chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 77.0
Sex: F
Vaccine: COVID19
Symptoms: Dyspnoea, Electrolyte imbalance, Endotracheal intubation, Febrile neutropenia, Intensive care
Clinical narrative: Discharge Provider: MD Primary Care Physician at Discharge: DO  Admission Date: 6/10/2022  PRESENTING PROBLEM: Thrombocytopenia [D69.6] Febrile neutropenia [D70.9, R50.81] Electrolyte abnormality [E87.8] Pulmonary embolism, unspecified chronicity, unspecified pulmonary embolism type, unspecified whether acute cor pulmonale present [I26.99] Pneumonia due to COVID-19 virus [U07.1, J12.82] Acute respiratory failure with hypoxia [J96.01]   HOSPITAL COURSE:   Patient is a 78 y.o. female with history of active small cell lung carcinoma s/p radiation therapy and was on active chemotherapy (last session completed two weeks ago), COPD, HTN who presented initially due to sepsis in the setting of febrile neutropenia who was also found to be positive for COVID-19. She was admitted on 6/10 from the infusion clinic after having 1-week of worsening shortness of breath, cough, and chills. She had sepsis due to Pseudomonas bacteremia and pneumonia. During hospitalization she declined and developed AHHRF was placed on BiPap with worsening VBG and was transferred to ICU and subsequently intubated on 6/12.    During her stay she was also found to have a new acute thrombus right lower extremity and small pulmonary emolism. She had severe pancytopenia with platelets <10 so an IVC filter placed on 6/12 and unable to anticoagulate. She then suffered from worsening renal failure and required renal replacement therapy. Found to have worsening respiratory status, as well as a candida bacteremia. Shock persisted. A family meeting on 6/21/2022 with first degree relatives agreed upon comfort care measures given that her wishes were not to be kept alive on life support. Family presented at bedside and comfort care measures in place.   Patient was pronounced at 6:54pm on 06/21/2022 secondary to respiratory failure in the setting of pseudomonas pneumonia, covid pneumonia, and candida bacteremia. Called and updated family over the phone
Age: 77.0
Sex: F
Vaccine: COVID19
Symptoms: Pancytopenia, Platelet count decreased, Pneumonia, Pneumonia pseudomonal, Positive airway pressure therapy
Clinical narrative: Discharge Provider: MD Primary Care Physician at Discharge: DO  Admission Date: 6/10/2022  PRESENTING PROBLEM: Thrombocytopenia [D69.6] Febrile neutropenia [D70.9, R50.81] Electrolyte abnormality [E87.8] Pulmonary embolism, unspecified chronicity, unspecified pulmonary embolism type, unspecified whether acute cor pulmonale present [I26.99] Pneumonia due to COVID-19 virus [U07.1, J12.82] Acute respiratory failure with hypoxia [J96.01]   HOSPITAL COURSE:   Patient is a 78 y.o. female with history of active small cell lung carcinoma s/p radiation therapy and was on active chemotherapy (last session completed two weeks ago), COPD, HTN who presented initially due to sepsis in the setting of febrile neutropenia who was also found to be positive for COVID-19. She was admitted on 6/10 from the infusion clinic after having 1-week of worsening shortness of breath, cough, and chills. She had sepsis due to Pseudomonas bacteremia and pneumonia. During hospitalization she declined and developed AHHRF was placed on BiPap with worsening VBG and was transferred to ICU and subsequently intubated on 6/12.    During her stay she was also found to have a new acute thrombus right lower extremity and small pulmonary emolism. She had severe pancytopenia with platelets <10 so an IVC filter placed on 6/12 and unable to anticoagulate. She then suffered from worsening renal failure and required renal replacement therapy. Found to have worsening respiratory status, as well as a candida bacteremia. Shock persisted. A family meeting on 6/21/2022 with first degree relatives agreed upon comfort care measures given that her wishes were not to be kept alive on life support. Family presented at bedside and comfort care measures in place.   Patient was pronounced at 6:54pm on 06/21/2022 secondary to respiratory failure in the setting of pseudomonas pneumonia, covid pneumonia, and candida bacteremia. Called and updated family over the phone
Age: 77.0
Sex: F
Vaccine: COVID19
Symptoms: Pseudomonal bacteraemia, Pulmonary embolism, Renal failure, Renal replacement therapy, Respiratory disorder
Clinical narrative: Discharge Provider: MD Primary Care Physician at Discharge: DO  Admission Date: 6/10/2022  PRESENTING PROBLEM: Thrombocytopenia [D69.6] Febrile neutropenia [D70.9, R50.81] Electrolyte abnormality [E87.8] Pulmonary embolism, unspecified chronicity, unspecified pulmonary embolism type, unspecified whether acute cor pulmonale present [I26.99] Pneumonia due to COVID-19 virus [U07.1, J12.82] Acute respiratory failure with hypoxia [J96.01]   HOSPITAL COURSE:   Patient is a 78 y.o. female with history of active small cell lung carcinoma s/p radiation therapy and was on active chemotherapy (last session completed two weeks ago), COPD, HTN who presented initially due to sepsis in the setting of febrile neutropenia who was also found to be positive for COVID-19. She was admitted on 6/10 from the infusion clinic after having 1-week of worsening shortness of breath, cough, and chills. She had sepsis due to Pseudomonas bacteremia and pneumonia. During hospitalization she declined and developed AHHRF was placed on BiPap with worsening VBG and was transferred to ICU and subsequently intubated on 6/12.    During her stay she was also found to have a new acute thrombus right lower extremity and small pulmonary emolism. She had severe pancytopenia with platelets <10 so an IVC filter placed on 6/12 and unable to anticoagulate. She then suffered from worsening renal failure and required renal replacement therapy. Found to have worsening respiratory status, as well as a candida bacteremia. Shock persisted. A family meeting on 6/21/2022 with first degree relatives agreed upon comfort care measures given that her wishes were not to be kept alive on life support. Family presented at bedside and comfort care measures in place.   Patient was pronounced at 6:54pm on 06/21/2022 secondary to respiratory failure in the setting of pseudomonas pneumonia, covid pneumonia, and candida bacteremia. Called and updated family over the phone
Age: 77.0
Sex: F
Vaccine: COVID19
Symptoms: Respiratory failure, SARS-CoV-2 test positive, Sepsis, Shock, Thrombocytopenia
Clinical narrative: Discharge Provider: MD Primary Care Physician at Discharge: DO  Admission Date: 6/10/2022  PRESENTING PROBLEM: Thrombocytopenia [D69.6] Febrile neutropenia [D70.9, R50.81] Electrolyte abnormality [E87.8] Pulmonary embolism, unspecified chronicity, unspecified pulmonary embolism type, unspecified whether acute cor pulmonale present [I26.99] Pneumonia due to COVID-19 virus [U07.1, J12.82] Acute respiratory failure with hypoxia [J96.01]   HOSPITAL COURSE:   Patient is a 78 y.o. female with history of active small cell lung carcinoma s/p radiation therapy and was on active chemotherapy (last session completed two weeks ago), COPD, HTN who presented initially due to sepsis in the setting of febrile neutropenia who was also found to be positive for COVID-19. She was admitted on 6/10 from the infusion clinic after having 1-week of worsening shortness of breath, cough, and chills. She had sepsis due to Pseudomonas bacteremia and pneumonia. During hospitalization she declined and developed AHHRF was placed on BiPap with worsening VBG and was transferred to ICU and subsequently intubated on 6/12.    During her stay she was also found to have a new acute thrombus right lower extremity and small pulmonary emolism. She had severe pancytopenia with platelets <10 so an IVC filter placed on 6/12 and unable to anticoagulate. She then suffered from worsening renal failure and required renal replacement therapy. Found to have worsening respiratory status, as well as a candida bacteremia. Shock persisted. A family meeting on 6/21/2022 with first degree relatives agreed upon comfort care measures given that her wishes were not to be kept alive on life support. Family presented at bedside and comfort care measures in place.   Patient was pronounced at 6:54pm on 06/21/2022 secondary to respiratory failure in the setting of pseudomonas pneumonia, covid pneumonia, and candida bacteremia. Called and updated family over the phone
Age: 77.0
Sex: F
Vaccine: COVID19
Symptoms: Thrombosis, Vena cava filter insertion
Clinical narrative: Discharge Provider: MD Primary Care Physician at Discharge: DO  Admission Date: 6/10/2022  PRESENTING PROBLEM: Thrombocytopenia [D69.6] Febrile neutropenia [D70.9, R50.81] Electrolyte abnormality [E87.8] Pulmonary embolism, unspecified chronicity, unspecified pulmonary embolism type, unspecified whether acute cor pulmonale present [I26.99] Pneumonia due to COVID-19 virus [U07.1, J12.82] Acute respiratory failure with hypoxia [J96.01]   HOSPITAL COURSE:   Patient is a 78 y.o. female with history of active small cell lung carcinoma s/p radiation therapy and was on active chemotherapy (last session completed two weeks ago), COPD, HTN who presented initially due to sepsis in the setting of febrile neutropenia who was also found to be positive for COVID-19. She was admitted on 6/10 from the infusion clinic after having 1-week of worsening shortness of breath, cough, and chills. She had sepsis due to Pseudomonas bacteremia and pneumonia. During hospitalization she declined and developed AHHRF was placed on BiPap with worsening VBG and was transferred to ICU and subsequently intubated on 6/12.    During her stay she was also found to have a new acute thrombus right lower extremity and small pulmonary emolism. She had severe pancytopenia with platelets <10 so an IVC filter placed on 6/12 and unable to anticoagulate. She then suffered from worsening renal failure and required renal replacement therapy. Found to have worsening respiratory status, as well as a candida bacteremia. Shock persisted. A family meeting on 6/21/2022 with first degree relatives agreed upon comfort care measures given that her wishes were not to be kept alive on life support. Family presented at bedside and comfort care measures in place.   Patient was pronounced at 6:54pm on 06/21/2022 secondary to respiratory failure in the setting of pseudomonas pneumonia, covid pneumonia, and candida bacteremia. Called and updated family over the phone
Age: 40.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Vaccine given beyond use date
Age: 50.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Cough, Hyperaesthesia, Lethargy, Malaise
Clinical narrative: On 05/20/2022, I started having symptoms. I began to notice some sinus drainage in my throat and coughing. Later that evening, I began feeling lethargic. I had to fly that day from and wore a mask the whole time. When I returned home, I tested positive with a home test for Covid. On Monday morning, 5/23, I called my doctor who prescribed Paxlovid, along with a prescription cough medicine and a decongestant. While on Paxlovid, I experienced a terrible metallic grapefruit like taste in my mouth which persisted the entire time I was on the medication. Almost immediately after beginning the medications, I began to feel better. I did experience a strange skin sensitivity on my chest to the point that I could not wear a shirt prior to seeing my doctor. My doctor advised that it was nothing to be too concerned about and it did go away by Thursday. The lethargy was the other main symptom that I experienced. I never had fever or loss of taste or smell. In total, my symptoms lasted around 7 days. By the following Friday, I felt much better.
Age: 50.0
Sex: M
Vaccine: COVID19
Symptoms: Paranasal sinus hypersecretion, SARS-CoV-2 test positive, Sensitive skin, Upper-airway cough syndrome
Clinical narrative: On 05/20/2022, I started having symptoms. I began to notice some sinus drainage in my throat and coughing. Later that evening, I began feeling lethargic. I had to fly that day from and wore a mask the whole time. When I returned home, I tested positive with a home test for Covid. On Monday morning, 5/23, I called my doctor who prescribed Paxlovid, along with a prescription cough medicine and a decongestant. While on Paxlovid, I experienced a terrible metallic grapefruit like taste in my mouth which persisted the entire time I was on the medication. Almost immediately after beginning the medications, I began to feel better. I did experience a strange skin sensitivity on my chest to the point that I could not wear a shirt prior to seeing my doctor. My doctor advised that it was nothing to be too concerned about and it did go away by Thursday. The lethargy was the other main symptom that I experienced. I never had fever or loss of taste or smell. In total, my symptoms lasted around 7 days. By the following Friday, I felt much better.
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Stored in freezer >2 weeks
Age: 45.0
Sex: U
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Vaccine given beyond use date
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Vaccine administered beyond use date.
Age: 17.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Stored in freezer >2 weeks
Age: 79.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Stored in freezer >2 weeks.
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: Aphasia, COVID-19, Cough, Diplopia, Dry throat
Clinical narrative: It started on the June 19th in the afternoon I was very tired, I was hot, I was cold, I thought I was in the sun too much. But I didn't know I had a low-grade fever at the time. I had a dry throat and headache. I don't get headaches so when I got home I checked my temperature it was 100.5 which is low grade but it's enough to cause my other thing to happen which is stroke like symptoms. I took a COVID-19 test because why would I have a fever. The line was very faint. I went to bed I had a bad nights sleep, I did take TYLENOL. My headache got really bad I woke in the middle of the night and took an ADVIL PM to try and sleep better. I woke up the next day and took another test it was positive. I went to urgent care they did another test it was positive. I started to get a mirage, one eye got really big and one got really small and I was having double vision. I called my neuro. On Tuesday my voice changed really bad. Sometime my vocal cords are paralyzed and it is hard to speak. My temp stayed normal because I was taking TYLENOL. The neuro called back and told me to go to the ER but I didn't think my throat would get that bad to the point where I wouldn't be able to breathe. Wednesday my symptoms peaked. And yesterday there was a cough also and I was very tired but I kept taking the TYLENOL. In the morning I went to sleep and as the day went on I started to feel some improvement. Sometimes it takes a week sometimes it takes up to 3 weeks if it's really bad. So I am dealing with COVID-19 symptoms and symptoms of a stroke.
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: Dysphonia, Fatigue, Feeling cold, Feeling hot, Headache
Clinical narrative: It started on the June 19th in the afternoon I was very tired, I was hot, I was cold, I thought I was in the sun too much. But I didn't know I had a low-grade fever at the time. I had a dry throat and headache. I don't get headaches so when I got home I checked my temperature it was 100.5 which is low grade but it's enough to cause my other thing to happen which is stroke like symptoms. I took a COVID-19 test because why would I have a fever. The line was very faint. I went to bed I had a bad nights sleep, I did take TYLENOL. My headache got really bad I woke in the middle of the night and took an ADVIL PM to try and sleep better. I woke up the next day and took another test it was positive. I went to urgent care they did another test it was positive. I started to get a mirage, one eye got really big and one got really small and I was having double vision. I called my neuro. On Tuesday my voice changed really bad. Sometime my vocal cords are paralyzed and it is hard to speak. My temp stayed normal because I was taking TYLENOL. The neuro called back and told me to go to the ER but I didn't think my throat would get that bad to the point where I wouldn't be able to breathe. Wednesday my symptoms peaked. And yesterday there was a cough also and I was very tired but I kept taking the TYLENOL. In the morning I went to sleep and as the day went on I started to feel some improvement. Sometimes it takes a week sometimes it takes up to 3 weeks if it's really bad. So I am dealing with COVID-19 symptoms and symptoms of a stroke.
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: Insomnia, Neurological symptom, Ophthalmic migraine, Pyrexia, SARS-CoV-2 test positive
Clinical narrative: It started on the June 19th in the afternoon I was very tired, I was hot, I was cold, I thought I was in the sun too much. But I didn't know I had a low-grade fever at the time. I had a dry throat and headache. I don't get headaches so when I got home I checked my temperature it was 100.5 which is low grade but it's enough to cause my other thing to happen which is stroke like symptoms. I took a COVID-19 test because why would I have a fever. The line was very faint. I went to bed I had a bad nights sleep, I did take TYLENOL. My headache got really bad I woke in the middle of the night and took an ADVIL PM to try and sleep better. I woke up the next day and took another test it was positive. I went to urgent care they did another test it was positive. I started to get a mirage, one eye got really big and one got really small and I was having double vision. I called my neuro. On Tuesday my voice changed really bad. Sometime my vocal cords are paralyzed and it is hard to speak. My temp stayed normal because I was taking TYLENOL. The neuro called back and told me to go to the ER but I didn't think my throat would get that bad to the point where I wouldn't be able to breathe. Wednesday my symptoms peaked. And yesterday there was a cough also and I was very tired but I kept taking the TYLENOL. In the morning I went to sleep and as the day went on I started to feel some improvement. Sometimes it takes a week sometimes it takes up to 3 weeks if it's really bad. So I am dealing with COVID-19 symptoms and symptoms of a stroke.
Age: 82.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Vaccine administered beyond use date.
Age: 36.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: STORED IN FREEZER > 2 WEEKS
Age: 57.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Death, SARS-CoV-2 test positive
Clinical narrative: PFIZER COVID VACCINE #3 GIVEN 9/9/21, LOT # FC3184; pt had a positive COVID test at Medical Center; per death certificate, pt passed away at home with cause of death being COVID 19; no other records.
Age: 79.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Breast pain, Cardiac function test normal, Dyspnoea, Fatigue, Mammogram normal
Clinical narrative: After 2 shots, plus 2 boosters I noticed I had become increasingly breathless,  left arm still sore,  increasing fatigue each time...strange pains in left breast...so bad that I had mammogram, all clear.  Tingle in back of neck, down shoulders, gasping for breath ...went to ER....heart tests done...heart OK....lungs showed small nodule but sounded clear....VERY slowly feeling better.
Age: 79.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Pain in extremity, Paraesthesia, Pulmonary mass
Clinical narrative: After 2 shots, plus 2 boosters I noticed I had become increasingly breathless,  left arm still sore,  increasing fatigue each time...strange pains in left breast...so bad that I had mammogram, all clear.  Tingle in back of neck, down shoulders, gasping for breath ...went to ER....heart tests done...heart OK....lungs showed small nodule but sounded clear....VERY slowly feeling better.
Age: 18.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: STORED IN FREEZER > 2 WEEKS
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Vaccine administered beyond use date.
Age: 32.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Vaccine given beyond use date
Age: 36.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Vaccine given beyond use date.
Age: 74.0
Sex: F
Vaccine: PPV
Symptoms: Decreased appetite, Fatigue, Headache, Injection site reaction, Pain
Clinical narrative: first night paralyzed left arm at injection site, intense pain, swollen. Second day could raise arm parallel to body, 99.8 fever, exhaustion, headaches, loss of appetite. Third day arm could be raised in front of body, fever gone, rest remained, left arm swollen, rose-colored and mild, irritating itching by nightfall. Fourth day, arm rather mobile, somewhat less itching and swelling on upper arm, other reactions gone. No treatment.
Age: 74.0
Sex: F
Vaccine: PPV
Symptoms: Paralysis, Pruritus, Pyrexia, Skin discolouration, Swelling
Clinical narrative: first night paralyzed left arm at injection site, intense pain, swollen. Second day could raise arm parallel to body, 99.8 fever, exhaustion, headaches, loss of appetite. Third day arm could be raised in front of body, fever gone, rest remained, left arm swollen, rose-colored and mild, irritating itching by nightfall. Fourth day, arm rather mobile, somewhat less itching and swelling on upper arm, other reactions gone. No treatment.
Age: 83.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: STORED IN FREEZER > 2 WEEKS
Age: 66.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Vaccine administered beyond use date.
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Vaccine given beyond use date
Age: 33.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Stored in freezer >2 weeks
Age: 57.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Pfizer vaccine given on 06/15/22, BUD date 06/13/22.  Provider notified.  Upon manager calling manufacturer: pfizer states that vaccine is stable 2 days beyond the 10 week BUD date
Age: 26.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: STORED IN FREEZER > 2 WEEKS.
Age: 38.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: STORED IN FREEZER > 2 WEEKS
Age: 21.0
Sex: M
Vaccine: HPV9, HPV9
Symptoms: Extra dose administered, No adverse event
Clinical narrative: PATIENT AT CLINIC TO RECEIVE SECOND DOSE OF HPV9. FIRST DOSE WAS GIVEN 11/23/21 AND SECOND DOSE WAS GIVEN ON 5/5/22.  UPON FURTHER REVIEW, PATIENT RECEIVED A DOSE OF HPV4 ON 11/6/12 AT PCPS OFFICE. THIRD DOSE OF HPV9 WAS NOT NEEDED. NO ADVERSE REACTIONS OCCURED AND PATIENT DENIED ANY SIDE EFFECTS FROM RECEIVING HPV9 DOSE ON 5/5/22.
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: Blood test, Cardiac stress test, Chest pain, Echocardiogram, Electrocardiogram abnormal
Clinical narrative: On June 2, I didn?t feel myself. I was having chest pain, so I went to the nurse, and I asked her to take my blood pressure the reading was 192/120. I don?t take any blood pressure medication because I don?t have issues with my blood pressure. The nurse told me to go to urgent care. The Urgent Care center where they took my blood pressure, and it was still high. The doctor in the clinic gave me nitroglycerine. They also did a EKG and it was abnormal too. I was then transported to the nearest ER. I was given more nitroglycerine in the ambulance. Then I was admitted into the hospital for 3 days. They did several EKGs, a stress test, bloodwork and an ultrasound of my heart with contrast. In the hospital they had me on medication. I am now on a baby aspirin, amlodipine besylate, metoprolol and I was instructed to take my blood pressure every day. I am currently waiting on one more test to come back before I go to see my cardiologist
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: Feeling abnormal, Hypertension, Laboratory test, Scan with contrast
Clinical narrative: On June 2, I didn?t feel myself. I was having chest pain, so I went to the nurse, and I asked her to take my blood pressure the reading was 192/120. I don?t take any blood pressure medication because I don?t have issues with my blood pressure. The nurse told me to go to urgent care. The Urgent Care center where they took my blood pressure, and it was still high. The doctor in the clinic gave me nitroglycerine. They also did a EKG and it was abnormal too. I was then transported to the nearest ER. I was given more nitroglycerine in the ambulance. Then I was admitted into the hospital for 3 days. They did several EKGs, a stress test, bloodwork and an ultrasound of my heart with contrast. In the hospital they had me on medication. I am now on a baby aspirin, amlodipine besylate, metoprolol and I was instructed to take my blood pressure every day. I am currently waiting on one more test to come back before I go to see my cardiologist
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Stored in freezer >2 weeks
Age: 57.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: hospitalized with covid; fully vaccinated with booster
Age: 2.0
Sex: M
Vaccine: COVID19
Symptoms: Circumstance or information capable of leading to medication error, Underdose
Clinical narrative: EUA - young moderna dose 1. Patient moved away during administration and only received a partial dose (majority of solution was not injected). Parent informed and clinical team. Patient was re-vaccinated per guidelines. no issues/reaction noted to scriber during time of this report.
Age: 74.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: STORED IN FREEZER > 2 WEEKS
Age: 17.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Vaccine administered beyond use date.
Age: 83.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Stored in freezer >2 weeks
Age: 13.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: STORED IN FREEZER > 2 WEEKS
Age: 83.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Stored in freezer >2 weeks
Age: 56.0
Sex: F
Vaccine: HEP, MMR, TDAP, VARCEL
Symptoms: Incorrect route of product administration, No adverse event
Clinical narrative: IM injection given SC route.  patient was observed for 45 minutes;  no adverse event occurred;
Age: 87.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Stored in freezer >2 weeks
Age: 63.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Vaccine given beyond use date
Age: 11.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: STORED IN FREEZER > 2 WEEKS
Age: 81.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Stored in freezer >2 weeks
Age: 40.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: STORED IN FREEZER > 2 WEEKS.
Age: 66.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Blood aldosterone, Full blood count, Hypertension, Metabolic function test, Renin
Clinical narrative: Patient was diagnosed with hypertension about 4-5 months after the vaccine, but had not had blood pressure checked between the vaccination and the diagnosis of hypertension.  It was done at a dental visit.  She was found to have a high aldosterone to renin ration, but blood pressures were treated easily with amlodipine.
Age: 75.0
Sex: F
Vaccine: COVID19
Symptoms: Pain in extremity, Tendonitis
Clinical narrative: I got the shot on Thursday the 16th and Saturday morning, the 18th, I woke up with my left thumb was extremely painful (same side as the shot). I?ve never had anything like that happen before. I?ve never experienced anything like that in regards to getting the COVID shots. I already had an appointment to see my doctor on Tuesday for a regular checkup. While I was there, I told her about it and asked if it could be perhaps a side effect. I saw that joint pain could be a side effect of the vaccine. She examined the thumb and thought it was tendonitis. She prescribed 3-day course of prednisone. She said if that didn?t fix that in 5-6 days, she gave me a referral to a hand specialist. Previous experience with other COVID vaccines have been mild so this instance surprised me. Unsure if it has anything to do with the vaccine at this time.
Age: 56.0
Sex: F
Vaccine: UNK
Symptoms: Fatigue, Headache, Tinnitus
Clinical narrative: headache and mild fatigue started the next day. They dissipated within a few days. Tinnitus started on June 20. I noticed it at 2 a.m. It's still going 3 days later.
Age: 52.0
Sex: F
Vaccine: COVID19, PNC20
Symptoms: Arthralgia, Extra dose administered, Musculoskeletal discomfort
Clinical narrative: ight shoulder pain   two weeks ago - vaccines b/l shoulders 06/09/2022 at local Pharmacy  now right shoulder is pain following prevnar vaccine   initially some soreness  then more persistent discomfort  no swollen LN on right  no prior injuries  no bruising or swelling  no rash/hives.
Age: 53.0
Sex: U
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: STORED IN FREEZER > 2 WEEKS
Age: 87.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Stored in freezer >2 weeks
Age: 4.0
Sex: F
Vaccine: DTAPIPV, MMRV
Symptoms: Chest X-ray normal, Condition aggravated, Drooling, Electroencephalogram abnormal, Full blood count
Clinical narrative: Breakthrough seizure  - shaking of all extremities, drooling and left eye gaze deviation  No symptoms prior to episode, noted to be warm and potentially febrile per patients mother
Age: 4.0
Sex: F
Vaccine: DTAPIPV, MMRV
Symptoms: Gaze palsy, Metabolic function test normal, Seizure, Skin warm, Tremor
Clinical narrative: Breakthrough seizure  - shaking of all extremities, drooling and left eye gaze deviation  No symptoms prior to episode, noted to be warm and potentially febrile per patients mother
Age: 4.0
Sex: F
Vaccine: DTAPIPV, MMRV
Symptoms: Urine analysis normal, White blood cell count increased
Clinical narrative: Breakthrough seizure  - shaking of all extremities, drooling and left eye gaze deviation  No symptoms prior to episode, noted to be warm and potentially febrile per patients mother
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: STORED IN FREEZER > 2 WEEKS
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Stored in freezer >2 weeks
Age: 78.0
Sex: F
Vaccine: COVID19
Symptoms: Anticoagulant therapy, COVID-19, Death, Diarrhoea, General physical health deterioration
Clinical narrative: 1/12/22 pt brought to Ed via EMS reporting poor oral intake; O2 sats 85% on RA; placed on NRB; decreased responsiveness, diarrhea x 2 days, vomiting 1 x; admitted started on ABX and fluids; found to be positive for COVID; given Remdesivir, Heparin; pt's condition worsened became hypothermic requiring Bair Hugger blanket; severe sepsis; poor prognosis; DNR; in patient hospice where he expired
Age: 78.0
Sex: F
Vaccine: COVID19
Symptoms: Hypophagia, Hyporesponsive to stimuli, Hypothermia, SARS-CoV-2 test positive, Sepsis
Clinical narrative: 1/12/22 pt brought to Ed via EMS reporting poor oral intake; O2 sats 85% on RA; placed on NRB; decreased responsiveness, diarrhea x 2 days, vomiting 1 x; admitted started on ABX and fluids; found to be positive for COVID; given Remdesivir, Heparin; pt's condition worsened became hypothermic requiring Bair Hugger blanket; severe sepsis; poor prognosis; DNR; in patient hospice where he expired
Age: 78.0
Sex: F
Vaccine: COVID19
Symptoms: Vomiting
Clinical narrative: 1/12/22 pt brought to Ed via EMS reporting poor oral intake; O2 sats 85% on RA; placed on NRB; decreased responsiveness, diarrhea x 2 days, vomiting 1 x; admitted started on ABX and fluids; found to be positive for COVID; given Remdesivir, Heparin; pt's condition worsened became hypothermic requiring Bair Hugger blanket; severe sepsis; poor prognosis; DNR; in patient hospice where he expired
Age: 33.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: STORED IN FREEZER > 2 WEEKS
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Ageusia, COVID-19, Decreased appetite, Exposure to SARS-CoV-2, Fatigue
Clinical narrative: I started to feel tired but I did not attribute it to COVID-19. A friend contacted me to advise that they tested positive. I then took an at home COVID-19 Test and it was positive. I contacted my doctor and asked for Paxlovid and I started taking it yesterday. I am having sleeplessness, headache, loss of appetite and taste.
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Headache, Insomnia, SARS-CoV-2 test positive
Clinical narrative: I started to feel tired but I did not attribute it to COVID-19. A friend contacted me to advise that they tested positive. I then took an at home COVID-19 Test and it was positive. I contacted my doctor and asked for Paxlovid and I started taking it yesterday. I am having sleeplessness, headache, loss of appetite and taste.
Age: 59.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: STORED IN FREEZER > 2 WEEKS
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: STORED IN FREEZER > 2 WEEKS
Age: 75.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, Cardiac failure congestive, Dyspnoea, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: Patient presented to the emergency department via EMS on 5/26/2022 with shortness of breath, subsequently admitted from 5/26-5/31. Tested COVID-19 positive via PCR on 5/26. CHF. This meets criteria for vaccine breakthrough case review.
Age: 69.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Tested positive for Covid-19 on June 14, 2022
Age: 98.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Stored in freezer >2 weeks
Age: 60.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: STORED IN FREEZER > 2 WEEKS.
Age: 43.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Cough, Diarrhoea, Dyspnoea, Fatigue
Clinical narrative: Covid symptoms and two positive tests. Had covid for 12 days. Started with sore throat, but did not test positive for two days after. Struggled to get enough oxygen, coughing, sneezing, headache, fatigue, diarrhea, body aches, sore throat for 10 days.
Age: 43.0
Sex: F
Vaccine: COVID19
Symptoms: Headache, Malaise, Oropharyngeal pain, Pain, SARS-CoV-2 test positive
Clinical narrative: Covid symptoms and two positive tests. Had covid for 12 days. Started with sore throat, but did not test positive for two days after. Struggled to get enough oxygen, coughing, sneezing, headache, fatigue, diarrhea, body aches, sore throat for 10 days.
Age: 43.0
Sex: F
Vaccine: COVID19
Symptoms: Sneezing
Clinical narrative: Covid symptoms and two positive tests. Had covid for 12 days. Started with sore throat, but did not test positive for two days after. Struggled to get enough oxygen, coughing, sneezing, headache, fatigue, diarrhea, body aches, sore throat for 10 days.
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Stored in freezer >2 weeks
Age: 70.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: STORED IN FREEZER > 2 WEEKS
Age: 13.0
Sex: M
Vaccine: HEP, HEPA, IPV, MMRV, TD
Symptoms: Limb discomfort, Pain in extremity
Clinical narrative: On June 22, 2022, pt. arrived around 9:00AM with mother and 2 siblings for immunization visit. Pt did not receive any immunizations until age 12 due to mother's beliefs against vaccines. Mother reports they have moved and he needs all his vaccines to enroll in school. Mother desires pt. to receive all  vaccines that he is due for. Nurse attempted to reduce cost to patient by suggesting combination vaccine MMRV proquad without checking age range for vaccine. Patient was checked in around 9:30 AM and Nurse began preparing vaccines for both children.  After counseling, mother agreed for vaccines and signed for them around 9:45AM. Vaccination of pt. began around 9:50AM and MMRV proquad was given in right arm subcutaneous. Nurse realized error at 10:00AM and patient stayed in office until 10:15AM. Pt denies SOB, swelling of throat or tongue. Pt reports only heavy, sore arm feeling due to multiple vaccines.
Age: 12.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: STORED IN FREEZER > 2 WEEKS
Age: 82.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Stored in freezer >2 weeks
Age: 77.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Vaccine administered beyond use date.
Age: 15.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: STORED IN FREEZER > 2 WEEKS
Age: 64.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Vaccine administered beyond use date.
Age: 55.0
Sex: F
Vaccine: COVID19, TDAP
Symptoms: Product storage error
Clinical narrative: Pfizer vaccine given beyond use date
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Vaccine administered beyond use date.
Age: 79.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: My husband had it so I  quarantined with him, I decided to get tested myself when I went to my Dr. I tested positive on 6/21/2022. My Dr. prescribed Dexamethasone , and Cephalexin
Age: 58.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Vaccine administered beyond use date.
Age: 67.0
Sex: M
Vaccine: VARZOS
Symptoms: Herpes zoster
Clinical narrative: Per patient's wife, patient had developed shingles post vaccination administration.
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: STORED IN FREEZER > 2 WEEKS
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Chills, Fatigue, Headache, Migraine
Clinical narrative: When I woke up I was congested, fatigued, sore throat, and a headache.  I took a COVID-19 test immediately and it was positive.  I reached out to the Dr. that morning and had a virtual telehealth visit that afternoon, and they prescribed me Paxlovid. Benzonatate 200 mg capsule, and nasal spray and advised over the counter medication Tylenol, Mucinex, and throat lozenges.  The next day my symptoms got worse with fever, chills, fatigue, and a migraine.  I had symptoms for probably 5 or 6 days and on day 4/5 I started to feel better and finished the Paxlovid on day 5 and I probably had a day or two that I had a relapse on day 10 or 11 with runny nose, congested, and fatigued and that is were I am at now, not recovered but still experiencing symptoms and I am functioning.   I took another test and it is still positive.
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: Oropharyngeal pain, Pyrexia, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive
Clinical narrative: When I woke up I was congested, fatigued, sore throat, and a headache.  I took a COVID-19 test immediately and it was positive.  I reached out to the Dr. that morning and had a virtual telehealth visit that afternoon, and they prescribed me Paxlovid. Benzonatate 200 mg capsule, and nasal spray and advised over the counter medication Tylenol, Mucinex, and throat lozenges.  The next day my symptoms got worse with fever, chills, fatigue, and a migraine.  I had symptoms for probably 5 or 6 days and on day 4/5 I started to feel better and finished the Paxlovid on day 5 and I probably had a day or two that I had a relapse on day 10 or 11 with runny nose, congested, and fatigued and that is were I am at now, not recovered but still experiencing symptoms and I am functioning.   I took another test and it is still positive.
Age: 22.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Vaccine administered beyond use date.
Age: 70.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Stored in freezer >2 weeks
Age: 54.0
Sex: U
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: STORED IN FREEZER > 2 WEEKS
Age: 80.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect dose administered, Injection site pain
Clinical narrative: Vaccine administering error: At our COVID vaccination clinic, patient was accidentally given Moderna COVID vaccine (18 and up) 0.3 ml instead of 0.25ml as the 2nd COVID vaccine booster.  Patient was contacted the same day and notified this vaccine administering error. Then patient was contacted again the next day to follow up. Patient did not have any other signs or symptoms except pain in the injection site.
Age: 28.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: STORED IN FREEZER > 2 WEEKS
Age: 36.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Stored in freezer >2 weeks
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Vaccine administered beyond use date.
Age: 50.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: STORED IN FREEZER > 2 WEEKS
Age: 57.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered, Product storage error
Clinical narrative: Stored in freezer >2 weeks
Age: 60.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Vaccine administered beyond use date.
Age: 82.0
Sex: F
Vaccine: COVID19
Symptoms: Dyspnoea, Hypotonia
Clinical narrative: Patient was flaccid and difficulty breathing
Age: 20.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Stored in freezer >2 weeks
Age: 55.0
Sex: M
Vaccine: HEPA
Symptoms: Expired product administered, No adverse event
Clinical narrative: Expired dose administered to patient, no adverse effects reported or observed
Age: 62.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Vaccine administered beyond use date.
Age: 72.0
Sex: M
Vaccine: COVID19
Symptoms: Amnesia, Blood testosterone decreased, Central nervous system lesion, Confusional state, Endocrine disorder
Clinical narrative: Began as slight nausea and progressed to lethargy and memory loss followed by symptoms related to endocrine system, e.g., drastic drop in testosterone determined by primary care physician.  Symptoms progressed within days to drastic memory loss and confusion and within approximately three to four weeks to mri diagnosing inflammation of the brain presenting as 3 lesions positioned in center of brain positioned directly on hypothalamus.  Initial diagnosis as potential lymphoma or neurosarcoidosis to completely "rare" as described hematologist/oncologist, Dr., and eventually neuro oncologist, Dr., Hospital. Hospitalization on April 27, 2022 into Hospital Neuro  Critical Care with complete shutdown of endocrine system stemming from brain inflammation.
Age: 72.0
Sex: M
Vaccine: COVID19
Symptoms: Intensive care, Lethargy, Lumbar puncture, Magnetic resonance imaging head abnormal, Nausea
Clinical narrative: Began as slight nausea and progressed to lethargy and memory loss followed by symptoms related to endocrine system, e.g., drastic drop in testosterone determined by primary care physician.  Symptoms progressed within days to drastic memory loss and confusion and within approximately three to four weeks to mri diagnosing inflammation of the brain presenting as 3 lesions positioned in center of brain positioned directly on hypothalamus.  Initial diagnosis as potential lymphoma or neurosarcoidosis to completely "rare" as described hematologist/oncologist, Dr., and eventually neuro oncologist, Dr., Hospital. Hospitalization on April 27, 2022 into Hospital Neuro  Critical Care with complete shutdown of endocrine system stemming from brain inflammation.
Age: 72.0
Sex: M
Vaccine: COVID19
Symptoms: Noninfective encephalitis, Ultrasound scan
Clinical narrative: Began as slight nausea and progressed to lethargy and memory loss followed by symptoms related to endocrine system, e.g., drastic drop in testosterone determined by primary care physician.  Symptoms progressed within days to drastic memory loss and confusion and within approximately three to four weeks to mri diagnosing inflammation of the brain presenting as 3 lesions positioned in center of brain positioned directly on hypothalamus.  Initial diagnosis as potential lymphoma or neurosarcoidosis to completely "rare" as described hematologist/oncologist, Dr., and eventually neuro oncologist, Dr., Hospital. Hospitalization on April 27, 2022 into Hospital Neuro  Critical Care with complete shutdown of endocrine system stemming from brain inflammation.
Age: 12.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Stored in freezer >2 weeks
Age: 10.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Stored in freezer >2 weeks
Age: 44.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, Chest pain, Condition aggravated, Cough, Dyspnoea
Clinical narrative: Pt to ED 6/3 for cough, headache, shortness of breath, fatigue, and +COVID test at home. Remdesivir and Decadron started, Rocephin and Zithromax continued. 6/5 patient is a&o x4.vital signs are stable, coughing and is complaining of chest pain and headache. 6/6 pt currently on 4L NC satting 91%, pt is A&OX4, denies being in pain with no discomfort or SOB. 6/7 pt alert x 4, denies any pain or discomfort. Pt discharged 6/8.
Age: 44.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Fatigue, Headache, SARS-CoV-2 test positive
Clinical narrative: Pt to ED 6/3 for cough, headache, shortness of breath, fatigue, and +COVID test at home. Remdesivir and Decadron started, Rocephin and Zithromax continued. 6/5 patient is a&o x4.vital signs are stable, coughing and is complaining of chest pain and headache. 6/6 pt currently on 4L NC satting 91%, pt is A&OX4, denies being in pain with no discomfort or SOB. 6/7 pt alert x 4, denies any pain or discomfort. Pt discharged 6/8.
Age: 14.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Stored in freezer >2 weeks
Age: 71.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Aphasia, Chills, Hyperhidrosis
Clinical narrative: could not speak, chills, sweating
Age: 71.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Aphonia, Dysphonia, Feeling cold, Hyperhidrosis, Investigation
Clinical narrative: could not speak, chills, sweating
Age: 71.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Neck pain, Vocal cord disorder
Clinical narrative: could not speak, chills, sweating
Age: 1.0
Sex: F
Vaccine: HEP, MMRV
Symptoms: Influenza virus test, Mononucleosis heterophile test, SARS-CoV-2 test, Streptococcus test, Urticaria
Clinical narrative: diffuse rash, viral vs hives
Age: 1.0
Sex: F
Vaccine: HEP, MMRV
Symptoms: Viral rash
Clinical narrative: diffuse rash, viral vs hives
Age: 11.0
Sex: F
Vaccine: COVID19
Symptoms: Product preparation issue
Clinical narrative: It was discovered a couple of hours after vaccine was administered that the vaccine had not been diluted per package directions. Patient tolerated the vaccine well here in the office, I reached out the the family but was not able to connect with them. Will notify parents and check on patient.
Age: 36.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Stored in freezer >2 weeks
Age: 82.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: STORED IN FREEZER > 2 WEEKS
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: STORED IN FREEZER > 2 WEEKS
Age: 63.0
Sex: M
Vaccine: COVID19
Symptoms: Extra dose administered, Injection site pain
Clinical narrative: Vaccine administering error: At our COVID vaccination clinic, patient was accidentally given Moderna COVID vaccine (18 and up) 0.3 ml instead of 0.25ml as the 2nd COVID vaccine booster.  Patient was contacted the same day and notified this vaccine administering error. Then patient was contacted again the next day to follow up. Patient did not have any other signs or symptoms except pain in the injection site.