chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 0.17
Sex: M
Vaccine: DTAPIPVHIB
Symptoms: Medication error, No adverse event, Product preparation error, Wrong technique in product usage process
Clinical narrative: PENTACEL was administered without reconstituting with the HIB portion of the vaccine, only the DTAP/IPV was administered with no reported adverse event; PENTACEL was administered without reconstituting with the HIB portion of the vaccine, only the DTAP/IPV was administered with no reported adverse event; Initial information received on 13-Dec-2022 regarding an unsolicited valid  non-serious case received from a other health professional.  This case involves a 2 months old male patient who was diagnosed with pentacel was administered without reconstituting with the hib portion of the vaccine, only the dtap/ipv was administered with no reported adverse event after receiving vaccine diphtheria/tetanus/5 hybrid ac pertussis/ipv(mrc5)/hib(prp/t) vaccine [pentacel].  The patient's past medical history, medical treatment(s), vaccination(s) and family history were not provided.  On an unknown date, the patient received suspect diphtheria/tetanus/5 hybrid ac pertussis/ipv(mrc5)/hib(prp/t) vaccine at a dose of 0.5 ml (strength, frequency, formulation, route, batch number, expiry date: unknown) via intramuscular route in unknown administration site for Immunization  On 08-Dec-2022 the patient diagnosed with non-serious event of pentacel was administered without reconstituting with the hib portion of the vaccine, only the dtap/ipv was administered with no reported adverse event (Product preparation error,Wrong technique in product usage process) (unknown latency) following the administration of diphtheria/tetanus/5 hybrid ac pertussis/ipv(mrc5)/hib(prp/t) vaccine.  Action taken was not applicable.  At time of reporting, the outcome was Unknown for both events    This suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holder's compliance with the requirements set out in the Directive 2001/83/EC and Module VI of the Good Pharmacovigilance Practices. The classification as a medical error is in no way intended, nor should it be interpreted or construed as an allegation or claim made by the marketing authorization holder that any third party has contributed to or is to be held liable for the occurrence of this medication error.
Sex: U
Vaccine: COVID19
Symptoms: Ageusia, Anosmia
Clinical narrative: CANNOT TASTE; CANNOT SMELL; This spontaneous report received from a patient via a company representative concerned a patient of unspecified age and sex. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin, and batch number were not reported) dose, start therapy date were not reported for covid-19 prophylaxis. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported.  On an unspecified date, the patient experienced cannot taste, and cannot smell. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the cannot taste and cannot smell was not reported. This report was non-serious. This case is a duplicate of 20221237736.
Sex: U
Vaccine: COVID19-2
Symptoms: No adverse event, Wrong product administered
Clinical narrative: In the pharmacy I work in, we have given someone a booster shot as a second dose; No adverse event; This spontaneous case was reported by an other health care professional and describes the occurrence of WRONG PRODUCT ADMINISTERED (In the pharmacy I work in, we have given someone a booster shot as a second dose) and NO ADVERSE EVENT (No adverse event) in a  patient of an unknown age and gender who received mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) for COVID-19 prophylaxis.     No Medical History information was reported.    On an unknown date, the patient received dose of mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (unknown route) 1 dosage form. On an unknown date, the patient experienced WRONG PRODUCT ADMINISTERED (In the pharmacy I work in, we have given someone a booster shot as a second dose) and NO ADVERSE EVENT (No adverse event). At the time of the report, WRONG PRODUCT ADMINISTERED (In the pharmacy I work in, we have given someone a booster shot as a second dose) and NO ADVERSE EVENT (No adverse event) outcome was unknown.        The action taken with mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (Unknown) was unknown.   For mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (Unknown), the reporter considered NO ADVERSE EVENT (No adverse event) to be not related. No further causality assessment was provided for WRONG PRODUCT ADMINISTERED (In the pharmacy I work in, we have given someone a booster shot as a second dose).    No concomitant medicine were reported. No treatment medicine were reported.
Age: 71.0
Sex: U
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: no adverse event; Dose of expired Bivalent was administered on today (19Dec2022); This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Dose of expired Bivalent was administered on today (19Dec2022)) and NO ADVERSE EVENT (no adverse event) in a 71-year-old patient of an unknown gender who received mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (batch no. 023H22A) for COVID-19 prophylaxis.     No Medical History information was reported.    On 19-Dec-2022, the patient received dose of mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (unknown route) 1 dosage form. On 19-Dec-2022, the patient experienced EXPIRED PRODUCT ADMINISTERED (Dose of expired Bivalent was administered on today (19Dec2022)). On an unknown date, the patient experienced NO ADVERSE EVENT (no adverse event). At the time of the report, EXPIRED PRODUCT ADMINISTERED (Dose of expired Bivalent was administered on today (19Dec2022)) and NO ADVERSE EVENT (no adverse event) outcome was unknown.        For mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (Unknown), the reporter considered NO ADVERSE EVENT (no adverse event) to be not related. No further causality assessment was provided for EXPIRED PRODUCT ADMINISTERED (Dose of expired Bivalent was administered on today (19Dec2022)).    Concomitant medications were not reported.   Treatment medications were not reported.
Age: 1.0
Sex: M
Vaccine: FLU4, HEPA, MMR, PNC13, VARCEL
Symptoms: Erythema, Flushing, Rash macular, Respiratory symptom, Vomiting
Clinical narrative: Flushed cheeks, splotchy rash, erythematous legs, and vomiting.  Also occurred after first dose of Augmentin. Difficult to tell if vaccine reaction, medication reaction, or viral symptoms as he had OM at the time and URI sx. No fevers and was not acting ill.
Age: 16.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Error: Improper Storage (ex. temp./location)-
Age: 19.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Error: Improper Storage (ex. temp./location)-
Age: 77.0
Sex: M
Vaccine: COVID19
Symptoms: Colon cancer, Death, Metastases to liver
Clinical narrative: Narrative:  77yo male patient died of colon cancer with mets to the liver on 7/11/2021. Pt had received covid vaccines on 3/4/21 & 4/1/21. This death is not related to covid vaccines.
Age: 24.0
Sex: F
Vaccine: FLU4, TDAP
Symptoms: Arthralgia
Clinical narrative: Shoulder Pain (L)
Age: 17.0
Sex: F
Vaccine: MENB
Symptoms: Pain in extremity, Pruritus, Rash, Rash erythematous, Skin warm
Clinical narrative: (L) Arm large red rash warm to touch & very itchy/painful motrin/ice PRN notated in chart.
Age: 24.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Error: Improper Storage (ex. temp./location)-
Age: 33.0
Sex: F
Vaccine: COVID19-2
Symptoms: Hypoaesthesia
Clinical narrative: Systemic: Numbness (specify: facial area, extremities)-Mild, Additional Details: PATIENT ECPEREINCED FACIAL NUMBNESS IN LEFT CHEEK BONE AREA THAT SELF RESOLVED ON 12/16/2022 THEN WOKE UP IN THE MORNING AND NUMBNESS WAS IN ALL OF LEFT CHEEK. NOT PAINFUL BUT JUST SOME SMALL NUMBNESS THAT HAS BEEN SELF RESOLVING THUS FAR
Age: 31.0
Sex: F
Vaccine: COVID19-2
Symptoms: Incorrect product formulation administered
Clinical narrative: Error: Wrong Vaccine/Product Administered-
Age: 77.0
Sex: F
Vaccine: COVID19-2
Symptoms: Rash
Clinical narrative: Systemic: Allergic: Rash Generalized-Medium, Additional Details: Patient received two vaccines in same day (Fluad and Pfizer Covid Bivalent) in opposite arms. Woke up next day with rash all over body. Patient was instructed to call physician for further evaluation. Patient did not report any other symptoms other than rash
Age: 60.0
Sex: M
Vaccine: FLU4
Symptoms: Arthralgia, Injection site erythema, Injection site pain, Injection site swelling, Insomnia
Clinical narrative: Site: Pain at Injection Site-Severe, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Severe, Systemic: Joint Pain-Severe, Systemic: Unable to Sleep-Medium
Age: 11.0
Sex: F
Vaccine: COVID19-2
Symptoms: Product administered to patient of inappropriate age
Clinical narrative: Error: Wrong Age for Vaccine Given-
Age: 55.0
Sex: F
Vaccine: COVID19-2
Symptoms: Anaphylactic reaction, Dysphagia, Dyspnoea, Pharyngeal swelling, Throat tightness
Clinical narrative: Systemic: Allergic: Anaphylaxis-Medium, Systemic: Allergic: Difficulty Breathing-Medium, Systemic: Allergic: Difficulty Swallowing, Throat Tightness-Medium, Systemic: pt had difficulty with previous vaccines, however risk verses benefit of not receiving vaccine could be life threatening for patient if to obtain covid-Medium, Additional Details: pt had a previous anaphylactic reaction to 1st dose of covid, informed me that she wanted to continue with vaccine. we prepped emergency products. pt's throat started to swell, gave 1st dose of epipen. waiting 5 mins, gave 2nd dose so patient swelling  went completely down. pt immediately felt better. she was monitored for 30 minutes, offered benadryl (pt couldn't take benadryl), gave zyrtec and water until better. pt was extremely satisfied with care.
Age: 23.0
Sex: F
Vaccine: COVID19-2
Symptoms: Dizziness, Loss of consciousness, Pallor, Syncope
Clinical narrative: Site: Redness at Injection Site-Mild, Systemic: Fainting / Unresponsive-Mild, Systemic: Weakness-Mild, Additional Details: I gave flucelvax on left arm then preceeded to give moderna bivalent on right arm. After applyingbandaid pt told me she felt like she was going to faint. He face looked pale. I asked her to lay on the ground. As i was moving her she fainted in my arms. about 5 second later she regained consciousness. and I slowly moved her to ground with her legs on top of the chair. Her father came to watch her and I asked if she wanted water and proceeded to dial 911. she was smiling and using her phone after
Age: 14.0
Sex: F
Vaccine: COVID19-2
Symptoms: Dizziness, Hypoaesthesia, Hypotension, Nausea, Pallor
Clinical narrative: Systemic: Dizziness / Lightheadness-Severe, Systemic: Flushed / Sweating-Severe, Systemic: Hypotension-Severe, Systemic: Nausea-Severe, Systemic: Numbness (specify: facial area, extremities)-Severe, Systemic: Vomiting-Severe, Additional Details: She became lightheaded, dizzy and hypotensive as measured by BP cuff. She looked pale and also mentioned that her hands felt numb. I had her put her legs up, gave her water, offered Tylenol & Benadryl but patient was too nauseous. Patient then vomited, color came back to her face and she immediately felt much better. I kept her here to observe & suggested a salty snack to help with BP. When she felt better & after a snack, I retook her blood pressure and it had improved.
Age: 14.0
Sex: F
Vaccine: COVID19-2
Symptoms: Vomiting
Clinical narrative: Systemic: Dizziness / Lightheadness-Severe, Systemic: Flushed / Sweating-Severe, Systemic: Hypotension-Severe, Systemic: Nausea-Severe, Systemic: Numbness (specify: facial area, extremities)-Severe, Systemic: Vomiting-Severe, Additional Details: She became lightheaded, dizzy and hypotensive as measured by BP cuff. She looked pale and also mentioned that her hands felt numb. I had her put her legs up, gave her water, offered Tylenol & Benadryl but patient was too nauseous. Patient then vomited, color came back to her face and she immediately felt much better. I kept her here to observe & suggested a salty snack to help with BP. When she felt better & after a snack, I retook her blood pressure and it had improved.
Age: 77.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Pfizer 2/26/21, 3/19/21, 9/21/21, 4/2/22, 10/24/22. Positive on 12/16/22
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, COVID-19 pneumonia, Chronic obstructive pulmonary disease, Condition aggravated, Diabetic neuropathy
Clinical narrative: Discharge Provider: MD  Primary Care Provider : DO    Admission Date: 12/13/2022 Discharge Date: 12/17/2022  COVID positive Date 12/13/2022   CONDITION ON DISCHARGE: Stable and improved. Home Health Care Svc    HOSPITAL COURSE:   Admitted for COVID pneumonia, complicated by Pulmonary fibrosis and COPD. Had full course of remdesivir. History of long intubation and prolonged recovery from covid at the start of the pandemic.   Also: recent intramedullary nail left femur (October), HTN, DM2 with neuropathy, HLD, Osteoporosis, Recurrent UTIs
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Hyperlipidaemia, Hypertension, Intramedullary rod insertion, Osteoporosis, Pulmonary fibrosis
Clinical narrative: Discharge Provider: MD  Primary Care Provider : DO    Admission Date: 12/13/2022 Discharge Date: 12/17/2022  COVID positive Date 12/13/2022   CONDITION ON DISCHARGE: Stable and improved. Home Health Care Svc    HOSPITAL COURSE:   Admitted for COVID pneumonia, complicated by Pulmonary fibrosis and COPD. Had full course of remdesivir. History of long intubation and prolonged recovery from covid at the start of the pandemic.   Also: recent intramedullary nail left femur (October), HTN, DM2 with neuropathy, HLD, Osteoporosis, Recurrent UTIs
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Type 2 diabetes mellitus, Urinary tract infection
Clinical narrative: Discharge Provider: MD  Primary Care Provider : DO    Admission Date: 12/13/2022 Discharge Date: 12/17/2022  COVID positive Date 12/13/2022   CONDITION ON DISCHARGE: Stable and improved. Home Health Care Svc    HOSPITAL COURSE:   Admitted for COVID pneumonia, complicated by Pulmonary fibrosis and COPD. Had full course of remdesivir. History of long intubation and prolonged recovery from covid at the start of the pandemic.   Also: recent intramedullary nail left femur (October), HTN, DM2 with neuropathy, HLD, Osteoporosis, Recurrent UTIs
Age: 63.0
Sex: F
Vaccine: HEPA, IPV, MNQ, TYP
Symptoms: Dyspnoea, Erythema, Flushing, Pruritus, Urticaria
Clinical narrative: Pt came into the clinic for a travel consult. Pt received Menveo, Typhoid, IPV(Polio), and Hepatitis A #1 vaccine. Post vaccination pt was instructed to wait in the lobby for 15 minutes. While the pt was in the lobby, 10 minutes post vaccine administration, pt c/o itching all over the body. Pt went up to receptionist to report symptoms. Receptionist informed RN to check on pt. Upon assessment, pt noted to be flushed, with redness in face and pt c/o itching all over, and visible hives noted on neck, arms, chest, clavicle area and back. Pt denied SOB or trouble breathing. Pt assisted to exam room, and alerted another RN, and MD for further assessment/evaluation. After a couple of minutes in exam room, pt stated, "something in my throat/itching", and RN noted hives spreading all over face and body. MD was notified, and in room, and Adult Epi Pen(0.3mg) administered IM. Vital Signs were taken, Code was called at the same time as Epi Pen was administered.  1 minute after Epi Pen was administered, pt stated that her throat sensation is improving. Pt also reported that her itching was improving.  Code team arrived 2 minutes after Epi pen was administered. Ambulance was called at the same time. Pt was stable, and paramedics assisted pt to gurney and was transferred to ER via an ambulance for further evaluation.
Age: 45.0
Sex: F
Vaccine: COVID19
Symptoms: Antral follicle count low, Heavy menstrual bleeding, Joint stiffness, Menstruation irregular, Mobility decreased
Clinical narrative: Post Dose #1 on 8/25/22, my menstrual cycle came 2 weeks early. I am regular at 28 days usually. I was in the midst of fertility treatment IUI cycle. I had taken clomid to induce follicle growth in my ovaries. On monitoring visit prior I had 2-3 follicles growing. After the second vaccine my follicles ceased and there was no growth and my fertility cycle was canceled. My menstrual cycles were off for the months of September, October and November with extremely heavy bleeding day 1-3, bleeding through feminine products despite changing them every 1-2 hours, bleeding through products at night with accidents, then moderate on day 4 then suddenly stopped. Normally my cycle is 6 days. Day 1 is moderate, day 2-3 is heavy but not bleeding through feminine products, and I haven?t had an ?accident? in over 30 years, then light for day 4, day 5 is moderate again then tapers off during day 6, and can have sone slow taper/spitting into day 7.  In addition, all my joints felt stiff. I couldn?t even bend my leg to wash the bottom of my feet for over 2 weeks. I still feel very stiff but can bend my legs more now
Age: 45.0
Sex: F
Vaccine: COVID19
Symptoms: Ultrasound scan abnormal
Clinical narrative: Post Dose #1 on 8/25/22, my menstrual cycle came 2 weeks early. I am regular at 28 days usually. I was in the midst of fertility treatment IUI cycle. I had taken clomid to induce follicle growth in my ovaries. On monitoring visit prior I had 2-3 follicles growing. After the second vaccine my follicles ceased and there was no growth and my fertility cycle was canceled. My menstrual cycles were off for the months of September, October and November with extremely heavy bleeding day 1-3, bleeding through feminine products despite changing them every 1-2 hours, bleeding through products at night with accidents, then moderate on day 4 then suddenly stopped. Normally my cycle is 6 days. Day 1 is moderate, day 2-3 is heavy but not bleeding through feminine products, and I haven?t had an ?accident? in over 30 years, then light for day 4, day 5 is moderate again then tapers off during day 6, and can have sone slow taper/spitting into day 7.  In addition, all my joints felt stiff. I couldn?t even bend my leg to wash the bottom of my feet for over 2 weeks. I still feel very stiff but can bend my legs more now
Age: 86.0
Sex: M
Vaccine: COVID19-2
Symptoms: COVID-19, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: COVID vaccine breakthrough case
Age: 92.0
Sex: M
Vaccine: FLU4
Symptoms: Guillain-Barre syndrome, Malaise
Clinical narrative: Patient reports that approximately 15 days he attended his primary doctor because he did not feel well and received a diagnosis from Guillain-Barré.
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: Blood creatine phosphokinase, Blood magnesium, Blood test, C-reactive protein, Chest X-ray
Clinical narrative: Within two days of the injection, I felt both sharp and dull chest pain and tightness radiating through left shoulder, arm, back, neck and jaw. Exhaustion beyond the tiredness from previous two Modern vaccines. Shortness of breath. Dramatic reduction in ability to function beyond bedrest and going to the bathroom.
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: Chest discomfort, Chest pain, Dyspnoea, Echocardiogram, Electrocardiogram
Clinical narrative: Within two days of the injection, I felt both sharp and dull chest pain and tightness radiating through left shoulder, arm, back, neck and jaw. Exhaustion beyond the tiredness from previous two Modern vaccines. Shortness of breath. Dramatic reduction in ability to function beyond bedrest and going to the bathroom.
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Fibrin D dimer, Full blood count, Influenza A virus test, Influenza B virus test
Clinical narrative: Within two days of the injection, I felt both sharp and dull chest pain and tightness radiating through left shoulder, arm, back, neck and jaw. Exhaustion beyond the tiredness from previous two Modern vaccines. Shortness of breath. Dramatic reduction in ability to function beyond bedrest and going to the bathroom.
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: Loss of personal independence in daily activities, N-terminal prohormone brain natriuretic peptide, Pain, SARS-CoV-2 antibody test, Troponin T
Clinical narrative: Within two days of the injection, I felt both sharp and dull chest pain and tightness radiating through left shoulder, arm, back, neck and jaw. Exhaustion beyond the tiredness from previous two Modern vaccines. Shortness of breath. Dramatic reduction in ability to function beyond bedrest and going to the bathroom.
Age: 44.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Decreased appetite, Dry throat, Respiratory tract congestion, SARS-CoV-2 test positive
Clinical narrative: The only symptom I had was a dry throat and it was hard for me to eat,  I also had a little bit of congestion.
Age: 66.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Angiogram cerebral abnormal, Antithrombin III, Arteriogram carotid abnormal, Atrial septal defect, COVID-19
Clinical narrative: Patient with history of 2 COVID vaccines who admitted to hospital with COVID detected PCR.  Provider d/c note "67 YO female with PMH distant Hx DVT RLE (not on OAC), COPD, MDD, DM2, GERD, HLD, HTN who presents 12/7/22 with altered mentation secondary to tripping a week prior to presentation. She lost consciousness for about an hour. She reports right-sided weakness. She did not report any numbness or slurred speech. She was found to be covid positive. Neurological examination revealed BL LE weakness. MRI of the brain revealed acute to subacute bilateral ACA infarcts. TEE showed a small PFO and EF of 60-65%. CTA of the head and neck showed proximal occlusion of this azygos anterior cerebral artery variant. High-grade stenosis of the right vertebral artery ostium. Repeat CT head 12/10 showed evolving ischemic infarction, likely subacute, in the anterior cerebral artery distribution bilaterally. No evidence of hemorrhagic transformation. Anti-thrombin 3 was 99, factor VIII was 293. She was monitored in the hospital with serial neurochecks and treated with DAPT. She was evaluated by neurology who recommended DAPT for 90 days and after that to Dc ASA and continue Plavix, to continue Atorvastatin 40mg daily, and to pursue a 30 day event monitor to evaluate for arrythmias, as well as a heme outpatient workup. She improved clinically and was assessed to be appropriate for discharge to rehab on 12/15/2022   Neurological Exam on Day of discharge- AAOx3, Sensation intact in all dermatomes.  No asterixis present, cranial nerves intact. Finger to nose testing intact. Heel to shin slight deficit on left fully intact on right.slight motor deficit on left upper extremity."
Age: 66.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Cerebral artery occlusion, Cerebral infarction, Echocardiogram, Ejection fraction normal, Factor VIII activity test
Clinical narrative: Patient with history of 2 COVID vaccines who admitted to hospital with COVID detected PCR.  Provider d/c note "67 YO female with PMH distant Hx DVT RLE (not on OAC), COPD, MDD, DM2, GERD, HLD, HTN who presents 12/7/22 with altered mentation secondary to tripping a week prior to presentation. She lost consciousness for about an hour. She reports right-sided weakness. She did not report any numbness or slurred speech. She was found to be covid positive. Neurological examination revealed BL LE weakness. MRI of the brain revealed acute to subacute bilateral ACA infarcts. TEE showed a small PFO and EF of 60-65%. CTA of the head and neck showed proximal occlusion of this azygos anterior cerebral artery variant. High-grade stenosis of the right vertebral artery ostium. Repeat CT head 12/10 showed evolving ischemic infarction, likely subacute, in the anterior cerebral artery distribution bilaterally. No evidence of hemorrhagic transformation. Anti-thrombin 3 was 99, factor VIII was 293. She was monitored in the hospital with serial neurochecks and treated with DAPT. She was evaluated by neurology who recommended DAPT for 90 days and after that to Dc ASA and continue Plavix, to continue Atorvastatin 40mg daily, and to pursue a 30 day event monitor to evaluate for arrythmias, as well as a heme outpatient workup. She improved clinically and was assessed to be appropriate for discharge to rehab on 12/15/2022   Neurological Exam on Day of discharge- AAOx3, Sensation intact in all dermatomes.  No asterixis present, cranial nerves intact. Finger to nose testing intact. Heel to shin slight deficit on left fully intact on right.slight motor deficit on left upper extremity."
Age: 66.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Gait disturbance, Hemiparesis, Ischaemic cerebral infarction, Loss of consciousness, Magnetic resonance imaging head abnormal
Clinical narrative: Patient with history of 2 COVID vaccines who admitted to hospital with COVID detected PCR.  Provider d/c note "67 YO female with PMH distant Hx DVT RLE (not on OAC), COPD, MDD, DM2, GERD, HLD, HTN who presents 12/7/22 with altered mentation secondary to tripping a week prior to presentation. She lost consciousness for about an hour. She reports right-sided weakness. She did not report any numbness or slurred speech. She was found to be covid positive. Neurological examination revealed BL LE weakness. MRI of the brain revealed acute to subacute bilateral ACA infarcts. TEE showed a small PFO and EF of 60-65%. CTA of the head and neck showed proximal occlusion of this azygos anterior cerebral artery variant. High-grade stenosis of the right vertebral artery ostium. Repeat CT head 12/10 showed evolving ischemic infarction, likely subacute, in the anterior cerebral artery distribution bilaterally. No evidence of hemorrhagic transformation. Anti-thrombin 3 was 99, factor VIII was 293. She was monitored in the hospital with serial neurochecks and treated with DAPT. She was evaluated by neurology who recommended DAPT for 90 days and after that to Dc ASA and continue Plavix, to continue Atorvastatin 40mg daily, and to pursue a 30 day event monitor to evaluate for arrythmias, as well as a heme outpatient workup. She improved clinically and was assessed to be appropriate for discharge to rehab on 12/15/2022   Neurological Exam on Day of discharge- AAOx3, Sensation intact in all dermatomes.  No asterixis present, cranial nerves intact. Finger to nose testing intact. Heel to shin slight deficit on left fully intact on right.slight motor deficit on left upper extremity."
Age: 66.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Mental status changes, Motor dysfunction, Muscular weakness, Neurological examination abnormal, SARS-CoV-2 test positive
Clinical narrative: Patient with history of 2 COVID vaccines who admitted to hospital with COVID detected PCR.  Provider d/c note "67 YO female with PMH distant Hx DVT RLE (not on OAC), COPD, MDD, DM2, GERD, HLD, HTN who presents 12/7/22 with altered mentation secondary to tripping a week prior to presentation. She lost consciousness for about an hour. She reports right-sided weakness. She did not report any numbness or slurred speech. She was found to be covid positive. Neurological examination revealed BL LE weakness. MRI of the brain revealed acute to subacute bilateral ACA infarcts. TEE showed a small PFO and EF of 60-65%. CTA of the head and neck showed proximal occlusion of this azygos anterior cerebral artery variant. High-grade stenosis of the right vertebral artery ostium. Repeat CT head 12/10 showed evolving ischemic infarction, likely subacute, in the anterior cerebral artery distribution bilaterally. No evidence of hemorrhagic transformation. Anti-thrombin 3 was 99, factor VIII was 293. She was monitored in the hospital with serial neurochecks and treated with DAPT. She was evaluated by neurology who recommended DAPT for 90 days and after that to Dc ASA and continue Plavix, to continue Atorvastatin 40mg daily, and to pursue a 30 day event monitor to evaluate for arrythmias, as well as a heme outpatient workup. She improved clinically and was assessed to be appropriate for discharge to rehab on 12/15/2022   Neurological Exam on Day of discharge- AAOx3, Sensation intact in all dermatomes.  No asterixis present, cranial nerves intact. Finger to nose testing intact. Heel to shin slight deficit on left fully intact on right.slight motor deficit on left upper extremity."
Age: 66.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Vertebral artery stenosis
Clinical narrative: Patient with history of 2 COVID vaccines who admitted to hospital with COVID detected PCR.  Provider d/c note "67 YO female with PMH distant Hx DVT RLE (not on OAC), COPD, MDD, DM2, GERD, HLD, HTN who presents 12/7/22 with altered mentation secondary to tripping a week prior to presentation. She lost consciousness for about an hour. She reports right-sided weakness. She did not report any numbness or slurred speech. She was found to be covid positive. Neurological examination revealed BL LE weakness. MRI of the brain revealed acute to subacute bilateral ACA infarcts. TEE showed a small PFO and EF of 60-65%. CTA of the head and neck showed proximal occlusion of this azygos anterior cerebral artery variant. High-grade stenosis of the right vertebral artery ostium. Repeat CT head 12/10 showed evolving ischemic infarction, likely subacute, in the anterior cerebral artery distribution bilaterally. No evidence of hemorrhagic transformation. Anti-thrombin 3 was 99, factor VIII was 293. She was monitored in the hospital with serial neurochecks and treated with DAPT. She was evaluated by neurology who recommended DAPT for 90 days and after that to Dc ASA and continue Plavix, to continue Atorvastatin 40mg daily, and to pursue a 30 day event monitor to evaluate for arrythmias, as well as a heme outpatient workup. She improved clinically and was assessed to be appropriate for discharge to rehab on 12/15/2022   Neurological Exam on Day of discharge- AAOx3, Sensation intact in all dermatomes.  No asterixis present, cranial nerves intact. Finger to nose testing intact. Heel to shin slight deficit on left fully intact on right.slight motor deficit on left upper extremity."
Age: 41.0
Sex: F
Vaccine: COVID19-2
Symptoms: No adverse event, Underdose
Clinical narrative: Patient who is an adult was given 0.25mL of the Moderna Bivalent COVID booster vaccine, which is less than the authorized dose of 0.50mL.  No adverse events were noted at the time of the administration.
Age: 61.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Anticoagulant therapy, Atrial fibrillation, COVID-19, Cardiac pacemaker insertion, Cardiac pacemaker removal
Clinical narrative: Patient with history of 3 COVID vaccines who was found to be COVID detected during stay.  "62 year old male s/p traumatic fall from second story roof (~12 feet) onto his face. The patient presented via ambulance with GCS 6; intubated in ED for airway protection.  Incidentally found to be COVID positive. Noted injuries below. Patient was extubated on hospital day three (12/7). He was diagnosed with pulmonary embolism in the right upper lobe on hospital day 5. Given his head bleeds. Neurosurgery recommended continuing heparin SQ BID until stable head CT on 12/15. The patient was then transitioned to xarelto and a repeat head CT showed head bleeds to remain stable. During the patient's stay, he developed symptomatic junctional bradycardia. A temporary pacemaker was placed and eventually removed. The patient also developed atrial fibrillation with RVR and was placed on lopressor and propafenone. During the patient's stay he did have hypokalemia. This resolved after transitioning from chlorthalidone to spironolactone. The patient eventually was discharged in stable condition. The patient was discharged with 30 days total of xarelto; xarelto 15mg BID x 21 days total followed by xarelto 20mg QD.  He was also discharged with Rythmol x 14 days and spironolactone x 14 days. He will follow up Cardiology, as well as with his PCP for management of his medications. "
Age: 61.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Cerebral haemorrhage, Coma scale, Computerised tomogram head abnormal, Endotracheal intubation, Extubation
Clinical narrative: Patient with history of 3 COVID vaccines who was found to be COVID detected during stay.  "62 year old male s/p traumatic fall from second story roof (~12 feet) onto his face. The patient presented via ambulance with GCS 6; intubated in ED for airway protection.  Incidentally found to be COVID positive. Noted injuries below. Patient was extubated on hospital day three (12/7). He was diagnosed with pulmonary embolism in the right upper lobe on hospital day 5. Given his head bleeds. Neurosurgery recommended continuing heparin SQ BID until stable head CT on 12/15. The patient was then transitioned to xarelto and a repeat head CT showed head bleeds to remain stable. During the patient's stay, he developed symptomatic junctional bradycardia. A temporary pacemaker was placed and eventually removed. The patient also developed atrial fibrillation with RVR and was placed on lopressor and propafenone. During the patient's stay he did have hypokalemia. This resolved after transitioning from chlorthalidone to spironolactone. The patient eventually was discharged in stable condition. The patient was discharged with 30 days total of xarelto; xarelto 15mg BID x 21 days total followed by xarelto 20mg QD.  He was also discharged with Rythmol x 14 days and spironolactone x 14 days. He will follow up Cardiology, as well as with his PCP for management of his medications. "
Age: 61.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Face injury, Fall, Hypokalaemia, Injury, Nodal arrhythmia
Clinical narrative: Patient with history of 3 COVID vaccines who was found to be COVID detected during stay.  "62 year old male s/p traumatic fall from second story roof (~12 feet) onto his face. The patient presented via ambulance with GCS 6; intubated in ED for airway protection.  Incidentally found to be COVID positive. Noted injuries below. Patient was extubated on hospital day three (12/7). He was diagnosed with pulmonary embolism in the right upper lobe on hospital day 5. Given his head bleeds. Neurosurgery recommended continuing heparin SQ BID until stable head CT on 12/15. The patient was then transitioned to xarelto and a repeat head CT showed head bleeds to remain stable. During the patient's stay, he developed symptomatic junctional bradycardia. A temporary pacemaker was placed and eventually removed. The patient also developed atrial fibrillation with RVR and was placed on lopressor and propafenone. During the patient's stay he did have hypokalemia. This resolved after transitioning from chlorthalidone to spironolactone. The patient eventually was discharged in stable condition. The patient was discharged with 30 days total of xarelto; xarelto 15mg BID x 21 days total followed by xarelto 20mg QD.  He was also discharged with Rythmol x 14 days and spironolactone x 14 days. He will follow up Cardiology, as well as with his PCP for management of his medications. "
Age: 61.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Pulmonary embolism, SARS-CoV-2 test positive
Clinical narrative: Patient with history of 3 COVID vaccines who was found to be COVID detected during stay.  "62 year old male s/p traumatic fall from second story roof (~12 feet) onto his face. The patient presented via ambulance with GCS 6; intubated in ED for airway protection.  Incidentally found to be COVID positive. Noted injuries below. Patient was extubated on hospital day three (12/7). He was diagnosed with pulmonary embolism in the right upper lobe on hospital day 5. Given his head bleeds. Neurosurgery recommended continuing heparin SQ BID until stable head CT on 12/15. The patient was then transitioned to xarelto and a repeat head CT showed head bleeds to remain stable. During the patient's stay, he developed symptomatic junctional bradycardia. A temporary pacemaker was placed and eventually removed. The patient also developed atrial fibrillation with RVR and was placed on lopressor and propafenone. During the patient's stay he did have hypokalemia. This resolved after transitioning from chlorthalidone to spironolactone. The patient eventually was discharged in stable condition. The patient was discharged with 30 days total of xarelto; xarelto 15mg BID x 21 days total followed by xarelto 20mg QD.  He was also discharged with Rythmol x 14 days and spironolactone x 14 days. He will follow up Cardiology, as well as with his PCP for management of his medications. "
Age: 73.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Asthenia, Balance disorder, Dysstasia, Gait inability
Clinical narrative: Patient was seen in the ER by Dr. for c/o general weakness and the inability to walk or stand.  He was placed on our general ward under the care of Dr. with a Dx of unsteadiness on feet.
Age: 61.0
Sex: M
Vaccine: VARZOS
Symptoms: Chills, Hyperhidrosis, Pain, Pyrexia
Clinical narrative: Chills, sweats, tiredness, and aches. Mild fever.
Age: 70.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: C-reactive protein increased, COVID-19, Corynebacterium test positive, Culture wound positive, Enterococcus test positive
Clinical narrative: Patient with history of 3 COVID vaccines who admitted with COVID detected PCR.  Provider d/c note:  "71 year old male with past medical history AS s/p TAVR, Afib s/p PVI and ablation, CHF s/p PPM, DM2, hx DVT, ESRD on HD MWF, FSGS, hypothyroidism, OSA, hx R BKA who presented to the ED on 12/15 with worsening wound on the L 5th digit for 2-3 months. Patient follows with o/p wound care who had attempted multiple courses of antibiotics. Had o/p XR of digit prior to ED visit which demonstrated swelling and ulcer of distal finger, suspicious for osteomyelitis. Labs significant for Hgb 12.8 (at baseline), ESR 73, CRP 4.4, LA 2.6, INR 4.5. Last took coumadin on 12/13, INR was 8.0, holding. In the ED, patient started on vancomycin and cefepime. Receiving HD on 12/16. Hand surgeon consulted, reviewed XR and does not believe patient has osteomyelitis. Plan to continue managing patient non-operatively at this time with follow-up appointment on 12/19. Nephrology consulted for ESRD on HD. Wound care consulted for R BKA draining and chronic LLE wounds.  Medical team consulted for wound cultures growing Proteus Vulgaris, E. Faecalis, Corynebacterium Striatum. Upon review of the case and imaging, medical team recommends 6 weeks of oral antibiotics with ciprofloxacin 500 mg daily and amoxicillin 500 mg q12h with medical team follow up in 4 weeks. He was otherwise medically optimized and discharged in stable condition.   Necrotic wound of L 5th digit - Follow-up appointment with hand surgeon on 12/19 - Start taking ciprofloxacin 500 mg daily and amoxicillin 500 mg twice daily for 6 weeks - follow up in clinic in 4 weeks   Afib Elevated INR - Last dose warfarin 12/13 d/t elevated INR 8.0 - Currently INR 3.4, planning to give 3mg tablet - Continue home warfarin at discharge   Issues Requiring Follow Up:  Medical team for antibiotics, treatment of necrotic wound Hand Surgery for further evaluation of necrotic L 5th digit wound"
Age: 70.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Haemodialysis, Haemoglobin decreased, International normalised ratio increased, Limb injury, Peripheral swelling
Clinical narrative: Patient with history of 3 COVID vaccines who admitted with COVID detected PCR.  Provider d/c note:  "71 year old male with past medical history AS s/p TAVR, Afib s/p PVI and ablation, CHF s/p PPM, DM2, hx DVT, ESRD on HD MWF, FSGS, hypothyroidism, OSA, hx R BKA who presented to the ED on 12/15 with worsening wound on the L 5th digit for 2-3 months. Patient follows with o/p wound care who had attempted multiple courses of antibiotics. Had o/p XR of digit prior to ED visit which demonstrated swelling and ulcer of distal finger, suspicious for osteomyelitis. Labs significant for Hgb 12.8 (at baseline), ESR 73, CRP 4.4, LA 2.6, INR 4.5. Last took coumadin on 12/13, INR was 8.0, holding. In the ED, patient started on vancomycin and cefepime. Receiving HD on 12/16. Hand surgeon consulted, reviewed XR and does not believe patient has osteomyelitis. Plan to continue managing patient non-operatively at this time with follow-up appointment on 12/19. Nephrology consulted for ESRD on HD. Wound care consulted for R BKA draining and chronic LLE wounds.  Medical team consulted for wound cultures growing Proteus Vulgaris, E. Faecalis, Corynebacterium Striatum. Upon review of the case and imaging, medical team recommends 6 weeks of oral antibiotics with ciprofloxacin 500 mg daily and amoxicillin 500 mg q12h with medical team follow up in 4 weeks. He was otherwise medically optimized and discharged in stable condition.   Necrotic wound of L 5th digit - Follow-up appointment with hand surgeon on 12/19 - Start taking ciprofloxacin 500 mg daily and amoxicillin 500 mg twice daily for 6 weeks - follow up in clinic in 4 weeks   Afib Elevated INR - Last dose warfarin 12/13 d/t elevated INR 8.0 - Currently INR 3.4, planning to give 3mg tablet - Continue home warfarin at discharge   Issues Requiring Follow Up:  Medical team for antibiotics, treatment of necrotic wound Hand Surgery for further evaluation of necrotic L 5th digit wound"
Age: 70.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Proteus test positive, Red blood cell sedimentation rate increased, SARS-CoV-2 test positive, Skin ulcer, Wound necrosis
Clinical narrative: Patient with history of 3 COVID vaccines who admitted with COVID detected PCR.  Provider d/c note:  "71 year old male with past medical history AS s/p TAVR, Afib s/p PVI and ablation, CHF s/p PPM, DM2, hx DVT, ESRD on HD MWF, FSGS, hypothyroidism, OSA, hx R BKA who presented to the ED on 12/15 with worsening wound on the L 5th digit for 2-3 months. Patient follows with o/p wound care who had attempted multiple courses of antibiotics. Had o/p XR of digit prior to ED visit which demonstrated swelling and ulcer of distal finger, suspicious for osteomyelitis. Labs significant for Hgb 12.8 (at baseline), ESR 73, CRP 4.4, LA 2.6, INR 4.5. Last took coumadin on 12/13, INR was 8.0, holding. In the ED, patient started on vancomycin and cefepime. Receiving HD on 12/16. Hand surgeon consulted, reviewed XR and does not believe patient has osteomyelitis. Plan to continue managing patient non-operatively at this time with follow-up appointment on 12/19. Nephrology consulted for ESRD on HD. Wound care consulted for R BKA draining and chronic LLE wounds.  Medical team consulted for wound cultures growing Proteus Vulgaris, E. Faecalis, Corynebacterium Striatum. Upon review of the case and imaging, medical team recommends 6 weeks of oral antibiotics with ciprofloxacin 500 mg daily and amoxicillin 500 mg q12h with medical team follow up in 4 weeks. He was otherwise medically optimized and discharged in stable condition.   Necrotic wound of L 5th digit - Follow-up appointment with hand surgeon on 12/19 - Start taking ciprofloxacin 500 mg daily and amoxicillin 500 mg twice daily for 6 weeks - follow up in clinic in 4 weeks   Afib Elevated INR - Last dose warfarin 12/13 d/t elevated INR 8.0 - Currently INR 3.4, planning to give 3mg tablet - Continue home warfarin at discharge   Issues Requiring Follow Up:  Medical team for antibiotics, treatment of necrotic wound Hand Surgery for further evaluation of necrotic L 5th digit wound"
Age: 70.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: X-ray limb abnormal
Clinical narrative: Patient with history of 3 COVID vaccines who admitted with COVID detected PCR.  Provider d/c note:  "71 year old male with past medical history AS s/p TAVR, Afib s/p PVI and ablation, CHF s/p PPM, DM2, hx DVT, ESRD on HD MWF, FSGS, hypothyroidism, OSA, hx R BKA who presented to the ED on 12/15 with worsening wound on the L 5th digit for 2-3 months. Patient follows with o/p wound care who had attempted multiple courses of antibiotics. Had o/p XR of digit prior to ED visit which demonstrated swelling and ulcer of distal finger, suspicious for osteomyelitis. Labs significant for Hgb 12.8 (at baseline), ESR 73, CRP 4.4, LA 2.6, INR 4.5. Last took coumadin on 12/13, INR was 8.0, holding. In the ED, patient started on vancomycin and cefepime. Receiving HD on 12/16. Hand surgeon consulted, reviewed XR and does not believe patient has osteomyelitis. Plan to continue managing patient non-operatively at this time with follow-up appointment on 12/19. Nephrology consulted for ESRD on HD. Wound care consulted for R BKA draining and chronic LLE wounds.  Medical team consulted for wound cultures growing Proteus Vulgaris, E. Faecalis, Corynebacterium Striatum. Upon review of the case and imaging, medical team recommends 6 weeks of oral antibiotics with ciprofloxacin 500 mg daily and amoxicillin 500 mg q12h with medical team follow up in 4 weeks. He was otherwise medically optimized and discharged in stable condition.   Necrotic wound of L 5th digit - Follow-up appointment with hand surgeon on 12/19 - Start taking ciprofloxacin 500 mg daily and amoxicillin 500 mg twice daily for 6 weeks - follow up in clinic in 4 weeks   Afib Elevated INR - Last dose warfarin 12/13 d/t elevated INR 8.0 - Currently INR 3.4, planning to give 3mg tablet - Continue home warfarin at discharge   Issues Requiring Follow Up:  Medical team for antibiotics, treatment of necrotic wound Hand Surgery for further evaluation of necrotic L 5th digit wound"
Age: 48.0
Sex: F
Vaccine: COVID19-2
Symptoms: Heart rate increased, Palpitations
Clinical narrative: Heart rate 197 bpm and heart palpitations which subsided as of 12/20/22
Age: 38.0
Sex: M
Vaccine: COVID19-2
Symptoms: No adverse event, Underdose
Clinical narrative: Patient who is an adult was given 0.25mL of the Moderna Bivalent COVID booster vaccine, which is less than the authorized dose of 0.50mL.  No adverse events were noted at the time of the administration.
Age: 74.0
Sex: F
Vaccine: COVID19-2
Symptoms: COVID-19, Malaise, Oropharyngeal pain, Pain in extremity, Pyrexia
Clinical narrative: After the vaccination, my arm was sore for a day. On 11/27/2022, I began not feeling well with a runny nose, sore throat chest congestion and a fever. On 11/29/2022, I tested positive for COVID-19 with a home test. I contacted my doctor and I had to insist for the prescription Paxlovid. The doctor did not recommend the medication because of the side effects and the potential to rebound. I did not have any side effects and I did not rebound.
Age: 74.0
Sex: F
Vaccine: COVID19-2
Symptoms: Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive
Clinical narrative: After the vaccination, my arm was sore for a day. On 11/27/2022, I began not feeling well with a runny nose, sore throat chest congestion and a fever. On 11/29/2022, I tested positive for COVID-19 with a home test. I contacted my doctor and I had to insist for the prescription Paxlovid. The doctor did not recommend the medication because of the side effects and the potential to rebound. I did not have any side effects and I did not rebound.