recovered. By 6:30pm had R gaze preference but minimal residual rigidity. He had a full brain MRI which showed multiple areas of T2 hyperintense signal encephalitis/meningitis. He was admitted to PICU for monitoring and ongoing care, LP, acyclovir, antibiotics, and workup as per plan. His infectious studies including HSV PCR have been negative to date. He is receiving treatment with high dose IV steroids for presumed ADEM.
Age: 1.92
Sex: M
Vaccine: FLU4, HEPA
Symptoms: Herpes simplex test negative, Hypertonia, Hyporesponsive to stimuli, Intensive care, Irritability
Clinical narrative: Hepatitis A vaccine Influenza vaccine Developed likely ADEM (acute disseminated meningoencephalitis) From Admission Note: Patient was in his usual state of health until the evening of 2/21 when he started with retching, abdominal pain, back arching, NBNB vomiting, diarrhea. Yesterday, 2/22, he continued to have a few episodes of NBNB emesis and diarrhea. The family called the PCP, who recommended supportive care at home. This morning at 7:30am (2/23) he woke up from sleep and was crying, had a small mucous vomit, then had a 15min seizure (bruxism and teeth chattering, eye deviation up and right, whole body shivering/shaking, minimally responsive). Otherwise he was recently well, fully vaccinated, no sick contacts, no fevers. No toxin exposures. Had vaccines a few weeks ago, had an elevated lead level of 9 planned to follow with the PCP. No recent traumas. He recently spent the last 5 months away from home and returned a few weeks ago. No FH of seizures or neurologic conditions. The family called EMS, per report the shaking seemed to have subsided by EMS arrival however patient was post-ictal. He was transported to hospital. There he had stable VS, irritable. He had a non-con CT that was reportedly normal. Labs with WBC 18, otherwise CBC normal, BMP normal, LFTs normal, no blood culture. Received 20cc/kg of NS. He was transferred to another hospital for ongoing care. In the ED, he was slightly post-ictal and not encephalopathy, responsive, apprehensive with caregivers, nonfocal neuro exam except for mild ataxia (vs peripheral IV in foot). He was tolerating PO. Abdominal US in ED was also negative. He also had a spot EEG which showed some possible L temporal slowing, non-epileptogenic. He was admitted to the floor for monitoring for unprovoked seizure. On the floor this afternoon, he has been slightly "sleepy" but interactive and arousable with a non-focal exam. Around 5:30pm today, he had a 15 min seizure (R eye deviation, unresponsive, intermittent whining sounds, bruxism, shaking, lip tremulousness). He had emesis with desat to 87% placed on the non-rebreather. Treated with 0.1mg/kg ativan with resolution of the seizures. Afterwards was post-ictal with some upper extremity posturing and overall rigidity and hypertonicity. He gradually recovered. By 6:30pm had R gaze preference but minimal residual rigidity. He had a full brain MRI which showed multiple areas of T2 hyperintense signal encephalitis/meningitis. He was admitted to PICU for monitoring and ongoing care, LP, acyclovir, antibiotics, and workup as per plan. His infectious studies including HSV PCR have been negative to date. He is receiving treatment with high dose IV steroids for presumed ADEM.
Age: 1.92
Sex: M
Vaccine: FLU4, HEPA
Symptoms: Liver function test normal, Metabolic function test normal, Muscle rigidity, Mycoplasma test, Neurological examination abnormal
Clinical narrative: Hepatitis A vaccine Influenza vaccine Developed likely ADEM (acute disseminated meningoencephalitis) From Admission Note: Patient was in his usual state of health until the evening of 2/21 when he started with retching, abdominal pain, back arching, NBNB vomiting, diarrhea. Yesterday, 2/22, he continued to have a few episodes of NBNB emesis and diarrhea. The family called the PCP, who recommended supportive care at home. This morning at 7:30am (2/23) he woke up from sleep and was crying, had a small mucous vomit, then had a 15min seizure (bruxism and teeth chattering, eye deviation up and right, whole body shivering/shaking, minimally responsive). Otherwise he was recently well, fully vaccinated, no sick contacts, no fevers. No toxin exposures. Had vaccines a few weeks ago, had an elevated lead level of 9 planned to follow with the PCP. No recent traumas. He recently spent the last 5 months away from home and returned a few weeks ago. No FH of seizures or neurologic conditions. The family called EMS, per report the shaking seemed to have subsided by EMS arrival however patient was post-ictal. He was transported to hospital. There he had stable VS, irritable. He had a non-con CT that was reportedly normal. Labs with WBC 18, otherwise CBC normal, BMP normal, LFTs normal, no blood culture. Received 20cc/kg of NS. He was transferred to another hospital for ongoing care. In the ED, he was slightly post-ictal and not encephalopathy, responsive, apprehensive with caregivers, nonfocal neuro exam except for mild ataxia (vs peripheral IV in foot). He was tolerating PO. Abdominal US in ED was also negative. He also had a spot EEG which showed some possible L temporal slowing, non-epileptogenic. He was admitted to the floor for monitoring for unprovoked seizure. On the floor this afternoon, he has been slightly "sleepy" but interactive and arousable with a non-focal exam. Around 5:30pm today, he had a 15 min seizure (R eye deviation, unresponsive, intermittent whining sounds, bruxism, shaking, lip tremulousness). He had emesis with desat to 87% placed on the non-rebreather. Treated with 0.1mg/kg ativan with resolution of the seizures. Afterwards was post-ictal with some upper extremity posturing and overall rigidity and hypertonicity. He gradually recovered. By 6:30pm had R gaze preference but minimal residual rigidity. He had a full brain MRI which showed multiple areas of T2 hyperintense signal encephalitis/meningitis. He was admitted to PICU for monitoring and ongoing care, LP, acyclovir, antibiotics, and workup as per plan. His infectious studies including HSV PCR have been negative to date. He is receiving treatment with high dose IV steroids for presumed ADEM.
Age: 1.92
Sex: M
Vaccine: FLU4, HEPA
Symptoms: Nuclear magnetic resonance imaging brain abnormal, Opisthotonus, Oxygen saturation decreased, Polymerase chain reaction, Postictal state
Clinical narrative: Hepatitis A vaccine Influenza vaccine Developed likely ADEM (acute disseminated meningoencephalitis) From Admission Note: Patient was in his usual state of health until the evening of 2/21 when he started with retching, abdominal pain, back arching, NBNB vomiting, diarrhea. Yesterday, 2/22, he continued to have a few episodes of NBNB emesis and diarrhea. The family called the PCP, who recommended supportive care at home. This morning at 7:30am (2/23) he woke up from sleep and was crying, had a small mucous vomit, then had a 15min seizure (bruxism and teeth chattering, eye deviation up and right, whole body shivering/shaking, minimally responsive). Otherwise he was recently well, fully vaccinated, no sick contacts, no fevers. No toxin exposures. Had vaccines a few weeks ago, had an elevated lead level of 9 planned to follow with the PCP. No recent traumas. He recently spent the last 5 months away from home and returned a few weeks ago. No FH of seizures or neurologic conditions. The family called EMS, per report the shaking seemed to have subsided by EMS arrival however patient was post-ictal. He was transported to hospital. There he had stable VS, irritable. He had a non-con CT that was reportedly normal. Labs with WBC 18, otherwise CBC normal, BMP normal, LFTs normal, no blood culture. Received 20cc/kg of NS. He was transferred to another hospital for ongoing care. In the ED, he was slightly post-ictal and not encephalopathy, responsive, apprehensive with caregivers, nonfocal neuro exam except for mild ataxia (vs peripheral IV in foot). He was tolerating PO. Abdominal US in ED was also negative. He also had a spot EEG which showed some possible L temporal slowing, non-epileptogenic. He was admitted to the floor for monitoring for unprovoked seizure. On the floor this afternoon, he has been slightly "sleepy" but interactive and arousable with a non-focal exam. Around 5:30pm today, he had a 15 min seizure (R eye deviation, unresponsive, intermittent whining sounds, bruxism, shaking, lip tremulousness). He had emesis with desat to 87% placed on the non-rebreather. Treated with 0.1mg/kg ativan with resolution of the seizures. Afterwards was post-ictal with some upper extremity posturing and overall rigidity and hypertonicity. He gradually recovered. By 6:30pm had R gaze preference but minimal residual rigidity. He had a full brain MRI which showed multiple areas of T2 hyperintense signal encephalitis/meningitis. He was admitted to PICU for monitoring and ongoing care, LP, acyclovir, antibiotics, and workup as per plan. His infectious studies including HSV PCR have been negative to date. He is receiving treatment with high dose IV steroids for presumed ADEM.
Age: 1.92
Sex: M
Vaccine: FLU4, HEPA
Symptoms: Posturing, Retching, Secretion discharge, Seizure, Somnolence
Clinical narrative: Hepatitis A vaccine Influenza vaccine Developed likely ADEM (acute disseminated meningoencephalitis) From Admission Note: Patient was in his usual state of health until the evening of 2/21 when he started with retching, abdominal pain, back arching, NBNB vomiting, diarrhea. Yesterday, 2/22, he continued to have a few episodes of NBNB emesis and diarrhea. The family called the PCP, who recommended supportive care at home. This morning at 7:30am (2/23) he woke up from sleep and was crying, had a small mucous vomit, then had a 15min seizure (bruxism and teeth chattering, eye deviation up and right, whole body shivering/shaking, minimally responsive). Otherwise he was recently well, fully vaccinated, no sick contacts, no fevers. No toxin exposures. Had vaccines a few weeks ago, had an elevated lead level of 9 planned to follow with the PCP. No recent traumas. He recently spent the last 5 months away from home and returned a few weeks ago. No FH of seizures or neurologic conditions. The family called EMS, per report the shaking seemed to have subsided by EMS arrival however patient was post-ictal. He was transported to hospital. There he had stable VS, irritable. He had a non-con CT that was reportedly normal. Labs with WBC 18, otherwise CBC normal, BMP normal, LFTs normal, no blood culture. Received 20cc/kg of NS. He was transferred to another hospital for ongoing care. In the ED, he was slightly post-ictal and not encephalopathy, responsive, apprehensive with caregivers, nonfocal neuro exam except for mild ataxia (vs peripheral IV in foot). He was tolerating PO. Abdominal US in ED was also negative. He also had a spot EEG which showed some possible L temporal slowing, non-epileptogenic. He was admitted to the floor for monitoring for unprovoked seizure. On the floor this afternoon, he has been slightly "sleepy" but interactive and arousable with a non-focal exam. Around 5:30pm today, he had a 15 min seizure (R eye deviation, unresponsive, intermittent whining sounds, bruxism, shaking, lip tremulousness). He had emesis with desat to 87% placed on the non-rebreather. Treated with 0.1mg/kg ativan with resolution of the seizures. Afterwards was post-ictal with some upper extremity posturing and overall rigidity and hypertonicity. He gradually recovered. By 6:30pm had R gaze preference but minimal residual rigidity. He had a full brain MRI which showed multiple areas of T2 hyperintense signal encephalitis/meningitis. He was admitted to PICU for monitoring and ongoing care, LP, acyclovir, antibiotics, and workup as per plan. His infectious studies including HSV PCR have been negative to date. He is receiving treatment with high dose IV steroids for presumed ADEM.
Age: 1.92
Sex: M
Vaccine: FLU4, HEPA
Symptoms: Tremor, Ultrasound abdomen normal, Unresponsive to stimuli, Vomiting, White blood cell count increased
Clinical narrative: Hepatitis A vaccine Influenza vaccine Developed likely ADEM (acute disseminated meningoencephalitis) From Admission Note: Patient was in his usual state of health until the evening of 2/21 when he started with retching, abdominal pain, back arching, NBNB vomiting, diarrhea. Yesterday, 2/22, he continued to have a few episodes of NBNB emesis and diarrhea. The family called the PCP, who recommended supportive care at home. This morning at 7:30am (2/23) he woke up from sleep and was crying, had a small mucous vomit, then had a 15min seizure (bruxism and teeth chattering, eye deviation up and right, whole body shivering/shaking, minimally responsive). Otherwise he was recently well, fully vaccinated, no sick contacts, no fevers. No toxin exposures. Had vaccines a few weeks ago, had an elevated lead level of 9 planned to follow with the PCP. No recent traumas. He recently spent the last 5 months away from home and returned a few weeks ago. No FH of seizures or neurologic conditions. The family called EMS, per report the shaking seemed to have subsided by EMS arrival however patient was post-ictal. He was transported to hospital. There he had stable VS, irritable. He had a non-con CT that was reportedly normal. Labs with WBC 18, otherwise CBC normal, BMP normal, LFTs normal, no blood culture. Received 20cc/kg of NS. He was transferred to another hospital for ongoing care. In the ED, he was slightly post-ictal and not encephalopathy, responsive, apprehensive with caregivers, nonfocal neuro exam except for mild ataxia (vs peripheral IV in foot). He was tolerating PO. Abdominal US in ED was also negative. He also had a spot EEG which showed some possible L temporal slowing, non-epileptogenic. He was admitted to the floor for monitoring for unprovoked seizure. On the floor this afternoon, he has been slightly "sleepy" but interactive and arousable with a non-focal exam. Around 5:30pm today, he had a 15 min seizure (R eye deviation, unresponsive, intermittent whining sounds, bruxism, shaking, lip tremulousness). He had emesis with desat to 87% placed on the non-rebreather. Treated with 0.1mg/kg ativan with resolution of the seizures. Afterwards was post-ictal with some upper extremity posturing and overall rigidity and hypertonicity. He gradually recovered. By 6:30pm had R gaze preference but minimal residual rigidity. He had a full brain MRI which showed multiple areas of T2 hyperintense signal encephalitis/meningitis. He was admitted to PICU for monitoring and ongoing care, LP, acyclovir, antibiotics, and workup as per plan. His infectious studies including HSV PCR have been negative to date. He is receiving treatment with high dose IV steroids for presumed ADEM.
Age: 4.0
Sex: M
Vaccine: DTAPIPV, MMRV
Symptoms: Injection site cellulitis
Clinical narrative: Cellulitis left thigh, treated through ED on 02/24/18, with Prednisone and oral antibiotic.
Age: 65.0
Sex: M
Vaccine: PPV
Symptoms: Injection site pain, Injection site swelling
Clinical narrative: Pt came in to get PNEUMOVAX vaccine, stated he had gotten PREVNAR 13 over a year ago.  Vaccine was administered in left arm, a little lower on arm due to clothing restrictions, but still was delivered IM. Pt came into pharmacy next day, reporting pain and swelling at injection site. Upon inspection, left arm was swollen and red. Pt stated onset happened last night and prevented sleep.  I advised pt to take Ibuoprofen, 400 mg every 4-6 hours to help with swelling. I asked him to keep me informed on his condition, and that if swelling was getting worse and hadn't improved with addition of ibuprofen or into the next day, to seek attention at an urgent care facility. Advised if any drowsiness or CNS side effects, then to seek immediate help/hospital. Of note, pt had actually received PNEUMOVAX 23 at a different facility 2-3 months prior, but wasn't aware until after side effect already occurred.
Age: 26.0
Sex: M
Vaccine: HEP
Symptoms: Loss of personal independence in daily activities, Vomiting
Clinical narrative: Stated vomiting and could not report to work on 2-27-18.
Age: 11.0
Sex: M
Vaccine: MNQ, TDAP
Symptoms: Expired product administered, No adverse event
Clinical narrative: 2/21/18 Went to enter vaccination into data system after it had been given earlier (2/19/18) and realized an expired dose (1/30/18) had been given to resident by LPN. Resident has shown no S/S of an adverse reaction to having received the expired vaccine. Both the CDC and Sanofi (manufacturer) stated that he wouldn't have any more of a reaction to the expired dose than one that would be non-expired; but that this dose would be considered - not effective and would need to be repeated later on. Dr. (campus PCP) does not want him vaccinated at this point. Will review his chart within the year, to determine when to re-vaccinate patient. Resident had the flu 2/4/18 and was treated w/TAMIFLU, SUDAFED and TYLENOL x 5 days. He was symptom free at time of vaccination when his yearly physical was completed on 2/13/2018.
Age: 18.0
Sex: F
Vaccine: MENB
Symptoms: Hypersensitivity
Clinical narrative: Local allergic reaction (5 cm). Pt given BENADRYL and TYLENOL. No wheeze, SOB or throat symptoms.
Age: 4.0
Sex: F
Vaccine: DTAPIPV, FLU4, HEPA, MMRV
Symptoms: Erythema, Swelling
Clinical narrative: Pt with redness, swelling.
Age: 47.0
Sex: F
Vaccine: HEP, MNQ
Symptoms: Injection site swelling, Malaise, Pain, Pyrexia
Clinical narrative: This is a 47-year-old I am asked to see. She received 2 shots on 2/22/2018. These were hepatitis B #3 and a MENACTRA vaccine, both of which she had previously received. She reports that the next day she developed swelling in the left upper arm at the site were both shots have been given.  This was associated with general unwellness and she says "I thought I was going to die". She reports a measured fever of 101F. She had aches and pains all over. She did not have any coexisting upper respiratory symptoms are cough and does not think that she developed a coincidental infection.
Age: 4.0
Sex: F
Vaccine: DTAP, MMRV
Symptoms: Injection site swelling, Injection site warmth, Local reaction, Pyrexia
Clinical narrative: I am unsure of the exact vaccination. However the next day, I went to touch my granddaughter's arm and it felt warm. upon removing her shirt, it was noted that her left upper arm and bicep was almost twice the size of her other arm, very warm to the touch, and she was running a low grade fever. My daughter (her mother) called the office right away and a nurse came back and said, "it is a local reaction", treat it with warm compresses and tylenol. I had taken a picture of it and sent it to my daughter, who then tried calling back and no one answered (this of course a Friday afternoon). We contemplated taking her to the ER, however, the news was reporting to stay away if possible due to the flu outbreak. She was seen the following day by the pediatrician. This doctor called it a "local" reaction. However, I have given immunizations for 3 years and never saw one like this!
Age: 29.0
Sex: F
Vaccine: HEP
Symptoms: Pruritus, Urticaria
Clinical narrative: On 2/23/17 Patient was given the Hepatitis B vaccine AT 1300, had no proof so CDC recommends re-vaccinating even though she had an Immune titer. States she had, had 3 previous Hepatitis B vaccines before she thought. After receiving the vaccine that evening about 6 pm she had some mild itching to her head, arms and chest. Saturday woke up with itching and then had hives, arms, abdomen, sides, head, took Benadryl 50 mg that night and then Sunday itching and hives continued, took Benadryl again at night. Monday morning woke up with hives to arms, legs, chest and torso, head so went to the physician at Urgent Care. Was given a Steroid shot, prescription for Claritin and Prednisone and instructed to take Benadryl at night. Monday night put on Calamine lotion and took baking soda bath. Today Tuesday states she feels much better. To take Prednisone tid for 5 days, bid for 5 days and once a day for 5 days. To take Claritin daily and Benadryl daily at night. No hives visible today.
Age: 1.0
Sex: F
Vaccine: HIBV, MMR, PNC13, VARCEL
Symptoms: Erythema, Injection site erythema
Clinical narrative: 1 red round mark noted on right front thigh, 1 red round mark noted on left lateral thigh, 3 red round mark noted on posterior back. Encouraged to follow up with PMD or take child to ER.
Age: 1.17
Sex: M
Vaccine: HEP, PNC13
Symptoms: Crying, Gait disturbance, Pyrexia, Rash, Tremor
Clinical narrative: Fever, rash, unsteady with his gait, shaky, crying instead of communicating with almost words. Crying constantly unless held. Just off.