chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 39.0
Sex: M
Vaccine: HEP, HEPA
Symptoms: Asthenia, Myalgia
Clinical narrative: Pt. felt weak, muscle soreness for 3-4 days two weeks after administration of Hep A and Hep B vaccines. Advised to see his healthcare provider.
Age: 0.75
Sex: M
Vaccine: DTAPIPVHIB, HEP, PNC
Symptoms: Expired drug administered
Clinical narrative: Pt received an expired dose of Hep B. Parents were advised to revaccinate patient. No adverse reactions have been reported.
Age: 0.17
Sex: F
Vaccine: DTAPIPVHIB, HEP, PNC, RV5
Symptoms: Expired drug administered
Clinical narrative: Pt received an expired dose of Hep B. Parents were advised to revaccinate patient. No adverse reactions have been reported.
Age: 0.17
Sex: M
Vaccine: DTAPIPVHIB, HEP, PNC, RV5
Symptoms: Expired drug administered
Clinical narrative: Pt received an expired dose of Hep B. Parents were advised to revaccinate patient. No adverse reactions have been reported.
Age: 29.0
Sex: F
Vaccine: DTAP
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth, Paraesthesia, Rash macular
Clinical narrative: Pt called clinic, c/o redness and blotching of the left upper arm with swelling.  Area was warm to touch and swollen from shoulder to the elbow. Pt also c/o fingers tingling.  Pt was given Prednisone 20 mg bid for five days per Dr.
Age: 18.0
Sex: F
Vaccine: YF
Symptoms: Pyrexia
Clinical narrative: Mother called on 4-6-09 stating that patient had a fever of 103.6 for 48 hours.  No other symptoms noted.
Age: 40.0
Sex: F
Vaccine: TDAP
Symptoms: Burning sensation, Injected limb mobility decreased, Injection site haematoma, Injection site pain, Neck pain
Clinical narrative: pain started out as aching 1 hour after vaccination.  Client states pain (Left Arm) was at it's worst 1 week after vaccine (04-03-09) when she experienced burning pain from her thumb up to her neck with the strongest pain between her elbow and shoulder.  Client denies redness or swelling at site, states had quarter-sized bruise where vaccine given.  Denies fever. States has been difficult to use arm because of the pain. States pain has improved with use of OTC pain reliever and "Icy-Hot" topical rub.  Client has not seen physician at this time, encouraged to see her family physician for further follow-up at time of report.
Age: 40.0
Sex: F
Vaccine: TDAP
Symptoms: Pain in extremity
Clinical narrative: pain started out as aching 1 hour after vaccination.  Client states pain (Left Arm) was at it's worst 1 week after vaccine (04-03-09) when she experienced burning pain from her thumb up to her neck with the strongest pain between her elbow and shoulder.  Client denies redness or swelling at site, states had quarter-sized bruise where vaccine given.  Denies fever. States has been difficult to use arm because of the pain. States pain has improved with use of OTC pain reliever and "Icy-Hot" topical rub.  Client has not seen physician at this time, encouraged to see her family physician for further follow-up at time of report.
Age: 39.0
Sex: M
Vaccine: MMR, MMR
Symptoms: Blood immunoglobulin G, Blood immunoglobulin M, Dysphonia, Local swelling, Similar reaction on previous exposure to drug
Clinical narrative: On 3/27/09 the employee went to the ER around 10 pm due to swelling in neck, change in voice and difficutly speaking.  States he did not have difficulty breathing.  Was given Predisone.   Patient stated later that he had noticed some swelling in neck after 1st injection on 2/24/09.
Age: 39.0
Sex: M
Vaccine: MMR, MMR
Symptoms: Speech disorder
Clinical narrative: On 3/27/09 the employee went to the ER around 10 pm due to swelling in neck, change in voice and difficutly speaking.  States he did not have difficulty breathing.  Was given Predisone.   Patient stated later that he had noticed some swelling in neck after 1st injection on 2/24/09.
Age: 39.0
Sex: M
Vaccine: MMR, MMR
Symptoms: Haematology test abnormal, Hypersensitivity, Local swelling, Measles antibody, Similar reaction on previous exposure to drug
Clinical narrative: On 3/27/09 the employee went to the ER around 10 pm due to swelling in neck, change in voice and difficutly speaking.  States he did not have difficulty breathing.  Was given Predisone.   Patient stated later that he had noticed some swelling in neck after 1st injection on 2/24/09.
Age: 39.0
Sex: M
Vaccine: MMR, MMR
Symptoms: Speech disorder, Swelling face
Clinical narrative: On 3/27/09 the employee went to the ER around 10 pm due to swelling in neck, change in voice and difficutly speaking.  States he did not have difficulty breathing.  Was given Predisone.   Patient stated later that he had noticed some swelling in neck after 1st injection on 2/24/09.
Age: 14.0
Sex: F
Vaccine: FLU3, HPV4, MNQ, TDAP
Symptoms: Antinuclear antibody negative, Arthralgia, Borrelia burgdorferi serology negative, Full blood count normal, Joint swelling
Clinical narrative: swelling pain of both knees. 4/13/09 MR and vax info received from PCP.  In for 14 yr WCC with normal exam 11/11/08. Vax given.  Returned 12/22/08 with c/o several day hx of cough, runny nose, ear pain, chest congestion and sore throat.  PE (+) for red throat, stuffy nose, few small nodes. Assess:  Asthma.  Pharyngitis. Returned 2/12/09 with c/o sore throat and cough, H/A, presyncope.  PE (+) for T=101.5'F, nasal congestion, pharyngeal erythema, shiners.  Assess:  Sinusitis.  Fever.  Pharyngitis.  Returned 2/17/09 with same c/o as 2/12/09.  Additionally, back pain with coughing. PE (+) for red throat, few nodes and stuffy nose. Sent for CXR. Assess:  Asthma.  Returned 3/30/09 with c/o knee pain and swelling x 5 months. No injury other than foot injury prior to that. PE (+) for swollen knees with fluid in joints. Assess:  joint pain and swelling.
Age: 14.0
Sex: F
Vaccine: FLU3, HPV4, MNQ, TDAP
Symptoms: Red blood cell sedimentation rate normal, Rheumatoid factor negative, Streptococcal identification test negative
Clinical narrative: swelling pain of both knees. 4/13/09 MR and vax info received from PCP.  In for 14 yr WCC with normal exam 11/11/08. Vax given.  Returned 12/22/08 with c/o several day hx of cough, runny nose, ear pain, chest congestion and sore throat.  PE (+) for red throat, stuffy nose, few small nodes. Assess:  Asthma.  Pharyngitis. Returned 2/12/09 with c/o sore throat and cough, H/A, presyncope.  PE (+) for T=101.5'F, nasal congestion, pharyngeal erythema, shiners.  Assess:  Sinusitis.  Fever.  Pharyngitis.  Returned 2/17/09 with same c/o as 2/12/09.  Additionally, back pain with coughing. PE (+) for red throat, few nodes and stuffy nose. Sent for CXR. Assess:  Asthma.  Returned 3/30/09 with c/o knee pain and swelling x 5 months. No injury other than foot injury prior to that. PE (+) for swollen knees with fluid in joints. Assess:  joint pain and swelling.
Age: 19.0
Sex: F
Vaccine: TD
Symptoms: Activities of daily living impaired, Chest pain, Walking disability
Clinical narrative: Approximately 24 hours after the vaccine was received the patient had severe chest pain.  The chest pain began evening and lasted for over an hour.  The pain began mildly and was intermittent then increased in severity so that it was difficult for the patient to function normally, such as walking etc.  The patient considered going to the emergency room of the local hospital, but the pain began to slowly subside and the patient did not go in.  Temperature was not taken
Age: 60.0
Sex: F
Vaccine: VARZOS
Symptoms: Erythema, Induration, Pruritus, Swelling, Tenderness
Clinical narrative: Patient noticed on 4/5/08 at 2:00AM, soreness, itching and a knot on left arm where Zostavax was administered. Patient applied alcohol to help with itching. Patient states taking Tylenol on 4/3/09 until today 4/6/09 for soreness. States knot has gone done in size. Reddened area with two inch circumfurance present today 4/6/09, knot about the size of a quarter noticed. Recommended patient to apply ice to help with swelling.
Age: 5.0
Sex: F
Vaccine: DTAPIPV, MMR, VARCEL
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth, Pain, Pyrexia
Clinical narrative: 4/3/09 @ 9am- phone call from parent. Parent reports child right upper arm is red, swollen, & hot to the touch. Symptoms began on 4/01/09 and is worse today. Has been giving tylenol for fever & pain. Also has been applying a warm press to area. Began warm press & tylenol today. Continue current therapy/tx. If no improvement see PMD>
Age: 6.0
Sex: F
Vaccine: HEPA, VARCEL
Symptoms: Rash papular
Clinical narrative: Rash - localized papules. No bullae or blisters around site of injection (left upper thigh) Possible folliculitis but possible local varicella from vaccine.
Age: 17.0
Sex: F
Vaccine: HEP, HEPA, HPV4, VARCEL
Symptoms: Erythema, Induration, Skin warm, Swelling, Tenderness
Clinical narrative: Varicella given 3/31/09 approx. 10:30am. Pt. noticed it was tender an swollen 4/01/09 approx. 6:30 pm. 4/02/09 area red, raised, hot to touch & increased tenderness. Red area approx. 60mm x 50mm & area at induration apprx. 40mm x 25mm. Pt. temp. 97.3 No diff. breathing, shortness fo breath or other problems. Referred to MD for evaluation.
Age: 0.4
Sex: M
Vaccine: DTAPIPVHIB, HEP, PNC
Symptoms: Inappropriate schedule of drug administration
Clinical narrative: Rotateq (rotavirus) vaccine given vinitial dose at 19 weeeks of age, after the recommended start age of 15 weeks, by mistake. No physical reaction to infant according to parent when nurse checked back on day after and 4 days after vaccine administration. When error reported to mother of child. No adverse reaction reported by parent as of 04/06/09.
Age: 4.0
Sex: F
Vaccine: DTAP, HEPA, IPV
Symptoms: Injection site erythema, Injection site pain, Injection site warmth
Clinical narrative: Child received IPV and DTAP in Right thigh on 4/3/2009. Now has pink/red and hot area to site measuring 3.5 x 4 inches.  Painful to palpation. Placed on Bactrim 2 tsp po bid x 7 days.
Age: 28.0
Sex: F
Vaccine: PPV
Symptoms: Injection site erythema, Injection site pain, Injection site rash, Injection site swelling, Syncope
Clinical narrative: 24hrs after shot pt had swollen, painful area at site, 1" red circle at site with rash around it. Syncopal episode on 4/1. Transported to hospital by ambulance. Admitted with diagnosis of cellulitis. Discharged 4/5/2009.  4/8/09 Received hospital medical records of 4/1-4/5/2009. FINAL DX: cellulitis right arm secondary to vaccination Records reveal patient experienced fever, chills, syncope w/LOC, twitching of right extremities & right arm injection site pain & redness x 2 days.  Tx w/IVF & IV antibiotics.  Markedly improved & d/c to home on continued oral antibiotics.
Age: 34.0
Sex: F
Vaccine: PPV
Symptoms: Injection site pain, Injection site swelling, Oedema peripheral, Pain in extremity, Pyrexia
Clinical narrative: Pt was given Pneumovax vaccine as ordered. Left deltoid injection site wiped down with alcohol swab, and vaccine given. Site dabbed w/ cotton ball, covered w/ band aid. VIS given.  PPD also placed to lower left arm. Pt dc'd home. Pt came back the next day saying her arm is swollen and painful.  Left deltoid area raised, tender to touch. Not able to measure site, but borders marked with pen, rough approximation 6x4 inches. Provider sent pt home on antibiotic, and told pt that she will check on her today. Spoke w/ provider today, and writer was told that pt states she is still febrile and her arm is still swollen, and now red, but she feels better.
Age: 18.0
Sex: F
Vaccine: HPV4
Symptoms: Alopecia, Headache
Clinical narrative: Unexplained sudden and severe hair loss resulting in many visits to dermatologists over the last year and a half.  This has resulted in meds prescribed by two dermatologists without significant results.  Our daughter has also experienced several episodes of mono-like symptoms resulting in visits to the campus doctor and local doctor with negative test results.  She continues to be extremely fatigued even when well-rested and has unexplainable headaches. 4/8/09 PCP notes received. Pt seen 3/23/07 for OV with c/o planter's wart on foot, anxiety r/t school work and difficulty focusing, keratosis on arms and allergy sx.  PE (+) for allergic facies, boggy nares with some throat drainage.  Sent for derm consult and allergy meds prescribed.  1st HPV vax given. Seen again 7/6/07 with c/o URI with ear pain, cough and sore throat. Assess:  Nasal Pharyngitis.   Per TC with MD-not aware of any AE from vax. Has not been seen since 7/6/07 visit. 4/14/09 Derm consults received.  Pt presented 6/19/08 with c/o warts: thumb and plantar, and 8 month hx of hair loss.  Generalized hair thinning noted.   Warts removed and shampoo rx. Returned 7/10/08 for wart and mole check. F/U 3/19/09 for warts, acne and hair loss from the scalp.  PE (+) for circular patches of hair loss with moderate flaking and minimal erythema of the scalp.
Age: 19.0
Sex: F
Vaccine: IPV, TDAP, HEPA, IPV, MMR, TDAP
Symptoms: Erythema, Pain, Pyrexia, Rash, Rash macular
Clinical narrative: Pt called Clinic on 4-6-09 to report that she had experienced painful, red blotchy raised rash on left upper arm which presented on 4-5-09 at approximately 8 am. Pt stated rash extended from left shoulder to left elbow. Pt also stated that she took oral Benadryl. Seen at clinic 4-6-09 and observed localized red, raised, patchy rash  measuring 2.5" wide by 5.5" long to left deltoid area. Temperature 99.6 orally. No lymphadenopathy. Area warm to touch. ROM intact to left arm. Patient advised to continue Benadryl, apply cool compress to area, Tylenol for discomfort and return to Clinic in AM for evaluation.
Age: 19.0
Sex: F
Vaccine: IPV, TDAP, HEPA, IPV, MMR, TDAP
Symptoms: Skin warm, Swelling
Clinical narrative: Pt called Clinic on 4-6-09 to report that she had experienced painful, red blotchy raised rash on left upper arm which presented on 4-5-09 at approximately 8 am. Pt stated rash extended from left shoulder to left elbow. Pt also stated that she took oral Benadryl. Seen at clinic 4-6-09 and observed localized red, raised, patchy rash  measuring 2.5" wide by 5.5" long to left deltoid area. Temperature 99.6 orally. No lymphadenopathy. Area warm to touch. ROM intact to left arm. Patient advised to continue Benadryl, apply cool compress to area, Tylenol for discomfort and return to Clinic in AM for evaluation.
Age: 19.0
Sex: F
Vaccine: IPV, TDAP, HEPA, IPV, MMR, TDAP
Symptoms: Pain, Pyrexia, Rash erythematous, Rash macular, Skin warm
Clinical narrative: Pt called Clinic on 4-6-09 to report that she had experienced painful, red blotchy raised rash on left upper arm which presented on 4-5-09 at approximately 8 am. Pt stated rash extended from left shoulder to left elbow. Pt also stated that she took oral Benadryl. Seen at clinic 4-6-09 and observed localized red, raised, patchy rash  measuring 2.5" wide by 5.5" long to left deltoid area. Temperature 99.6 orally. No lymphadenopathy. Area warm to touch. ROM intact to left arm. Patient advised to continue Benadryl, apply cool compress to area, Tylenol for discomfort and return to Clinic in AM for evaluation.
Age: 30.0
Sex: F
Vaccine: DTAP
Symptoms: Hypotonic-hyporesponsive episode
Clinical narrative: Hypotonic-Hyporesponsive Episode, onset was about 2 hours after receiving DTaP vaccine, lasted approximately 4 hours
Age: 28.0
Sex: M
Vaccine: TDAP
Symptoms: Chills, Injection site erythema, Injection site pain, Injection site warmth, Pain
Clinical narrative: PT HAD A TDAP SHOT ON FRIDAY(04-03-09) AND SAT. HE HAD BODY PAIN & CHILLS.LEFT ARM WARM AND TENDER TO THE TOUCH. TODAY PT PRESENTED WITH A WARM ARM/NO PAIN JUST RED.
Age: 28.0
Sex: M
Vaccine: TDAP
Symptoms: Skin reaction
Clinical narrative: PT HAD A TDAP SHOT ON FRIDAY(04-03-09) AND SAT. HE HAD BODY PAIN & CHILLS.LEFT ARM WARM AND TENDER TO THE TOUCH. TODAY PT PRESENTED WITH A WARM ARM/NO PAIN JUST RED.
Age: 79.0
Sex: F
Vaccine: VARZOS
Symptoms: Asthenia, Fatigue, Headache, Injection site erythema, Injection site swelling
Clinical narrative: red, swollen, feverish arm where shot was administered.  Headache, neck ache, weakness, general feeling of tiredness.
Age: 79.0
Sex: F
Vaccine: VARZOS
Symptoms: Injection site warmth, Neck pain
Clinical narrative: red, swollen, feverish arm where shot was administered.  Headache, neck ache, weakness, general feeling of tiredness.
Age: 14.0
Sex: F
Vaccine: MNQ
Symptoms: Hypoaesthesia, Oropharyngeal pain, Paraesthesia
Clinical narrative: He had some numbness and tingling across the upper back and neck and extending down into his arms bilaterally.  This was resolving when seen on 4/3/2009 and he had no objective unusual findings at that time.  At the same time he also developed mild sore throat. He has not had nasal congestion.
Age: 60.0
Sex: F
Vaccine: FLU3
Symptoms: Chest discomfort, Muscle spasms
Clinical narrative: This case was reported by a consumer and described the occurrence of feels like having a heart attack in a 60-year-old female subject who was vaccinated with FLUARIX (GlaxoSmithKline) and received Omeprazole. A physician or other health care professional has not verified this report. Concurrent medical conditions included severe allergies and high blood pressure. Concurrent medications included Lisinopril. In October 2008 the subject received unspecified dose of FLUARIX (unknown). The following day, the subject took Omeprazole. That same day, she experienced leg cramping. The leg cramping became worse as the days progressed and she soon developed a funny feeling in her chest and she felt that she was having a heart attack. The subject consulted a healthcare professional regarding the events. Medical attention was required at a doctor's office. This case was assessed as medically serious by GSK. At the time of reporting the events were resolved.
Age: 11.0
Sex: F
Vaccine: MNQ, TDAP, MNQ
Symptoms: Blood culture negative, Blood test abnormal, CSF culture negative, CSF protein increased, CSF test abnormal
Clinical narrative: On 3/30/09, pt presented w/ about 14 hr hx of fever, headache and vomiting and 20 min of purpuric rash. Pt directed to ER then Peds ICU. CSF increased protein, increased WBC (+) gram stain. Gram (-) intracellular diplococci.  4/20/09 MR received for DOS 3/30-4/5/2009 with d/C DX:  Menigococcus.  Pt initially presented to PCP with c/o fever, vomiting and petechial/purpuric lesionson extremities. Referred to ED to eval and tx.  PE (+) for waxing/waning mental status changes with intermittant slurred incoherent speech, decreased ROM of the neck, nuchal rigidity, diffuse petechiae and hemorrhagic macules.  Admitted for concern of neisseria meningitidis. Tx abx with improvement in mental status and rashes. Noted to have bloody urine. D/C 4/5/09 for outpt f/u.
Age: 11.0
Sex: F
Vaccine: MNQ, TDAP, MNQ
Symptoms: Headache, Intensive care, Meningitis meningococcal, Polymerase chain reaction, Purpura
Clinical narrative: On 3/30/09, pt presented w/ about 14 hr hx of fever, headache and vomiting and 20 min of purpuric rash. Pt directed to ER then Peds ICU. CSF increased protein, increased WBC (+) gram stain. Gram (-) intracellular diplococci.  4/20/09 MR received for DOS 3/30-4/5/2009 with d/C DX:  Menigococcus.  Pt initially presented to PCP with c/o fever, vomiting and petechial/purpuric lesionson extremities. Referred to ED to eval and tx.  PE (+) for waxing/waning mental status changes with intermittant slurred incoherent speech, decreased ROM of the neck, nuchal rigidity, diffuse petechiae and hemorrhagic macules.  Admitted for concern of neisseria meningitidis. Tx abx with improvement in mental status and rashes. Noted to have bloody urine. D/C 4/5/09 for outpt f/u.
Age: 11.0
Sex: F
Vaccine: MNQ, TDAP, MNQ
Symptoms: Pyrexia, Vomiting
Clinical narrative: On 3/30/09, pt presented w/ about 14 hr hx of fever, headache and vomiting and 20 min of purpuric rash. Pt directed to ER then Peds ICU. CSF increased protein, increased WBC (+) gram stain. Gram (-) intracellular diplococci.  4/20/09 MR received for DOS 3/30-4/5/2009 with d/C DX:  Menigococcus.  Pt initially presented to PCP with c/o fever, vomiting and petechial/purpuric lesionson extremities. Referred to ED to eval and tx.  PE (+) for waxing/waning mental status changes with intermittant slurred incoherent speech, decreased ROM of the neck, nuchal rigidity, diffuse petechiae and hemorrhagic macules.  Admitted for concern of neisseria meningitidis. Tx abx with improvement in mental status and rashes. Noted to have bloody urine. D/C 4/5/09 for outpt f/u.
Age: 11.0
Sex: F
Vaccine: MNQ, TDAP, MNQ
Symptoms: Meningitis bacterial
Clinical narrative: On 3/30/09, pt presented w/ about 14 hr hx of fever, headache and vomiting and 20 min of purpuric rash. Pt directed to ER then Peds ICU. CSF increased protein, increased WBC (+) gram stain. Gram (-) intracellular diplococci.  4/20/09 MR received for DOS 3/30-4/5/2009 with d/C DX:  Menigococcus.  Pt initially presented to PCP with c/o fever, vomiting and petechial/purpuric lesionson extremities. Referred to ED to eval and tx.  PE (+) for waxing/waning mental status changes with intermittant slurred incoherent speech, decreased ROM of the neck, nuchal rigidity, diffuse petechiae and hemorrhagic macules.  Admitted for concern of neisseria meningitidis. Tx abx with improvement in mental status and rashes. Noted to have bloody urine. D/C 4/5/09 for outpt f/u.
Age: 0.5
Sex: M
Vaccine: DTAPIPVHIB, PNC, RV5
Symptoms: Computerised tomogram normal, Decreased activity, Depressed level of consciousness, Electroencephalogram normal, Hypotonia
Clinical narrative: The grandmother and mother report that this 6-month-old infant has been a bit fussy and out of sorts since he received immunizations two days ago and a little bit more so yesterday than the day before when he received the immunizations. This morning he seemed pretty much his normal self, although slightly fussy and was brought to daycare. There has been no fever, no congestion or cough, no vomiting or diarrhea, and no other specific symptoms. The remainder of the review of systems is noncontributory. In the daycare, the daycare provider noted that the child had taken a nap and then was awake. She was getting him ready for feeding but he was lying on the floor and she noted he was suddenly limp and pale and weakly responsive. She carried him around, checked his airway, removed clothing, and the infant remained very pale and limp. Mother was called and when she arrived, she said that he was so pale and limp that she was worried that he was dead. She brought him immediately to see doctor where she was equally concerned about the extreme pallor and limpness with hypoactivity. There was no fever measured at any time either there or in the emergency room where he was taken next by ambulance. His physical examination with the exception of the pallor and limpness has remained normal throughout these visits.  4/7/09 Received hospital medical records of 3/19-3/22/2009. FINAL DX: no discharge summary dictated,  Admitted for decreased LOC, anemia, leukocytosis. Records reveal patient experienced irritability, hypotonia, pallor, hypoactivity.  Seen by PCP & taken to ER by ambulance.  In ER, tx w/IVF, IV antibiotics.     Seen by PCP 3/23/09 & dx w/viral gastroenteritis & probable seizures.
Age: 0.5
Sex: M
Vaccine: DTAPIPVHIB, PNC, RV5
Symptoms: Irritability, Pallor
Clinical narrative: The grandmother and mother report that this 6-month-old infant has been a bit fussy and out of sorts since he received immunizations two days ago and a little bit more so yesterday than the day before when he received the immunizations. This morning he seemed pretty much his normal self, although slightly fussy and was brought to daycare. There has been no fever, no congestion or cough, no vomiting or diarrhea, and no other specific symptoms. The remainder of the review of systems is noncontributory. In the daycare, the daycare provider noted that the child had taken a nap and then was awake. She was getting him ready for feeding but he was lying on the floor and she noted he was suddenly limp and pale and weakly responsive. She carried him around, checked his airway, removed clothing, and the infant remained very pale and limp. Mother was called and when she arrived, she said that he was so pale and limp that she was worried that he was dead. She brought him immediately to see doctor where she was equally concerned about the extreme pallor and limpness with hypoactivity. There was no fever measured at any time either there or in the emergency room where he was taken next by ambulance. His physical examination with the exception of the pallor and limpness has remained normal throughout these visits.  4/7/09 Received hospital medical records of 3/19-3/22/2009. FINAL DX: no discharge summary dictated,  Admitted for decreased LOC, anemia, leukocytosis. Records reveal patient experienced irritability, hypotonia, pallor, hypoactivity.  Seen by PCP & taken to ER by ambulance.  In ER, tx w/IVF, IV antibiotics.     Seen by PCP 3/23/09 & dx w/viral gastroenteritis & probable seizures.
Age: 15.0
Sex: F
Vaccine: MNQ
Symptoms: Back pain, Diarrhoea, Headache, Influenza serology negative, Lymphocyte percentage decreased
Clinical narrative: Progressive Diarrhea, Vomiting, Back Pain, Body Aches, HA.  From 033009 --> 033109 To ER Admitted Observation.  Discharged 040109.  To School 040209.4/15/09-records received-for DOS 3/31/-4/1/09-DC DX: Adverse reaction to meningitis vaccination. Allergic rhinitis. Presented to ED with C/O severe achiness, discomfort, crying from discomfort, feeling nauseous, admitted. Symptoms began with sore throat and tightness in throat, achy all over, pain in low back and neck. Diarrhea and feeling chilled with some rigors. Mild cough.One episode of vomiting. At time of discharge back to normal self.
Age: 15.0
Sex: F
Vaccine: MNQ
Symptoms: Metabolic function test normal, Monocyte percentage increased, Neutrophil percentage increased, Pain, Streptococcal identification test negative
Clinical narrative: Progressive Diarrhea, Vomiting, Back Pain, Body Aches, HA.  From 033009 --> 033109 To ER Admitted Observation.  Discharged 040109.  To School 040209.4/15/09-records received-for DOS 3/31/-4/1/09-DC DX: Adverse reaction to meningitis vaccination. Allergic rhinitis. Presented to ED with C/O severe achiness, discomfort, crying from discomfort, feeling nauseous, admitted. Symptoms began with sore throat and tightness in throat, achy all over, pain in low back and neck. Diarrhea and feeling chilled with some rigors. Mild cough.One episode of vomiting. At time of discharge back to normal self.
Age: 15.0
Sex: F
Vaccine: MNQ
Symptoms: Vomiting
Clinical narrative: Progressive Diarrhea, Vomiting, Back Pain, Body Aches, HA.  From 033009 --> 033109 To ER Admitted Observation.  Discharged 040109.  To School 040209.4/15/09-records received-for DOS 3/31/-4/1/09-DC DX: Adverse reaction to meningitis vaccination. Allergic rhinitis. Presented to ED with C/O severe achiness, discomfort, crying from discomfort, feeling nauseous, admitted. Symptoms began with sore throat and tightness in throat, achy all over, pain in low back and neck. Diarrhea and feeling chilled with some rigors. Mild cough.One episode of vomiting. At time of discharge back to normal self.
Age: 1.3
Sex: F
Vaccine: DTAP, VARCEL
Symptoms: Skin discolouration
Clinical narrative: She had a reddish purplish area on leg not acting sick otherwise. Recommended she watch it for a few days and if not better to be seen.
Age: 12.0
Sex: F
Vaccine: MNQ, TDAP, VARCEL
Symptoms: Burning sensation, Injection site erythema, Injection site irritation
Clinical narrative: Erythema at injection site "burning" to left arm, both arms, now legs and eyes. No rash, no swelling and no fever, VSS. Advise; Monitor.
Age: 17.0
Sex: M
Vaccine: MNQ, TDAP
Symptoms: Back pain, Headache, Pain in extremity, Pyrexia
Clinical narrative: Headache: onset: 3/10/09-present. OTC MOTRIN taken for symptoms. Lower back pain: onset:3/10/09 x 1day. Fever: onset:3/10/09 x 1day Reported by mo. of pt. temp unknown. Left arm pain: onset: 3/10/09-present.
Age: 5.0
Sex: M
Vaccine: DTAP, IPV, MMR
Symptoms: Injection site erythema, Injection site swelling
Clinical narrative: Redness and swelling L leg. Started the day after lZ. Worsened x 24 hours then improved, used ice only.
Age: 14.0
Sex: M
Vaccine: TDAP
Symptoms: Erythema, Nausea, Oedema peripheral, Pain in extremity
Clinical narrative: Fri - 4-3-09 - School nurse phoned HD and stated that student's L upper arm was somewhat red with some swelling. Client c/o nausea and L arm pain. Referred to PMD. Mother phoned HD today to say she took student to Express Care. Told no PE x 1 week, TYLENOL q4-6h prn and cold compresses.
Age: 0.5
Sex: M
Vaccine: DTAP, HIBV, IPV, PNC, RV5
Symptoms: Crying, Hypophagia, Irritability, Pyrexia, Vomiting
Clinical narrative: Irritability with long periods of crying and inconsolability. Fever 101.8 rectal. Vomiting x 1. decreased oral intake.
Age: 7.0
Sex: U
Vaccine: HEPA, VARCEL
Symptoms: Cellulitis, Erythema, Oedema peripheral
Clinical narrative: Both legs red and swollen. Cellulitis - given antibiotics. Went to urgent care - Then follow up and office 6/23/08.
Age: 4.0
Sex: M
Vaccine: HEPA, IPV, MMR, TDAP
Symptoms: Wrong drug administered
Clinical narrative: No adverse events recorded
Age: 74.0
Sex: M
Vaccine: FLU3
Symptoms: Asthenia, Hyperhidrosis, Syncope
Clinical narrative: 2-3 hours after dose, experienced syncope and became diaphoretic and weak. Drove self to local Ed and was admitted for cardiac evaluation. Outcome of work-up is unknown, however patient survived in good shape.
Age: 0.2
Sex: U
Vaccine: DTAPHEPBIP, DTAPIPV, HIBV, PNC, DTAPHEPBIP, DTAPIPV, HIBV, PNC, RV1
Symptoms: Incorrect route of drug administration
Clinical narrative: This case was reported by a healthcare professional and described the occurrence of intramuscular formulation administered by other route in a 2-month-old subject of unspecified gender who was vaccinated with KINRIX, (GlaxoSmithKline).  Previous and/or concurrent vaccination included HIB, manufacturer unspecified given on 23 January 2009; PEDIARIX, (GlaxoSmithKline) given on 23 January 2009; PREVNAR (non-GSK manufacturer) given on 23 January 2009.  On 23 January 2009 the subject inadvertently received 1st dose of KINRIX (.5 ml) orally experienced intramuscular formulation administered by other route and bad taste.  Since the child was an infant, the reporter stated that it appeared that the solution tasted bad since the child acted like it tasted bad.  The events resolved on 23 January 2009.  Follow-up information was received on 09 February 2009 from the reporting nurse.  The nurse reported that a doctor's office called the health department to see if there were any specified problems associated with the "problem error" they had.  ROTARIX liquid was mixed with KINRIX and given orally per the doctor's office staff.  The nurse considered that the events could have been associated with erroneous administration:  ROTARIX mixed with KINRIX and given orally.
Age: 0.2
Sex: U
Vaccine: DTAPHEPBIP, DTAPIPV, HIBV, PNC, DTAPHEPBIP, DTAPIPV, HIBV, PNC, RV1
Symptoms: Incorrect route of drug administration, Product taste abnormal
Clinical narrative: This case was reported by a healthcare professional and described the occurrence of intramuscular formulation administered by other route in a 2-month-old subject of unspecified gender who was vaccinated with KINRIX, (GlaxoSmithKline).  Previous and/or concurrent vaccination included HIB, manufacturer unspecified given on 23 January 2009; PEDIARIX, (GlaxoSmithKline) given on 23 January 2009; PREVNAR (non-GSK manufacturer) given on 23 January 2009.  On 23 January 2009 the subject inadvertently received 1st dose of KINRIX (.5 ml) orally experienced intramuscular formulation administered by other route and bad taste.  Since the child was an infant, the reporter stated that it appeared that the solution tasted bad since the child acted like it tasted bad.  The events resolved on 23 January 2009.  Follow-up information was received on 09 February 2009 from the reporting nurse.  The nurse reported that a doctor's office called the health department to see if there were any specified problems associated with the "problem error" they had.  ROTARIX liquid was mixed with KINRIX and given orally per the doctor's office staff.  The nurse considered that the events could have been associated with erroneous administration:  ROTARIX mixed with KINRIX and given orally.
Age: 36.0
Sex: M
Vaccine: ANTH, SMALL, SMALL, ANTH, PPV, SMALL, SMALL
Symptoms: Catheterisation cardiac, Dyspnoea, Electrocardiogram normal, Hyperhidrosis, Myocarditis
Clinical narrative: Subendocardial infarction (410.7), unspecified site (410.9).  This case was identified as part of a study.
Age: 36.0
Sex: M
Vaccine: ANTH, SMALL, SMALL, ANTH, PPV, SMALL, SMALL
Symptoms: Troponin increased
Clinical narrative: Subendocardial infarction (410.7), unspecified site (410.9).  This case was identified as part of a study.
Age: 36.0
Sex: M
Vaccine: ANTH, SMALL, SMALL, ANTH, PPV, SMALL, SMALL
Symptoms: Myocardial infarction, Troponin I increased
Clinical narrative: Subendocardial infarction (410.7), unspecified site (410.9).  This case was identified as part of a study.
Age: 36.0
Sex: M
Vaccine: ANTH, SMALL, SMALL, ANTH, PPV, SMALL, SMALL
Symptoms: Arterial occlusive disease, Catheterisation cardiac abnormal, Chest pain, Dyspnoea, Echocardiogram normal
Clinical narrative: Subendocardial infarction (410.7), unspecified site (410.9).  This case was identified as part of a study.
Age: 36.0
Sex: M
Vaccine: ANTH, SMALL, SMALL, ANTH, PPV, SMALL, SMALL
Symptoms: Electrocardiogram normal, Hyperhidrosis, Myocarditis, Pain, Pyrexia
Clinical narrative: Subendocardial infarction (410.7), unspecified site (410.9).  This case was identified as part of a study.
Age: 36.0
Sex: M
Vaccine: ANTH, SMALL, SMALL, ANTH, PPV, SMALL, SMALL
Symptoms: Myocardial infarction, Troponin I
Clinical narrative: Subendocardial infarction (410.7), unspecified site (410.9).  This case was identified as part of a study.
Age: 18.0
Sex: F
Vaccine: HPV4
Symptoms: Drug exposure during pregnancy, Induced labour, Pre-eclampsia, Premature labour, Smear cervix normal
Clinical narrative: Information has been received from a Nurse Practitioner for the Pregnancy Registry for GARDASIL concerning an 18 year old female patient with no drugs reactions or allergies who on 11-APR-2008 was vaccinated with a first dose of GARDASIL (Lot# not reported). On 18-JUN-2008 she received third dose of GARDASIL (Lot# not reported). On 01-APR-2009 she received third dose of GARDASIL (Lot# not reported). There was no concomitant medication. When the patient received first and second dose of vaccine she became pregnant. The patient experienced pre-eclampsia and the physician had to induce delivery and used magnesium sulfate during labor. The patient was hospitalized. Delivery was at 36 weeks and 4 days. The patient had a healthy baby boy on 27-JAN-2009. In July - 2008 Cervical smear was performed and showed normal results. The patient sought medical attention was at office. The Nurse practitioner considered pre-eclampsia and premature to be other important medical events and life threatening. Additional information has been requested.
Age: 50.0
Sex: F
Vaccine: VARZOS
Symptoms: Blister, Herpes zoster, Pain, Rash
Clinical narrative: Information has been received from a concerning a 50 year old nurse female who was also a nurse was vaccinated with a dose of ZOSTAVAX (Oka/Merck), lot number: 662755/1621X. The patient experienced shingles after receiving the vaccine. She developed rash on her upper neck, blisters and pain on the right side only from the back of her neck. No further information was provided. Subsequently the patient recovered. The patient sought medical attention. Shingles was considered to be disabling by the nurse. Additional information has been requested.
Sex: U
Vaccine: RV5
Symptoms: Haematochezia
Clinical narrative: Information has been received from a physician concerning a patient with milk allergy who was vaccinated with ROTATEQ vaccine. Upon return for an office visit, the infant presented with bloody stool. Upon internal review, Bloody stool was determined to be an other important medical event. Additional information has been requested.
Age: 4.0
Sex: M
Vaccine: DTAP, IPV, MMR, VARCEL
Symptoms: Blindness, Cell marker, Computerised tomogram, Gait disturbance, Haematocrit decreased
Clinical narrative: Fever one week after vaccinations - resolved after two days. Lethargic, irritable 2-3 weeks later for about two weeks. One month after immunizations, severe bilateral vision loss. Vision loss continues at the present time.  4/20/09 D/C Summary received for DOS 2/11-22/09 with D/C Dx:  Optic Neuritis. Pt admitted for eval and tx  of optic neuritis which had been dx in 12/2008 and failed tx with IVIG and steroids for visual disturbances. Now with lower extremity weakness.  PE (+) for wide-based, unsteady gait and 4/5 strength at hip flexors.   Tx with plasmapheresis. Pupils still sluggish on L. Visual acuity still decreased on L at d/c. F/U to be continued as outpt. 5/12/2010 Follow up: Permanent Blindness in left eye and reduced vision in right eye. Severe optic nerve damage.
Age: 4.0
Sex: M
Vaccine: DTAP, IPV, MMR, VARCEL
Symptoms: Haemoglobin normal, Immunoglobulin therapy, Irritability, Laboratory test abnormal, Lethargy
Clinical narrative: Fever one week after vaccinations - resolved after two days. Lethargic, irritable 2-3 weeks later for about two weeks. One month after immunizations, severe bilateral vision loss. Vision loss continues at the present time.  4/20/09 D/C Summary received for DOS 2/11-22/09 with D/C Dx:  Optic Neuritis. Pt admitted for eval and tx  of optic neuritis which had been dx in 12/2008 and failed tx with IVIG and steroids for visual disturbances. Now with lower extremity weakness.  PE (+) for wide-based, unsteady gait and 4/5 strength at hip flexors.   Tx with plasmapheresis. Pupils still sluggish on L. Visual acuity still decreased on L at d/c. F/U to be continued as outpt. 5/12/2010 Follow up: Permanent Blindness in left eye and reduced vision in right eye. Severe optic nerve damage.
Age: 4.0
Sex: M
Vaccine: DTAP, IPV, MMR, VARCEL
Symptoms: Lumbar puncture, Muscular weakness, Nerve injury, Pyrexia, Venogram
Clinical narrative: Fever one week after vaccinations - resolved after two days. Lethargic, irritable 2-3 weeks later for about two weeks. One month after immunizations, severe bilateral vision loss. Vision loss continues at the present time.  4/20/09 D/C Summary received for DOS 2/11-22/09 with D/C Dx:  Optic Neuritis. Pt admitted for eval and tx  of optic neuritis which had been dx in 12/2008 and failed tx with IVIG and steroids for visual disturbances. Now with lower extremity weakness.  PE (+) for wide-based, unsteady gait and 4/5 strength at hip flexors.   Tx with plasmapheresis. Pupils still sluggish on L. Visual acuity still decreased on L at d/c. F/U to be continued as outpt. 5/12/2010 Follow up: Permanent Blindness in left eye and reduced vision in right eye. Severe optic nerve damage.
Age: 4.0
Sex: M
Vaccine: DTAP, IPV, MMR, VARCEL
Symptoms: Injection site erythema, Injection site swelling
Clinical narrative: Red swollen thigh left - side left day #2 after vaccination.  ER on 4-5-09 No tx.
Age: 4.0
Sex: M
Vaccine: DTAPIPV, MMR, VARCEL
Symptoms: Injection site erythema, Injection site induration
Clinical narrative: Redness to site with induration x 3-4 days. Left arm.
Age: 66.0
Sex: F
Vaccine: VARZOS, VARZOS
Symptoms: Dyspnoea, Erythema, Injection site irritation, Injection site pain, Oedema peripheral
Clinical narrative: Received shingle shot. Asked nurse if it would hurt, no just like flu shot. It did hurt and burned. 03-19-09 4 AM Difficulties Breathing for 1 Hr. Noticed itching all over body. Later swelling of LT arm- Got worse- Called nurse. From Scan 03-20-09, suggested urgent care, Called Dr, got cephalexin 500 mg capsules for 10 days 4times Daily and Cream. Swelling and dark red part is gone. Still itch. (See Attached)
Age: 66.0
Sex: F
Vaccine: VARZOS, VARZOS
Symptoms: Pruritus generalised
Clinical narrative: Received shingle shot. Asked nurse if it would hurt, no just like flu shot. It did hurt and burned. 03-19-09 4 AM Difficulties Breathing for 1 Hr. Noticed itching all over body. Later swelling of LT arm- Got worse- Called nurse. From Scan 03-20-09, suggested urgent care, Called Dr, got cephalexin 500 mg capsules for 10 days 4times Daily and Cream. Swelling and dark red part is gone. Still itch. (See Attached)
Age: 66.0
Sex: F
Vaccine: VARZOS, VARZOS
Symptoms: Burning sensation, Dyspnoea, Erythema, Pain, Pruritus
Clinical narrative: Received shingle shot. Asked nurse if it would hurt, no just like flu shot. It did hurt and burned. 03-19-09 4 AM Difficulties Breathing for 1 Hr. Noticed itching all over body. Later swelling of LT arm- Got worse- Called nurse. From Scan 03-20-09, suggested urgent care, Called Dr, got cephalexin 500 mg capsules for 10 days 4times Daily and Cream. Swelling and dark red part is gone. Still itch. (See Attached)
Age: 69.0
Sex: F
Vaccine: VARZOS
Symptoms: Petechiae, Platelet count normal
Clinical narrative: Developed petechial rash on inner thighs, abdomen, behind knees 5 days after vaccine give. No itch - No vesicles. No rash at injection site. Platelet count normal (273). rash resolved spontaneously and was completely gone by 3/27/09.
Age: 30.0
Sex: F
Vaccine: TDAP
Symptoms: Arthralgia, Headache, Malaise, Myalgia
Clinical narrative: Laceration so had ADACEL vaccine (administered off -site) 10 days later, presented to me with myalgias, arthralgias, headache, malaise. Ok to contact Pt for more info.
Age: 20.0
Sex: F
Vaccine: HPV4
Symptoms: Urticaria
Clinical narrative: 1st GUARDISIL vaccine administered 7/8/08 pt report hives all over body within hours of injection lasting 3-4 days.  Tx with BENADRYL.
Age: 1.3
Sex: M
Vaccine: DTAP, MMR
Symptoms: Discomfort, Injection site erythema, Injection site swelling
Clinical narrative: Increase swelling & erythema of entire thigh > 72 hrs Discomfort & ambulation > 48 hrs.
Age: 0.7
Sex: M
Vaccine: DTAPHEPBIP, PNC
Symptoms: Injection site erythema, Injection site urticaria
Clinical narrative: About a 2cm red wheal appeared after 9 month immunizations given. No discomfort/problems noted, but wheal has persisted since shots (on right thigh).
Age: 1.25
Sex: F
Vaccine: HEPA, MMR, VARCEL
Symptoms: Injection site erythema, Injection site induration, Local reaction, Pyrexia
Clinical narrative: Local reaction right thigh with erythema and induration developed nine days after immunizations.  Also with low grade temp. (99.9)
Age: 83.0
Sex: M
Vaccine: VARZOS
Symptoms: Herpes zoster, Rash, Viral DNA test positive
Clinical narrative: Developed rash L side neck in dermatomal pattern consistent with VZV.
Age: 2.0
Sex: M
Vaccine: DTAP, HEPA, MMR, VARCEL
Symptoms: Pyrexia, Rash erythematous, Rash maculo-papular, Rash morbilliform, Urticaria
Clinical narrative: Vaccine given 3/19/09, fever developed 3/27/09.  Rash erythematous macular papule with palms/soles & buccal urticaria developed 3/29.  Looks like measles.
Age: 12.0
Sex: F
Vaccine: DT, HPV4
Symptoms: Syncope
Clinical narrative: Syncopal event.
Age: 0.5
Sex: F
Vaccine: DTAPIPVHIB, PNC, RV5
Symptoms: Diarrhoea, Vomiting
Clinical narrative: Pt. received 6 mo. well baby checkup on 2/23/09.  Vaccines listed below given.  Pt. came in to see MD on 2/28/09.  Vomiting began on 2/25 with Diarrhea.  Diarrhea continued over 5 days post vaccination.
Age: 69.0
Sex: F
Vaccine: VARZOS
Symptoms: Injection site erythema, Injection site urticaria
Clinical narrative: 3/30 Pt called, c/o erythema (L) upper arm at injection site, Sl. raised "welt" in appearance, "larger than half dollar" in size. No c/o discomfort, and decrease in size now.
Age: 1.2
Sex: M
Vaccine: HIBV, MMR, PNC, VARCEL
Symptoms: Pallor, Rash generalised, Rash maculo-papular
Clinical narrative: Presented to the office on 3/31/09 with c/o rash all over body since Sunday 3/29/09. Spreading rash not itchy. No fever. Non vesicular, maculopapular blanching erythematous rash generalized to whole body.
Age: 4.0
Sex: F
Vaccine: DTAPIPV
Symptoms: Erythema, Local reaction, Skin warm, Swelling
Clinical narrative: Received KINRIX 3/24/09 (R) deltoid. Seen 3/26/09 with swelling, erythema, warm to touch no tenderness no induration. Negative node. Ab after vaccine. Local reaction; allergies.
Age: 14.0
Sex: F
Vaccine: HPV4, HPV4, HPVX, HPV4
Symptoms: Activities of daily living impaired, Anorexia, Borrelia burgdorferi serology negative, Dizziness, Epstein-Barr virus antibody negative
Clinical narrative: Protracted headache  5/26/09 Received PCP medical records of 12/3/08-5/18/2009. FINAL DX:migraine HA; probable psychiatric illness Records reveal pt stated she was well on 12/3 for HPV #2.  RTC 2/26 w/HA, cold s/s, dizzy, light sensitivity.  Was on antibiotic prescribed by parent for presumed sinusitis.  Dx w/migraine, possible vertigo & presumed sinusitis.  HA persisted w/photophobia, phonophobia & nausea.  Missed several days of school.  Seen in ER 3/6/09 & Neuro consult done & dx migraine HA.  Initially responded well to meds but recurred on daily basis.  Outpatient Neuro eval 3/26, meds adjusted.  HA persisted w/4# wt loss & unsteady gait.  Added steroid pulse, labs & PT.  Neuro f/u 4/13/09 w/mild improvement.  Meds adjusted.  Neuro 2nd opinion suggested non-neuro findings, referred for psych & strongly encouraged to return to school even if using w/c.
Age: 14.0
Sex: F
Vaccine: HPV4, HPV4, HPVX, HPV4
Symptoms: Gait disturbance, Insomnia, Migraine, Nausea, Nuclear magnetic resonance imaging normal
Clinical narrative: Protracted headache  5/26/09 Received PCP medical records of 12/3/08-5/18/2009. FINAL DX:migraine HA; probable psychiatric illness Records reveal pt stated she was well on 12/3 for HPV #2.  RTC 2/26 w/HA, cold s/s, dizzy, light sensitivity.  Was on antibiotic prescribed by parent for presumed sinusitis.  Dx w/migraine, possible vertigo & presumed sinusitis.  HA persisted w/photophobia, phonophobia & nausea.  Missed several days of school.  Seen in ER 3/6/09 & Neuro consult done & dx migraine HA.  Initially responded well to meds but recurred on daily basis.  Outpatient Neuro eval 3/26, meds adjusted.  HA persisted w/4# wt loss & unsteady gait.  Added steroid pulse, labs & PT.  Neuro f/u 4/13/09 w/mild improvement.  Meds adjusted.  Neuro 2nd opinion suggested non-neuro findings, referred for psych & strongly encouraged to return to school even if using w/c.
Age: 14.0
Sex: F
Vaccine: HPV4, HPV4, HPVX, HPV4
Symptoms: Oropharyngeal pain, Photophobia, Reading disorder, Weight decreased, Wheelchair user
Clinical narrative: Protracted headache  5/26/09 Received PCP medical records of 12/3/08-5/18/2009. FINAL DX:migraine HA; probable psychiatric illness Records reveal pt stated she was well on 12/3 for HPV #2.  RTC 2/26 w/HA, cold s/s, dizzy, light sensitivity.  Was on antibiotic prescribed by parent for presumed sinusitis.  Dx w/migraine, possible vertigo & presumed sinusitis.  HA persisted w/photophobia, phonophobia & nausea.  Missed several days of school.  Seen in ER 3/6/09 & Neuro consult done & dx migraine HA.  Initially responded well to meds but recurred on daily basis.  Outpatient Neuro eval 3/26, meds adjusted.  HA persisted w/4# wt loss & unsteady gait.  Added steroid pulse, labs & PT.  Neuro f/u 4/13/09 w/mild improvement.  Meds adjusted.  Neuro 2nd opinion suggested non-neuro findings, referred for psych & strongly encouraged to return to school even if using w/c.
Age: 14.0
Sex: F
Vaccine: HPV4, HPV4, HPVX, HPV4
Symptoms: Agitation, Anorexia, Asthenia, Balance disorder, Electromyogram normal
Clinical narrative: Protracted headache  5/26/09 Received PCP medical records of 12/3/08-5/18/2009. FINAL DX:migraine HA; probable psychiatric illness Records reveal pt stated she was well on 12/3 for HPV #2.  RTC 2/26 w/HA, cold s/s, dizzy, light sensitivity.  Was on antibiotic prescribed by parent for presumed sinusitis.  Dx w/migraine, possible vertigo & presumed sinusitis.  HA persisted w/photophobia, phonophobia & nausea.  Missed several days of school.  Seen in ER 3/6/09 & Neuro consult done & dx migraine HA.  Initially responded well to meds but recurred on daily basis.  Outpatient Neuro eval 3/26, meds adjusted.  HA persisted w/4# wt loss & unsteady gait.  Added steroid pulse, labs & PT.  Neuro f/u 4/13/09 w/mild improvement.  Meds adjusted.  Neuro 2nd opinion suggested non-neuro findings, referred for psych & strongly encouraged to return to school even if using w/c.