chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 4.0
Sex: M
Vaccine: VARCEL, VARCEL
Symptoms: Blister, Herpes zoster, Methicillin-resistant staphylococcal aureus test positive, Pruritus, Staphylococcal infection
Clinical narrative: Information has been received from a public health director concerning his son, a 10 year old male who 5 year ago, who in 2003 was vaccinated with a dose of VARIVAX (Oka/Merck).  On 06-SEP-2008, the child had severe itch on left thigh that turned into open blistery sores.  The sores extended from 3 inches below the left knee up to the left hip.  At that time, child went into a hot tub and developed a severe MRSA infection of the left thigh, which the caller stated was serious.  On 08-SEP-2008, the child developed shingles in the webbing of his right hand.  The shingles traveled from right hand all the way to  under the right armpit.  The child had shingles on both sides of the body, which caller stated was unique.  The child was treated with BACTRIM, and many antibiotic ointments.  The caller stated they tried to get a scab/specimen for testing, but it was too late.  MRSA test was performed with positive result.  The child had fully recovered.  The reporter considered MRSA infection to be an other important medical event.  Additional information has been requested.
Age: 43.0
Sex: M
Vaccine: FLU3, PPV
Symptoms: Erythema, Oedema peripheral, Pain in extremity, Pruritus
Clinical narrative: PT REPORTED ON 10/5/08 THAT HE EXPERIENCED SWELLING, ITCHING, REDNESS, AND PAIN IN THE LEFT ARM ON THE DAY AFTER RECEIVING PNEUMOVAX.  HE WENT IN TO MEDICAL CENTER 10/4/08 AND WAS GIVEN RX'S FOR METHYLPREDNISOLONE, TRAMADOL/APAP, AND CLARITHROMYCIN.  ALSO WAS INSTRUCTED TO USE ICE ON ARM EVERY 20 MINUTES. ON 10/6/08 PT REPORTED HIS ARM STILL HAD SOME REDNESS AND ITCHING, BUT THE SWELLING HAD GONE DOWN AND WAS MUCH BETTER.
Age: 71.0
Sex: F
Vaccine: FLU3, PPV
Symptoms: Erythema, Oedema peripheral, Pruritus
Clinical narrative: PT REPORTED ON 10/4/08 THAT HER UPPER ARM WAS SIGNIFICANTLY SWOLLEN TO THE ELBOW.  IT WAS ALSO VERY RED AND ITCHED. PT USED ICE ON THE ARM BUT DID NOT SEEK MEDICAL ATTENTION. ON 10/6/08 PT REPORTED THAT THE REDNESS WAS GONE. SHE WAS STILL EXPERIENCING SOME ITCHING, AND HAD SOME SWELLING IN THE UPPER ARM NEAR THE ELBOW.
Age: 59.0
Sex: U
Vaccine: FLU3
Symptoms: Arthralgia, Chest discomfort, Headache, Muscle spasms, Nausea
Clinical narrative: Severe Headache, tightening of throat and chest tingling in arm, muscle spasms, nausea, soreness in joints, blurred vision start 10:30P 10/8/08 subsided some by 1:30P 10/9/08. Headache and tight chest still ongoing.
Age: 59.0
Sex: U
Vaccine: FLU3
Symptoms: Paraesthesia, Throat tightness, Vision blurred
Clinical narrative: Severe Headache, tightening of throat and chest tingling in arm, muscle spasms, nausea, soreness in joints, blurred vision start 10:30P 10/8/08 subsided some by 1:30P 10/9/08. Headache and tight chest still ongoing.
Age: 41.0
Sex: F
Vaccine: FLUX
Symptoms: Activities of daily living impaired, Cough, Dizziness
Clinical narrative: Cough, feeling lightheaded. Monitored virtual signs, no other treatment. Employee went home for the day.
Age: 67.0
Sex: F
Vaccine: FLU3
Symptoms: Pain in extremity, Pyrexia, Skin nodule
Clinical narrative: Sharp pain or knot in left arm, fever since I got the flu shot. Told Doctor about it and my husband. Still pain
Age: 19.0
Sex: F
Vaccine: ANTH, SMALL, TYP
Symptoms: CSF culture negative, Culture negative, Dysphagia, Genital ulceration, Herpes simplex serology negative
Clinical narrative: Smallpox on 9/19. Broke out with vaginal burning on 9/28. Seen 10/1 - labial ulcerations - denied sexual contact. Herpes culture negative. Admitted 10/4 for altered mental status. Negative LP, Head CT. Seen 10/6 - doing much better, no pain. Unable to swallow Valcyclovir. 12/31/08-records received-10/2/08-presented to ED with C/O vulvar burning found to have blisters consistent with herpes. Vaginal smear positive for vaccine strain vaccine virus. Male parter recently vaccinated with small pox vaccine. DX vaccine self innoculation. On overnight admission 10/4/08 acute mental status changes syncope, headache.
Age: 19.0
Sex: F
Vaccine: ANTH, SMALL, TYP
Symptoms: Mental status changes, Post vaccination autoinoculation, Pregnancy test negative, Virus culture negative, Vulval ulceration
Clinical narrative: Smallpox on 9/19. Broke out with vaginal burning on 9/28. Seen 10/1 - labial ulcerations - denied sexual contact. Herpes culture negative. Admitted 10/4 for altered mental status. Negative LP, Head CT. Seen 10/6 - doing much better, no pain. Unable to swallow Valcyclovir. 12/31/08-records received-10/2/08-presented to ED with C/O vulvar burning found to have blisters consistent with herpes. Vaginal smear positive for vaccine strain vaccine virus. Male parter recently vaccinated with small pox vaccine. DX vaccine self innoculation. On overnight admission 10/4/08 acute mental status changes syncope, headache.
Age: 19.0
Sex: F
Vaccine: ANTH, SMALL, TYP
Symptoms: Vulvovaginal burning sensation
Clinical narrative: Smallpox on 9/19. Broke out with vaginal burning on 9/28. Seen 10/1 - labial ulcerations - denied sexual contact. Herpes culture negative. Admitted 10/4 for altered mental status. Negative LP, Head CT. Seen 10/6 - doing much better, no pain. Unable to swallow Valcyclovir. 12/31/08-records received-10/2/08-presented to ED with C/O vulvar burning found to have blisters consistent with herpes. Vaginal smear positive for vaccine strain vaccine virus. Male parter recently vaccinated with small pox vaccine. DX vaccine self innoculation. On overnight admission 10/4/08 acute mental status changes syncope, headache.
Age: 15.0
Sex: F
Vaccine: HEPA, MNQ, TDAP
Symptoms: Burning sensation
Clinical narrative: 24 hours after receiving vaccines 10/1/08 complaints of burning sensation from RT deltoid muscle RT arm down to RD hand fingers; 48 hours later complained of burning in RT chest area to parent - parent will me know if she takes her in for medical evaluation (RN). 10/6/08 10:15 pt back to parent - child doing fine - burning numbness resolved - did not seek medical assessment.
Age: 6.0
Sex: F
Vaccine: FLUN3, HEPA, VARCEL
Symptoms: Injection site pain, X-ray
Clinical narrative: Pt presented 5 wks later complaining of pain at injection site. rec MOTRIN +/- x ray
Age: 0.5
Sex: U
Vaccine: DTAP, HIBV, PNC, RV5
Symptoms: Injection site vesicles
Clinical narrative: Superficial blister at site of injection. Noted 2 days after.
Age: 9.0
Sex: M
Vaccine: MNQ, VARCEL
Symptoms: Inappropriate schedule of drug administration, Induration, Local reaction, Swelling
Clinical narrative: Local severe swelling on induration.
Age: 16.0
Sex: M
Vaccine: FLU3, TDAP
Symptoms: Convulsion, Pyrexia
Clinical narrative: Fever 102 within 24 hrs of vaccine shot seizure <5 min with no need for intervention.
Age: 66.0
Sex: F
Vaccine: FLU3, PPV
Symptoms: Hypoaesthesia, Injection site swelling, Pain in extremity
Clinical narrative: Patient's left arm began to hurt at about 12:30PM and by 4PM the same day, her arm was swelling about 4 inches around the site of injection. Her arm was also starting to feel numb. The pharmacy advised her to put ice on the swelling and take benadryl. By Thursday morning, her arm was still swollen so she called her doctor and she was advised to take Benadryl and Zyrtec. By Friday, patient was feeling much better & the swelling had gone down.
Age: 38.0
Sex: M
Vaccine: FLU3, PPV
Symptoms: Erythema, Local reaction, Myalgia, Pyrexia, Urticaria
Clinical narrative: Local, redness, erythema, whelps. Systemic: fever, myalgia.
Age: 0.2
Sex: F
Vaccine: DTAPHEPBIP, HIBV, PNC, RV5
Symptoms: Irritability, Pyrexia
Clinical narrative: Fever and irritability. Treatment TYLENOL.
Age: 54.0
Sex: F
Vaccine: FLU3, PPV
Symptoms: Erythema, Lymphadenopathy, Oedema peripheral, Pruritus, Skin warm
Clinical narrative: Severe redness, warmth, itching swelling (R) upper arm shoulder and lymphadenopathy (R) supraclavicular and (R) axillary within 24-48 hours of vaccination. No SOB.
Age: 49.0
Sex: M
Vaccine: FLUN3
Symptoms: Erythema, Pruritus, Urticaria
Clinical narrative: 9/18 Next morning lg whelp under right arm by afternoon developed 2 cm whelps inside left bicep itching and reddened, persisted for 5 days used OTC CORTAID ointment for itching.
Age: 14.0
Sex: F
Vaccine: HPV4
Symptoms: Hypoaesthesia, Injection site anaesthesia
Clinical narrative: Numbness of left arm and leg; then felt left side radiating from injection site within 12 hours after injection. Numbness subsided except for a 1 inch area around injection site.  10/15/2008 office note received for DOS 9/3/2008. Pt presented with c/o numbness/tingling on L side of body including leg, arm and torso. Innjection site has the worst numness at visit, approx 1 in in diameter. PE (+) for mild induration.  Assessment:  Numbness..
Age: 0.36
Sex: M
Vaccine: DTAPHEPBIP, HIBV, PNC, RV5
Symptoms: Crying, Feeling hot, Pyrexia
Clinical narrative: Fever - hot to the touch. 100 after TYLENOL. Cried 4 hrs straight. No treatment  x TYLENOL.
Age: 34.0
Sex: M
Vaccine: FLUN3
Symptoms: Activities of daily living impaired, Asthenia, Condition aggravated, Cough, Dizziness
Clinical narrative: See attached description of events. Client states he has allergies and has had ear infection in the past. Monday, I felt a little tired that morning but nothing substantial. Received the vaccine around noon. The rest of the day was the same, just tired. Medication, none. Tuesday, Woke up with a pounding headache above my right eye, felt tired and weak throughout the day, acquired a sore throat about 1:00. Medication, Ibuprofen about 500mg. Wednesday, Woke up with a slight headache above my right eye, felt very dizzy, had watery eyes, clear drainage from the nose, throat felt better but had a dry cough. Went home at 10:00 sick. Medication, Ibuprofen about 1000mg. Thursday, Woke up with a headache more isolated to the back of the head, felt less dizzy than Wednesday but still dizzy, drainage's had diminished and dry cough was almost gone. Medication, Ibuprofen about 500mg up until sending this e-mail. Will take about 500mgs more before the days end. Main concern at this point is getting rid of the headache and dizziness.
Age: 34.0
Sex: M
Vaccine: FLUN3
Symptoms: Fatigue, Headache, Lacrimation increased, Oropharyngeal pain, Rhinorrhoea
Clinical narrative: See attached description of events. Client states he has allergies and has had ear infection in the past. Monday, I felt a little tired that morning but nothing substantial. Received the vaccine around noon. The rest of the day was the same, just tired. Medication, none. Tuesday, Woke up with a pounding headache above my right eye, felt tired and weak throughout the day, acquired a sore throat about 1:00. Medication, Ibuprofen about 500mg. Wednesday, Woke up with a slight headache above my right eye, felt very dizzy, had watery eyes, clear drainage from the nose, throat felt better but had a dry cough. Went home at 10:00 sick. Medication, Ibuprofen about 1000mg. Thursday, Woke up with a headache more isolated to the back of the head, felt less dizzy than Wednesday but still dizzy, drainage's had diminished and dry cough was almost gone. Medication, Ibuprofen about 500mg up until sending this e-mail. Will take about 500mgs more before the days end. Main concern at this point is getting rid of the headache and dizziness.
Age: 75.0
Sex: F
Vaccine: TD
Symptoms: Contusion, Erythema, Induration, Pruritus, Skin warm
Clinical narrative: 1 inch x 1 inch indurated, hot to touch, red and bruising 2 ins. below injection site, itchy.
Age: 8.0
Sex: M
Vaccine: DTAP, HEP, IPV, VARCEL
Symptoms: Inappropriate schedule of drug administration
Clinical narrative: None, no adverse events. HD would like this form filled out because DTap was  given at age 8. Says it is ok and it is a viable booster.
Age: 3.0
Sex: F
Vaccine: DTAP, HEP, HIBV, MMR, VARCEL
Symptoms: Injection site erythema, Injection site pruritus, Injection site warmth
Clinical narrative: Patient here for TB test reading. Noted that patient had red area on dorsal aspect of left arm. Area about 50x50 cm. Mother reports was larger and "itchy"yesterday. Area warm to touch, not raised. Mother reports area much improved today.
Age: 67.0
Sex: F
Vaccine: PPV
Symptoms: Chills, Immobile, Injection site haematoma, Injection site swelling, Injection site warmth
Clinical narrative: Pt awoke at 2:30AM on 10/3/08 with severe pain and immobility in (R) upper arm. Pt also had chills/chattering teeth at 2:30AM. Pt took TYLENOL and applied heating pad to R upper arm. Pt reported feeling better at 8:30 AM 10/3/08 with limited movement to R arm, mild swelling at injection site and quarter size bruise at injection site. No fever/chills. Pt did not check temperature during c/o chills. Pt complained injection site being warmer than normal.
Age: 67.0
Sex: F
Vaccine: PPV
Symptoms: Pain
Clinical narrative: Pt awoke at 2:30AM on 10/3/08 with severe pain and immobility in (R) upper arm. Pt also had chills/chattering teeth at 2:30AM. Pt took TYLENOL and applied heating pad to R upper arm. Pt reported feeling better at 8:30 AM 10/3/08 with limited movement to R arm, mild swelling at injection site and quarter size bruise at injection site. No fever/chills. Pt did not check temperature during c/o chills. Pt complained injection site being warmer than normal.
Age: 13.0
Sex: F
Vaccine: VARCEL
Symptoms: No adverse event
Clinical narrative: None stated
Age: 1.4
Sex: M
Vaccine: MMR, VARCEL
Symptoms: Rash papular
Clinical narrative: Scalp, several papular lesions. Scalp not yet vesicles.
Age: 5.0
Sex: M
Vaccine: DTAP, HEPA, IPV, MMR
Symptoms: Injection site erythema, Injection site swelling
Clinical narrative: Left leg swelling and erythema - thigh to knee. BENADRYL and ice.
Age: 0.3
Sex: F
Vaccine: DTAPHEPBIP, HIBV, PNC
Symptoms: Hypotonia
Clinical narrative: Pt. experienced 2 episodes of "going limp that lasted about 2-4 seconds" per episode on 9-18-08; per mother, recovered quickly.
Age: 62.0
Sex: M
Vaccine: HEPAB
Symptoms: Asthenia
Clinical narrative: 1) On 8/29/08 described the following TWINRIX #2 had 2 "episodes" of lack of upper body strength (from collarbone to nipple line) lasting several minutes saw his physician. 2) Phoned office 9/25/08. Had two more "episodes" following TWINRIX #3 on 9/25/08. First episode on 9/13 lasting 2-3 min, 9/16 lasting 5 min. States as if "somebody pulled a switch".
Age: 4.0
Sex: F
Vaccine: TYP
Symptoms: Dysphagia, Oropharyngeal pain, Pharyngeal erythema, Pharyngeal oedema, Pharyngitis
Clinical narrative: Possible swelling and redness of pharynx see nurses notes. Approximately 10 minutes after receiving TYPHOID injection, child was in restroom with parent reporting "Fuzzy" Throat and difficulty swallowing; "It hurt a little bit". Child had rec'd a portion of juice after the injection with her sticker. Parent reports child has had a banana allergy when very small girl but she grew out of it. "Examined pharynx with Light in clinic; significant erythema and mild swelling noted. No difficulty swallowing cool water after exam. Child acting normally. Skin warm and dry, no pallor. No SOB. Assessment: Likely has mild pharyngitis which may have been exacerbated by the juice. Will complete VAERS regardless. Left clinic about 30 minutes after injection with parent without incident.
Age: 4.0
Sex: F
Vaccine: TYP
Symptoms: Throat irritation
Clinical narrative: Possible swelling and redness of pharynx see nurses notes. Approximately 10 minutes after receiving TYPHOID injection, child was in restroom with parent reporting "Fuzzy" Throat and difficulty swallowing; "It hurt a little bit". Child had rec'd a portion of juice after the injection with her sticker. Parent reports child has had a banana allergy when very small girl but she grew out of it. "Examined pharynx with Light in clinic; significant erythema and mild swelling noted. No difficulty swallowing cool water after exam. Child acting normally. Skin warm and dry, no pallor. No SOB. Assessment: Likely has mild pharyngitis which may have been exacerbated by the juice. Will complete VAERS regardless. Left clinic about 30 minutes after injection with parent without incident.
Age: 32.0
Sex: M
Vaccine: YF
Symptoms: Ear discomfort, Erythema, Nausea, Pharyngeal oedema
Clinical narrative: Initial report received on 01 October 2008 from a nurse.  A 32-year-old male patient, who has past medical history of asthma, had received a first dose of YF VAX (Lot # UF307AB) on 01 October 2008.  The route and site of administration were not reported.  Approximately 20 minutes post-vaccination, the patient experienced throat swelling, nausea, burning sensation of ears, redness of the face, chest, back and hands.  The patient required medical evaluation and was treated with SOLU-MEDROL, BENADRYL and "ZOPHRAN."  Treatment medication routes were not provided.  Per the reporter, no diagnostic testing's were performed.  At an unspecified amount of time later, on 01 October 2008, the patient's symptoms resolved.
Sex: F
Vaccine: PPV, TDAP
Symptoms: Cellulitis, Injection site erythema, Injection site pain, Injection site rash, Injection site swelling
Clinical narrative: Initial report was received 30 September 2008 from a health care professional. A cluster of two unidentified patients had each received an intramuscular left deltoid injection of ADACEL, lot number C2995BA and an injection of PNEUMOVAX, lot number 0803U (manufacturer Merck, route and site not reported) on an unspecified date and four days later, developed pain and tenderness, swelling, increased redness, warmth, and an erythematic lesion (with no blisters) at the left deltoid injection site. The patients had no concurrent illness at the time of vaccination and had not received any other vaccines within four weeks of ADACEL and PNEUMOVAX. The patients were evaluated by their physician and were diagnosed with Cellulitis. Corrective treatments consisted of warm compress application for two to three days, MOTRIN prn, and KEFLEX for seven to ten days. The recovery status for each patient was unknown at the time of the report. Follow-up information was received 03 October 2008 from a health care professional who provided patient identifiers for both unidentified patients. This case shall reference the adult female patient with a reported date of birth of //1949. The reporter confirmed the patient had received PNEUMOVAX lot number 0803U and ADACEL, lot number C2995BA. No additional information was provided at the time of the report. The second patient referenced is captured in case number 2008-03037.
Sex: F
Vaccine: PPV, TDAP
Symptoms: Injection site warmth
Clinical narrative: Initial report was received 30 September 2008 from a health care professional. A cluster of two unidentified patients had each received an intramuscular left deltoid injection of ADACEL, lot number C2995BA and an injection of PNEUMOVAX, lot number 0803U (manufacturer Merck, route and site not reported) on an unspecified date and four days later, developed pain and tenderness, swelling, increased redness, warmth, and an erythematic lesion (with no blisters) at the left deltoid injection site. The patients had no concurrent illness at the time of vaccination and had not received any other vaccines within four weeks of ADACEL and PNEUMOVAX. The patients were evaluated by their physician and were diagnosed with Cellulitis. Corrective treatments consisted of warm compress application for two to three days, MOTRIN prn, and KEFLEX for seven to ten days. The recovery status for each patient was unknown at the time of the report. Follow-up information was received 03 October 2008 from a health care professional who provided patient identifiers for both unidentified patients. This case shall reference the adult female patient with a reported date of birth of //1949. The reporter confirmed the patient had received PNEUMOVAX lot number 0803U and ADACEL, lot number C2995BA. No additional information was provided at the time of the report. The second patient referenced is captured in case number 2008-03037.
Sex: F
Vaccine: PPV, TDAP
Symptoms: Cellulitis, Injection site erythema, Injection site pain, Injection site rash, Injection site swelling
Clinical narrative: Initial report was received 03 October 2008 from a health care professional.  An adult female patient (age not reported) had received an intramuscular left deltoid injection of ADACEL, lot number C2995BA and an injection of PNEUMOVAX, lot number 1679U (manufacturer Merck, route and site not reported) on an unspecified date and four days later, developed pain and tenderness, swelling, increased redness, warmth, and an erythematic lesion (with no blisters) at the left deltoid injection site.  The patient had no concurrent illness at the time of vaccination and had not received any other vaccines within four weeks of ADACEL and PNEUMOVAX.  The patient was evaluated by her physician and had been diagnosed with Cellulitis.  Corrective treatments consisted of a warm compress application for two to three days, Motrin prn, and Keflex for seven to ten days.  The patient's recovery status was unknown at the time of the report.  This event involved a cluster of two patients in which the other patient had been captured in case number 2008-03022.
Sex: F
Vaccine: PPV, TDAP
Symptoms: Injection site warmth
Clinical narrative: Initial report was received 03 October 2008 from a health care professional.  An adult female patient (age not reported) had received an intramuscular left deltoid injection of ADACEL, lot number C2995BA and an injection of PNEUMOVAX, lot number 1679U (manufacturer Merck, route and site not reported) on an unspecified date and four days later, developed pain and tenderness, swelling, increased redness, warmth, and an erythematic lesion (with no blisters) at the left deltoid injection site.  The patient had no concurrent illness at the time of vaccination and had not received any other vaccines within four weeks of ADACEL and PNEUMOVAX.  The patient was evaluated by her physician and had been diagnosed with Cellulitis.  Corrective treatments consisted of a warm compress application for two to three days, Motrin prn, and Keflex for seven to ten days.  The patient's recovery status was unknown at the time of the report.  This event involved a cluster of two patients in which the other patient had been captured in case number 2008-03022.
Age: 25.0
Sex: F
Vaccine: TDAP
Symptoms: Drug exposure during pregnancy, Gestational diabetes, Pregnancy test positive, Ultrasound scan normal
Clinical narrative: Initial report received on 03 December 2007 from a health care professional.  A 25-year-old female patient had received a right deltoid injection of ADACEL, lot number C2842AA, on 03 December 2007.  The patient took a pregnancy test on the same day which was positive.  Date of last menstrual period was 03 November 2007, and the estimated date of delivery was reported as "10 August 2007."  Current medications were none.  There was no adverse event reported.  Follow-up information received on 23 June 2008 from a physician.  The ADACEL had been administered intramuscularly on 03 December 2007.  The patient had received no previous doses of ADACEL and there was no illness at the time of vaccination.  The physician confirmed that the date of the last menstrual period was 03 November 2007 and the estimated date of delivery was corrected to 11 August 2008.  The patient's prenatal testing included an ultrasound on 24 March 2008, which was normal.  The current pregnancy had no complications.  The patient's past obstetric history included one live full-term birth with no congenital anomalies.  The physician confirmed that there was no adverse event.  Follow-up information was received from a health care professional on 06 October 2008.  Based on new information, which indicates the patient developed gestational diabetes mellitus (onset date not reported), the case has been upgraded to serious.  Treatment with metformin was initiated on 16 June 2008.  On 23 July 2008, gestation week 37 2/7, the pregnancy ended with a vaginal delivery of a live female infant (weight 7 pounds, 11 ounces; length 21 inches).  There were no complications of labor and/or delivery.  The infant had no congenital anomalies.  Apgar scores were 9 at one minute and 10 at five minutes.
Age: 48.0
Sex: F
Vaccine: TDAP
Symptoms: Asthma, Injection site erythema, Injection site pruritus, Injection site warmth, Wheezing
Clinical narrative: Initial report received on 06 October 2008 from a health care professional.  A 48 year old female patient with asthma, received on 30 September 2008 an intramuscular dose of ADACEL (lot# C2998BA), into the right deltoid.  No other vaccines were given.  The same day of vaccination, the patient experienced redness, itching and warmth from injection site to elbow.  Approximately 3 days after, she experienced wheezing and asthma flare-up.  The patient medical history also included hyperlipidemia, osteopenia and depression.  On 23 September 2008, 7 days prior to vaccination she was treated with SOLUMEDROL 125 mg for asthma flare up.  It was reported that she required a doctor visit.  At the time of the report, she was treated with prednisone and the wheezing persisted.  It was unknown when she received her previous Td vaccination.  The reporter denied adverse events following previous vaccinations.  The patient's concomitant medications also included: Albuterol, calcium with vitamin D and citalopram 20 mg.  The patient did not recover.
Age: 12.0
Sex: M
Vaccine: TDAP
Symptoms: Injection site erythema, Injection site pruritus, Wheezing
Clinical narrative: Initial report was received 06 October 2008 from a health care professional.  A 12-year-old male patient with a history of asthma, had received an injection of ADACEL (lot number, route, site and date of administration not reported) and complained of redness and itching at the injection site.  According to the reporter, the patient "additionally started wheezing following reaction".  The reporter had no additional information at the time of the report.  Documents held by sender: None.
Age: 69.0
Sex: F
Vaccine: VARZOS
Symptoms: Paraesthesia, Pruritus, Pruritus generalised
Clinical narrative: Information has been received from a registered pharmacist (R.PH) concerning a 69 year old retired female with diabetes and no allergies who 22- May-2008 was vaccinated subcutaneously in the left arm with a dose of ZOSTER vaccine live (lot# 659411/0293X). Concomitant therapy included SITAGLIPTIN phosphate (MSD), PANTOPRAZOLE sodium (PROTONIX), SIMVASTATIN, METFORMIN, VERAMPRIL, CLONIDINE, SPIRONOLACTONE and HYROCHLOROTHIAZIDE (+) VALSARTAN (DIOVAN HCT). On 23-MAY-2008 the patient developed itching and tingling over the whole body. The itching and tingling were described as strange feeling over the whole body, not related to the injection site. There was no rash, but the skin was described as itchy. The itching and tingling were not constant, but went away and then returned and had continued and not improved since starting. At the time of this report, the patient did not recover. The patient contacted pharmacist. No product quality complaint was involved. Follow up information was recovered from a pharmacist concerning the patient did see her family doctor and recovered. Additional information is not expected.
Sex: F
Vaccine: VARZOS
Symptoms: Injection site irritation, Injection site swelling
Clinical narrative: Information has been received from a physician concerning a female who on 10-JUN-2008 was vaccinated with a dose of 0.65ml dose of ZOSTAVAX (injection site unspecified). It was reported that on 12-JUN-2008 the patient developed irritation on the injection site and a little bit of swelling on it. The physician reported that the patient sought medical attention at the office. The outcome was not reported. Additional information has been requested.
Age: 24.0
Sex: F
Vaccine: HPV4
Symptoms: Caesarean section, Drug exposure during pregnancy, Gestational diabetes, Ultrasound scan, Urine human chorionic gonadotropin
Clinical narrative: Information has been received from a health professional concerning a 24 year old female with no medical history who in July 2007, was vaccinated with a second dose of GARDASIL.  After the vaccination the patient found to be pregnant.  Medical attention was sought.  No product quality complaint was involved.  On 06-MAR-2008, the patient delivered a normal, healthy male baby weighing 8 lb and 4.75 onz, length not reported, apgar score 8/9, head circumference not reported.  No congenital anomalies.  Complications during pregnancy included gestational diabetes.  Complications during labor/delivery included labor stalled at 9cm and the patient subsequently underwent a Caesarian section.  Upon internal review stalled at 9 cm was considered to be an other important medical event.  No further information is available.
Sex: F
Vaccine: HPV4
Symptoms: Convulsion, Myoclonic epilepsy
Clinical narrative: Information has been received from a healthcare worker concerning a female relative of hers who has been experiencing seizures since she received a dose of GARDASIL (therapy started date, dose, route, site unknown) and has been diagnosed with Juvenile myoclonic epilepsy (JME).  The patient's medical history and drug reactions/allergies were unspecified by the reporter.  The patient has been evaluated by an unspecified obstetrician/gynecologist and a neurologist.  The patient has not recovered.  No other information is available at this time.  Upon internal review, juvenile myoclonic epilepsy was considered to be an other important medical event.  Additional information has been requested.
Age: 1.1
Sex: M
Vaccine: IPV, MMR, VARCEL
Symptoms: Autism spectrum disorder, Diarrhoea, Pyrexia, Rash
Clinical narrative: rash, high fever, diahhrea 1/27/2010 Autism Spectrum Disorder
Age: 62.0
Sex: M
Vaccine: FLUX
Symptoms: Asthenia, Feeling cold, Pyrexia
Clinical narrative: 3 to 4 hours after shot   started a fever I couldn't get warm   few hours later my fever rose and the rest of me was freezing this lasted the rest of the night until 6 am    fever is gone now  but i feel weak   never had this happen to me before
Age: 51.0
Sex: F
Vaccine: FLU3, PPV
Symptoms: Cellulitis, Injection site erythema, Injection site swelling
Clinical narrative: Patient was administered flu vaccination on 10/7/08 as well as pneumovax.  Flu shot was given in L arm, Pneumovax in the R arm at approximately 2PM.  Later that evening, the patient noted significant swelling and redness about her R upper arm, without accompanying fever or chills.  She sought care in the ER and was given a prescription for keflex for cellulitis and prednisone x 4 days.  Followup visit in the office with me on 10/8/08 showed improvement in redness, still with significant swelling, distal R extremity was neurovascularly intact.  No sign of lymphangitis.  I advised the patient to fill her prescription for keflex and prednisone, and to call if worsening signs or symptoms.
Age: 34.0
Sex: F
Vaccine: FLUX
Symptoms: Dehydration, Dizziness, Fatigue, Influenza like illness, Pain
Clinical narrative: Fever of 99.9 - 102.5 for 36 hours +. Aches, pains, dizziness, extreme fatigue, dehydration (flu-like symptoms)
Age: 34.0
Sex: F
Vaccine: FLUX
Symptoms: Pyrexia
Clinical narrative: Fever of 99.9 - 102.5 for 36 hours +. Aches, pains, dizziness, extreme fatigue, dehydration (flu-like symptoms)
Age: 0.33
Sex: F
Vaccine: DTAP
Symptoms: Injection site swelling, Injection site warmth, Irritability, Wheezing
Clinical narrative: EXTREMELY HOT & SWOLLEN @ INJECTION SITE; EXTREMELY FUSSY CHILD; WHEEZING IN CHEST AFTER 24 HRS. OF VACCINATION
Age: 5.0
Sex: M
Vaccine: FLU3
Symptoms: Erythema
Clinical narrative: 15 X 6 cm erythema, treated with cool compress, monitor for progression
Age: 2.0
Sex: M
Vaccine: FLU3
Symptoms: Body temperature increased, Condition aggravated, Febrile convulsion
Clinical narrative: Pt had a febrile seizure 5 days after vaccination; temp was measured at 103 in ER; pt does have a history of febrile and afebrile seizures prior
Age: 13.0
Sex: M
Vaccine: TDAP
Symptoms: Blood glucose normal, Cold sweat, Hypotonia, Immediate post-injection reaction, Oxygen saturation normal
Clinical narrative: TDAP ADMINISTERED AT APPROX. 8:30AM PT. IMMEDIATELY WENT LIMP AND UNRESPONSIVE AND WAS PLACED IN FLOOR IN TRENDELENBURG POSITION. INITIAL B.P. 120/90 PULSE THREADY SKIN COLD AND CLAMMY WITH NO RESPONSE FROM PT. RECHECK B.P. 118/88, MONITORED FOR APPROX. 10 MIN.PT. ASSESSED BY FNP, PERRL O2 STARTED BY MASK AT 2L/MIN B.P. 110/55 PULSE 68 CALLED EMS. EMS ARRIVED ON SCENE AT 08:57 O2 SAT 98% BP 108/62 BS 100 TRANSPORTED BY AMBULANCE TO ER
Age: 13.0
Sex: M
Vaccine: TDAP
Symptoms: Oxygen supplementation, Pulse abnormal, Unresponsive to stimuli
Clinical narrative: TDAP ADMINISTERED AT APPROX. 8:30AM PT. IMMEDIATELY WENT LIMP AND UNRESPONSIVE AND WAS PLACED IN FLOOR IN TRENDELENBURG POSITION. INITIAL B.P. 120/90 PULSE THREADY SKIN COLD AND CLAMMY WITH NO RESPONSE FROM PT. RECHECK B.P. 118/88, MONITORED FOR APPROX. 10 MIN.PT. ASSESSED BY FNP, PERRL O2 STARTED BY MASK AT 2L/MIN B.P. 110/55 PULSE 68 CALLED EMS. EMS ARRIVED ON SCENE AT 08:57 O2 SAT 98% BP 108/62 BS 100 TRANSPORTED BY AMBULANCE TO ER
Age: 73.0
Sex: U
Vaccine: VARZOS
Symptoms: Blister, Facial pain, Herpes zoster, Skin lesion
Clinical narrative: Patient had Zoster vaccine on 7-8-08.  Went to doctor on 8-15-08 after having pain and 3-4 blisters on face for approximately 1 week and was dx with Shingles.  Dr. tx with Azithromycin pack and Prednisone at that time.  On 10-4-08, patient had a reoccurrence of Shingles in the waistline area and was seen by the doctor on 1--6-08 and was tx with Famciclovir 500mg TID x 3 days with 1 refill.  Patient still has lesions but much improved and pain is also lessened.
Age: 53.0
Sex: F
Vaccine: FLU3
Symptoms: Activities of daily living impaired, Headache, Malaise, Nausea
Clinical narrative: nausea, headache, malaise             missed two days of work
Age: 55.0
Sex: F
Vaccine: FLU3
Symptoms: Arthralgia, Dizziness, Headache, Pyrexia
Clinical narrative: Shot administered 12:45PM 10/8/08.  Awoke at 5AM 10/9/08 feeling dizzy and feverish.  Headache and joint aches about 8AM. A coworker that received vaccine at same time did not experience any ill effects.
Age: 54.0
Sex: F
Vaccine: FLU3, PPV
Symptoms: Erythema, Oedema peripheral, Pain in extremity
Clinical narrative: PATIENT RECEIVED VACCINE 10-8-08 , SHE CALLED THE PHARMACY ON 10-9-08 TO TELL ME HER ARM WAS HURTING  , RED AND SWOLLEN . I SPOKE WITH HER PERSONALLY TO SEE IF IT WAS ONLY RED AT THE INJECTION SITE SHE SAID IT WAS RED THERE FIRST , BUT NOW HER WHOLE ARM IS RED AND SWOLLEN. I TOLD HER TO PUT ICE ON HER ARM AND CALL HER DR ABOUT COMING IN THE LOOK AT HER ARM.
Age: 58.0
Sex: M
Vaccine: FLU3
Symptoms: Hypoaesthesia facial, Lip swelling
Clinical narrative: 48 hours after injection the employee stated his lower right side of lip was swollen and right side of lower face felt numb - employee is unsure if he had a little pimple on his lip when this event started - given benadryl and bactrim
Age: 8.0
Sex: M
Vaccine: VARCEL
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Injection site vesicles, Pyrexia
Clinical narrative: Pt obtained red swollen painful area with blisters surronding it, possibly 5 or more lesions surronding site of injection for varicella vaccine as well as low grade fever 100.5
Age: 34.0
Sex: F
Vaccine: FLUN3, FLUN3
Symptoms: Hypoaesthesia oral, Pruritus, Rash macular, Swollen tongue
Clinical narrative: Pt is a female teacher who received FluMist through our school-based influenza vaccination program on October 2, 2008. Within an hour of receiving FluMist, pt complained that her tongue was getting numb and swollen, and she was becoming itchy and splotchy. She was treated at the school with Benadryl 25 mg by mouth but refused additional Benadryl or Epipen. EMS arrived at the school and administered intravenously 25 mg of Benadryl. She was subsequently taken to emergency department and by the time she arrived she was feeling better. She never experienced hypotension, wheezes, stridor, or respiratory distress. Pt was not hospitalized and discharged home on Benadryl 25 mg by mouth every 6 hours until midnight.   Past Medical History: Nasal allergies Medication: Wellbutrin SR, Allegra D, Nasacort spray and birth control pill.   Influenza vaccine: FluMist Date of Vaccination: 02 Oct 2008 Date of Birth: 02 Aug 1974 Date of SAE: 02 Oct 2008 SAE:   Event was related to FluMist and serious
Age: 67.0
Sex: F
Vaccine: FLU3, PPV
Symptoms: Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling, Pyrexia
Clinical narrative: PATIENT IS EXPERIENCING PAIN, SWELLING, REDNESS AND ITCHING OF THE RIGHT ARM BETWEEN THE ELBOW AND SHOULDER.  SYMPTOMS ARE PREVALENT ON THE UNDERSIDE OF THE ARM (FATTY AREA OF TRICEP) AND DELTOID. PATIENT ALSO COMPLAINS OF SLIGHT FEVER ON 10/9/08.  PT WAS GIVEN 50 MG OF DIPHENHYDRAMINE ELIXIR AROUND 3:00 PM ON 10/8/08 AND ADVISED TO USE COLD COMPRESS ON AREA. PT DID NOT WANT TO TAKE DIPHENHYDRAMINE EARLIER WHILE WORKING.
Age: 14.0
Sex: M
Vaccine: MNQ, TDAP
Symptoms: Inappropriate schedule of drug administration
Clinical narrative: Pt. given 2nd dose of meningococcol (Menactra) in error.  First dose given at M.D. office 04/16/2008.  Nurse did not adequately check vaccine history document to notice vaccine already given. No adverse reaction to report at this time. Mother of patient notified of error.
Age: 55.0
Sex: F
Vaccine: FLU3
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth, Local reaction
Clinical narrative: INJECTION SITE LOCAL REACTION---SWOLLEN, RED, HOT TO TOUCH---TYLENOL AND MOTRIN AT HOME
Age: 73.0
Sex: F
Vaccine: FLU3
Symptoms: Injection site bruising, Injection site induration, Injection site pain
Clinical narrative: Patient called 1 hour after receiving the shot reporting pain,bruising and hard knot formed at injection site. Recommend cold compress and analgesic. If symptoms worsen, call the doctor and follow up. Followed up with patient 3 hours later, she was doing better. Informed patient to follow up with the doctor if symptoms don't resolve.
Age: 39.0
Sex: F
Vaccine: FLU3
Symptoms: Injection site erythema, Injection site swelling
Clinical narrative: INFECTION SITE--RED SWOLLEN
Age: 38.0
Sex: F
Vaccine: FLU3
Symptoms: Injection site erythema, Injection site induration, Injection site warmth
Clinical narrative: Pt has a 60 x 90mm red warm knot on her left deltoid.  She doesn't have any pain or discomfort.
Age: 18.0
Sex: F
Vaccine: FLUX
Symptoms: Asthma, Condition aggravated, Cough, Rhinorrhoea, Wheezing
Clinical narrative: Wheezing, runny nose, coughing, asthma.  Treated with Albuterol through nebulizer.
Age: 9.0
Sex: M
Vaccine: FLUN3
Symptoms: Diarrhoea, Nausea, Vomiting
Clinical narrative: Nausea and vomiting, diarrhea
Age: 67.0
Sex: F
Vaccine: FLU3
Symptoms: Urticaria
Clinical narrative: Patient received vaccine on 10-6-08 at about 11:30am. Later in the evening hives developed all over her body. She called the pharmacy on Wednesday, at that time the hives were still present, but were not as severe as on Tuesday. She came into the pharmacy on Thursday morning (10-9-08) to show us her hives and ask about management and how long the reaction could last.
Age: 86.0
Sex: M
Vaccine: FLU3, PPV
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth
Clinical narrative: significant erythema, warmth, swelling at injection site upon examination; Pt received injection on a Friday afternoon 9/26/08. He called in on Monday morning 9/29/08 complaining that his arm was "still hot and red" and was advised to come in to the clinic. Pt was examined and given an injection of triamcinolone 60mg IM with further instructions to return if his symptoms did not resolve. As of this date he has not returned for further treatment.
Age: 60.0
Sex: F
Vaccine: FLU3
Symptoms: Erythema, Oedema peripheral, Pain in extremity
Clinical narrative: Pt c\o pain and edema to right deltoid starting in PM of 9/18/08. Was vaccinated with influenza to right deltoid IM on 9/16/08. Area of edema and erythema less than 1 cm to right deltoid found on exam. Pt prescribed Keflex 500mg BID for 10 days. May take loratadine or benadryl OTC prn itching qd. Apply ice packs prn. Motrin 600mg tid prn pain q 6 hrs.
Age: 74.0
Sex: M
Vaccine: FLU3, PPV
Symptoms: Discomfort, Erythema, Oedema peripheral, Skin warm
Clinical narrative: Noticed discomfort that didn't resolve by bedtime of 10/8/08. Redness and swelling of upper arm, hot to touch. No self treatment as of today. Area is expanding and is uncomfortable. Referred to Dr today.
Age: 45.0
Sex: M
Vaccine: FLU3
Symptoms: Cough, Dyspnoea, Eyelid oedema, Oedema mouth
Clinical narrative: SOFT TISSUE UNDER TONGUE STARTED SWELLING.  EYE LIDS SWELLED, COUGHING, DIFFICULTY BREATHING.  EVENT OCCURRED APPROXIMATELY 2 1/2 HOURS AFTER ADMINISTRATION OF VACCINE.  BENADRYL/ZANTAC GIVEN WHICH REVERSED REACTION.  HAD TO BE REPEATED 4 HOURS LATER WHEN SYMPTOMS RESUMED.  NO EPINEPHRINE HAD TO BE ADMINISTERED. 10/20/08 Per hospital RN, pt was not treated at facility. Was administered Epipen at home by spouse who is an RN.
Age: 63.0
Sex: M
Vaccine: FLU3
Symptoms: Asthenia, Cold sweat, Erythema, Hyperhidrosis, Hypoventilation
Clinical narrative: I administered Flulaval IM at 11:30 AM to pt. in his left Deltoid. At 11:35 the pt., who was seated, c/o feeling weak and placed his head between his legs. He became unresponsive, and I leaned him back in the chair to prevent him from falling. His back began to arch, his eyes were open and glassy, and respirations became slow and shallow. He did not respond to voice or painful stimuli. His skin was pale and clammy when I was checking for a pulse. He appeared to be having a seizure until his face became very red and respirations ceased. I could not detect a pulse and there were no respirations. Other female staff assisted me in lowering him to the floor to start CPR. We put him down hard in our haste, and he began breathing again. At this point, his color was pasty gray and he was extremely diaporetic. 911 was called, and by the time the paramedics arrived at approximately 11:48 AM, the pt. was able to respond to their questions. He was very weak and tremorous and had been incontinent of urine. He was transported to the ER for further evaluation.
Age: 63.0
Sex: M
Vaccine: FLU3
Symptoms: Opisthotonus, Pallor, Pulse absent, Respiratory rate decreased, Tremor
Clinical narrative: I administered Flulaval IM at 11:30 AM to pt. in his left Deltoid. At 11:35 the pt., who was seated, c/o feeling weak and placed his head between his legs. He became unresponsive, and I leaned him back in the chair to prevent him from falling. His back began to arch, his eyes were open and glassy, and respirations became slow and shallow. He did not respond to voice or painful stimuli. His skin was pale and clammy when I was checking for a pulse. He appeared to be having a seizure until his face became very red and respirations ceased. I could not detect a pulse and there were no respirations. Other female staff assisted me in lowering him to the floor to start CPR. We put him down hard in our haste, and he began breathing again. At this point, his color was pasty gray and he was extremely diaporetic. 911 was called, and by the time the paramedics arrived at approximately 11:48 AM, the pt. was able to respond to their questions. He was very weak and tremorous and had been incontinent of urine. He was transported to the ER for further evaluation.
Age: 63.0
Sex: M
Vaccine: FLU3
Symptoms: Unresponsive to stimuli, Urinary incontinence
Clinical narrative: I administered Flulaval IM at 11:30 AM to pt. in his left Deltoid. At 11:35 the pt., who was seated, c/o feeling weak and placed his head between his legs. He became unresponsive, and I leaned him back in the chair to prevent him from falling. His back began to arch, his eyes were open and glassy, and respirations became slow and shallow. He did not respond to voice or painful stimuli. His skin was pale and clammy when I was checking for a pulse. He appeared to be having a seizure until his face became very red and respirations ceased. I could not detect a pulse and there were no respirations. Other female staff assisted me in lowering him to the floor to start CPR. We put him down hard in our haste, and he began breathing again. At this point, his color was pasty gray and he was extremely diaporetic. 911 was called, and by the time the paramedics arrived at approximately 11:48 AM, the pt. was able to respond to their questions. He was very weak and tremorous and had been incontinent of urine. He was transported to the ER for further evaluation.
Age: 72.0
Sex: F
Vaccine: FLUX
Symptoms: Chills, Myalgia, Pyrexia
Clinical narrative: Developed chills, muscle aches and high fever (102.6).  Improvement noted approximatelt 12 hours after onset.
Age: 55.0
Sex: F
Vaccine: FLU3, PPV
Symptoms: Injection site pain, Injection site urticaria, Local reaction
Clinical narrative: Large 15cm x 17cm local painful whelp on the site of injection on the left arm
Age: 48.0
Sex: F
Vaccine: FLUX
Symptoms: Chills, Dizziness, Full blood count, Headache, Prothrombin time
Clinical narrative: After i received flu shot I had a bad headache.On 10-8-08  I woke up with chills and dizzines I called my doctors office  that morning I told the assisant my symptoms, and that I had a flu shot on 10-7-08. Nurse returned my call.I asked if it was okay to take some meclizine she asked what amount I  told her . I had some relief, the next morning 10-9-08 .I woke with the same sympotoms.
Age: 47.0
Sex: F
Vaccine: FLU3
Symptoms: Asthenia, Dizziness, Dysphonia, Heart rate increased, Nausea
Clinical narrative: Shot was administered at appx. 3:30 pm and about 15 mins. after I was nauseated, throwing up, hives, weak and dizzy.  Later that evening, I was horse and rapid heart rate.  My throat started swelling and the EMTs were called after 10:00 pm and I was transported to Medical Center.  I was seen by Dr.  I was given an IV of steroids, Benedryl drew blood and was told that I had a bad reaction to the flu shot.  I am still taking steroids, Methyiprednisolone and Hydroxyzpam.
Age: 47.0
Sex: F
Vaccine: FLU3
Symptoms: Pharyngeal oedema, Urticaria, Vaccination complication, Vomiting
Clinical narrative: Shot was administered at appx. 3:30 pm and about 15 mins. after I was nauseated, throwing up, hives, weak and dizzy.  Later that evening, I was horse and rapid heart rate.  My throat started swelling and the EMTs were called after 10:00 pm and I was transported to Medical Center.  I was seen by Dr.  I was given an IV of steroids, Benedryl drew blood and was told that I had a bad reaction to the flu shot.  I am still taking steroids, Methyiprednisolone and Hydroxyzpam.
Age: 22.0
Sex: F
Vaccine: HPV4
Symptoms: Malaise, Pharyngolaryngeal pain, Pyrexia
Clinical narrative: Patient called this am and stated that since she had her injection yesterday, has a sore throat, fever and doesn't feel well.
Age: 70.0
Sex: M
Vaccine: FLU3
Symptoms: Nausea, Urticaria, Vomiting
Clinical narrative: Vaccine given left arm 10/6/08. 10/7/08 in afternoon started with nausea and hives over most of body. vomited x 2. Nausea resolved by 10/8/08 and hives persist upon my exam this PM (10/9/0) Hives on exam predominately upper body left arm worse than right. After detailed history could not find any other known triggers. No fever or other systemic symptoms.
Age: 63.0
Sex: F
Vaccine: PPV
Symptoms: Erythema, Oedema peripheral, Pain in extremity, Skin warm
Clinical narrative: Around 4-5 hours after the vaccine was given, the patient's arm was red and warm to the touch.  I then became swollen and painful.  She was given benadryl 50 mg and tylenol 500 mg 9 hours after the vaccine was given.
Age: 2.0
Sex: M
Vaccine: DTAP
Symptoms: Blood culture negative, Erythema, Lymphocyte percentage increased, Methicillin-resistant staphylococcal aureus test negative, Neutrophil percentage decreased
Clinical narrative: Significant arm swelling noted 14 hours after Dtap administration--erythematous, mildly pruritic, warm, no fever or pain. No history of previous reaction. IM epi, benadryl and ancef did not help.
Age: 2.0
Sex: M
Vaccine: DTAP
Symptoms: No reaction on previous exposure to drug, Oedema peripheral, Pruritus, Skin warm, White blood cell count increased
Clinical narrative: Significant arm swelling noted 14 hours after Dtap administration--erythematous, mildly pruritic, warm, no fever or pain. No history of previous reaction. IM epi, benadryl and ancef did not help.