chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 49.0
Sex: F
Vaccine: FLU3
Symptoms: Palpitations, Postnasal drip, Shoulder pain, Skin burning sensation
Clinical narrative: A report was received from a health care professional on 2/9/04 concerning a female vaccinee of unspecified age who experienced ear pain within a few days of vaccination and neck pain, chills, headaches, post-nasal drip, muscle spasms, an increase in blood pressure, an increase in heart rate, fluid in her ear, sinus congestion, a sensation of her body being on fire, diarrhea, palpitations with shortness of breath, loss of appetite, hair loss, night sweats, pain in the right deltoid, pain in the right shoulder joint, numbness in the fingers, muscle cramps, fatigue, cough, tingling in the head and jaw and was unable to turn her head an unspecified length of time after receiving Fluvirin on the right side on 10/23/03.  On an unspecified date the vaccinee experienced right ear pain within a few days of vaccination and right-sided neck pain, chills, headaches which lasted approximately 1.5 weeks, severe post-nasal drip (on the right side only), muscle spasms in the jaw and neck, an increase in blood pressure, an increase in heart rate, fluid in her right ear, severe sinus congestion, a sensation of her body being on fire lasting for about 10 hours, diarrhea, palpitations with shortness of breath, loss of appetite, hair loss, night sweats, pain in the right deltoid, pain in the right shoulder joint, numbness in the fingers, muscle cramps in her right calf and thigh, fatigue, cough, a sensation of tingling in the head and jaw and was unable to turn her head. The reporter indicated that all symptoms began shortly after receiving Fluvirin. The vaccinee indicated that most of the symptoms had subsided but continues to have problems with sinus congestion, nasal discharge, fatigue, blocked ears, and muscle pain but not as significant as when experienced initially. The vaccinee also experienced some symptoms on the left side but were less intense. The vaccinee was unable to exercise when the symptoms were most intense. At the time of reporting she had commenced exercising again and noted that the muscles on the right side of her body were significantly more painful than the muscles on the left side. Laboratory tests including thyroid function and head CT were normal. It was suggested that the symptoms experienced by the vaccinee may be due to a reaction to the immunization or may be due to a type of flu virus. There was insufficient information to determine the reporter's causality. Update 1, 4/20/04: Further information was received from a health care professional who is also the 49 year old consumer who experienced neuropathies and paraesthesia after receiving Fluvirin. The vaccinee's symptoms were considered to be disabling. The vaccinee has undergone numerous tests. However, no diagnosis has been confirmed and she continues to experience neuropathies, paraesthesias and muscle spasms. The vaccinee has a medical history of normal childhood illnesses. The vaccinee was treated with gabapentin, cyclobenzaprine hydrochloride and physical and massage therapy. Follow up pending.
Age: 0.4
Sex: M
Vaccine: DTAP, HBHEPB, IPV, PNC
Symptoms: Malaise, Pyrexia, Urticaria
Clinical narrative: Hives-temp 104-received vaccines at 0900am and became ill at 2:30pm-required overnight stay in hospital.
Age: 4.0
Sex: F
Vaccine: DTAP, HEP, MMR
Symptoms: Erythema, Urticaria
Clinical narrative: Immunizations given 4/30/04 at 6:00pm, returned to office at 7:15pm with erythema surrounding nose and upper neck, wheals and erythema spread to upper trunk and extremities at 7:20pm, vital signs stable. At 7:20 given Benadryl 12.5mg PO, spreading of erythema continued on upper extremities, at 7:30 given Benadryl 12.5mg IM. 7:40pm erythema and wheals noted to decrease. Parent requested to bring child to ER for further monitoring- sent to ER at 7:50p.m.
Age: 37.0
Sex: F
Vaccine: MMR
Symptoms: Arthralgia, Oedema
Clinical narrative: PT PHONE THIS PHN R.N. ON 4/29/04 AND STATED SHE HAD HAD MMR ON 4/1/04 AND APPROX 3 WKS AFTER SHE STARTED HAVING SWELLING AND PAIN IN R KNEE, THEN L KNEE THEN EVENTUALLY WRISTS WERE SORE AND THEN HER ANKLES, HANDS AND NOW HER INDEX FINGER IS SWOLLEN. PAIN AND EDEMA ROTATE SITES.   THIS SN ADVISED HER TO MAKE APPT C HER DR, AND GAVE HER ALL THE INFO I HAD OUT OF PACKAGE INSERT, AND EPI BOOK, I THEN PHONED DEPT OF PUB HEALTH, VACCINE LINE AND WAS ADVISED TO PHONE THE MANUFACTURER.  I CONTACTED THE MANUFACTURER AND INFORMED THEM OF ABOVE AND THEY STATED THEY HAD FILLED OUT A VAERS. AND THAT I COULD FILL OUT ONE AS WELL.  ON 5/3/04 I CONTACTED PT AND SHE STATED SHE HAD PAIN IN HANDS THIS WKEND AND THAT MD HAD PUT HER ON CELEBREX AND SHE WAS WITHOUT PAIN THIS AM, AND DR. WAS HOPING IT WAS FROM MMR AND TO CHECK WITH DR IN 2 WK, IF JOINT PAIN CONTINUED THEY WOULD RUN MORE TESTS THEN.
Age: 31.0
Sex: M
Vaccine: SMALL
Symptoms: Chest pain, Chills, Cow pox, Laboratory test abnormal, Myalgia
Clinical narrative: Primary vaccinee.  Epicarditis 11 days after vaccination, beginning with substernal pleuritic chest pain, better when leaning forward. ST elevation precordial, 1, avL, PR depressed. No significant SOB. Treated with indomethacin 50 mg tid to relieve symptoms. Patient now feeling well, without symptoms since 7 Jul.  Nurse follow up on 05/27/04 states: "Per review of hospital records, diagnosis of pericarditis is confirmed (already coded). A second diagnosis of generalized vaccinia (GENERALIZED VACCINIA) is noted. (If you are not sure if this COSTART should be added, check) Pt had vesicular lesions on arm and opposite shoulder. Hospital staff did consult government agency and state health dept. It was determined pt did not require VIG treatments. Please also add to Box 7 fever (FEVER), chills (CHILLS), rigors (same as CHILLS) with myalgia (MYALGIA). Please add to Box 19 past medical history of Lyme disease (INFECT), Irritable Bowel Syndrome (can't find a suitable COSTART), and trench foot (can't find suitable COSTART)."
Age: 31.0
Sex: M
Vaccine: SMALL
Symptoms: Pericarditis, Pyrexia
Clinical narrative: Primary vaccinee.  Epicarditis 11 days after vaccination, beginning with substernal pleuritic chest pain, better when leaning forward. ST elevation precordial, 1, avL, PR depressed. No significant SOB. Treated with indomethacin 50 mg tid to relieve symptoms. Patient now feeling well, without symptoms since 7 Jul.  Nurse follow up on 05/27/04 states: "Per review of hospital records, diagnosis of pericarditis is confirmed (already coded). A second diagnosis of generalized vaccinia (GENERALIZED VACCINIA) is noted. (If you are not sure if this COSTART should be added, check) Pt had vesicular lesions on arm and opposite shoulder. Hospital staff did consult government agency and state health dept. It was determined pt did not require VIG treatments. Please also add to Box 7 fever (FEVER), chills (CHILLS), rigors (same as CHILLS) with myalgia (MYALGIA). Please add to Box 19 past medical history of Lyme disease (INFECT), Irritable Bowel Syndrome (can't find a suitable COSTART), and trench foot (can't find suitable COSTART)."
Age: 15.0
Sex: M
Vaccine: TD
Symptoms: Erythema, Injection site oedema, Oedema, Pain, Pyrexia
Clinical narrative: Woke up 04/22/04 with high fever (102.2).  After Tylenol, slept most of the day.  Woke up that evening, took a shower, complained if sore left arm.  Left arm swollen, sore and red from shoulder to elbow.  Continued to run fever, given Benadryl for 2 days.  Slowly swelling went down.  Saw physician at this time.  Swelling only around injection site on Sunday. 04/25/04
Age: 1.0
Sex: M
Vaccine: MMR, VARCEL
Symptoms: Anorexia, Diarrhoea, Encephalopathy, Hypertension, Hypokinesia
Clinical narrative: Information has been received from a case in litigation from a consumer concerning a 12 month old male who on 04/16/02 was vaccinated with MMRII.  Concomitant suspect therapy included varicella virus vaccine live, for the treatment of prophylaxis (duration and dose not reported), vaccinated also on 04/16/02.  The reporter stated that on approximately 04/16/02 the pt developed various symptoms including a body rash, low grade fever, fussiness, decreased activity, not eating, slight diarrhea and episodes of vomiting.  On 04/26/02 the pt was examined by his pediatrician who assessed the pt as being encephalopathic.  The pt was taken by ambulance to the hospital and he was hospitalized.  The pt's condition worsened and he was placed in the pediatric intensive care unit.  During the pt's hospitalization, the pt underwent evaluations, consultations, diagnostic testing and lab analysis (specific tests and results unknown).  The pt was diagnosed with status epilepticus, respiratory distress, hypertension and abnormal diagnostic results and scans.  The pt was discharged on 05/04/02.  The reporter stated that over the following five months, the pt's condition deteriorated and required additional emergency room visits, and hospitalization.  Subsequently, the pt died on 10/25/02.  Cause of death was not specified. Additional information has been requested.
Age: 1.0
Sex: M
Vaccine: MMR, VARCEL
Symptoms: Irritability, Laboratory test abnormal, Pyrexia, Rash, Respiratory distress
Clinical narrative: Information has been received from a case in litigation from a consumer concerning a 12 month old male who on 04/16/02 was vaccinated with MMRII.  Concomitant suspect therapy included varicella virus vaccine live, for the treatment of prophylaxis (duration and dose not reported), vaccinated also on 04/16/02.  The reporter stated that on approximately 04/16/02 the pt developed various symptoms including a body rash, low grade fever, fussiness, decreased activity, not eating, slight diarrhea and episodes of vomiting.  On 04/26/02 the pt was examined by his pediatrician who assessed the pt as being encephalopathic.  The pt was taken by ambulance to the hospital and he was hospitalized.  The pt's condition worsened and he was placed in the pediatric intensive care unit.  During the pt's hospitalization, the pt underwent evaluations, consultations, diagnostic testing and lab analysis (specific tests and results unknown).  The pt was diagnosed with status epilepticus, respiratory distress, hypertension and abnormal diagnostic results and scans.  The pt was discharged on 05/04/02.  The reporter stated that over the following five months, the pt's condition deteriorated and required additional emergency room visits, and hospitalization.  Subsequently, the pt died on 10/25/02.  Cause of death was not specified. Additional information has been requested.
Age: 1.0
Sex: M
Vaccine: MMR, VARCEL
Symptoms: Status epilepticus, Vomiting
Clinical narrative: Information has been received from a case in litigation from a consumer concerning a 12 month old male who on 04/16/02 was vaccinated with MMRII.  Concomitant suspect therapy included varicella virus vaccine live, for the treatment of prophylaxis (duration and dose not reported), vaccinated also on 04/16/02.  The reporter stated that on approximately 04/16/02 the pt developed various symptoms including a body rash, low grade fever, fussiness, decreased activity, not eating, slight diarrhea and episodes of vomiting.  On 04/26/02 the pt was examined by his pediatrician who assessed the pt as being encephalopathic.  The pt was taken by ambulance to the hospital and he was hospitalized.  The pt's condition worsened and he was placed in the pediatric intensive care unit.  During the pt's hospitalization, the pt underwent evaluations, consultations, diagnostic testing and lab analysis (specific tests and results unknown).  The pt was diagnosed with status epilepticus, respiratory distress, hypertension and abnormal diagnostic results and scans.  The pt was discharged on 05/04/02.  The reporter stated that over the following five months, the pt's condition deteriorated and required additional emergency room visits, and hospitalization.  Subsequently, the pt died on 10/25/02.  Cause of death was not specified. Additional information has been requested.
Age: 62.0
Sex: F
Vaccine: HEPA, TD, TYP, HEPA, TD, TYP
Symptoms: Atrial flutter, Blood pressure increased, Chest discomfort, Malaise, Sensation of heaviness
Clinical narrative: Vaccinations given about 11:30 AM. Pt left office approximately 30 minutes later with no apparent adverse reactions. called about 5 minutes complained of dizziness, feeling sleepy while driving. Pulled over to call us. Nurse went to pt (1 block away). Bp= 148/92 Pulse=64. Pt stated was high for her. Complained of tightness in chest and dizziness when turning head. Called husband. Retook BP 164-94. Pulse 68. Call 911 for emergency care. Taken to hosp. Pt called about 3:30 told us now she was being released for hospital, to thank us. MD thinks it may have been typhoid vaccine.
Age: 62.0
Sex: F
Vaccine: HEPA, TD, TYP, HEPA, TD, TYP
Symptoms: Somnolence, Throat tightness
Clinical narrative: Vaccinations given about 11:30 AM. Pt left office approximately 30 minutes later with no apparent adverse reactions. called about 5 minutes complained of dizziness, feeling sleepy while driving. Pulled over to call us. Nurse went to pt (1 block away). Bp= 148/92 Pulse=64. Pt stated was high for her. Complained of tightness in chest and dizziness when turning head. Called husband. Retook BP 164-94. Pulse 68. Call 911 for emergency care. Taken to hosp. Pt called about 3:30 told us now she was being released for hospital, to thank us. MD thinks it may have been typhoid vaccine.
Age: 62.0
Sex: F
Vaccine: HEPA, TD, TYP, HEPA, TD, TYP
Symptoms: Chest discomfort, Dizziness, Somnolence
Clinical narrative: Vaccinations given about 11:30 AM. Pt left office approximately 30 minutes later with no apparent adverse reactions. called about 5 minutes complained of dizziness, feeling sleepy while driving. Pulled over to call us. Nurse went to pt (1 block away). Bp= 148/92 Pulse=64. Pt stated was high for her. Complained of tightness in chest and dizziness when turning head. Called husband. Retook BP 164-94. Pulse 68. Call 911 for emergency care. Taken to hosp. Pt called about 3:30 told us now she was being released for hospital, to thank us. MD thinks it may have been typhoid vaccine.
Age: 4.0
Sex: M
Vaccine: DTAP, IPV, MMR
Symptoms: Cellulitis, Injection site reaction, Pyrexia
Clinical narrative: After pt receive DTaP/IPV he developed cellulitis at injection site, pt was febrile and received IV Antibiotics. Nurse follow up on 05/19/04 states: Per review of hospital d/c summary, diagnosis of cellulitis is confirmed and has already been coded.
Age: 41.0
Sex: F
Vaccine: TTOX
Symptoms: Muscular weakness, Nerve injury, Pain, Radiculitis brachial
Clinical narrative: Patient claim right arm & shoulder pain occurred right after (ie within 24 hours) Tetanus injection. Patient developed RDS of arm and was found to have Brachial plexus syndrome that was not causing any symptoms UNTIL after injection. 06/09/2005:  Patient has not recovered.  Residual symptoms include chronic pain syndrome, thoracic outlet syndrom with right lower trunk pelsxopathy causing right arm pain and hand weakness.
Age: 0.33
Sex: M
Vaccine: DTAP, HBHEPB, IPV, PNC
Symptoms: Eye movement disorder, Musculoskeletal stiffness, Pyrexia
Clinical narrative: Had vaccine 4/20/04 on 4/21/04 had 2 episodes of stiffening of the body and rolling of eyes-5AM lasting 2 min., 6AM lasting 3 min., temp 105 degrees F.  Medical records on 05/05/04 states no new information. Nurse follow up on 05/13/04 states no new information.
Age: 15.0
Sex: M
Vaccine: FLU3
Symptoms: Pruritus, Rash
Clinical narrative: Rash/itching on back and arm at 5:15 (about 1 hour after administration)
Age: 33.0
Sex: F
Vaccine: ANTH
Symptoms: Infection, Swelling
Clinical narrative: Shot administered around 1300, 17Apr04. Swelling/infection progressed in right arm to approx 8inx10in on 19Apr04. Seen by personal physician on 20Apr04-prescribed Cephalexin 500mg, QIDx14days. Diagnosed as an acute infection.
Age: 4.0
Sex: F
Vaccine: DTAP, IPV
Symptoms: Erythema, Tenderness
Clinical narrative: Immunizations given 04/26/2004. 4/28/04 pt came in with left arm red and sore (5-6cm long) on back and arm.
Age: 5.0
Sex: F
Vaccine: DTAP, IPV, MMR
Symptoms: Injection site swelling, Rash macular
Clinical narrative: Within 24hours of injection in left thigh, swollen, mild red measles rash. Not red, warm.  Fluctuent.
Age: 1.08
Sex: F
Vaccine: HBHEPB, MMR, VARCEL
Symptoms: Rash papular, Rash vesicular
Clinical narrative: 17-20 papular rash, 2 with vesicle formation on face, arms, chest, back perueum.
Age: 40.0
Sex: F
Vaccine: TD
Symptoms: Erythema, Pain, Swelling
Clinical narrative: Right upper arm red, swollen and painful, localized to deltoid. Treated with Bentra 10mg bid. Benadryl prn.
Age: 4.75
Sex: F
Vaccine: DTAP
Symptoms: Erythema, Swelling
Clinical narrative: DTaP administered LD on 4/29/04. On 4/30 mom called exp that child's left arm swollen/red. Pt's mom gave child tylenol and applied cold compress. I had mom come in to see RN on 4/30. Area still slightly red/ swollen. Afebrile. Per MD to  continue tylenol/ benadryl PRN.
Age: 4.9
Sex: M
Vaccine: DTAP, IPV, MMR
Symptoms: Swelling
Clinical narrative: Swelling of right upper arm from shoulder down to elbow.
Age: 4.0
Sex: M
Vaccine: DTAP, IPV, MMR
Symptoms: Erythema, Feeling hot, Pain, Swelling, Tenderness
Clinical narrative: Right arm became warm, tender to touch, red. Later that day, painful and swelled somewhat. Went to the ER that night.
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMR
Symptoms: Erythema, Pruritus, Swelling
Clinical narrative: Mother states child's left arm swelled from to of arms to elbow- red and had itching. Child 24 hours treatment with Benedryl and ice bag per order of PMD.
Age: 1.6
Sex: F
Vaccine: DTAP
Symptoms: Convulsion, Febrile convulsion, Pyrexia
Clinical narrative: 3/17/04. 10:30 DTAP 4TH, stayed 20 min. At 2am low grade fever, MD gave tylenol. 6AM seizure. 911-EMT temp 103. ER temp was Temp 101. Febrile seizure, related to DTAP -pertussis in DTAP. Give DT next dose.
Age: 5.0
Sex: M
Vaccine: DTAP, IPV, MMR
Symptoms: Rash, Skin discolouration
Clinical narrative: Child came in HD 9 days post second MMR administration with small pink pinpoint rash over upper and lower extremeties bilat and trunk of body. Grandmother states rash just occurred today  A-febrile. No other symptoms present.
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMR
Symptoms: Erythema, Swelling
Clinical narrative: Phone call from pt's mom on 3/10/04 and states pt's left upper arm red and swollen site of "saucer". Has alternated with ice and heat x 5hrs with no improvement. Advise to see PCP today. Phone call from mother and states saw PCP and Dr's Nurse Pract. and was given steroid injection and told to alternate tylenol and motrin and if not better in one week to return to them.
Age: 0.8
Sex: F
Vaccine: DTAPHEPBIP, HIBV, PNC
Symptoms: Rash erythematous
Clinical narrative: Within 5-10 minutes of receiving injection, mom observed red rash on hands, within 20-30 minutes spread to right ear; no respiratory distress. Child playful and active.
Age: 7.0
Sex: M
Vaccine: VARCEL
Symptoms: Drug ineffective, Pyrexia, Rash vesicular, Viral infection, Vomiting
Clinical narrative: Acquired chicken pox, low grade temp, symptoms lasted 3 days. Sym included vomitting, red sores on torso and face. Given tyl. 1st first day only.
Age: 6.0
Sex: M
Vaccine: DTAP
Symptoms: Erythema, Pyrexia, Swelling
Clinical narrative: Received DTaP vac in right deltoid 12/16/2003. Mother states child has had no significant fever On PM of 12/17/2003 mother noticed increased swelling and redness at injection site. Arm was red and swollen from shoulder to elbow. Mom took him to ER, CBC was WNL. Treated with Tylenol with children's Motrin. On 12/18/2003 swelling was less- now from right detoid to just above elbow.
Age: 4.0
Sex: F
Vaccine: DTAP, IPV
Symptoms: Erythema, Injection site warmth, Swelling
Clinical narrative: Vaccinated on 3/23/04 with DTaP and IPV (DTaP-LAA and IPV LLA). Returned on 3/25/04 with localized 8cmx8cm reaction to LAA. Area red, hot to touch with swelling noted. Referred to PMD. Started on Atarax 3/25/04.
Age: 24.0
Sex: F
Vaccine: MMR
Symptoms: Feeling hot, Injection site erythema, Injection site induration, Injection site pain, Pain
Clinical narrative: On 10/7/2003 received MMR. On 10/17/2003 noticed pain and redness at injection site and hardness. Some days has pain in arm and other times is not sore. 10/27/03-LUA red, induration 2cmx2cm; warm to touch. No red streaks . 11/04/03 PC to pt.
Age: 4.0
Sex: M
Vaccine: VARCEL
Symptoms: Drug ineffective, Infection
Clinical narrative: Probable Chickenpox.
Age: 2.0
Sex: F
Vaccine: DTAP, HEPA
Symptoms: Injection site erythema
Clinical narrative: 4 cm x 4 cm round red area where vaccine was administered. Ice applied to area at left arm IM.
Age: 61.0
Sex: M
Vaccine: PPV
Symptoms: Arthralgia, Oedema, Pain
Clinical narrative: Patient called clinic on 4/23 with complaints of achiness in wrists, swelling in hands. Denied fever, redness, warmth or swelling at injection site. On 4/25 went to ER with lower and upper extremity swelling, moderate joint pain.
Age: 0.17
Sex: M
Vaccine: DTAP, HIBV, IPV, PNC
Symptoms: Screaming
Clinical narrative: 3 hours of constant crying. Started 3 hours after receiving vaccinations.
Age: 5.0
Sex: F
Vaccine: DTAP, HEPA, IPV, MMR
Symptoms: Injection site rash
Clinical narrative: Small quarter sized rash around injection site left upper thigh. No irritation noted. Both Hep A and MMR given in this area.
Age: 5.0
Sex: M
Vaccine: DTAP, IPV, MMR, VARCEL
Symptoms: Erythema, Oedema
Clinical narrative: Left upper arm red & swollen (shots given on 4-24-04). Mom took son to doctor on 4-26-04. Instructed to give Benadryl- spoke to mom on 4-27-04- she stated swelling is resolving.
Age: 7.0
Sex: F
Vaccine: VARCEL
Symptoms: Erythema, Rash papular, Skin nodule
Clinical narrative: erythema papular vesicular rash, scattered: scalp, behind ears, few on face, bottom, legs, feet, even soles. 2 or more surrounding erythema rash slight pustular appearance.
Age: 6.0
Sex: F
Vaccine: MMR, VARCEL
Symptoms: Blister, Drug ineffective, Infection, Rash maculo-papular, Rash pruritic
Clinical narrative: Pt seen today with maculopapular lesions over trunk, neck, legs, same with wheals/blisters - rash is pruritic- I feel she has varicella// Treated with Benadryl Oatmeal baths.
Age: 6.0
Sex: F
Vaccine: MMR, VARCEL
Symptoms: Skin ulcer, Urticaria
Clinical narrative: Pt seen today with maculopapular lesions over trunk, neck, legs, same with wheals/blisters - rash is pruritic- I feel she has varicella// Treated with Benadryl Oatmeal baths.
Age: 1.0
Sex: M
Vaccine: IPV, MMR, VARCEL
Symptoms: Pyrexia, Rash
Clinical narrative: Fever, rash 2 days after immunization MMR, Varicella- 4/21/04 Benadryl 1ml Cold given today.
Age: 2.0
Sex: M
Vaccine: MMR, VARCEL
Symptoms: Drug ineffective, Infection, Rash vesicular
Clinical narrative: Vesicular rash in dermatomal distribution on thigh appears to be varicella zoster- culture sent. Seen on 4-26-04. Treatment with Acyclovir.
Age: 7.0
Sex: M
Vaccine: MMR, VARCEL
Symptoms: Drug ineffective, Infection
Clinical narrative: Developed Zoster (shingles) right side of abdomen, typical appearance.
Age: 12.0
Sex: F
Vaccine: TD
Symptoms: Erythema, Feeling hot, Injection site reaction
Clinical narrative: Local reaction to left forearm left deltoid with red warm area approximately 5 cm x 5 cm.
Age: 4.0
Sex: M
Vaccine: DTAP, IPV, MMR
Symptoms: Body temperature increased, Erythema, Oedema
Clinical narrative: 0n 4/28/04. Mom reports onset of redness late yesterday(4/27/04). This am 4/28/04 at approx 4 am. Reports temperature elevation with swelling to right arm muscle area. Has been applying cool cloth since last night. Advised warm cloth now continue with Tylenol every 4-6 hours as needed temp. If persist for more than 24 hours consult PMD. No answer at home on 4/30/04.
Age: 47.0
Sex: F
Vaccine: PPV
Symptoms: Arthralgia, Erythema
Clinical narrative: Redness & soreness to elbow lasting 5 days pt did not report until 4/29/04. Inj. date 4/21/04.
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMR
Symptoms: Erythema, Injection site swelling, Pyrexia
Clinical narrative: Red, raised, feverish area around injection site approximately 12 cm in diameter.
Age: 1.42
Sex: M
Vaccine: DTAP, IPV
Symptoms: Erythema, Injection site swelling, Pyrexia
Clinical narrative: Red, raised, feverish area around injection site approximately 10 cm in diameter.
Age: 4.0
Sex: F
Vaccine: DTAP, MMR
Symptoms: Erythema, Injection site swelling
Clinical narrative: Red, raised, feverish area around injection site approximately 12 cm - diameter.
Age: 5.0
Sex: F
Vaccine: DTAP
Symptoms: Cellulitis, Injection site reaction
Clinical narrative: Cellulitis at site of injection currently being treated with antibiotics, anti inflammatory diphenhydramine (2 days after injection).
Age: 1.5
Sex: M
Vaccine: DT
Symptoms: Erythema, Oedema
Clinical narrative: Mother called 2 days after vaccine given describing large red swollen area.
Age: 5.0
Sex: M
Vaccine: DTAP, IPV, MMR
Symptoms: Erythema, Rash
Clinical narrative: Patchy, erythematous rash left chest, bilateral groin, nontender.
Age: 0.6
Sex: F
Vaccine: DTAPHEPBIP, HIBV, PNC
Symptoms: Injection site mass
Clinical narrative: Mom called 04/23/04 stating child has bump under skin on left leg where she had gotten Pediarix injection.  No pain, no infection noted at this time.
Sex: M
Vaccine: DTAP, HEPA
Symptoms: Injection site erythema, Injection site oedema, Injection site warmth
Clinical narrative: Right deltoid and part of shoulder with increased swelling, erythematous, warm to touch.  No fever.  Treatment: cold compression, Motrin.
Age: 5.0
Sex: M
Vaccine: DTAP
Symptoms: Injection site oedema
Clinical narrative: Right leg swollen at injection site.
Age: 44.0
Sex: F
Vaccine: TD
Symptoms: Bursitis, Pain, Subdural effusion
Clinical narrative: Aching and throbbing throughout left arm one half hour after DT given.  Pain worse with movement.  Continued pain. Diagnosed with subacromial and subdeltoid bursititis.  Injection likely superior to ideal site.
Age: 13.0
Sex: F
Vaccine: TD
Symptoms: Erythema, Pain
Clinical narrative: Sore 2 days then, size of softball sore, red bumps, no fever.
Age: 1.3
Sex: F
Vaccine: DTAP, HIBV, MMR, VARCEL
Symptoms: Convulsion, Pyrexia
Clinical narrative: About 72 hours after vaccinations below had 2 short seizures (1 minute apart) with temperature: 106.2 pr.  Also took 1st dose of Mefloquine 1/4 tablet for Malaria prophylaxis.
Age: 1.4
Sex: M
Vaccine: DTAP, HIBV, MMR
Symptoms: Conjunctivitis, Cough, Pyrexia, Rash, Rhinitis
Clinical narrative: Low grade fever (onset 04/11; highest temp 100.4); Cough, coryza, conjunctivitis (onset 04/16; bilateral). Rash (onset 04/13; began on face-spread to chest, back and extremities) rash duration 10+ days.
Age: 0.2
Sex: F
Vaccine: DTAP, HBHEPB, IPV, PNC
Symptoms: Crying
Clinical narrative: Unconsolable crying for around 4 hours. Calmed with Tylenol 15mg/kg and bath.
Age: 4.0
Sex: M
Vaccine: DTAP, HEPA, IPV, MMR
Symptoms: Injection site erythema, Injection site induration, Injection site pain
Clinical narrative: Right thigh 7.7.5 inch: Red, indurated, tender.
Age: 4.0
Sex: F
Vaccine: DTAP, IPV
Symptoms: Injection site erythema, Injection site induration, Injection site warmth
Clinical narrative: Right upper arm 5x4cm, red, hot, indurated.
Age: 5.0
Sex: M
Vaccine: DTAP, IPV, MMR
Symptoms: Injection site erythema, Injection site induration
Clinical narrative: Erythema surrounding injection site on left upper arm.  Mild induration.
Age: 1.0
Sex: F
Vaccine: MMR, VARCEL
Symptoms: Dermatitis bullous, Drug ineffective, Infection
Clinical narrative: Developed herpes zoster like rash on right abdomen/flank after receiving Varicella/MMR on 03/24/04.
Age: 1.3
Sex: M
Vaccine: HBHEPB, MMR, VARCEL
Symptoms: Injection site oedema, Injection site warmth
Clinical narrative: Lower left extremity edema with warmth to touch at injection site, no redness noted.
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMR
Symptoms: Injection site erythema, Injection site oedema, Injection site warmth
Clinical narrative: 04/01/04: Left thigh with redness and slight swelling and warm to touch.  Deferred to MD to evaluate.
Age: 57.0
Sex: M
Vaccine: DT
Symptoms: Chills, Headache, Hyperhidrosis, Oedema, Pain
Clinical narrative: 1) Headache and fever - 3 days 2) Sweats and chills - 3 days 3) Sore arm and swelling - 14+ days
Age: 57.0
Sex: M
Vaccine: DT
Symptoms: Pyrexia
Clinical narrative: 1) Headache and fever - 3 days 2) Sweats and chills - 3 days 3) Sore arm and swelling - 14+ days
Age: 1.3
Sex: F
Vaccine: DTAPH, MMR, VARCEL, DTAPH, MMR, VARCEL
Symptoms: Dermatitis bullous, Erythema, Infection, Pruritus, Pyrexia
Clinical narrative: On 04/16/04 mother called to report child temp of 102.0.  2-3 red "itchy" spots to face and on chest area. Varicella vaccine administered on 04/05/04.  Advised mother to take child to pediatrician ASAP for assessment.   On 4/19/04 spoke with mother.  Pediatrician diagnosed chickenpox.  Comfort measures advised for itching.
Age: 1.3
Sex: F
Vaccine: DTAPH, MMR, VARCEL, DTAPH, MMR, VARCEL
Symptoms: Drug ineffective, Pruritus, Pyrexia, Viral infection
Clinical narrative: On 04/16/04 mother called to report child temp of 102.0.  2-3 red "itchy" spots to face and on chest area. Varicella vaccine administered on 04/05/04.  Advised mother to take child to pediatrician ASAP for assessment.   On 4/19/04 spoke with mother.  Pediatrician diagnosed chickenpox.  Comfort measures advised for itching.
Age: 32.0
Sex: M
Vaccine: ANTH
Symptoms: Pruritus, Skin burning sensation
Clinical narrative: APPROX 0700 ON 4 MAY 2004 MEMBER HAD BILATERAL BURNING AND ITCHING SENSATION FROM BICEP DOWN TO TIPS OF FINGERS.  MEMBER SPOKE WITH FLIGHT SURGEON, AND WAS TOLD CONTINUE TO MONITOR.  IF CONDITION WORSENS SEEK MEDICAL ATTENTION.
Age: 23.0
Sex: F
Vaccine: ANTH
Symptoms: Discomfort, Erythema, Feeling hot, Oedema, Pain
Clinical narrative: AVA # 1 13 Feb 2003 Left arm swelling on top of deltoid area the size of a fist. Area was red and painful and lasted a couple of days. AVA # 2 25 Feb 2003 Given SC in left arm. Pt reported increase swelling and discomfort. AVA # 3 11 Mar 2003 Given IM in right arm. Noticed increased swelling extending from shoulder to elbow. Skin was hard and warm to touch. Went to MD and was given antibiotics and took ibuprofen regularly. Had pain with movement. Redness lasted 3-4 days. AVA # 4 05 Sep 2003 Given SC left arm. States this was her worse reaction. Had "hard" skin from shoulder to elbow and swelling with redness from elbow to wrist. Had " extreme" pain Went to emergency room and was given oral steroids. Swelling lasted 3-4 days.
Age: 2.0
Sex: F
Vaccine: DTAPHEPBIP, HIBV, PNC
Symptoms: Coma, Dyskinesia, Staring
Clinical narrative: On 04/19/2004, at approx. 1504 hrs. mother of pt. contacted our office and left voicemail message on our nurse advice line state the pt. had immunizations that morning and had jerking movements later.  I spoke with the pt's mother on 4/20/04.  Mother first states that approximately 1-2 hours after immunizations, pt had rythmic and fast head jerking sporadically for 20-25 minutes.  Then mother of patient stated pt. had jerking head motion for 20 minutes "solid".  Mother stated patient seemed oriented and eyes were focused.  Mother then stated patient would "go into blank stare and would not be responsive but would just scream and cry" during the episodes.  Mother denied vomiting, diarrhea, LOC.  States holding child did not stop movements.  Mother did not take pt. to emergency room.  She states she called "Ask A Nurse" after the episode ended and was told that if situation occurred again, to take pt. to ER at that time.  Reiterated that pt. does indeed need to go to ER if situation occurs again.  Mom asked if this was going to be reported to vaccine pharmaceutical company; I advised mom the situation would be reported.
Age: 38.0
Sex: M
Vaccine: ANTH, SMALL
Symptoms: Injection site erythema, Injection site oedema, Injection site reaction, Injection site warmth, Pruritus
Clinical narrative: Developed erythema, edema, heat and pruritis over right triceps (injection site) after the 5th dose of Anthrax vaccine prior to deployment.
Age: 0.2
Sex: F
Vaccine: DTAPHEPBIP, HIBV, PNC
Symptoms: Respiratory arrest
Clinical narrative: Patient seen in prior week for viral type illness, had unremarkable CBCs, recovering fairly well, seen on 4/9/04, assessed as stable enough for shots, given standard Pediarix, Hib and Prevnar.  No history known to me about weekend, taken to day care, respiratory arrest described.  Taken to ER, seen by MD, resusitation unsuccessful.
Age: 47.0
Sex: F
Vaccine: HEP, MMR, TD
Symptoms: Erythema, Headache, Hyperhidrosis, Pyrexia
Clinical narrative: On the night of 04-27-04, the patient patient stated that she had a fever, cold sweats, headache and red skin on her face. Patient returned to the Health Center on 04-29-04 and was taken to a hospital emergency room by EMS.
Age: 31.0
Sex: M
Vaccine: ANTH
Symptoms: Lymphadenopathy, Nasal congestion, Pharyngolaryngeal pain, Sensory disturbance, Sinus congestion
Clinical narrative: 31 year old male started the anthrax series while deployed.  While deployed he experienced nasal congestion that was unusual for him.  On return from deployment, he continued to experience chronic nasal congestion and noticed that his senses of smell and taste were diminished.  Flonase has been prescribed, but has not relieved any of the symptoms.  Within 24 hours of receipt of the fifth anthrax vaccine, he had completely lost his sense of taste and smell, had maxillary sinus pressure, bilateral cervical lymphadenopathy and preauricular adenopathy on the right.  He completed a 14 day course of Septra DS during which time the lymphadenopathy resolved.  One week after he completed the antibiotics, his sense of taste and smell returned for two days.  The nasal congestion and sinus pressure have not resolved despite continued use of Flonase.  On 19 April he was started on a 7 day course of Tequin and Entex.  He was able to taste and smell for a few days, but has lost those senses again since completing the medications.  He has also noted recurrent sore throat recently.  He is scheduled for a MRI of the brain 17 May 2004.  He has not had an ENT consult at this point.
Sex: U
Vaccine: DTAP, IPV, MMR
Symptoms: Abdominal pain, Lethargy, Muscle twitching, Pyrexia, Tremor
Clinical narrative: Pt. was complaining of abd. cramping, shaking, twitching, lethargy within a course of 3 hours. Pt. also had a fever of 103. Tylenol was administered by parent.
Age: 44.0
Sex: F
Vaccine: SMALL
Symptoms: Dizziness, Fatigue, Injection site oedema, Injection site pain, Lymphadenopathy
Clinical narrative: Developed infraclavicular lymphadenopathy three days after receipt of smallpox vaccination.  History of Present Illness:    CC:  "Pain and swelling near my left shoulder x 2 days." Service member received SPV (re-vaccinee) on 22 April 2004 (5 days ago).  She had previously received SPV in 1959 and reports no known problems with that vaccine.  She had no complaints on the day of the vaccination.  She attended the Smallpox Briefing and received the educational brochures.  She does report that her arm was sore the afternoon after the vaccination.  Everyone in her unit was given "down-time" after the vaccinations, and she returned to her room for a nap.   Two days later (24 April 2004), she noticed that she felt a little tired and lightheaded.  The next day (25 April 2004), she reports that she felt even more tired and "spacey and lightheaded."  She also had a slight headache but no vision changes or stiff neck.  No fever, shortness of breath, chest pain, palpitations, or rash.  On 26 April 2004 (Day 4 after SPV), she reported to the Medical Center Emergency Dept. because she had noted a "swollen, tender lump" near her left shoulder.  She was told that it was likely an inflamed lymph node from the SPV and told to follow-up with the Healthcare Center. Member reported to the Vaccine Healthcare Center on 27 April 2004.  She reports that she already feels much better and that the "lump" has decreased drastically in size.  She denies any chest pain, shortness of breath, cough, fever, or rash.  Her headache and lightheadedness have resolved.  She also reports some irritation from the band-aids.  She denies any injury to the arm but has been carrying a heavy pack.  She denies any recent URI, asthma episodes, or seasonal allergic rhinitis symptoms.  Treatment Plan/ Recommendations:  1.  Provided reassurance her symptoms of lymphadenopathy, generalized malaise, and lightheadedness are common after smallpox vaccination, although the lymphadenopathy is typically seen in axillary area and neck/cervical region.  Would expect the lymph node to continue to decrease in size and tenderness over the next 1-2 weeks.  If lymph node remains inflamed, instructed patient that she would need further evaluation.  Unable to schedule follow-up appointment as she is scheduled to deploy within one week.  She verbalizes understanding and states that she will follow-up with her local unit medical staff and has VHC contact information, if needed. 2. Instructed patient that she also is having irritation from the band-aids.  Changed the dressing to non-adherent gauze and paper tape.  Supplies provided to patient. 3. Reinforced education on methods to prevent autoinoculation from SPV site and proper care of site and disposal of bandages. 4. Referred patient to PCP for follow-up of elevated blood pressure.  She states that her blood pressure usually runs 120-130/80. 5. Meds:  Motrin 800 mg po q 8 hours with food prn discomfort.  #30 with 1 RF.   6. Avoid strenuous activity with left arm x 48-72 hours.
Age: 44.0
Sex: F
Vaccine: SMALL
Symptoms: Malaise, Tenderness
Clinical narrative: Developed infraclavicular lymphadenopathy three days after receipt of smallpox vaccination.  History of Present Illness:    CC:  "Pain and swelling near my left shoulder x 2 days." Service member received SPV (re-vaccinee) on 22 April 2004 (5 days ago).  She had previously received SPV in 1959 and reports no known problems with that vaccine.  She had no complaints on the day of the vaccination.  She attended the Smallpox Briefing and received the educational brochures.  She does report that her arm was sore the afternoon after the vaccination.  Everyone in her unit was given "down-time" after the vaccinations, and she returned to her room for a nap.   Two days later (24 April 2004), she noticed that she felt a little tired and lightheaded.  The next day (25 April 2004), she reports that she felt even more tired and "spacey and lightheaded."  She also had a slight headache but no vision changes or stiff neck.  No fever, shortness of breath, chest pain, palpitations, or rash.  On 26 April 2004 (Day 4 after SPV), she reported to the Medical Center Emergency Dept. because she had noted a "swollen, tender lump" near her left shoulder.  She was told that it was likely an inflamed lymph node from the SPV and told to follow-up with the Healthcare Center. Member reported to the Vaccine Healthcare Center on 27 April 2004.  She reports that she already feels much better and that the "lump" has decreased drastically in size.  She denies any chest pain, shortness of breath, cough, fever, or rash.  Her headache and lightheadedness have resolved.  She also reports some irritation from the band-aids.  She denies any injury to the arm but has been carrying a heavy pack.  She denies any recent URI, asthma episodes, or seasonal allergic rhinitis symptoms.  Treatment Plan/ Recommendations:  1.  Provided reassurance her symptoms of lymphadenopathy, generalized malaise, and lightheadedness are common after smallpox vaccination, although the lymphadenopathy is typically seen in axillary area and neck/cervical region.  Would expect the lymph node to continue to decrease in size and tenderness over the next 1-2 weeks.  If lymph node remains inflamed, instructed patient that she would need further evaluation.  Unable to schedule follow-up appointment as she is scheduled to deploy within one week.  She verbalizes understanding and states that she will follow-up with her local unit medical staff and has VHC contact information, if needed. 2. Instructed patient that she also is having irritation from the band-aids.  Changed the dressing to non-adherent gauze and paper tape.  Supplies provided to patient. 3. Reinforced education on methods to prevent autoinoculation from SPV site and proper care of site and disposal of bandages. 4. Referred patient to PCP for follow-up of elevated blood pressure.  She states that her blood pressure usually runs 120-130/80. 5. Meds:  Motrin 800 mg po q 8 hours with food prn discomfort.  #30 with 1 RF.   6. Avoid strenuous activity with left arm x 48-72 hours.
Age: 25.0
Sex: M
Vaccine: MEA
Symptoms: Pyrexia
Clinical narrative: Nine days after receiving the Measles vaccine (single dose, not MMR), my son developed a slight fever (about 101F) which rose to 102.7F within 24 hours. During this time we administered children's Tylenol, as well as warm baths.
Age: 1.3
Sex: M
Vaccine: DTAP, IPV
Symptoms: Feeling hot, Oedema, Tenderness
Clinical narrative: Child developed edematous, warm to touch & tender left leg from hip to knee. Started approximately 24hrs after immunizations given. Child required MD visit where mother reports he was given Benadryl, & a 7 day course of medicine. Mother believed the medicine was Amoxicillin. The leg had decreased swelling starting on 5/2/04
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMR, VARCEL
Symptoms: Angioneurotic oedema, Dysphonia, Erythema, Pruritus, Rash
Clinical narrative: Approximately 1 hour after immunizations were administered, patient's mother called clinic stating patient had a red rash all over her body which was very itchy and patient was also complaining of feeling like there was a horse in her throat.  Parents were instructed to bring her back immediately.  They arrived within 10-15 minutes.  She was noted to have a highly erythematous rash from head to toe which was quite pruritic.  No angioedema or respiratory distress.  She was treated with an IM injection of Benadryl and a SQ injection of epinephrine.  Her symptoms resolved very quickly.
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMR, VARCEL
Symptoms: Respiratory distress
Clinical narrative: Approximately 1 hour after immunizations were administered, patient's mother called clinic stating patient had a red rash all over her body which was very itchy and patient was also complaining of feeling like there was a horse in her throat.  Parents were instructed to bring her back immediately.  They arrived within 10-15 minutes.  She was noted to have a highly erythematous rash from head to toe which was quite pruritic.  No angioedema or respiratory distress.  She was treated with an IM injection of Benadryl and a SQ injection of epinephrine.  Her symptoms resolved very quickly.
Age: 0.36
Sex: F
Vaccine: DTAPHEPBIP, HIBV, PNC
Symptoms: Convulsion, Pyrexia, White blood cell count increased
Clinical narrative: mother reported child experienced "seizure" on 5/3/04@11:30 pm.& stated child's temp 101F tympanic.  Child pmh of seizures x3 @ 3months of age. CT-scan/eeg at that time negative. child taking 9mg phenobarbitol po, qd, according to mother.  No seizure activity since that one initial episode @ 3months. Child received 1st Pediarix @ 2months w/o any complications. Pt seen today @ 9am in the "outpatient" clinic dept for eval. diagnosed with URI.
Age: 1.4
Sex: M
Vaccine: DTAP
Symptoms: Coordination abnormal, Injection site erythema, Otitis media, Pyrexia, Rash
Clinical narrative: ON DAY OF VACCINATION DEVELOPED FEVER X 4 MORE DAYS WITH CHERRY RED SPOT AT SITE OF INJECTION. ATAXIC X 4 DAYS SCREAMING LIKE HE'S NEVER SCREAMED BEFORE. SEEN BY KP MD FELT HAD OM. PLACED ON OMNICEF DEVELOPED RASH 20 MINUTES PAST DOSE AND SEEN NEXT DAY AND OTITIS WAS GONE.
Age: 1.4
Sex: M
Vaccine: DTAP
Symptoms: Screaming
Clinical narrative: ON DAY OF VACCINATION DEVELOPED FEVER X 4 MORE DAYS WITH CHERRY RED SPOT AT SITE OF INJECTION. ATAXIC X 4 DAYS SCREAMING LIKE HE'S NEVER SCREAMED BEFORE. SEEN BY KP MD FELT HAD OM. PLACED ON OMNICEF DEVELOPED RASH 20 MINUTES PAST DOSE AND SEEN NEXT DAY AND OTITIS WAS GONE.
Age: 34.0
Sex: U
Vaccine: TYP
Symptoms: Erythema, Hypersensitivity, Injection site induration
Clinical narrative: See attached summary update of clinical summary dated 22Mar02.  This service member was seen approx. 2 yrs ago following a possible adverse reaction to a typhoid injection he received on 5Mar02. He experienced both local and systemic symptoms approximately 6-8 hours following the immunization. He was advised to be evaluated before receiving additional typhoid injections. He is here today to be skin tested (prick and ID) for possible allergy to typhoid vaccine. Skin testing accomplised with no untoward reaction to either the prick or ID test. We asked that the service member return to the clinic 23Mar04 in the AM for evalutation or sooner should symptoms occur. The following day this service member demonstrated a Hypersensitivity Type IV delayed reaction to typhoid vaccine-both at 1:10 dilution (22mmX25mm erythema; 5mmX5mm induration); and at full strength (40mmX33mm erythema; 10mmX10mm induration). Discussed use of oral typhoid vaccine, bottled water and thorough hand washing if in areas of high risk
Age: 11.0
Sex: F
Vaccine: DT, TD
Symptoms: Injection site erythema, Injection site swelling
Clinical narrative: Soreness around vaccination area, a red circle appeared around needle mark, pain in right arm, circle became enlarged, pain in right arm traveled to arm pit area, arm hurt when raised.
Age: 11.0
Sex: F
Vaccine: DT, TD
Symptoms: Injection site erythema, Pain, Tenderness
Clinical narrative: Soreness around vaccination area, a red circle appeared around needle mark, pain in right arm, circle became enlarged, pain in right arm traveled to arm pit area, arm hurt when raised.
Age: 0.2
Sex: F
Vaccine: DTAP, HEP, HIBV, IPV
Symptoms: Influenza like illness, Pyrexia, Rhinitis
Clinical narrative: Received five vaccines IM on 12/26 then developed flu-like symptoms the following day. Expired on the AM 12/29 at home.  Nurse follow up on 06/21/04 states: "Fever, URI, Rhinitis."
Age: 7.0
Sex: M
Vaccine: PPV
Symptoms: Cellulitis, Cough, Headache, Hypokinesia, Injection site erythema
Clinical narrative: Information has been received from consumer concerning her 7 year old son with asthma and seasonal allergy who on 04/19/04 was vaccinated in the right arm with a dose of pneumococcal 23v polysaccharide vaccine (Lot # 647655/0869N).  Concomitant therapy included cetirizine hydrochloride (Zyrtec) and montelukast sodium (Singulair).  Prior to vaccination the pt was treated for chronic sinus infection with amoxicillin/clavulanate potassium (Augmentin) 875mg and an unspecified steroid for duration of 20 days.  On the night of vaccination, the pt woke with fever 104F, screaming in pain from a large, hard, red, hot golf ball size area on his upper right arm at the injection site.  He was treated with tub baths, acetaminophen (Tylenol) and ibuprofen (Advil).  On 04/20/04 he was seen in the office and a chest x-ray and CBC were performed.  The pt's fever continued and he also had a deep cough and headache.  The physician called to confirm that the pt was treated with amoxicillin/clavulanate potassium (Augmentin) and the medication was finished on 04/16/04.  He also confirmed that the pt had a severe local reaction and cough as per his visit on 04/20/04.  There was no chest x-ray report yet and CBC results included; WBC 13,000 and neutrophils 80% with 2% bands.  He reported that the child would be seen again on 04/21/04 and would probably be restarted on amoxicillin/clavulanate potassium (Augmentin).  The pt had no previous reaction to vaccinations and did not receive pneumococcal 4 6B 9V 14 18C 19F 23F conj vaccine (crm197) (Prevnar) in the past.  There was no product quality complaint involved.  Additional information from the pt's mother on 04/23/04 indicated that the pt had cellulitis of the affected arm.  He was not able to move it and his arm is in a sling.  He continues his amoxicillin/clavulanate potasssium (Augmentin) and will be seen by his doctor again today, 04/23/04.  The pt's mother reported that "the area of the injection was not cleansed prior to the injection by the allergists nurse".  Her son also had "15 allergy tests in the other arm on the same day as the vaccination and the syringe with the (pneumococcal 23v polysaccharide vaccine) was carried on the same tray as the allergy test syringes".  Upon internal review, cellulitis and not able to move his arm were determined to be other important medical events (OMIC).  Additional information has been requested.