chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 0.4
Sex: M
Vaccine: DTAPIPVHIB, PNC, RV1
Symptoms: Blister, Erythema, Skin exfoliation, Stevens-Johnson syndrome
Clinical narrative: This serious case was received on 01 April 2009 from a health care professional. A 5 month old male patient received PENTACEL (lot number C3188AA), ROTARIX (manufacturer GSK, lot number A41DA693A), and PREVNAR (manufacturer Wyeth, lot number D37016) on 01 April 2009 at 10:45 AM. On 29 January 2009 the patient received a first dose of PENTACEL and on 23 January 2009 first dose of ROTARIX, PREVNAR, and Hep B (lot numbers were not reported). Concomitant therapy included PREVACID. On 01 April 2009 at 1:30 PM the patient developed a big red area on the neck with white blisters and both knees and thighs were bright red with purple blisters and peeling skin. He went to the physician's office and the patient was subsequently admitted to the hospital. The reporter stated that the patient had "JOHNSON syndrome". The recovery status was not reported. List of Documents held by Sender: None.
Age: 24.0
Sex: F
Vaccine: HPV4, HPV4
Symptoms: Full blood count normal, Injected limb mobility decreased, Musculoskeletal pain, Nuclear magnetic resonance imaging abnormal, Pain in extremity
Clinical narrative: Information has been received from a nurse practitioner concerning a 24 year old female who on 18-FEB-2009 was vaccinated with her second dose of GARDASIL (lot number, route and site not reported). On 18-FEB-2009 when she received this vaccination it was noted that the vaccine was "hard to inject". The patient's left arm became "quite sore" and it became hard for her to raise her arm. She had "deep discomfort". On 26-FEB-2009 the patient was seen by the NP continuing symptoms, sleep problems and pain in the front of her shoulder. An X-ray was negative. A magnetic resonance imaging reported reabsorption in the humeral head and a tiny partial thickness tear of the distal tendon. The diagnosis was possible vaccine injection into the bone. Her complete blood count was normal. The patient also reported less intense pain after her first dose vaccination with GARDASIL (lot number, route and site not reported). The patient did not recover at the time of reporting. Possible vaccine injection into the bone, left arm quite sore, sleep problems and pain in the front of her shoulder were considered to be disabling. Additional information has been requested. 5/12/09 PCP records received. In for routine GYN exam 2/18/09 with normal PE. HPV#2 given in L arm. RN reported injection was difficult.   RTC 2/26/09 with c/o worsening arm soreness, now difficult to raise. Pain with ROM on exam, otherwise WNL. tx: ice, NSAIDS.  RTC 3/16/09 with continued c/o arm pain, now disturbing sleep. Now localized to front of shoulder joint. Sent for X-rays/MRI which showed a partial bursal side thickness tear of the distal supraspinatus tendon and a partial thickness tear of distal infraspinatus tendon.  Assess:  Pain in Limb.
Age: 24.0
Sex: F
Vaccine: HPV4, HPV4
Symptoms: Similar reaction on previous exposure to drug, Sleep disorder, Tendon injury, Wrong technique in drug usage process, X-ray normal
Clinical narrative: Information has been received from a nurse practitioner concerning a 24 year old female who on 18-FEB-2009 was vaccinated with her second dose of GARDASIL (lot number, route and site not reported). On 18-FEB-2009 when she received this vaccination it was noted that the vaccine was "hard to inject". The patient's left arm became "quite sore" and it became hard for her to raise her arm. She had "deep discomfort". On 26-FEB-2009 the patient was seen by the NP continuing symptoms, sleep problems and pain in the front of her shoulder. An X-ray was negative. A magnetic resonance imaging reported reabsorption in the humeral head and a tiny partial thickness tear of the distal tendon. The diagnosis was possible vaccine injection into the bone. Her complete blood count was normal. The patient also reported less intense pain after her first dose vaccination with GARDASIL (lot number, route and site not reported). The patient did not recover at the time of reporting. Possible vaccine injection into the bone, left arm quite sore, sleep problems and pain in the front of her shoulder were considered to be disabling. Additional information has been requested. 5/12/09 PCP records received. In for routine GYN exam 2/18/09 with normal PE. HPV#2 given in L arm. RN reported injection was difficult.   RTC 2/26/09 with c/o worsening arm soreness, now difficult to raise. Pain with ROM on exam, otherwise WNL. tx: ice, NSAIDS.  RTC 3/16/09 with continued c/o arm pain, now disturbing sleep. Now localized to front of shoulder joint. Sent for X-rays/MRI which showed a partial bursal side thickness tear of the distal supraspinatus tendon and a partial thickness tear of distal infraspinatus tendon.  Assess:  Pain in Limb.
Age: 24.0
Sex: F
Vaccine: HPV4, HPV4
Symptoms: Nuclear magnetic resonance imaging, Pain in extremity, Wrong technique in drug usage process
Clinical narrative: Information has been received from a nurse practitioner concerning a 24 year old female who on 18-FEB-2009 was vaccinated with her second dose of GARDASIL (lot number, route and site not reported). On 18-FEB-2009 when she received this vaccination it was noted that the vaccine was "hard to inject". The patient's left arm became "quite sore" and it became hard for her to raise her arm. She had "deep discomfort". On 26-FEB-2009 the patient was seen by the NP continuing symptoms, sleep problems and pain in the front of her shoulder. An X-ray was negative. A magnetic resonance imaging reported reabsorption in the humeral head and a tiny partial thickness tear of the distal tendon. The diagnosis was possible vaccine injection into the bone. Her complete blood count was normal. The patient also reported less intense pain after her first dose vaccination with GARDASIL (lot number, route and site not reported). The patient did not recover at the time of reporting. Possible vaccine injection into the bone, left arm quite sore, sleep problems and pain in the front of her shoulder were considered to be disabling. Additional information has been requested. 5/12/09 PCP records received. In for routine GYN exam 2/18/09 with normal PE. HPV#2 given in L arm. RN reported injection was difficult.   RTC 2/26/09 with c/o worsening arm soreness, now difficult to raise. Pain with ROM on exam, otherwise WNL. tx: ice, NSAIDS.  RTC 3/16/09 with continued c/o arm pain, now disturbing sleep. Now localized to front of shoulder joint. Sent for X-rays/MRI which showed a partial bursal side thickness tear of the distal supraspinatus tendon and a partial thickness tear of distal infraspinatus tendon.  Assess:  Pain in Limb.
Sex: U
Vaccine: RV5
Symptoms: Cardiac arrest, Resuscitation
Clinical narrative: Information has been received from a physician concerning a patient who was vaccinated with ROTATEQ (lot number not reported) oral. Subsequently the patient's heart stopped. The patient was resuscitated in the office. The patient recovered from heart stopped. The patient's heart stopped was considered as an other important event by the physician since resuscitation was required. Additional information has been requested.
Age: 2.0
Sex: U
Vaccine: RV5
Symptoms: Rotavirus infection
Clinical narrative: Information has been received from a physician concerning a 2-3 year old patient who was vaccinated with ROTATEQ (lot number not reported) oral. Subsequently the patient was hospitalized with rotavirus. It was unknown that the patient received how many 2ml doses of ROTATEQ. Additional information has been requested.
Age: 24.0
Sex: F
Vaccine: FLU3, MMR, TD, VARCEL
Symptoms: Condition aggravated, Convulsion, Grand mal convulsion, Head injury
Clinical narrative: Seizure - Full clonic/tonic 1 hr 45 minutes after receiving routine immunizations - Family describes today's episode the same as in the past (same seizure activity). Ambulance called to take Pt. to hospital because she hit her head on wall at onset of seizure.  4/14/09 Received Clinic & ER medical records for 4/1/09 & 4/3/09. FINAL DX: Seizure disorder Records reveal patient experienced unwitnessed siezure in clinic lobby, hit head on wall, tonic clonic movements of arms & stiff legs x approx 15 secs.  Afterward was back to baseline of minimally responsive & nonverbal per family who also states this episode is her typical seizure.  Had been out of meds x 3 wks since arrival from out of country.  PE revealed contracted UE & LE, multi dental caries.  Tx w/meds & referred to neuro on d/c to home.
Age: 1.34
Sex: F
Vaccine: DTAP, HEP, VARCEL
Symptoms: Erythema multiforme, Full blood count, Pyrexia, Red blood cell sedimentation rate
Clinical narrative: Fever 2 days after vaccine. Hospitalized 1 week after with erythema multiforme. 2 weeks after in ER with transient synovitis and fever.  Hospital records of 3/27/-3/28/2009. FINAL DX: no d/c summary dictated.  H&P states probable erythema multiforme; fever. Records reveal patient experienced rash all over x 1 day, fever, decreased activity, & swelling of extremities x several days.  Peds consult done & admitted.  Was on amoxicillin for OM at that time & amoxicillin d/c.  Tx w/antihistamine had no effect.  Admitted for observation, tx w/steroids & antihistamine.  Remained stable & d/c to home.  4/20/09 Received ER medical records of 4/7/2009. FINAL DX: toxic synovitis; URI, viral. Records reveal patient experienced fever, runny nose, cough, congestion x 2 days & right leg pain & limping x 1 day.  Fever in ER 101.8, heart rate 135.
Age: 1.0
Sex: M
Vaccine: HEPA, MMR, PNC, VARCEL
Clinical narrative: Erythema multiforme major possible KAWASAKI's Disease.  4/27/09 MR received for DOS 3/24-28/2009 with D/C DX:  Erythema multiforme major s/p amoxicillin use.  Possible MMR rxn.  Possible Kawasaki's disease. Pt admitted from PCP's office with fever, diffuse body rash and red, cracked lips.  Noted to be dehydrated on admission. Initially thought to be Stevens-Johnson syndrome. Concern for Kawasaki's so started on ASA and IVIG. Pt became afebrile and rash resolving. Some desquamation on the palms.
Age: 0.51
Sex: F
Vaccine: DTAP, IPV, PNC, RV5
Symptoms: Developmental delay, Electroencephalogram abnormal, Infantile spasms, Irritability, Speech disorder developmental
Clinical narrative: Infantile spasms started on the 3rd day after vaccinations and progressed. Diagnosed in January 2009, being treated with medications (TOPAMAX, B6). Led to developmental delays.  4/27/09 MR received for DOS 1/6-8/2009 with D/C DX:  Seizures, likely infantile spasms. Pt presented with 6 month hx of arm jerking with central core stiffening, which have recently increased in severity and number. Parents report pt is sometimes sleepy afterwards and has been increasingly irritable lately and babbling less. Admission PE WNL. Admitted for W/u. 5/12/10 Delayed developement (receiving special ed. services). Still on seizure meds, speech delay.
Age: 64.0
Sex: F
Vaccine: VARZOS
Symptoms: Injection site erythema, Injection site haematoma, Injection site induration, Injection site swelling
Clinical narrative: T=99.7 swelling, induration + erythema at injection site - induration 4X5cm; erythema 12 X 8 1/2 cm with some bruising onset at approximately 3hrs after injection these findings 3days after injection -> Rx w/ Benadryl, application ice + Tylenol.
Age: 18.0
Sex: F
Vaccine: TDAP
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Vomiting
Clinical narrative: 3/20/2009 swelling, redness and pain at site 9 hrs after shot. Also vomiting. Patient called MD on 3/25/09 regarding above instructed to take Ibuprofen and PEPTO BISMOL, put ice on site. 3/26/09 no further vomiting. Swelling and pain decreased.
Age: 64.0
Sex: F
Vaccine: MEN
Symptoms: Headache, Heart rate increased, Injection site discolouration, Injection site erythema, Injection site mass
Clinical narrative: Within 2 hrs of vaccination, Pt developed "big knot" at the injection site, and the site turned blue.  Heart rate became elevated.  She had bad headache that evening.  The next day, injection site was red and warm, heart rate normal.  Arm remained bruised and tender for 3 weeks.
Age: 64.0
Sex: F
Vaccine: MEN
Symptoms: Injection site swelling, Injection site warmth
Clinical narrative: Within 2 hrs of vaccination, Pt developed "big knot" at the injection site, and the site turned blue.  Heart rate became elevated.  She had bad headache that evening.  The next day, injection site was red and warm, heart rate normal.  Arm remained bruised and tender for 3 weeks.
Age: 14.0
Sex: M
Vaccine: HEPA, MNQ, TDAP, VARCEL
Symptoms: Dizziness, Pain, Palpitations, Pyrexia
Clinical narrative: Called 3-27-09 with c/o dizziness, pain, racing heartbeat & fever.  (did not know how high).  Too dizzy to stand up.  Person suggested they go to urgent care.  They did not.  Called to check on home 3-31-09- says is fine now.
Age: 45.0
Sex: F
Vaccine: FLU3, HEP, MMR, TDAP
Symptoms: Contusion, Erythema, Oedema peripheral
Clinical narrative: Pt came into clinic after shots for immigration.  She was given a Tdap and an MMR in left arm.  Six days later she came back to clinic with a bruised and swollen arm with a large red ring around it.  She was sent to see a doctor.
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMR, VARCEL
Symptoms: Injection site rash, Injection site swelling
Clinical narrative: She had a swelling and rash at site of VARIVAX.
Age: 23.0
Sex: F
Vaccine: TDAP
Symptoms: Injection site discharge, Pruritus, Swelling
Clinical narrative: 3/17/09 Received PC from Pt states LA started itching and swelling this weekend. Tdap was given on 1-28-09 states applied soaks to LA area. On 3/16/09 area started draining called HD 3/17/09 advise see PMD. Saw PMD 3/17/09 was given antibiotic to take.
Age: 48.0
Sex: U
Vaccine: TDAP
Symptoms: Arthralgia, Injection site erythema, Injection site warmth, Local reaction, Musculoskeletal pain
Clinical narrative: Local Rxn w/ redness & warmth x 40 hours:  then pain in arm radiating to shoulder/neck & elbow -> referred to physical therapy on 4-3-09.
Age: 48.0
Sex: U
Vaccine: TDAP
Symptoms: Neck pain, Pain in extremity
Clinical narrative: Local Rxn w/ redness & warmth x 40 hours:  then pain in arm radiating to shoulder/neck & elbow -> referred to physical therapy on 4-3-09.
Age: 34.0
Sex: F
Vaccine: TDAP
Symptoms: Chills, Dry mouth, Feeling abnormal, Pain, Pruritus
Clinical narrative: Afternoon after receiving vaccine felt itchy, dry mouth, felt generally "bad" - low grade temp 99.1 - Following day temp is PM 102 degrees - TYLENOL taken 6AM and 10 AM and 7 PM. Aches and chills-dry mouth - 2nd day  following slept till 2 PM in afternoon - Started feeling better 3 PM on 2nd day.
Age: 34.0
Sex: F
Vaccine: TDAP
Symptoms: Pyrexia
Clinical narrative: Afternoon after receiving vaccine felt itchy, dry mouth, felt generally "bad" - low grade temp 99.1 - Following day temp is PM 102 degrees - TYLENOL taken 6AM and 10 AM and 7 PM. Aches and chills-dry mouth - 2nd day  following slept till 2 PM in afternoon - Started feeling better 3 PM on 2nd day.
Age: 1.5
Sex: F
Vaccine: MMR, PNC, VARCEL
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Pyrexia
Clinical narrative: Mom stated child had a tem up to 102 degrees within 24 hrs (off and on). Soreness, redness, and slight swelling to area where shot was given (L) Vastus lateralis (2 cm X 2 cm of redness)
Age: 26.0
Sex: F
Vaccine: HPV4
Symptoms: Pruritus
Clinical narrative: Pt. notes truncal pruritis (primarily B/L breasts).  Sx occurred 24-48 hours s/p vaccine (GARDASIL) # T and lasted approx. 4 wks.  Denies rash/ fever/ chills/ sob.
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMR
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
Clinical narrative: Injection site - swollen, red, soreness, fever (at the injection site) left leg where DTAP + Polio were given.
Age: 21.0
Sex: F
Vaccine: ANTH, TYP
Symptoms: Drug exposure during pregnancy, Pregnancy test positive
Clinical narrative: Patient received ANTRAX and Typhoid on 12 Mar 09. Smallpox on 19 Mar 2009. Patient found out this month that she was pregnant when she received the vaccines. States she had no problems at this point.
Age: 4.0
Sex: M
Vaccine: DTAP, IPV, MMR, VARCEL
Symptoms: Herpes zoster
Clinical narrative: Diagnosed with shingles along L4 - L5 distribution today.
Age: 11.0
Sex: M
Vaccine: TDAP
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth
Clinical narrative: (lt) arm - reddened, "hst to touch", swollen - taken to Urgent care by Mom - 4-1-09 - Placed on KEFLEX po tid - arm resolved 4-30-09
Age: 33.0
Sex: F
Vaccine: FLU3
Symptoms: Unevaluable event
Clinical narrative: Non stated.
Age: 11.0
Sex: M
Vaccine: MNQ, TDAP
Symptoms: Erythema, Feeling hot, Pain
Clinical narrative: Spreading redness, warm to touch, pain. Oral BENADRYL, ice packs PRN.
Age: 42.0
Sex: M
Vaccine: TDAP
Symptoms: Fatigue, Night sweats
Clinical narrative: Fatigue; night sweats 3/12/09 + 3/13/09.
Age: 5.0
Sex: M
Vaccine: DTAP, MMR
Symptoms: Injection site discharge, Injection site erythema, Injection site swelling
Clinical narrative: Right thigh was red & swollen with some oozing coming from area between both shots.  Redness was approx.   14-16 cm X 14 cm. Child given BENADRYL & BACTROBAN ointment.
Age: 69.0
Sex: F
Vaccine: VARZOS
Symptoms: Erythema, Induration, Skin warm, Swelling
Clinical narrative: 5cm area erythema, swelling, heat, hardness possible cord. No vesicles.
Age: 0.5
Sex: F
Vaccine: DTAPIPVHIB, HEP, PNC, RV5
Symptoms: Restlessness, Urticaria
Clinical narrative: Morning of 04-1-09 : "Restussness" Morning of 4-2-09: Hives
Age: 55.0
Sex: F
Vaccine: HEPAB, TDAP
Symptoms: Erythema, Injection site pain, Skin warm, Swelling
Clinical narrative: Pt received injection and by next morning felt pain/soreness to area of injection. 48 hours after injection Pt. noticed a swelling an redness starting two inches below and separated from injection site. 72 hours after injection (today) Pt has same reddened area, warm to touch and raised. Doctor prescribed BENADRYL cream to area. Return to MD if symptoms worsen. Area was approx. 10cm x 4 cm.
Age: 4.0
Sex: F
Vaccine: IPV, MMR, TDAP, VARCEL
Symptoms: Wrong drug administered
Clinical narrative: Patient inadvertently received BOOSTRIX instead of KINRIX.  No adverse events were noted.  Mother was notified of error
Age: 15.0
Sex: F
Vaccine: HPV4
Symptoms: Blood pressure decreased, Syncope
Clinical narrative: Approximately 5 minutes post injection, Pt experienced syncopal episode lasting 10 seconds. BP 90/62 at episode. After orientation X 3 was re- established, Pt reported feeling better. BP 96/64 at discharge. Discharged in the care of her mother. No injury noted. Physician aware.
Age: 5.0
Sex: F
Vaccine: DTAPIPV, HEPA, MMR, VARCEL
Symptoms: Injection site cellulitis, Injection site erythema, Injection site streaking, Injection site swelling
Clinical narrative: Large, red, hard area with streaking - Pt. dx. in ER with cellulitis - Parent reported (L) deltoid
Age: 5.0
Sex: M
Vaccine: DTAPIPV, HEPA, MMR, VARCEL
Symptoms: Feeling hot, Generalised erythema, Induration, Swelling
Clinical narrative: Patient right shoulder and right deltoid, red, swollen, hard and warm to touch. Denies pain or fever at this time. Began 4/11/09 and continues today 4/13/09.
Age: 14.0
Sex: F
Vaccine: VARCEL
Symptoms: Cellulitis, Erythema
Clinical narrative: Cellulitis 4X6 inch area of redness 2 days after VARIVAX. Augmentin 875 mg -125mg - 1 tab Q 12 X 10d.
Age: 4.0
Sex: F
Vaccine: DTAP, HEPA, IPV
Symptoms: Injection site urticaria
Clinical narrative: Pt developed hives at the IPV site.
Age: 54.0
Sex: M
Vaccine: PPV
Symptoms: Injection site erythema, Injection site induration, Injection site pruritus
Clinical narrative: Patient developed erythema & puritis of left upper arm within hours of receiving injection there (10 inch X 10 inch area of erythema & slight induration.  Told to take BENADRYL as needed orally and use topical BENADRYL in affected area
Sex: U
Vaccine: DTAP
Symptoms: Erythema, Fatigue, Pain, Swelling, Type III immune complex mediated reaction
Clinical narrative: Arthus reaction left shoulder - Swelling, pain, redness, fatigue started day after ADACEL administration - Tx MEDROL, Ibuprofen
Age: 1.4
Sex: F
Vaccine: DTAP
Symptoms: Erythema, Skin warm, Swelling
Clinical narrative: Reddened, warm to touch, swollen size of tennis ball.
Age: 32.0
Sex: F
Vaccine: HEP, TD
Symptoms: Injection site nodule
Clinical narrative: On 3/9/09 Pt received Td & Hep B on both L Delt.  Pt. states she has marble size knot under skin @ site.
Age: 1.2
Sex: F
Vaccine: DTAP, PNC
Symptoms: Injection site erythema, Injection site vesicles
Clinical narrative: 3 X 3 cm erythema R upper arm with vesicles.
Age: 4.0
Sex: F
Vaccine: IPV, VARCEL
Symptoms: Injection site erythema, Injection site swelling
Clinical narrative: Left thigh red w swelling. Ice packs (treatment).
Age: 13.0
Sex: F
Vaccine: VARCEL
Symptoms: Headache, Injection site erythema, Injection site pruritus, Injection site swelling
Clinical narrative: Significant itch, redness + swelling at vaccine site starting approximately 8 hours after administration associated with moderate headache persisting at recheck on 4/3/9.
Age: 31.0
Sex: F
Vaccine: TDAP, VARCEL
Symptoms: Pruritus, Rash
Clinical narrative: 3/19/09 Started with rash neck + chest 3/20 face, arm leg c/o itching - approx 45
Age: 48.0
Sex: F
Vaccine: TDAP
Symptoms: Blood pressure increased, Epistaxis, Fatigue, Nausea, Pain
Clinical narrative: Fever, total body aches, nausea, fatigue, elevated B/P and tachycardia, epistaxis;  Serum sickness.
Age: 48.0
Sex: F
Vaccine: TDAP
Symptoms: Pyrexia, Serum sickness, Tachycardia
Clinical narrative: Fever, total body aches, nausea, fatigue, elevated B/P and tachycardia, epistaxis;  Serum sickness.
Age: 61.0
Sex: F
Vaccine: HEPAB
Symptoms: Headache, Skin discolouration, Urticaria
Clinical narrative: 2 hours after rec vaccine, welts developed on Rt neck, between breasts + underneath breasts, Rt + Lt outer arm proximal to elbows. C/o headache, relieved by Aspirin 2 tabs every 6 hours x 24 hours. Shea butter to welts which are brown color. Referred to family clinic.
Age: 7.0
Sex: F
Vaccine: HEPA, VARCEL
Symptoms: Erythema, Skin warm
Clinical narrative: 12x14 cms- erythema on right right arm with calor.  There was no induration nor tenderness.
Age: 21.0
Sex: F
Vaccine: HPV4
Symptoms: Cough, Rash
Clinical narrative: Pt states rash on face day following administration of GARDASIL. Also a cough.
Age: 1.0
Sex: F
Vaccine: HEP, HIBV, PNC, VARCEL
Symptoms: Injection site rash
Clinical narrative: VARIVAX eruptions treated with BENADRYL / CALAMINE
Age: 0.3
Sex: F
Vaccine: DTAPHEPBIP, HIBV, PNC, RV1
Symptoms: Vomiting
Clinical narrative: This case was reported by a healthcare professional and described the occurrence of vomiting in a 3-month-old (almost 4 month old) female subject who was vaccinated with ROTARIX. Concurrent vaccination included HIB and PEDIARIX and PREVNAR all given on 4 March 2009. There were no concurrent medications. On 4 March 2009 at 15:02 the subject received 1st dose of ROTARIX (oral). On 4 March 2009, at 15:20, just 18 minutes after vaccination with ROTARIX, the subject experienced vomiting. At the time of reporting the outcome of the event was unspecified. The healthcare professional considered the event was unrelated to vaccination with ROTARIX.
Age: 0.3
Sex: M
Vaccine: DTAPIPVHIB, PNC, RV1
Symptoms: Rash
Clinical narrative: This case was reported by a physician via a sales representative and described the occurrence of rash in a 4-month-old male subject who was vaccinated with ROTARIX, PREVNAR and PENTACEL. There were no concurrent medications. On the afternoon of 1 April 2009 the subject received 2nd dose of ROTARIX at 1.0 ml, 2nd dose of PREVNAR and 2nd dose of PENTACEL. On 1 April 2009, at an unspecified time after vaccination with ROTARIX, PENTACEL and PREVNAR, the subject experienced a severe rash and was seen in the emergency room. At the time of reporting the event was unresolved.
Age: 1.3
Sex: M
Vaccine: DTAP, FLU3, PNC
Symptoms: Erythema, Induration
Clinical narrative: Seen 4/9/09 with small induration and some redness. Advised to put cold compress + should resolve in a few day by doctor.
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMR, VARCEL
Symptoms: Injection site erythema, Injection site induration, Injection site swelling
Clinical narrative: Right thigh with erythema and swelling 8cmx4cm are of pinpoint induration for 2 days.
Age: 12.0
Sex: F
Vaccine: MNQ, VARCEL
Symptoms: Erythema, Pruritus, Skin warm
Clinical narrative: Pt developed 8cm X 4.5 cm warm, erythematous raised lesion on upper arm 2 days after receiving VARIVAX. Itchy. No fever.
Age: 25.0
Sex: M
Vaccine: HEPAB
Symptoms: Pruritus, Rash
Clinical narrative: Patient reports a rash - itching - developed 2 days after vaccine given 3/18/2009 - Reports used Neosporin with success - Referred to PMD or clinic for evaluation - walked into health unit 3/26/2009 to report rash.
Age: 0.2
Sex: F
Vaccine: DTAPIPVHIB, HEP, PNC, RV5
Symptoms: Abnormal behaviour, Crying, Decreased activity, Decreased appetite, Irritability
Clinical narrative: 4/3/09 Hx acting different, restless, low grade fever, crying, screaming with sucking, poor appetite, restless x 2 days. Onset 4/2/09. Assessment: Pallor, irritable, shrill cry at rest, increasing with any movement. Decreased spontaneous activity, staring gaze.  5/29/09 Received hospital medical records of 4/3-4/5/2009. FINAL DX: febrile illness; anorexia; irritability s/p immunizations. Records reveal patient experienced low grade fever, poor appetite, restlessness, inconsolable crying, abnormal behavior x 2 days.  Had exposure to family members w/sore throat.
Age: 0.2
Sex: F
Vaccine: DTAPIPVHIB, HEP, PNC, RV5
Symptoms: Pallor, Pyrexia, Red blood cell sedimentation rate increased, Respiratory syncytial virus test negative, Restlessness
Clinical narrative: 4/3/09 Hx acting different, restless, low grade fever, crying, screaming with sucking, poor appetite, restless x 2 days. Onset 4/2/09. Assessment: Pallor, irritable, shrill cry at rest, increasing with any movement. Decreased spontaneous activity, staring gaze.  5/29/09 Received hospital medical records of 4/3-4/5/2009. FINAL DX: febrile illness; anorexia; irritability s/p immunizations. Records reveal patient experienced low grade fever, poor appetite, restlessness, inconsolable crying, abnormal behavior x 2 days.  Had exposure to family members w/sore throat.
Age: 0.2
Sex: F
Vaccine: DTAPIPVHIB, HEP, PNC, RV5
Symptoms: Screaming, Staring, White blood cell count normal
Clinical narrative: 4/3/09 Hx acting different, restless, low grade fever, crying, screaming with sucking, poor appetite, restless x 2 days. Onset 4/2/09. Assessment: Pallor, irritable, shrill cry at rest, increasing with any movement. Decreased spontaneous activity, staring gaze.  5/29/09 Received hospital medical records of 4/3-4/5/2009. FINAL DX: febrile illness; anorexia; irritability s/p immunizations. Records reveal patient experienced low grade fever, poor appetite, restlessness, inconsolable crying, abnormal behavior x 2 days.  Had exposure to family members w/sore throat.
Age: 1.67
Sex: M
Vaccine: HEPA, MMR
Symptoms: Irritability, Pyrexia, Vomiting
Clinical narrative: fever, irritability 8 days after vaccination.  Fever lasted 3 days and ranged from 100.3 to 104.2  1 episode of vommitting on day 3.  Treated fever with motrin and tylenol
Age: 24.0
Sex: M
Vaccine: MMR
Symptoms: Chills, Dry skin, Eye pain, Fatigue, Measles antibody negative
Clinical narrative: Vaccinated 12 days ago with MMR.  Had some arm soreness which has resolved.  Then on Saturday 8 days after vaccine - he developed subjective fever and chills.  Fatigued.  Eye pain, but no tearing or injection.  These have since resolved.  Yesterday, on Monday (day 10) noticed a rash first on his face and chest that is mildly itchy like dry skin can be.  No longer febrile or with eye pain.  Mildly sore throat, no cough or congestion.  Denies abdominal pain. Supportive care - nsaid, rest, moisturize dry skin.
Age: 24.0
Sex: M
Vaccine: MMR
Symptoms: Oropharyngeal pain, Pain in extremity, Pruritus, Pyrexia, Rash
Clinical narrative: Vaccinated 12 days ago with MMR.  Had some arm soreness which has resolved.  Then on Saturday 8 days after vaccine - he developed subjective fever and chills.  Fatigued.  Eye pain, but no tearing or injection.  These have since resolved.  Yesterday, on Monday (day 10) noticed a rash first on his face and chest that is mildly itchy like dry skin can be.  No longer febrile or with eye pain.  Mildly sore throat, no cough or congestion.  Denies abdominal pain. Supportive care - nsaid, rest, moisturize dry skin.
Age: 1.0
Sex: F
Vaccine: HIBV, MMR, PPV
Symptoms: Pyrexia, Rash, Roseola, Skin discolouration, Urticaria
Clinical narrative: Nine days after receiving the 1st MMR vaccination our daughter developed a fever (highest recorded was 101.3), had minor vomiting (4 episodes total), and a rash presented itself on her abdomen, back, neck, tempal area, and scalp.  The rash appears as small pinkish/reddish dots that are slightly raised.  Our daughter also started to itch her scalp.
Age: 1.0
Sex: F
Vaccine: HIBV, MMR, PPV
Symptoms: Vomiting
Clinical narrative: Nine days after receiving the 1st MMR vaccination our daughter developed a fever (highest recorded was 101.3), had minor vomiting (4 episodes total), and a rash presented itself on her abdomen, back, neck, tempal area, and scalp.  The rash appears as small pinkish/reddish dots that are slightly raised.  Our daughter also started to itch her scalp.
Age: 81.0
Sex: M
Vaccine: VARZOS
Symptoms: Headache
Clinical narrative: PATIENT CALLED COMPLAINING OF HEADACHE WHEICH STARTED APPROXIMATELY TWO DAYS AFTER RECEIVEING  ZOSTAVAX.  tHE PATIENT ALSO STATED HE SUFFERS FROM ALLERGIES AND TAKES ANTIHISTAMINES.
Age: 10.0
Sex: M
Vaccine: HEPA, VARCEL
Symptoms: Blister, Erythema, Local reaction
Clinical narrative: Pt mom reported that son's developed arm blister, redness. Local reaction 11 April 2009. Dr. made aware and advised pt to apply cold ice pack, and it keep dry and clean. Follow up if there's any other signs and symptoms.
Age: 10.0
Sex: F
Vaccine: VARCEL
Symptoms: Swelling
Clinical narrative: Mildly swollen area 1" to 2" wide per mom.
Age: 83.0
Sex: F
Vaccine: VARZOS
Symptoms: Rash erythematous
Clinical narrative: Pt noted an oval shaped, bright red rash on Saturday morning.  As of Monday morning it was resolving.  Denied pain at site or itching.
Age: 5.0
Sex: F
Vaccine: DTAPIPV, MMR, VARCEL
Symptoms: Abnormal behaviour, Computerised tomogram, Febrile convulsion
Clinical narrative: Parent reported child was not acting herself at preschool that morning, as reported by her teachers. Parent reported paying special attention for a possible fever per instructions from nurse administering vaccine. Parent denied child had any temperature to her knowledge; however, went on to have a febrile seizure approximately 21 hours following vaccination. Child was taken to ER where a CT scan was done and parent was given instructions for Tylenol and Motrin alternating schedule usage.
Age: 21.0
Sex: F
Vaccine: HPV4
Symptoms: Condition aggravated, Suicidal ideation
Clinical narrative: Severe suicidal ideation, ever since vaccination was administered.  This has continued to worsen.  Before being vaccinated, mental health was at the best it had been in years.
Age: 29.0
Sex: F
Vaccine: RAB
Symptoms: Urticaria
Clinical narrative: HIVES OVER FACE AND NECK APPROX  HOURS AFTER VACCINATION WITH 1ST OF PRE-EXPOSURE SERIES RABIES PCEC VACCINE
Age: 4.0
Sex: M
Vaccine: DTAP, VARCEL
Symptoms: Injection site erythema, Injection site induration, Injection site warmth
Clinical narrative: Immunized 4/8/09, The following day in the afternoon the client came to office w/his father and an examination of the arm was made.  Red circular area on his left arm at the sites of the immunizations, the area was warm to touch, area reddened: 1 1/4 x 3/3/4.  With a palable firmess to area that was reddened.  Noted the client with sinus drainage.  The father of client advised the client had the symptom (nasal drainage) before the immunization. No other symptoms noted (ie:  fever, nausea, shortness of breathe or pain). Symptoms resolved with 2 days of oral Benadryl.  As suggested by personal physician.
Age: 42.0
Sex: F
Vaccine: FLU3
Symptoms: Guillain-Barre syndrome
Clinical narrative: numbness in fingers/hands/feet approximately 3 weeks post flu shot.  Diagnosed with GBS.  4/27/09 Received hospital medical records of 11/24-12/1/2008. FINAL DX: Guillain-Barre; possible neurogenic bladder; e. cole UTI Records reveal patient experienced rapid onset of progressive weakness of LEs & UEs.  Had been out of the country x 3 wks & during return flight home developed HA, hand weakness, difficulty walking, numbness of feet, balance difficulty, pain of upper back, glutes & thighs .  Neuro consult done.  Reflexes diminished.  LP done & tx w/IVIG x 5 days w/some improvement.  Had neurogenic bladder requiring Foley cath.  Had continued neuropathic pain of right side.  Improved slowly & d/c to inpatient rehab.
Age: 1.25
Sex: F
Vaccine: DTAP, MMRV
Symptoms: Pyrexia, Rash generalised
Clinical narrative: Immunization given on 3/31/2009.  Child had tactile fever for one day on 4/9/2009 with onset of generalized body rash which is still present at time of reporting.
Age: 13.0
Sex: F
Vaccine: HEPA, HPV4, TDAP, VARCEL
Symptoms: Blood test, Epilepsy, Erythema, Headache, Lumbar puncture
Clinical narrative: Client recieved four vaccines on 4/2/09. The client parent requested all vaccine be given in the same extremity due to a previous injury in the other arm and the client fear of being unable to walk if we used the lower extremities. The parent reports that the Right arm was swollen and became very red and sore on 4/4/09. The client also had reported a headache which began on that date and a low grade fever. Her mother treated her with Motrin. On 4/6/09 the mother called to report that the client began vomiting the night before and that her arm was still swollen but not warm to touch and appered to be improving. The mother was advised to take her daughter to her doctor to be evaluated. The client's mother was contacted on 4/8/09 and informed that the client had been admitted to Hospital. On 4/13 futher follow up revealed that the client was home and has been diagnosed with parietal epliepsy.  4/16/09 MR received for DOS 4/8-10/2009 with D/C DX:  Morbid Obesity.  Pseudotumor Cerebri.  Abnormal EEG. Pt initially presented to PCP with c/o dizziness upon standing, one episode of nausea and vomiting,  and worsening of chronic H/A (~9 month hx). Pt recently fell out of a chair but did not have LOC. Pt sent to local hospital and transferred to current facility for neuro w/u. Started on Topamax after abnormal EEG. Pt still reporting mild dizziness and H/A at d/c.
Age: 13.0
Sex: F
Vaccine: HEPA, HPV4, TDAP, VARCEL
Symptoms: Oedema peripheral, Pain in extremity, Pyrexia, Vomiting
Clinical narrative: Client recieved four vaccines on 4/2/09. The client parent requested all vaccine be given in the same extremity due to a previous injury in the other arm and the client fear of being unable to walk if we used the lower extremities. The parent reports that the Right arm was swollen and became very red and sore on 4/4/09. The client also had reported a headache which began on that date and a low grade fever. Her mother treated her with Motrin. On 4/6/09 the mother called to report that the client began vomiting the night before and that her arm was still swollen but not warm to touch and appered to be improving. The mother was advised to take her daughter to her doctor to be evaluated. The client's mother was contacted on 4/8/09 and informed that the client had been admitted to Hospital. On 4/13 futher follow up revealed that the client was home and has been diagnosed with parietal epliepsy.  4/16/09 MR received for DOS 4/8-10/2009 with D/C DX:  Morbid Obesity.  Pseudotumor Cerebri.  Abnormal EEG. Pt initially presented to PCP with c/o dizziness upon standing, one episode of nausea and vomiting,  and worsening of chronic H/A (~9 month hx). Pt recently fell out of a chair but did not have LOC. Pt sent to local hospital and transferred to current facility for neuro w/u. Started on Topamax after abnormal EEG. Pt still reporting mild dizziness and H/A at d/c.
Age: 66.0
Sex: M
Vaccine: PPV
Symptoms: Pain, Pain in extremity, Pyrexia
Clinical narrative: PT STATES HE REC'D PNEUMOVAX ON 4/7/09 AND THAT EVENING HE HAD FEVER FOR TWO DAYS AND SEVERE BODY ACHES. PT STATES HE'LL NEVER TAKE ANOTHER FLU SHOT OR PNEUMONIA SHOT AGAIN. PT STATES ARM STILL SORE TODAY.
Age: 0.5
Sex: M
Vaccine: DTAPIPVHIB, HEP, PNC, RV5
Symptoms: Inappropriate schedule of drug administration
Clinical narrative: 6 month old child received Hepatitis A # 1 at 6 months instead of 12 months, per standard, in error. In follow up with the parent, child has had no adverse symptoms. Patient seen in the clinic on 3/20/09. Health status stable.
Age: 4.0
Sex: M
Vaccine: DTAP, IPV, MMR, VARCEL
Symptoms: Injection site erythema, Injection site induration, Injection site swelling
Clinical narrative: mother noticed Saturday night 4/11/2009 a red, raised area on left deltoid.  seen today 4/13/2009 PM in office with 4X4cm area with redness and mild swelling on left deltoid.Beginning to clear centrally. Nurse practitioner able to palpate firm centralized swelling.  Nurse practitioner instructed mom to apply cool cloth PRN.
Age: 38.0
Sex: F
Vaccine: PPV
Symptoms: Malaise
Clinical narrative: See History & Physical. This patient received a Pneumococcal vaccine probably on 3-25-09 and we do not know where. Patient came to agency on 3-28-09 with adverse reaction.  Malaise. 6/8/09 Received hospital medical records of 3/27-4/1/2009. FINAL DX: inflammatory or immune right arm cellulitis Records reveal patient experienced fever, SOB, tachycardia, altered mental status, intermittent low blood pressure, and right arm cellulitis w/swelling, induration & tenderness.  Tx w/IV antibiotics, resolved completely but developed diarrhea.  No antibiotics at d/c to home but on tapering steroids, nystatin powder for axillary rash & acidophilus.
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMR, VARCEL
Symptoms: Injection site erythema, Injection site induration
Clinical narrative: Approximately 2" induration and redness of upper left arm where VARIVAX was given. Mom contacted office and was given instructions to give BENADRYL one tsp every 4-6 hours and apply warm compresses. To call if no improvement. 4/13/09 spoke with mom by phone, states only has red ring where induration used to be.
Age: 61.0
Sex: F
Vaccine: VARZOS
Symptoms: Injection site erythema
Clinical narrative: Red spot on arm at shot site. It's there a month. Almost gone away.
Age: 11.0
Sex: F
Vaccine: MNQ, TDAP
Symptoms: Convulsion, Dizziness, Headache, Tremor
Clinical narrative: 11 y/o experienced a short, 5 second seizure like episode five minutes after receiving the following vaccines (Meningococcal (Menactra) lot#, and PPD(Tuberculin test. Pt complained of H/A dizziness and feeling shacky after the seizure no rashes, Dysphea or SOB
Age: 72.0
Sex: F
Vaccine: VARZOS
Symptoms: Injection site erythema, Injection site mass, Injection site pruritus
Clinical narrative: Patient received vaccination on 4-8-09 & called pharmacy on 4-11-09 to report that the site of injection had a egg shaped lump that was red & itchy.  Pharmacist told patient to seek medical attention.
Age: 4.0
Sex: M
Vaccine: DTAP, MMR, VARCEL
Symptoms: Injection site vesicles
Clinical narrative: Blister on the site of injection; next day after immunization, Mupirocin oint TID x 7 days.
Age: 14.0
Sex: F
Vaccine: MNQ, TDAP, VARCEL
Symptoms: Injection site erythema, Injection site haematoma
Clinical narrative: VARIVAX given L arm on 4/9/09, Pt returns on 4/11 with Lt arm about 50 cents size red area with some bruising on upper aspect at injection site, to f/u if worsens - TYLENOL, cold compresses.
Age: 39.0
Sex: F
Vaccine: PPV
Symptoms: Arthralgia, Asthenia, Fatigue, Injection site oedema, Injection site pain
Clinical narrative: Severe pain and edema localized at injection site. Unable to lift arm, unable to touch arm or put pressure on arm or sleep on left side x 72hrs.  Generalized severe body and joint aches, fatigue, and lack of energy x 72hrs.  Would have missed 2 workdays if this would have happened on a weekday vs. a friday.
Age: 39.0
Sex: F
Vaccine: PPV
Symptoms: Joint range of motion decreased, Pain
Clinical narrative: Severe pain and edema localized at injection site. Unable to lift arm, unable to touch arm or put pressure on arm or sleep on left side x 72hrs.  Generalized severe body and joint aches, fatigue, and lack of energy x 72hrs.  Would have missed 2 workdays if this would have happened on a weekday vs. a friday.
Age: 32.0
Sex: F
Vaccine: ANTH, SMALL
Symptoms: Blister, Eschar, Injection site erythema, Injection site swelling, Pruritus
Clinical narrative: Smallpox vaccination on July 1st.  Arm is swollen with 1cm of erythema around the vaccination site and eschar forming.  She also appears to have urticarial lesions on her palms and some mixed diffuse macular, pustular lesions on her arms legs and trunks.  She describes itching.  States some of the lesions did fill with liquid and burst.  Only 3 popped.  Stated blister is hard but the drainage is clear.  None of the blisters look like her vaccination site.  Symptoms: Lesions, Pustule, Lesions, macule, Lesions, Vesicle, Pruritus.
Age: 32.0
Sex: F
Vaccine: ANTH, SMALL
Symptoms: Rash macular, Rash pustular, Urticaria
Clinical narrative: Smallpox vaccination on July 1st.  Arm is swollen with 1cm of erythema around the vaccination site and eschar forming.  She also appears to have urticarial lesions on her palms and some mixed diffuse macular, pustular lesions on her arms legs and trunks.  She describes itching.  States some of the lesions did fill with liquid and burst.  Only 3 popped.  Stated blister is hard but the drainage is clear.  None of the blisters look like her vaccination site.  Symptoms: Lesions, Pustule, Lesions, macule, Lesions, Vesicle, Pruritus.
Age: 24.0
Sex: M
Vaccine: ANTH
Symptoms: Alanine aminotransferase normal, Antinuclear antibody, Aspartate aminotransferase increased, Blood albumin decreased, Blood alkaline phosphatase normal
Clinical narrative: The pt received AVA #4 on 8/8/08. On 9/2/08 at 0400 the pt woke with severe substernal chest pain (10/10). The pain was worse lying supine, with deep breaths and activity. The patient was constant but decreased to a 5/10 when sitting up or resting. At 2300 the pt reported to medical. EKG and CXR reported as normal. The pt was Medevac'd and evaluated on 9/3/09. The medical record indicates neg Troponin and D-dimer, EKG: NSR, normal CXR and ECHO wnl (see below). The pt was diagnosed with chest wall pain of non-cardiac origin. On 9/5/09 the pt complained of tightness in his chest that was worse when lying supine and with deep inspiration. The records also indicate that the patient had an URI for 3 days (since 9/2/08). The pt was diagnosed with pleurisy and treated with Toradol and Naprosyn bid. On 9/7/09 the pt was seen for 10/10 chest pain worse with lying supine and deep inspirations; transferred to another facility; diagnosed with Pericarditis; treated with Indocin and Colchicine; and had repeat ECHO (see below). The pt was discharged on 9/10/09 to his duty station. The pt was seen by cardiology on 9/15 and the pt reported intermittent sharp positional chest pain. The pt was placed on light duty for 30 days and instructed to continue the Indocin and Colchicine (Instructed to stop 2 weeks following symptoms resolution). ECHO was repeated (see below). The pt followed up with Cardiology on 10/31/09 and reported occasional chest pain with maximal activity. The pt was returned to full duty without restriction and "worldwide deployable".
Age: 24.0
Sex: M
Vaccine: ANTH
Symptoms: Blood bilirubin normal, Blood calcium normal, Blood chloride normal, Blood creatine phosphokinase increased, Blood glucose increased
Clinical narrative: The pt received AVA #4 on 8/8/08. On 9/2/08 at 0400 the pt woke with severe substernal chest pain (10/10). The pain was worse lying supine, with deep breaths and activity. The patient was constant but decreased to a 5/10 when sitting up or resting. At 2300 the pt reported to medical. EKG and CXR reported as normal. The pt was Medevac'd and evaluated on 9/3/09. The medical record indicates neg Troponin and D-dimer, EKG: NSR, normal CXR and ECHO wnl (see below). The pt was diagnosed with chest wall pain of non-cardiac origin. On 9/5/09 the pt complained of tightness in his chest that was worse when lying supine and with deep inspiration. The records also indicate that the patient had an URI for 3 days (since 9/2/08). The pt was diagnosed with pleurisy and treated with Toradol and Naprosyn bid. On 9/7/09 the pt was seen for 10/10 chest pain worse with lying supine and deep inspirations; transferred to another facility; diagnosed with Pericarditis; treated with Indocin and Colchicine; and had repeat ECHO (see below). The pt was discharged on 9/10/09 to his duty station. The pt was seen by cardiology on 9/15 and the pt reported intermittent sharp positional chest pain. The pt was placed on light duty for 30 days and instructed to continue the Indocin and Colchicine (Instructed to stop 2 weeks following symptoms resolution). ECHO was repeated (see below). The pt followed up with Cardiology on 10/31/09 and reported occasional chest pain with maximal activity. The pt was returned to full duty without restriction and "worldwide deployable".
Age: 24.0
Sex: M
Vaccine: ANTH
Symptoms: Blood magnesium normal, Blood potassium normal, Blood sodium normal, Blood thyroid stimulating hormone, Blood urea normal
Clinical narrative: The pt received AVA #4 on 8/8/08. On 9/2/08 at 0400 the pt woke with severe substernal chest pain (10/10). The pain was worse lying supine, with deep breaths and activity. The patient was constant but decreased to a 5/10 when sitting up or resting. At 2300 the pt reported to medical. EKG and CXR reported as normal. The pt was Medevac'd and evaluated on 9/3/09. The medical record indicates neg Troponin and D-dimer, EKG: NSR, normal CXR and ECHO wnl (see below). The pt was diagnosed with chest wall pain of non-cardiac origin. On 9/5/09 the pt complained of tightness in his chest that was worse when lying supine and with deep inspiration. The records also indicate that the patient had an URI for 3 days (since 9/2/08). The pt was diagnosed with pleurisy and treated with Toradol and Naprosyn bid. On 9/7/09 the pt was seen for 10/10 chest pain worse with lying supine and deep inspirations; transferred to another facility; diagnosed with Pericarditis; treated with Indocin and Colchicine; and had repeat ECHO (see below). The pt was discharged on 9/10/09 to his duty station. The pt was seen by cardiology on 9/15 and the pt reported intermittent sharp positional chest pain. The pt was placed on light duty for 30 days and instructed to continue the Indocin and Colchicine (Instructed to stop 2 weeks following symptoms resolution). ECHO was repeated (see below). The pt followed up with Cardiology on 10/31/09 and reported occasional chest pain with maximal activity. The pt was returned to full duty without restriction and "worldwide deployable".