chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 76.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Dermatitis, Dermatitis contact, Rash
Clinical narrative: Body rash  appearing a few days after  first shot.  I tried to treat myself with anti rash/itch over the counter medication.  Finally i was seen at urgent clinic and treated for ALLERGIC CONTACT DERMANITIS  and RHUS DERMATITIS on  2/22/2021. I asked  about possibility of adverse reaction to vaccine. They said not likely. Informed them that i was getting second shot on 2/23/2021. They said mention this rash. I did and was told not to worry by  personnel administrating the second vaccine
Age: 66.0
Sex: F
Vaccine: COVID19
Symptoms: Body temperature increased, Chills, Feeling cold, Hyperhidrosis
Clinical narrative: WOKE UP 10 HOURS AFTER THE SHOT AND HAD CHILLS FOR OVER 4 HOURS AND RUNNING 103 FEVER. COULD NOT GET WARMED UP. THURSDAY RAN FRIDAY MORNING AT 1;00 AM. I ROTATED TY FEVER ALL DAY ANYWHERE FROM 100-102. FEVER FINALLY BROKE . I TOOK TYLENOL EVERY 4 HOURS TO KEEP FEVER DOWN.  TODAY IS FRIDAY AND SWEATING. THIS WAS WORST HAN THE FLU.
Age: 29.0
Sex: F
Vaccine: COVID19
Symptoms: Asthenia, Diarrhoea, Fatigue, Feeling cold, Pyrexia
Clinical narrative: Severe chills, fever of 100.7, vomiting, fatigue, weakness for less than 12 hours Chills, diarrhea, fatigue, weakness for three days
Age: 29.0
Sex: F
Vaccine: COVID19
Symptoms: Vomiting
Clinical narrative: Severe chills, fever of 100.7, vomiting, fatigue, weakness for less than 12 hours Chills, diarrhea, fatigue, weakness for three days
Age: 78.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Erythema, Pruritus, Skin warm, Swelling
Clinical narrative: Swollen, red, warm to touch, itchy, still occuring
Age: 78.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Chills, Fatigue, Headache, Injection site pruritus, Injection site rash
Clinical narrative: Swollen, red, warm to touch, itchy, still occuring
Age: 78.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Injection site swelling, Injection site warmth
Clinical narrative: Swollen, red, warm to touch, itchy, still occuring
Age: 40.0
Sex: F
Vaccine: COVID19
Symptoms: Nausea
Clinical narrative: a couple minutes after receiving the vaccine the patient reported nausea.  was directed to have a seat, provided with a bag in case of vomitting (not needed) and a bottle of water.  a few minutes later she was feeling better.  had patient remain at pharmacy for 30 minutes post vaccination. and she continued to be fine.
Age: 62.0
Sex: M
Vaccine: COVID19
Symptoms: Confusional state, Dizziness, Hyperhidrosis, Hyperventilation, Memory impairment
Clinical narrative: Patient was seen at Facility 10 minutes after his Pfizer  immunization.  He had wooziness, and hyperventilation with a breathing rate of  40.  He was transferred by wheelchair to a stretcher.  Initial Vitals:  BP  128/68, O2 sat 96% on 2 liters O2, pulse 68; veteran was diaphoretic, with clear  lungs.  He did not recall he had an immunization, and was uncertain of his own  age.  He did report he was on metformin for DMII.  911 was called. He was  transported to Hospital ER by EMTs.
Age: 57.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Eyelid irritation, Periorbital swelling
Clinical narrative: Day 4 after shot - both eyelids were sensitive to touch.  Severe pain in both knees. Day 5 both eyelids were puffy and swollen.  Severe pain in both knees. Day 7 - both issues had subsided but still discomfort
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Cyanosis, Dizziness, Headache, Hypoaesthesia, Hypoaesthesia oral
Clinical narrative: Patient stated she felt her tongue was feeling numb and also her arm.she also stated she felt sightly dizzness,noticed her lips were blue upon arrival. 12:15pm;upon arrival patient was taking her own po benadryl 50ml .assisted patient to back via wheelchair .checked bp.sats,o2 sats and respirations. During those moment,snack was provided,assessment done every 10 mins,Patient denies any sob or wheezing at the moment.vs Patient stated she was having a headache but didn't want to take anything for it. provided some gatorade to drink and noticed the color of the skin return back to normal. 1:05pm ; pt stated she felt better after eating the snack and drinking gatorade ,assisted her to walk around to make sure she felt comfortable which she did but complain of since dizziness,still refused for EMS to be called,she sat for total of 35 mins . 1:10pm: pt was wheelchair to her car accompanied with husband and education was provided on calling 911 if symptoms is not improved and also to notify her pcp.
Age: 74.0
Sex: M
Vaccine: COVID19
Symptoms: Chills, Cough, Fatigue, Pyrexia
Clinical narrative: 2 weeks after shot, he continues with fatigue, had chills again today and fever for last 2 nights. Also has a cough.
Age: 53.0
Sex: M
Vaccine: COVID19
Symptoms: Body temperature increased, Feeling abnormal, Malaise, Musculoskeletal stiffness, Seizure
Clinical narrative: The morning after he received his vaccine he started feeling sick and then started to run a temperature. By evening his temperature was 102.9.  Then the seizures started, first his "left" hand up his arm and down his left side. His right hand and arm was shaking rapidly. His left leg stiffened and his toes pointed down and then the seizure traveled to his right side. He remained conscious but somewhat dazed. This went on all night. By 10:00 the next day, Thursday the seizures stopped. His temperature went back to normal Friday morning.
Age: 53.0
Sex: M
Vaccine: COVID19
Symptoms: Tremor
Clinical narrative: The morning after he received his vaccine he started feeling sick and then started to run a temperature. By evening his temperature was 102.9.  Then the seizures started, first his "left" hand up his arm and down his left side. His right hand and arm was shaking rapidly. His left leg stiffened and his toes pointed down and then the seizure traveled to his right side. He remained conscious but somewhat dazed. This went on all night. By 10:00 the next day, Thursday the seizures stopped. His temperature went back to normal Friday morning.
Age: 28.0
Sex: M
Vaccine: COVID19
Symptoms: Cough, Fatigue
Clinical narrative: I became fatigued on Thurs evening. I started coughing, which was consistent to my asthma starting on Friday. I was on steroids and a 5 day course of Azithromycin. I had my vaccine on 12/30/20 and started steroids on 1/10/21 and Azithromycin a few days after that. I started improving after steroids, but was resolved completely with antibiotics.
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site erythema, Injection site pruritus, Injection site warmth
Clinical narrative: Redness in vaccination area.  Feels warm and itched a little.  Two days later seems to be getting better.  Not as red and does not itch anymore.
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Erythema, Injection site pruritus, Injection site swelling, Swelling
Clinical narrative: He got the vaccine and the first two days he had very little reaction, had a small swelling, then it went away.  Yesterday, 3/11/21 the injection site area went to itching, and then he noticed a pretty good swelling in that area, and now the swelling is fairly deep, 3/4" high and about 3" across, about as big as 1/2 the size around as a baseball and sticks up about an inch.  It's red to touch.  His son is a nurse and told him some remedies for the symptoms.   He has taken some ibuprofen for it as well, which did not do anything for the swelling.
Age: 90.0
Sex: M
Vaccine: COVID19
Symptoms: Immune thrombocytopenia, Platelet count decreased
Clinical narrative: Patient developed ITP after receiving the covid-19 vaccination.  He was admitted at the outside hospital in January 2021 and was found with a platelet level of 79.  He presented in this admission at hospital his platelets dropped to 30.
Age: 44.0
Sex: F
Vaccine: COVID19
Symptoms: Blood pressure decreased, Dizziness, Eye swelling
Clinical narrative: Pt received the first dose of the Moderna COVID vaccine on 3/6/21. The following morning, she had moderately swollen eyes and mild dizziness. Eyes swollen since Friday after covid vaccine, BP noted to be low after taken twice. Pt went to ED and was put on Pepcid, Benadryl, and Prednisone. Pt feels the same, no improvement in the eye swelling. The dizziness is gone now. No fever, redness or pain at the injection site. Pt is swallowing and breathing without difficulty.                      Any treatment So Far: prednisone, benadryl, pepcid
Age: 59.0
Sex: M
Vaccine: COVID19
Symptoms: Abdominal pain lower, Body temperature increased, Myalgia, Pain
Clinical narrative: Fever of 102.6 degrees for two days.  Severe abdominal muscle pain.  Unable to sit, stand, or lay down without being in severe pain.  Abdomen was soar to the touch across entire lower area, encompassing entire left to right side areas.
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Fatigue, Headache, Pain
Clinical narrative: Body aches, chills, headache, fatigue
Age: 49.0
Sex: F
Vaccine: COVID19
Symptoms: Hypoaesthesia oral
Clinical narrative: Numbness of the tongue began about two hours after administration of the vaccine.  Persisted for 36 hours and resolved on its own.
Age: 81.0
Sex: F
Vaccine: COVID19
Symptoms: Dry skin, Rash, Rash erythematous, Rash pruritic, Scratch
Clinical narrative: Patient had no issues when receiving Pfizer Vaccine #1.  Presented on 3/8/21 for Pfizer Vaccine #2.  10:47AM: Received Pfizer Vaccine #2 in Right Deltoid.  10:58AM: Patient reported itching and rash on B/L UE.   10:59AM: Assessed by CRNP. Patient has erythema rash RUE>LUE. However the actual vaccination site was clean, dry, intact with no erythema. The erythema was located below the site and went down to her wrist. Erythema on LUE from elbow down to wrist. No rash noted on chest, trunk, stomach. Patient reports only itching on arms. She has multiple drug allergies and states she only has hives from them. Of note, patient also had very dry skin. Lotion applied to skin and Benadryl 25mg PO administered. Patient continued to be monitored in observation area.  11:15AM: CRNP reassessed and rash appeared to be improving but patient still had some itching 11:30AM: CRNP reassessed and rash on LUE resolved but scratch marks noted. RUE rash still present but improved with scratch marks noted. Encouraged patient to keep sleeves covered over arms and to stop scratching. Patient felt well enough to leave.  11:32AM: CRNP called nephew and updated him on patient's status. Patient was assisted to lobby by MA. Nephew was waiting in lobby for patient to drive her home.
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Blood pressure increased, Limb discomfort, Muscle fatigue
Clinical narrative: The day after receiving the vaccine, in the evening, the patient noticed her blood pressure was elevated, she had muscle fatigue (both arms and both legs felt very "heavy"), and she felt as though she might faint but has yet to have a syncopal episode.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Headache, Muscle spasms, Pain, Pyrexia
Clinical narrative: 102+ fever muscle cramping, joint pain, severe headaches body sorness
Age: 66.0
Sex: F
Vaccine: COVID19
Symptoms: Back pain, Condition aggravated, Headache, Injection site pain, Muscle spasms
Clinical narrative: On March 10, 2021, day after second dose of the Moderna vaccine, I started having low back spasms and low back pain  as well as pain at the injection site. The next day, I continued to have low back spasms, low back pain and pain at the injection site.  On March 12, 2021, my symptoms got worse with continued low back spasms and pain, pain at the injection site, my fibromyalgia flared up causing pretty much overall pain, as well as my sciatica flared up.  I also have a mild headache.  I used a heating pad on my lower back.  It helped some but the pain still exists.
Age: 66.0
Sex: F
Vaccine: COVID19
Symptoms: Pain
Clinical narrative: On March 10, 2021, day after second dose of the Moderna vaccine, I started having low back spasms and low back pain  as well as pain at the injection site. The next day, I continued to have low back spasms, low back pain and pain at the injection site.  On March 12, 2021, my symptoms got worse with continued low back spasms and pain, pain at the injection site, my fibromyalgia flared up causing pretty much overall pain, as well as my sciatica flared up.  I also have a mild headache.  I used a heating pad on my lower back.  It helped some but the pain still exists.
Age: 52.0
Sex: M
Vaccine: COVID19
Symptoms: Dizziness, Hypertension, Nausea
Clinical narrative: S: Patient is a 53 y/o male c/o having dizziness and nausea while he is walking towards his car after 5 minutes of getting vaccine. Reports having high blood pressure. He did take his medication this morning. O:  1st reading vitals BP 150/70 HR 64 Oxygen sat 94 pain 0/10 resp. 18 2nd reading 130/80 Hr 68 oxygen saturation 96 Clamy to touch. Negative for shortness of breath, throat swelling, facial swelling, negative for rash. Negative for numbness or tingling of lips or throat.  Cardio: Negative for arm pain, back pain, weakness, palpitations  Neuro: Alert x4, negative for limb weakness, neg for slurring, neg  Medications: losartan 50 mg daily, carveidlol 12.5 mg bid, famotidine 20 mg every other day, simvasta
Age: 66.0
Sex: F
Vaccine: COVID19
Symptoms: Urticaria
Clinical narrative: Severe hives on right leg
Age: 45.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness, Dyspnoea, Headache
Clinical narrative: experienced headache, severe dizziness and Shortness of breath. Accompanied via Security officer and vehicle to the ED
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Blood pressure increased, Condition aggravated, Erythema, Fatigue, Heart rate increased
Clinical narrative: Pt got her first dose of Moderna covid vaccine on 3-3-21 at 3:45pm - was fine at pharmacy and waited 15 mins, then went to the next store and started to feel unwell, her bp was high after with high pulse, is now sick with sinus congestion, flu symptoms, and fatigue. She is now having incontinence issues after the vaccine as well, is on medication that was working just fine prior. Pt now has swelling, redness, and blood vessel flare ups in her left ankle that hasn't occurred in a long time. Feels like the vaccine has exasperated some of her medical conditions.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Incontinence, Influenza, Malaise, Sinus congestion, Swelling
Clinical narrative: Pt got her first dose of Moderna covid vaccine on 3-3-21 at 3:45pm - was fine at pharmacy and waited 15 mins, then went to the next store and started to feel unwell, her bp was high after with high pulse, is now sick with sinus congestion, flu symptoms, and fatigue. She is now having incontinence issues after the vaccine as well, is on medication that was working just fine prior. Pt now has swelling, redness, and blood vessel flare ups in her left ankle that hasn't occurred in a long time. Feels like the vaccine has exasperated some of her medical conditions.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Vasculitis
Clinical narrative: Pt got her first dose of Moderna covid vaccine on 3-3-21 at 3:45pm - was fine at pharmacy and waited 15 mins, then went to the next store and started to feel unwell, her bp was high after with high pulse, is now sick with sinus congestion, flu symptoms, and fatigue. She is now having incontinence issues after the vaccine as well, is on medication that was working just fine prior. Pt now has swelling, redness, and blood vessel flare ups in her left ankle that hasn't occurred in a long time. Feels like the vaccine has exasperated some of her medical conditions.
Age: 89.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Confusional state, Gait disturbance, Hallucination, visual, Hypoxia
Clinical narrative: Started having confusion at 3#0 a.m. Sunday morning. Unstable gait and hypoxia at home. More congested than usual. Had 2nd COVID vaccine 4 weeks ago. Had visual  hallucinations with seeing "bugs" Admitted with positive COVID  and Influenza B  diagnosis.
Age: 89.0
Sex: M
Vaccine: COVID19
Symptoms: Influenza, Influenza B virus test positive, Respiratory tract congestion, SARS-CoV-2 test positive
Clinical narrative: Started having confusion at 3#0 a.m. Sunday morning. Unstable gait and hypoxia at home. More congested than usual. Had 2nd COVID vaccine 4 weeks ago. Had visual  hallucinations with seeing "bugs" Admitted with positive COVID  and Influenza B  diagnosis.
Age: 30.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Epistaxis, Extra dose administered, Nausea, Pain
Clinical narrative: While getting the vaccine, there was a malfunction of the syringe and it seemed to fall apart in the nurses hand. She stated that approx 80 percent of the vaccine was injected and asked if I wanted another dose. I agreed without thinking. Afterwards, i experienced nasuea, body aches, chills and a nosebleed. After discussing it with my coworkers, it was pointed that the vaccine may be unsafe in the quanity I was given. I was hoping to get information on whether I should be worried about a getting nearly twice the recommended dosage.
Age: 61.0
Sex: F
Vaccine: COVID19
Symptoms: Headache, Nausea, SARS-CoV-2 test negative, Vomiting
Clinical narrative: I got my shot on March 5 and on March 9 I woke-up with super bad headache and vomited many times the morning of the 9th. My headache pain was an 8 out of 10 from March 9 to March 11 and remained super nauseous. I got some anti nauseous medicine from the doctor. On March 12, I woke-up perfectly well. This headache and nauseousness felt like my usual reaction to soybean ingestion. I normally have a delayed reaction when I ingest soy bean. Normally, if I ingest soybean, i react 7-12 hours later. I am positive that I did not have any soybean before or after my vaccination.
Age: 42.0
Sex: F
Vaccine: COVID19
Symptoms: Dysphagia, Pharyngeal swelling
Clinical narrative: 08:03- Vaccine administered at  Hospital in ED. Observation time increased to 30 minutes related to history of anaphylaxis. 08:18- Pt complains of difficulty swallowing and feeling as though throat swelling. Patient placed on monitor. O2 sat 98-100% on room air.  Epi 0.3mg administered in left outer thigh at this time. 09:21- Patient continued to be monitored in ED but not registered as an ED patient. Patient denies needing to be seen by provider. Symptoms resolved. Patient states "I'm fine. I'm better than fine, I'm great." 09:25-Patient discharged from observation. Instructed to return to ED or call 911 if symptoms return. Patient voiced understanding.
Age: 43.0
Sex: M
Vaccine: COVID19
Symptoms: Immediate post-injection reaction, Loss of consciousness, Pallor
Clinical narrative: Patient passed out immediately , pale  Patient regained consciousness within a minute. No further issues.
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Diarrhoea, Headache, Hyperhidrosis, Vomiting
Clinical narrative: Severe headache, chills, sweats, vomiting,  diarrhea
Age: 77.0
Sex: F
Vaccine: COVID19
Symptoms: Haemorrhoids, Proctalgia, Rectal haemorrhage
Clinical narrative: On 3/11/2021 the patient presented to the ED for rectal bleeding after a bowel movement and rectal pain. The patient had apparent external hemorrhoids. The patient denied diarrhea.
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Insomnia, Pruritus, Urticaria
Clinical narrative: One week after vaccination, patient awoke with intense generalized itching  (she described as a "internal burning itchiness" that was "all over").  She saw no rash or hives.  Continued for remainder of night, difficult to sleep.  Next day her husband found what he described as a few "faint, non raised patches of very light hives" on the patient's back.  She looked more carefully and found a few small similar patches on both arms and legs.  Treated with OTC lotion, CeraVe Itch Relief Lotion from store.  Patient says 12 hours after onset that the "insane burning/ itching has subsided for now."  Patient reports no new foods, clothing, washing machine detergent, illnesses, or other exposures.  I am a physician, and the patient called me (her brother) to ask me whether this was a known side effect of the Janssen COVID vaccine.  I did not see this described in the FDA advisory committee data package, but just a general reference that urticaria would be an expected side effect to a vaccine.
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Dizziness, Headache
Clinical narrative: headache, light headed, dizzy
Age: 46.0
Sex: F
Vaccine: COVID19
Symptoms: Intermenstrual bleeding, Menopause
Clinical narrative: States she started having spotting the day after her 1st moderna vaccine and it continued for 10 more days. She stated that she has not had a period in several years. She states her gynecologist will see her at her regularly scheduled next appointment.
Age: 69.0
Sex: M
Vaccine: COVID19
Symptoms: Amnesia, Loss of personal independence in daily activities, Pain in extremity
Clinical narrative: Sore arm first day. Short-term memory loss. Can't do tasks that were easy and error-free before vaccination.
Age: 46.0
Sex: F
Vaccine: COVID19
Symptoms: Hypoaesthesia
Clinical narrative: A half hour after the shot, I felt numbness from my neck to my ear on right side and it spread across my face in about an hour.  An hour after that, my right arm and leg were numb.  within 5 hours, all symptoms were gone.
Age: 33.0
Sex: M
Vaccine: COVID19
Symptoms: Anxiety, Feeling abnormal, Tunnel vision, Vision blurred
Clinical narrative: 33 yo M with NKA, history of fainting in the past and anxiety about vaccines and needles was in the drive through clinic to receive COVID-19 Janssen vaccine on 3/12.  After receiving the vaccine at 0943 (lot # 1802070) in right deltoid,  the patient began to feel anxious.  He had been or was watching EMS working with another patient who had experienced an ADR. He began to feel "floaty" and noted he was blinking uncontrollably. He reported some tunnel vision/blurred vision. He states he recalled a nurse rubbing on his chest and placing a cold pack on his neck and at this point he began to feel better. He states he was trying to "fight" the feeling and was tensing up his extremities but denied convulsions or any loss
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Bilevel positive airway pressure, Blood creatinine increased, Blood urea increased, Cardiomegaly, Chest X-ray abnormal
Clinical narrative: 3/6/21 ER   59 y.o. female who presents with SHORTNESSS OF BREATH FROM NURSING HOME.  EMS STATES THAT PT HAD COPIOUS ORAL SECRETIONS AND WAS IN REESPIRATORY DISTRESS UPON THEIR ARRIVAL.EMS PRE-ARRIVAL TREATMENT:  IV ATTEMPTS UNSUCCESSFUL, PLACED ON BIPAP AND SATS CAME UP TO 98%  Presented by EMS from facility with altered mental status confusion Desat 85 on 02 3L NC foaming at the mouth is  What nursing home staff reported; EMS unable to get IV access but did apply CPAP at 10 with sat of 99%; patient will wake up with painful stimuli.      Nursing Home reports patient wears BIPAP S.T. rate 20/8/10 at night and 2 hours during the  Day COVID vaccination Pfizer patient received 1/7/2021 and 1/28/2021 Took insulins this morning and guaifenesin, blood sugar accu check 221 Transferred to higher level of care
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Confusional state, Continuous positive airway pressure, Dyspnoea, Electrocardiogram normal, Foaming at mouth
Clinical narrative: 3/6/21 ER   59 y.o. female who presents with SHORTNESSS OF BREATH FROM NURSING HOME.  EMS STATES THAT PT HAD COPIOUS ORAL SECRETIONS AND WAS IN REESPIRATORY DISTRESS UPON THEIR ARRIVAL.EMS PRE-ARRIVAL TREATMENT:  IV ATTEMPTS UNSUCCESSFUL, PLACED ON BIPAP AND SATS CAME UP TO 98%  Presented by EMS from facility with altered mental status confusion Desat 85 on 02 3L NC foaming at the mouth is  What nursing home staff reported; EMS unable to get IV access but did apply CPAP at 10 with sat of 99%; patient will wake up with painful stimuli.      Nursing Home reports patient wears BIPAP S.T. rate 20/8/10 at night and 2 hours during the  Day COVID vaccination Pfizer patient received 1/7/2021 and 1/28/2021 Took insulins this morning and guaifenesin, blood sugar accu check 221 Transferred to higher level of care
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Laboratory test, Lung opacity, Pneumonia, Pulmonary oedema, Renal function test
Clinical narrative: 3/6/21 ER   59 y.o. female who presents with SHORTNESSS OF BREATH FROM NURSING HOME.  EMS STATES THAT PT HAD COPIOUS ORAL SECRETIONS AND WAS IN REESPIRATORY DISTRESS UPON THEIR ARRIVAL.EMS PRE-ARRIVAL TREATMENT:  IV ATTEMPTS UNSUCCESSFUL, PLACED ON BIPAP AND SATS CAME UP TO 98%  Presented by EMS from facility with altered mental status confusion Desat 85 on 02 3L NC foaming at the mouth is  What nursing home staff reported; EMS unable to get IV access but did apply CPAP at 10 with sat of 99%; patient will wake up with painful stimuli.      Nursing Home reports patient wears BIPAP S.T. rate 20/8/10 at night and 2 hours during the  Day COVID vaccination Pfizer patient received 1/7/2021 and 1/28/2021 Took insulins this morning and guaifenesin, blood sugar accu check 221 Transferred to higher level of care
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Respiratory distress, Salivary hypersecretion
Clinical narrative: 3/6/21 ER   59 y.o. female who presents with SHORTNESSS OF BREATH FROM NURSING HOME.  EMS STATES THAT PT HAD COPIOUS ORAL SECRETIONS AND WAS IN REESPIRATORY DISTRESS UPON THEIR ARRIVAL.EMS PRE-ARRIVAL TREATMENT:  IV ATTEMPTS UNSUCCESSFUL, PLACED ON BIPAP AND SATS CAME UP TO 98%  Presented by EMS from facility with altered mental status confusion Desat 85 on 02 3L NC foaming at the mouth is  What nursing home staff reported; EMS unable to get IV access but did apply CPAP at 10 with sat of 99%; patient will wake up with painful stimuli.      Nursing Home reports patient wears BIPAP S.T. rate 20/8/10 at night and 2 hours during the  Day COVID vaccination Pfizer patient received 1/7/2021 and 1/28/2021 Took insulins this morning and guaifenesin, blood sugar accu check 221 Transferred to higher level of care
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness, Dysgeusia, Pharyngeal hypoaesthesia, Throat tightness
Clinical narrative: APPROXIMATELY  15 MINUTES AFTER MODERNA DOSE #1 PATIENT COMPLAINED OF HEAD FEELING DIZZY, METALLIC TASTE IN MOUTH AND NUMBNESS TO THROAT.  THEN PATIENT SAID THROAT FELT "TIGHT".  EPI AND BENADRYL IM WAS ADMINISTERED ON SITE. PATIENT REPORTS FEELING SOME RELIEF AFTER BEING DOSED.  PATIENT WAS TRANSPORTED VIA EMS TO HOSPITAL
Age: 81.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth, Rash macular
Clinical narrative: Arm got red, swollen, itch, warm to touch from shoulder down to elbow.  Symptoms have improved but still has big red blotch Patient took tylenol for symptoms
Age: 61.0
Sex: M
Vaccine: COVID19
Symptoms: Pruritus, Rash
Clinical narrative: Histimine reaction: re-emergence of poison-ivy type rash on left wrist area (had poison-ivy in this area in 2019) Treating with Benadryl spray / topical, and with Benadryl oral. 48 hours itch and rash still present / no significant change
Age: 60.0
Sex: M
Vaccine: COVID19
Symptoms: Blood glucose decreased, Syncope, Vision blurred
Clinical narrative: Patient was at work when he had blurry vision and an episode of syncope.
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Anxiety, Cough, Dyspnoea, Pharyngeal swelling, Rash
Clinical narrative: SOB, wheezing, swelling throat, rash, tachycardia, and coughing following Pfizer COVID-19 mRNA vaccine (first dose) IM.  Took to ED for evaluation. epinephrine 0.3 mg IM given in addition to methylprednisolone 125 mg IV and diphenhydramine 50 mg IV and famotidine 20 mg IV with a slight improvement in anxiety, throat tightness breath, however patient with persistent wheezing and cough. Albuterol 5 mg trialed without significant improvement in symptoms. Given persistent respiratory symptoms, repeat epinephrine 0.3 mg IM given with continued improvement in symptoms. Monitored patient for 4 hours and symptoms completely resolved. Discharged patient in care of granddaughter with outpatient epinephrine IM prescription.
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Tachycardia, Throat tightness, Wheezing
Clinical narrative: SOB, wheezing, swelling throat, rash, tachycardia, and coughing following Pfizer COVID-19 mRNA vaccine (first dose) IM.  Took to ED for evaluation. epinephrine 0.3 mg IM given in addition to methylprednisolone 125 mg IV and diphenhydramine 50 mg IV and famotidine 20 mg IV with a slight improvement in anxiety, throat tightness breath, however patient with persistent wheezing and cough. Albuterol 5 mg trialed without significant improvement in symptoms. Given persistent respiratory symptoms, repeat epinephrine 0.3 mg IM given with continued improvement in symptoms. Monitored patient for 4 hours and symptoms completely resolved. Discharged patient in care of granddaughter with outpatient epinephrine IM prescription.
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Chills, Ear pain, Fatigue, Headache
Clinical narrative: Fever, chills, joint pain, headache, fatique, vomited one time -started 11 hrs after injection * pain in left jaw,ear, started 48 hours after vaccine. Difficult to chew, talk - pain almost constant but worse when lying down. ?TMJ pain? Treating with heat, ice,  celebrex, muscle relaxant@ nite.  Has continued for 9 days.  No facial drooping.
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: Mastication disorder, Pain in jaw, Pyrexia, Speech disorder, Vomiting
Clinical narrative: Fever, chills, joint pain, headache, fatique, vomited one time -started 11 hrs after injection * pain in left jaw,ear, started 48 hours after vaccine. Difficult to chew, talk - pain almost constant but worse when lying down. ?TMJ pain? Treating with heat, ice,  celebrex, muscle relaxant@ nite.  Has continued for 9 days.  No facial drooping.
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Hypoaesthesia, Lethargy
Clinical narrative: right sided facial numbness that started same night of vaccination about 8-9 hours after, lethargy that started right away
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Balance disorder, Dyspnoea, Feeling abnormal, Gait disturbance, Gait inability
Clinical narrative: Extreme pain, muscle spasms, could not walk, high temperature, headache for 24 hours, wobbliness and difficulty walking, winded, lack of clarity next day
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Muscle spasms, Pain, Pyrexia
Clinical narrative: Extreme pain, muscle spasms, could not walk, high temperature, headache for 24 hours, wobbliness and difficulty walking, winded, lack of clarity next day
Age: 44.0
Sex: F
Vaccine: COVID19
Symptoms: Dyspnoea, Pharyngeal swelling, Swollen tongue, Tracheal oedema
Clinical narrative: Swollen throat, swollen tongue. Swollen trachea. Respiratory difficulty
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Decreased appetite, Fatigue, Headache, Malaise, Pyrexia
Clinical narrative: headache and fever within 5 hours after injection followed by congestion, loss of appetite and extreme malaise. Fever ranged between 99.0 and 101 degrees and broke after 36 hours. Headache lasted 24 hours, congestion for 48 hours. Fatigue for 48 hours
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Respiratory tract congestion
Clinical narrative: headache and fever within 5 hours after injection followed by congestion, loss of appetite and extreme malaise. Fever ranged between 99.0 and 101 degrees and broke after 36 hours. Headache lasted 24 hours, congestion for 48 hours. Fatigue for 48 hours
Age: 82.0
Sex: F
Vaccine: COVID19
Symptoms: Erythema, Feeling hot, Pruritus, Swelling
Clinical narrative: Síntomas: picor, hinchazon, calor localizada, rojo
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Nausea, Pyrexia
Clinical narrative: Moderna COVID-19 vaccine EUA: fever 99.5, slight nausea, headache; took Tylenol/every 8 hours and felt better
Age: 46.0
Sex: F
Vaccine: COVID19
Symptoms: Breast tenderness, Chills, Menstrual discomfort, Menstruation irregular, Migraine
Clinical narrative: 24 hours after vaccination, I experienced migraine headache, chills and vomiting. These events lasted for approximately 16 hours. Within 72 after vaccination, I had an unexpected menstrual cycle.  This cycle was abnormal in its timing and length. I have continued to experience menstrual-related symptoms since his cycle - breast tenderness, cramping, headache.
Age: 46.0
Sex: F
Vaccine: COVID19
Symptoms: Muscle spasms, Vomiting
Clinical narrative: 24 hours after vaccination, I experienced migraine headache, chills and vomiting. These events lasted for approximately 16 hours. Within 72 after vaccination, I had an unexpected menstrual cycle.  This cycle was abnormal in its timing and length. I have continued to experience menstrual-related symptoms since his cycle - breast tenderness, cramping, headache.
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal pain upper, Chills, Hyperhidrosis, Pyrexia, Syncope
Clinical narrative: Fever, chills, sweat, near pass out, severe stomach cramping
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: Confusional state, Feeling abnormal, Feeling drunk, Gait disturbance
Clinical narrative: A few hours had gone by and I felt okay.  I went to work.  I began feeling  ?foggy? and ?intoxicated ?.  I could think straight  nor could I walk straight.  I went to the ER.
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: Body temperature increased, Chills, Fatigue, Headache, Heart rate increased
Clinical narrative: Chills, body ache, headache, fever, tired, sore arm with this shot and the first Temperature of 100.4 treated by self with Tylenol  Resting heart rate usually 55-57 but increased to 77-84 End of side effects March 12, 2021 at 7:00
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: Pain, Pain in extremity, Pyrexia
Clinical narrative: Chills, body ache, headache, fever, tired, sore arm with this shot and the first Temperature of 100.4 treated by self with Tylenol  Resting heart rate usually 55-57 but increased to 77-84 End of side effects March 12, 2021 at 7:00
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Headache, Influenza like illness, Pain, Vomiting
Clinical narrative: Severe headache, vomiting (yellow & clear, no food), severe flulike general pain for 6 hours, then sleep    Had taken migraine relief pills on Feb 16 at noon for migraine symptoms.   Took 2 extra strength tylenol on Feb 18 for extended headache following vaccination previous day
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Headache, Pyrexia
Clinical narrative: Fever Chills Headache
Age: 68.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Blood test, Computerised tomogram head normal, Electrocardiogram, Headache, Hypertension
Clinical narrative: 3 hrs after 1st vaccine developed bad headache, lasted about 36 hrs and then completely resolved.  12 hrs after 2nd vaccine, same headache last about 24 hrs then completely resolved Feb 28 same headache suddenly redeveloped and have been chronic since that time along with new dx of HTN.  Seen by doctor 2 times and ER that did CT of head/EKG/labs all normal so final discharge dx was migraines with HTN. I have never had headaches or HTN in my past medical history. Rx Lisinopril 10mg and Medrol 6 day dose pack have done little to relieve these symtoms.
Age: 68.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Migraine
Clinical narrative: 3 hrs after 1st vaccine developed bad headache, lasted about 36 hrs and then completely resolved.  12 hrs after 2nd vaccine, same headache last about 24 hrs then completely resolved Feb 28 same headache suddenly redeveloped and have been chronic since that time along with new dx of HTN.  Seen by doctor 2 times and ER that did CT of head/EKG/labs all normal so final discharge dx was migraines with HTN. I have never had headaches or HTN in my past medical history. Rx Lisinopril 10mg and Medrol 6 day dose pack have done little to relieve these symtoms.
Age: 68.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Headache
Clinical narrative: 3 hrs after 1st vaccine developed bad headache, lasted about 36 hrs and then completely resolved.  12 hrs after 2nd vaccine, same headache last about 24 hrs then completely resolved Feb 28 same headache suddenly redeveloped and have been chronic since that time along with new dx of HTN.  Seen by doctor 2 times and ER that did CT of head/EKG/labs all normal so final discharge dx was migraines with HTN. I have never had headaches or HTN in my past medical history. Rx Lisinopril 10mg and Medrol 6 day dose pack have done little to relieve these symtoms.
Age: 16.0
Sex: F
Vaccine: COVID19
Symptoms: No adverse event, Product administered to patient of inappropriate age
Clinical narrative: This patient is 16.5 years old, and under the guidance of the physician the Moderna vaccination was administered.  The patient had no adverse effects from the vaccine.
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Asthenia, Dizziness, Rash, Rash erythematous, Syncope
Clinical narrative: On March 2, areas of red rash with welts started to appear on inner knees. By evening an continuing into the night of March 3, these red rash areas with large welts spread all over body. A steroid ointment and antihistamine were used to calm. After approximately 5 days the rash was gone. This rash appeared to look like the internet article pictures from BFF and Self, only the pictures were of the arm of injection.
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Urticaria
Clinical narrative: On March 2, areas of red rash with welts started to appear on inner knees. By evening an continuing into the night of March 3, these red rash areas with large welts spread all over body. A steroid ointment and antihistamine were used to calm. After approximately 5 days the rash was gone. This rash appeared to look like the internet article pictures from BFF and Self, only the pictures were of the arm of injection.
Age: 26.0
Sex: F
Vaccine: UNK
Symptoms: Culture throat negative, Pharyngeal swelling
Clinical narrative: Patient states she experienced throat swelling 2 days after receiving the Moderna vaccination.
Age: 55.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site pruritus, Injection site swelling, Injection site warmth, Peripheral swelling
Clinical narrative: About 24 hours after the vaccine my arm swelled to the size of an average size chocolate chip cookie. It went away after about 60 hours. About 8 days after the vaccine it, reappeared even larger, perhaps 4 inches in diameter. At day 12 it is still swollen to about 4 inches in diameter at the injection site. It is warm and itchy.
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: Plantar fasciitis
Clinical narrative: plantar fasciitis,  currently working with a physical therapist
Age: 66.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site swelling, Joint swelling, Peripheral swelling, Pruritus
Clinical narrative: Upon asking questions on the COVID-19 Immunization Consent Form on 3/12/21, it was noted that the patient could have possibly had a mild anaphylactic reaction to her first Moderna vaccination 28 days ago. She received the first vaccination to her left deltoid, and states that she had moderate swelling at her injection site. She also reports she still has left breast pruritus, mild swelling of her left arm, mild swelling of her bilateral hands, and swelling of her bilateral legs, ankles, and feet. She also had a runny nose after the vaccination, but that has resolved. Patient was sent to ER by her PCP.
Age: 58.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Herpes zoster
Clinical narrative: Constant fatigue since one day post vaccine. Developed shingles 02-10-21.
Age: 97.0
Sex: F
Vaccine: COVID19
Symptoms: Asthenia, Chills, Cough, Dyspnoea, Loss of personal independence in daily activities
Clinical narrative: Chills, weakness, cough, runny nose, trouble breathing. Saturday  the 27 is when it started, she woke with all these symptoms, she needed assistance with everything  she normally does by herself ex: taking shower, getting dressed.  Everyday after she got 10% better and as of this notice she still isn?t back 100%.. She better than she was but suffering from the effects. She?s not going to get second shot because she says it will kill her. I want her to get it but if the 2nd shot is worse than first I can?t in good conscience let her get it.
Age: 97.0
Sex: F
Vaccine: COVID19
Symptoms: Rhinorrhoea
Clinical narrative: Chills, weakness, cough, runny nose, trouble breathing. Saturday  the 27 is when it started, she woke with all these symptoms, she needed assistance with everything  she normally does by herself ex: taking shower, getting dressed.  Everyday after she got 10% better and as of this notice she still isn?t back 100%.. She better than she was but suffering from the effects. She?s not going to get second shot because she says it will kill her. I want her to get it but if the 2nd shot is worse than first I can?t in good conscience let her get it.
Age: 65.0
Sex: M
Vaccine: COVID19
Symptoms: Rash, Urticaria
Clinical narrative: Three days after the second Pfizer vaccine, the patient developed generalized urticaria.  This has slowly improved since it began, but the rash is still present.
Age: 59.0
Sex: M
Vaccine: COVID19
Symptoms: Epistaxis
Clinical narrative: One day after shot i started uncontrollable nose bleeds. Wen to the ER twice locally. Sent to specific location via ambulance for a surgery to stop bleeds.
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: Body temperature increased, Chills, Headache, Pain
Clinical narrative: Chills, 101 temperature, severe headache, body aches.
Age: 45.0
Sex: F
Vaccine: COVID19
Symptoms: Rash erythematous, Rash papular, Rash pruritic, Skin warm
Clinical narrative: Red rash: raised, hot to touch, itchy. 5mm long, 2mm wide.
Age: 27.0
Sex: M
Vaccine: COVID19
Symptoms: Blindness, Dizziness, Dyspnoea, Fatigue, Feeling hot
Clinical narrative: Pt. was vaccinated by another pharmacist at our remote clinic at an elementary school at 11:35am 3/11/21. Within less than 3 minutes the patient informed a student  that he did not feel well. He reported: itching, feeling hot, shortness of breath, dizziness, loss of vision, and thirst. The student alerted me and I assessed the pt. He was responsive, but felt "tired". He was sitting on the floor. I told the student to call 911. I continued talking with the pt. as I was preparing the epinephrine and placing a blood pressure cuff on his arm. He became less responsive and asked me for the epinephrine. I injected him with an EpiPen 0.3mg in his outer left thigh through his pants (at 11:43am). Within approximately 30s-1min the pt. became more responsive. I then took his pulse and BP shortly before EMS arrived (11:52am) . They performed the second blood pressure reading and the pt. was transferred to their care at that point.
Age: 27.0
Sex: M
Vaccine: COVID19
Symptoms: Hyporesponsive to stimuli, Malaise, Pruritus, Thirst
Clinical narrative: Pt. was vaccinated by another pharmacist at our remote clinic at an elementary school at 11:35am 3/11/21. Within less than 3 minutes the patient informed a student  that he did not feel well. He reported: itching, feeling hot, shortness of breath, dizziness, loss of vision, and thirst. The student alerted me and I assessed the pt. He was responsive, but felt "tired". He was sitting on the floor. I told the student to call 911. I continued talking with the pt. as I was preparing the epinephrine and placing a blood pressure cuff on his arm. He became less responsive and asked me for the epinephrine. I injected him with an EpiPen 0.3mg in his outer left thigh through his pants (at 11:43am). Within approximately 30s-1min the pt. became more responsive. I then took his pulse and BP shortly before EMS arrived (11:52am) . They performed the second blood pressure reading and the pt. was transferred to their care at that point.
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Fatigue, Headache, Pain, Pyrexia
Clinical narrative: The evening of 3/3 I started to feel very tired.  I went to sleep early.  During the night I started to have chills and aches.  By the time I woke up on Thursday, 3-4 I had a fever of 100 degrees, a runny nose, chills, aching body, headache, and fatigue.  I just slept all day and took Tylenol.  By Friday morning the only symptom I had was a headache and fatigue.
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: Rhinorrhoea
Clinical narrative: The evening of 3/3 I started to feel very tired.  I went to sleep early.  During the night I started to have chills and aches.  By the time I woke up on Thursday, 3-4 I had a fever of 100 degrees, a runny nose, chills, aching body, headache, and fatigue.  I just slept all day and took Tylenol.  By Friday morning the only symptom I had was a headache and fatigue.
Age: 55.0
Sex: M
Vaccine: COVID19
Symptoms: Arthralgia, Condition aggravated, Confusional state, Gait disturbance, Seizure
Clinical narrative: Patient states they received Vaccine on Monday, became confused at work on Tuesday and then presented to ED after multiple seizures overnight Wednesday and then was having trouble ambulating. also complains of left elbow pain
Age: 62.0
Sex: U
Vaccine: UNK, COVID19
Symptoms: Unevaluable event
Clinical narrative: None stated.
Age: 62.0
Sex: U
Vaccine: UNK, COVID19
Symptoms: Dyspnoea, Fatigue, Lethargy, Pain, Pyrexia
Clinical narrative: None stated.
Age: 62.0
Sex: U
Vaccine: UNK, COVID19
Symptoms: Vomiting
Clinical narrative: None stated.
Age: 62.0
Sex: M
Vaccine: UNK, COVID19
Symptoms: Unevaluable event
Clinical narrative: Fever of 102.5 Severe Vomitting Shortness of Breath Body Aches Extreme fatigue/lethargic
Age: 62.0
Sex: M
Vaccine: UNK, COVID19
Symptoms: Dyspnoea, Fatigue, Lethargy, Pain, Pyrexia
Clinical narrative: Fever of 102.5 Severe Vomitting Shortness of Breath Body Aches Extreme fatigue/lethargic
Age: 62.0
Sex: M
Vaccine: UNK, COVID19
Symptoms: Vomiting
Clinical narrative: Fever of 102.5 Severe Vomitting Shortness of Breath Body Aches Extreme fatigue/lethargic
Age: 51.0
Sex: M
Vaccine: COVID19
Symptoms: Electrocardiogram, Supraventricular tachycardia, Tachycardia
Clinical narrative: Covid vaccine given at 1255, started having tachycardia at 1530 reports heart rate was 143, PCP recommended to wait a couple of hours to see if heart rate would decrease and it didn't so patient went to ER at 1730. Was transferred via ambulance to Hospital at 2213. Diagnosed with Supraventricular Tachycardia on 03-9-21.
Age: 66.0
Sex: F
Vaccine: COVID19
Symptoms: Erythema, Rash, Skin warm, Swelling
Clinical narrative: Swelling rash with warm to touch and skin was red, and it was BIG.
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Genital herpes, Nasal herpes, Stomatitis
Clinical narrative: sores in mouth, genitilia and nose.  Second shot received 3/3/2021, Symptoms started 3/5/2021 with sore in my mouth and in genital area.  Then a sore showed up in my nose on 3/10/2021.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Blood calcium, Blood chloride, Blood creatinine, Blood glucose, Blood potassium
Clinical narrative: 3/6/21  Chief Complaint Patient presents with ? Hypertension ? Headache   HPI Patient is a 71 y.o. female who presents with complaints of high blood pressure and headache reports her blood pressures been high over 200 and his headache in the front of her head moderate sharp better with rest worse with movement ongoing now for the past few hours  3/7/21  Chief Complaint Patient presents with ? Hypertension ? Nausea   HPI Patient is a 71 y.o. female who presents with complaint of neck pain that has been going on for 1 year and radiating to the back of the head.  Pain is sharp and makes it impossible for her to sleep at night.  Patient also complained of migraine headache that is throbbing and bitemporal worsened by light and noise.  Patient was seen in this ER yesterday and CT of the head showed right maxillary sinusitis and C-spine showed multilevel degenerative disease.  Patient also has elevated blood pressure 180/100 mmHg this morning and this may be due to pain.  Patient returned today because she has not felt any better and the pharmacies are not open because of we can not.  No fever or chills, no chest pain, no abdominal pain and no vomiting but has nausea.