chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 48.0
Sex: F
Vaccine: FLUX
Symptoms: Nasal congestion, Pain, Pain in extremity, Rash, Rhinorrhoea
Clinical narrative: Day 1, 10/26/11, Patient symptoms: warm, red, swollen area (approximately 6" oval) around injection site on left arm. Left arm felt stiff, painful. Patient had sensation of tendonitis in deltoid musculature (popping, catching, sensation) when actively using left arm. Patient felt fatigued around 1600. Symptoms waxed and waned. Treatment: Patient took 400 mg of ADVIL at 11:30 and at 18:30. Day 2, 10/27, Patient symptoms: generalized fatigue; mild runny nose, chills. Left upper arm pain radiated into the left side of neck, chest wall, axilla, scapula region and extended through the full length of the left arm. Patient's tendonitis sensations increased, involving shoulder flexor and extensor muscles, elbow flexor, extensor and supinator muscles and wrist flexors. Left arm joint pain increased, especially in the elbow. Deltoid region felt warm to the touch. Symptoms waxed and waned. Day 3-4, 10/28-29, Patient symptoms: generalized fatigue, mild runny nose, heaviness in chest, rash on chest, left arm and face, chills. Left arm tendonitis sensations as described in day 2 increased, and on day 4, included mild numbness on the left side of face, left axilla and throughout length of left arm. The numb sensations lasted for a few hours. Symptoms waxed and waned. Day 5, 10/30, Patient symptoms: generalized fatigue, mild runny, stuffy nose and sinuses; left arm tendonitis decreased; warmth in deltoid region, chills. Symptoms waxed and waned. Day 6, 10/31, patient symptoms: sneezing, mild runny nose, sinus pain, hoarse voice, chills. Symptoms waxed and waned. Symptoms stopped by day 7, Nov 1.
Age: 48.0
Sex: F
Vaccine: FLUX
Symptoms: Sinus congestion, Sinus headache, Sneezing, Tendonitis
Clinical narrative: Day 1, 10/26/11, Patient symptoms: warm, red, swollen area (approximately 6" oval) around injection site on left arm. Left arm felt stiff, painful. Patient had sensation of tendonitis in deltoid musculature (popping, catching, sensation) when actively using left arm. Patient felt fatigued around 1600. Symptoms waxed and waned. Treatment: Patient took 400 mg of ADVIL at 11:30 and at 18:30. Day 2, 10/27, Patient symptoms: generalized fatigue; mild runny nose, chills. Left upper arm pain radiated into the left side of neck, chest wall, axilla, scapula region and extended through the full length of the left arm. Patient's tendonitis sensations increased, involving shoulder flexor and extensor muscles, elbow flexor, extensor and supinator muscles and wrist flexors. Left arm joint pain increased, especially in the elbow. Deltoid region felt warm to the touch. Symptoms waxed and waned. Day 3-4, 10/28-29, Patient symptoms: generalized fatigue, mild runny nose, heaviness in chest, rash on chest, left arm and face, chills. Left arm tendonitis sensations as described in day 2 increased, and on day 4, included mild numbness on the left side of face, left axilla and throughout length of left arm. The numb sensations lasted for a few hours. Symptoms waxed and waned. Day 5, 10/30, Patient symptoms: generalized fatigue, mild runny, stuffy nose and sinuses; left arm tendonitis decreased; warmth in deltoid region, chills. Symptoms waxed and waned. Day 6, 10/31, patient symptoms: sneezing, mild runny nose, sinus pain, hoarse voice, chills. Symptoms waxed and waned. Symptoms stopped by day 7, Nov 1.
Age: 77.0
Sex: F
Vaccine: FLU3
Symptoms: Back pain, Blood pressure increased, Headache, Heart rate increased, Insomnia
Clinical narrative: Palpitations, blood pressure elevation (149/`03), headache, nauseous, shaky, pain in back, rapid pulse, trouble sleeping due to rapid pulse and elevated blood pressure. Over 20 years ago I received the live swine flu vaccine, of which I had a horrible reaction to. I ended up with Guillain-Barre Syndrome, but the doctors that I went to did not diagnose it as such. As a matter of fact they didn't know what the problem was, so I suffered all that time and still have reactions but not as often. As a result I refused to get my yearly flu shot - so last year was my first shot since that time. When I went this year (2011) I informed the person who was giving the vaccines of my previous problem and I was reassured that I would be perfectly ok. Well to my surprise after I had the reaction I had I was informed it contained the "swine flu" H1N1 vaccine. This is why I had the reaction to the flu shot.... rapid heart beat, elevated BP, nausea, headache, back pain, trouble sleeping. I had trouble with the rapid heart beat but I finally went to a doctor who finally treated it and I have been on the medication ever since (timolol maleate).
Age: 77.0
Sex: F
Vaccine: FLU3
Symptoms: Nausea, Palpitations, Tremor
Clinical narrative: Palpitations, blood pressure elevation (149/`03), headache, nauseous, shaky, pain in back, rapid pulse, trouble sleeping due to rapid pulse and elevated blood pressure. Over 20 years ago I received the live swine flu vaccine, of which I had a horrible reaction to. I ended up with Guillain-Barre Syndrome, but the doctors that I went to did not diagnose it as such. As a matter of fact they didn't know what the problem was, so I suffered all that time and still have reactions but not as often. As a result I refused to get my yearly flu shot - so last year was my first shot since that time. When I went this year (2011) I informed the person who was giving the vaccines of my previous problem and I was reassured that I would be perfectly ok. Well to my surprise after I had the reaction I had I was informed it contained the "swine flu" H1N1 vaccine. This is why I had the reaction to the flu shot.... rapid heart beat, elevated BP, nausea, headache, back pain, trouble sleeping. I had trouble with the rapid heart beat but I finally went to a doctor who finally treated it and I have been on the medication ever since (timolol maleate).
Age: 1.93
Sex: M
Vaccine: FLU3, HEPA, TDAP
Symptoms: Injection site erythema
Clinical narrative: Redness at injection site.
Age: 62.0
Sex: M
Vaccine: FLU3
Symptoms: Chills, Cough, Oropharyngeal pain, Respiratory tract congestion, Rhinorrhoea
Clinical narrative: Woke up next day w/scratchy throat, by Friday (48hrs) sore throat, runny nose. By 8th & 9th coughing, congestion, chills, started taking ROBITUSSIN & TYELNOL.
Age: 62.0
Sex: M
Vaccine: FLU3
Symptoms: Throat irritation
Clinical narrative: Woke up next day w/scratchy throat, by Friday (48hrs) sore throat, runny nose. By 8th & 9th coughing, congestion, chills, started taking ROBITUSSIN & TYELNOL.
Age: 73.0
Sex: M
Vaccine: FLU3
Symptoms: Arthralgia, Hypokinesia, Joint stiffness
Clinical narrative: Patients came in describing knee pain (right) 2 days after administration of FLUZONE HD. Pt has hx of knee surgery a year ago. He said after the vaccine his knee felt tight and immovable. Pt's knee pain improved w/o any medication after 4 days.
Age: 5.0
Sex: M
Vaccine: FLU3
Symptoms: Body temperature increased
Clinical narrative: Patient running temperature 102 degrees two days post vaccine.
Age: 78.0
Sex: F
Vaccine: FLU3
Symptoms: Pain in extremity
Clinical narrative: Unable to follow up with customer - phone disc. Per conversation of operation manager with the patient. Following the shot, she began to have soreness in her arm, soreness did not go away and she visited her primary care physician to receive a cortisone shot. The shot was not effective. She returned the next week for another cortisone shot. As of 10/19 she is staring to feel better.
Age: 1.35
Sex: M
Vaccine: DTAPIPVHIB, FLU3, HEPA, PNC
Symptoms: Ear infection, Lip swelling
Clinical narrative: Woke up today with swelling of upper lip. No hx trauma. Previous episode 8/2011. * Received immuniz x 4 - 10/26/11. Also has ear infection - started antib 10/28/11.
Age: 24.0
Sex: F
Vaccine: FLU3
Symptoms: Back pain, Injection site pain, Musculoskeletal pain, Pain
Clinical narrative: Persistent soreness at injection site and radiating to shoulder and back.
Age: 51.0
Sex: M
Vaccine: ANTH
Symptoms: Injection site erythema, Injection site pruritus
Clinical narrative: Redness and itching to site.
Age: 63.0
Sex: F
Vaccine: FLU3
Symptoms: Arthralgia, Bone pain, Chills, Tremor
Clinical narrative: Severe chills and shaking.  Severe joint/bone pain.
Age: 1.34
Sex: M
Vaccine: DTAP, HIBV, MMRV, VARZOS
Symptoms: No adverse event, Wrong drug administered
Clinical narrative: Patient was scheduled for 15 month shots 11/8/2011.  Patient was given DTaP, Hib, MMR, and was inadvertently given Zostavax instead of varicella.  0.5ml Error was discovered when entering vaccines.  Parents were notified and explained.  No adverse reactions reported.
Age: 51.0
Sex: M
Vaccine: FLU3
Symptoms: Eye irritation, Ocular hyperaemia
Clinical narrative: Patient's eyes began to burn and got really blood shot. Called Pharmacist and recommended Benadryl. Worse on Tuesday 11/10/2011 and got Systane Gel Drops from Eye Doctor. Better but still red and irritated.
Age: 1.36
Sex: M
Vaccine: FLU3
Symptoms: Urticaria
Clinical narrative: Hives in armpits, then progressed onto torso and a few on sides of leg. No other symptoms. No treatment, resovled on own.
Age: 40.0
Sex: F
Vaccine: FLU3
Symptoms: Ear pain, Neck pain, Pain in extremity, Pain in jaw
Clinical narrative: Pain down arm, radiating to neck, ear and jaw.  Pain in neck continues nearly 3 weeks later, pain in jaw and ear intermittent.
Age: 71.0
Sex: M
Vaccine: FLU3
Symptoms: Dyspnoea, Feeling abnormal, Heart rate increased, Muscle fatigue, Muscle spasms
Clinical narrative: About 2 hours after vaccine, patient experienced rapid heart rate, shortness of breath, difficulty breathing, and muscle cramps in his legs. He laid down for about 2 hours and considered calling his physician because he felt so bad. After he went to bed later, his sleep was restless with some continued shortness of breath. The following day, the symptoms were resolved except for muscle fatigue.
Age: 71.0
Sex: M
Vaccine: FLU3
Symptoms: Poor quality sleep
Clinical narrative: About 2 hours after vaccine, patient experienced rapid heart rate, shortness of breath, difficulty breathing, and muscle cramps in his legs. He laid down for about 2 hours and considered calling his physician because he felt so bad. After he went to bed later, his sleep was restless with some continued shortness of breath. The following day, the symptoms were resolved except for muscle fatigue.
Age: 94.0
Sex: M
Vaccine: FLU3
Symptoms: Arthralgia, Aspartate aminotransferase increased, Asthenia, Band neutrophil count, Blood creatinine increased
Clinical narrative: The patient initially was seen on 10/26 with a 10 day history of myalgias, arthralgias, malaise, fatigue, lightheadedness, and productive cough. This interestingly began about 2 weeks following his influenza vaccine. At that time he was afebrile, and oxygen saturations improved following a Duoneb treatment. Labs revealed a WBC of 3.7 with 71 segs, 3 bands, 14 lymphs, 10 monos. Creatinine was at baseline at 1.8, with eGFR of 38. BNP was 80. Chest xray showed no acute process. Patient was treated symptomatically with increase in scheduled nebulizer treatments, cough suppressants, mucolytics. Increased Vitamin D and Vitamin C supplementation, and close followup.  He then presented to the ER last evening after his son noted increasing weakness, lower extremity edema, and slurred speech. The patient had O2 sats of 87% on room air, which came up to 96% with 2 liters of oxygen. BNP was elevated at 270. Creatinine was up to 2.1, BUN 53, and elevated AST at 67. WBC 4.8 with 72 segs, 11 bands. Urine was negative except for 5-10 RBCs/hpf. He was given rx for Lasix 20mg. Blood cultures were drawn and are pending. Hospitalization was offered per the ED notes, however patient declined, likely due to the severity of his wife's dementia and reluctance to leave her alone at home.  The patient had already scheduled a follow up appt with myself today. His son came in and asked for help transferring patient into a wheelchair from their van, due to increased weakness. He stated he had almost dropped him trying to get him in the van at home. Notes patient seems lethargic and color poor, no further slurring of speech since yesterday. Reports cough had essentially resolved since his last visit. I did go out to their van, and observed patient sitting in passenger seat, indeed lethargic, but awake and oriented. Patient looked grey. PRIMARY DIAGNOSIS: Staphylococcus hominis sepsis SECONDARY DIAGNOSIS: COPD exacerbation; Acute bronchitis; CHF exacerbation; Bilateral lower extremity weakness and upper extremity tremors; Acute on chronic renal failure; AODM; Iron deficiency anemia; GUIAC positive stool  Patient required discharge to skilled nursing facility for extended rehab due to persistent lower extremity weakness. At baseline patient was able function quite well at home.
Age: 94.0
Sex: M
Vaccine: FLU3
Symptoms: Blood culture, Blood urea increased, Brain natriuretic peptide increased, Bronchitis, Cardiac failure congestive
Clinical narrative: The patient initially was seen on 10/26 with a 10 day history of myalgias, arthralgias, malaise, fatigue, lightheadedness, and productive cough. This interestingly began about 2 weeks following his influenza vaccine. At that time he was afebrile, and oxygen saturations improved following a Duoneb treatment. Labs revealed a WBC of 3.7 with 71 segs, 3 bands, 14 lymphs, 10 monos. Creatinine was at baseline at 1.8, with eGFR of 38. BNP was 80. Chest xray showed no acute process. Patient was treated symptomatically with increase in scheduled nebulizer treatments, cough suppressants, mucolytics. Increased Vitamin D and Vitamin C supplementation, and close followup.  He then presented to the ER last evening after his son noted increasing weakness, lower extremity edema, and slurred speech. The patient had O2 sats of 87% on room air, which came up to 96% with 2 liters of oxygen. BNP was elevated at 270. Creatinine was up to 2.1, BUN 53, and elevated AST at 67. WBC 4.8 with 72 segs, 11 bands. Urine was negative except for 5-10 RBCs/hpf. He was given rx for Lasix 20mg. Blood cultures were drawn and are pending. Hospitalization was offered per the ED notes, however patient declined, likely due to the severity of his wife's dementia and reluctance to leave her alone at home.  The patient had already scheduled a follow up appt with myself today. His son came in and asked for help transferring patient into a wheelchair from their van, due to increased weakness. He stated he had almost dropped him trying to get him in the van at home. Notes patient seems lethargic and color poor, no further slurring of speech since yesterday. Reports cough had essentially resolved since his last visit. I did go out to their van, and observed patient sitting in passenger seat, indeed lethargic, but awake and oriented. Patient looked grey. PRIMARY DIAGNOSIS: Staphylococcus hominis sepsis SECONDARY DIAGNOSIS: COPD exacerbation; Acute bronchitis; CHF exacerbation; Bilateral lower extremity weakness and upper extremity tremors; Acute on chronic renal failure; AODM; Iron deficiency anemia; GUIAC positive stool  Patient required discharge to skilled nursing facility for extended rehab due to persistent lower extremity weakness. At baseline patient was able function quite well at home.
Age: 94.0
Sex: M
Vaccine: FLU3
Symptoms: Chest X-ray normal, Chronic obstructive pulmonary disease, Condition aggravated, Dizziness, Dysarthria
Clinical narrative: The patient initially was seen on 10/26 with a 10 day history of myalgias, arthralgias, malaise, fatigue, lightheadedness, and productive cough. This interestingly began about 2 weeks following his influenza vaccine. At that time he was afebrile, and oxygen saturations improved following a Duoneb treatment. Labs revealed a WBC of 3.7 with 71 segs, 3 bands, 14 lymphs, 10 monos. Creatinine was at baseline at 1.8, with eGFR of 38. BNP was 80. Chest xray showed no acute process. Patient was treated symptomatically with increase in scheduled nebulizer treatments, cough suppressants, mucolytics. Increased Vitamin D and Vitamin C supplementation, and close followup.  He then presented to the ER last evening after his son noted increasing weakness, lower extremity edema, and slurred speech. The patient had O2 sats of 87% on room air, which came up to 96% with 2 liters of oxygen. BNP was elevated at 270. Creatinine was up to 2.1, BUN 53, and elevated AST at 67. WBC 4.8 with 72 segs, 11 bands. Urine was negative except for 5-10 RBCs/hpf. He was given rx for Lasix 20mg. Blood cultures were drawn and are pending. Hospitalization was offered per the ED notes, however patient declined, likely due to the severity of his wife's dementia and reluctance to leave her alone at home.  The patient had already scheduled a follow up appt with myself today. His son came in and asked for help transferring patient into a wheelchair from their van, due to increased weakness. He stated he had almost dropped him trying to get him in the van at home. Notes patient seems lethargic and color poor, no further slurring of speech since yesterday. Reports cough had essentially resolved since his last visit. I did go out to their van, and observed patient sitting in passenger seat, indeed lethargic, but awake and oriented. Patient looked grey. PRIMARY DIAGNOSIS: Staphylococcus hominis sepsis SECONDARY DIAGNOSIS: COPD exacerbation; Acute bronchitis; CHF exacerbation; Bilateral lower extremity weakness and upper extremity tremors; Acute on chronic renal failure; AODM; Iron deficiency anemia; GUIAC positive stool  Patient required discharge to skilled nursing facility for extended rehab due to persistent lower extremity weakness. At baseline patient was able function quite well at home.
Age: 94.0
Sex: M
Vaccine: FLU3
Symptoms: Fatigue, Glomerular filtration rate decreased, Iron deficiency anaemia, Lethargy, Lymphocyte count decreased
Clinical narrative: The patient initially was seen on 10/26 with a 10 day history of myalgias, arthralgias, malaise, fatigue, lightheadedness, and productive cough. This interestingly began about 2 weeks following his influenza vaccine. At that time he was afebrile, and oxygen saturations improved following a Duoneb treatment. Labs revealed a WBC of 3.7 with 71 segs, 3 bands, 14 lymphs, 10 monos. Creatinine was at baseline at 1.8, with eGFR of 38. BNP was 80. Chest xray showed no acute process. Patient was treated symptomatically with increase in scheduled nebulizer treatments, cough suppressants, mucolytics. Increased Vitamin D and Vitamin C supplementation, and close followup.  He then presented to the ER last evening after his son noted increasing weakness, lower extremity edema, and slurred speech. The patient had O2 sats of 87% on room air, which came up to 96% with 2 liters of oxygen. BNP was elevated at 270. Creatinine was up to 2.1, BUN 53, and elevated AST at 67. WBC 4.8 with 72 segs, 11 bands. Urine was negative except for 5-10 RBCs/hpf. He was given rx for Lasix 20mg. Blood cultures were drawn and are pending. Hospitalization was offered per the ED notes, however patient declined, likely due to the severity of his wife's dementia and reluctance to leave her alone at home.  The patient had already scheduled a follow up appt with myself today. His son came in and asked for help transferring patient into a wheelchair from their van, due to increased weakness. He stated he had almost dropped him trying to get him in the van at home. Notes patient seems lethargic and color poor, no further slurring of speech since yesterday. Reports cough had essentially resolved since his last visit. I did go out to their van, and observed patient sitting in passenger seat, indeed lethargic, but awake and oriented. Patient looked grey. PRIMARY DIAGNOSIS: Staphylococcus hominis sepsis SECONDARY DIAGNOSIS: COPD exacerbation; Acute bronchitis; CHF exacerbation; Bilateral lower extremity weakness and upper extremity tremors; Acute on chronic renal failure; AODM; Iron deficiency anemia; GUIAC positive stool  Patient required discharge to skilled nursing facility for extended rehab due to persistent lower extremity weakness. At baseline patient was able function quite well at home.
Age: 94.0
Sex: M
Vaccine: FLU3
Symptoms: Malaise, Monocyte count increased, Muscular weakness, Myalgia, Neutrophil count increased
Clinical narrative: The patient initially was seen on 10/26 with a 10 day history of myalgias, arthralgias, malaise, fatigue, lightheadedness, and productive cough. This interestingly began about 2 weeks following his influenza vaccine. At that time he was afebrile, and oxygen saturations improved following a Duoneb treatment. Labs revealed a WBC of 3.7 with 71 segs, 3 bands, 14 lymphs, 10 monos. Creatinine was at baseline at 1.8, with eGFR of 38. BNP was 80. Chest xray showed no acute process. Patient was treated symptomatically with increase in scheduled nebulizer treatments, cough suppressants, mucolytics. Increased Vitamin D and Vitamin C supplementation, and close followup.  He then presented to the ER last evening after his son noted increasing weakness, lower extremity edema, and slurred speech. The patient had O2 sats of 87% on room air, which came up to 96% with 2 liters of oxygen. BNP was elevated at 270. Creatinine was up to 2.1, BUN 53, and elevated AST at 67. WBC 4.8 with 72 segs, 11 bands. Urine was negative except for 5-10 RBCs/hpf. He was given rx for Lasix 20mg. Blood cultures were drawn and are pending. Hospitalization was offered per the ED notes, however patient declined, likely due to the severity of his wife's dementia and reluctance to leave her alone at home.  The patient had already scheduled a follow up appt with myself today. His son came in and asked for help transferring patient into a wheelchair from their van, due to increased weakness. He stated he had almost dropped him trying to get him in the van at home. Notes patient seems lethargic and color poor, no further slurring of speech since yesterday. Reports cough had essentially resolved since his last visit. I did go out to their van, and observed patient sitting in passenger seat, indeed lethargic, but awake and oriented. Patient looked grey. PRIMARY DIAGNOSIS: Staphylococcus hominis sepsis SECONDARY DIAGNOSIS: COPD exacerbation; Acute bronchitis; CHF exacerbation; Bilateral lower extremity weakness and upper extremity tremors; Acute on chronic renal failure; AODM; Iron deficiency anemia; GUIAC positive stool  Patient required discharge to skilled nursing facility for extended rehab due to persistent lower extremity weakness. At baseline patient was able function quite well at home.
Age: 94.0
Sex: M
Vaccine: FLU3
Symptoms: Occult blood positive, Oedema peripheral, Pallor, Productive cough, Red blood cells urine positive
Clinical narrative: The patient initially was seen on 10/26 with a 10 day history of myalgias, arthralgias, malaise, fatigue, lightheadedness, and productive cough. This interestingly began about 2 weeks following his influenza vaccine. At that time he was afebrile, and oxygen saturations improved following a Duoneb treatment. Labs revealed a WBC of 3.7 with 71 segs, 3 bands, 14 lymphs, 10 monos. Creatinine was at baseline at 1.8, with eGFR of 38. BNP was 80. Chest xray showed no acute process. Patient was treated symptomatically with increase in scheduled nebulizer treatments, cough suppressants, mucolytics. Increased Vitamin D and Vitamin C supplementation, and close followup.  He then presented to the ER last evening after his son noted increasing weakness, lower extremity edema, and slurred speech. The patient had O2 sats of 87% on room air, which came up to 96% with 2 liters of oxygen. BNP was elevated at 270. Creatinine was up to 2.1, BUN 53, and elevated AST at 67. WBC 4.8 with 72 segs, 11 bands. Urine was negative except for 5-10 RBCs/hpf. He was given rx for Lasix 20mg. Blood cultures were drawn and are pending. Hospitalization was offered per the ED notes, however patient declined, likely due to the severity of his wife's dementia and reluctance to leave her alone at home.  The patient had already scheduled a follow up appt with myself today. His son came in and asked for help transferring patient into a wheelchair from their van, due to increased weakness. He stated he had almost dropped him trying to get him in the van at home. Notes patient seems lethargic and color poor, no further slurring of speech since yesterday. Reports cough had essentially resolved since his last visit. I did go out to their van, and observed patient sitting in passenger seat, indeed lethargic, but awake and oriented. Patient looked grey. PRIMARY DIAGNOSIS: Staphylococcus hominis sepsis SECONDARY DIAGNOSIS: COPD exacerbation; Acute bronchitis; CHF exacerbation; Bilateral lower extremity weakness and upper extremity tremors; Acute on chronic renal failure; AODM; Iron deficiency anemia; GUIAC positive stool  Patient required discharge to skilled nursing facility for extended rehab due to persistent lower extremity weakness. At baseline patient was able function quite well at home.
Age: 94.0
Sex: M
Vaccine: FLU3
Symptoms: Renal failure acute, Sepsis, Skin discolouration, Staphylococcal sepsis, Tremor
Clinical narrative: The patient initially was seen on 10/26 with a 10 day history of myalgias, arthralgias, malaise, fatigue, lightheadedness, and productive cough. This interestingly began about 2 weeks following his influenza vaccine. At that time he was afebrile, and oxygen saturations improved following a Duoneb treatment. Labs revealed a WBC of 3.7 with 71 segs, 3 bands, 14 lymphs, 10 monos. Creatinine was at baseline at 1.8, with eGFR of 38. BNP was 80. Chest xray showed no acute process. Patient was treated symptomatically with increase in scheduled nebulizer treatments, cough suppressants, mucolytics. Increased Vitamin D and Vitamin C supplementation, and close followup.  He then presented to the ER last evening after his son noted increasing weakness, lower extremity edema, and slurred speech. The patient had O2 sats of 87% on room air, which came up to 96% with 2 liters of oxygen. BNP was elevated at 270. Creatinine was up to 2.1, BUN 53, and elevated AST at 67. WBC 4.8 with 72 segs, 11 bands. Urine was negative except for 5-10 RBCs/hpf. He was given rx for Lasix 20mg. Blood cultures were drawn and are pending. Hospitalization was offered per the ED notes, however patient declined, likely due to the severity of his wife's dementia and reluctance to leave her alone at home.  The patient had already scheduled a follow up appt with myself today. His son came in and asked for help transferring patient into a wheelchair from their van, due to increased weakness. He stated he had almost dropped him trying to get him in the van at home. Notes patient seems lethargic and color poor, no further slurring of speech since yesterday. Reports cough had essentially resolved since his last visit. I did go out to their van, and observed patient sitting in passenger seat, indeed lethargic, but awake and oriented. Patient looked grey. PRIMARY DIAGNOSIS: Staphylococcus hominis sepsis SECONDARY DIAGNOSIS: COPD exacerbation; Acute bronchitis; CHF exacerbation; Bilateral lower extremity weakness and upper extremity tremors; Acute on chronic renal failure; AODM; Iron deficiency anemia; GUIAC positive stool  Patient required discharge to skilled nursing facility for extended rehab due to persistent lower extremity weakness. At baseline patient was able function quite well at home.
Age: 94.0
Sex: M
Vaccine: FLU3
Symptoms: Type 2 diabetes mellitus, Wheelchair user, White blood cell count decreased
Clinical narrative: The patient initially was seen on 10/26 with a 10 day history of myalgias, arthralgias, malaise, fatigue, lightheadedness, and productive cough. This interestingly began about 2 weeks following his influenza vaccine. At that time he was afebrile, and oxygen saturations improved following a Duoneb treatment. Labs revealed a WBC of 3.7 with 71 segs, 3 bands, 14 lymphs, 10 monos. Creatinine was at baseline at 1.8, with eGFR of 38. BNP was 80. Chest xray showed no acute process. Patient was treated symptomatically with increase in scheduled nebulizer treatments, cough suppressants, mucolytics. Increased Vitamin D and Vitamin C supplementation, and close followup.  He then presented to the ER last evening after his son noted increasing weakness, lower extremity edema, and slurred speech. The patient had O2 sats of 87% on room air, which came up to 96% with 2 liters of oxygen. BNP was elevated at 270. Creatinine was up to 2.1, BUN 53, and elevated AST at 67. WBC 4.8 with 72 segs, 11 bands. Urine was negative except for 5-10 RBCs/hpf. He was given rx for Lasix 20mg. Blood cultures were drawn and are pending. Hospitalization was offered per the ED notes, however patient declined, likely due to the severity of his wife's dementia and reluctance to leave her alone at home.  The patient had already scheduled a follow up appt with myself today. His son came in and asked for help transferring patient into a wheelchair from their van, due to increased weakness. He stated he had almost dropped him trying to get him in the van at home. Notes patient seems lethargic and color poor, no further slurring of speech since yesterday. Reports cough had essentially resolved since his last visit. I did go out to their van, and observed patient sitting in passenger seat, indeed lethargic, but awake and oriented. Patient looked grey. PRIMARY DIAGNOSIS: Staphylococcus hominis sepsis SECONDARY DIAGNOSIS: COPD exacerbation; Acute bronchitis; CHF exacerbation; Bilateral lower extremity weakness and upper extremity tremors; Acute on chronic renal failure; AODM; Iron deficiency anemia; GUIAC positive stool  Patient required discharge to skilled nursing facility for extended rehab due to persistent lower extremity weakness. At baseline patient was able function quite well at home.
Age: 31.0
Sex: M
Vaccine: FLU3
Symptoms: Pruritus, Pyrexia, Rash, Vaccination complication
Clinical narrative: Patient reports onset of rash and itching accompanied by fever (he did not take his temperature) on the evening of Monday, 10/31/2011. patient took Tylenol and Benadryl at home, and saw a physician the next day, who prescribed Prednisone for the symptoms and told patient the reaction was likely from the flu vaccine, since no other cause could be determined.
Age: 32.0
Sex: F
Vaccine: FLUX
Symptoms: Urticaria
Clinical narrative: Hives all over body.
Age: 26.0
Sex: F
Vaccine: FLU3
Symptoms: Activities of daily living impaired, Dizziness, Fatigue, Headache, Hypoaesthesia
Clinical narrative: Extremely fatigue-7-14 days. Injection site swollen- 4 days. Mouth, throat and tongue swollen- 2 days. Injection site pain and left side muscle pain and numbness at times-7 days. Fever- 2 days. Headache- 2 days. Nausea- 5 days. Dizziness- 2 days. Treatment- Bed rest, took time off work.
Age: 26.0
Sex: F
Vaccine: FLU3
Symptoms: Injection site pain, Injection site swelling, Myalgia, Nausea, Oedema mouth
Clinical narrative: Extremely fatigue-7-14 days. Injection site swollen- 4 days. Mouth, throat and tongue swollen- 2 days. Injection site pain and left side muscle pain and numbness at times-7 days. Fever- 2 days. Headache- 2 days. Nausea- 5 days. Dizziness- 2 days. Treatment- Bed rest, took time off work.
Age: 26.0
Sex: F
Vaccine: FLU3
Symptoms: Pyrexia, Swollen tongue, Throat tightness
Clinical narrative: Extremely fatigue-7-14 days. Injection site swollen- 4 days. Mouth, throat and tongue swollen- 2 days. Injection site pain and left side muscle pain and numbness at times-7 days. Fever- 2 days. Headache- 2 days. Nausea- 5 days. Dizziness- 2 days. Treatment- Bed rest, took time off work.
Age: 48.0
Sex: F
Vaccine: FLU3
Symptoms: Blood test, Electromyogram, Lumbar puncture, Mobility decreased, Muscular weakness
Clinical narrative: Severe right arm and leg pain and weakness, progressed to inability to move arms and legs while in emergency room.
Age: 48.0
Sex: F
Vaccine: FLU3
Symptoms: Nuclear magnetic resonance imaging, Nuclear magnetic resonance imaging brain, Pain in extremity
Clinical narrative: Severe right arm and leg pain and weakness, progressed to inability to move arms and legs while in emergency room.
Age: 13.0
Sex: F
Vaccine: MNQ, TDAP, VARCEL
Symptoms: Bone pain, Crying
Clinical narrative: Client awoke in the morning crying and complaining of spine pain.  Child's primary care physician notified by mother.  Physician prescribed Tylenol 3 1-2 tabs po q6hrs PRN.  2 tabs administered on the afternoon of 10/26/11.  Child slept through the night and required only 1 tablet for pain on the morning of 10/27/2011.
Age: 5.0
Sex: M
Vaccine: FLUN3
Symptoms: Headache, Pyrexia, Vomiting
Clinical narrative: Child developed fever up to 103F, headaches and vomiting a few hours after administration of LAIV.  Mom has been giving Tylenol q4hrs.
Age: 1.01
Sex: F
Vaccine: PNC, VARCEL, DTAP, IPV, MMR, VARCEL
Symptoms: Blister, Pyrexia, Varicella post vaccine
Clinical narrative: PT RECEIVED VERY SEVERE CASE OF VARICELLA AFTER 2 DOSES OF VARIVAX VACCINE. THIS WAS BREAKTHROUGH ILLNESS. PT HAD OVER 500 BLISTERS VERY HIGH FEVER. VARICELLA REPORT IN CDRSS CASE ID 463809
Age: 4.0
Sex: F
Vaccine: PNC, VARCEL, DTAP, IPV, MMR, VARCEL
Symptoms: Blister, Pyrexia, Varicella post vaccine
Clinical narrative: PT RECEIVED VERY SEVERE CASE OF VARICELLA AFTER RECEIVING 2 DOSES OF VARIVAX VACCINE. THIS WAS BREAKTHROUGH ILLNESS. PT HAD OVER 500 BLISTERS VERY HIGH FEVER. VARICELLA REPORT IN CDRSS ID 463809
Age: 35.0
Sex: F
Vaccine: FLU3
Symptoms: Injection site pain, Injection site reaction, Myalgia, Neck pain, Pain in extremity
Clinical narrative: Pain, muscle pain radiating from site of injection, radiated down into arm (R).  Approximately within an hour pain also radiating into R neck area.  By 11 (1.5hr post injection) took 2 Advil which helped pain some.
Age: 33.0
Sex: F
Vaccine: FLUX
Symptoms: Injected limb mobility decreased, Injection site pain, Pain
Clinical narrative: 3 weeks later, the site of patient's flu shot injection is still very sore (right arm); when pushing on the site, it hurts down to the muscle. Patient has trouble lifting arm over head to remove clothing, pain deep in the tissue when doing other simple tasks as well.
Age: 63.0
Sex: F
Vaccine: FLUX
Symptoms: Axillary pain, Musculoskeletal pain, Pain in extremity, Skin warm, Tenderness
Clinical narrative: Extremely Sore. Pain radiating down entire arm, under arm, armpit, front & back of arm & across & under shoulder blade. Slightly warm to touch & whelps appeared on upper arm the next day 11/08/2011.  Took ibuprofen, Benadryl & used Arthritis Cool Blue Alcohol on upper arm. This date 07/09/11 still extremely sore & with some whelps, tenderness & warm to touch. Would have gone to back to facility had it not been so far away.
Age: 63.0
Sex: F
Vaccine: FLUX
Symptoms: Urticaria
Clinical narrative: Extremely Sore. Pain radiating down entire arm, under arm, armpit, front & back of arm & across & under shoulder blade. Slightly warm to touch & whelps appeared on upper arm the next day 11/08/2011.  Took ibuprofen, Benadryl & used Arthritis Cool Blue Alcohol on upper arm. This date 07/09/11 still extremely sore & with some whelps, tenderness & warm to touch. Would have gone to back to facility had it not been so far away.
Age: 1.02
Sex: M
Vaccine: VARCEL, DTAP, IPV, MMR, VARCEL
Symptoms: Varicella post vaccine
Clinical narrative: PT RECEIVED A MILD CASE OF VARICELLA AFTER RECEIVING 2 DOSES OF VARIVAX VACCINE. THIS WAS BREAKTHROUGH ILLNESS. VARICELLA REPORT IN CDRSS CASE ID 463810
Age: 4.0
Sex: M
Vaccine: VARCEL, DTAP, IPV, MMR, VARCEL
Symptoms: Varicella post vaccine
Clinical narrative: PT RECEIVED A MILD CASE OF VARICELLA AFTER RECEIVING 2 DOSES OF VARIVAX VACCINE. THIS WAS A BREAKTHROUGH ILLNESS. VARICELLA REPORT IN CDRSS CASE ID 463810
Age: 57.0
Sex: F
Vaccine: FLU3, PPV
Symptoms: Injection site reaction, Injection site swelling, Nausea, Pruritus, Skin tightness
Clinical narrative: Patient describes very swollen arm at site of Pneumovax injection.  Tight skin and visible swelling from shoulder to elbow.  She also describes itching, but no rash.  Patient also reports nausea.  Symptoms resolved after Benadryl.
Age: 29.0
Sex: M
Vaccine: FLU3
Symptoms: Ammonia, Anti-thyroid antibody, Blood culture, Blood glucose, Blood ketone body
Clinical narrative: Altered mental status. DX Acute encephalopathy. States forgetting to do things and care for himself that he normally does. Couldn't remember name or address.
Age: 29.0
Sex: M
Vaccine: FLU3
Symptoms: Blood thyroid stimulating hormone, C-reactive protein, Computerised tomogram head, Encephalopathy, Full blood count
Clinical narrative: Altered mental status. DX Acute encephalopathy. States forgetting to do things and care for himself that he normally does. Couldn't remember name or address.
Age: 29.0
Sex: M
Vaccine: FLU3
Symptoms: Influenza virus test, Memory impairment, Mental status changes, Metabolic function test, Nuclear magnetic resonance imaging brain
Clinical narrative: Altered mental status. DX Acute encephalopathy. States forgetting to do things and care for himself that he normally does. Couldn't remember name or address.
Age: 29.0
Sex: M
Vaccine: FLU3
Symptoms: Red blood cell sedimentation rate, Renal function test, Thyroid stimulating immunoglobulin
Clinical narrative: Altered mental status. DX Acute encephalopathy. States forgetting to do things and care for himself that he normally does. Couldn't remember name or address.
Age: 18.0
Sex: M
Vaccine: FLUN3, TD
Symptoms: Expired drug administered, Incorrect dose administered
Clinical narrative: 10/28/11 Administered Td that expired on 10/15/11. 10/28/11 Admnistered FluMist patient had received TIV Fluzone on 10/13/11.
Age: 39.0
Sex: F
Vaccine: FLUN3
Symptoms: Urticaria
Clinical narrative: Hives for several days.
Age: 29.0
Sex: F
Vaccine: FLU3
Symptoms: Myalgia, Pain
Clinical narrative: Deep Muscle soreness after vaccination, worsening over time, so much so that by 10/19/11 was unable to complete lift, push or pull with Left arm without pain.
Age: 50.0
Sex: F
Vaccine: FLU3
Symptoms: Chest discomfort, Dysphonia, Dyspnoea, Eye irritation, Ocular hyperaemia
Clinical narrative: 3-4PM Very Blood Shot eyes 7-9PM Eyes more irritated, chest/lung tightness (felt as though patient couldn't catch their breath), hoarse voice. 9-11 Eyes (sclera) bright red, chect congestion/tightness continued - eased only slightly after 4 Advil cold and sinus over the course of the night. Symptoms eased a bit but persisted through the next day.
Age: 50.0
Sex: F
Vaccine: FLU3
Symptoms: Pulmonary congestion
Clinical narrative: 3-4PM Very Blood Shot eyes 7-9PM Eyes more irritated, chest/lung tightness (felt as though patient couldn't catch their breath), hoarse voice. 9-11 Eyes (sclera) bright red, chect congestion/tightness continued - eased only slightly after 4 Advil cold and sinus over the course of the night. Symptoms eased a bit but persisted through the next day.
Age: 78.0
Sex: M
Vaccine: FLU3
Symptoms: Headache
Clinical narrative: "Headache".
Age: 39.0
Sex: F
Vaccine: FLU3
Symptoms: Hypertension, Lethargy, Presyncope, Pyrexia, Tachycardia
Clinical narrative: Fever, hypertension, tachycardia, tachypnea, near syncope, lethargy.
Age: 39.0
Sex: F
Vaccine: FLU3
Symptoms: Tachypnoea
Clinical narrative: Fever, hypertension, tachycardia, tachypnea, near syncope, lethargy.
Age: 30.0
Sex: F
Vaccine: FLUX
Symptoms: Cognitive disorder, Dizziness, Lacrimation increased, Mydriasis, Nausea
Clinical narrative: Patient became nauseated, dizzy, could not comprehend what people were saying, eyes started to become watery and very dilated. Patient took one Benadryl pill and in two hours felt a lot better but eyes were still dilated.
Age: 14.0
Sex: F
Vaccine: HPV4
Symptoms: Abdominal pain, Activities of daily living impaired, Back pain, Feeling cold, Headache
Clinical narrative: Within a weeks time we had to take her to the emergency room for severe abdominal pain. Her plight has been virtually chronic ever since. We have had multiple encounters with medical professionals who have been left dumbfounded by her symptoms if muscular fatigue, abdominal pain, hot and cold flashes, headaches an back pain. Has caused missed school which resulted in alternative education, and missed work for parents.
Age: 14.0
Sex: F
Vaccine: HPV4
Symptoms: Hot flush, Muscle fatigue
Clinical narrative: Within a weeks time we had to take her to the emergency room for severe abdominal pain. Her plight has been virtually chronic ever since. We have had multiple encounters with medical professionals who have been left dumbfounded by her symptoms if muscular fatigue, abdominal pain, hot and cold flashes, headaches an back pain. Has caused missed school which resulted in alternative education, and missed work for parents.
Age: 54.0
Sex: M
Vaccine: FLU3
Symptoms: Blood test normal, Conjunctivitis, Dizziness, Dyspnoea, Eye swelling
Clinical narrative: Difficulty breathing, swollen eyes, excessive conjunctivitis, light headedness.
Age: 60.0
Sex: F
Vaccine: FLUX
Symptoms: Back pain, Cough, Influenza like illness, Pain, Painful respiration
Clinical narrative: Cough, back aching, trunk of body aching. Hurt to take a breath! Patient considered going to Emergency Room. Took some Ibuprofen and after about 30 minutes the aching was better, went to bed. The next day patient felt like had flu like symptoms and was "off their mark" at work.
Age: 28.0
Sex: F
Vaccine: FLUX
Symptoms: Diarrhoea, Pyrexia
Clinical narrative: Fever, Diarrhea.
Age: 62.0
Sex: M
Vaccine: FLUX
Symptoms: Asthenia, Cough, Dry eye, Exercise tolerance decreased, Eye irritation
Clinical narrative: Sudden congestion began in lungs.  Required coughing to clear throat and lungs.  The speed of congestion increased, requiring heavy, continuous coughing at times.  This continued for at least 4 hours. Congestion spread to head, and a headache developed. Eyes became scratchy, extremely bloodshot (no whites remaining), and were almost impossible to keep open because of the pain, even with the use of eyedrops.  This continued into the following day until around 5:00 PM when the redness started to clear.  Eyes continue to become dry quickly and occasionally into this third day. The physical feeling of being ill (no nausea, but out-of-sorts and weak) began at this time and continue also into this third day.   Heavy exhaustion and very low endurance has continued for these three days following, with improvement (50% or so) seen in this third day.
Age: 62.0
Sex: M
Vaccine: FLUX
Symptoms: Eye pain, Fatigue, Feeling abnormal, Headache, Malaise
Clinical narrative: Sudden congestion began in lungs.  Required coughing to clear throat and lungs.  The speed of congestion increased, requiring heavy, continuous coughing at times.  This continued for at least 4 hours. Congestion spread to head, and a headache developed. Eyes became scratchy, extremely bloodshot (no whites remaining), and were almost impossible to keep open because of the pain, even with the use of eyedrops.  This continued into the following day until around 5:00 PM when the redness started to clear.  Eyes continue to become dry quickly and occasionally into this third day. The physical feeling of being ill (no nausea, but out-of-sorts and weak) began at this time and continue also into this third day.   Heavy exhaustion and very low endurance has continued for these three days following, with improvement (50% or so) seen in this third day.
Age: 62.0
Sex: M
Vaccine: FLUX
Symptoms: Ocular hyperaemia, Pulmonary congestion, Upper respiratory tract congestion
Clinical narrative: Sudden congestion began in lungs.  Required coughing to clear throat and lungs.  The speed of congestion increased, requiring heavy, continuous coughing at times.  This continued for at least 4 hours. Congestion spread to head, and a headache developed. Eyes became scratchy, extremely bloodshot (no whites remaining), and were almost impossible to keep open because of the pain, even with the use of eyedrops.  This continued into the following day until around 5:00 PM when the redness started to clear.  Eyes continue to become dry quickly and occasionally into this third day. The physical feeling of being ill (no nausea, but out-of-sorts and weak) began at this time and continue also into this third day.   Heavy exhaustion and very low endurance has continued for these three days following, with improvement (50% or so) seen in this third day.
Age: 70.0
Sex: F
Vaccine: FLU3
Symptoms: Chills, Headache, Myalgia, Pyrexia
Clinical narrative: Approx 4hrs post inj. -chills, fever, headache, myalgia, sympt. decreased at 12 and 24hrs but still present somewhat.
Age: 1.5
Sex: F
Vaccine: VARCEL
Symptoms: Injection site erythema, Injection site pain, Injection site vesicles, Local reaction
Clinical narrative: Patient developed a 1/4 inch red spot at site of vaccine injection on 11/4/2011.  On 11/8/2011, initial 1/4 inch spot had blisters on it and there was a pinker ring surrounding the area.  Patient indicated there was pain at the site.  Parent took patient to doctor on 11/9/2011.  Doctor indicated that the spot was a localized reaction to Varicella vaccine.
Age: 8.0
Sex: M
Vaccine: FLUN3
Symptoms: Syncope
Clinical narrative: Pt fainted in the waiting room on his way out of the building just a few minutes after receiving the Live, Intranasal Influenza Vaccine.
Age: 0.31
Sex: F
Vaccine: DTAP
Symptoms: Injection site swelling, Pyrexia, Vomiting
Clinical narrative: Vomiting, fever, leg swelling.
Age: 65.0
Sex: F
Vaccine: FLUX
Symptoms: Cellulitis, Erythema, Mobility decreased, Muscle mass, Oedema peripheral
Clinical narrative: Red-swelling-hot to touch-extended from top of shoulder to 3 inches before bend of elbow-wrapped over half way around arm-multiple lumps in muscle-incomplete arm movement-low grade fever-saw doctor-was told patient had cellulitis-prescribed antibiotic-otc Claritin-Motrin.
Age: 65.0
Sex: F
Vaccine: FLUX
Symptoms: Pyrexia, Skin warm
Clinical narrative: Red-swelling-hot to touch-extended from top of shoulder to 3 inches before bend of elbow-wrapped over half way around arm-multiple lumps in muscle-incomplete arm movement-low grade fever-saw doctor-was told patient had cellulitis-prescribed antibiotic-otc Claritin-Motrin.
Age: 0.02
Sex: M
Vaccine: HEP
Symptoms: Vomiting, Vomiting projectile
Clinical narrative: Vomiting at every feeding (breastfed only, 2 week old). Vomiting started at 8:00 PM until 11/08/2011 4:00 AM. Some heavy vomiting (through nose and projectile, with bile). No treatment.
Age: 67.0
Sex: F
Vaccine: FLU3, PPV
Symptoms: Feeling of body temperature change, Hypersomnia, Injection site erythema, Injection site warmth
Clinical narrative: Patient was very warm, then cold. Slept all evening. Arm was red & warm. Patient said she had same reaction last year to flu shot.
Age: 22.0
Sex: F
Vaccine: FLUX(H1N1)
Symptoms: Abortion spontaneous
Clinical narrative: Miscarriage.
Age: 45.0
Sex: F
Vaccine: FLU3, PPV
Symptoms: Injection site erythema, Injection site swelling
Clinical narrative: This currently 65 year old female reports redness and swelling "that is more than just a little" on 09Nov2011 at the site of Pneumovax 23 administration. Pneumovax 23 was administered 08Nov2011 SC in right lower tricep. Patient was referred to MD for evaluation of reaction on 09Nov2011. Patient stated that she was heading immediatly to an urgent care center.