chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 71.0
Sex: F
Vaccine: FLU3, PPV
Symptoms: Malaise, Peripheral swelling, Pyrexia
Clinical narrative: Patient had a very sore, red, and swollen arm, much more than when she has gotten previous vaccines.  It started the night of getting the shot.  It has been getting better over the past few days, but the redness has moved to the front of her arm.  She also stated she was diagnosed with cellulitis and was put on an antibiotic.  She also had a fever, chills, and felt overall awful the night of and day after getting the shot.  She does feel better now, 3 days later,  but still has visible redness and says it still hurts, but is getting better each day.
Age: 83.0
Sex: M
Vaccine: FLU4
Symptoms: Influenza like illness, Injection site pain, Musculoskeletal pain, Pain in extremity
Clinical narrative: His shoulder has been sore since the injection and hurts to lift his arm.  He has also felt like he has had a cold since the vaccination too.  He is not sure if the arm pain is from the vaccine or pre-existing.
Age: 28.0
Sex: F
Vaccine: SMALL
Symptoms: Blood test, Magnetic resonance imaging brain, Paralysis
Clinical narrative: I received the smallpox vaccination on 12 September 2019. On 12 October 2019, I started experiencing  temporary paralysis on the right side of my body. My right arm, my right leg, the right side of my face, and mouth were affected each time. Each "episode" would last no more than 20-30 seconds. Initially, these "episodes" would happen once a day however, some days it would occur twice. These happened an approximately 12 times in a one week period.
Age: 60.0
Sex: F
Vaccine: VARZOS
Symptoms: Arthralgia, Chills, Headache, Impaired work ability, Malaise
Clinical narrative: Approx 4 hours after injection, malaise, chills, muscle and joint aches.  Then headache nausea and vomiting followed approx  12 hours after injection.  Symptoms  lasted 36 hours.
Age: 60.0
Sex: F
Vaccine: VARZOS
Symptoms: Myalgia, Nausea, Vomiting
Clinical narrative: Approx 4 hours after injection, malaise, chills, muscle and joint aches.  Then headache nausea and vomiting followed approx  12 hours after injection.  Symptoms  lasted 36 hours.
Age: 4.0
Sex: F
Vaccine: DTAPIPV, FLU4, MMRV
Symptoms: Cellulitis, Erythema, Induration
Clinical narrative: Bilateral cellulitis of lower extremities. 18x3.5 cm of erythema and some induration and warmth over lateral left thigh. Lateral right thigh 3x3 erythematous area. Augmentin prescribed for treatment.
Age: 65.0
Sex: M
Vaccine: FLUA3
Symptoms: Bursitis
Clinical narrative: Patient states he now has bursitis
Age: 66.0
Sex: F
Vaccine: PPV
Symptoms: Hypersensitivity, Urticaria
Clinical narrative: Patient presents clinic with complaints of continued allergic reaction symptoms.  Continues to demonstrate hives.  Has been utilizing 25 mg of Benadryl every 4 hours.  Additionally, has been coating urticarial rash areas with hydrocortisone and Benadryl cream.  Has utilized over-the-counter calamine lotion.  Additionally, has utilized a topical poison IV relief cream.  States this is unbearable.  States the only time she had relief was after the Solu-Medrol shot.  Continues with the Medrol Dosepak.  Would like to discuss an additional steroid injection.
Age: 81.0
Sex: F
Vaccine: PPV
Symptoms: Injection site erythema, Injection site pain, Injection site swelling
Clinical narrative: redness;swollen bump below injection site; painful to the touch
Age: 66.0
Sex: F
Vaccine: FLU3
Symptoms: Erythema, Peripheral swelling, Pyrexia
Clinical narrative: Patient's arm was swollen and red and had a fever for 1 day.
Age: 76.0
Sex: F
Vaccine: FLU3, PPV
Symptoms: Erythema, Full blood count, Red blood cell sedimentation rate, Swelling, Tenderness
Clinical narrative: Redness, swelling, and tenderness
Age: 79.0
Sex: F
Vaccine: VARZOS
Symptoms: Fatigue, Injection site erythema, Injection site induration, Injection site swelling, Injection site warmth
Clinical narrative: redness,  hardness, swelling, warmth at site . body aches, fatigue.  ice pack to site x 15 min several x over 2 days. Site almost normal by 5 days after injection
Age: 79.0
Sex: F
Vaccine: VARZOS
Symptoms: Pain
Clinical narrative: redness,  hardness, swelling, warmth at site . body aches, fatigue.  ice pack to site x 15 min several x over 2 days. Site almost normal by 5 days after injection
Age: 4.0
Sex: M
Vaccine: UNK
Symptoms: Injection site infection
Clinical narrative: Rt thigh with signs of infection 2-3 days s/p IM vaccination admin.  Pt with VIS  (Influenza, Polio, DTaP, MMRV) forms only and it is not clear which vaccines were given in the right thigh.  Pt to be treated with cephalexin antibiotics, follow up with PCP on Monday for recheck and advised to have them report the exact vaccines given with name, lot #, etc.
Age: 65.0
Sex: F
Vaccine: FLU3
Symptoms: Dizziness, Dyspepsia, Fall, Flatulence, Haemorrhage
Clinical narrative: Hiccups for 10 minutes,  indigestion, gas buildup , could not burp or expel gas, muscle pain around rib cage, back and chest,nausea, dizziness, fainting, vomiting,fell on floor and hit my nose which made it bleed. Did not stay unconscious for long, recovered quickly .had not pain afterwards took pepto bismal  for slight nausea then I felt all better. This all occurred between 9:30 pm to  12:30 am.
Age: 65.0
Sex: F
Vaccine: FLU3
Symptoms: Hiccups, Loss of consciousness, Myalgia, Nasal injury, Nausea
Clinical narrative: Hiccups for 10 minutes,  indigestion, gas buildup , could not burp or expel gas, muscle pain around rib cage, back and chest,nausea, dizziness, fainting, vomiting,fell on floor and hit my nose which made it bleed. Did not stay unconscious for long, recovered quickly .had not pain afterwards took pepto bismal  for slight nausea then I felt all better. This all occurred between 9:30 pm to  12:30 am.
Age: 65.0
Sex: F
Vaccine: FLU3
Symptoms: Syncope, Vomiting
Clinical narrative: Hiccups for 10 minutes,  indigestion, gas buildup , could not burp or expel gas, muscle pain around rib cage, back and chest,nausea, dizziness, fainting, vomiting,fell on floor and hit my nose which made it bleed. Did not stay unconscious for long, recovered quickly .had not pain afterwards took pepto bismal  for slight nausea then I felt all better. This all occurred between 9:30 pm to  12:30 am.
Age: 29.0
Sex: M
Vaccine: FLU3
Symptoms: Fear of injection, Generalised tonic-clonic seizure, Loss of consciousness
Clinical narrative: Patient was very fearful of needles and was looking the other way after rolling sleeve over the shoulder.  I administered the vaccine to the patient...He passed out and then experienced a tonic-clonic like seizure.  It seemed like a psychogenic seizure on presentation but unsure.  It lasted 30 seconds or so.  His wife was visibly upset and crying.  When he came to, he didn't realize that anything had happened.  I held on to him and made sure he did not fall off the chair.  I was going to try to put him on the ground but he came to before I could attempt to do that.  We gave him water which he consumed quite quickly.  We talked to him and his wife and they felt comfortable to leave.  We advised him to see a physician and told the wife that she should drive him home.
Age: 79.0
Sex: F
Vaccine: FLUA3
Symptoms: Asthenia, Chills, Headache, Lower respiratory tract infection, Pain
Clinical narrative: Patient stated has headache, chest congestion, weakness, aches all over, chills and fever that started the evening of the vaccination
Age: 79.0
Sex: F
Vaccine: FLUA3
Symptoms: Pyrexia
Clinical narrative: Patient stated has headache, chest congestion, weakness, aches all over, chills and fever that started the evening of the vaccination
Age: 45.0
Sex: F
Vaccine: FLUC4
Symptoms: Pain, Skin swelling
Clinical narrative: Skin appears to be raised, diameter of about 1 cm. The affected area is sore, however area around is not.
Age: 58.0
Sex: M
Vaccine: UNK
Symptoms: Acoustic stimulation tests abnormal, Deafness neurosensory, Deafness unilateral, Sudden hearing loss
Clinical narrative: Sudden Sensorineural Hearing Loss right ear.
Age: 70.0
Sex: F
Vaccine: FLU3
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth
Clinical narrative: Patient called the pharmacy on 10/25/19 and said she had a reaction to the vaccine. Her arm was warm and swollen around the injection site. The redness was about 4 inches surrounding the site of injection.
Age: 46.0
Sex: F
Vaccine: FLU4
Symptoms: Pyrexia
Clinical narrative: Fever >100 for 48 hours
Age: 69.0
Sex: M
Vaccine: FLU3, PPV
Symptoms: Injection site erythema, Injection site swelling, Pyrexia
Clinical narrative: Pt said he noticed redness at injection site about 24 hours post vaccinations. He then redness and swelling that extended from injection site to right below elbow around 48 hours post vaccination which was accompanied by fever of 102.2 degrees F. Fever subsided with Tylenol. Today pt no longer has fever, but continues to have redness and swelling between injection site and elbow
Age: 59.0
Sex: M
Vaccine: FLU4
Symptoms: Rash
Clinical narrative: Rash shoulders, chest, back
Age: 63.0
Sex: F
Vaccine: FLU4
Symptoms: Injection site inflammation, Injection site warmth
Clinical narrative: Patient presented on 10/24/2019 displaying injection site. Upper arm was warm to touch and inflamed to elbow. No other complaints. Patient advised to seek further medical attention from her physician. Doctor was unsure if reaction was allergy or cellulitis, so he marked the inflamed area and called in KEFLEX for patient. Patient was instructed to check area on 10/25 and if redness and inflammation had spread further then she should pick up the prescription, but if same or reduced, she should continue to monitor. RPH spoke to patient in the morning of 10/25 and area hade reduced, so patient is monitoring as instructed.
Age: 42.0
Sex: F
Vaccine: FLU4
Symptoms: Computerised tomogram abnormal, Electrocardiogram, Electroencephalogram, Hypoaesthesia, Magnetic resonance imaging
Clinical narrative: Day after immunization patient experienced left sided numbness but no muscle weakness. Tested negative for stroke and Guillan Barre. Still experiencing numbness in alternating sites (hands, arms, feet, cheeks) but less severe. Symptoms were most severe the first seven days
Age: 18.0
Sex: M
Vaccine: FLU4, VARCEL
Symptoms: Rash
Clinical narrative: Rash noticed on back, neck and face examined by Dr., Benadryl given 50Mg ice Pack Placed Monitored 30 minutes
Age: 67.0
Sex: F
Vaccine: FLU3, PPV
Symptoms: Erythema, Peripheral swelling
Clinical narrative: PATIENT CONTACTED US ON 10/22/19 STATING HER ARM WAS RED, SWOLLEN (ABOUT SIZE OF PALM OF HAND). IT WAS RECOMMEND TO ICE IT, TAKE TYLENOL & CONTACT MD DR TREATED WITH BACTRIM DS FOR 5 DAYS
Age: 3.0
Sex: M
Vaccine: FLU4
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth, Muscle swelling
Clinical narrative: Erythema, warmth, and swelling of L bicep/deltoid 8.5 inches L arm circumference compared to 6.5 in R arm at site of flu vaccine injection approx. 24 hrs s/p vaccine
Age: 5.0
Sex: F
Vaccine: DTAP
Symptoms: Cellulitis, Injection site erythema, Injection site warmth
Clinical narrative: 10/22/19 PT Presented small erythema + warm @ shot area. RX for Cephalexin 7.5mL 10/23/19 F/U for Cellulitis 10/24/19 F/U for Cellulitis Resolved
Age: 57.0
Sex: M
Vaccine: HEP
Symptoms: Injection site pruritus, Injection site rash
Clinical narrative: 10/22/19 Employee reported having a rash at site of injection with pruritis. 4 small circular  2-4cm  rash, flat,
Sex: F
Vaccine: FLU4, MENB, MNQ
Symptoms: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site urticaria
Clinical narrative: (L) deltoid 5-6 CM elevated red Hive like lesion with swelling an itching
Sex: F
Vaccine: FLU4
Symptoms: Hypoaesthesia, Paraesthesia
Clinical narrative: Had flu vaccine on 10/13/19, on 10/14/19 patient started experiencing numbness and tingling bilateral feet.
Age: 63.0
Sex: F
Vaccine: VARZOS
Symptoms: Fatigue, Headache, Influenza like illness, Injection site urticaria, Pyrexia
Clinical narrative: Flu like symptoms, Rash on trunk, Headache, Welt at injection site, Fever, tired Patient experienced with Both shots
Age: 63.0
Sex: F
Vaccine: VARZOS
Symptoms: Rash, Vaccine positive rechallenge
Clinical narrative: Flu like symptoms, Rash on trunk, Headache, Welt at injection site, Fever, tired Patient experienced with Both shots
Age: 16.0
Sex: M
Vaccine: FLU4, MENB, MNQ
Symptoms: Diarrhoea, Discomfort, Dizziness, Nausea
Clinical narrative: Soreness, Dizziness, Nausea, Diarrhea
Age: 40.0
Sex: F
Vaccine: FLU4, HEPA, PPV
Symptoms: Body temperature increased, Injection site erythema, Injection site swelling, Injection site warmth, Pain
Clinical narrative: Shots given on 10/21/19. Pt ran elevated temp and body aches 10/22/19. Redness and swelling 2" below the injection sites. Warm to the touch.
Age: 66.0
Sex: M
Vaccine: VARZOS
Symptoms: Incorrect route of product administration, Injection site bruising, Injection site erythema, Injection site swelling
Clinical narrative: patient came in to ask Pharmacist on duty to look at her arm where she previously received Shingles vaccine. It appeared that the vaccine had been given SQ on the back side of the patients arm. the back side of the arm was bruised with redness and swelling. the Pharmacist on duty asked the patient what area of the arm She received the vaccine and she said on the back of her arm. Patient was advised to take acetaminophen and use heat or ice to relieve discomfort.
Age: 34.0
Sex: F
Vaccine: FLU4
Symptoms: Arthralgia, Headache, Injection site pain, Myalgia, Pyrexia
Clinical narrative: Headache, Lots of joint pain, muscle pain, fever. Pain in arm where vaccination was injected.
Age: 9.0
Sex: M
Vaccine: FLU4
Symptoms: Injection site haemorrhage, Syncope, Vomiting
Clinical narrative: gave the vaccine it bleed a little covered with a cotton ball applied pressure until it stopped. covered with a Band-Aid. about a minute later child asked to use restroom 5 seconds later child fainted in the chair. the mother and the intern caught the child in the chair and laid them down on the ground. Once the child regained consciousness, the intern then came to come get me. Once I arrived the child vomited and we then proceeded to monitor the child for the next 20 minutes.
Sex: F
Vaccine: VARZOS
Symptoms: Erythema, Malaise, Mobility decreased, Pain, Swelling
Clinical narrative: Patient complains of pain, swollen, redness and can not raise arm. Feel sick all days for 1 day.
Age: 73.0
Sex: F
Vaccine: FLUA3
Symptoms: Injection site erythema, Injection site warmth
Clinical narrative: Patient said her arm was warm at the site of the injection and turned very red almost to her elbow. She said it lasted about 2 days and then it went away.
Age: 83.0
Sex: F
Vaccine: PPV
Symptoms: Cellulitis, Erythema, Pain in extremity, Peripheral swelling
Clinical narrative: PATIENT PRESENTED TO HER DOCTOR (AND SUBSEQUENTLY) PHARMACY WITH REDNESS, SEVERE SWELLING, AND PAIN OF HER LEFT ARM TWO DAYS AFTER PNEUMONIA VACCINE. HER HUSBAND, WHO HAD THE SAME VACCINE, WAS EXPERIENCING THE SAME SYMPTOMS. DOCTOR DIAGNOSED AS CELLULITIS AND PRESCRIBED KEFLEX 500MG TID FOR 10 DAYS.
Age: 35.0
Sex: F
Vaccine: VARCEL
Symptoms: Injection site erythema, Injection site pustule, Injection site rash
Clinical narrative: Redness and rash at injection site. Bumps and pustules in this area. Patient was seen by her physician who thought the rash to be shingles.
Age: 83.0
Sex: M
Vaccine: PPV
Symptoms: Cellulitis, Erythema, Pain in extremity, Peripheral swelling
Clinical narrative: Patient present to urgent care (and subsequently) pharmacy with redness. Severe swelling, and pain of his left arm two days after pneumonia vaccine. His wife, who had the same vaccine, was experiencing the same symptoms. Doctor diagnosed as cellulitis and prescribed KEFLEX 500MG TID for 7 days.
Age: 23.0
Sex: M
Vaccine: FLUC4
Symptoms: Asthenia, Fatigue, Hyperhidrosis, Loss of consciousness, Pallor
Clinical narrative: Patient lost consciousness following administration of vaccine. Happened within 5 minutes of receiving. He regained consciousness roughly 30 seconds to 1 minute later, but complained of fatigue and continued to have vision difficulties/ weakness. Patient was very pale and skin was hot to the touch, noticeable perspiration. EMS was called and patient was taken to local emergency department.
Age: 23.0
Sex: M
Vaccine: FLUC4
Symptoms: Skin warm, Visual impairment
Clinical narrative: Patient lost consciousness following administration of vaccine. Happened within 5 minutes of receiving. He regained consciousness roughly 30 seconds to 1 minute later, but complained of fatigue and continued to have vision difficulties/ weakness. Patient was very pale and skin was hot to the touch, noticeable perspiration. EMS was called and patient was taken to local emergency department.
Age: 65.0
Sex: F
Vaccine: FLU3
Symptoms: Alcohol use, Feeling hot, Pruritus, Rash macular
Clinical narrative: Pt got vaccine, then in the evening went to a party and had a couple of drinks. Said it was very hot at the party. After being back at home after the party; started getting itchy and broke out in a rash and blotches all over (even under breast and on scalp and feet). Today, 10/26, she took a shower and it made her more itchy. I told her to take Benadryl and if unbearable to contact the MD on call and maybe they would prescribe something for her. She said that she didn't want to do that. She asked if she could put something on it and I told her that she could try some hydrocortisone on the really itchy spots (kind of hard since it is all over). She could also use an Aveeno bath (she can't get in tub). And I told her to keep in mind possibly calling the on call MD if it worsened. I will also check back with her. She said that she never had any reaction before. 6:06 pm I called her back - said still itchy - took Benadryl earlier and just took 2 more. I suggested that she contact the MD on call.
Age: 57.0
Sex: F
Vaccine: VARZOS
Symptoms: Chills, Diarrhoea, Fatigue, Gastrointestinal pain, Headache
Clinical narrative: Arm pain, headache, fatigue, chills, diarrhea, lower GI pain, ringing in ears, hives, whole body itching
Age: 57.0
Sex: F
Vaccine: VARZOS
Symptoms: Pain in extremity, Pruritus, Tinnitus, Urticaria
Clinical narrative: Arm pain, headache, fatigue, chills, diarrhea, lower GI pain, ringing in ears, hives, whole body itching
Age: 22.0
Sex: F
Vaccine: FLU4
Symptoms: Chest pain, Computerised tomogram, Inflammation, Lumbar puncture, Skin warm
Clinical narrative: After a couple of hours the patient had a red inflamed hand/arm. Went to the ER and after a dose of steroid and pain meds was fine. Again on 10/26 had chest pain and a CT scan was done to rule out a clot. Spinal tap was done and further neuro follow up is required
Age: 68.0
Sex: F
Vaccine: FLU3
Symptoms: Fall, Gait inability, Muscular weakness
Clinical narrative: Extreme muscle weakness leading to fall 12 hours after injection.  Unable to walk unaided for another 12 hours.  Muscle weakness lessens but does not cease after 36 hours.
Age: 73.0
Sex: M
Vaccine: VARZOS, VARZOS
Symptoms: Pain in extremity, Paraesthesia
Clinical narrative: Tingling in the left arm and pain
Age: 73.0
Sex: M
Vaccine: VARZOS, VARZOS
Symptoms: Paraesthesia
Clinical narrative: Tingling in the left arm and pain
Age: 8.0
Sex: M
Vaccine: FLU4
Symptoms: Chills
Clinical narrative: Patient woke middle of the night after receiving flu vaccine with rigors.  no fever.  Symptoms abated with Motrin.  I spoke to mother on phone as MD on call for clinic.  No other symptoms reported.
Age: 65.0
Sex: F
Vaccine: FLU3, PNC13
Symptoms: Mobility decreased, Pain in extremity
Clinical narrative: Patient complaining of arm pain and limitation of arm movement.
Age: 21.0
Sex: F
Vaccine: FLU4
Symptoms: Abdominal pain upper, Cough, Headache, Insomnia, Myalgia
Clinical narrative: Fever of 102F Headache Stomach ache Muscle aches Unable to sleep Cough
Age: 21.0
Sex: F
Vaccine: FLU4
Symptoms: Pyrexia
Clinical narrative: Fever of 102F Headache Stomach ache Muscle aches Unable to sleep Cough
Age: 60.0
Sex: F
Vaccine: VARZOS
Symptoms: Rash
Clinical narrative: Rash on upper chest extending to neck. No trouble breathing.
Age: 12.0
Sex: F
Vaccine: FLUC4
Symptoms: Crying, Erythema, Fall, Gaze palsy
Clinical narrative: MOM STATES THAT HER EYES ROLLED UP AND SHE FELL TO THE FLOOR. MOM WAS AFRAID SHE'D HAD HER FIRST SEIZURE. I RESPONDED QUICKLY TO THE REQUEST FOR HELP. WHEN I ARRIVED, PT WAS STANDING WITH ASSISTANCE, SHE WAS RED IN THE FACE WITH TEARS, SHE WAS SPEAKING CLEARLY AND RESPONSIVE. BBECAUSE SHE WAS SHOOK UP BUT LUCID, SHE DID NOT APPEAR LIKE SHE NEEDED TO LIE DOWN. WE WENT TO A SITTING AREA. SHE CONTINUED TO CRY AND ANSWER QUESTIONS. SHE DID NOT INJURE HERSELF DURING THE FALL. THE FAMILY STATES SHE FELL ON HER BOTTOM. I MONITERRED THE PATIENT FOR ABOUT 5-10 MINUTES WITH THE FAMILY. SH APPEARED TO HAVE RECOVERRED. I ASKKED MOM TO CONITNUE TO MONITOR HER FOR VOMITTING, HEADACHE, STOMACH UPSET AND TAKE ANNY SYMPTOMS SERIOUSLY. I REASSURED MOM THAT A SIEZURE WAS UNLIKELY AND FAINTING WAS MOST LIKELY WHAT TOOK PLACE.    I CALLED MOM ABOUT AN HOUR LATER, SHE STATES THAT PATIENT HAD RECOVERRED AND IS ACTING NORMAL, SHE IS STILL MONITORING HER
Age: 46.0
Sex: F
Vaccine: MMR
Symptoms: Erythema, Pruritus, Rash, Urticaria
Clinical narrative: Rash, hives, red spots and itching
Age: 15.0
Sex: F
Vaccine: FLU4
Symptoms: Posture abnormal
Clinical narrative: Patient seated while receiving flu shot, upon completion, her head dropped and she slumped in chair.  Her father present and leaned over to "hug" her, stating her name and asking if she was ok.  She did not lose consciousness, her eyes were open.  She quickly became alert and said she was ok.  Pt. stated this has happened in the past during bloodwork.  Pt. also stated she was at a sleep-over last night, got to bed late and had not eaten anything this morning.
Age: 49.0
Sex: M
Vaccine: FLUC4
Symptoms: Chills, Fatigue, Headache, Malaise, Myalgia
Clinical narrative: at about 10pm on the day of the vaccination I began experiencing very strong chills, my temperature was 99.1F (my typical temperature is 97.6F). I took 400mg of Advil, got covered with a few blankets and went to bed. I kept waking up through the night and at some point (around 2am) I checked and was running a fever of 101F. I woke up in the morning (8am) with no fever but feeling malaise, muscle soreness and a headache, which lasted through the next day but no fever nor chills. I woke up on the second day after vaccination still having slight headache and a fatigue. No fever nor chills. This is my condition at the time of writing this report.
Age: 49.0
Sex: M
Vaccine: FLUC4
Symptoms: Pyrexia
Clinical narrative: at about 10pm on the day of the vaccination I began experiencing very strong chills, my temperature was 99.1F (my typical temperature is 97.6F). I took 400mg of Advil, got covered with a few blankets and went to bed. I kept waking up through the night and at some point (around 2am) I checked and was running a fever of 101F. I woke up in the morning (8am) with no fever but feeling malaise, muscle soreness and a headache, which lasted through the next day but no fever nor chills. I woke up on the second day after vaccination still having slight headache and a fatigue. No fever nor chills. This is my condition at the time of writing this report.
Age: 13.0
Sex: M
Vaccine: HEP
Symptoms: Abdominal pain upper, Chills, Cough, Hyperhidrosis, Nasal congestion
Clinical narrative: 9/16 sore throat, fever 101 degrees, sore left forearm, stomach ache, sweats and chills, body aches- treated with ibuprofen - called doctors office to see if needed to bring him in didn't advise as long as treatment at home was working  9/17 all above plus cough developed and worsened needed nebulizer treatment - treated with Levalbuterol and Budesonide continued Nebulizer treatments from 9/17-9/20 From 9/20-10/1 congested and stuffy nose
Age: 13.0
Sex: M
Vaccine: HEP
Symptoms: Oropharyngeal pain, Pain, Pain in extremity, Pyrexia
Clinical narrative: 9/16 sore throat, fever 101 degrees, sore left forearm, stomach ache, sweats and chills, body aches- treated with ibuprofen - called doctors office to see if needed to bring him in didn't advise as long as treatment at home was working  9/17 all above plus cough developed and worsened needed nebulizer treatment - treated with Levalbuterol and Budesonide continued Nebulizer treatments from 9/17-9/20 From 9/20-10/1 congested and stuffy nose
Age: 1.17
Sex: F
Vaccine: DTAP, HIBV, PNC13
Symptoms: Carbon dioxide decreased, Diarrhoea, Hypophagia, Lethargy, Ultrasound abdomen normal
Clinical narrative: pt began with vomiting night of imms, persistent non bilious emesis x 2 days, diarrhea day following imms.  af  lethargic, poor po intake, and decreased urine output,  resulting in hospitalization for hydration
Age: 1.17
Sex: F
Vaccine: DTAP, HIBV, PNC13
Symptoms: Urine output decreased, Vomiting, White blood cell count normal
Clinical narrative: pt began with vomiting night of imms, persistent non bilious emesis x 2 days, diarrhea day following imms.  af  lethargic, poor po intake, and decreased urine output,  resulting in hospitalization for hydration
Age: 60.0
Sex: F
Vaccine: VARZOS
Symptoms: Chills, Diarrhoea, Fatigue, Lethargy, Nausea
Clinical narrative: Nausea and diarrhea started 3 hours after administration. Sever diarrhea lasted for a few hours. Had chills all night and then felt very lethargic and drained the next day. Felt somewhat better on the day after that and then significantly better with just a sore arm the day after that.
Age: 60.0
Sex: F
Vaccine: VARZOS
Symptoms: Pain in extremity
Clinical narrative: Nausea and diarrhea started 3 hours after administration. Sever diarrhea lasted for a few hours. Had chills all night and then felt very lethargic and drained the next day. Felt somewhat better on the day after that and then significantly better with just a sore arm the day after that.
Age: 70.0
Sex: F
Vaccine: PPV
Symptoms: Injection site erythema, Injection site swelling
Clinical narrative: pt reported redness and swelling around the injection site, that started to spread down pt's arm over the past 2 days. Aleve, Benadryl, and Icy hot was used per patient.
Age: 31.0
Sex: M
Vaccine: FLUC4
Symptoms: Injection site pain
Clinical narrative: Patient came to the pharmacy stating that his arm is still sore from his flu shot that he got on 10/11/19. He said that the soreness is consistent and doesn't get any better or any worse. He tried to take Ibuprofen for 2 days and he states that it doesn't help.
Age: 86.0
Sex: F
Vaccine: VARZOS
Symptoms: Dyspnoea, Headache
Clinical narrative: patient experienced shortness of breath and headache for about 8-12 hours following administration of vaccine
Age: 76.0
Sex: F
Vaccine: FLU3
Symptoms: Erythema, Skin warm, Swelling
Clinical narrative: Patient had red raised area about 2 inches by 3 inches, area was hot. I told patient to ice area and when I called to follow up she said the area was better.
Age: 71.0
Sex: F
Vaccine: VARZOS
Symptoms: Injection site erythema, Vaccination site swelling
Clinical narrative: Patient noticed redness and swelling at the site of vaccination, one day after the vaccine was administered. No treatment necessary as the swelling and redness have reduced.
Age: 90.0
Sex: F
Vaccine: FLUR4
Symptoms: Dizziness, Fall
Clinical narrative: Per notes: Pt's daughter call around noon and said she got the vaccine Thursday and was dizzy Friday and Saturday.  There were no other side effects but she went to the doctor just to double check.  At ~6pm the grandson answered the phone and stated the pt is at the hospital because she fell.  Tried to call multiple times on Sunday for a follow-up but no answer.  Pt's medical hx is unknown and no list of pt current medications.
Age: 75.0
Sex: F
Vaccine: TDAP
Symptoms: Injection site nodule, Injection site pain
Clinical narrative: Patient had no pain or swelling initially but about 3-4 days later the injection site began to hurt and formed a "knot" about the size of a nickel.  It has since gotten bigger and is now 2 inches across.  She has not applied ice or taken anti-inflammatories.  She will call her doctor tomorrow and apply ice to the site today and work the muscle in circular motion to get it moving.
Age: 27.0
Sex: M
Vaccine: FLU4
Symptoms: Dizziness, Immediate post-injection reaction, Syncope
Clinical narrative: Patient was given the shot by Pharmacist. Right after the shot the patient said he was feeling faint, slowly fainted & was assisted slowly to the floor. He woke up less than 45 seconds later & told us he only had a salad & nuts for lunch. We gave him a 2 cups of water and a piece of chocolate & he said he felt fine afterwards.
Age: 67.0
Sex: F
Vaccine: PPV
Symptoms: Pain, Pain in extremity, Peripheral swelling, Skin warm
Clinical narrative: Patient experienced soreness the evening she received the pneumovax shot and awoke the next morning with severe swelling in the arm, pain, and warmth to the touch.
Age: 37.0
Sex: F
Vaccine: FLU4
Symptoms: Eye pruritus, Eye swelling, Urticaria
Clinical narrative: First sign was itchy eyes.  Then lower left eye started to swell.  Hives on thighs and eyes swollen shut within 15 minutes of eyes becoming itchy.
Age: 65.0
Sex: M
Vaccine: FLUA3
Symptoms: Contusion, Hyperaesthesia, Hypersensitivity vasculitis, Petechiae
Clinical narrative: Started as petechiae near toes. Spread into larger red spots on ankles, legs, buttocks, arms, and wrists.  Spread consistently over a period of a week, with some spots growing together into significant bruised and sensitive areas.  Note: This was the first time I received a larger dose due to being over 65 years of age.
Age: 70.0
Sex: U
Vaccine: FLUA3
Symptoms: Contusion, Pain
Clinical narrative: Bruising, soreness/pain
Age: 27.0
Sex: M
Vaccine: UNK
Symptoms: Dizziness, Dyspnoea, Nausea, Oropharyngeal discomfort
Clinical narrative: Shortness of breath. Throat felt like it collapse dizziness nausea.
Age: 38.0
Sex: F
Vaccine: FLU3
Symptoms: Insomnia, Vomiting
Clinical narrative: insomnia and vomiting over night
Age: 66.0
Sex: F
Vaccine: FLU3
Symptoms: Dyspnoea, Feeling cold, Pain in extremity
Clinical narrative: Patient reported trouble breathing , soreness in arm, denied rash, or any signs of anaphylaxis. Patient reported feeling cold, but did not seem to have fever. Recommended patient go and be seen by medical provider for evaluation, and to keep checking temperature in case fever develops. Patient acknowledged understanding and will follow up with patient on 10/28/19
Age: 36.0
Sex: F
Vaccine: FLU4
Symptoms: Back pain, Blood test, Chest X-ray, Computerised tomogram, Dysphagia
Clinical narrative: Exteme Fatigue, muscle weakness in both legs and arms, unsteady gait, difficulty breathing anx swallowing, lower back pain, changes in voice Numbness om various body parts including left side of face.  Changes in hearing on left ear
Age: 36.0
Sex: F
Vaccine: FLU4
Symptoms: Dysphonia, Dyspnoea, Fatigue, Gait disturbance, Hypoacusis
Clinical narrative: Exteme Fatigue, muscle weakness in both legs and arms, unsteady gait, difficulty breathing anx swallowing, lower back pain, changes in voice Numbness om various body parts including left side of face.  Changes in hearing on left ear
Age: 36.0
Sex: F
Vaccine: FLU4
Symptoms: Hypoaesthesia, Lumbar puncture, Muscular weakness, Scan with contrast
Clinical narrative: Exteme Fatigue, muscle weakness in both legs and arms, unsteady gait, difficulty breathing anx swallowing, lower back pain, changes in voice Numbness om various body parts including left side of face.  Changes in hearing on left ear
Age: 37.0
Sex: F
Vaccine: FLU4
Symptoms: Joint range of motion decreased, Neck pain, Pain in extremity
Clinical narrative: PATIENT DESCRIBES SORENESS, PAIN, AND DECREASED RANGE OF MOTION IN THE LEFT ARM AS WELL AS SOME PAIN RUNNING INTO THE NECK REGION AS WELL
Age: 68.0
Sex: M
Vaccine: FLU3
Symptoms: Chills, Pyrexia
Clinical narrative: low grade fever and uncontrollable shivering.  Symptoms dissipated after approximately 6 hours.  Took ibuprofen,600mg,  for fever.
Age: 73.0
Sex: M
Vaccine: VARZOS
Symptoms: Tremor
Clinical narrative: shaking/tremors in hand and arm that the vaccine was administered in for ~8-12 hours after receiving vaccine
Age: 75.0
Sex: F
Vaccine: FLU3
Symptoms: Mobility decreased, Musculoskeletal pain, Myalgia
Clinical narrative: deep muscular pain developed following day after vaccine. pain has continued to increase over the last 4 weeks and is now radiating into shoulder. patient has difficulty raising hand above head.
Age: 70.0
Sex: F
Vaccine: FLUR4
Symptoms: Headache, Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
Clinical narrative: Patient states she experienced sharp pain, warmth, and redness at injection site. Within 2 hours she was nauseous and had a headache and was vomiting. She spoke with her doctor over the phone and he recommended an OTC antibiotic ointment because she was concerned the site was injected. He told her to followup at the office with any changes. As of 10/26 when I spoke with her, injection site still red and swollen but no fever or nausea
Age: 70.0
Sex: F
Vaccine: FLUR4
Symptoms: Nausea, Vomiting
Clinical narrative: Patient states she experienced sharp pain, warmth, and redness at injection site. Within 2 hours she was nauseous and had a headache and was vomiting. She spoke with her doctor over the phone and he recommended an OTC antibiotic ointment because she was concerned the site was injected. He told her to followup at the office with any changes. As of 10/26 when I spoke with her, injection site still red and swollen but no fever or nausea
Age: 72.0
Sex: F
Vaccine: VARZOS
Symptoms: Injection site erythema, Injection site reaction, Pain in extremity, Rash macular
Clinical narrative: Red blotchy area around shot origin. Area extended to shoulder and around arm. Arm hurt but this is 2nd shot and it hurt with the 1st shot to. No fever and it did not itch.
Age: 65.0
Sex: F
Vaccine: PNC13
Symptoms: Erythema, Injection site erythema, Injection site pruritus, Injection site warmth, Pruritus
Clinical narrative: Red, not, itching from below the injection site to above the wrist
Age: 65.0
Sex: F
Vaccine: PNC13
Symptoms: Skin warm
Clinical narrative: Red, not, itching from below the injection site to above the wrist
Age: 56.0
Sex: M
Vaccine: FLUR4, PPV
Symptoms: Injected limb mobility decreased, Injection site pain, Pain
Clinical narrative: Patient called us to report severe pain (12 out of 10) in left arm where he received two immunizations the day before.  He received the vaccines around 10AM on 10/26/19 and didn't have any concerns before going to bed that night. He woke up at 3AM on 10/27/19 with severe pain and reports very little mobility without shooting pain from front of shoulder to back of shoulder where vaccines were given. He was applying ice and using ibuprofen to help relieve the pain.  He was instructed to contact his doctor if the pain did not improve over the next 24 - 36 hours.
Age: 73.0
Sex: M
Vaccine: PPV
Symptoms: Injection site bruising, Injection site swelling, Injection site warmth
Clinical narrative: Pt received Pneumovax on 9/19, and reported swelling, fever, and bruising at the injection site for a couple of days.  Received Prevnar13 last year with no issues.
Age: 72.0
Sex: M
Vaccine: FLU3
Symptoms: Blood pressure increased, Dizziness
Clinical narrative: Patient left the pharmacy and went to see his doctor for a normal visit. The provider informed him that his blood pressure was elevated at 146/90, but did not recommend treatment. Patient called pharmacy 2 days later to ask if this could be related to the vaccine since his blood pressure has remained elevated and he is having dizziness.
Age: 59.0
Sex: F
Vaccine: VARZOS
Symptoms: Asthenia, Back pain, Chills, Fatigue, Feeling abnormal
Clinical narrative: I was in the evening services for Yom Kippur Tuesday Oct. 8 when the symptoms began.  Both my hands were shaking uncontrollably, my left shoulder (where I had the shot) became extremely sore as did my back and my neck. It felt like I had pulled a muscle in my neck. I was very cold. When we left services and went outside, my teeth started to chatter uncontrollably and I had trouble talking as a result. All the other symptoms continued. I went to bed soon after we got home around 10 pm.  I checked and my shoulder area around the shot was red, but it was a small area. I used several extra blankets because I had trouble getting warm. I didn't sleep well. The next morning (Wednesday) I woke up with an awful headache, pain in my teeth/gums like a sinus infection, no energy and a little bit of nausea. My husband thought I maybe had a temperature, but I thought I might have been warm from all the extra blankets. I stook acetaminophen (2 tabs). At that time I wasn't cold and my hands didn't tremble. But I felt awful. I only was up for about 90 minutes. My head hurt so much, I just wanted to sleep. I slept for 5 hours. I woke up and took more acetaminophen. I still had a headache and lacked energy but my symptoms were improving. The next day (Thursday), I stayed home from work again because I still felt exhausted and physically worn out from the symptoms.  By Friday I was a little tired but basically better.
Age: 59.0
Sex: F
Vaccine: VARZOS
Symptoms: Feeling cold, Gingival pain, Headache, Injection site erythema, Injection site pain
Clinical narrative: I was in the evening services for Yom Kippur Tuesday Oct. 8 when the symptoms began.  Both my hands were shaking uncontrollably, my left shoulder (where I had the shot) became extremely sore as did my back and my neck. It felt like I had pulled a muscle in my neck. I was very cold. When we left services and went outside, my teeth started to chatter uncontrollably and I had trouble talking as a result. All the other symptoms continued. I went to bed soon after we got home around 10 pm.  I checked and my shoulder area around the shot was red, but it was a small area. I used several extra blankets because I had trouble getting warm. I didn't sleep well. The next morning (Wednesday) I woke up with an awful headache, pain in my teeth/gums like a sinus infection, no energy and a little bit of nausea. My husband thought I maybe had a temperature, but I thought I might have been warm from all the extra blankets. I stook acetaminophen (2 tabs). At that time I wasn't cold and my hands didn't tremble. But I felt awful. I only was up for about 90 minutes. My head hurt so much, I just wanted to sleep. I slept for 5 hours. I woke up and took more acetaminophen. I still had a headache and lacked energy but my symptoms were improving. The next day (Thursday), I stayed home from work again because I still felt exhausted and physically worn out from the symptoms.  By Friday I was a little tired but basically better.
Age: 59.0
Sex: F
Vaccine: VARZOS
Symptoms: Muscle strain, Nausea, Neck pain, Poor quality sleep, Speech disorder
Clinical narrative: I was in the evening services for Yom Kippur Tuesday Oct. 8 when the symptoms began.  Both my hands were shaking uncontrollably, my left shoulder (where I had the shot) became extremely sore as did my back and my neck. It felt like I had pulled a muscle in my neck. I was very cold. When we left services and went outside, my teeth started to chatter uncontrollably and I had trouble talking as a result. All the other symptoms continued. I went to bed soon after we got home around 10 pm.  I checked and my shoulder area around the shot was red, but it was a small area. I used several extra blankets because I had trouble getting warm. I didn't sleep well. The next morning (Wednesday) I woke up with an awful headache, pain in my teeth/gums like a sinus infection, no energy and a little bit of nausea. My husband thought I maybe had a temperature, but I thought I might have been warm from all the extra blankets. I stook acetaminophen (2 tabs). At that time I wasn't cold and my hands didn't tremble. But I felt awful. I only was up for about 90 minutes. My head hurt so much, I just wanted to sleep. I slept for 5 hours. I woke up and took more acetaminophen. I still had a headache and lacked energy but my symptoms were improving. The next day (Thursday), I stayed home from work again because I still felt exhausted and physically worn out from the symptoms.  By Friday I was a little tired but basically better.
Age: 59.0
Sex: F
Vaccine: VARZOS
Symptoms: Toothache, Tremor
Clinical narrative: I was in the evening services for Yom Kippur Tuesday Oct. 8 when the symptoms began.  Both my hands were shaking uncontrollably, my left shoulder (where I had the shot) became extremely sore as did my back and my neck. It felt like I had pulled a muscle in my neck. I was very cold. When we left services and went outside, my teeth started to chatter uncontrollably and I had trouble talking as a result. All the other symptoms continued. I went to bed soon after we got home around 10 pm.  I checked and my shoulder area around the shot was red, but it was a small area. I used several extra blankets because I had trouble getting warm. I didn't sleep well. The next morning (Wednesday) I woke up with an awful headache, pain in my teeth/gums like a sinus infection, no energy and a little bit of nausea. My husband thought I maybe had a temperature, but I thought I might have been warm from all the extra blankets. I stook acetaminophen (2 tabs). At that time I wasn't cold and my hands didn't tremble. But I felt awful. I only was up for about 90 minutes. My head hurt so much, I just wanted to sleep. I slept for 5 hours. I woke up and took more acetaminophen. I still had a headache and lacked energy but my symptoms were improving. The next day (Thursday), I stayed home from work again because I still felt exhausted and physically worn out from the symptoms.  By Friday I was a little tired but basically better.
Age: 42.0
Sex: F
Vaccine: FLUC4
Symptoms: Immediate post-injection reaction, Injection site pain, Pain
Clinical narrative: Immediate significant pain at injections site. Injection felt too high up on arm. Felt like a large volume was being injected.  Injection site was sore for several days and shoulder pain has persisted since.  Can still fell where injection occurred. Pain with lifting shoulder forward up or back.  Have been taking ibuprofen for pain.  At the point that additional medical care may be necessary.
Age: 56.0
Sex: F
Vaccine: FLU4
Symptoms: Injection site erythema, Injection site pain, Injection site swelling
Clinical narrative: Soreness, redness, swelling  around injection site
Age: 39.0
Sex: F
Vaccine: FLUR4
Symptoms: Cellulitis, Erythema, Peripheral swelling, Skin warm
Clinical narrative: Patient received influenza vaccination in the morning before work and noticed throughout the day that her arm was feeling more strange than it had to prior influenza vaccines.  When she went home from work, she noticed that her arm was very red, swollen, and warm to the touch.  She took a Benadryl that evening and reported the reaction to us the next day.  She said her arm had improved slightly overnight, but she still went to her work's staff physician who diagnosed her with cellulitis.  The physician did not think it was vaccine related but patient has no other signs of bites, scratches, or cuts at the infection site.
Age: 67.0
Sex: M
Vaccine: PPV
Symptoms: Injected limb mobility decreased, Pain, Pain in extremity
Clinical narrative: Patient came into pharmacy day after shot claiming that he cannot move his left arm, not even to put on h is socks. He states that movement results in sharp stabbing pain "like an icepick into his arm." Pharmacist on duty observed the arm. It did not appear swollen or red. The bandage and shot site was just above the midline of the upper third of the deltoid muscle. Pharmacist advised anti-inflammatory, pt already taking naproxen and also advised icing.
Age: 26.0
Sex: M
Vaccine: FLU4
Symptoms: Chills, Injection site erythema, Injection site pain, Injection site swelling
Clinical narrative: Patient had chills after vaccine in evening. Woke up on Friday AM with redness and pain to injection site. Patient took Benadryl with minimal relief. Patient states by Saturday AM, area was more painful and swollen.
Age: 68.0
Sex: M
Vaccine: PPV
Symptoms: Erythema, Musculoskeletal disorder, Pain in extremity, Peripheral swelling, Skin warm
Clinical narrative: The night of the vaccine he lost use of his arm. Arm became very painful warm and swollen. On Sunday (48 hours) after receiving the shot the patient came to the pharmacy. His entire upper arm (shoulder and bicep) were swollen, red, erythematous, and painful.
Age: 55.0
Sex: M
Vaccine: FLU4
Symptoms: Mobility decreased, Pain in extremity
Clinical narrative: Patient called 1 month later to say that his arm was painful to the point that he could not move it, pain scale of 8, and that he needed to contact his doctor due to the pain, in which he was prescribed ibuprofen for the pain. He said that at this time the pain had gotten better, but was still there and not completely gone.
Age: 76.0
Sex: M
Vaccine: VARZOS
Symptoms: Ankle fracture, Fall, Presyncope, Urticaria, X-ray limb abnormal
Clinical narrative: severe widespread uticaria.  minimal control with antihistamines.  steroid dose park required.  vasovagal response produced a fall with fractured ankle
Age: 83.0
Sex: M
Vaccine: PPV
Symptoms: Hyperhidrosis, Vaccination site oedema, Vaccination site swelling, Vaccination site warmth
Clinical narrative: Swelling and edema of right upper arm from vaccine site in the deltoid to the elbow.  Per patient wife arm is also warm to the touch and patient began sweating today (10/27/2019)
Age: 67.0
Sex: F
Vaccine: PPV
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
Clinical narrative: Patients left arm was swollen, red, hot and painful to touch from shoulder down to elbow
Age: 59.0
Sex: F
Vaccine: VARZOS
Symptoms: Headache, Pain
Clinical narrative: Severe body aches and headache for 1 day
Age: 71.0
Sex: F
Vaccine: VARZOS
Symptoms: Erythema, Urticaria
Clinical narrative: lot is of the powder the lot for the diluent suspension is 4ZM93 Patient had a large red wheal on left arm and hives on chest and neck
Age: 10.0
Sex: M
Vaccine: FLU4
Symptoms: Crying, Feeling abnormal, Feeling hot, Panic reaction, Visual impairment
Clinical narrative: Patient sat down to receive vaccination, no signs of nervousness and watched while the intern give the vaccination to him and then watched while the intern gave his sister the vaccination. Shortly after patient said he could not see very well and his face felt hot and funny. He started to cry and freak out a bit so he set him down in the chair and told him to breathe slowly and deeply.  The patient went limp, did not lose consciousness. We got the patient some water and some peanut butter crackers. The symptoms only lasted a few minutes but we had the patient stay for 30 minutes so we could observe him. Patient felt better and went home.
Age: 73.0
Sex: M
Vaccine: FLUA3
Symptoms: Injection site pain, Musculoskeletal pain
Clinical narrative: Patient states about a week to 10 days out from vaccine he has had trouble with his left arm, not particularly the left shoulder but the upper arm. He says he has pain in the arm to the degree that he can not put his pants or a belt on. He was seen by his physician and given tramadol with no relief. He says that he also has pain in the right shoulder as well. He does not believe that the pain is related to the vaccination, but that he just doesn't know. I gave him some biofreeze to rub on the arm and followed up with him today and he said that the biofreeze seems to help, but after that wears off, the pain returns.  I have asked him to keep us informed as to how his pain is progressing.
Age: 51.0
Sex: F
Vaccine: FLU4
Symptoms: Malaise, Myalgia, Pyrexia
Clinical narrative: Fever reaching 100.6 that didn?t respond to NSAIDS.  Myalgia  Malaise
Age: 62.0
Sex: F
Vaccine: UNK, VARZOS
Symptoms: Asthenia, Chills, Decreased appetite, Erythema, Fatigue
Clinical narrative: Headache. pain and swelling in arm that got shingles vaccine.  Red and hot to touch.  101 fever. Chilling. Fatigued. No energy. No appetite.   Started 10/25 2019 round 830pm and have not abated.
Age: 62.0
Sex: F
Vaccine: UNK, VARZOS
Symptoms: Headache, Pain in extremity, Peripheral swelling, Pyrexia, Skin warm
Clinical narrative: Headache. pain and swelling in arm that got shingles vaccine.  Red and hot to touch.  101 fever. Chilling. Fatigued. No energy. No appetite.   Started 10/25 2019 round 830pm and have not abated.