chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 72.0
Sex: F
Vaccine: FLU3
Symptoms: Cardiovascular disorder, Lung disorder, Myocardial infarction
Clinical narrative: This subject is a 72 year old female who died in her home while enrolled in a study. The subject received two doses of the study vaccine. The last dose prior to the death was given on 10/6/03. The subject's daughter reported that her mom was found dead in her home on 3/17/04, 163 post immunization. Suspected cause of death is a heart attack. No autopsy performed. Subject was not brought to the hospital. The death was reported by the investigator as unrelated to the study vaccine. Nurse follow up on 05/17/04 states: COPD, Hypertensive cardiovascular disease (Lung dis, Cardiovasc dis). The death was reported by the investigator as unrelated to the stud vaccine. Additional information received 7 April 2004. Concomitmant therapies and relevant medical history. Cross reference with 2003-00300 (SAE #2003-0-1056)- Same patient.
Age: 17.0
Sex: F
Vaccine: HEPA
Symptoms: Amnesia, Arthralgia, Back pain, Confusional state, Depression
Clinical narrative: This case was reported by a consumer and described the occurrence of joint pain in a 17 year old female pt who received hep A vaccine inactivated (Havrix). A physician or other health care professional has not verified this report. The pt's past medical history included gluten intolerance. On 6/26/01, the pt received the first dose of Havrix. On 5/28/02, the pt received the second dose of Havrix. On an unspecified date in 2003, approximately ten months after administration of the second dose of Havrix, the pt developed joint pain in her neck, knees, shoulders and hips. Between ten and sixteen months after receiving her second dose of Havrix, the pt also developed headache, blurred vision, fatigue, dizziness, "brain fog," memory loss, malaise, depression, and felt dazed. The reporter noted that the area near the pt's spine was very sensitive to pain. The reporter felt that "heavy metals are accumulating and that the pt is experiencing adrenal fatigue/ burnout/ insufficiency." The reporter also stated that the pt "cannot complete school work because of fatigue." As of 3/24/04, the events were unresolved. The reporter is the pt's mother.
Age: 17.0
Sex: F
Vaccine: HEPA
Symptoms: Dizziness, Fatigue, Headache, Vision blurred
Clinical narrative: This case was reported by a consumer and described the occurrence of joint pain in a 17 year old female pt who received hep A vaccine inactivated (Havrix). A physician or other health care professional has not verified this report. The pt's past medical history included gluten intolerance. On 6/26/01, the pt received the first dose of Havrix. On 5/28/02, the pt received the second dose of Havrix. On an unspecified date in 2003, approximately ten months after administration of the second dose of Havrix, the pt developed joint pain in her neck, knees, shoulders and hips. Between ten and sixteen months after receiving her second dose of Havrix, the pt also developed headache, blurred vision, fatigue, dizziness, "brain fog," memory loss, malaise, depression, and felt dazed. The reporter noted that the area near the pt's spine was very sensitive to pain. The reporter felt that "heavy metals are accumulating and that the pt is experiencing adrenal fatigue/ burnout/ insufficiency." The reporter also stated that the pt "cannot complete school work because of fatigue." As of 3/24/04, the events were unresolved. The reporter is the pt's mother.
Age: 9.0
Sex: F
Vaccine: VARCEL
Symptoms: Asthenia, CSF test abnormal, Dysphonia, Guillain-Barre syndrome, Headache
Clinical narrative: Guillain-Barré syndrome. Neurologic symptoms developed 2/21/04. Headache for 2 wks prior to 2/24/04. Thigh pain L 2 wks prior to 2/24/04. Recovery is in progress. Admitted 2/25/04 with progressive neurologic changes; tests c/w GBS. Nurse follow up on 05/18/04: urinary incontinence, weakness lower extremities, hypertension, hoarse voice, fluid retention.
Age: 9.0
Sex: F
Vaccine: VARCEL
Symptoms: Hypertension, Laboratory test abnormal, Neurological symptom, Oedema, Pain
Clinical narrative: Guillain-Barré syndrome. Neurologic symptoms developed 2/21/04. Headache for 2 wks prior to 2/24/04. Thigh pain L 2 wks prior to 2/24/04. Recovery is in progress. Admitted 2/25/04 with progressive neurologic changes; tests c/w GBS. Nurse follow up on 05/18/04: urinary incontinence, weakness lower extremities, hypertension, hoarse voice, fluid retention.
Age: 9.0
Sex: F
Vaccine: VARCEL
Symptoms: Urinary incontinence
Clinical narrative: Guillain-Barré syndrome. Neurologic symptoms developed 2/21/04. Headache for 2 wks prior to 2/24/04. Thigh pain L 2 wks prior to 2/24/04. Recovery is in progress. Admitted 2/25/04 with progressive neurologic changes; tests c/w GBS. Nurse follow up on 05/18/04: urinary incontinence, weakness lower extremities, hypertension, hoarse voice, fluid retention.
Age: 1.0
Sex: F
Vaccine: HBHEPB, MMR
Symptoms: Meningitis, Pyrexia, Viral infection
Clinical narrative: Child admitted to hospital with aseptic meningitis 3 days after receiving MMR, Hib and hep B #2. Developed fever 1 day after received vaccine. Follow up on 05/11/04: "No prior vaccinations after adverse events."  Nurse follow up on 07/19/04 states: "Viral meningitis."
Age: 0.42
Sex: M
Vaccine: DTAP, HIBV, PNC
Symptoms: Grand mal convulsion, Loss of consciousness, Myoclonus, Neurodevelopmental disorder
Clinical narrative: Developed grand mal seizures with loss of consciousness 10 days after DTaP administered. Seizures are recurrent and ongoing. But seizures continue. THe discharge summaries ad out pt. neuro. evals received on 4/5/04 state myoclonus and developmental delay.
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMR
Symptoms: Condition aggravated, Crying, Dyspnoea, Hypersensitivity, Tremor
Clinical narrative: After vaccine administration-pt cried immediately then vomited within five minutes of shot. Child ? wheezing, vomited again, not breathing well; crying whole time. Epipen Jr given. Transferred via 911 to ER. The hospital summary received on 4/6/04 states tremulous, and an allergic react to vaccine.
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMR
Symptoms: Vomiting, Wheezing
Clinical narrative: After vaccine administration-pt cried immediately then vomited within five minutes of shot. Child ? wheezing, vomited again, not breathing well; crying whole time. Epipen Jr given. Transferred via 911 to ER. The hospital summary received on 4/6/04 states tremulous, and an allergic react to vaccine.
Age: 70.0
Sex: F
Vaccine: FLU3
Symptoms: Headache, Hyperglycaemia, Hypoaesthesia, Influenza like illness, Injection site pain
Clinical narrative: Woke night up terrible pain in left hand, palm and fingers. Next couple days, left arm ached like flu, went across shoulder and down right arm to hand-HA's not been normal to this date 3/30/04. Left fingers are numb and hurt like have been too cold. Right fingers not as bad as left-after 4 mo some better. Went to Dr 12/8/03. Ibuprofen for pain. Still not normal. Constant pain and numbness sometime better/ worse-has never gone away. Where shot given-still sore. Information from Annual Follow-up report states not completely - still numbness in fingers all time. But not as bad and not near the pain.
Age: 70.0
Sex: F
Vaccine: FLU3
Symptoms: Laboratory test abnormal, Pain
Clinical narrative: Woke night up terrible pain in left hand, palm and fingers. Next couple days, left arm ached like flu, went across shoulder and down right arm to hand-HA's not been normal to this date 3/30/04. Left fingers are numb and hurt like have been too cold. Right fingers not as bad as left-after 4 mo some better. Went to Dr 12/8/03. Ibuprofen for pain. Still not normal. Constant pain and numbness sometime better/ worse-has never gone away. Where shot given-still sore. Information from Annual Follow-up report states not completely - still numbness in fingers all time. But not as bad and not near the pain.
Age: 25.0
Sex: M
Vaccine: ANTH
Symptoms: Erythema, Injection site swelling
Clinical narrative: 5X10 cm red raised non-tender area to right deltoid. 2 days post anthrax vaccine.
Age: 36.0
Sex: F
Vaccine: ANTH
Symptoms: Hypersensitivity, Injection site erythema, Injection site swelling, Pruritus, Tenderness
Clinical narrative: Upon waking up the day after receiving shot, 1.5" inches welt at injection site. Welt was raised, perfectly round, bright red, itchy and sore area. Welt remained for 48 hours. Injection site still sore and has 1 inch bump under skin. No treatment requested or given.
Age: 36.0
Sex: F
Vaccine: ANTH
Symptoms: Urticaria
Clinical narrative: Upon waking up the day after receiving shot, 1.5" inches welt at injection site. Welt was raised, perfectly round, bright red, itchy and sore area. Welt remained for 48 hours. Injection site still sore and has 1 inch bump under skin. No treatment requested or given.
Age: 11.0
Sex: F
Vaccine: MMR, TD
Symptoms: Erythema, Lymphadenopathy, Pain, Swelling
Clinical narrative: Received Td in LD on 3/29/04. Mother of patient called 4/1/04 complained of redness, swelling of left upper arm. Mother also stated swollen lymph node under left arm. Patient complained of rib pain on left side on 3/30/2004.
Age: 0.3
Sex: F
Vaccine: DTAPHEPBIP, HIBV, PNC
Symptoms: Urticaria
Clinical narrative: Onset of widespread urticaria <24 hours post immunization. No wheezing.
Age: 1.0
Sex: F
Vaccine: MMR, VARCEL
Symptoms: Drug ineffective, Rash erythematous, Rash macular, Rash vesicular, Skin ulcer
Clinical narrative: 9 Days after administration of varicella vaccine and MMR vaccine, pt developed ~200 erythematous macules involving scalp, face, arms, chest, back, legs, sparing palms and soles. 3 lesions one longer than .5 cm with ? vesicle formation in center.
Sex: F
Vaccine: DTAP, MMR
Symptoms: Injection site erythema, Oedema peripheral
Clinical narrative: Patient received DaTP immunization on 3/23/04 at 4pm on the left deltoid and returned on 3/25/04 at 3pm for local reaction check. Seen by charge nurse. Injection site was swollen, red. Advised for local compresses. No fever. Retrun to see MD if needed.
Age: 4.0
Sex: F
Vaccine: DTAP
Symptoms: Injection site erythema, Injection site swelling
Clinical narrative: Local redness/ swelling to site greater than typical vaccine.
Age: 3.5
Sex: F
Vaccine: DTAP, HEPA
Symptoms: Injection site erythema, Injection site swelling
Clinical narrative: Red swelling to left deltoid where injection was administered. Follow up on 04/20/04: "Everything correct."
Age: 4.8
Sex: F
Vaccine: DTAP, IPV, MMR
Symptoms: Injection site erythema, Injection site induration, Injection site oedema, Injection site pain, Injection site warmth
Clinical narrative: Right deltoid, red, edematous, hard, warm to touch. Painful.
Age: 4.08
Sex: M
Vaccine: DTAP, IPV, MMR
Symptoms: Lymphadenopathy, Swelling
Clinical narrative: Significant local reaction with swelling of entire left thigh, knee to groin. Shotty inguinal lyphodenopathy
Age: 45.0
Sex: F
Vaccine: TD
Symptoms: Neck pain, Pain
Clinical narrative: Significant pain in left upper arm radiating down arm and up neck. Painful within rage of most. Very intense 1st day. Currently rates 7/10. Said okay. Tylenol, Ibuprofen, Aleve, heat, ice
Age: 4.9
Sex: F
Vaccine: TTOX
Symptoms: Medication error, Swelling
Clinical narrative: Patient given vaccine Td adult on 3/19/04 instead of DTaP and received a long swelling on right deltoid area but no urticaria or difficulty breathing. Also given IPOL in same arm.
Age: 5.0
Sex: M
Vaccine: DTAP, HIBV, IPV, MMR
Symptoms: Urticaria
Clinical narrative: Significant urticaria particularly near eyes and mouth. No resp. distress nor tachypnea. 25mg Benadryl given po. Symptoms completely resolved within 45min period of time. Throughout vials were stable.
Age: 0.3
Sex: M
Vaccine: DTAPHEPBIP, HIBV
Symptoms: Erythema, Feeling hot, Injection site erythema, Irritability
Clinical narrative: Erythema at injection site; L>R. Slowly involved distal leg to feet, bilat, which became erythematous, warm to touch, no urticaria. Child fussy. Received 6.25mg Benadryl. Post 20-30 min observation legs/ feet no longer erythematous. He was no longer fussy.
Age: 4.0
Sex: M
Vaccine: DTAP, IPV
Symptoms: Injection site erythema, Injection site oedema
Clinical narrative: Immunization given 3/10/04. On 3/12/04 pt seen with 12cmx4cm edema/erythema right upper arm. Given Benadryl and Motrin. Pt returned on 3/24- Rx gone right arm within normal limits. Pt without complaint.
Age: 69.0
Sex: F
Vaccine: TD
Symptoms: Cellulitis, Erythema, Feeling hot, Injection site reaction, Pain
Clinical narrative: Pain, burning, warm, red, cellulitis--Keflex and Prednisone for 10 days
Age: 69.0
Sex: F
Vaccine: TD
Symptoms: Skin burning sensation
Clinical narrative: Pain, burning, warm, red, cellulitis--Keflex and Prednisone for 10 days
Age: 55.0
Sex: F
Vaccine: DTP
Symptoms: Erythema, Feeling hot, Injection site hypersensitivity, Pruritus
Clinical narrative: Redness, warmth, itching at site- Prednisone and Keflez for 10 days.
Age: 5.0
Sex: M
Vaccine: DTAP, IPV, MMR
Symptoms: Ear pain, Urticaria
Clinical narrative: Mother states approximately one hour after receiving immunizations, child stated his "ears were burning." Mother looked to find child covered in hives from head to toe. Mother called physician, who advised Benadryl. After giving one dose mother stated child greatly improved, mother gave another dose six hours later and hives completely went away.
Age: 5.0
Sex: F
Vaccine: DTAP, IPV, MMR
Symptoms: Injection site erythema
Clinical narrative: Redness at polio site measuring 5 inches x 10 inches on left arm and at MMR sites on right arm measuring 2 inches x 3 inches. Atarax given.
Sex: F
Vaccine: TD
Symptoms: Myalgia, Oedema, Urticaria, Wheezing
Clinical narrative: These events were reported by mother 3/19/04 left arm become quite swollen and sore. Developed hives & wheezing. Pt history of asthma. Mother treated with Benadryl and Albuteral. Child reportedly did well after that.
Age: 18.0
Sex: F
Vaccine: MMR, TD
Symptoms: Pruritus, Urticaria
Clinical narrative: These events were reported by the mother 3/19/04. Pt developed hives- apparently isolated areas- not generalized with itching. No respiratory problems. She was treated with Benadryl.
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMR
Symptoms: Erythema, Feeling hot, Oedema
Clinical narrative: Pt arm became swollen, red & hot to touch.
Age: 4.0
Sex: F
Vaccine: MMR
Symptoms: Abdominal pain, Lethargy, Vomiting
Clinical narrative: 1/2 after vaccine (MMR) vomiting, lethargic, abdominal pain- Administered Solucortef 1 cc for CAH and Childrens Benadryl 1 1/2 tsp.
Age: 4.0
Sex: M
Vaccine: DTAP, IPV, MMR
Symptoms: Erythema, Feeling hot, Oedema, Pruritus
Clinical narrative: Left arm swollen to elbow and up to scapula. Denies fever, complains of itching, redness, swelling, warm, red. Started 3/28. Started going down 3/29/2004.
Age: 0.17
Sex: U
Vaccine: DTAPHEPBIP, HBPV, PNC
Symptoms: Contusion, Erythema, Petechiae, Platelet disorder, Rash
Clinical narrative: Patient was seen for a well child visit on January 22, 2004. His examination was perfectly negative and vaccines were given. He was again seen on February 24th 2004. His parents brought him in for evaluation of a rash which he had for about a month. Immunizations were given on January 22, 2004, these were the second doses of the vaccines. It was reported that a couple hours after the vaccines were given, the same afternoon, a red rash appeared. The rash had not changed over the month period of time. The child had a bit of a cold when he was first seen. He is breast fed. His physical examination revealed a healthy appearing child who had a large number of petechiae on the extremities. There was some bruising in the groin crease, along the diaper line, and there appeared to be a larger bruise, which was fading, on his back. He was immediately sent for evaluation following a CBC which showed a platelet count of less than 10,000. The remainder of the CBC was normal.
Age: 0.17
Sex: M
Vaccine: DTAPHEPBIP, PNC
Symptoms: Pyrexia
Clinical narrative: 3/23/04 mother reported T- 100.8 axillary (4:00 am).
Age: 4.0
Sex: M
Vaccine: DTAP, IPV
Symptoms: Erythema, Feeling hot, Oedema
Clinical narrative: Left deltoid swollen, mild erythema, hot to touch. Slight extension of erythema distal to deltoid. Full range of motion of arm. No bruising, not painful on exam.
Age: 0.42
Sex: F
Vaccine: DTAPHEPBIP, HIBV, PNC
Symptoms: Oedema, Tenderness
Clinical narrative: Pt received Pediarix, Prevnar + Hib vaccines on 3/29/04. Bilat thighs swollen, tender. Presented for RSV vaccine today- Aborted 2 hours to end of season.
Age: 4.0
Sex: M
Vaccine: DTAP, IPV, MMR
Symptoms: Erythema, Infection, Oedema, Pain, Pruritus
Clinical narrative: DTaP given 3/29/04. Today (4/1/04) arm swollen, pink, elbow- shoulder, questionable itchy; min pain. T 100.5. Questionable hyperimmune response vs infection.
Age: 1.5
Sex: F
Vaccine: DTAP
Symptoms: Injection site erythema, Injection site induration, Injection site warmth, Oedema
Clinical narrative: Left thigh with 4 inch x 4 inch red area at site of injection of DTaP (DTaP given on 3-30-04); area with swelling/ hardness/ & hotness on 3-31-04.
Age: 57.0
Sex: F
Vaccine: DTP
Symptoms: Feeling hot, Injection site erythema, Tenderness
Clinical narrative: Vac. site warm, red, tender, with redness extending down arm almost to elbow.
Age: 6.0
Sex: F
Vaccine: DTAP, HIBV, IPV
Symptoms: Cellulitis, Erythema, Injection site inflammation, Oedema, Pain
Clinical narrative: 48 hours after injection, patient experienced swelling, redness & pain in right ark. (below skin). Treatment: warm compress to arm every 4 hours. Motrin for pain & inflammation.
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMR
Symptoms: Erythema, Feeling hot, Oedema
Clinical narrative: DTaP was given in left deltoid muscle on 4-1-04. The mother came by & told nurse her arm swelled real big, was red & fevered. I took her to the ER on Sun & they gave her Benadryl. I've been giving her Benadryl & Motrin. "It's not as big today as it was."  The mother did not bring the pt & was the the health department needed to see the arm. Mother said "she can't today she has to go find birth certificate."
Age: 1.3
Sex: M
Vaccine: DTAP, HIBV
Symptoms: Angioneurotic oedema, Injection site erythema, Injection site swelling, Injection site warmth, Urticaria
Clinical narrative: Urticarial rash, entire body after eating one bite of peanut butter jelly sandwich, 24 hours after vaccine was administered.  Area around DTaP was red, warm, and swollen also, but area around Pedvax was not.  Hives were giant and over entire body.  Given epinephrine 1:1000 x 2 with prompt resolution of hives within 1.5 hours.
Age: 5.0
Sex: M
Vaccine: DTAP, IPV, MMR
Symptoms: Bacterial infection, Pain, Swelling
Clinical narrative: Patient had significant swelling of right arm where the vaccine was given, and pain. swelling started the night after receiving the vaccine and continued to get worse.  2 days after receiving the vaccine, he was seen at an urgent care clinic, and was diagnosed with a staph infection, and placed on antibiotics.  He began to improve that evening, and was recovered in several days.
Age: 48.0
Sex: F
Vaccine: HEP
Symptoms: Injection site pain, Joint range of motion decreased, Shoulder pain
Clinical narrative: Ct. reports great soreness in arm, esp. at site with decreased range of motion, and pain with use X 2 wks; continued soreness with use in shoulder joint.
Age: 21.0
Sex: M
Vaccine: SMALL, TYP, SMALL, TYP
Symptoms: Cellulitis, Conjunctivitis, Diplopia, Erythema, Eye inflammation
Clinical narrative: Patient was admitted to hospital on 04/01/04 with diagnosis of orbital cellulitis, mucopurulent blepharoconjunctivitis possibly secondary to self-inoculation of vaccinia.  He received his primary smallpox vaccination on 03/23/04, along with typhoid vaccination.  He attended the SPV briefing on that date and received educational brochure.  He reports no complaints on the date of vaccination.  His smallpox vaccination site has followed the normal course of healing.  His only complaint has been that the site was itchy and red.  No chest pain shortness of breath.  Few discrete papules on bilateral papules on bilateral upper extremities, but patient states this is baseline for him.  1 pustule on forehead-? acne.   On 03/31/04 (day 8 post-vaccination) he was at the range and reports that sand blew into his left eye.  By the time he arrived back to work, the eye had become itchy and red.  The next morning upon awakening, his left eyelid was matted together.  He describes his left eye as painful, burning, and itching.  Since awakening, clear tears have been running out of his eye.  His vision is blurry in his left eye and he complains of diplopia.  He does not wear contacts or glasses.  When he looks at a bright light, he experiences intense pain.  If he closes his left eye and looks at light, he does not experience any pain.  No other complaints except for a mild headache.  He reports that he has followed all precautions after receipt of smallpox vaccination. He wore a long-sleeve shirt during the day but did not keep a bandage over the site.  When he arrived home, he would apply a bandaid over the site and wear a short-sleeve shirt.  He reports that he washed his hands frequently, kept his laundry separate, did not share linens, and always washed his hands after touching the site.  He does state that the site was extremely pruritic and is afraid that he might have scratched the site at night and ?rubbed his eye.  An emergent ophthalmology consult was obtained, and the service member was admitted with a diagnosis of periorbital cellulitis under the service of family practice with ophthalmology consulted.  He was started on empiric antibiotic coverage with Cefuroxime 1.5 gm IV q 8 hours.  VIG has been requested and is being shipped.  No evidence of vaccinia keratitis.  Viral and bacterial cultures are pending.  CT scan shows evidence of pre-septal cellulitis with NO post-septal involvement.  Nurse follow up on 08/19/04 states: "Keratitis."
Age: 21.0
Sex: M
Vaccine: SMALL, TYP, SMALL, TYP
Symptoms: Eye irritation, Eye pain, Headache, Injection site hypersensitivity, Keratitis
Clinical narrative: Patient was admitted to hospital on 04/01/04 with diagnosis of orbital cellulitis, mucopurulent blepharoconjunctivitis possibly secondary to self-inoculation of vaccinia.  He received his primary smallpox vaccination on 03/23/04, along with typhoid vaccination.  He attended the SPV briefing on that date and received educational brochure.  He reports no complaints on the date of vaccination.  His smallpox vaccination site has followed the normal course of healing.  His only complaint has been that the site was itchy and red.  No chest pain shortness of breath.  Few discrete papules on bilateral papules on bilateral upper extremities, but patient states this is baseline for him.  1 pustule on forehead-? acne.   On 03/31/04 (day 8 post-vaccination) he was at the range and reports that sand blew into his left eye.  By the time he arrived back to work, the eye had become itchy and red.  The next morning upon awakening, his left eyelid was matted together.  He describes his left eye as painful, burning, and itching.  Since awakening, clear tears have been running out of his eye.  His vision is blurry in his left eye and he complains of diplopia.  He does not wear contacts or glasses.  When he looks at a bright light, he experiences intense pain.  If he closes his left eye and looks at light, he does not experience any pain.  No other complaints except for a mild headache.  He reports that he has followed all precautions after receipt of smallpox vaccination. He wore a long-sleeve shirt during the day but did not keep a bandage over the site.  When he arrived home, he would apply a bandaid over the site and wear a short-sleeve shirt.  He reports that he washed his hands frequently, kept his laundry separate, did not share linens, and always washed his hands after touching the site.  He does state that the site was extremely pruritic and is afraid that he might have scratched the site at night and ?rubbed his eye.  An emergent ophthalmology consult was obtained, and the service member was admitted with a diagnosis of periorbital cellulitis under the service of family practice with ophthalmology consulted.  He was started on empiric antibiotic coverage with Cefuroxime 1.5 gm IV q 8 hours.  VIG has been requested and is being shipped.  No evidence of vaccinia keratitis.  Viral and bacterial cultures are pending.  CT scan shows evidence of pre-septal cellulitis with NO post-septal involvement.  Nurse follow up on 08/19/04 states: "Keratitis."
Age: 21.0
Sex: M
Vaccine: SMALL, TYP, SMALL, TYP
Symptoms: Laboratory test abnormal, Lacrimal disorder, Photosensitivity reaction, Pruritus, Rash papular
Clinical narrative: Patient was admitted to hospital on 04/01/04 with diagnosis of orbital cellulitis, mucopurulent blepharoconjunctivitis possibly secondary to self-inoculation of vaccinia.  He received his primary smallpox vaccination on 03/23/04, along with typhoid vaccination.  He attended the SPV briefing on that date and received educational brochure.  He reports no complaints on the date of vaccination.  His smallpox vaccination site has followed the normal course of healing.  His only complaint has been that the site was itchy and red.  No chest pain shortness of breath.  Few discrete papules on bilateral papules on bilateral upper extremities, but patient states this is baseline for him.  1 pustule on forehead-? acne.   On 03/31/04 (day 8 post-vaccination) he was at the range and reports that sand blew into his left eye.  By the time he arrived back to work, the eye had become itchy and red.  The next morning upon awakening, his left eyelid was matted together.  He describes his left eye as painful, burning, and itching.  Since awakening, clear tears have been running out of his eye.  His vision is blurry in his left eye and he complains of diplopia.  He does not wear contacts or glasses.  When he looks at a bright light, he experiences intense pain.  If he closes his left eye and looks at light, he does not experience any pain.  No other complaints except for a mild headache.  He reports that he has followed all precautions after receipt of smallpox vaccination. He wore a long-sleeve shirt during the day but did not keep a bandage over the site.  When he arrived home, he would apply a bandaid over the site and wear a short-sleeve shirt.  He reports that he washed his hands frequently, kept his laundry separate, did not share linens, and always washed his hands after touching the site.  He does state that the site was extremely pruritic and is afraid that he might have scratched the site at night and ?rubbed his eye.  An emergent ophthalmology consult was obtained, and the service member was admitted with a diagnosis of periorbital cellulitis under the service of family practice with ophthalmology consulted.  He was started on empiric antibiotic coverage with Cefuroxime 1.5 gm IV q 8 hours.  VIG has been requested and is being shipped.  No evidence of vaccinia keratitis.  Viral and bacterial cultures are pending.  CT scan shows evidence of pre-septal cellulitis with NO post-septal involvement.  Nurse follow up on 08/19/04 states: "Keratitis."
Age: 21.0
Sex: M
Vaccine: SMALL, TYP, SMALL, TYP
Symptoms: Vaccination complication, Vision blurred
Clinical narrative: Patient was admitted to hospital on 04/01/04 with diagnosis of orbital cellulitis, mucopurulent blepharoconjunctivitis possibly secondary to self-inoculation of vaccinia.  He received his primary smallpox vaccination on 03/23/04, along with typhoid vaccination.  He attended the SPV briefing on that date and received educational brochure.  He reports no complaints on the date of vaccination.  His smallpox vaccination site has followed the normal course of healing.  His only complaint has been that the site was itchy and red.  No chest pain shortness of breath.  Few discrete papules on bilateral papules on bilateral upper extremities, but patient states this is baseline for him.  1 pustule on forehead-? acne.   On 03/31/04 (day 8 post-vaccination) he was at the range and reports that sand blew into his left eye.  By the time he arrived back to work, the eye had become itchy and red.  The next morning upon awakening, his left eyelid was matted together.  He describes his left eye as painful, burning, and itching.  Since awakening, clear tears have been running out of his eye.  His vision is blurry in his left eye and he complains of diplopia.  He does not wear contacts or glasses.  When he looks at a bright light, he experiences intense pain.  If he closes his left eye and looks at light, he does not experience any pain.  No other complaints except for a mild headache.  He reports that he has followed all precautions after receipt of smallpox vaccination. He wore a long-sleeve shirt during the day but did not keep a bandage over the site.  When he arrived home, he would apply a bandaid over the site and wear a short-sleeve shirt.  He reports that he washed his hands frequently, kept his laundry separate, did not share linens, and always washed his hands after touching the site.  He does state that the site was extremely pruritic and is afraid that he might have scratched the site at night and ?rubbed his eye.  An emergent ophthalmology consult was obtained, and the service member was admitted with a diagnosis of periorbital cellulitis under the service of family practice with ophthalmology consulted.  He was started on empiric antibiotic coverage with Cefuroxime 1.5 gm IV q 8 hours.  VIG has been requested and is being shipped.  No evidence of vaccinia keratitis.  Viral and bacterial cultures are pending.  CT scan shows evidence of pre-septal cellulitis with NO post-septal involvement.  Nurse follow up on 08/19/04 states: "Keratitis."
Age: 21.0
Sex: M
Vaccine: SMALL, TYP, SMALL, TYP
Symptoms: Cellulitis, Chills, Conjunctivitis, Corneal lesion, Dizziness
Clinical narrative: Patient was admitted to hospital on 04/01/04 with diagnosis of orbital cellulitis, mucopurulent blepharoconjunctivitis possibly secondary to self-inoculation of vaccinia.  He received his primary smallpox vaccination on 03/23/04, along with typhoid vaccination.  He attended the SPV briefing on that date and received educational brochure.  He reports no complaints on the date of vaccination.  His smallpox vaccination site has followed the normal course of healing.  His only complaint has been that the site was itchy and red.  No chest pain shortness of breath.  Few discrete papules on bilateral papules on bilateral upper extremities, but patient states this is baseline for him.  1 pustule on forehead-? acne.   On 03/31/04 (day 8 post-vaccination) he was at the range and reports that sand blew into his left eye.  By the time he arrived back to work, the eye had become itchy and red.  The next morning upon awakening, his left eyelid was matted together.  He describes his left eye as painful, burning, and itching.  Since awakening, clear tears have been running out of his eye.  His vision is blurry in his left eye and he complains of diplopia.  He does not wear contacts or glasses.  When he looks at a bright light, he experiences intense pain.  If he closes his left eye and looks at light, he does not experience any pain.  No other complaints except for a mild headache.  He reports that he has followed all precautions after receipt of smallpox vaccination. He wore a long-sleeve shirt during the day but did not keep a bandage over the site.  When he arrived home, he would apply a bandaid over the site and wear a short-sleeve shirt.  He reports that he washed his hands frequently, kept his laundry separate, did not share linens, and always washed his hands after touching the site.  He does state that the site was extremely pruritic and is afraid that he might have scratched the site at night and ?rubbed his eye.  An emergent ophthalmology consult was obtained, and the service member was admitted with a diagnosis of periorbital cellulitis under the service of family practice with ophthalmology consulted.  He was started on empiric antibiotic coverage with Cefuroxime 1.5 gm IV q 8 hours.  VIG has been requested and is being shipped.  No evidence of vaccinia keratitis.  Viral and bacterial cultures are pending.  CT scan shows evidence of pre-septal cellulitis with NO post-septal involvement.  Nurse follow up on 08/19/04 states: "Keratitis."
Age: 21.0
Sex: M
Vaccine: SMALL, TYP, SMALL, TYP
Symptoms: Iritis, Keratitis, Laboratory test abnormal, Nausea, Visual disturbance
Clinical narrative: Patient was admitted to hospital on 04/01/04 with diagnosis of orbital cellulitis, mucopurulent blepharoconjunctivitis possibly secondary to self-inoculation of vaccinia.  He received his primary smallpox vaccination on 03/23/04, along with typhoid vaccination.  He attended the SPV briefing on that date and received educational brochure.  He reports no complaints on the date of vaccination.  His smallpox vaccination site has followed the normal course of healing.  His only complaint has been that the site was itchy and red.  No chest pain shortness of breath.  Few discrete papules on bilateral papules on bilateral upper extremities, but patient states this is baseline for him.  1 pustule on forehead-? acne.   On 03/31/04 (day 8 post-vaccination) he was at the range and reports that sand blew into his left eye.  By the time he arrived back to work, the eye had become itchy and red.  The next morning upon awakening, his left eyelid was matted together.  He describes his left eye as painful, burning, and itching.  Since awakening, clear tears have been running out of his eye.  His vision is blurry in his left eye and he complains of diplopia.  He does not wear contacts or glasses.  When he looks at a bright light, he experiences intense pain.  If he closes his left eye and looks at light, he does not experience any pain.  No other complaints except for a mild headache.  He reports that he has followed all precautions after receipt of smallpox vaccination. He wore a long-sleeve shirt during the day but did not keep a bandage over the site.  When he arrived home, he would apply a bandaid over the site and wear a short-sleeve shirt.  He reports that he washed his hands frequently, kept his laundry separate, did not share linens, and always washed his hands after touching the site.  He does state that the site was extremely pruritic and is afraid that he might have scratched the site at night and ?rubbed his eye.  An emergent ophthalmology consult was obtained, and the service member was admitted with a diagnosis of periorbital cellulitis under the service of family practice with ophthalmology consulted.  He was started on empiric antibiotic coverage with Cefuroxime 1.5 gm IV q 8 hours.  VIG has been requested and is being shipped.  No evidence of vaccinia keratitis.  Viral and bacterial cultures are pending.  CT scan shows evidence of pre-septal cellulitis with NO post-septal involvement.  Nurse follow up on 08/19/04 states: "Keratitis."
Age: 22.0
Sex: F
Vaccine: SMALL
Symptoms: Cough, Dehydration, Nasal congestion, Pruritus, Pyrexia
Clinical narrative: 1ST anthrax vaccination on February 11, 2003. The following day she was deployed. Upon arrival there, she then received her primary smallpox vaccination on February 16, 2003. She reports that on approximately February 17, 2003 she noticed a rash that consisted of tiny vesicles. She first noticed them in her left axillia. The vesicles were pruritic. The rash progressed to her arms, chest, breasts, abdomen, buttocks, upper thighs, tops of both feet, and behind her knees bilaterally. The vesicles would rupture and become a dry scabbed over lesion. At the same time, she developed a fever that was greater that 100 degrees F. She also reports that she had a cough, chest congestion, rhinnorhea, and dehydration. She reported to the infirmary for evaluation and was kept over night while she received IV fluids. She was given Zithromax for the respiratory symptoms; however, reports that the symptoms persisted for approximately one month. The respiratory symptoms resolved, however, the rash persisted. She reports that she was evaluated by numerous providers while deployed; no one could identify the etiology of the rash. Cultures were performed, however, she does not know the results. She was treated with several medications including: topical steroids, antifungals, allergy medication, and Benadyl; these were not effective in resolving her symptoms. She reports that the rash persisted approximately seven months, finally resolving 2 months after she returned from deployment.
Age: 22.0
Sex: F
Vaccine: SMALL
Symptoms: Rash vesicular, Rhinorrhoea, Skin ulcer
Clinical narrative: 1ST anthrax vaccination on February 11, 2003. The following day she was deployed. Upon arrival there, she then received her primary smallpox vaccination on February 16, 2003. She reports that on approximately February 17, 2003 she noticed a rash that consisted of tiny vesicles. She first noticed them in her left axillia. The vesicles were pruritic. The rash progressed to her arms, chest, breasts, abdomen, buttocks, upper thighs, tops of both feet, and behind her knees bilaterally. The vesicles would rupture and become a dry scabbed over lesion. At the same time, she developed a fever that was greater that 100 degrees F. She also reports that she had a cough, chest congestion, rhinnorhea, and dehydration. She reported to the infirmary for evaluation and was kept over night while she received IV fluids. She was given Zithromax for the respiratory symptoms; however, reports that the symptoms persisted for approximately one month. The respiratory symptoms resolved, however, the rash persisted. She reports that she was evaluated by numerous providers while deployed; no one could identify the etiology of the rash. Cultures were performed, however, she does not know the results. She was treated with several medications including: topical steroids, antifungals, allergy medication, and Benadyl; these were not effective in resolving her symptoms. She reports that the rash persisted approximately seven months, finally resolving 2 months after she returned from deployment.
Age: 0.1
Sex: M
Vaccine: MMR, VARCEL
Symptoms: Pyrexia, Rash
Clinical narrative: One week after shots (mmr and Chicken pox) moderate fever and small raised bumps on torso and face. Temperature was normal after 12 hours and bumps dissappeared in 48 hours.
Age: 1.0
Sex: F
Vaccine: HIBV, VARCEL
Symptoms: Drug ineffective, Infection
Clinical narrative: Child developed break-through Varicella virus on March 30, 2004 after receiving the vaccine on March 26, 2004.
Age: 22.0
Sex: M
Vaccine: HEPAB
Symptoms: Asthenia, Atelectasis, Balance disorder, Cough, Dysphagia
Clinical narrative: On December 19 patient (pt) received his influenza, IPV, meningococcal, and Td vaccinations. On December 24 he then received Hep A-HepB #1. He stated he felt fine and approx 1 wk later he developed URI symptoms consisting of a non-productive cough and nasal congestion. He denied fever or diarrhea.  Approx 2-3 days prior to admission he noticed weakness that started in his legs and arms associated with numbness and tingling. Also noticed drooping of his eyelids. Went to the emergency room on Jan 12 and was admitted with a diagnosis of probable Guillain Barre Syndrome (GBS).  Hospital Course as transcribed from discharge summary:  Pt was admitted to neurology service after two days of ptosis, followed by rapidly progressive diffuse bilateral weakness and paresthesias. Pt noted only a recent mild URI with no anticedent diarrhea. Admitted to ICU for close monitoring of neuro-muscular and resp status. EMG c/w GBS. Pt given IV Solumedrol and IVIG (2g/kg) continuous infusion for 48 hours. Head CT was performed which was negative for acute bleed. Pt transferred to MICU service on HD#2 secondary to impending intubation (increasing dysphagia and SOB). Pt electively intubated on 1/14. He then was noted to have a RLL infiltrate that slowly progressed, and on 1/16 he became febrile. Pt started on ABX for aspiration pneumonia. A CT angio was obtained on 1/18 and displayed a collapsed RLL, likely from mucous plug. On 1/19, bronchoscopy was performed, and copious secretions suctioned, but unable to re-expand RLL. Pt began to show increased strength and did well on CPAP trials 1/20-21, and subsequently was extubated 1/21. Pt transferred to 9D and back to the neurology service on 1/22. Pts strength recovering well. Pneumonia resolved with ABX therapy. Residual neuro deficits include: left eye ptosis, some unsteadiness/difficulty balancing, Positive Rhomberg, shuffling/steppage gait, difficulty with fine motor skills, DTRs 0-1+.  Update 4-2-04: Pt is now at home and reports that he is doing well. He states that all of his strength has returned but he is still working on his endurance. He states that he still tires easily and that he is increasing his activity.  Nurse follow up on 06/28/04 states: "ADD: Fine motor skill decreased, decreased HR, decreased BP, Nausea, Ileus."  Follow up on 06/25/04 states: "The final diagnosis is still guillain-Barre syndrome.  The diagnosis was made by a neurologist. The pt experienced other illnesses such as mild upper respiratory infection.  The pt never previously experienced GBS related illnesses. The pt never previouisly received influenza vaccination. "
Age: 22.0
Sex: M
Vaccine: HEPAB
Symptoms: Dyspnoea, Eyelid ptosis, Fatigue, Gait disturbance, Guillain-Barre syndrome
Clinical narrative: On December 19 patient (pt) received his influenza, IPV, meningococcal, and Td vaccinations. On December 24 he then received Hep A-HepB #1. He stated he felt fine and approx 1 wk later he developed URI symptoms consisting of a non-productive cough and nasal congestion. He denied fever or diarrhea.  Approx 2-3 days prior to admission he noticed weakness that started in his legs and arms associated with numbness and tingling. Also noticed drooping of his eyelids. Went to the emergency room on Jan 12 and was admitted with a diagnosis of probable Guillain Barre Syndrome (GBS).  Hospital Course as transcribed from discharge summary:  Pt was admitted to neurology service after two days of ptosis, followed by rapidly progressive diffuse bilateral weakness and paresthesias. Pt noted only a recent mild URI with no anticedent diarrhea. Admitted to ICU for close monitoring of neuro-muscular and resp status. EMG c/w GBS. Pt given IV Solumedrol and IVIG (2g/kg) continuous infusion for 48 hours. Head CT was performed which was negative for acute bleed. Pt transferred to MICU service on HD#2 secondary to impending intubation (increasing dysphagia and SOB). Pt electively intubated on 1/14. He then was noted to have a RLL infiltrate that slowly progressed, and on 1/16 he became febrile. Pt started on ABX for aspiration pneumonia. A CT angio was obtained on 1/18 and displayed a collapsed RLL, likely from mucous plug. On 1/19, bronchoscopy was performed, and copious secretions suctioned, but unable to re-expand RLL. Pt began to show increased strength and did well on CPAP trials 1/20-21, and subsequently was extubated 1/21. Pt transferred to 9D and back to the neurology service on 1/22. Pts strength recovering well. Pneumonia resolved with ABX therapy. Residual neuro deficits include: left eye ptosis, some unsteadiness/difficulty balancing, Positive Rhomberg, shuffling/steppage gait, difficulty with fine motor skills, DTRs 0-1+.  Update 4-2-04: Pt is now at home and reports that he is doing well. He states that all of his strength has returned but he is still working on his endurance. He states that he still tires easily and that he is increasing his activity.  Nurse follow up on 06/28/04 states: "ADD: Fine motor skill decreased, decreased HR, decreased BP, Nausea, Ileus."  Follow up on 06/25/04 states: "The final diagnosis is still guillain-Barre syndrome.  The diagnosis was made by a neurologist. The pt experienced other illnesses such as mild upper respiratory infection.  The pt never previously experienced GBS related illnesses. The pt never previouisly received influenza vaccination. "
Age: 22.0
Sex: M
Vaccine: HEPAB
Symptoms: Hypoaesthesia, Hypokinesia, Laboratory test abnormal, Lung disorder, Nasal congestion
Clinical narrative: On December 19 patient (pt) received his influenza, IPV, meningococcal, and Td vaccinations. On December 24 he then received Hep A-HepB #1. He stated he felt fine and approx 1 wk later he developed URI symptoms consisting of a non-productive cough and nasal congestion. He denied fever or diarrhea.  Approx 2-3 days prior to admission he noticed weakness that started in his legs and arms associated with numbness and tingling. Also noticed drooping of his eyelids. Went to the emergency room on Jan 12 and was admitted with a diagnosis of probable Guillain Barre Syndrome (GBS).  Hospital Course as transcribed from discharge summary:  Pt was admitted to neurology service after two days of ptosis, followed by rapidly progressive diffuse bilateral weakness and paresthesias. Pt noted only a recent mild URI with no anticedent diarrhea. Admitted to ICU for close monitoring of neuro-muscular and resp status. EMG c/w GBS. Pt given IV Solumedrol and IVIG (2g/kg) continuous infusion for 48 hours. Head CT was performed which was negative for acute bleed. Pt transferred to MICU service on HD#2 secondary to impending intubation (increasing dysphagia and SOB). Pt electively intubated on 1/14. He then was noted to have a RLL infiltrate that slowly progressed, and on 1/16 he became febrile. Pt started on ABX for aspiration pneumonia. A CT angio was obtained on 1/18 and displayed a collapsed RLL, likely from mucous plug. On 1/19, bronchoscopy was performed, and copious secretions suctioned, but unable to re-expand RLL. Pt began to show increased strength and did well on CPAP trials 1/20-21, and subsequently was extubated 1/21. Pt transferred to 9D and back to the neurology service on 1/22. Pts strength recovering well. Pneumonia resolved with ABX therapy. Residual neuro deficits include: left eye ptosis, some unsteadiness/difficulty balancing, Positive Rhomberg, shuffling/steppage gait, difficulty with fine motor skills, DTRs 0-1+.  Update 4-2-04: Pt is now at home and reports that he is doing well. He states that all of his strength has returned but he is still working on his endurance. He states that he still tires easily and that he is increasing his activity.  Nurse follow up on 06/28/04 states: "ADD: Fine motor skill decreased, decreased HR, decreased BP, Nausea, Ileus."  Follow up on 06/25/04 states: "The final diagnosis is still guillain-Barre syndrome.  The diagnosis was made by a neurologist. The pt experienced other illnesses such as mild upper respiratory infection.  The pt never previously experienced GBS related illnesses. The pt never previouisly received influenza vaccination. "