chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 55.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Respiratory symptom, SARS-CoV-2 test positive, Skin ulcer, Surgery, Vaccine breakthrough infection
Clinical narrative: Administration error: mixed manufacture regimen. The individual was vaccinated with the Pfizer product on 01/22/2021 and the Moderna product on 02/23/2021.  Also breakthrough COVID-19 disease after which death occurred. The individual had an ongoing issue with a non-healing foot ulcer for which they were hospitalized 08/11/2021-08/24/2021. They were subsequently transferred to a different facility (Hospital), on 08/25/2021 for a surgery related to this ongoing issue. where they tested positive on 08/25/2021 after becoming symptomatic with fever, chills, and "respiratory symptoms." While hospitalized, the individual developed stroke-like symptoms but CT head scan was negative for acute stroke processes. They were transferred to Medical Center on 09/02/2021, where stroke was confirmed. They remained hospitalized until their death on 09/07/2021, after being placed on comfort care given poor prognosis.
Age: 34.0
Sex: F
Vaccine: COVID19
Symptoms: Pruritus
Clinical narrative: A few hours later I noticed I was itchy everywhere.
Age: 68.0
Sex: F
Vaccine: PPV
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
Clinical narrative: PATIENT HAD A RED SWELLING, HOT TO TOUCH AT THE INJECTION SITE AND AROUND THE AREA OF VACCINATION.  PATIENT SAID IT WAS EXTREMELY SORE AND IT WAS STILL RED WHEN THE PATIENT CAME INTO THE PHARMACY TO SHOW US.
Age: 99.0
Sex: F
Vaccine: COVID19
Symptoms: Extra dose administered, No adverse event
Clinical narrative: Client received a second booster dose of Janssen.  There were no adverse reactions, no treatment required.  Outcome of client is stable with no adverse reaction.
Age: 11.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Patient was administered a dose that had expired based on stability requirements
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Cardiac failure, Dyspnoea, Thrombosis
Clinical narrative: Breathing started to be laborious 6 days after Phyzer booster on 16 Feb 2022, got worse, heart failed , no oxygen . Blood clots
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: Arrhythmia, Atrial fibrillation, Blood magnesium, Blood phosphorus, Blood thyroid stimulating hormone
Clinical narrative: Starting one week after shot - on 4/15/21 - Accelerated heartbeat - out of rhythm heartbeat.  Continued to get worse,  Hospitalized on 4/21/21.  Diagnosed with AFib, Heartrate over 170 bpm -
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: Brain natriuretic peptide, Differential white blood cell count, Echocardiogram, Full blood count, Heart rate increased
Clinical narrative: Starting one week after shot - on 4/15/21 - Accelerated heartbeat - out of rhythm heartbeat.  Continued to get worse,  Hospitalized on 4/21/21.  Diagnosed with AFib, Heartrate over 170 bpm -
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: Metabolic function test, Procalcitonin, Troponin, Ultrasound Doppler
Clinical narrative: Starting one week after shot - on 4/15/21 - Accelerated heartbeat - out of rhythm heartbeat.  Continued to get worse,  Hospitalized on 4/21/21.  Diagnosed with AFib, Heartrate over 170 bpm -
Age: 53.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Anti-thyroid antibody, Autoimmune thyroiditis, Blood thyroid stimulating hormone increased, Hypothyroidism, Thyroxine free normal
Clinical narrative: Hypothyroidism, autoimmune hashimoto disease
Age: 41.0
Sex: F
Vaccine: TDAP
Symptoms: Dehydration, Diarrhoea, Flushing, Pharyngeal swelling, Wheezing
Clinical narrative: DIARRHEA, DEHYDRTAION, FLUSHING, WHEEZING, THROAT SWOLLEN.  USED BENADRYL 50GM AND XOPENEX INHALER 3 PUFFS EVERY 6 HOURS UNTIL RESOLVED IN 12 HOURS.
Age: 5.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Patient was administered an expired dose based on stability of vaccine
Age: 75.0
Sex: F
Vaccine: COVID19
Symptoms: Decreased appetite, Fatigue, Headache, Hypertension
Clinical narrative: Tired, loss of appetite, high blood and headache.
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: Headache, Pain, Pyrexia, Similar reaction on previous exposure to drug, Vomiting
Clinical narrative: Vomiting x 2 days, body ache, fever x 2 days, headache,
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Asthenia, Fatigue, Feeling abnormal, Headache, Pain
Clinical narrative: Headache and feeling poor all over with a full body ache. Along with fatigue and weakness. This lasted 2 days.
Age: 57.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Anxiety, COVID-19, Cardiac arrest, Death, Dyspnoea
Clinical narrative: This is an instance of breakthrough COVID-19 disease after which death occurred.   The individual was vaccinated with the Moderna product on 05/06/2021 and 06/03/2021. They presented to Emergency Department on 10/22/2021 with primary complaints of fever, shortness of breath, and anxiety. They were admitted to hospital same-day. They also tested positive for COVID-19 on 10/22/2021. They also died later the same day, after suffering a cardiac arrest.
Age: 57.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Pyrexia, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: This is an instance of breakthrough COVID-19 disease after which death occurred.   The individual was vaccinated with the Moderna product on 05/06/2021 and 06/03/2021. They presented to Emergency Department on 10/22/2021 with primary complaints of fever, shortness of breath, and anxiety. They were admitted to hospital same-day. They also tested positive for COVID-19 on 10/22/2021. They also died later the same day, after suffering a cardiac arrest.
Age: 14.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Menstrual disorder
Clinical narrative: Regular menstrual cycles became irregular.
Age: 62.0
Sex: M
Vaccine: COVID19
Symptoms: Atrial fibrillation
Clinical narrative: 3 months after Pfizer dose 3, I had a reaction I began having Atrial Fib (on and off).
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Blood test, Cardiac monitoring, Electrocardiogram, Fatigue, Implantable defibrillator insertion
Clinical narrative: After the vaccine I was feeling really tired and couldn't stay awake. I went in to urgent care center, where I was transferred to the Hospital I was admitted for 7 days. I ended up getting a pacemaker and defibrillator. Still under doctors care.
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Somnolence
Clinical narrative: After the vaccine I was feeling really tired and couldn't stay awake. I went in to urgent care center, where I was transferred to the Hospital I was admitted for 7 days. I ended up getting a pacemaker and defibrillator. Still under doctors care.
Age: 73.0
Sex: M
Vaccine: COVID19
Symptoms: Deafness unilateral, Tinnitus
Clinical narrative: Tinnitus and hearing loss
Age: 44.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Dyspnoea
Clinical narrative: severe SOB beginning 04/20/2022
Age: 13.0
Sex: F
Vaccine: COVID19
Symptoms: Bradycardia, Hyperhidrosis, Loss of consciousness, Mydriasis, Pallor
Clinical narrative: patient experienced syncopal event with temporary LOC, regained spontaneously; HR bradycardic to 44 per pulse oximeter; pulse oximeter 95%, pupils dilated to 8 mm, skin diaphoretic, pale
Age: 13.0
Sex: F
Vaccine: COVID19
Symptoms: Syncope
Clinical narrative: patient experienced syncopal event with temporary LOC, regained spontaneously; HR bradycardic to 44 per pulse oximeter; pulse oximeter 95%, pupils dilated to 8 mm, skin diaphoretic, pale
Age: 52.0
Sex: F
Vaccine: UNK
Symptoms: Chills, Malaise, Pain, Pyrexia
Clinical narrative: Body aches, chills, low-grade fever, and malaise began about eighteen hours after the vaccination.  Ibuprofen 400mg alleviated the symptoms earlier in the day. However, ibuprofen 400mg was retaken about 1800, twenty-seven hours after the injection, without relief of the symptoms.
Age: 90.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Death, General physical health deterioration, Malaise, Pneumonia
Clinical narrative: This is an instance of breakthrough COVID-19 after which death occurred.   The individual was vaccinated with the Moderna product on 01/21/2021 and 02/18/2021. They became symptomatic for COVID-19 on  10/28/2021 and tested positive for COVID-19 on 10/29/2021 at a clinic. They were admitted to hospital on 11/01/2021. They were found to have pneumonia and their health continued to decline. Per the individual's wishes, they were put on comfort care only and had a DNR order in place. The individual died on 11/13/2021.
Age: 90.0
Sex: M
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: This is an instance of breakthrough COVID-19 after which death occurred.   The individual was vaccinated with the Moderna product on 01/21/2021 and 02/18/2021. They became symptomatic for COVID-19 on  10/28/2021 and tested positive for COVID-19 on 10/29/2021 at a clinic. They were admitted to hospital on 11/01/2021. They were found to have pneumonia and their health continued to decline. Per the individual's wishes, they were put on comfort care only and had a DNR order in place. The individual died on 11/13/2021.
Age: 43.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: VACCINE WAS GIVEN BEYOND USE DATE. VACCINE WAS RECEIVED IN REFRIGERATOR ON 01/11/2022 AND KEPT IN APPROPRIATE TEMPERATURE (2-8 CELSIUS). VACCINE WAS ADMINISTERED TO PATIENT 14 DAYS PAST THE 30 DAY TIME IN REFRIGERATOR.
Age: 82.0
Sex: F
Vaccine: COVID19
Symptoms: Blood lactic acid increased, COVID-19, Chest X-ray normal, Cough, Hypertension
Clinical narrative: Patient received pfizer vaccine on 1/27/21, 2/17/21, and 11/2/21. Presented to ER on 4/19/22 and tested positive for COVID19.presents to ED from an independent living facility with fever and cough.  Afebrile while in the ED.  She is hypertensive.  Daughter is providing much of the history given history of severe dementia.  Patient is noted to have a mild leukocytosis and a lactic acid elevation likely more so in response to volume depletion as does not appear septic.  She has a UTI and tested +ive for COVID.  She has been fully vaccinated and boosted against COVID.  CXR is unremarkable.  She remains on RA.  She again is hemodynamically stable.  She will be admitted at this time for further management.  Received ceftriaxone and doxy.  Discharged on 4/21/22 on cephalexin.
Age: 82.0
Sex: F
Vaccine: COVID19
Symptoms: Hypovolaemia, Leukocytosis, Pyrexia, SARS-CoV-2 test positive, Urinary tract infection
Clinical narrative: Patient received pfizer vaccine on 1/27/21, 2/17/21, and 11/2/21. Presented to ER on 4/19/22 and tested positive for COVID19.presents to ED from an independent living facility with fever and cough.  Afebrile while in the ED.  She is hypertensive.  Daughter is providing much of the history given history of severe dementia.  Patient is noted to have a mild leukocytosis and a lactic acid elevation likely more so in response to volume depletion as does not appear septic.  She has a UTI and tested +ive for COVID.  She has been fully vaccinated and boosted against COVID.  CXR is unremarkable.  She remains on RA.  She again is hemodynamically stable.  She will be admitted at this time for further management.  Received ceftriaxone and doxy.  Discharged on 4/21/22 on cephalexin.
Age: 58.0
Sex: F
Vaccine: UNK
Symptoms: Dehydration, Vomiting
Clinical narrative: Per Patient received zoster vaccine and started vomiting at 2am on 04/212021 patient was prescribed zofran and if not better in 1-2 days advice to go to ER for hydration
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Blood sodium decreased, Blood test abnormal, Fall, Hyponatraemia, Impaired work ability
Clinical narrative: I wasn't feeling well all winter, I couldn't feel good but I have been anemic so I got an IV infusion. My sodium bottomed out and I ended up in the hospital. My sodium was normal prior to the booster. We spent Christmas out of the area and I was having memory lapses. On April 2 I had a small fall and April 3 I was in a car accident. April 5 I went to the ER. Right before the holiday I went back in. I was an emergency admit again. Everything was off, white count, red count, and I see all kinds of specialists. I left my job because I couldn't think anymore.
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Malaise, Memory impairment, Red blood cell count abnormal, Road traffic accident, White blood cell count abnormal
Clinical narrative: I wasn't feeling well all winter, I couldn't feel good but I have been anemic so I got an IV infusion. My sodium bottomed out and I ended up in the hospital. My sodium was normal prior to the booster. We spent Christmas out of the area and I was having memory lapses. On April 2 I had a small fall and April 3 I was in a car accident. April 5 I went to the ER. Right before the holiday I went back in. I was an emergency admit again. Everything was off, white count, red count, and I see all kinds of specialists. I left my job because I couldn't think anymore.
Age: 26.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: VACCINE WAS GIVEN BEYOND USE DATE. VACCINE WAS RECEIVED IN REFRIGERATOR ON 01/11/2022 AND KEPT IN APPROPRIATE TEMPERATURE (2-8 CELSIUS). VACCINE WAS ADMINISTERED TO PATIENT 16 DAYS PAST THE 30 DAY TIME IN REFRIGERATOR.
Age: 63.0
Sex: M
Vaccine: COVID19
Symptoms: Atrial fibrillation, Condition aggravated
Clinical narrative: I used to have occasional Atrial Fibrillation but after this 4th dose my this has become been constant. My PCP recommended that I see a Cardiologist for my heart condition, I have an upcoming appointment on 5/13/2022 at a local medical facility. My doctor also wants me to have a sleep study.
Age: 47.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: Patient received expired Moderna booster vaccine. Patient exhibits no adverse signs or symptoms. Patient evaluated and instructed to report any issues. He verbalized his understanding. No treatment given.
Age: 55.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: Patient received expired Moderna booster vaccine.  Patient exhibits not adverse signs or symptoms.   Patient evaluated and instructed to report any issues.  He verbalized his understanding.  No treatment given.
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Muscular weakness
Clinical narrative: Joint soreness. Weak left knee.
Age: 58.0
Sex: F
Vaccine: VARZOS
Symptoms: Abdominal discomfort, Asthenia, Chills, Headache, Muscular weakness
Clinical narrative: headach,fever,chills,weakness, muscle weakness,upset stomach, sweating(night)
Age: 58.0
Sex: F
Vaccine: VARZOS
Symptoms: Night sweats, Pyrexia
Clinical narrative: headach,fever,chills,weakness, muscle weakness,upset stomach, sweating(night)
Age: 49.0
Sex: M
Vaccine: COVID19, PNC20, TDAP, VARZOS
Symptoms: Fall, Syncope
Clinical narrative: The patient had syncope. He fell on the floor from a sitting position.
Age: 46.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Vaccine given beyond-use-date. Vaccine received in refrigerator on 01/11/2022 and kept in appropriate temperature (2-8 Celsius). Vaccine administered to patient 14 days past the 30-day time in refrigerator.
Age: 41.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: Patient received expired Moderna booster vaccine.  Patient exhibits not adverse signs or symptoms.   Patient evaluated and instructed to report any issues.  He verbalized his understanding.  No treatment given.
Age: 37.0
Sex: F
Vaccine: COVID19
Symptoms: Unevaluable event
Clinical narrative: na
Age: 62.0
Sex: M
Vaccine: COVID19
Symptoms: Extra dose administered, Wrong product administered
Clinical narrative: Patient came in for booster shot and requested Janssen vaccine.  However, after vaccination realized patient had already received a booster shot of Janssen in November (his primary dose was also Janssen), so this would be his second booster.  Since patient getting 2nd booster he should have received either Moderna or Pfizer (since these are the 2 vaccinations approved for the 2nd booster).   Made patient aware of this  and at this point he was doing well--no adverse effects as of yet.
Age: 63.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: Patient received expired Moderna booster vaccine.  Patient exhibits not adverse signs or symptoms.   Patient evaluated and instructed to report any issues.  He verbalized his understanding.  No treatment given.
Age: 37.0
Sex: F
Vaccine: COVID19
Symptoms: Influenza virus test negative, Respiratory tract congestion, SARS-CoV-2 test negative, Streptococcus test negative, Upper-airway cough syndrome
Clinical narrative: Congestion in my throat with postnasal drip for about 4-5 days and stayed home. After being clear for 6 days it came back, and I decided to seek care. 4/6/2022 At Urgent care I had COVID-19, strep, and Flu, all came back negative. The doctor suggested to drink more fluids and take anti-histamine. I just went home and got more rest.  After about a day I felt right as rain and up to today (4/21/2021) feel that I have recovered.
Age: 12.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: VACCINE WAS GIVEN BEYOND USE DATE. VACCINE WAS RECEIVED IN REFRIGERATOR ON 01/11/2022 AND KEPT IN APPROPRIATE TEMPERATURE (2-8 CELSIUS). VACCINE WAS ADMINISTERED TO PATIENT 16 DAYS PAST THE 30 DAY TIME IN REFRIGERATOR.
Age: 51.0
Sex: F
Vaccine: VARZOS
Symptoms: Chills, Dizziness, Fatigue, Feeling abnormal, Headache
Clinical narrative: started that evening with dizziness/fever 101/ chills/ muscles body aches. headache(bad) nausea (vomiting the next day) severe exhaustion, brain fog.  These symptoms persisted 3 days, seemed to be getting better then another round of teeth chattering chills on day four with recurring fever, headache same symptoms as day 1.  Day 5 better but still  feeling extremely tired muscle aches lingering headache low grade fever 99.5.  Day 6: same as day 5.  Tomorrow will be day 7
Age: 51.0
Sex: F
Vaccine: VARZOS
Symptoms: Myalgia, Nausea, Pain, Pyrexia, Vomiting
Clinical narrative: started that evening with dizziness/fever 101/ chills/ muscles body aches. headache(bad) nausea (vomiting the next day) severe exhaustion, brain fog.  These symptoms persisted 3 days, seemed to be getting better then another round of teeth chattering chills on day four with recurring fever, headache same symptoms as day 1.  Day 5 better but still  feeling extremely tired muscle aches lingering headache low grade fever 99.5.  Day 6: same as day 5.  Tomorrow will be day 7
Age: 23.0
Sex: M
Vaccine: COVID19
Symptoms: Unevaluable event
Clinical narrative: na
Age: 49.0
Sex: M
Vaccine: COVID19, FLU4
Symptoms: Acute cardiac event, Cardiac arrest, Cardioversion, Cough, Implantable defibrillator insertion
Clinical narrative: slight intermittent dry cough a week prior to Cardiac event  Sudden Cardiac arrest (pulseless ventricular fibrillation) CPR administered, 3 defibrillations by EMS Transport to Medical Center where substantial additional treatment provided Implant of Boston Scientific S-ICD (subcutaneous defibrillator) Discharge from hospital and recovering well
Age: 49.0
Sex: M
Vaccine: COVID19, FLU4
Symptoms: Interchange of vaccine products, Laboratory test normal, Pulse absent, Resuscitation, SARS-CoV-2 test negative
Clinical narrative: slight intermittent dry cough a week prior to Cardiac event  Sudden Cardiac arrest (pulseless ventricular fibrillation) CPR administered, 3 defibrillations by EMS Transport to Medical Center where substantial additional treatment provided Implant of Boston Scientific S-ICD (subcutaneous defibrillator) Discharge from hospital and recovering well
Age: 49.0
Sex: M
Vaccine: COVID19, FLU4
Symptoms: Ventricular fibrillation
Clinical narrative: slight intermittent dry cough a week prior to Cardiac event  Sudden Cardiac arrest (pulseless ventricular fibrillation) CPR administered, 3 defibrillations by EMS Transport to Medical Center where substantial additional treatment provided Implant of Boston Scientific S-ICD (subcutaneous defibrillator) Discharge from hospital and recovering well
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, COVID-19 pneumonia, Computerised tomogram thorax abnormal, Diarrhoea, Fatigue
Clinical narrative: On 2/2/2022, I began having the symptoms of COVID-19. First of all, everything suddenly tasted bad. On 2/3/2022, I began feeling fatigued and nauseous. On 2/5/2022, I underwent a rapid test and got a negative result. On 2/9/2022, I began vomiting and having diarrhea. On 2/21/2022, I went to the ER locally. When I got to the ER, I was tested for COVID-19, and I got a positive result. I was admitted and placed in a COVID-19 room when one became available. I was given a steroid shot. I was also given a steroid pill just before I fell asleep. They continued giving me the steroid pill every day, and I continued to take it for 7 days altogether. I was in the hospital for 2 days and then released. I have leukemia, and when I went for my regular 3-month checkup with my oncologist on 3/2/2022, I underwent CT scans. As a result of the findings on the CT scan, my oncologist was advised that I had COVID-19 pneumonia. I wasn't given any treatments for it, and I was back at the office on 3/7/2022. I continued to have diarrhea intermittently until around 3/23/2022, but I was no longer nauseous.
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: Malaise, Nausea, SARS-CoV-2 test positive, Taste disorder, Vomiting
Clinical narrative: On 2/2/2022, I began having the symptoms of COVID-19. First of all, everything suddenly tasted bad. On 2/3/2022, I began feeling fatigued and nauseous. On 2/5/2022, I underwent a rapid test and got a negative result. On 2/9/2022, I began vomiting and having diarrhea. On 2/21/2022, I went to the ER locally. When I got to the ER, I was tested for COVID-19, and I got a positive result. I was admitted and placed in a COVID-19 room when one became available. I was given a steroid shot. I was also given a steroid pill just before I fell asleep. They continued giving me the steroid pill every day, and I continued to take it for 7 days altogether. I was in the hospital for 2 days and then released. I have leukemia, and when I went for my regular 3-month checkup with my oncologist on 3/2/2022, I underwent CT scans. As a result of the findings on the CT scan, my oncologist was advised that I had COVID-19 pneumonia. I wasn't given any treatments for it, and I was back at the office on 3/7/2022. I continued to have diarrhea intermittently until around 3/23/2022, but I was no longer nauseous.
Age: 53.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: Patient received expired Moderna booster vaccine.  Patient exhibits not adverse signs or symptoms.   Patient evaluated and instructed to report any issues.  He verbalized his understanding.  No treatment given.
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Asthenia, Chills, Confusional state, Fall, Nausea
Clinical narrative: Developed severe chills an hour after she received vaccine.  Reports fever for 2 days (did not check temperature).  Continued to have mild weakness, nausea, mild body aches for almost 10 days. Daughter reported she fell out of bed and was confused.
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Pain, Pyrexia
Clinical narrative: Developed severe chills an hour after she received vaccine.  Reports fever for 2 days (did not check temperature).  Continued to have mild weakness, nausea, mild body aches for almost 10 days. Daughter reported she fell out of bed and was confused.
Age: 21.0
Sex: M
Vaccine: COVID19
Symptoms: Unevaluable event
Clinical narrative: na
Age: 13.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Vaccine given beyond-use-date. Vaccine received in refrigerator on 01/11/2022 and kept in appropriate temperature (2-8 Celsius). Vaccine administered to patient 16 days past the 30-day time in refrigerator.
Age: 77.0
Sex: F
Vaccine: COVID19
Symptoms: Muscle spasms, Pain
Clinical narrative: Caused a spasm of neck muscles which was very painful. This is still on going. Pain is lessened by about 50%.
Age: 22.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: Patient received expired Moderna booster vaccine.  Patient exhibits not adverse signs or symptoms.   Patient evaluated and instructed to report any issues.  He verbalized his understanding.  No treatment given.
Age: 14.0
Sex: M
Vaccine: COVID19
Symptoms: Unevaluable event
Clinical narrative: na
Age: 53.0
Sex: F
Vaccine: COVID19
Symptoms: Headache, Influenza
Clinical narrative: Headache was very intense. Other adverse effects included flu symptoms. 11 months later, I am still getting the headaches. I have yearly allergies to pollens, but I no longer get sinus headaches, I get the headaches that are squeezing the middle of my brain. They last from 2 to 7 days. I received the Johnson & Johnson injection October 2021. I got the same headache and intense flu symptoms. I did not go back to the hospital due to experiencing these symptoms in the past. I have not gone back to the hospital or doctor's office for the headaches, since they go away after a few days.
Age: 62.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: Patient received expired Moderna booster vaccine. Patient exhibits no adverse signs or symptoms.  Patient evaluated and instructed to report any issues. He verbalized his understanding.  No treatment given.
Age: 80.0
Sex: M
Vaccine: COVID19
Symptoms: Unevaluable event
Clinical narrative: na
Sex: U
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: VACCINE WAS GIVEN BEYOND USE DATE. VACCINE WAS RECEIVED IN REFRIGERATOR ON 01/11/2022 AND KEPT IN APPROPRIATE TEMPERATURE (2-8 CELSIUS). VACCINE WAS ADMINISTERED TO PATIENT 16 DAYS PAST THE 30 DAY TIME IN REFRIGERATOR.
Age: 37.0
Sex: F
Vaccine: COVID19
Symptoms: Heavy menstrual bleeding, Intermenstrual bleeding, Menstruation irregular
Clinical narrative: I noticed after my 2nd vaccine that I had a breakthrough menstrual bleeding mid-cycle and sometimes heavier than others for no reason. It happened the first time in the summer when I first sought care and the doctor said to just watch it and if it became a bigger deal to let her know, but it's been more frequent lately between the 2nd and 3rd dose that it's been happening.
Age: 40.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: Patient received expired Moderna booster vaccine.  Patient exhibits not adverse signs or symptoms.   Patient evaluated and instructed to report any issues.  He verbalized his understanding.  No treatment given.
Age: 64.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: Patient received expired Moderna booster vaccine.  Patient exhibits not adverse signs or symptoms.   Patient evaluated and instructed to report any issues.  He verbalized his understanding.  No treatment given.
Age: 77.0
Sex: F
Vaccine: COVID19
Symptoms: Angiogram, Aortic dissection, Death
Clinical narrative: Patient died of an aortic dissection 13 days after receiving vaccine.  It is not clear if there was any correlation.
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: Unevaluable event
Clinical narrative: N/A.
Age: 33.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: Patient received expired Moderna booster vaccine.  Patient exhibits not adverse signs or symptoms.   Patient evaluated and instructed to report any issues.  He verbalized his understanding.  No treatment given.
Age: 70.0
Sex: M
Vaccine: COVID19
Symptoms: Needle issue, Skin atrophy
Clinical narrative: the needle would not fully go into the patient's muscle due to minimal muscle mass (patient was very thin ) and toughness of the tissue .  therefore , I took the needle out without injecting any vaccine component and prepared a new syringe/dose , then I successfully injected the patient with a dose the second time.
Age: 39.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: Patient received expired Moderna booster vaccine.  Patient exhibits not adverse signs or symptoms.   Patient evaluated and instructed to report any issues.  He verbalized his understanding.  No treatment given.
Age: 61.0
Sex: M
Vaccine: COVID19
Symptoms: Cardiac flutter, Dizziness
Clinical narrative: Heart fluttering, dizziness
Age: 16.0
Sex: F
Vaccine: HPV9, IPV, MMR, MNQ, TDAP, VARCEL
Symptoms: Breast pain, Hypoaesthesia, Injection site erythema, Injection site induration, Injection site reaction
Clinical narrative: Pt was seen on 3/23/22, she received vaccines given (IPV#4, Tdap#1, Varicella #2) on Rt arm. Pt c/o reddness, warm to touch, hard lump on back of rt arm. rt arm feels numb and fingers are tingly. Pt has not taking any medication for pain. Pt also feeling pain in rt breast area. 2:27PM  reaction at site of HPV vaccine May be cellulitis ATB prescribed, advised to take 800mg ibuprofen Q8H with food until numbness and tingling ceases   Risks and/or benefits and potential side effects of prescribed medication were reviewed with the parent/patient and all questions answered.  Parent/patient verbalizes understanding, denies any barriers to adherence and agrees to call the clinic with any concerns. RTC in 5 days for f/u    Report reaction if no improvement with antibiotics
Age: 16.0
Sex: F
Vaccine: HPV9, IPV, MMR, MNQ, TDAP, VARCEL
Symptoms: Injection site warmth, Pain, Paraesthesia
Clinical narrative: Pt was seen on 3/23/22, she received vaccines given (IPV#4, Tdap#1, Varicella #2) on Rt arm. Pt c/o reddness, warm to touch, hard lump on back of rt arm. rt arm feels numb and fingers are tingly. Pt has not taking any medication for pain. Pt also feeling pain in rt breast area. 2:27PM  reaction at site of HPV vaccine May be cellulitis ATB prescribed, advised to take 800mg ibuprofen Q8H with food until numbness and tingling ceases   Risks and/or benefits and potential side effects of prescribed medication were reviewed with the parent/patient and all questions answered.  Parent/patient verbalizes understanding, denies any barriers to adherence and agrees to call the clinic with any concerns. RTC in 5 days for f/u    Report reaction if no improvement with antibiotics
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Anaphylactic reaction
Clinical narrative: Anaphylaxis requiring two, six-hour ER visits. Treatment included multiple epinephrine injections.
Age: 19.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site paraesthesia, Injection site swelling
Clinical narrative: Patient states swelling at injection site on same day. Swelling got progressively larger day by day. On 4/21, patient was at gym and felt a tingly sensation around swollen arm. Patient has not seen a physician. They have an appointment tomorrow with doctor.
Age: 17.0
Sex: M
Vaccine: COVID19
Symptoms: Unevaluable event
Clinical narrative: na
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Asthenia, Dizziness, Facial pain, Feeling hot
Clinical narrative: muscle pain, All joints hurt except my elbow joints,  I have stabbing pain in both sides of my face when I get these stabbing pains I get nauseous, dizzy and weak. I also hear a very horrible noise in my head. it sounds like lots of wind chimes chiming horribly at the same time. It feels like a heat lamp is held on both buttocks. and like both my feet are in warm water. my eye sight have drastically declined.
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Myalgia, Nausea, Tinnitus, Visual impairment
Clinical narrative: muscle pain, All joints hurt except my elbow joints,  I have stabbing pain in both sides of my face when I get these stabbing pains I get nauseous, dizzy and weak. I also hear a very horrible noise in my head. it sounds like lots of wind chimes chiming horribly at the same time. It feels like a heat lamp is held on both buttocks. and like both my feet are in warm water. my eye sight have drastically declined.
Age: 54.0
Sex: F
Vaccine: TDAP
Symptoms: Back pain, Injection site pain, Pain, Pain in extremity
Clinical narrative: Patient Describes unbearable and consistent pain in and around injection site that radiates all down the arm and to opposite side of back.  Pain started 2 days post injection and has continued through today with little to no relief.  patient has been prescribed Medrol dosepak which she has used for 3 days and pain not resolved.  patient denies any other injury
Age: 31.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Arthralgia, Chills, Eyelid pain, Headache, Impaired work ability
Clinical narrative: I got my 3rd dose on 4/19/22 at 6:45pm. The following day (4/20/22) I was in bed (took off work the full day) with fever, chills, headache, and muscle / joint pain. I also noticed a sharp pain that sporadically occurred in both eyelids throughout the late afternoon. On  4/21/22 I woke up at 10am and my right undereye was slightly swollen and mildly purple on the lower lid. Over the course of the day, the swelling increased and extended into my mid-cheek. It is currently 9:14pm on 4/21/22 and the swelling persists. I am considering going to urgent care or seeing if I can visit a GP tomorrow.
Age: 31.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Mobility decreased, Myalgia, Pyrexia, Skin discolouration, Swelling face
Clinical narrative: I got my 3rd dose on 4/19/22 at 6:45pm. The following day (4/20/22) I was in bed (took off work the full day) with fever, chills, headache, and muscle / joint pain. I also noticed a sharp pain that sporadically occurred in both eyelids throughout the late afternoon. On  4/21/22 I woke up at 10am and my right undereye was slightly swollen and mildly purple on the lower lid. Over the course of the day, the swelling increased and extended into my mid-cheek. It is currently 9:14pm on 4/21/22 and the swelling persists. I am considering going to urgent care or seeing if I can visit a GP tomorrow.
Age: 31.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Swelling of eyelid
Clinical narrative: I got my 3rd dose on 4/19/22 at 6:45pm. The following day (4/20/22) I was in bed (took off work the full day) with fever, chills, headache, and muscle / joint pain. I also noticed a sharp pain that sporadically occurred in both eyelids throughout the late afternoon. On  4/21/22 I woke up at 10am and my right undereye was slightly swollen and mildly purple on the lower lid. Over the course of the day, the swelling increased and extended into my mid-cheek. It is currently 9:14pm on 4/21/22 and the swelling persists. I am considering going to urgent care or seeing if I can visit a GP tomorrow.
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Heavy menstrual bleeding, Intermenstrual bleeding
Clinical narrative: I noticed after my 2nd vaccine I had breakthrough menstrual bleeding mid cycle and sometimes heavier than others for no reason. It happened the first in the summer when I first sought care and doctor said to just watch it and if it became a bigger deal to let her know, but it's been more frequent lately. Between 2nd and 3rd dose and it's been happening. Since the 3rd dose it has been Pretty much the same thing, but it's happened monthly now with the menstrual bleeding. It is still ongoing.
Age: 33.0
Sex: M
Vaccine: COVID19
Symptoms: Unevaluable event
Clinical narrative: N/A.
Age: 42.0
Sex: M
Vaccine: COVID19
Symptoms: Cardiovascular function test, Chest discomfort, Chest pain, Pain, Pain in extremity
Clinical narrative: Progressive chest tightness, chest pain relieved with leaning forward, pain with use of left (injection) arm, radiating pain up and down the left chest, left arm, and left jaw.
Age: 42.0
Sex: M
Vaccine: COVID19
Symptoms: Pain in jaw
Clinical narrative: Progressive chest tightness, chest pain relieved with leaning forward, pain with use of left (injection) arm, radiating pain up and down the left chest, left arm, and left jaw.
Age: 4.0
Sex: M
Vaccine: DTAPIPV, MMR, VARCEL
Symptoms: Irritability, Pyrexia
Clinical narrative: Fever and fussines developed after receiving vaccines Tmax of 101, higher than expected for normal immune response to vaccines No s/s of infection or other illness Continue ibuprofen, may add APAP as needed when ibuprofen wears off prior to 6 hours Push fluids to prevent dehydration F/u tomorrow if not significantly improved
Age: 67.0
Sex: F
Vaccine: TDAP, VARZOS
Symptoms: Rash, Urticaria
Clinical narrative: Patient developed rash/hives beginning 3-4 days following receiving both Shingrix & Boostrix but she also started taking gabapentin for the first time that day.
Age: 44.0
Sex: M
Vaccine: COVID19
Symptoms: Unevaluable event
Clinical narrative: na
Age: 41.0
Sex: F
Vaccine: COVID19
Symptoms: Erythema, Mechanical urticaria, Pruritus, Scratch, Urticaria
Clinical narrative: 2 weeks after receiving the booster 3rd shot. I developed Dermatographia and hives. Anything that touches my skin roughly or scrapes it I get hives and horrible itching. If I scratch my skin you can see the red lines and I develop itchy raised hives. They last for about a half hour then go away and come back if something touches my skin.
Age: 38.0
Sex: M
Vaccine: COVID19
Symptoms: Epistaxis
Clinical narrative: Nose bleeds without any direct irritation. Occurred approximately 6 times over the course of 2 weeks, specifically while driving.
Age: 56.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Chills, Headache, Pyrexia, Tremor
Clinical narrative: Because I had reported some changes in my body previously, I received a phone call from someone in late 2021  that I should file my concerns. 1.  After both injections I suffered fever, chills and headaches for about 1/5 - 2 days. 2.  I've noticed since I've had the injections, I have developed a tremor when I hold things in my left arm. NO, I do not know if this is related to the vaccine, but so little is known regarding the vaccine, I decided to go ahead and document in case others have complained about the same thing.
Age: 26.0
Sex: F
Vaccine: COVID19
Symptoms: Tremor
Clinical narrative: A few months after my first and second Pfizer Covid vaccine I developed a tremor in my hands and body. I have seen multiple neurologists who say my tremor doesn't present as normal for essential tremor or other disorders where tremors show up typically. It only just occurred to me that the tremor developed pretty shortly after vaccination and it got worse in the last couple months following my booster shot in January 2022.
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Abdomen scan, Arthralgia, Back pain, Blood test, Chest X-ray
Clinical narrative: Chills & fever of over 100 for around 7 days, as well as severe migraines, urinary issues, joint, back, and side aches.
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Flank pain, Influenza virus test, Migraine, Pyrexia
Clinical narrative: Chills & fever of over 100 for around 7 days, as well as severe migraines, urinary issues, joint, back, and side aches.
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test, Scan, Scan brain, Urinary tract disorder, Urine analysis
Clinical narrative: Chills & fever of over 100 for around 7 days, as well as severe migraines, urinary issues, joint, back, and side aches.
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Anxiety, Emotional disorder, Fatigue, Pain in extremity
Clinical narrative: pain in arm, tiredness, nontypical emotional feelings of anxiety (I do not have any history of anxiety). Anxiety comes as odd twinges and come on abruptly and then are gone after a few minutes. Never had anything like this in my entire life.
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Aphasia, Blood test, Burning sensation, Cardiac flutter, Chest discomfort
Clinical narrative: About 20 minutes after shot left side of face started to tingle.  Moved up face and grew numb.  Felt like shot of novocaine from Dentist.  Felt very nauseous, thought I would throw up.  Hand started tingling, some numbness in arm, some pressure in chest, no pain.  Called Dr., went to walk-in clinic.  By that time, teeth were chattering, very fatigued and would have slept except for nausea.  They did EKG.  Doctor said all fine but probably related to shot. Went home.  Severe headache that night, could not lie down.   Arm sore, not painful.  Sore throat, swollen glands.  Week later, lower cheek still numb, headache better.  Jan 18 - Arm starts intense itch and breaking out in rash.  Spreading under arm.   Left eye very sore and bloodshot.  Face increasing numbness (left side).  Headache back.  Extreme fatigue, tinnitus.    Jan 19 - Arm worse, feels like shingles, fatigued laid down and could hardly move.  Husband woke me.  Could not form words because of numb lips.  Arm burning, extreme itch.  Throat sore.  Jan 21 - Face very numb, rash improving, eyes itching, throughout sore, swollen.  New rash at shot site.  Jan 23 - Lips tingling, numb face, headache, arm much more sore.  Very nauseous.  Jan 27 - Face numb, rash on face.  Jan 29 - Face numb, nauseous, sweating, arm breaking out itchy.  Jan 30 - Left eye very sore/bloodshot.  Burning and red welt at shot site.  Rash on left side of face and numb.  Feb 1 - Left eye very sore, neck sore. Feb 2-4 - Can't smile the same.  Left side weaker,  Tongue numb.  Feb 16 - Face now tingling, not as numb.  Rash on arm.  Nauseous.  Eye painful.  Feb. 24 - Woke in night - lips numb, Left eye numb into brow.   April 21 - Still having original symptoms.  Face numbness increase/decrease.  Heart fluttering, palpitations, chest discomfort that has become painful, have trouble getting enough breath.  Constant.
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Chest pain, Chills, Dyspnoea, Electrocardiogram normal, Eye pain
Clinical narrative: About 20 minutes after shot left side of face started to tingle.  Moved up face and grew numb.  Felt like shot of novocaine from Dentist.  Felt very nauseous, thought I would throw up.  Hand started tingling, some numbness in arm, some pressure in chest, no pain.  Called Dr., went to walk-in clinic.  By that time, teeth were chattering, very fatigued and would have slept except for nausea.  They did EKG.  Doctor said all fine but probably related to shot. Went home.  Severe headache that night, could not lie down.   Arm sore, not painful.  Sore throat, swollen glands.  Week later, lower cheek still numb, headache better.  Jan 18 - Arm starts intense itch and breaking out in rash.  Spreading under arm.   Left eye very sore and bloodshot.  Face increasing numbness (left side).  Headache back.  Extreme fatigue, tinnitus.    Jan 19 - Arm worse, feels like shingles, fatigued laid down and could hardly move.  Husband woke me.  Could not form words because of numb lips.  Arm burning, extreme itch.  Throat sore.  Jan 21 - Face very numb, rash improving, eyes itching, throughout sore, swollen.  New rash at shot site.  Jan 23 - Lips tingling, numb face, headache, arm much more sore.  Very nauseous.  Jan 27 - Face numb, rash on face.  Jan 29 - Face numb, nauseous, sweating, arm breaking out itchy.  Jan 30 - Left eye very sore/bloodshot.  Burning and red welt at shot site.  Rash on left side of face and numb.  Feb 1 - Left eye very sore, neck sore. Feb 2-4 - Can't smile the same.  Left side weaker,  Tongue numb.  Feb 16 - Face now tingling, not as numb.  Rash on arm.  Nauseous.  Eye painful.  Feb. 24 - Woke in night - lips numb, Left eye numb into brow.   April 21 - Still having original symptoms.  Face numbness increase/decrease.  Heart fluttering, palpitations, chest discomfort that has become painful, have trouble getting enough breath.  Constant.
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Eye pruritus, Fatigue, Headache, Hemiparesis, Hyperhidrosis
Clinical narrative: About 20 minutes after shot left side of face started to tingle.  Moved up face and grew numb.  Felt like shot of novocaine from Dentist.  Felt very nauseous, thought I would throw up.  Hand started tingling, some numbness in arm, some pressure in chest, no pain.  Called Dr., went to walk-in clinic.  By that time, teeth were chattering, very fatigued and would have slept except for nausea.  They did EKG.  Doctor said all fine but probably related to shot. Went home.  Severe headache that night, could not lie down.   Arm sore, not painful.  Sore throat, swollen glands.  Week later, lower cheek still numb, headache better.  Jan 18 - Arm starts intense itch and breaking out in rash.  Spreading under arm.   Left eye very sore and bloodshot.  Face increasing numbness (left side).  Headache back.  Extreme fatigue, tinnitus.    Jan 19 - Arm worse, feels like shingles, fatigued laid down and could hardly move.  Husband woke me.  Could not form words because of numb lips.  Arm burning, extreme itch.  Throat sore.  Jan 21 - Face very numb, rash improving, eyes itching, throughout sore, swollen.  New rash at shot site.  Jan 23 - Lips tingling, numb face, headache, arm much more sore.  Very nauseous.  Jan 27 - Face numb, rash on face.  Jan 29 - Face numb, nauseous, sweating, arm breaking out itchy.  Jan 30 - Left eye very sore/bloodshot.  Burning and red welt at shot site.  Rash on left side of face and numb.  Feb 1 - Left eye very sore, neck sore. Feb 2-4 - Can't smile the same.  Left side weaker,  Tongue numb.  Feb 16 - Face now tingling, not as numb.  Rash on arm.  Nauseous.  Eye painful.  Feb. 24 - Woke in night - lips numb, Left eye numb into brow.   April 21 - Still having original symptoms.  Face numbness increase/decrease.  Heart fluttering, palpitations, chest discomfort that has become painful, have trouble getting enough breath.  Constant.
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Hypoaesthesia, Hypoaesthesia oral, Injection site erythema, Injection site pain, Injection site rash
Clinical narrative: About 20 minutes after shot left side of face started to tingle.  Moved up face and grew numb.  Felt like shot of novocaine from Dentist.  Felt very nauseous, thought I would throw up.  Hand started tingling, some numbness in arm, some pressure in chest, no pain.  Called Dr., went to walk-in clinic.  By that time, teeth were chattering, very fatigued and would have slept except for nausea.  They did EKG.  Doctor said all fine but probably related to shot. Went home.  Severe headache that night, could not lie down.   Arm sore, not painful.  Sore throat, swollen glands.  Week later, lower cheek still numb, headache better.  Jan 18 - Arm starts intense itch and breaking out in rash.  Spreading under arm.   Left eye very sore and bloodshot.  Face increasing numbness (left side).  Headache back.  Extreme fatigue, tinnitus.    Jan 19 - Arm worse, feels like shingles, fatigued laid down and could hardly move.  Husband woke me.  Could not form words because of numb lips.  Arm burning, extreme itch.  Throat sore.  Jan 21 - Face very numb, rash improving, eyes itching, throughout sore, swollen.  New rash at shot site.  Jan 23 - Lips tingling, numb face, headache, arm much more sore.  Very nauseous.  Jan 27 - Face numb, rash on face.  Jan 29 - Face numb, nauseous, sweating, arm breaking out itchy.  Jan 30 - Left eye very sore/bloodshot.  Burning and red welt at shot site.  Rash on left side of face and numb.  Feb 1 - Left eye very sore, neck sore. Feb 2-4 - Can't smile the same.  Left side weaker,  Tongue numb.  Feb 16 - Face now tingling, not as numb.  Rash on arm.  Nauseous.  Eye painful.  Feb. 24 - Woke in night - lips numb, Left eye numb into brow.   April 21 - Still having original symptoms.  Face numbness increase/decrease.  Heart fluttering, palpitations, chest discomfort that has become painful, have trouble getting enough breath.  Constant.