chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 59.0
Sex: M
Vaccine: COVID19
Symptoms: International normalised ratio normal, Lipase increased, Liver disorder, Liver function test normal, Nausea
Clinical narrative: Patient is a 62 y.o. male patient of MD with history of ESRD, morbid obesity, DM type II, atrial fibrillation, hypothyroidism transferred to Medical Center for trauma evaluation.     Acute respiratory failure with hypoxia Tachypnea, dyspnea, hypoxia presentation Placed on 2 L nasal cannula in ED. Currently on 2L NC, wean as tolerated CTA of chest without acute gross abnormalities. Likely multifactorial (hypoventilation syndrome, untreated OSA). Pulmonary consulted.  Breathing treatments as needed   Covid-19 Virus Infection Tested positive on arrival; no obvious infiltrates on imaging Continue dexamethasone for 10-day course as was on nasal cannula and hypoxic initially   Acute pancreatitis Periumbilical abdominal pain as well as nausea. No other red flags. Possibly trauma related CT scan of abdomen with mild free fluid in the right upper quadrant in the left pararenal space. Lipase elevated to 1,279 > currently trending down to 281 Evaluated by trauma team in ED. No concern for surgical issues. Holding IV fluids in setting of ESRD. Pain and nausea control as needed. RUQ US evaluation limited due to body habitus; no evidence of acute cholecystitis; Increased echogenicity and heterogeneous echotexture of the liver suggestive of hepatocellular disease and/or steatosis. LFTs stable, INR 1.1; TG 235, ANA negative GI consulted, continue supportive care Currently advanced to solids, tolerating diet Fall Right proximal humerus Fracture Patient sustained a fall off his motorized scooter Diagnosed with right humerus fracture, Currently on sling. Transferred to medical center to be evaluated by trauma team. No other acute traumatic issues and scans; trauma team signed off.  Orthopedics consulted for recommendations - non operative mgmt Patient follow-up in clinic or at medical center as an outpatient PT/OT consulted - recommended for SNF, however patient refusing SNF, preferring to go home with home health care. Counseled on risks of not following this recommendation with regard to re-admission, falls, clinical decline, and potential risk of life-threatening measures such as death. Patient voiced understanding Pain control as needed.   Hyperkalemia - resolved Potassium of 6.3 on presentation. In setting of ESRD. K currently stable Nephrology consulted   ESRD On hemodialysis 3 times a week. Nephrology consulted for inpatient hemodialysis Monitor renal function closely   Paroxysmal atrial fibrillation Rate controlled on admission. Restart home regimen (propafenone, and eliquis). Continue to monitor on telemetry   DM type II A1c 7.8 home dose of long-acting insulin (30 units twice daily). lantus to 30 units bid, continue SSI BG currently slightly above goal, continue to monitor and titrate   Hypothyroidism TSH level 4.52, FT4 0.8 resume dose levothyroxine   Thrombocytopenia, POA - resolved Platelets 114 on arrival, currently 157 OSA Per patient, not using CPAP anymore.   Morbid obesity Body mass index is 46.54 kg/m².
Age: 59.0
Sex: M
Vaccine: COVID19
Symptoms: Pancreatitis acute, Platelet count decreased, SARS-CoV-2 test positive, Tachypnoea, Thrombocytopenia
Clinical narrative: Patient is a 62 y.o. male patient of MD with history of ESRD, morbid obesity, DM type II, atrial fibrillation, hypothyroidism transferred to Medical Center for trauma evaluation.     Acute respiratory failure with hypoxia Tachypnea, dyspnea, hypoxia presentation Placed on 2 L nasal cannula in ED. Currently on 2L NC, wean as tolerated CTA of chest without acute gross abnormalities. Likely multifactorial (hypoventilation syndrome, untreated OSA). Pulmonary consulted.  Breathing treatments as needed   Covid-19 Virus Infection Tested positive on arrival; no obvious infiltrates on imaging Continue dexamethasone for 10-day course as was on nasal cannula and hypoxic initially   Acute pancreatitis Periumbilical abdominal pain as well as nausea. No other red flags. Possibly trauma related CT scan of abdomen with mild free fluid in the right upper quadrant in the left pararenal space. Lipase elevated to 1,279 > currently trending down to 281 Evaluated by trauma team in ED. No concern for surgical issues. Holding IV fluids in setting of ESRD. Pain and nausea control as needed. RUQ US evaluation limited due to body habitus; no evidence of acute cholecystitis; Increased echogenicity and heterogeneous echotexture of the liver suggestive of hepatocellular disease and/or steatosis. LFTs stable, INR 1.1; TG 235, ANA negative GI consulted, continue supportive care Currently advanced to solids, tolerating diet Fall Right proximal humerus Fracture Patient sustained a fall off his motorized scooter Diagnosed with right humerus fracture, Currently on sling. Transferred to medical center to be evaluated by trauma team. No other acute traumatic issues and scans; trauma team signed off.  Orthopedics consulted for recommendations - non operative mgmt Patient follow-up in clinic or at medical center as an outpatient PT/OT consulted - recommended for SNF, however patient refusing SNF, preferring to go home with home health care. Counseled on risks of not following this recommendation with regard to re-admission, falls, clinical decline, and potential risk of life-threatening measures such as death. Patient voiced understanding Pain control as needed.   Hyperkalemia - resolved Potassium of 6.3 on presentation. In setting of ESRD. K currently stable Nephrology consulted   ESRD On hemodialysis 3 times a week. Nephrology consulted for inpatient hemodialysis Monitor renal function closely   Paroxysmal atrial fibrillation Rate controlled on admission. Restart home regimen (propafenone, and eliquis). Continue to monitor on telemetry   DM type II A1c 7.8 home dose of long-acting insulin (30 units twice daily). lantus to 30 units bid, continue SSI BG currently slightly above goal, continue to monitor and titrate   Hypothyroidism TSH level 4.52, FT4 0.8 resume dose levothyroxine   Thrombocytopenia, POA - resolved Platelets 114 on arrival, currently 157 OSA Per patient, not using CPAP anymore.   Morbid obesity Body mass index is 46.54 kg/m².
Age: 59.0
Sex: M
Vaccine: COVID19
Symptoms: Thyroxine free normal, Ultrasound abdomen abnormal
Clinical narrative: Patient is a 62 y.o. male patient of MD with history of ESRD, morbid obesity, DM type II, atrial fibrillation, hypothyroidism transferred to Medical Center for trauma evaluation.     Acute respiratory failure with hypoxia Tachypnea, dyspnea, hypoxia presentation Placed on 2 L nasal cannula in ED. Currently on 2L NC, wean as tolerated CTA of chest without acute gross abnormalities. Likely multifactorial (hypoventilation syndrome, untreated OSA). Pulmonary consulted.  Breathing treatments as needed   Covid-19 Virus Infection Tested positive on arrival; no obvious infiltrates on imaging Continue dexamethasone for 10-day course as was on nasal cannula and hypoxic initially   Acute pancreatitis Periumbilical abdominal pain as well as nausea. No other red flags. Possibly trauma related CT scan of abdomen with mild free fluid in the right upper quadrant in the left pararenal space. Lipase elevated to 1,279 > currently trending down to 281 Evaluated by trauma team in ED. No concern for surgical issues. Holding IV fluids in setting of ESRD. Pain and nausea control as needed. RUQ US evaluation limited due to body habitus; no evidence of acute cholecystitis; Increased echogenicity and heterogeneous echotexture of the liver suggestive of hepatocellular disease and/or steatosis. LFTs stable, INR 1.1; TG 235, ANA negative GI consulted, continue supportive care Currently advanced to solids, tolerating diet Fall Right proximal humerus Fracture Patient sustained a fall off his motorized scooter Diagnosed with right humerus fracture, Currently on sling. Transferred to medical center to be evaluated by trauma team. No other acute traumatic issues and scans; trauma team signed off.  Orthopedics consulted for recommendations - non operative mgmt Patient follow-up in clinic or at medical center as an outpatient PT/OT consulted - recommended for SNF, however patient refusing SNF, preferring to go home with home health care. Counseled on risks of not following this recommendation with regard to re-admission, falls, clinical decline, and potential risk of life-threatening measures such as death. Patient voiced understanding Pain control as needed.   Hyperkalemia - resolved Potassium of 6.3 on presentation. In setting of ESRD. K currently stable Nephrology consulted   ESRD On hemodialysis 3 times a week. Nephrology consulted for inpatient hemodialysis Monitor renal function closely   Paroxysmal atrial fibrillation Rate controlled on admission. Restart home regimen (propafenone, and eliquis). Continue to monitor on telemetry   DM type II A1c 7.8 home dose of long-acting insulin (30 units twice daily). lantus to 30 units bid, continue SSI BG currently slightly above goal, continue to monitor and titrate   Hypothyroidism TSH level 4.52, FT4 0.8 resume dose levothyroxine   Thrombocytopenia, POA - resolved Platelets 114 on arrival, currently 157 OSA Per patient, not using CPAP anymore.   Morbid obesity Body mass index is 46.54 kg/m².
Age: 67.0
Sex: F
Vaccine: COVID19-2
Symptoms: Acute respiratory failure, COVID-19, Chest X-ray abnormal, Condition aggravated, Cough
Clinical narrative: Patient is a 68 y.o. female patient of, MD with history of morbid obesity, chronic pain, IBS, ESBL UTI, OSA, abd pain presented to Doctors Hospital with SOB.   Acute respiratory failure with hypoxia - resolved Chronic respiratory failure, reports 5 L home O2 requirement at nighttime and laying down COVID-19, POA Possible CAP Cough and SOB x 3 days.  Called PCP prior to admission advised ED evaluation Currently requiring 5L all day; baseline 5L O2 only at night CXR (10/10) pulm vascular congestion, diffuse interstitial infiltrates and opacifications Afebrile, no leukocytosis Positive covid-19 test Started on remdesivir and steroids. Remdesivir course will not keep patient in hospital if she is medically improved for discharge otherwise. Pulm hygiene ID consulted for assistance with COVID-specific therapies Started on dexamethasone as well as remdesivir which was discontinued as patient was improved before course completion   Morbid obesity BMI 65.37 Patient would benefit from bariatric surgery referral outpatient   Reduced mobility, on admission Patient with wheelchair in her room which she utilizes much of the time at home   Fibromyalgia Back pain Per history S/p L4 laminectomy by Dr. (NS) 10/2020 Resume home flexeril   OSA Compliant with CPAP Ordered Chronic Abdominal pain Asymptomatic on arrival Recently admitted 10/5 for assistance with bowel prep for planned EGD/colonoscopy per Dr., GI Bowel prep was not ordered and procedure was not able to be completed Follow up with GI outpt   Residence prior to admission: house or apartment Was patient transferred from outlying hospital or ED no
Age: 67.0
Sex: F
Vaccine: COVID19-2
Symptoms: Dyspnoea, Hypoxia, Lung infiltration, Lung opacity, Mobility decreased
Clinical narrative: Patient is a 68 y.o. female patient of, MD with history of morbid obesity, chronic pain, IBS, ESBL UTI, OSA, abd pain presented to Doctors Hospital with SOB.   Acute respiratory failure with hypoxia - resolved Chronic respiratory failure, reports 5 L home O2 requirement at nighttime and laying down COVID-19, POA Possible CAP Cough and SOB x 3 days.  Called PCP prior to admission advised ED evaluation Currently requiring 5L all day; baseline 5L O2 only at night CXR (10/10) pulm vascular congestion, diffuse interstitial infiltrates and opacifications Afebrile, no leukocytosis Positive covid-19 test Started on remdesivir and steroids. Remdesivir course will not keep patient in hospital if she is medically improved for discharge otherwise. Pulm hygiene ID consulted for assistance with COVID-specific therapies Started on dexamethasone as well as remdesivir which was discontinued as patient was improved before course completion   Morbid obesity BMI 65.37 Patient would benefit from bariatric surgery referral outpatient   Reduced mobility, on admission Patient with wheelchair in her room which she utilizes much of the time at home   Fibromyalgia Back pain Per history S/p L4 laminectomy by Dr. (NS) 10/2020 Resume home flexeril   OSA Compliant with CPAP Ordered Chronic Abdominal pain Asymptomatic on arrival Recently admitted 10/5 for assistance with bowel prep for planned EGD/colonoscopy per Dr., GI Bowel prep was not ordered and procedure was not able to be completed Follow up with GI outpt   Residence prior to admission: house or apartment Was patient transferred from outlying hospital or ED no
Age: 67.0
Sex: F
Vaccine: COVID19-2
Symptoms: Pulmonary congestion, SARS-CoV-2 test positive
Clinical narrative: Patient is a 68 y.o. female patient of, MD with history of morbid obesity, chronic pain, IBS, ESBL UTI, OSA, abd pain presented to Doctors Hospital with SOB.   Acute respiratory failure with hypoxia - resolved Chronic respiratory failure, reports 5 L home O2 requirement at nighttime and laying down COVID-19, POA Possible CAP Cough and SOB x 3 days.  Called PCP prior to admission advised ED evaluation Currently requiring 5L all day; baseline 5L O2 only at night CXR (10/10) pulm vascular congestion, diffuse interstitial infiltrates and opacifications Afebrile, no leukocytosis Positive covid-19 test Started on remdesivir and steroids. Remdesivir course will not keep patient in hospital if she is medically improved for discharge otherwise. Pulm hygiene ID consulted for assistance with COVID-specific therapies Started on dexamethasone as well as remdesivir which was discontinued as patient was improved before course completion   Morbid obesity BMI 65.37 Patient would benefit from bariatric surgery referral outpatient   Reduced mobility, on admission Patient with wheelchair in her room which she utilizes much of the time at home   Fibromyalgia Back pain Per history S/p L4 laminectomy by Dr. (NS) 10/2020 Resume home flexeril   OSA Compliant with CPAP Ordered Chronic Abdominal pain Asymptomatic on arrival Recently admitted 10/5 for assistance with bowel prep for planned EGD/colonoscopy per Dr., GI Bowel prep was not ordered and procedure was not able to be completed Follow up with GI outpt   Residence prior to admission: house or apartment Was patient transferred from outlying hospital or ED no
Age: 37.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Dyspepsia, Headache, Pain, Pain in extremity
Clinical narrative: Right arm pain 3 hours post when lifting arm. Temperature of 98.0 feeling chilled and feverish, some sneezing. Diffuse pain Sunday night. Swelling and indigestion probably from swelling. Severe headache that was not responsive to over the counter pain medication
Age: 37.0
Sex: F
Vaccine: COVID19
Symptoms: Pyrexia, Sneezing, Swelling
Clinical narrative: Right arm pain 3 hours post when lifting arm. Temperature of 98.0 feeling chilled and feverish, some sneezing. Diffuse pain Sunday night. Swelling and indigestion probably from swelling. Severe headache that was not responsive to over the counter pain medication
Age: 37.0
Sex: M
Vaccine: COVID19
Symptoms: Tinnitus
Clinical narrative: Persistent tinnitus. Since the vaccine, I have a constant ringing in my ears. It is very high in pitch and constantly noticeable. Similar to the volume of quiet speech.
Age: 21.0
Sex: F
Vaccine: FLUC4
Symptoms: Urticaria
Clinical narrative: Patient developed hives after administration.  Patient has a history of egg allergy, and a history to thimerosol.  Patient also documents a history of allergic reaction to the flu vaccine, but had successfully received FluBlok in the past.
Age: 18.0
Sex: M
Vaccine: FLU4
Symptoms: Eye pruritus, Eye swelling, Ocular hyperaemia
Clinical narrative: Patient reported the day after receiving flu vaccine his left eye became red and swollen itchy . No discharge, blurred vision. patient reports it got better on it's own.  As of 11/27/23 still a little bit red.
Age: 29.0
Sex: F
Vaccine: JEV1, TYP
Symptoms: Dizziness, Hyperhidrosis, Malaise, Pallor, Syncope
Clinical narrative: After giving the patient the last injection Patient got pallor and diaphoretic.  Patient stated that she was not feeling well.  Asked patient is she would like to lay down, she stated she would.  While helping patient from chair to table, Patient became very lightheaded.  Patient did not make it to the bed and fainted between the chair and the bed.  I was able to help patient the floor.  I called for help, patient came too about 2 minutes latter.  Patient, nurse and reporter helped patient to the table. Nurse left to give report to Dr, and returned with orders to take VS and to monitor.  I was able to ask patient if this has happened before patient stated no.   Patient did say eat breakfast.  VS at 0921 was 99/66 HR 77, Vital signs at 0930 was 115/72.  Patient stated that she is feeling better.  Call spouse to come tot he clinic and take patient home.  Gave repot to Dr again about the condition of the patient.  Patient released to spouse with instructions that if she starts to feel unwell to take patient the the ED.  Spouse understood
Age: 71.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: COVID-19, Death, SARS-CoV-2 test positive
Clinical narrative: Pt was hospitalized with covid on 11/22-11/27 and pt died
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Ankylosing spondylitis, Arthralgia, Autoimmune disorder, Incorrect dose administered, Knee arthroplasty
Clinical narrative: I received the booster administered by my employer. I received a letter 4 months later stating I was given the wrong dosage.  I should have been given .25ml but was given .50ml which is for immune comprised people. Later that year I started developing severe pain in my joints. I have had 2 surgeries as a result of this and have been diagnosed with an autoimmune disease affecting my joints. I did not have this before I was given the wrong dosage.
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Wrist surgery
Clinical narrative: I received the booster administered by my employer. I received a letter 4 months later stating I was given the wrong dosage.  I should have been given .25ml but was given .50ml which is for immune comprised people. Later that year I started developing severe pain in my joints. I have had 2 surgeries as a result of this and have been diagnosed with an autoimmune disease affecting my joints. I did not have this before I was given the wrong dosage.
Age: 2.0
Sex: M
Vaccine: COVID19
Symptoms: Blood glucose normal, Body temperature increased, Confusional state, Eye movement disorder, Fatigue
Clinical narrative: From ED note: MRN:   Encounter Date: 11/17/2023  ED 11/17/2023 (1 hours) Status: Discharged Emergency Department Last attending:  MD ? Treatment team Primary impression: Febrile seizure (code) Chief complaint: Febrile Seizure; Referred by, MD Cosigned by: MD at 11/18/2023 9:20 AM Attestation signed by, MD at 11/18/2023 9:20 AM 11/18/23 Medical Center Hospital  ED Attending Standard Attestation My date of service is 11/17/2023. I was present for and performed key portions of the examination of the patient. I am personally involved in the management of the patient. I agree with the findings and care plan as documented by the resident. ED Attending(s): Interpreter used? (Optional): No Patient is a 2 y.o. old male, with no past medical history, up-to-date on vaccines, brought in by EMS after febrile seizure. Mom checked his temperature this morning, which was 100.3. Later this morning, he became more tired, out of it, less responsive, and his eyes rolled back in his head for 1 to 2 minutes. Mom did not recall any shaking activity. He was unresponsive for 1 to 2 minutes when his eyes were rolled back. She called EMS at this time. On EMS arrival, his temperature was 103. They reported that he appeared very confused but was awake on transit. Fingerstick glucose wnl.  Of note, patient had COVID-vaccine yesterday and has had nasal congestion over the past few days. Did not receive any antipyretics this morning
Age: 2.0
Sex: M
Vaccine: COVID19
Symptoms: Febrile convulsion, Hyporesponsive to stimuli, Nasal congestion, Unresponsive to stimuli
Clinical narrative: From ED note: MRN:   Encounter Date: 11/17/2023  ED 11/17/2023 (1 hours) Status: Discharged Emergency Department Last attending:  MD ? Treatment team Primary impression: Febrile seizure (code) Chief complaint: Febrile Seizure; Referred by, MD Cosigned by: MD at 11/18/2023 9:20 AM Attestation signed by, MD at 11/18/2023 9:20 AM 11/18/23 Medical Center Hospital  ED Attending Standard Attestation My date of service is 11/17/2023. I was present for and performed key portions of the examination of the patient. I am personally involved in the management of the patient. I agree with the findings and care plan as documented by the resident. ED Attending(s): Interpreter used? (Optional): No Patient is a 2 y.o. old male, with no past medical history, up-to-date on vaccines, brought in by EMS after febrile seizure. Mom checked his temperature this morning, which was 100.3. Later this morning, he became more tired, out of it, less responsive, and his eyes rolled back in his head for 1 to 2 minutes. Mom did not recall any shaking activity. He was unresponsive for 1 to 2 minutes when his eyes were rolled back. She called EMS at this time. On EMS arrival, his temperature was 103. They reported that he appeared very confused but was awake on transit. Fingerstick glucose wnl.  Of note, patient had COVID-vaccine yesterday and has had nasal congestion over the past few days. Did not receive any antipyretics this morning
Age: 79.0
Sex: M
Vaccine: COVID19
Symptoms: Discomfort, Product administered at inappropriate site
Clinical narrative: Patient complains that vaccine admin was too high on the arm (towards the shoulder area). Patient went to urgent care after pcp instructed patient to seek medical attention due to complaints of discomfort.
Age: 92.0
Sex: M
Vaccine: COVID19
Symptoms: Injection site pruritus, Pruritus
Clinical narrative: Itching at injection site and down the arm
Age: 87.0
Sex: M
Vaccine: COVID19, FLU4, RSV
Symptoms: Angiogram cerebral, Arteriogram carotid, Blood lactic acid normal, Blood thyroid stimulating hormone normal, C-reactive protein normal
Clinical narrative: Influenza and Covid vaccine administered on 10/10/23.  Patient seen in express clinic for upper respiratory infection on 10/18/23 and treated with azithromycin.  RSV vaccine administered on 10/24/23.  Patient seen in clinic for bilateral leg weakness on 11/15/23 that started three days prior.  Patient seen in emergency department on 11/18/23 for progressive bilateral leg weakness and failure.  Patient admitted to hospital that day with a diagnosis of Guillain- barre syndrome and treated with intravenous immunoglobulin 0.4 g/kg/day x 5 days.   Progressive nature of leg weakness ceased after day 1 of IVIG therapy,  and gradual return of leg function started to return around day 3 or 4 of therapy.   Patient discharged to skilled nursing facility to continue PT/OT as he is not back at his baseline strength as of the time of this report.
Age: 87.0
Sex: M
Vaccine: COVID19, FLU4, RSV
Symptoms: Computerised tomogram head, Full blood count normal, Guillain-Barre syndrome, Immunoglobulin therapy, Magnetic resonance imaging spinal
Clinical narrative: Influenza and Covid vaccine administered on 10/10/23.  Patient seen in express clinic for upper respiratory infection on 10/18/23 and treated with azithromycin.  RSV vaccine administered on 10/24/23.  Patient seen in clinic for bilateral leg weakness on 11/15/23 that started three days prior.  Patient seen in emergency department on 11/18/23 for progressive bilateral leg weakness and failure.  Patient admitted to hospital that day with a diagnosis of Guillain- barre syndrome and treated with intravenous immunoglobulin 0.4 g/kg/day x 5 days.   Progressive nature of leg weakness ceased after day 1 of IVIG therapy,  and gradual return of leg function started to return around day 3 or 4 of therapy.   Patient discharged to skilled nursing facility to continue PT/OT as he is not back at his baseline strength as of the time of this report.
Age: 87.0
Sex: M
Vaccine: COVID19, FLU4, RSV
Symptoms: Metabolic function test, Muscular weakness, Musculoskeletal disorder, Red blood cell sedimentation rate increased, Ultrasound Doppler
Clinical narrative: Influenza and Covid vaccine administered on 10/10/23.  Patient seen in express clinic for upper respiratory infection on 10/18/23 and treated with azithromycin.  RSV vaccine administered on 10/24/23.  Patient seen in clinic for bilateral leg weakness on 11/15/23 that started three days prior.  Patient seen in emergency department on 11/18/23 for progressive bilateral leg weakness and failure.  Patient admitted to hospital that day with a diagnosis of Guillain- barre syndrome and treated with intravenous immunoglobulin 0.4 g/kg/day x 5 days.   Progressive nature of leg weakness ceased after day 1 of IVIG therapy,  and gradual return of leg function started to return around day 3 or 4 of therapy.   Patient discharged to skilled nursing facility to continue PT/OT as he is not back at his baseline strength as of the time of this report.
Age: 87.0
Sex: M
Vaccine: COVID19, FLU4, RSV
Symptoms: Upper respiratory tract infection, Vitamin B12 normal, X-ray limb abnormal, X-ray of pelvis and hip
Clinical narrative: Influenza and Covid vaccine administered on 10/10/23.  Patient seen in express clinic for upper respiratory infection on 10/18/23 and treated with azithromycin.  RSV vaccine administered on 10/24/23.  Patient seen in clinic for bilateral leg weakness on 11/15/23 that started three days prior.  Patient seen in emergency department on 11/18/23 for progressive bilateral leg weakness and failure.  Patient admitted to hospital that day with a diagnosis of Guillain- barre syndrome and treated with intravenous immunoglobulin 0.4 g/kg/day x 5 days.   Progressive nature of leg weakness ceased after day 1 of IVIG therapy,  and gradual return of leg function started to return around day 3 or 4 of therapy.   Patient discharged to skilled nursing facility to continue PT/OT as he is not back at his baseline strength as of the time of this report.
Age: 84.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site erythema, Injection site inflammation, Injection site pain
Clinical narrative: Day after receiving injection patient noted "large area of" redness, inflammation, and pain at injection site.  States symptoms lasted 4-5 days
Age: 62.0
Sex: F
Vaccine: FLUC4, RSV
Symptoms: Cough, Influenza virus test, Respiratory syncytial virus test, SARS-CoV-2 test
Clinical narrative: Cough 5 weeks non-Productive
Age: 36.0
Sex: F
Vaccine: RSV
Symptoms: Exposure during pregnancy, Haemorrhage in pregnancy, Muscle spasms, Premature delivery, Premature labour
Clinical narrative: 35 weeks pregnant, approximately 5 hours after receiving the vaccine I experienced cramping and  bleeding.  I was admitted to hospital where they confirmed spontaneous pre term labor and delivered in less than 24 hours from receiving the vaccine.
Age: 86.0
Sex: F
Vaccine: RSV
Symptoms: Arthralgia, Cough, Hypoxia, Influenza virus test negative, Respiratory syncytial virus test negative
Clinical narrative: Coughing, achey, hypoxia-negative nasal swab for RSV, Covid and influenza day of visit
Age: 86.0
Sex: F
Vaccine: RSV
Symptoms: SARS-CoV-2 test negative
Clinical narrative: Coughing, achey, hypoxia-negative nasal swab for RSV, Covid and influenza day of visit
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: Angiocardiogram, Pericarditis
Clinical narrative: Pericarditis
Age: 2.0
Sex: F
Vaccine: MMRV, VARCEL
Symptoms: Wrong product administered
Clinical narrative: After administration of these vaccines and after the child had left the clinic I realized I had given the proquad in place of a MMR. Therefore the patient received a proquad and a varicella at the same visit. The child had no symptoms of adverse reaction at the time of their departure. Once the mistake was found I called the caregiver to check on the child and notify her of the mistake. She reported the child was fine. I instructed her to seek medical attention for any adverse reactions.
Age: 66.0
Sex: F
Vaccine: RSV
Symptoms: Injected limb mobility decreased, Pain in extremity
Clinical narrative: On 11/27/2023, patient reported pain, and limited range of motion in the left arm, where the vaccine was administered. These effects were ongoing, and were especially distressing since the patient stated they had been undergoing physical therapy and felt as though they had lost substantial progress. I referred them to their provider for further assessment of any injury.
Age: 33.0
Sex: F
Vaccine: FLU4
Symptoms: Throat tightness
Clinical narrative: Patient reporting throat closing within about 30 minutes of vaccination. Given diphenhydramine, monitored for about 30 minutes and able to discharge home from clinic.
Age: 1.75
Sex: F
Vaccine: MMRV, VARCEL
Symptoms: No adverse event, Product administered to patient of inappropriate age, Wrong product administered
Clinical narrative: After administering the above vaccines and the child had exited the clinic the nurse realized she had given proquad in place of a MMR. Therefore the child received a Proquad and a varicella at this visit. The nurse states when she went back and looked there was no MMR and she mistook the proquad box for the MMR. I phoned the caregiver to check on the child and notify the caregiver of the error. She states the child was doing fine. I counseled her to seek medical attention if the child has any adverse reaction or medical emergencies. An incident report was completed and sent to our supervisor. We discussed how to avoid this mistake in the future by reviewing the 5 Rs of vaccine administration.
Age: 77.0
Sex: M
Vaccine: RSV
Symptoms: Arthralgia
Clinical narrative: multiple joint arthralgia
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: hospitalized with covid; fully vaccinated
Age: 71.0
Sex: M
Vaccine: COVID19-2
Symptoms: Angiogram pulmonary normal, Blood creatinine increased, Blood lactic acid normal, COVID-19, Cardiac telemetry abnormal
Clinical narrative: 72 y.o. male patient of, MD with history of DM2, CKD, HTN, BPH. Presented to PCP office with COVID-19 and found to have an abnormal tachycardic rhythm and sent to ED for evaluation. He was in sinus tachycardia, and admitted for observation of heart rate and Sepsis criteria met. His vital signs improved after IVF and he was medical stable to go home.    Sepsis, resolved COVID-19 infection Cough started 10/3; positive for COVID on 10/04 HR and RR high normal, hemodynamically stable WBC and LA wnl Continued Paxlovid Deferred blood cultures and urine cultures in setting of known viral infection   Tachycardia, resolved Likely in the setting of COVID, dehydration EKG in ED with sinus tachycardia (HR 138) CXR, CTPA nonacute S/p IVF Telemetry with sinus tachycardia and NSR   Chronic Conditions HTN: Amlodipine, Atorvastatin, Lisinopril, Hydrochlorothiazide DM2: Glyburide, Metformin; 7/2023 A1c 6.9% CKD: Cr 1.47 BPH: finasteride
Age: 71.0
Sex: M
Vaccine: COVID19-2
Symptoms: Chest X-ray normal, Cough, Dehydration, Electrocardiogram abnormal, Glycosylated haemoglobin normal
Clinical narrative: 72 y.o. male patient of, MD with history of DM2, CKD, HTN, BPH. Presented to PCP office with COVID-19 and found to have an abnormal tachycardic rhythm and sent to ED for evaluation. He was in sinus tachycardia, and admitted for observation of heart rate and Sepsis criteria met. His vital signs improved after IVF and he was medical stable to go home.    Sepsis, resolved COVID-19 infection Cough started 10/3; positive for COVID on 10/04 HR and RR high normal, hemodynamically stable WBC and LA wnl Continued Paxlovid Deferred blood cultures and urine cultures in setting of known viral infection   Tachycardia, resolved Likely in the setting of COVID, dehydration EKG in ED with sinus tachycardia (HR 138) CXR, CTPA nonacute S/p IVF Telemetry with sinus tachycardia and NSR   Chronic Conditions HTN: Amlodipine, Atorvastatin, Lisinopril, Hydrochlorothiazide DM2: Glyburide, Metformin; 7/2023 A1c 6.9% CKD: Cr 1.47 BPH: finasteride
Age: 71.0
Sex: M
Vaccine: COVID19-2
Symptoms: SARS-CoV-2 test positive, Sepsis, Sinus rhythm, Sinus tachycardia, Tachycardia
Clinical narrative: 72 y.o. male patient of, MD with history of DM2, CKD, HTN, BPH. Presented to PCP office with COVID-19 and found to have an abnormal tachycardic rhythm and sent to ED for evaluation. He was in sinus tachycardia, and admitted for observation of heart rate and Sepsis criteria met. His vital signs improved after IVF and he was medical stable to go home.    Sepsis, resolved COVID-19 infection Cough started 10/3; positive for COVID on 10/04 HR and RR high normal, hemodynamically stable WBC and LA wnl Continued Paxlovid Deferred blood cultures and urine cultures in setting of known viral infection   Tachycardia, resolved Likely in the setting of COVID, dehydration EKG in ED with sinus tachycardia (HR 138) CXR, CTPA nonacute S/p IVF Telemetry with sinus tachycardia and NSR   Chronic Conditions HTN: Amlodipine, Atorvastatin, Lisinopril, Hydrochlorothiazide DM2: Glyburide, Metformin; 7/2023 A1c 6.9% CKD: Cr 1.47 BPH: finasteride
Age: 71.0
Sex: M
Vaccine: COVID19-2
Symptoms: Viral infection, White blood cell count normal
Clinical narrative: 72 y.o. male patient of, MD with history of DM2, CKD, HTN, BPH. Presented to PCP office with COVID-19 and found to have an abnormal tachycardic rhythm and sent to ED for evaluation. He was in sinus tachycardia, and admitted for observation of heart rate and Sepsis criteria met. His vital signs improved after IVF and he was medical stable to go home.    Sepsis, resolved COVID-19 infection Cough started 10/3; positive for COVID on 10/04 HR and RR high normal, hemodynamically stable WBC and LA wnl Continued Paxlovid Deferred blood cultures and urine cultures in setting of known viral infection   Tachycardia, resolved Likely in the setting of COVID, dehydration EKG in ED with sinus tachycardia (HR 138) CXR, CTPA nonacute S/p IVF Telemetry with sinus tachycardia and NSR   Chronic Conditions HTN: Amlodipine, Atorvastatin, Lisinopril, Hydrochlorothiazide DM2: Glyburide, Metformin; 7/2023 A1c 6.9% CKD: Cr 1.47 BPH: finasteride
Age: 66.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Atrial fibrillation, COVID-19, Chronic left ventricular failure, Death
Clinical narrative: Patient is a 67 y.o. female with a past medical history that includes COPD, Lung CA s/p SBRT, HFpEF, DVT not on AC, Afib, GERD, Anxiety. She presented on 10/6/2023 via EMS from a SNF with SOB and hypoxia. She was found to be COVID positive. Started on HHNC, Decadron, remdesevir, and empiric abx. TTE showed pericardial effusion that increased in size. Cardiology recommended no acute intervention. Patient with worsening respiratory status on HHFNC, couldn't tolerate BiPAP.  Family decided to transition to comfort care given her poor prognosis. Hospice service consulted. Patient passed away 10/8/23   Discharge Diagnoses: 1. Acute on chronic respiratory failure with hypoxia & hypercapnia 2. Severe sepsis 3. COVID-19 4. Acute encephalopathy, likely metabolic 5. Chronic diastolic heart failure 6. Hyperkalemia 7. Anxiety/depression 8. Atrial fibrillation 9. History of DVT 10. Dysphagia
Age: 66.0
Sex: F
Vaccine: COVID19
Symptoms: Depression, Device intolerance, Dysphagia, Dyspnoea, Echocardiogram
Clinical narrative: Patient is a 67 y.o. female with a past medical history that includes COPD, Lung CA s/p SBRT, HFpEF, DVT not on AC, Afib, GERD, Anxiety. She presented on 10/6/2023 via EMS from a SNF with SOB and hypoxia. She was found to be COVID positive. Started on HHNC, Decadron, remdesevir, and empiric abx. TTE showed pericardial effusion that increased in size. Cardiology recommended no acute intervention. Patient with worsening respiratory status on HHFNC, couldn't tolerate BiPAP.  Family decided to transition to comfort care given her poor prognosis. Hospice service consulted. Patient passed away 10/8/23   Discharge Diagnoses: 1. Acute on chronic respiratory failure with hypoxia & hypercapnia 2. Severe sepsis 3. COVID-19 4. Acute encephalopathy, likely metabolic 5. Chronic diastolic heart failure 6. Hyperkalemia 7. Anxiety/depression 8. Atrial fibrillation 9. History of DVT 10. Dysphagia
Age: 66.0
Sex: F
Vaccine: COVID19
Symptoms: Hypercapnia, Hyperkalaemia, Hypoxia, Metabolic encephalopathy, Pericardial effusion
Clinical narrative: Patient is a 67 y.o. female with a past medical history that includes COPD, Lung CA s/p SBRT, HFpEF, DVT not on AC, Afib, GERD, Anxiety. She presented on 10/6/2023 via EMS from a SNF with SOB and hypoxia. She was found to be COVID positive. Started on HHNC, Decadron, remdesevir, and empiric abx. TTE showed pericardial effusion that increased in size. Cardiology recommended no acute intervention. Patient with worsening respiratory status on HHFNC, couldn't tolerate BiPAP.  Family decided to transition to comfort care given her poor prognosis. Hospice service consulted. Patient passed away 10/8/23   Discharge Diagnoses: 1. Acute on chronic respiratory failure with hypoxia & hypercapnia 2. Severe sepsis 3. COVID-19 4. Acute encephalopathy, likely metabolic 5. Chronic diastolic heart failure 6. Hyperkalemia 7. Anxiety/depression 8. Atrial fibrillation 9. History of DVT 10. Dysphagia
Age: 66.0
Sex: F
Vaccine: COVID19
Symptoms: Positive airway pressure therapy, Respiratory distress, SARS-CoV-2 test positive, Sepsis
Clinical narrative: Patient is a 67 y.o. female with a past medical history that includes COPD, Lung CA s/p SBRT, HFpEF, DVT not on AC, Afib, GERD, Anxiety. She presented on 10/6/2023 via EMS from a SNF with SOB and hypoxia. She was found to be COVID positive. Started on HHNC, Decadron, remdesevir, and empiric abx. TTE showed pericardial effusion that increased in size. Cardiology recommended no acute intervention. Patient with worsening respiratory status on HHFNC, couldn't tolerate BiPAP.  Family decided to transition to comfort care given her poor prognosis. Hospice service consulted. Patient passed away 10/8/23   Discharge Diagnoses: 1. Acute on chronic respiratory failure with hypoxia & hypercapnia 2. Severe sepsis 3. COVID-19 4. Acute encephalopathy, likely metabolic 5. Chronic diastolic heart failure 6. Hyperkalemia 7. Anxiety/depression 8. Atrial fibrillation 9. History of DVT 10. Dysphagia
Age: 1.0
Sex: F
Vaccine: FLUC4, HEPA, MMRV, PNC20, FLUC4, HEPA, MMRV, PNC20, FLUX(H1N1), HEPA, MMRV, PNC20, TD, UNK, UNK, UNK
Symptoms: Death
Clinical narrative: Death, patient was found by parents on  11/26/23 overnight.
Age: 1.0
Sex: F
Vaccine: FLUC4, HEPA, MMRV, PNC20, FLUC4, HEPA, MMRV, PNC20, FLUX(H1N1), HEPA, MMRV, PNC20, TD, UNK, UNK, UNK
Symptoms: Death, Increased bronchial secretion, Lung disorder, Resuscitation
Clinical narrative: Death, patient was found by parents on  11/26/23 overnight.
Age: 17.0
Sex: M
Vaccine: FLU4, HPV9, MENB
Symptoms: Dizziness, Pallor, Syncope
Clinical narrative: Post vaccination, client with syncopal episode and pale color; ammonia inhalant administered and responsive within seconds. client reported feeling dizziness.  Repositioned from sitting to supine; color pink.  Monitored for period of fifteen minutes in nurse's station.     No further complaints at completion of observation phase.
Age: 85.0
Sex: M
Vaccine: FLU4
Symptoms: Extra dose administered, No adverse event
Clinical narrative: No adverse reactions noted. Pt was given a high dose flu vaccine on 10/19/23 and on 11/15/23.
Age: 1.33
Sex: M
Vaccine: MMR
Symptoms: Abnormal behaviour, Aggression, Dizziness, Eye movement disorder, Fall
Clinical narrative: Patient had been jumping running and walking totally fine and where he should be for his age if not above where he should be. Then after receiving the shot - that day, he was wobbly, falling down, dizzy, eyes rolling back, legs would just give out and was very off center. He also was very aggressive and fuzzy. It has now been 3 months and during these 3 months he has been hitting his head hard against things (never did this before) , eyes are still rolling back and now he is having pain in his testicles..  he has not been the same since getting the shot.
Age: 1.33
Sex: M
Vaccine: MMR
Symptoms: Feeling abnormal, Gait disturbance, Muscular weakness, Testicular pain
Clinical narrative: Patient had been jumping running and walking totally fine and where he should be for his age if not above where he should be. Then after receiving the shot - that day, he was wobbly, falling down, dizzy, eyes rolling back, legs would just give out and was very off center. He also was very aggressive and fuzzy. It has now been 3 months and during these 3 months he has been hitting his head hard against things (never did this before) , eyes are still rolling back and now he is having pain in his testicles..  he has not been the same since getting the shot.
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, Blood pressure increased, COVID-19, Cerebral infarction, Cough
Clinical narrative: presented from facility for 2 weeks of worsening weakness without focal symptoms. Of note, patient tested positive for COVID 2/4/22 with mild symptoms (fatigue and cough) and completed course of steroids and remdesivir (2/4-2/8). MRI brain on admission notable for multi territory infarcts both chronic subacute embolic infarcts. NSGY and Neurology consulted. No obvious hemorrhage, no acute surgical intervention. On admission, patient with low platelets (20) in setting of hx of ITP and active infection. Platelets returned to baseline and patient was restarted on home ASA. Additionally, patient's pressures slightly elevated, was restarted on amlodipine 10mg daily.  Patient worked closely with PT/OT and returned back to neurological baseline prior to discharge.
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: Embolic cerebral infarction, Fatigue, Infection, Magnetic resonance imaging head abnormal, Nervous system disorder
Clinical narrative: presented from facility for 2 weeks of worsening weakness without focal symptoms. Of note, patient tested positive for COVID 2/4/22 with mild symptoms (fatigue and cough) and completed course of steroids and remdesivir (2/4-2/8). MRI brain on admission notable for multi territory infarcts both chronic subacute embolic infarcts. NSGY and Neurology consulted. No obvious hemorrhage, no acute surgical intervention. On admission, patient with low platelets (20) in setting of hx of ITP and active infection. Platelets returned to baseline and patient was restarted on home ASA. Additionally, patient's pressures slightly elevated, was restarted on amlodipine 10mg daily.  Patient worked closely with PT/OT and returned back to neurological baseline prior to discharge.
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: Platelet count decreased, SARS-CoV-2 test positive
Clinical narrative: presented from facility for 2 weeks of worsening weakness without focal symptoms. Of note, patient tested positive for COVID 2/4/22 with mild symptoms (fatigue and cough) and completed course of steroids and remdesivir (2/4-2/8). MRI brain on admission notable for multi territory infarcts both chronic subacute embolic infarcts. NSGY and Neurology consulted. No obvious hemorrhage, no acute surgical intervention. On admission, patient with low platelets (20) in setting of hx of ITP and active infection. Platelets returned to baseline and patient was restarted on home ASA. Additionally, patient's pressures slightly elevated, was restarted on amlodipine 10mg daily.  Patient worked closely with PT/OT and returned back to neurological baseline prior to discharge.
Age: 67.0
Sex: F
Vaccine: VARZOS
Symptoms: Dizziness, Pain, Palpitations
Clinical narrative: She got her vaccine, short of a minute very soon after her heart started racing.  Then it stopped after a short period of time, maybe 1 minute or so.  She was driving, and as soon as she got out of the car she was dizzy and was dizzy for the rest of the day like vertigo.  She did not feel she needed to go to the ER.  Later that night she had normal reactions, aches and pains.  She called her doctor and they responded to her that it happens to some people and that was it.  She is only calling as she read that is happens to some people and that some may have an allergic reaction and felt that she needed to report it.   This happened on a Saturday and on Sunday morning she was fine, and she called them on Monday.  It lasted throughout the day on Saturday and for 12 hours she felt a little bit dizzy.  She has never had this type of reaction before.  She has gotten the flu shot for years, has gotten all the COVID shots and has never had a reaction like this.  She has no history of any heart problems.
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: Acute kidney injury, Acute respiratory distress syndrome, Acute respiratory failure, Brain injury, COVID-19
Clinical narrative: Patient is a 63 y.o. female who presented with cough, shortness of breath as well as fevers and triggered severe sepsis with a severe cytokine release storm.  Patient had a positive Covid 19 test prior to admission.   She was hypoxic on presentation and placed on a non-rebreather.  She was started empirically on Rocephin and azithromycin along with Decadron, Singulair and Lovenox. Unfortunately, patient continued to worsen and was subsequently intubated for acute hypoxic respiratory failure.  She was treated with Veletri and is immunocompromised given a history of rheumatoid arthritis involving multiple sites.  Patient developed acute liver injury and had to come off of the remdesevir. The acute liver injury was felt secondary to shock liver.  She also developed acute kidney injury with acute tubular necrosis from the Covid sepsis.  She was seen by Nephrology and initiated on CRRT. She was on dobutamine which was weaned.  Patient had cardiomyopathy, felt secondary to Covid 19 myocarditis.  Patient was not responding to stimulation and cutting back on her sedation.  Brain imaging was done which showed anoxic type injury. Patient underwent a tracheostomy 01/07/2022 for her ongoing ARDS.  Patient will be transferred to LTAC.
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: Cardiomyopathy, Cough, Cytokine storm, Dyspnoea, Endotracheal intubation
Clinical narrative: Patient is a 63 y.o. female who presented with cough, shortness of breath as well as fevers and triggered severe sepsis with a severe cytokine release storm.  Patient had a positive Covid 19 test prior to admission.   She was hypoxic on presentation and placed on a non-rebreather.  She was started empirically on Rocephin and azithromycin along with Decadron, Singulair and Lovenox. Unfortunately, patient continued to worsen and was subsequently intubated for acute hypoxic respiratory failure.  She was treated with Veletri and is immunocompromised given a history of rheumatoid arthritis involving multiple sites.  Patient developed acute liver injury and had to come off of the remdesevir. The acute liver injury was felt secondary to shock liver.  She also developed acute kidney injury with acute tubular necrosis from the Covid sepsis.  She was seen by Nephrology and initiated on CRRT. She was on dobutamine which was weaned.  Patient had cardiomyopathy, felt secondary to Covid 19 myocarditis.  Patient was not responding to stimulation and cutting back on her sedation.  Brain imaging was done which showed anoxic type injury. Patient underwent a tracheostomy 01/07/2022 for her ongoing ARDS.  Patient will be transferred to LTAC.