chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 20.0
Sex: M
Vaccine: FLUN3, HEPAB, MMR, MNQ, PPV
Symptoms: Gait disturbance, Glucose urine absent, Gram stain negative, Guillain-Barre syndrome, Hypoaesthesia
Clinical narrative: Pt was in excellent health prior to service entry in May 2009. 13 May 2009 - Pt received multiple vaccines - See Vaccine History. The total number of 5 vaccines administered was divided between injections in both of his arms (2 and 3). He does not recall any significant local reactions at his vaccination sites. 28 May 2009 - Pt reported to Sick call for evaluation of URI symptoms. He was treated with MUCINEX, TYLENOL and SUDAFED. He reports multiple sick contacts with similar URI symptoms. 1 June 2009 - Seen on Sick Call. Diagnosed with Bronchitis and prescribed ZITHROMAX. 2 June 2009 - Pt awoke with tingling, numbness and weakness of his entire body, except for his head and neck. He was seen on sick call for follow up of bronchitis and he was placed on 72 hour quarters. (There was no mention of the numbness or weakness in the clinic note.) 5June 2009 - Pt returned to Sick Call with c/o falling "to his knees...can't feel legs, feet, shins, hands and fingers". (URI symptoms noted to have significantly improved.) No bowel or bladder symptoms or visual changes. Pt was released to duty. 8 June 2009 - Pt seen in the clinic for "body numbness". The following were noted: - Gait "off balance", ataxia, difficulty with balance - Increased concentration required to get dressed as buttons and laces hard to manipulate - Unable to feel when he plants his feet down - Difficulty writing and with fine manipulative tasks - Placed on 48 hour quarters. 10 June 2009 - Pt returned to sick call with c/o body numbness x 10 days and was referred to the ER after PCM consulted with Neurology. 11 June 2009 - Neurologist evaluated patient. HPI noted 10 day hx of numbness of all extremities and entire body, with subsequent generalized weakness, gait difficulty, soreness of calves and thighs. Exam revealed slightly diminished strength of UE and LE (4/5), with 3+/5 strength of distal muscle groups. Also on exam, pt was unable to walk a straight line, with abnormal heel walking and diminished DTRs in UEs and absent DTRs in LEs. Diagnosed with GBS. Treated with IVIGx5 days. Transferred to inpatient rehabilitation facility.  7/27/09 Hospital records received DOS 6/11/09 to 6/16/09. Discharge Diagnosis: Guillaine Barre Syndrome Patient c/o significant numbness in fingers and toes with generalized numbness of body below the neck.  Stumbles when he walks. Arthragias of knees, myalgias in thighs and calves. Easily fatigued, anorexia. URI symptoms such as cough and sore throat, bilateral upper extremity and lower extremity paresthesias, absent DTRs in bilateral lower extremities, decreased DTRs in bilateral upper extremities, weakness of the bilateral upper and lower extremities. Presence of CSF albuminocytologic dissociation (slightly elevated CSF protein with absent pleocytosis).
Age: 20.0
Sex: M
Vaccine: FLUN3, HEPAB, MMR, MNQ, PPV
Symptoms: Hypokinesia, Influenza serology positive, Nitrite urine absent, Pain in extremity, Paraesthesia
Clinical narrative: Pt was in excellent health prior to service entry in May 2009. 13 May 2009 - Pt received multiple vaccines - See Vaccine History. The total number of 5 vaccines administered was divided between injections in both of his arms (2 and 3). He does not recall any significant local reactions at his vaccination sites. 28 May 2009 - Pt reported to Sick call for evaluation of URI symptoms. He was treated with MUCINEX, TYLENOL and SUDAFED. He reports multiple sick contacts with similar URI symptoms. 1 June 2009 - Seen on Sick Call. Diagnosed with Bronchitis and prescribed ZITHROMAX. 2 June 2009 - Pt awoke with tingling, numbness and weakness of his entire body, except for his head and neck. He was seen on sick call for follow up of bronchitis and he was placed on 72 hour quarters. (There was no mention of the numbness or weakness in the clinic note.) 5June 2009 - Pt returned to Sick Call with c/o falling "to his knees...can't feel legs, feet, shins, hands and fingers". (URI symptoms noted to have significantly improved.) No bowel or bladder symptoms or visual changes. Pt was released to duty. 8 June 2009 - Pt seen in the clinic for "body numbness". The following were noted: - Gait "off balance", ataxia, difficulty with balance - Increased concentration required to get dressed as buttons and laces hard to manipulate - Unable to feel when he plants his feet down - Difficulty writing and with fine manipulative tasks - Placed on 48 hour quarters. 10 June 2009 - Pt returned to sick call with c/o body numbness x 10 days and was referred to the ER after PCM consulted with Neurology. 11 June 2009 - Neurologist evaluated patient. HPI noted 10 day hx of numbness of all extremities and entire body, with subsequent generalized weakness, gait difficulty, soreness of calves and thighs. Exam revealed slightly diminished strength of UE and LE (4/5), with 3+/5 strength of distal muscle groups. Also on exam, pt was unable to walk a straight line, with abnormal heel walking and diminished DTRs in UEs and absent DTRs in LEs. Diagnosed with GBS. Treated with IVIGx5 days. Transferred to inpatient rehabilitation facility.  7/27/09 Hospital records received DOS 6/11/09 to 6/16/09. Discharge Diagnosis: Guillaine Barre Syndrome Patient c/o significant numbness in fingers and toes with generalized numbness of body below the neck.  Stumbles when he walks. Arthragias of knees, myalgias in thighs and calves. Easily fatigued, anorexia. URI symptoms such as cough and sore throat, bilateral upper extremity and lower extremity paresthesias, absent DTRs in bilateral lower extremities, decreased DTRs in bilateral upper extremities, weakness of the bilateral upper and lower extremities. Presence of CSF albuminocytologic dissociation (slightly elevated CSF protein with absent pleocytosis).
Age: 20.0
Sex: M
Vaccine: FLUN3, HEPAB, MMR, MNQ, PPV
Symptoms: Red blood cell count decreased, Red blood cell sedimentation rate increased, Red blood cells CSF positive, Rehabilitation therapy, Rheumatoid factor negative
Clinical narrative: Pt was in excellent health prior to service entry in May 2009. 13 May 2009 - Pt received multiple vaccines - See Vaccine History. The total number of 5 vaccines administered was divided between injections in both of his arms (2 and 3). He does not recall any significant local reactions at his vaccination sites. 28 May 2009 - Pt reported to Sick call for evaluation of URI symptoms. He was treated with MUCINEX, TYLENOL and SUDAFED. He reports multiple sick contacts with similar URI symptoms. 1 June 2009 - Seen on Sick Call. Diagnosed with Bronchitis and prescribed ZITHROMAX. 2 June 2009 - Pt awoke with tingling, numbness and weakness of his entire body, except for his head and neck. He was seen on sick call for follow up of bronchitis and he was placed on 72 hour quarters. (There was no mention of the numbness or weakness in the clinic note.) 5June 2009 - Pt returned to Sick Call with c/o falling "to his knees...can't feel legs, feet, shins, hands and fingers". (URI symptoms noted to have significantly improved.) No bowel or bladder symptoms or visual changes. Pt was released to duty. 8 June 2009 - Pt seen in the clinic for "body numbness". The following were noted: - Gait "off balance", ataxia, difficulty with balance - Increased concentration required to get dressed as buttons and laces hard to manipulate - Unable to feel when he plants his feet down - Difficulty writing and with fine manipulative tasks - Placed on 48 hour quarters. 10 June 2009 - Pt returned to sick call with c/o body numbness x 10 days and was referred to the ER after PCM consulted with Neurology. 11 June 2009 - Neurologist evaluated patient. HPI noted 10 day hx of numbness of all extremities and entire body, with subsequent generalized weakness, gait difficulty, soreness of calves and thighs. Exam revealed slightly diminished strength of UE and LE (4/5), with 3+/5 strength of distal muscle groups. Also on exam, pt was unable to walk a straight line, with abnormal heel walking and diminished DTRs in UEs and absent DTRs in LEs. Diagnosed with GBS. Treated with IVIGx5 days. Transferred to inpatient rehabilitation facility.  7/27/09 Hospital records received DOS 6/11/09 to 6/16/09. Discharge Diagnosis: Guillaine Barre Syndrome Patient c/o significant numbness in fingers and toes with generalized numbness of body below the neck.  Stumbles when he walks. Arthragias of knees, myalgias in thighs and calves. Easily fatigued, anorexia. URI symptoms such as cough and sore throat, bilateral upper extremity and lower extremity paresthesias, absent DTRs in bilateral lower extremities, decreased DTRs in bilateral upper extremities, weakness of the bilateral upper and lower extremities. Presence of CSF albuminocytologic dissociation (slightly elevated CSF protein with absent pleocytosis).
Age: 20.0
Sex: M
Vaccine: FLUN3, HEPAB, MMR, MNQ, PPV
Symptoms: Sensory disturbance, Sensory loss, Specific gravity urine, Syphilis test negative, Upper respiratory tract infection
Clinical narrative: Pt was in excellent health prior to service entry in May 2009. 13 May 2009 - Pt received multiple vaccines - See Vaccine History. The total number of 5 vaccines administered was divided between injections in both of his arms (2 and 3). He does not recall any significant local reactions at his vaccination sites. 28 May 2009 - Pt reported to Sick call for evaluation of URI symptoms. He was treated with MUCINEX, TYLENOL and SUDAFED. He reports multiple sick contacts with similar URI symptoms. 1 June 2009 - Seen on Sick Call. Diagnosed with Bronchitis and prescribed ZITHROMAX. 2 June 2009 - Pt awoke with tingling, numbness and weakness of his entire body, except for his head and neck. He was seen on sick call for follow up of bronchitis and he was placed on 72 hour quarters. (There was no mention of the numbness or weakness in the clinic note.) 5June 2009 - Pt returned to Sick Call with c/o falling "to his knees...can't feel legs, feet, shins, hands and fingers". (URI symptoms noted to have significantly improved.) No bowel or bladder symptoms or visual changes. Pt was released to duty. 8 June 2009 - Pt seen in the clinic for "body numbness". The following were noted: - Gait "off balance", ataxia, difficulty with balance - Increased concentration required to get dressed as buttons and laces hard to manipulate - Unable to feel when he plants his feet down - Difficulty writing and with fine manipulative tasks - Placed on 48 hour quarters. 10 June 2009 - Pt returned to sick call with c/o body numbness x 10 days and was referred to the ER after PCM consulted with Neurology. 11 June 2009 - Neurologist evaluated patient. HPI noted 10 day hx of numbness of all extremities and entire body, with subsequent generalized weakness, gait difficulty, soreness of calves and thighs. Exam revealed slightly diminished strength of UE and LE (4/5), with 3+/5 strength of distal muscle groups. Also on exam, pt was unable to walk a straight line, with abnormal heel walking and diminished DTRs in UEs and absent DTRs in LEs. Diagnosed with GBS. Treated with IVIGx5 days. Transferred to inpatient rehabilitation facility.  7/27/09 Hospital records received DOS 6/11/09 to 6/16/09. Discharge Diagnosis: Guillaine Barre Syndrome Patient c/o significant numbness in fingers and toes with generalized numbness of body below the neck.  Stumbles when he walks. Arthragias of knees, myalgias in thighs and calves. Easily fatigued, anorexia. URI symptoms such as cough and sore throat, bilateral upper extremity and lower extremity paresthesias, absent DTRs in bilateral lower extremities, decreased DTRs in bilateral upper extremities, weakness of the bilateral upper and lower extremities. Presence of CSF albuminocytologic dissociation (slightly elevated CSF protein with absent pleocytosis).
Age: 20.0
Sex: M
Vaccine: FLUN3, HEPAB, MMR, MNQ, PPV
Symptoms: Urine leukocyte esterase, Urobilin urine
Clinical narrative: Pt was in excellent health prior to service entry in May 2009. 13 May 2009 - Pt received multiple vaccines - See Vaccine History. The total number of 5 vaccines administered was divided between injections in both of his arms (2 and 3). He does not recall any significant local reactions at his vaccination sites. 28 May 2009 - Pt reported to Sick call for evaluation of URI symptoms. He was treated with MUCINEX, TYLENOL and SUDAFED. He reports multiple sick contacts with similar URI symptoms. 1 June 2009 - Seen on Sick Call. Diagnosed with Bronchitis and prescribed ZITHROMAX. 2 June 2009 - Pt awoke with tingling, numbness and weakness of his entire body, except for his head and neck. He was seen on sick call for follow up of bronchitis and he was placed on 72 hour quarters. (There was no mention of the numbness or weakness in the clinic note.) 5June 2009 - Pt returned to Sick Call with c/o falling "to his knees...can't feel legs, feet, shins, hands and fingers". (URI symptoms noted to have significantly improved.) No bowel or bladder symptoms or visual changes. Pt was released to duty. 8 June 2009 - Pt seen in the clinic for "body numbness". The following were noted: - Gait "off balance", ataxia, difficulty with balance - Increased concentration required to get dressed as buttons and laces hard to manipulate - Unable to feel when he plants his feet down - Difficulty writing and with fine manipulative tasks - Placed on 48 hour quarters. 10 June 2009 - Pt returned to sick call with c/o body numbness x 10 days and was referred to the ER after PCM consulted with Neurology. 11 June 2009 - Neurologist evaluated patient. HPI noted 10 day hx of numbness of all extremities and entire body, with subsequent generalized weakness, gait difficulty, soreness of calves and thighs. Exam revealed slightly diminished strength of UE and LE (4/5), with 3+/5 strength of distal muscle groups. Also on exam, pt was unable to walk a straight line, with abnormal heel walking and diminished DTRs in UEs and absent DTRs in LEs. Diagnosed with GBS. Treated with IVIGx5 days. Transferred to inpatient rehabilitation facility.  7/27/09 Hospital records received DOS 6/11/09 to 6/16/09. Discharge Diagnosis: Guillaine Barre Syndrome Patient c/o significant numbness in fingers and toes with generalized numbness of body below the neck.  Stumbles when he walks. Arthragias of knees, myalgias in thighs and calves. Easily fatigued, anorexia. URI symptoms such as cough and sore throat, bilateral upper extremity and lower extremity paresthesias, absent DTRs in bilateral lower extremities, decreased DTRs in bilateral upper extremities, weakness of the bilateral upper and lower extremities. Presence of CSF albuminocytologic dissociation (slightly elevated CSF protein with absent pleocytosis).
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMR, VARCEL
Symptoms: Blister, Injection site erythema, Injection site swelling, Injection site warmth
Clinical narrative: 24 hrs after shot 2 areas of large blisters, 2" long (reported by mom) -  arm hot, swollen - bright red - client denies fever or pain
Age: 49.0
Sex: F
Vaccine: PPV, TDAP
Symptoms: Erythema, Oedema peripheral
Clinical narrative: Swelling and redness of right arm.
Age: 19.0
Sex: M
Vaccine: MNQ, TDAP, VARCEL
Symptoms: Corneal abrasion, Ulcerative keratitis
Clinical narrative: Corneal abrasion/ shield ulcer follow up OD- pt states no pain, feels it is resolved, using e-mycin ohs, VIROPTIC q2h, and VIGAMOX qid.
Age: 4.0
Sex: F
Vaccine: DTAP, HEPA, IPV, MMR, VARCEL
Symptoms: Fall, Heart rate normal, Induration, Oxygen saturation normal, Pain in extremity
Clinical narrative: About 10 minutes after vaccination became pale, unresponsive lasted 3-5 minutes.  See enclosed note. Pt is in today for her pre-kindergarten physical.  Note is in the chart.  She had a syncopal episode after receiving her vaccines.  She received a DTAP, POLIO, MMR, VARIVAX and HEPATITIS A.  Mother states that as she was sitting to her she started complaining that her arm was hurting as they were getting ready to leave.  Then mother said she kind of slumped over and slumped down.  Mother picked her up.  The medical assistant was called in and tried to give her sip of water, then she fainted and fell to the floor.  I was called into the room at that time.  Mother stated that she looked pale prior to her fainting.  No nausea or vomiting.  When I saw her again she was looking pale and was half sitting on mother's lap.  I lied her down on the table.  Her color started to improve.  She was unresponsive at this time; however when I was checking her pulse she did say "Ow".  I put a pulse ox monitor on her.  Heart rate was 75.  O2 saturation's were 95-100%.  She was breathing comfortably.  Heart had a regular rate and rhythm without murmur.  After saying "Ow" she remained unresponsive for about 3 minutes.  Again, her color finally improved.  When I started tickling her feet and her hands she started smiling and again became alert.  After that she remained in the office lying down, gradually sitting up and standing until she was feeling better.  She stayed in the office about a half an hour before mother felt she was well enough to leave.  I spoke with mother on the phone this evening, who states she is doing well.  She is back to herself.  Ate well.  No complaints.  Complains of her arm hurting a little bit and tingling a little bit from her vaccines.  Mother states that Pt has had no history of syncope before.  No history of breath-holding spells.  No history of seizures.  No seizure activity noted during her syncopal episode.  FAMILY HISTORY:  Significant for paternal grandfather with epilepsy and maternal grandfather with some sort of cardiac arrhythmia and hypertension.  ASSESSMENT: Significant vasovagal reaction after vaccines.  No evidence of seizure, cardiac or other etiology.  ? Hypotonic hypotensive episode (HHC) PLAN: Reassurance was given to mother.  Follow-up closely if she has any other syncopal episodes and to let me know.  I will fill out a VAERS report.
Age: 4.0
Sex: F
Vaccine: DTAP, HEPA, IPV, MMR, VARCEL
Symptoms: Pallor, Paraesthesia, Posture abnormal, Syncope, Unresponsive to stimuli
Clinical narrative: About 10 minutes after vaccination became pale, unresponsive lasted 3-5 minutes.  See enclosed note. Pt is in today for her pre-kindergarten physical.  Note is in the chart.  She had a syncopal episode after receiving her vaccines.  She received a DTAP, POLIO, MMR, VARIVAX and HEPATITIS A.  Mother states that as she was sitting to her she started complaining that her arm was hurting as they were getting ready to leave.  Then mother said she kind of slumped over and slumped down.  Mother picked her up.  The medical assistant was called in and tried to give her sip of water, then she fainted and fell to the floor.  I was called into the room at that time.  Mother stated that she looked pale prior to her fainting.  No nausea or vomiting.  When I saw her again she was looking pale and was half sitting on mother's lap.  I lied her down on the table.  Her color started to improve.  She was unresponsive at this time; however when I was checking her pulse she did say "Ow".  I put a pulse ox monitor on her.  Heart rate was 75.  O2 saturation's were 95-100%.  She was breathing comfortably.  Heart had a regular rate and rhythm without murmur.  After saying "Ow" she remained unresponsive for about 3 minutes.  Again, her color finally improved.  When I started tickling her feet and her hands she started smiling and again became alert.  After that she remained in the office lying down, gradually sitting up and standing until she was feeling better.  She stayed in the office about a half an hour before mother felt she was well enough to leave.  I spoke with mother on the phone this evening, who states she is doing well.  She is back to herself.  Ate well.  No complaints.  Complains of her arm hurting a little bit and tingling a little bit from her vaccines.  Mother states that Pt has had no history of syncope before.  No history of breath-holding spells.  No history of seizures.  No seizure activity noted during her syncopal episode.  FAMILY HISTORY:  Significant for paternal grandfather with epilepsy and maternal grandfather with some sort of cardiac arrhythmia and hypertension.  ASSESSMENT: Significant vasovagal reaction after vaccines.  No evidence of seizure, cardiac or other etiology.  ? Hypotonic hypotensive episode (HHC) PLAN: Reassurance was given to mother.  Follow-up closely if she has any other syncopal episodes and to let me know.  I will fill out a VAERS report.
Age: 1.0
Sex: F
Vaccine: HEPA, MMR, VARCEL
Symptoms: Culture, Rash, Rash vesicular
Clinical narrative: 06/25/09 - Started with multiple small vesicles on bottom. 6/26/09- Seen in office had started on trunk as well, some vesicles "blistered" culture done. Started on Acyclovir.
Age: 59.0
Sex: F
Vaccine: TDAP
Symptoms: Abdominal discomfort, Diarrhoea
Clinical narrative: Within a few hours of receiving TDAP.  Pt c/o hourly diarrhea X 10 or 12.  Denies fever, bloody stools, rash, nor v, or other sx.  Stomach was "sensitive" the next day but essentially well.
Age: 29.0
Sex: F
Vaccine: TDAP
Symptoms: Induration, Mass, Oedema peripheral, Pain in extremity
Clinical narrative: Hard lump in arm swelling & pain
Age: 5.0
Sex: M
Vaccine: DTAPIPV
Symptoms: Injection site cellulitis, Injection site discolouration
Clinical narrative: This case was reported by a physician and described the occurrence of injection site cellulitis in a 5-year-old male subject who was vaccinated with combined KINRIX, (GlaxoSmithKline).  The subject's medical history included enlarged tonsil and recurrent streptococcal throat.  On 1 June 2009 the subject received KINRIX (unknown route, left arm) as dose 5 in vaccination series.  On 4 June 2009, 3 days after vaccination with KINRIX, the subject experienced injection site cellulitis and discoloration of skin at injection site.  At the time of reporting the events were unresolved.  The physician considered the events were possibly related to vaccination with KINRIX.  The physician had reported this case to VAERS (reference number unknown).
Age: 11.0
Sex: M
Vaccine: MNQ, MNQ
Symptoms: Arthropathy, Ataxia, Blood product transfusion, CSF protein increased, CSF white blood cell count increased
Clinical narrative: Within a few days of receiving MENACTRA, pt developed toe numbness, then headache, nausea, followed by foot dragging and ataxia. Admit to hospital for IVIG for tx of Chronic Demyelinating Polyneuropathy.
Age: 11.0
Sex: M
Vaccine: MNQ, MNQ
Symptoms: Chronic inflammatory demyelinating polyradiculoneuropathy, Decreased appetite, Demyelinating polyneuropathy, Gait disturbance, Headache
Clinical narrative: Within a few days of receiving MENACTRA, pt developed toe numbness, then headache, nausea, followed by foot dragging and ataxia. Admit to hospital for IVIG for tx of Chronic Demyelinating Polyneuropathy.
Age: 11.0
Sex: M
Vaccine: MNQ, MNQ
Symptoms: Hypoaesthesia, Intracranial pressure increased, Nausea, Nuclear magnetic resonance imaging normal, Walking aid user
Clinical narrative: Within a few days of receiving MENACTRA, pt developed toe numbness, then headache, nausea, followed by foot dragging and ataxia. Admit to hospital for IVIG for tx of Chronic Demyelinating Polyneuropathy.
Age: 11.0
Sex: M
Vaccine: MNQ, MNQ
Symptoms: White blood cell count increased
Clinical narrative: Within a few days of receiving MENACTRA, pt developed toe numbness, then headache, nausea, followed by foot dragging and ataxia. Admit to hospital for IVIG for tx of Chronic Demyelinating Polyneuropathy.
Age: 11.0
Sex: M
Vaccine: MNQ, MNQ
Symptoms: Ataxia, Blood product transfusion, CSF protein increased, Demyelinating polyneuropathy, Gait disturbance
Clinical narrative: Within a few days of receiving MENACTRA, pt developed toe numbness, then headache, nausea, followed by foot dragging and ataxia. Admit to hospital for IVIG for tx of Chronic Demyelinating Polyneuropathy.
Age: 11.0
Sex: M
Vaccine: MNQ, MNQ
Symptoms: Headache, Hypoaesthesia, Intracranial pressure increased, Nausea, Nuclear magnetic resonance imaging normal
Clinical narrative: Within a few days of receiving MENACTRA, pt developed toe numbness, then headache, nausea, followed by foot dragging and ataxia. Admit to hospital for IVIG for tx of Chronic Demyelinating Polyneuropathy.
Age: 63.0
Sex: F
Vaccine: VARZOS, VARZOS
Symptoms: Back pain, Herpes zoster, Pain in extremity, Rash
Clinical narrative: Felt off/tired Thursday and Friday.  Saturday felt pain on top of legs hit as going up the stairs.  Sunday pain continued could hardly walk.  Monday had pain on top of kidneys area.  6/22 went to ER, CT scan negative, kidney & liver function normal.  Was given narcotics for pain.  Went home.  6/23 went to private doctor, sent back to ER with more of the same.  CT scan with contrast showed that narcotics affected bowel movement.  Went home 6/24 chiropractor came home and provided treatment for pain on shoulders. Left side found to be tender.  6/25 went back to ER and given sodium soda pop for bowels movements unsuccessfully.  6/25 was administered edema to clear her up.  That is when she noticed rash on back 3 inch trail from kidney area to belly button to pelvic area.  Doctor diagnosed her with shingles prescribed ACYCLOVIR.  Today helped pain but not gone.  Started as small blisters/ patches now all together.
Age: 63.0
Sex: F
Vaccine: VARZOS, VARZOS
Symptoms: Blister, Computerised tomogram normal, Enema administration, Fatigue, Gait disturbance
Clinical narrative: Felt off/tired Thursday and Friday.  Saturday felt pain on top of legs hit as going up the stairs.  Sunday pain continued could hardly walk.  Monday had pain on top of kidneys area.  6/22 went to ER, CT scan negative, kidney & liver function normal.  Was given narcotics for pain.  Went home.  6/23 went to private doctor, sent back to ER with more of the same.  CT scan with contrast showed that narcotics affected bowel movement.  Went home 6/24 chiropractor came home and provided treatment for pain on shoulders. Left side found to be tender.  6/25 went back to ER and given sodium soda pop for bowels movements unsuccessfully.  6/25 was administered edema to clear her up.  That is when she noticed rash on back 3 inch trail from kidney area to belly button to pelvic area.  Doctor diagnosed her with shingles prescribed ACYCLOVIR.  Today helped pain but not gone.  Started as small blisters/ patches now all together.
Age: 63.0
Sex: F
Vaccine: VARZOS, VARZOS
Symptoms: Herpes zoster, Liver function test normal, Musculoskeletal pain, Pain in extremity, Rash
Clinical narrative: Felt off/tired Thursday and Friday.  Saturday felt pain on top of legs hit as going up the stairs.  Sunday pain continued could hardly walk.  Monday had pain on top of kidneys area.  6/22 went to ER, CT scan negative, kidney & liver function normal.  Was given narcotics for pain.  Went home.  6/23 went to private doctor, sent back to ER with more of the same.  CT scan with contrast showed that narcotics affected bowel movement.  Went home 6/24 chiropractor came home and provided treatment for pain on shoulders. Left side found to be tender.  6/25 went back to ER and given sodium soda pop for bowels movements unsuccessfully.  6/25 was administered edema to clear her up.  That is when she noticed rash on back 3 inch trail from kidney area to belly button to pelvic area.  Doctor diagnosed her with shingles prescribed ACYCLOVIR.  Today helped pain but not gone.  Started as small blisters/ patches now all together.
Age: 63.0
Sex: F
Vaccine: VARZOS, VARZOS
Symptoms: Renal function test normal, Renal pain, Tenderness
Clinical narrative: Felt off/tired Thursday and Friday.  Saturday felt pain on top of legs hit as going up the stairs.  Sunday pain continued could hardly walk.  Monday had pain on top of kidneys area.  6/22 went to ER, CT scan negative, kidney & liver function normal.  Was given narcotics for pain.  Went home.  6/23 went to private doctor, sent back to ER with more of the same.  CT scan with contrast showed that narcotics affected bowel movement.  Went home 6/24 chiropractor came home and provided treatment for pain on shoulders. Left side found to be tender.  6/25 went back to ER and given sodium soda pop for bowels movements unsuccessfully.  6/25 was administered edema to clear her up.  That is when she noticed rash on back 3 inch trail from kidney area to belly button to pelvic area.  Doctor diagnosed her with shingles prescribed ACYCLOVIR.  Today helped pain but not gone.  Started as small blisters/ patches now all together.
Age: 18.0
Sex: F
Vaccine: MEN, TD
Symptoms: Asthenia, Chest discomfort, Feeling hot, Headache, Tremor
Clinical narrative: felt very weak/ shakey.  Chest was tight and felt a warm sensation going thru body like a dye from a cat-scan. Bad headache.
Age: 11.0
Sex: M
Vaccine: MNQ
Symptoms: Cough, Dyspnoea, Stridor, Wheezing, X-ray abnormal
Clinical narrative: Wheeze, stridor, cough and shortness of breath.  8/3/09 ER records received DOS  6/23/09 Assessment: Allergic reaction, vaccine adverse reaction, stridor. Patient presents with cough, wheezing, stridorous noises. Difficulty breathing. Sore throat and chest pain. Minimal subglottic edema. Mild inspiratory stridor. Initially complains of blurry vision, nausea, sore arms, headache.
Age: 0.2
Sex: M
Vaccine: DTAPIPVHIB, PNC, RV5
Symptoms: Diarrhoea, Pyrexia, Rotavirus test positive
Clinical narrative: 6 days following ROTATEQ vaccines.  Developed fever & diarrhea
Age: 13.0
Sex: F
Vaccine: HPV4
Symptoms: Deafness, Depression, Ear infection, Eye infection, Full blood count normal
Clinical narrative: Depression, mood swings, change in menstrual cycle ( increase to 2X monthly), cramping, loss of hearing, infection eye + ear.
Age: 13.0
Sex: F
Vaccine: HPV4
Symptoms: Menstrual disorder, Mood swings, Muscle spasms, Thyroid function test normal
Clinical narrative: Depression, mood swings, change in menstrual cycle ( increase to 2X monthly), cramping, loss of hearing, infection eye + ear.
Age: 48.0
Sex: F
Vaccine: MNQ
Symptoms: Erythema, Pain, Swelling
Clinical narrative: Swelling, Redness, Soreness 6cm X 6cm.
Age: 12.0
Sex: M
Vaccine: MEN, TDAP
Symptoms: Abdominal pain upper, Asthenia, Chills, Dyspnoea, Headache
Clinical narrative: Fever, chills, cold hands, pain in legs, weak, headache, stomachache, shortness of breathe
Age: 12.0
Sex: M
Vaccine: MEN, TDAP
Symptoms: Pain in extremity, Peripheral coldness, Pyrexia
Clinical narrative: Fever, chills, cold hands, pain in legs, weak, headache, stomachache, shortness of breathe
Sex: F
Vaccine: FLUX
Symptoms: Guillain-Barre syndrome, Monoplegia
Clinical narrative: Initial report was received 25 June 2009 from another manufacturer (document number 45220797), who received the report from a health care professional. A female patient had developed Guillain-Barre Syndrome and paralysis of her legs after she had received an unspecified influenza vaccination when she was a child. The patient's recovery status was not reported. No further information was available at the time of the report. Documents held by sender: None.
Age: 26.0
Sex: F
Vaccine: HPV4
Symptoms: Abortion spontaneous, Drug administered at inappropriate site, Drug exposure during pregnancy
Clinical narrative: Information has been received from a Certified Medical Assistant (C.M.A.), for the Pregnancy Registry for GARDASIL, concerning a 26 year old female who on 17-JUN-2008 was vaccinated intramuscularly with the first dose of GARDASIL (lot # 659962/1740U) in the left arm and on 22-SEP-2008 was vaccinated intramuscularly with the second dose of GARDASIL (lot # 660620/0571X) in the right hip. Concomitant therapy included hormonal contraceptives (unspecified). The patient became pregnant before the GARDASIL series had been completed. No adverse symptoms. It was reported that the last menstrual period (LMP) was 26-AUG-2008. Medical attention was sought via phone call. No product quality complaint was involved. Follow-up information was received from the nurse practitioner. The nurse reported that the patient had not received any concomitant vaccines when she received the first two doses of GARDASIL. The patient had not received the third dose of GARDASIL. The patient had a miscarriage sometime between August 2008 and December 2008. The patient had recovered from the miscarriage. The patient's last menstrual period (LMP) was also reported as 14-DEC-2008. Additional information has been requested.
Sex: F
Vaccine: FLUX, IPV
Symptoms: Allergy to vaccine, Immediate post-injection reaction, Influenza, Malaise
Clinical narrative: Initial report received 25 June 2009 from another manufacturer (document number 45220198), who received the report from a consumer, who is the patient. A female patient (age not reported) who had a history of unspecified reactions to many unspecified narcotics, reported that she was allergic to a flu vaccine (manufacturer, lot number and date of administration not reported) and immediately after receiving the vaccine, she came down with an extreme case of the flu. The patient also reported becoming "sick" after receiving polio vaccine (manufacturer, lot number and date of administration not reported) many years ago. The patient sought medical attention at a doctor's office and subsequently recovered (dates of recovery not reported). Documents held by sender: None.
Age: 53.0
Sex: F
Vaccine: PPV
Symptoms: Hypotension, Injection site reaction, Local reaction, Rash
Clinical narrative: Information has been received from a registered pharmacist concerning a 53 year old female on chemotherapy who on 05-JUN-2009 was vaccinated with PNEUMOVAX 23 (lot# 662745/1576X, route and site of administration not reported). On 06-JUN-2009 the patient developed rash on his chest and face, hypotension and local reaction at the injection site. The patient went to the emergency room for treatment, and he was given I.V. BENADRYL and sent home. The patient recovered on unknown date. She received chemotherapy on 18-JUN-2009. Upon internal review, rash, hypotension and local reaction at the injection site treated with I.V. BENADRYL was determined to be an other important medical event. This is a consolidation of two reports concerning the same patient. Additional information has been requested. It has been determined that WAES#0906USA03647 is a duplicate of WAES#0906USA02593. Therefore, WAES#0906USA03647 is being deleted from our files and consolidated into WAES#0906USA02593. WAES#0906USA03647 was previously submitted to the FDA on 22-JUN-2009.
Age: 2.0
Sex: F
Vaccine: HEPA
Symptoms: Autoimmune hepatitis, Biopsy liver abnormal, Hepatic enzyme increased, Jaundice
Clinical narrative: After patient's Hepatitis A immunization, she began languishing and eventually turned jaundiced.  After a liver biopsy, she was diagnosed with autoimmune hepatitis.  She is under constant medical examination and bloodwork and medicated daily with azathioprine and sometimes prednisone for flare ups to keep her immune system from getting out of control.  7/17/09 Consultant records received DOS 5/2/08 to 7/9/09. Assessment: Autoimmune Hepatitis. Patient presents with history of elevated liver enzymes and autoimmune hepatitis. Following discontinuation of steroids she appeared tired, episodes of vomiting, and some looser-lighter colored stools.
Age: 36.0
Sex: F
Vaccine: PPV, TDAP
Symptoms: Inappropriate schedule of drug administration
Clinical narrative: Patient was given inital dose of Tdap on 06/04/09 and was give a 2nd dose on 06/29/09.
Age: 18.0
Sex: M
Vaccine: HEP, MNQ, TDAP
Symptoms: Immediate post-injection reaction, Syncope
Clinical narrative: Developed syncope immediately following injection of Tdap. Patient sitting, depressed head between knees, passed ammonia inhalant briefly under his nose, applied cool cloth on the back of his neck. Had pt. remain seated for 10-15 min. BP 110/70
Age: 1.25
Sex: M
Vaccine: MMR, VARCEL
Symptoms: Varicella post vaccine
Clinical narrative: Varicella vaccine breakthrough.  Diagnosed in our office on 6/29/09 with Varicella.  Had over 100 lesions.  No fever.
Age: 52.0
Sex: F
Vaccine: TD
Symptoms: Diarrhoea, Guillain-Barre syndrome, Hypoaesthesia, Muscular weakness, Plasmapheresis
Clinical narrative: 6/12/09 - Pt presented to the emergency room for a cat bite.  Patient recieved a tetanus diptheria toxoid because hers was out of date.  6/17/09 - Pt presented to ER with numbness in her hands and feet. Numbness started on 6/16/09 with numbness in her fingers and felt "like legs were going to give out".  Symptoms worsened overnight and thus the reason for ER visit on 6/17/09.  6/17/09 - Pt diagnosed with Guillan Barre.  Physician believes Guillan Barre due to upper respiratory infection.  Husband of patient also stated pt had a "watery stool" prior to hospitalization.  Pt treated with 5 days of plasmapheresis every other day starting on 6/20/09.  Pt has improved and was discharged home on 6/29/09.  7/2/09 Hospital records received DOS 6/12/09 to 6/29/09. Assessment: Generalized weakness and numbness, likely Guillain-Barre syndrome. Patient presented with increasing tingling, upper and lower extremity numbness and weakness. Difficulty swallowing. Weakness triceps and deltoids. Unable to lift legs. Plasmapheresis. records received 7/8/09-ICD-9 codes 357.0 acute infectious polyneuritis. 518.81 respiratory failure. 599.0 urinary tract infection. 682.6 cellulitis of leg. 401.9 hyperlipidemia. 715.90 osteoarthros. 276.8 hypopotassemia. 719.7 difficulty walking. 790.29 other abnormal glucose. 276.51 dehydration.
Age: 20.0
Sex: F
Vaccine: HPV4, HPV4
Symptoms: Cardiac arrest, Electrocardiogram, Respiratory arrest
Clinical narrative: Pt stopped breathing and had a cardiac arrest. CPR required.  7/23/09 Hospital records received DOS 7/1/09 to 7/2/09. Assessment: Syncope vasovagal. Patient dizzy, passed out, loss of consciousness, not breathing spontaneously, CPR initiated. Bradycardia. Presented at ER lethargic and somnolent. Generalized aching severe in nature. Rash on arms. Anemia.
Age: 20.0
Sex: F
Vaccine: HPV4, HPV4
Symptoms: Cough, Dyspnoea, Gaze palsy, Lethargy, Pallor
Clinical narrative: Pt stopped breathing and had a cardiac arrest. CPR required.  7/23/09 Hospital records received DOS 7/1/09 to 7/2/09. Assessment: Syncope vasovagal. Patient dizzy, passed out, loss of consciousness, not breathing spontaneously, CPR initiated. Bradycardia. Presented at ER lethargic and somnolent. Generalized aching severe in nature. Rash on arms. Anemia.
Age: 20.0
Sex: F
Vaccine: HPV4, HPV4
Symptoms: Pulse absent, Respiratory arrest, Resuscitation, Unresponsive to stimuli
Clinical narrative: Pt stopped breathing and had a cardiac arrest. CPR required.  7/23/09 Hospital records received DOS 7/1/09 to 7/2/09. Assessment: Syncope vasovagal. Patient dizzy, passed out, loss of consciousness, not breathing spontaneously, CPR initiated. Bradycardia. Presented at ER lethargic and somnolent. Generalized aching severe in nature. Rash on arms. Anemia.
Age: 53.0
Sex: F
Vaccine: TDAP
Symptoms: Injection site erythema, Injection site pain, Pain, Pruritus, Pyrexia
Clinical narrative: On 06/19/09 pt received Tdap.That same evening pt noticed her upper left arm at the location the immunization was given became red, painful and she had a fever of 99 degrees.Her whole body felt achy which significantly improved after taking tylenol 1 gram 4 times a day. Over last 24 hours, she has noticed some mild itching and increase redness of the skin. Began Claritan every 4-6 hours and applied cold compresses 10-15 min prn.WBC 5.2.No antibiotic prescribed. On 07/01/09 symptoms improved, arm still itchy and slightly red. Continues with Claritan and cold compresses.
Age: 53.0
Sex: F
Vaccine: TDAP
Symptoms: White blood cell count normal
Clinical narrative: On 06/19/09 pt received Tdap.That same evening pt noticed her upper left arm at the location the immunization was given became red, painful and she had a fever of 99 degrees.Her whole body felt achy which significantly improved after taking tylenol 1 gram 4 times a day. Over last 24 hours, she has noticed some mild itching and increase redness of the skin. Began Claritan every 4-6 hours and applied cold compresses 10-15 min prn.WBC 5.2.No antibiotic prescribed. On 07/01/09 symptoms improved, arm still itchy and slightly red. Continues with Claritan and cold compresses.
Age: 4.0
Sex: F
Vaccine: DTAPIPV, MMR, VARCEL
Symptoms: Feeling hot, Headache, Injection site erythema, Injection site pain, Injection site swelling
Clinical narrative: 06/30/09 MT REPORTS CHILD FELT HOT, COMPLAINED OF HEADACHE & PAINFUL LEFT ARM. ARM SWOLLEN &HOT 6/30 & WORSE 07/01/09.GAVE TYLENOL & USED ICE ON IT. TODAY 07/01 LEFT DELTOID AREA IS WARM TO TOUCH, RED, & SWOLLEN 4 1/4" X 4".CHILD DOES NOT HAVE ANY FEVER TODAY AND IS PLAYING AND ACTING OKAY. DOES REPORT PAIN IN HER LEFT ARM.
Age: 4.0
Sex: F
Vaccine: DTAPIPV, MMR, VARCEL
Symptoms: Injection site warmth, Oedema peripheral
Clinical narrative: 06/30/09 MT REPORTS CHILD FELT HOT, COMPLAINED OF HEADACHE & PAINFUL LEFT ARM. ARM SWOLLEN &HOT 6/30 & WORSE 07/01/09.GAVE TYLENOL & USED ICE ON IT. TODAY 07/01 LEFT DELTOID AREA IS WARM TO TOUCH, RED, & SWOLLEN 4 1/4" X 4".CHILD DOES NOT HAVE ANY FEVER TODAY AND IS PLAYING AND ACTING OKAY. DOES REPORT PAIN IN HER LEFT ARM.
Age: 5.0
Sex: M
Vaccine: DTAP, IPV
Symptoms: Injection site induration, Injection site swelling, Injection site warmth
Clinical narrative: LOCAL REACTION TO L UPPER ARM--SWELLING (FIRM INDURATION) AND WARMTH OF L UPPER ARM FROM SHOULDER TO JUST ABOVE ELBOW NOTED STARTING THE EVENING OF 6/30/2009 BY MOM.
Sex: F
Vaccine: HEP
Symptoms: No adverse event, Overdose
Clinical narrative: FIRST DOSE OF HEPATITIS B WAS GIVEN TWICE. NO ADVERSE REACTIONS AT THIS TIME.
Age: 11.0
Sex: M
Vaccine: VARCEL
Symptoms: Lip swelling, Throat irritation, Throat tightness, Urticaria
Clinical narrative: With in 10 min after Varivax vaccine was administered patient began with throat itching, hives, lower lip swelling and throat tightening.  No audible wheezing, B/P stable. At 3pm patient was given three tsps of benadryl and epi-pen Jr 0.15 in each thigh with good improvement and transported to ER.
Age: 25.0
Sex: F
Vaccine: TDAP
Symptoms: Injected limb mobility decreased, Injection site pain
Clinical narrative: PERSISTENT PAIN IN LEFT DELTOID. NO LUMP, REDNESS OR SWELLING. FIRST SOUGHT TREATMENT 5/26/2009.  RECOMMENDED HEAT, IBUPROFEN.  FOLOW UP IN 2-4 WEEKS IF NOT IMPROVING.
Age: 45.0
Sex: F
Vaccine: VARCEL, VARCEL
Symptoms: Fatigue, Rash generalised, Rash papular, Scab, Skin lesion
Clinical narrative: Rcvd Varivax on 5/29/09.  Reports she  developed generalized papulovesicular rash on 6/17/09 @ 1600.  On 6/19/09 States 10 "bumps on face, 2 on neck, 1 on each wrist, and on shoulder". Denies fever, redness or drainage from lesions.  States most are "bumps", some are drying, and a couple are like "pimples".  States some tiredness over the past week.   On 6/22/09 dry, scabbed lesions: 1 Left foot 4-5 web space, 1 post. neck, 4 rt flank, 1 ant. neck, 1 rt upper thigh, 1 rt lower leg.  One 3mm vessicle left side under bra. 6/24/09 One vessicle noted rt post knee, she states noticed on 6/22/09.  All other lesions dry and crusted.  6/25/09 All lesions dry
Age: 45.0
Sex: F
Vaccine: VARCEL, VARCEL
Symptoms: Rash papular, Scab
Clinical narrative: Rcvd Varivax on 5/29/09.  Reports she  developed generalized papulovesicular rash on 6/17/09 @ 1600.  On 6/19/09 States 10 "bumps on face, 2 on neck, 1 on each wrist, and on shoulder". Denies fever, redness or drainage from lesions.  States most are "bumps", some are drying, and a couple are like "pimples".  States some tiredness over the past week.   On 6/22/09 dry, scabbed lesions: 1 Left foot 4-5 web space, 1 post. neck, 4 rt flank, 1 ant. neck, 1 rt upper thigh, 1 rt lower leg.  One 3mm vessicle left side under bra. 6/24/09 One vessicle noted rt post knee, she states noticed on 6/22/09.  All other lesions dry and crusted.  6/25/09 All lesions dry
Age: 12.0
Sex: M
Vaccine: MNQ, VARCEL
Symptoms: Injection site erythema, Injection site pain, Injection site warmth
Clinical narrative: Circular area (1 3/4"x1 1/4") of mild erythema to posterior right arm with smaller central area of erythema.  Warm to touch. Developed on the night of 6/30/09. Area unchanged during exam today. Per patient, the area is tender to the touch.
Age: 11.0
Sex: F
Vaccine: HPV4, MNQ, TDAP
Symptoms: Loss of consciousness
Clinical narrative: After giving last injection (which was gardasil) she said she felt like she was going to pass out then slumps into my arms.  She opened her eyes again after less than a minute.  BP 114/50 cool clothes to head water to drink.  Monitored for another 15 mins then sent home.
Age: 12.0
Sex: F
Vaccine: HEPA, HPV4, MNQ, TDAP, VARCEL
Symptoms: Injection site induration, Injection site swelling
Clinical narrative: 4 cm area of swelling/induration around injection site with associated pruritus.
Age: 60.0
Sex: F
Vaccine: TDAP
Symptoms: Abdominal pain upper, Diarrhoea, Differential white blood cell count, Full blood count, Glycosylated haemoglobin
Clinical narrative: Extreme watery diarrhea, nausea, stomach ache.
Age: 60.0
Sex: F
Vaccine: TDAP
Symptoms: Metabolic function test, Nausea
Clinical narrative: Extreme watery diarrhea, nausea, stomach ache.
Age: 38.0
Sex: M
Vaccine: ANTH, SMALL
Symptoms: Eye pruritus, Headache, Myopia, Ocular hyperaemia, Ophthalmological examination abnormal
Clinical narrative: Visual changes after AVA 1 and 2.  AVA 1 had black vision X 3-6 sec with needle injection.  1 hr later c/o difficult focusing on letters/numbers being unable to see clearly.  Had to squint and concentrate hard to interpret.  C/O photophobia.  He denied any blurring or diff seeing colors, objects, etc just reading.  Eyes seems red and itched.  No HA, dizziness, URI or other s/s with AVA.  Vision remained out of focus for 3 wks and then he seems use to it.  AVA 2 had same s/s with c/o frontal HA 8/10 for 3 days, which has resolved.  His light sensitivity is worse needing sun glasses when outside and flourscent lights bother him.  He does have PATENOL for itchy eyes used mainly in Jun/July due to cactus and other desert flowers blooming.
Age: 38.0
Sex: M
Vaccine: ANTH, SMALL
Symptoms: Optic neuropathy, Photophobia, Vaccine positive rechallenge, Vision blurred, Visual acuity reduced
Clinical narrative: Visual changes after AVA 1 and 2.  AVA 1 had black vision X 3-6 sec with needle injection.  1 hr later c/o difficult focusing on letters/numbers being unable to see clearly.  Had to squint and concentrate hard to interpret.  C/O photophobia.  He denied any blurring or diff seeing colors, objects, etc just reading.  Eyes seems red and itched.  No HA, dizziness, URI or other s/s with AVA.  Vision remained out of focus for 3 wks and then he seems use to it.  AVA 2 had same s/s with c/o frontal HA 8/10 for 3 days, which has resolved.  His light sensitivity is worse needing sun glasses when outside and flourscent lights bother him.  He does have PATENOL for itchy eyes used mainly in Jun/July due to cactus and other desert flowers blooming.
Age: 5.0
Sex: F
Vaccine: DTAP, HEPA, IPV, MMR, VARCEL
Symptoms: Injection site erythema, Injection site haematoma, Injection site induration, Injection site swelling
Clinical narrative: Child recd #2 dose of VARICELLA on 6/23/09 in right thigh on 6/25/09 mom noticed bruise and red swelling -> saw MD 6/25 and MD circled induration with instructions to mom.  Monday 6/29/09 post swimming mom noticed the site to have tripled saw MD 6/29/09, site measured 6 cm X 6 cm, child placed on antibiotics po BID X 10 days.
Age: 0.5
Sex: F
Vaccine: DTAPIPVHIB, HEP, PNC, RV5
Symptoms: Injection site erythema, Injection site induration
Clinical narrative: Received immunizations 6/29/2009 AM. On morning of 6/30/2009 noted red hard spot on Right thigh 7/1/09 Exam 11 x 20 mm area of erythema induration lateral to injection site. Presumed cellulitis, treated with KEFLEX.
Age: 43.0
Sex: M
Vaccine: TDAP
Symptoms: Erythema, Local reaction, Skin reaction, Swelling
Clinical narrative: Localized skin reaction. Red raised irregular border 10cm x 8cm. Fading center/clearing.
Age: 13.0
Sex: F
Vaccine: HPV4, MNQ, TDAP
Symptoms: Paraesthesia, Presyncope
Clinical narrative: 6-30-09 4:45 pm pt. c/o tingling in arms after injections of MENACTRA and HPV. Pt also given Tdap. Pt asked to wait twenty minutes to make sure she had no adverse reaction. Pt getting ready to leave at 5:30 and almost fainted. Pt placed in wheelchair given ammonia inhalant and taken to the hospital ER by wheelchair.