chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 25.0
Sex: F
Vaccine: HPV4
Symptoms: Dizziness, Hypoaesthesia, Injection site pain, Muscle spasms, Nausea
Clinical narrative: Pt states pain at injection site and radiating up her neck x 5 days, muscles spasms, numbness, fever, dizzy, nausea. Refused referral to urgent care and primary care provider.
Age: 25.0
Sex: F
Vaccine: HPV4
Symptoms: Neck pain, Pyrexia
Clinical narrative: Pt states pain at injection site and radiating up her neck x 5 days, muscles spasms, numbness, fever, dizzy, nausea. Refused referral to urgent care and primary care provider.
Age: 5.0
Sex: M
Vaccine: DTAPIPV, MMR, VARCEL
Symptoms: Erythema, Musculoskeletal pain, Oedema, Skin warm
Clinical narrative: Redness, warmth, edema, pain from shoulder to elbow.
Age: 2.0
Sex: M
Vaccine: PNC13
Symptoms: Cough, Irritability, Pain in extremity, Pyrexia, Rhinorrhoea
Clinical narrative: PCV 13 given 4/27/10. Mom reports that he had fever - dry cough & runny nose. Fussy & sore leg. Difficulty walking AM 4/28/10. In pm. 4/28/10 - walking normally, no erythema or tenderness at injection site.
Age: 5.0
Sex: M
Vaccine: DTAPIPV
Symptoms: Injection site oedema, Injection site warmth
Clinical narrative: Inj of KINRIX given left thigh -> positive local edema, negative erythema, negative urticaria, positive warmth.
Age: 2.0
Sex: M
Vaccine: PNC13
Symptoms: Gait disturbance, Injection site erythema, Injection site swelling, Pain in extremity, Tenderness
Clinical narrative: Pt. received PCV 13 4/27/10. Per mom leg was sore and child was unable to walk that evening. Starting 4/28/10 in PM mom noticed redness and swelling at injection site. Today 4x6 cm non tender erythema slightly swollen area on leg.
Age: 26.0
Sex: F
Vaccine: FLU(H1N1), PPV
Symptoms: Wrong drug administered
Clinical narrative: Patient was administered PNEUMOVAX vaccine by accident instead of H1N1 vaccine.
Age: 4.0
Sex: M
Vaccine: DTAP
Symptoms: Injection site erythema, Injection site oedema
Clinical narrative: DTaP to left arm 4/27, within 18 hours -> left upper arm shoulder -> Ac redness/edema without cellulitis.
Age: 80.0
Sex: M
Vaccine: PPV
Symptoms: Chills, Pain, Pain in extremity, Pyrexia, Skin warm
Clinical narrative: Low grade fever, chills, arm sore & hot to touch, body aches. Took acetaminophen. Ice on injection area.
Age: 13.0
Sex: F
Vaccine: HPV4
Symptoms: Headache, Ovarian cyst ruptured, Urinary tract infection, Vomiting, White blood cell count normal
Clinical narrative: Within 30 minutes of shot, headaches, recurrent vomited. Had 2 return visits to office and 2 visits to ER. Diagnosed ?UTI and ruptured ovarian cyst.
Age: 65.0
Sex: F
Vaccine: VARZOS
Symptoms: Erythema, Induration, Mass, Swelling
Clinical narrative: Swelling to 6 inches, hard lump in center, lasted 6 days, redness.
Age: 77.0
Sex: M
Vaccine: FLU(H1N1)
Symptoms: Injection site pain
Clinical narrative: Arm is still sore where vaccine administered. Is worst after sleeping on that side.
Age: 4.0
Sex: M
Vaccine: DTAPIPV, MMR, VARCEL
Symptoms: Injection site erythema
Clinical narrative: (L) leg redness about 5 cm in size at injection site.
Age: 51.0
Sex: F
Vaccine: PPV, TDAP
Symptoms: Cellulitis, Hypersensitivity
Clinical narrative: Right arm cellulitis vs severe allergic rxn.
Age: 19.0
Sex: M
Vaccine: HEP, MMR
Symptoms: No adverse event
Clinical narrative: 4-16-10 -> abd. pain began 3AM. 4-16-10 afternoon -> immunizations received. Symptoms clearly prior to immunizations; by history. 4-18-10 hospitalized x 9 days (see discharge summary).
Age: 11.0
Sex: F
Vaccine: TDAP
Symptoms: Body temperature increased, Erythema, Pain in extremity
Clinical narrative: Low grade temp 99.9, pt c/o of soreness in right arm to elbow area with raised reddened area.  On 4-22-10 pt returned to practice & Dr. assessed pt. noted 5 cm reddened area and ordered Cephalexin 125/5ml - 1 QID for 10 days.  Mother noted improvement by April 28th. Pt denied any resp. s/s.
Age: 0.34
Sex: M
Vaccine: DTAP
Symptoms: Convulsion, Electroencephalogram abnormal, Feeling abnormal, Tremor
Clinical narrative: Seizure, arms and head shaking, spacing out.
Age: 51.0
Sex: F
Vaccine: TDAP
Symptoms: Culture wound negative, Incisional drainage, Injection site pain, Lymphadenopathy
Clinical narrative: Reported supraclavicular lymph node swelling and severe pain in left deltoid.  Took 2 courses of oral antibiotics with minimal relief of symptoms.  MRI showed possible abscess.  4/30/10 Was admitted for IV antibiotics and on 5/1/2010 incision/drainage performed in the operating room.  Hospitalizion of 2 days.
Age: 48.0
Sex: M
Vaccine: PPV
Symptoms: Activities of daily living impaired, Dizziness, Fatigue, Hypersensitivity, Injection site erythema
Clinical narrative: PT CALLS TO REPORT THAT HE HAD A PNEUMONIA VACCINE ON 3/15/10. HE HAD A SEVERE REACTION AFTER THE VACCINE. FELT NAUSEA, AND DIZZINESS OVER NIGHT. NEXT DAY HE WAS EXTREMELY TIRED AND HAS DEVELOPED SEVERE PAIN IN HIS LEFT SHOULDER RADIATING TO HIS ARM. THE SITE OF THE VACCINE IS RED, THE SIZE OF A "SILVER COIN", AND VERY PAINFUL. HE CANNOT USE HIS ARM TO HELP HIMSELF WITH ADL.
Age: 48.0
Sex: M
Vaccine: PPV
Symptoms: Injection site swelling, Musculoskeletal pain, Nausea, Pain in extremity
Clinical narrative: PT CALLS TO REPORT THAT HE HAD A PNEUMONIA VACCINE ON 3/15/10. HE HAD A SEVERE REACTION AFTER THE VACCINE. FELT NAUSEA, AND DIZZINESS OVER NIGHT. NEXT DAY HE WAS EXTREMELY TIRED AND HAS DEVELOPED SEVERE PAIN IN HIS LEFT SHOULDER RADIATING TO HIS ARM. THE SITE OF THE VACCINE IS RED, THE SIZE OF A "SILVER COIN", AND VERY PAINFUL. HE CANNOT USE HIS ARM TO HELP HIMSELF WITH ADL.
Age: 14.0
Sex: F
Vaccine: HPV4, TDAP
Symptoms: Computerised tomogram head, Condition aggravated, Dyskinesia, Fall, Head injury
Clinical narrative: Fainted, fell to ground, hit her head on floor or table (unsure which).  Stiffening and jerking movements.  Unconscious approx. 30 seconds.
Age: 14.0
Sex: F
Vaccine: HPV4, TDAP
Symptoms: Loss of consciousness, Musculoskeletal stiffness, Syncope
Clinical narrative: Fainted, fell to ground, hit her head on floor or table (unsure which).  Stiffening and jerking movements.  Unconscious approx. 30 seconds.
Age: 23.0
Sex: F
Vaccine: FLU(H1N1), FLU3
Symptoms: Dyspnoea, Erythema, Eyelid oedema, Hypersensitivity, Pruritus generalised
Clinical narrative: Patient became very sleepy shortly after receiving the vaccine and subsequently went home to rest.  Patient woke up shortly thereafter, with severe wheezing, shortness of breath, red, puffy eyes and a complaint of general itchiness.
Age: 23.0
Sex: F
Vaccine: FLU(H1N1), FLU3
Symptoms: Somnolence, Wheezing
Clinical narrative: Patient became very sleepy shortly after receiving the vaccine and subsequently went home to rest.  Patient woke up shortly thereafter, with severe wheezing, shortness of breath, red, puffy eyes and a complaint of general itchiness.
Age: 1.41
Sex: M
Vaccine: MMR
Symptoms: Blood test, Pyrexia, Rash generalised
Clinical narrative: Rash on body, arms and legs began on the evening of 4/30 along with a low grade temp.  On 5/2/2010 the temp spiked to 102.6 and remained high (when not treated) for 12 hours.  Fever began to come down on 5/3/2010 and on 5/4/2010 temperature was normal.
Age: 69.0
Sex: F
Vaccine: FLUX
Symptoms: Loss of consciousness, Monoplegia
Clinical narrative: Paralysis started in right arm. Rush to emergency room. By which time I was unconscious.
Age: 32.0
Sex: F
Vaccine: TDAP
Symptoms: Limb discomfort, Musculoskeletal stiffness, Pain
Clinical narrative: Stiff and sore unable to raise arm above head after 9 days.
Age: 51.0
Sex: F
Vaccine: HEP, TDAP, HEP, TDAP
Symptoms: Lymphadenopathy, Pain, Rash
Clinical narrative: Rash covering both arms, pain, axillary lymphadenopathy treated with MEDROL dose pack with good resolution of symptoms.
Age: 51.0
Sex: F
Vaccine: HEP, TDAP, HEP, TDAP
Symptoms: Abdominal pain, Fatigue, Jaundice, Liver function test, Nausea
Clinical narrative: Rash covering both arms, pain, axillary lymphadenopathy treated with MEDROL dose pack with good resolution of symptoms.
Age: 51.0
Sex: F
Vaccine: HEP, TDAP, HEP, TDAP
Symptoms: Rash
Clinical narrative: Rash covering both arms, pain, axillary lymphadenopathy treated with MEDROL dose pack with good resolution of symptoms.
Age: 0.34
Sex: F
Vaccine: DTAPIPVHIB, PNC13, RV5, DTAPIPVHIB, PNC13, RV5
Symptoms: Decreased activity, Diarrhoea, Irritability, Lethargy, Pallor
Clinical narrative: Child had episode of diarrhea at 5:30pm, was a little cranky. Then at 9:15pm, patient noted to get very pale, threw up and had watery explosive stool. At this time child was very lethargic to parents, taken immediately to ER where child was responsive but decreased activity. IV fluids given as well as steroid. Uncertain about labs or other testing done.
Age: 0.34
Sex: F
Vaccine: DTAPIPVHIB, PNC13, RV5, DTAPIPVHIB, PNC13, RV5
Symptoms: Vomiting
Clinical narrative: Child had episode of diarrhea at 5:30pm, was a little cranky. Then at 9:15pm, patient noted to get very pale, threw up and had watery explosive stool. At this time child was very lethargic to parents, taken immediately to ER where child was responsive but decreased activity. IV fluids given as well as steroid. Uncertain about labs or other testing done.
Age: 0.34
Sex: F
Vaccine: DTAPIPVHIB, PNC13, RV5, DTAPIPVHIB, PNC13, RV5
Symptoms: Acidosis, Diarrhoea, Irritability, Lethargy, Vomiting
Clinical narrative: Child had episode of diarrhea at 5:30pm, was a little cranky. Then at 9:15pm, patient noted to get very pale, threw up and had watery explosive stool. At this time child was very lethargic to parents, taken immediately to ER where child was responsive but decreased activity. IV fluids given as well as steroid. Uncertain about labs or other testing done.
Age: 67.0
Sex: F
Vaccine: TDAP
Symptoms: Erythema, Headache, Pain, Pruritus, Throat tightness
Clinical narrative: Localized itching, redness, soreness, throat tightness, headache. Rxd loratadine, BENADRYL, MEDROL Pak.
Age: 2.0
Sex: M
Vaccine: HIBV, PNC13
Symptoms: Injection site erythema, Injection site swelling
Clinical narrative: Swelling and redness injection site.
Age: 18.0
Sex: F
Vaccine: IPV, MNQ, TDAP
Symptoms: Asthenia, Body temperature increased, Dizziness, Feeling cold
Clinical narrative: Client called 4/27 and left voice mail stating she was weak and dizzy at times starting on 4/27. Went to school 4/27 but feeling like she had a temperature but felt very cold. Returned call around 3 P.M. 4/26: Had not eaten since early A.M., not drinking much fluid. Suggested rest and encouraged protein and carb meal and 40 ounces of liquid. At 4:30 PM Called client to follow-up: Mother answered the phone. Daughter had a temp of 100.7 and asleep on the couch. Did not eat much snack. Will call 4/28. Called 4/28: Spoke to client's father as daughter went to school today. Reported she felt much better. Mentioned that there was a recent death in the family with close relative. VAERS completed and mailed.
Age: 27.0
Sex: F
Vaccine: TDAP
Symptoms: Chest discomfort, Electrocardiogram normal, Fatigue, Feeling abnormal, Nausea
Clinical narrative: TDAP administered IM at 4:55 PM left deltoid.  30 minutes later c/o feeling "floaty", chest tightness and tingling in the cheeks.  Vital signs were stable.  Brought to ED dept.  Pulse O2 sat level & EKG normal also - c/o fatigue and nausea.  Felt tired.
Age: 27.0
Sex: F
Vaccine: TDAP
Symptoms: Oxygen saturation normal, Paraesthesia
Clinical narrative: TDAP administered IM at 4:55 PM left deltoid.  30 minutes later c/o feeling "floaty", chest tightness and tingling in the cheeks.  Vital signs were stable.  Brought to ED dept.  Pulse O2 sat level & EKG normal also - c/o fatigue and nausea.  Felt tired.
Age: 80.0
Sex: F
Vaccine: FLU(H1N1)
Symptoms: Brain scan normal, Chills, Diarrhoea, Dizziness, Lower respiratory tract infection
Clinical narrative: Approximately 72-96 h pronounced chills; diarrhea onset after chills subsided lasting 7 days; upper respiratory infection after subsiding of diarrhea (untreated). Upper and lower respiratory infections persisting approx. 3 mos patient experiencing dizziness since 3-28-2010.
Age: 80.0
Sex: F
Vaccine: FLU(H1N1)
Symptoms: Spinal X-ray normal, Upper respiratory tract infection
Clinical narrative: Approximately 72-96 h pronounced chills; diarrhea onset after chills subsided lasting 7 days; upper respiratory infection after subsiding of diarrhea (untreated). Upper and lower respiratory infections persisting approx. 3 mos patient experiencing dizziness since 3-28-2010.
Sex: F
Vaccine: HEP, TDAP
Symptoms: Wrong drug administered
Clinical narrative: Infant received Tdap instead of HepB. No adverse events observed. No treatment needed.
Age: 0.14
Sex: F
Vaccine: DTAPH, HEP, IPV, PNC
Symptoms: Pyrexia
Clinical narrative: Fever to 101. No other symptoms.
Age: 0.52
Sex: M
Vaccine: DTAP, HIBV, IPV, PNC13
Symptoms: Crying
Clinical narrative: Constant crying; started approx 90 min. after vaccines given. Did not respond to TYLENOL. Seen in office at 1500 - quiet, consolable; cries if not being held.
Age: 0.51
Sex: F
Vaccine: DTAPIPVHIB, FLU(H1N1), HEP, PNC, RV5
Symptoms: Blood culture negative, Differential white blood cell count normal, Febrile convulsion, Full blood count normal, Gaze palsy
Clinical narrative: Approx. 12 hrs after vaccines given, pt had temp 104 and what sounds like a febrile seizure (eyes rolled back and very stiff).
Age: 0.51
Sex: F
Vaccine: DTAPIPVHIB, FLU(H1N1), HEP, PNC, RV5
Symptoms: Musculoskeletal stiffness
Clinical narrative: Approx. 12 hrs after vaccines given, pt had temp 104 and what sounds like a febrile seizure (eyes rolled back and very stiff).
Age: 37.0
Sex: M
Vaccine: HEPAB
Symptoms: Abnormal behaviour, Erythema, Feeling hot, Inappropriate schedule of drug administration, Myalgia
Clinical narrative: This case was reported by another manufacturer (Schering Plough) and described the occurrence of self-destructive behavior in a 37-year-old male subject who was vaccinated with TWINRIX, GlaxoSmithKline. On 13 November 2009 and 29 January 2010 the subject received unspecified dose of TWINRIX (unknown). On 13 November 2009, less than one day after vaccination with TWINRIX, the subject experienced self-destructive behavior, localized muscle pain, swelling, erythema, hotness, low grade fever, sleeps all day, and flipped out. On 29 January 2010, at the time of vaccination with TWINRIX, the subject experienced inappropriate schedule of vaccine administered. This case was assessed as medically serious by GSK. At the time of reporting the localized muscle pain, swelling, erythema, hotness, low grade fever and sleeps all day were resolved; self-destructive behavior and flipped out were unresolved.
Age: 37.0
Sex: M
Vaccine: HEPAB
Symptoms: Pyrexia, Self injurious behaviour, Somnolence, Swelling
Clinical narrative: This case was reported by another manufacturer (Schering Plough) and described the occurrence of self-destructive behavior in a 37-year-old male subject who was vaccinated with TWINRIX, GlaxoSmithKline. On 13 November 2009 and 29 January 2010 the subject received unspecified dose of TWINRIX (unknown). On 13 November 2009, less than one day after vaccination with TWINRIX, the subject experienced self-destructive behavior, localized muscle pain, swelling, erythema, hotness, low grade fever, sleeps all day, and flipped out. On 29 January 2010, at the time of vaccination with TWINRIX, the subject experienced inappropriate schedule of vaccine administered. This case was assessed as medically serious by GSK. At the time of reporting the localized muscle pain, swelling, erythema, hotness, low grade fever and sleeps all day were resolved; self-destructive behavior and flipped out were unresolved.
Age: 1.89
Sex: M
Vaccine: HEPA, TDAP
Symptoms: Wrong drug administered
Clinical narrative: No adverse reaction.  Tdap (BOOSTRIX) given instead of DTaP (INFANRIX).
Age: 68.0
Sex: F
Vaccine: PPV
Symptoms: Cough, Influenza like illness, Pyrexia, Upper respiratory tract congestion
Clinical narrative: Flu-like symptoms.  Low fever, congestion, cough, 5 days, no treatment.
Sex: U
Vaccine: DTAPIPV
Symptoms: Cellulitis
Clinical narrative: This case was reported by a healthcare professional via a representative and described the occurrence of cellulitis in a subject of unspecified age and gender who was vaccinated with KINRIX, (GlaxoSmithKline). On an unspecified date the subject received unspecified dose of KINRIX (unknown). At an unspecified time after vaccination with KINRIX, the subject experienced cellulitis. This case was assessed as medically serious by GSK. At the time of reporting the outcome of the event was unspecified. The sales representative reported that there has been 4 cases of cellulitis at this doctor's office recently. They have increased their doses of KINRIX during this time and were questioning whether it may have been a cause. The sales representative had no additional information.
Age: 44.0
Sex: F
Vaccine: FLU(H1N1), PPV
Symptoms: Axillary pain, Injection site pain, Musculoskeletal pain, Neck pain, Pyrexia
Clinical narrative: Pt. described soreness at injection site, armpit, shoulder & back of upper neck, (T99.0) per pt. (all on (R)), s/s began on afternoon following injection. No treatment. Instructed to go to ER if s/s severe. Did not go to ER.
Age: 67.0
Sex: M
Vaccine: FLU(H1N1)
Symptoms: Unevaluable event
Clinical narrative: Possible GUILLAIN BARRE Syndrome. Symptoms started approximately 6 weeks post-vaccination. Went to hospital -neurologist. Started on pheresis and gabapentin.
Age: 68.0
Sex: F
Vaccine: PPV
Symptoms: Fatigue, Headache, Influenza like illness, Injection site erythema, Injection site swelling
Clinical narrative: Right arm where shot was administered turned red & swollen on entire upper arm. Pain shooting in arm, flu like symptoms - a slight fever - tremendous headache - feeling tired. Upper arm hurt all the time for 4 days. Redness disappeared after 6 days, upper arm was itchy too.
Age: 68.0
Sex: F
Vaccine: PPV
Symptoms: Pain, Pain in extremity, Pruritus, Pyrexia
Clinical narrative: Right arm where shot was administered turned red & swollen on entire upper arm. Pain shooting in arm, flu like symptoms - a slight fever - tremendous headache - feeling tired. Upper arm hurt all the time for 4 days. Redness disappeared after 6 days, upper arm was itchy too.
Age: 5.0
Sex: F
Vaccine: DTAP, IPV, MMR, VARCEL
Symptoms: Urticaria
Clinical narrative: Hives - confluent at DTaP side, also present on trunk.
Age: 11.0
Sex: M
Vaccine: VARCEL
Symptoms: Incorrect route of drug administration, Injection site erythema, Injection site infection, Injection site swelling
Clinical narrative: Patient received Varicella in (Lt.) deltoid instead of S.Q. (by volunteer RN) during free shot clinic 4/24/10. (Lt.) deltoid area became very swollen, red, and parent says that it looks "infected" with fluid seeping out (4-28-10). Taking child to  his pediatrician.
Age: 2.0
Sex: M
Vaccine: PNC13
Symptoms: Injection site cellulitis
Clinical narrative: Cellulitis at site.
Age: 77.0
Sex: F
Vaccine: PPV
Symptoms: Injection site erythema, Injection site warmth
Clinical narrative: She was given a PNEUMOVAX .5 IM in her left deltoid IM on 4-27-10 at approx 3:15 PM.  She returned to the clinic at 2 PM on 4-28-10 - her left deltoid was red, warm to touch - T98.2.  She was started on BACTRIM DS BID X 10 days and she will return to the clinic on 4-30-10 for a recheck.  She was instructed to return sooner if the arm is getting worse.
Age: 76.0
Sex: U
Vaccine: FLUX(H1N1)
Symptoms: Arthralgia, Guillain-Barre syndrome, Immunoglobulin therapy, Muscular weakness, Pain in extremity
Clinical narrative: Sensory GUILLAIN-BARRE - severe pain in legs and hips for four days until diagnosed. TX: LYRICA 150mg 31 day, tramadol 50 mg every 6 hrs, weakness in legs continues/ IVIG -  4 day series plus 1 booster.
Age: 21.0
Sex: M
Vaccine: PPV
Symptoms: Ear, nose and throat examination normal, Sensation of foreign body
Clinical narrative: Globus sensation in throat starting 2 hours after vaccination. ENT evaluated and saw no evidence of inflammation in the airway. He has continued symptoms. No difficulty w/ breathing or eating.
Age: 37.0
Sex: M
Vaccine: SMALL, SMALL
Symptoms: Catheter placement, Chest discomfort, Culture wound, Injection site reaction, Myocarditis
Clinical narrative: Patient is a 37-year-old healthy gentleman who presented with chest discomfort on the early morning hours of April 28, 2010. Due to his elevated troponin he was evaluated with CAT scan showing no evidence of pulmonary embolism. He subsequently went to heart catheterization lab and underwent heart catheterization disclosing no significant obstructive coronary disease. The patient was seen by Infectious Disease due to abnormal left deltoid at the site of his recent smallpox vaccination. CDC was involved through Dr's conversations and evaluation of photographs of the deltoid lesion. The patient has done well. He will be discharged later today and will follow-up with Dr. within one week. He will follow-up me in the office in two to three weeks. At that time he will have an echocardiogram and plain treadmill stress test. If these are acceptable, then I think the patient can return to his usual activities including work without restriction. That decision will be made after evaluation of the patient following his echocardiogram and stress test. I believe the patient had myocarditis secondary to his smallpox vaccination. The timing is appropriate. The clinical picture is definitely consistent with myocarditis. This is definitely a known potential complication from a smallpox vaccination. The patient will be discharged later today.
Age: 37.0
Sex: M
Vaccine: SMALL, SMALL
Symptoms: Polymerase chain reaction, Skin lesion, Troponin increased, Vaccination complication
Clinical narrative: Patient is a 37-year-old healthy gentleman who presented with chest discomfort on the early morning hours of April 28, 2010. Due to his elevated troponin he was evaluated with CAT scan showing no evidence of pulmonary embolism. He subsequently went to heart catheterization lab and underwent heart catheterization disclosing no significant obstructive coronary disease. The patient was seen by Infectious Disease due to abnormal left deltoid at the site of his recent smallpox vaccination. CDC was involved through Dr's conversations and evaluation of photographs of the deltoid lesion. The patient has done well. He will be discharged later today and will follow-up with Dr. within one week. He will follow-up me in the office in two to three weeks. At that time he will have an echocardiogram and plain treadmill stress test. If these are acceptable, then I think the patient can return to his usual activities including work without restriction. That decision will be made after evaluation of the patient following his echocardiogram and stress test. I believe the patient had myocarditis secondary to his smallpox vaccination. The timing is appropriate. The clinical picture is definitely consistent with myocarditis. This is definitely a known potential complication from a smallpox vaccination. The patient will be discharged later today.
Age: 37.0
Sex: M
Vaccine: SMALL, SMALL
Symptoms: Cardiac enzymes increased, Catheterisation cardiac normal, Chest discomfort, Computerised tomogram normal, Culture wound
Clinical narrative: Patient is a 37-year-old healthy gentleman who presented with chest discomfort on the early morning hours of April 28, 2010. Due to his elevated troponin he was evaluated with CAT scan showing no evidence of pulmonary embolism. He subsequently went to heart catheterization lab and underwent heart catheterization disclosing no significant obstructive coronary disease. The patient was seen by Infectious Disease due to abnormal left deltoid at the site of his recent smallpox vaccination. CDC was involved through Dr's conversations and evaluation of photographs of the deltoid lesion. The patient has done well. He will be discharged later today and will follow-up with Dr. within one week. He will follow-up me in the office in two to three weeks. At that time he will have an echocardiogram and plain treadmill stress test. If these are acceptable, then I think the patient can return to his usual activities including work without restriction. That decision will be made after evaluation of the patient following his echocardiogram and stress test. I believe the patient had myocarditis secondary to his smallpox vaccination. The timing is appropriate. The clinical picture is definitely consistent with myocarditis. This is definitely a known potential complication from a smallpox vaccination. The patient will be discharged later today.
Age: 37.0
Sex: M
Vaccine: SMALL, SMALL
Symptoms: Electrocardiogram, Impaired work ability, Injection site reaction, Myocarditis, Polymerase chain reaction
Clinical narrative: Patient is a 37-year-old healthy gentleman who presented with chest discomfort on the early morning hours of April 28, 2010. Due to his elevated troponin he was evaluated with CAT scan showing no evidence of pulmonary embolism. He subsequently went to heart catheterization lab and underwent heart catheterization disclosing no significant obstructive coronary disease. The patient was seen by Infectious Disease due to abnormal left deltoid at the site of his recent smallpox vaccination. CDC was involved through Dr's conversations and evaluation of photographs of the deltoid lesion. The patient has done well. He will be discharged later today and will follow-up with Dr. within one week. He will follow-up me in the office in two to three weeks. At that time he will have an echocardiogram and plain treadmill stress test. If these are acceptable, then I think the patient can return to his usual activities including work without restriction. That decision will be made after evaluation of the patient following his echocardiogram and stress test. I believe the patient had myocarditis secondary to his smallpox vaccination. The timing is appropriate. The clinical picture is definitely consistent with myocarditis. This is definitely a known potential complication from a smallpox vaccination. The patient will be discharged later today.
Age: 37.0
Sex: M
Vaccine: SMALL, SMALL
Symptoms: Skin lesion, Troponin increased
Clinical narrative: Patient is a 37-year-old healthy gentleman who presented with chest discomfort on the early morning hours of April 28, 2010. Due to his elevated troponin he was evaluated with CAT scan showing no evidence of pulmonary embolism. He subsequently went to heart catheterization lab and underwent heart catheterization disclosing no significant obstructive coronary disease. The patient was seen by Infectious Disease due to abnormal left deltoid at the site of his recent smallpox vaccination. CDC was involved through Dr's conversations and evaluation of photographs of the deltoid lesion. The patient has done well. He will be discharged later today and will follow-up with Dr. within one week. He will follow-up me in the office in two to three weeks. At that time he will have an echocardiogram and plain treadmill stress test. If these are acceptable, then I think the patient can return to his usual activities including work without restriction. That decision will be made after evaluation of the patient following his echocardiogram and stress test. I believe the patient had myocarditis secondary to his smallpox vaccination. The timing is appropriate. The clinical picture is definitely consistent with myocarditis. This is definitely a known potential complication from a smallpox vaccination. The patient will be discharged later today.
Age: 71.0
Sex: M
Vaccine: FLU(H1N1), FLU(H1N1)
Symptoms: Diarrhoea, Vomiting
Clinical narrative: Vomiting, diarrhea.
Age: 71.0
Sex: M
Vaccine: FLU(H1N1), FLU(H1N1)
Symptoms: Diarrhoea, Nausea, Vomiting
Clinical narrative: Vomiting, diarrhea.
Age: 1.51
Sex: F
Vaccine: HEPA, PNC13
Symptoms: Injection site rash, Pyrexia
Clinical narrative: Rash behind site of injection on day of administering & fever 102 day after injection.  TX of TYLENOL.
Age: 3.0
Sex: M
Vaccine: DTAP, HEP, HIBV
Symptoms: Urticaria
Clinical narrative: Child received DTaP, HIB; Hep B vaccines on 4/29/10 and reported to ER that night with hives. Child seen in our office on 4/30/10 for urticaria. Tx'd with BENADRYL. Injection sites look benign.
Age: 1.01
Sex: M
Vaccine: HEPA, MMR, VARCEL
Symptoms: Rash generalised
Clinical narrative: Rash starting on torso and spreading to extremities.  No blistering.  Use hydrocortisone BID to body, QD to face.  Treatment for rubella / viral exanthem.
Age: 2.0
Sex: F
Vaccine: FLUN(H1N1), FLUX(H1N1), FLU3
Symptoms: Acoustic stimulation tests normal, Speech disorder, Thinking abnormal
Clinical narrative: DX about 1 month ago with a specific language impairment by SLP.  She is unable to repeat certain words. Cognitively she is fine.  Unable to process specific information. Can't speak in sentences with more than 4 words.  Hearing test WNL per audiologist.  Spoke fine prior to vaccination with H1N1.
Age: 2.0
Sex: F
Vaccine: FLUN(H1N1), FLUX(H1N1), FLU3
Symptoms: No reaction on previous exposure to drug, Speech disorder developmental, Urticaria
Clinical narrative: DX about 1 month ago with a specific language impairment by SLP.  She is unable to repeat certain words. Cognitively she is fine.  Unable to process specific information. Can't speak in sentences with more than 4 words.  Hearing test WNL per audiologist.  Spoke fine prior to vaccination with H1N1.
Age: 2.0
Sex: F
Vaccine: FLUN(H1N1), FLUX(H1N1), FLU3
Symptoms: Speech disorder developmental, Urticaria
Clinical narrative: DX about 1 month ago with a specific language impairment by SLP.  She is unable to repeat certain words. Cognitively she is fine.  Unable to process specific information. Can't speak in sentences with more than 4 words.  Hearing test WNL per audiologist.  Spoke fine prior to vaccination with H1N1.
Age: 51.0
Sex: F
Vaccine: TDAP
Symptoms: Palmar erythema, Skin exfoliation
Clinical narrative: Desquamative palmar rash.
Age: 0.42
Sex: M
Vaccine: RV5
Symptoms: Abnormal behaviour, Decreased appetite, Diarrhoea, Diet refusal, Gastrointestinal sounds abnormal
Clinical narrative: 1) Behavior change: very "fussy"/screaming episodes X 5 days started 4/28/10 Wed - 3.30 AM - Woke up screaming within 11 hrs of immunization and improved by 5/2/10 Sunday PM. ?? Abdominal cramps - no temperature noted - 2) Poor feeding: instead of usual 5 oz breast milk/formula every 2 1/2 to 3hrs, decreased to 2 to 3 oz and sometimes refused to feed and continued screaming. Improved by 5/2/2010 Sun PM. 3) Stools offensive odor and looser x 4-5 days, still went every other day some mucus in stool, no blood. Rectal exam negative - bowel sounds active.
Age: 0.42
Sex: M
Vaccine: RV5
Symptoms: Irritability, Mucous stools, Screaming, Streptococcus test negative
Clinical narrative: 1) Behavior change: very "fussy"/screaming episodes X 5 days started 4/28/10 Wed - 3.30 AM - Woke up screaming within 11 hrs of immunization and improved by 5/2/10 Sunday PM. ?? Abdominal cramps - no temperature noted - 2) Poor feeding: instead of usual 5 oz breast milk/formula every 2 1/2 to 3hrs, decreased to 2 to 3 oz and sometimes refused to feed and continued screaming. Improved by 5/2/2010 Sun PM. 3) Stools offensive odor and looser x 4-5 days, still went every other day some mucus in stool, no blood. Rectal exam negative - bowel sounds active.
Age: 4.0
Sex: F
Vaccine: HEPA
Symptoms: Erythema, Rash, Urticaria
Clinical narrative: 2 hours after HepA vaccine was given rash, redness, hives around injection site.
Age: 22.0
Sex: M
Vaccine: ANTH, FLU(H1N1), SMALL, TYP, ANTH, FLU(H1N1), SMALL, TYP
Symptoms: Activities of daily living impaired, Aggression, Agitation, Alanine aminotransferase increased, Alpha-1 anti-trypsin normal
Clinical narrative: 22 y/o male who collapsed after a prolonged high intensity exercise run wearing about 30-40 lbs of gear on field run for > 1 hour; felt "unwell" at the end of 4 mile run; walked around about 1 1/2 laps and then collapsed. Does not recall any events following collapse until about 8 days later while hospitalized. Pt felt well prior to run - "near 100%". Reports he was well hydrated. When patient transported by ambulance, he experienced an altered mental status (initially unresponsive, then agitated, combative) and his temperature was 109 degrees F, rectally, which was confirmed at ER as >107 degrees F, rectally. Efforts to cool and sedate (received ATIVAN and HALDOL --> intubated). Temp down to 103 degrees F --> transferred to another Hospital. Temp down to 101 on admission; given additional fentanyl and versed for agitation. Hemodynamically stable with HRs 80-90 and SBP 100-20s; O2 stats > 97%. Loose green stools. HOSPITAL COURSE: Agitated, febrile to 102 rectally despite cooling blanket, fan and ice packs. Given Librium d/t concern for DTs with ETOH intake of about 30 beers/week (last ETOH intake around 3/14/2010); given VERSED as needed for agitation. Concern for cerebral edema (per CT with concern for herniation; episode in scanner where he was unresponsive, sluggish small pupils, heart rate in 30s, requiring resuscitation -->MICU). Given Mannitol with improvement. F/u MRI w/o evidence of elevated ICP. Received coverage for infections (doxy, vancomycin, ceftriaxzone, and acyclovir). After consultation with CDC and VHC, VIG (X1) administered IV (6000 units per kg) and pat also received IV methylprednisolone. Over hospital course, temperature returned to normal after several days, LFTS improved and mental status improved to near baseline. By 24 March, patient was extubated. He was following commands and answering questions, but no recall of previous 7 days. He was discharged on 28 March 2010. 13 April, Follow up visit, problems with motor skills (difficulty using fork and pen) and continues to report memory lapses ( -- > repair MRI and Neurology follow-up appt). 26 April, Follow Up, problems with mild memory lapses with forgetting what he is doing and at time how to do simple things such as tie his shoes. Problems falling asleep with sleep initiation taking anywhere from 2-3 hours. Also, admits to increased mood swings but he admits to being under some pressure from all this going on.
Age: 22.0
Sex: M
Vaccine: ANTH, FLU(H1N1), SMALL, TYP, ANTH, FLU(H1N1), SMALL, TYP
Symptoms: Amnesia, Anion gap increased, Antimitochondrial antibody normal, Antinuclear antibody negative, Anxiety
Clinical narrative: 22 y/o male who collapsed after a prolonged high intensity exercise run wearing about 30-40 lbs of gear on field run for > 1 hour; felt "unwell" at the end of 4 mile run; walked around about 1 1/2 laps and then collapsed. Does not recall any events following collapse until about 8 days later while hospitalized. Pt felt well prior to run - "near 100%". Reports he was well hydrated. When patient transported by ambulance, he experienced an altered mental status (initially unresponsive, then agitated, combative) and his temperature was 109 degrees F, rectally, which was confirmed at ER as >107 degrees F, rectally. Efforts to cool and sedate (received ATIVAN and HALDOL --> intubated). Temp down to 103 degrees F --> transferred to another Hospital. Temp down to 101 on admission; given additional fentanyl and versed for agitation. Hemodynamically stable with HRs 80-90 and SBP 100-20s; O2 stats > 97%. Loose green stools. HOSPITAL COURSE: Agitated, febrile to 102 rectally despite cooling blanket, fan and ice packs. Given Librium d/t concern for DTs with ETOH intake of about 30 beers/week (last ETOH intake around 3/14/2010); given VERSED as needed for agitation. Concern for cerebral edema (per CT with concern for herniation; episode in scanner where he was unresponsive, sluggish small pupils, heart rate in 30s, requiring resuscitation -->MICU). Given Mannitol with improvement. F/u MRI w/o evidence of elevated ICP. Received coverage for infections (doxy, vancomycin, ceftriaxzone, and acyclovir). After consultation with CDC and VHC, VIG (X1) administered IV (6000 units per kg) and pat also received IV methylprednisolone. Over hospital course, temperature returned to normal after several days, LFTS improved and mental status improved to near baseline. By 24 March, patient was extubated. He was following commands and answering questions, but no recall of previous 7 days. He was discharged on 28 March 2010. 13 April, Follow up visit, problems with motor skills (difficulty using fork and pen) and continues to report memory lapses ( -- > repair MRI and Neurology follow-up appt). 26 April, Follow Up, problems with mild memory lapses with forgetting what he is doing and at time how to do simple things such as tie his shoes. Problems falling asleep with sleep initiation taking anywhere from 2-3 hours. Also, admits to increased mood swings but he admits to being under some pressure from all this going on.
Age: 22.0
Sex: M
Vaccine: ANTH, FLU(H1N1), SMALL, TYP, ANTH, FLU(H1N1), SMALL, TYP
Symptoms: Aspartate aminotransferase increased, Bacterial test negative, Bilirubin conjugated, Blood HIV RNA below assay limit, Blood albumin normal
Clinical narrative: 22 y/o male who collapsed after a prolonged high intensity exercise run wearing about 30-40 lbs of gear on field run for > 1 hour; felt "unwell" at the end of 4 mile run; walked around about 1 1/2 laps and then collapsed. Does not recall any events following collapse until about 8 days later while hospitalized. Pt felt well prior to run - "near 100%". Reports he was well hydrated. When patient transported by ambulance, he experienced an altered mental status (initially unresponsive, then agitated, combative) and his temperature was 109 degrees F, rectally, which was confirmed at ER as >107 degrees F, rectally. Efforts to cool and sedate (received ATIVAN and HALDOL --> intubated). Temp down to 103 degrees F --> transferred to another Hospital. Temp down to 101 on admission; given additional fentanyl and versed for agitation. Hemodynamically stable with HRs 80-90 and SBP 100-20s; O2 stats > 97%. Loose green stools. HOSPITAL COURSE: Agitated, febrile to 102 rectally despite cooling blanket, fan and ice packs. Given Librium d/t concern for DTs with ETOH intake of about 30 beers/week (last ETOH intake around 3/14/2010); given VERSED as needed for agitation. Concern for cerebral edema (per CT with concern for herniation; episode in scanner where he was unresponsive, sluggish small pupils, heart rate in 30s, requiring resuscitation -->MICU). Given Mannitol with improvement. F/u MRI w/o evidence of elevated ICP. Received coverage for infections (doxy, vancomycin, ceftriaxzone, and acyclovir). After consultation with CDC and VHC, VIG (X1) administered IV (6000 units per kg) and pat also received IV methylprednisolone. Over hospital course, temperature returned to normal after several days, LFTS improved and mental status improved to near baseline. By 24 March, patient was extubated. He was following commands and answering questions, but no recall of previous 7 days. He was discharged on 28 March 2010. 13 April, Follow up visit, problems with motor skills (difficulty using fork and pen) and continues to report memory lapses ( -- > repair MRI and Neurology follow-up appt). 26 April, Follow Up, problems with mild memory lapses with forgetting what he is doing and at time how to do simple things such as tie his shoes. Problems falling asleep with sleep initiation taking anywhere from 2-3 hours. Also, admits to increased mood swings but he admits to being under some pressure from all this going on.
Age: 22.0
Sex: M
Vaccine: ANTH, FLU(H1N1), SMALL, TYP, ANTH, FLU(H1N1), SMALL, TYP
Symptoms: Blood bicarbonate decreased, Blood bicarbonate normal, Blood bilirubin normal, Blood calcium increased, Blood chloride normal
Clinical narrative: 22 y/o male who collapsed after a prolonged high intensity exercise run wearing about 30-40 lbs of gear on field run for > 1 hour; felt "unwell" at the end of 4 mile run; walked around about 1 1/2 laps and then collapsed. Does not recall any events following collapse until about 8 days later while hospitalized. Pt felt well prior to run - "near 100%". Reports he was well hydrated. When patient transported by ambulance, he experienced an altered mental status (initially unresponsive, then agitated, combative) and his temperature was 109 degrees F, rectally, which was confirmed at ER as >107 degrees F, rectally. Efforts to cool and sedate (received ATIVAN and HALDOL --> intubated). Temp down to 103 degrees F --> transferred to another Hospital. Temp down to 101 on admission; given additional fentanyl and versed for agitation. Hemodynamically stable with HRs 80-90 and SBP 100-20s; O2 stats > 97%. Loose green stools. HOSPITAL COURSE: Agitated, febrile to 102 rectally despite cooling blanket, fan and ice packs. Given Librium d/t concern for DTs with ETOH intake of about 30 beers/week (last ETOH intake around 3/14/2010); given VERSED as needed for agitation. Concern for cerebral edema (per CT with concern for herniation; episode in scanner where he was unresponsive, sluggish small pupils, heart rate in 30s, requiring resuscitation -->MICU). Given Mannitol with improvement. F/u MRI w/o evidence of elevated ICP. Received coverage for infections (doxy, vancomycin, ceftriaxzone, and acyclovir). After consultation with CDC and VHC, VIG (X1) administered IV (6000 units per kg) and pat also received IV methylprednisolone. Over hospital course, temperature returned to normal after several days, LFTS improved and mental status improved to near baseline. By 24 March, patient was extubated. He was following commands and answering questions, but no recall of previous 7 days. He was discharged on 28 March 2010. 13 April, Follow up visit, problems with motor skills (difficulty using fork and pen) and continues to report memory lapses ( -- > repair MRI and Neurology follow-up appt). 26 April, Follow Up, problems with mild memory lapses with forgetting what he is doing and at time how to do simple things such as tie his shoes. Problems falling asleep with sleep initiation taking anywhere from 2-3 hours. Also, admits to increased mood swings but he admits to being under some pressure from all this going on.
Age: 22.0
Sex: M
Vaccine: ANTH, FLU(H1N1), SMALL, TYP, ANTH, FLU(H1N1), SMALL, TYP
Symptoms: Blood creatine phosphokinase increased, Blood creatinine increased, Blood culture negative, Blood immunoglobulin A normal, Blood immunoglobulin E
Clinical narrative: 22 y/o male who collapsed after a prolonged high intensity exercise run wearing about 30-40 lbs of gear on field run for > 1 hour; felt "unwell" at the end of 4 mile run; walked around about 1 1/2 laps and then collapsed. Does not recall any events following collapse until about 8 days later while hospitalized. Pt felt well prior to run - "near 100%". Reports he was well hydrated. When patient transported by ambulance, he experienced an altered mental status (initially unresponsive, then agitated, combative) and his temperature was 109 degrees F, rectally, which was confirmed at ER as >107 degrees F, rectally. Efforts to cool and sedate (received ATIVAN and HALDOL --> intubated). Temp down to 103 degrees F --> transferred to another Hospital. Temp down to 101 on admission; given additional fentanyl and versed for agitation. Hemodynamically stable with HRs 80-90 and SBP 100-20s; O2 stats > 97%. Loose green stools. HOSPITAL COURSE: Agitated, febrile to 102 rectally despite cooling blanket, fan and ice packs. Given Librium d/t concern for DTs with ETOH intake of about 30 beers/week (last ETOH intake around 3/14/2010); given VERSED as needed for agitation. Concern for cerebral edema (per CT with concern for herniation; episode in scanner where he was unresponsive, sluggish small pupils, heart rate in 30s, requiring resuscitation -->MICU). Given Mannitol with improvement. F/u MRI w/o evidence of elevated ICP. Received coverage for infections (doxy, vancomycin, ceftriaxzone, and acyclovir). After consultation with CDC and VHC, VIG (X1) administered IV (6000 units per kg) and pat also received IV methylprednisolone. Over hospital course, temperature returned to normal after several days, LFTS improved and mental status improved to near baseline. By 24 March, patient was extubated. He was following commands and answering questions, but no recall of previous 7 days. He was discharged on 28 March 2010. 13 April, Follow up visit, problems with motor skills (difficulty using fork and pen) and continues to report memory lapses ( -- > repair MRI and Neurology follow-up appt). 26 April, Follow Up, problems with mild memory lapses with forgetting what he is doing and at time how to do simple things such as tie his shoes. Problems falling asleep with sleep initiation taking anywhere from 2-3 hours. Also, admits to increased mood swings but he admits to being under some pressure from all this going on.
Age: 22.0
Sex: M
Vaccine: ANTH, FLU(H1N1), SMALL, TYP, ANTH, FLU(H1N1), SMALL, TYP
Symptoms: Blood immunoglobulin G normal, Blood immunoglobulin M decreased, Blood sodium normal, Blood thyroid stimulating hormone decreased, Blood urea normal
Clinical narrative: 22 y/o male who collapsed after a prolonged high intensity exercise run wearing about 30-40 lbs of gear on field run for > 1 hour; felt "unwell" at the end of 4 mile run; walked around about 1 1/2 laps and then collapsed. Does not recall any events following collapse until about 8 days later while hospitalized. Pt felt well prior to run - "near 100%". Reports he was well hydrated. When patient transported by ambulance, he experienced an altered mental status (initially unresponsive, then agitated, combative) and his temperature was 109 degrees F, rectally, which was confirmed at ER as >107 degrees F, rectally. Efforts to cool and sedate (received ATIVAN and HALDOL --> intubated). Temp down to 103 degrees F --> transferred to another Hospital. Temp down to 101 on admission; given additional fentanyl and versed for agitation. Hemodynamically stable with HRs 80-90 and SBP 100-20s; O2 stats > 97%. Loose green stools. HOSPITAL COURSE: Agitated, febrile to 102 rectally despite cooling blanket, fan and ice packs. Given Librium d/t concern for DTs with ETOH intake of about 30 beers/week (last ETOH intake around 3/14/2010); given VERSED as needed for agitation. Concern for cerebral edema (per CT with concern for herniation; episode in scanner where he was unresponsive, sluggish small pupils, heart rate in 30s, requiring resuscitation -->MICU). Given Mannitol with improvement. F/u MRI w/o evidence of elevated ICP. Received coverage for infections (doxy, vancomycin, ceftriaxzone, and acyclovir). After consultation with CDC and VHC, VIG (X1) administered IV (6000 units per kg) and pat also received IV methylprednisolone. Over hospital course, temperature returned to normal after several days, LFTS improved and mental status improved to near baseline. By 24 March, patient was extubated. He was following commands and answering questions, but no recall of previous 7 days. He was discharged on 28 March 2010. 13 April, Follow up visit, problems with motor skills (difficulty using fork and pen) and continues to report memory lapses ( -- > repair MRI and Neurology follow-up appt). 26 April, Follow Up, problems with mild memory lapses with forgetting what he is doing and at time how to do simple things such as tie his shoes. Problems falling asleep with sleep initiation taking anywhere from 2-3 hours. Also, admits to increased mood swings but he admits to being under some pressure from all this going on.