chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Sex: F
Vaccine: MNQ
Symptoms: Incorrect dose administered, Product preparation issue
Clinical narrative: inadvertent administration of only the diluent of Menveo to a patient; inadvertent administration of only the diluent of Menveo to a patient; This non-serious case was reported by a nurse via call center representative and described the occurrence of inappropriate preparation of medication in a 16-year-old female patient who received Men ACWY-CRM NVS (Menveo) (batch number AMVA926A, expiry date 31-MAY-2024) for prophylaxis.   On 21-JUL-2023, the patient received Menveo. On 21-JUL-2023, an unknown time after receiving Menveo, the patient experienced inappropriate preparation of medication (Verbatim: inadvertent administration of only the diluent of Menveo to a patient) and inappropriate dose of vaccine administered (Verbatim: inadvertent administration of only the diluent of Menveo to a patient). The outcome of the inappropriate preparation of medication and inappropriate dose of vaccine administered were unknown.   Additional Information: GSK receipt date: 28-Jul-2023 A nurse called to informed about the inadvertent administration of only the diluent of Menveo to a patient. The reporter told that it had not been determined who was the patient that received only the diluent. However, there were two potential patient who both received the 1st dose of Menveo back. The vaccine administration facility was the same as primary reporter. The reporter consented to follow-up. This is 1 of 2 linked patients cases, reported by the same reporter. The patient only received the diluent of Menveo vaccine which led to inappropriate preparation of medication and inappropriate dose of vaccine administered.; Sender's Comments:  US-GSK-US2023AMR104310:Different patient, same reporter, same product
Sex: F
Vaccine: HEPA
Symptoms: Accidental overdose, Product administered to patient of inappropriate age
Clinical narrative: inadvertently received an adult dose of Havrix for their second dose of the Havrix series; adult dose of Havrix for their second dose of the Havrix series; This non-serious case was reported by a nurse via call center representative and described the occurrence of accidental overdose in a adolescent female patient who received HAV (Havrix adult) for prophylaxis.   On an unknown date, the patient received the 2nd dose of Havrix adult. On an unknown date, an unknown time after receiving Havrix adult, the patient experienced accidental overdose (Verbatim: inadvertently received an adult dose of Havrix for their second dose of the Havrix series) and inappropriate age at vaccine administration (Verbatim: adult dose of Havrix for their second dose of the Havrix series). The outcome of the accidental overdose and inappropriate age at vaccine administration were unknown.   Additional Information: GSK Receipt Date: 31-JUL-2023 The reporter reported the patient inadvertently received an adult dose of Havrix of the Havrix series, which led to accidental overdose and inappropriate age at vaccine administration. The reporter consented to follow up.
Age: 34.0
Sex: F
Vaccine: HEP
Symptoms: Expired product administered
Clinical narrative: Expired Product Used; This non-serious case was reported by a other health professional via call center representative and described the occurrence of expired vaccine used in a 34-year-old female patient who received HBV (Engerix B) (batch number F73DG, expiry date 03-JUL-2023) for prophylaxis.   On 27-JUL-2023, the patient received the 1st dose of Engerix B. On 27-JUL-2023, an unknown time after receiving Engerix B, the patient experienced expired vaccine used (Verbatim: Expired Product Used). The outcome of the expired vaccine used was unknown.   Additional Information: GSK receipt date: 31-JUL-2023 A medical assistant thought that this was the patient's first dose in the series, however she was not certain.  At the time of reporting, the dose had not been repeated.  The reporter consented to follow up. The patient received an expired dose of Engerix-B vaccine which led to expired vaccine used.
Sex: M
Vaccine: MNQ
Symptoms: Incorrect dose administered, Product preparation error
Clinical narrative: Menveo-Reconstitution with saline solution; Menveo-Reconstitution with saline solution; This non-serious case was reported by a other health professional via call center representative and described the occurrence of wrong solution used in drug reconstitution in a 18-year-old male patient who received Men ACWY-CRM NVS (Menveo) (batch number AMVA911A, expiry date 31-MAR-2024) for prophylaxis.   On 21-JUL-2023, the patient received Menveo. On 21-JUL-2023, an unknown time after receiving Menveo, the patient experienced wrong solution used in drug reconstitution (Verbatim: Menveo-Reconstitution with saline solution) and inappropriate dose of vaccine administered (Verbatim: Menveo-Reconstitution with saline solution). The outcome of the wrong solution used in drug reconstitution and inappropriate dose of vaccine administered were unknown.   Additional Information: GSK Receipt Date: 31-JUL-2023 The reporter was a medical coordinator. The healthcare professional asked how to proceed with this patient. The reporter consented to follow up. The reporter called to report that a patient received a Menveo dose that was reconstituted with saline solution instead of the liquid CYW-135 conjugate vaccine component, which led to wrong solution used in drug reconstitution and inappropriate dose of vaccine administered.
Age: 16.0
Sex: M
Vaccine: MENB
Symptoms: Incorrect route of product administration
Clinical narrative: nurse administered a dose of Bexsero subcutaneously instead of intramuscular; This non-serious case was reported by a nurse via call center representative and described the occurrence of intramuscular formulation administered by other route in a 16-year-old male patient who received Men B NVS (Bexsero) (batch number 5AR2D, expiry date 31-DEC-2025) for prophylaxis.   On 28-JUL-2023, the patient received the 1st dose of Bexsero (subcutaneous, right arm). On 28-JUL-2023, an unknown time after receiving Bexsero, the patient experienced intramuscular formulation administered by other route (Verbatim: nurse administered a dose of Bexsero subcutaneously instead of intramuscular). The outcome of the intramuscular formulation administered by other route was unknown.   This report is made by GSK without prejudice and does not imply any admission or liability for the incident or its consequences.   Additional Information: GSK Receipt Date: 31-JUL-2023 The dose was administered in the right upper arm of a patient. At the time of reporting, the dose had not been repeated. The Vaccine Administration Facility was the same as Primary Reporter. The reporter consented to follow up. The reporter reported that a float nurse administered a dose of Bexsero subcutaneously instead of intramuscular, which led to intramuscular formulation administered by other route.
Sex: M
Vaccine: DTAPIPV
Symptoms: Product administered to patient of inappropriate age
Clinical narrative: Administration in patients under 4 years; This non-serious case was reported by a nurse via call center representative and described the occurrence of inappropriate age at vaccine administration in a male patient who received DTPa-IPV (Kinrix) (batch number 2KL4K, expiry date 08-NOV-2023) for prophylaxis.   On 31-JUL-2023, the patient received Kinrix. On 31-JUL-2023, an unknown time after receiving Kinrix, the patient experienced inappropriate age at vaccine administration (Verbatim: Administration in patients under 4 years). The outcome of the inappropriate age at vaccine administration was unknown.   This report is made by GSK without prejudice and does not imply any admission or liability for the incident or its consequences.   Additional Information: GSK Receipt Date: 31-JUL-2023 They provided information about vaccine, event and patient. The Vaccine Administration Facility was the same as Primary Reporter. The reporter consented to follow up.  The reporter called to report that a patient received a dose of Kinrix while being below 4 years of age, which led to inappropriate age at vaccine administration.
Age: 80.0
Sex: F
Vaccine: VARZOS
Symptoms: Asthenia, Decreased appetite, Fatigue, Pyrexia, Skin warm
Clinical narrative: fever; lost appetite; red sore and hot arm; weakness; tiredness; This non-serious case was reported by a consumer via call center representative and described the occurrence of fever in a 80-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis.   Previously administered products included Shingrix with an associated reaction of fatigue (1st dose received in May 2023 in left arm, refer case US2023103056).   On 23-JUL-2023, the patient received the 2nd dose of Shingrix (left arm). In JUL-2023, less than a week after receiving Shingrix, the patient experienced fever (Verbatim: fever), appetite lost (Verbatim: lost appetite), skin warm (Verbatim: red sore and hot arm), weakness (Verbatim: weakness) and tiredness (Verbatim: tiredness). Rechallenge with Shingrix was positive. On 27-JUL-2023, the outcome of the fever, appetite lost, skin warm, weakness and tiredness were resolved.   It was unknown if the reporter considered the fever, appetite lost, skin warm, weakness and tiredness to be related to Shingrix.     It was unknown if the company considered the fever, appetite lost, skin warm, weakness and tiredness to be related to Shingrix.   Linked case(s) involving the same patient:  US2023103056   Additional Information: GSK Receipt date: 27-JUL-2023 and 01-AUG-2023 The patient self-reported this case The patient received developed fever, lost appetite, red sore and hot arm, weakness and tiredness that lasted until the day of this report. The patient referred to health care professional (HCP). The reporter did not consent to follow-up.; Sender's Comments:  US-GSK-US2023103056:2nd case
Age: 80.0
Sex: F
Vaccine: VARZOS
Symptoms: Vaccine positive rechallenge
Clinical narrative: fever; lost appetite; red sore and hot arm; weakness; tiredness; This non-serious case was reported by a consumer via call center representative and described the occurrence of fever in a 80-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis.   Previously administered products included Shingrix with an associated reaction of fatigue (1st dose received in May 2023 in left arm, refer case US2023103056).   On 23-JUL-2023, the patient received the 2nd dose of Shingrix (left arm). In JUL-2023, less than a week after receiving Shingrix, the patient experienced fever (Verbatim: fever), appetite lost (Verbatim: lost appetite), skin warm (Verbatim: red sore and hot arm), weakness (Verbatim: weakness) and tiredness (Verbatim: tiredness). Rechallenge with Shingrix was positive. On 27-JUL-2023, the outcome of the fever, appetite lost, skin warm, weakness and tiredness were resolved.   It was unknown if the reporter considered the fever, appetite lost, skin warm, weakness and tiredness to be related to Shingrix.     It was unknown if the company considered the fever, appetite lost, skin warm, weakness and tiredness to be related to Shingrix.   Linked case(s) involving the same patient:  US2023103056   Additional Information: GSK Receipt date: 27-JUL-2023 and 01-AUG-2023 The patient self-reported this case The patient received developed fever, lost appetite, red sore and hot arm, weakness and tiredness that lasted until the day of this report. The patient referred to health care professional (HCP). The reporter did not consent to follow-up.; Sender's Comments:  US-GSK-US2023103056:2nd case
Age: 81.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Respiratory failure
Clinical narrative: ACUTE RESPIRATORY FAILURE RESPIRATORY FAILURE, UNSPECIFIED ACUITY
Age: 41.0
Sex: M
Vaccine: YF
Symptoms: Injection site reaction, Injection site swelling, Injection site warmth
Clinical narrative: Today worker woke up and noticed a reddened warm area at vaccine site. Worker seen by the Health Center today.   localized reaction to left upper are at site of vaccine. Site 4.5 cm redden, warm and slightly raised in a rough circular pattern.  Worker denies pain, itching to site.  Worker denies any other symptoms denies resp distress, denies having any fever or chills, itching, swelling of tongue.  Ice to area  Follow up with the Health center on Friday 8/4/23
Age: 56.0
Sex: M
Vaccine: COVID19
Symptoms: Hypotension, Symptom recurrence
Clinical narrative: HYPOTENSION 2/1/2023  --  RECURRENCE OF HOSPITALIZATION WITH SAME SYMPTOMS
Age: 63.0
Sex: M
Vaccine: TDAP, VARZOS
Symptoms: Dizziness, Fall, Head injury
Clinical narrative: Patient was administered 2 immunizations (Shingrix and Boostrix).  The patient fell twice inthe parking lot, the second time striking his head on the cart corral.  Division 1 filled out a report, the patient went to the hospital and received stiches.  The patient returned to the pharmacy to pick up another (unrelated) script and I spoke to him.  He said the provider said it was possibly related to the immunizations given, but there was no direct evidence to suppport that and they could not say for sure it was related.  The patient stated he was fine inside the store, but when went outside into the heat he became light headed and went down.
Age: 79.0
Sex: F
Vaccine: COVID19
Symptoms: Hypotension, Symptom recurrence
Clinical narrative: HYPOTENSION 1/18/2023  --  RECURRENCE OF HOSPITALIZATION WITH SAME SYMPTOMS
Age: 91.0
Sex: F
Vaccine: COVID19
Symptoms: Breakthrough COVID-19
Clinical narrative: Covid Breakthrough infection
Age: 52.0
Sex: M
Vaccine: COVID19
Symptoms: Neuromyelitis optica spectrum disorder, Symptom recurrence
Clinical narrative: NEUROMYELITIS OPTICA 3/19/2023  --  RECURRENCE OF HOSPITALIZATION WITH SAME SYMPTOMS
Age: 74.0
Sex: M
Vaccine: COVID19
Symptoms: Acute myocardial infarction, Deep vein thrombosis, Symptom recurrence
Clinical narrative: ACUTE NON ST ELEVATION MI ACUTE DVT OF RIGHT POPLITEAL VEIN 12/5/2022 &  11/16/2022  --  RECURRENCE OF HOSPITALIZATION WITH SAME SYMPTOMS
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Breakthrough COVID-19
Clinical narrative: Covid Breakthrough Infection
Age: 91.0
Sex: F
Vaccine: COVID19
Symptoms: Ankylosing spondylitis, Arteriogram coronary normal, Aspiration pleural cavity, Asthenia, Atrial fibrillation
Clinical narrative: "Patient is a 94 YO female patient with a history of mild mitral stenosis, macular degeneration, arthritis, peripheral neuropathy, and severe AS. She is a patient of a Dr. and has known severe AS for a couple of years, but without symptoms and at her advanced age, she had elected to not undergo further testing/intervention. Recent TTE demonstrates critical AS - AVA 0.5cm2, mean gradient 71mmHg, peak velocity 5.4m/s.  She was seen initially in the valve clinic on 6/15/23 and agreed to complete the CTA.  She then developed acute on chronic systolic heart failure with the HA class IV symptoms of DOE and leg swelling, leading her to a hospitalization.  A shared decision making model was used with the Heart Team and it was agreed upon that the patient would undergo urgent inpatient TAVR after CHF optimization.  She required bilateral thoracentesis with pigtail placement.  On 7/26/23, she underwent successful TAVR (Medtronic Evolut FX 26 mm) via right percutaneous approach with MAC anesthesia.  Coronary angiography performed prior to TAVR confirmed no CAD.  The patient tolerated the procedure well and was transported to a HCF then another facility in stable condition.  .  The patient's post procedure EKG was compared to the pre procedure EKG and demonstrated no significant changes at time of discharge but she did have new onset atrial fibrillation that was treated with Amiodarone and Metoprolol.  She converted to NSR prior to discharge - continue Metoprolol 12.5mg BID.  Decision against anticoagulation at this time as it was a singular episode in close proximity to her valve procedure and increased risk due to age/frailty.  She ambulated without difficulty with a walker and will continue PT/OT at a SNF.  Her bilateral groin access sites are clean, dry, and intact, without hematoma.  The patient will remain on Plavix for 1 month and then transition to ASA 81mg.  All other home medications were resumed appropriately.  Continue Lasix 20mg QD for CHF.  Follow up in 2 weeks.  Discharged to a SNF with PT/OT on 7/30/23.  Referral to cardiac rehab."
Age: 91.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Cardiac failure acute, Cardiac failure chronic, Cardioversion, Catheter placement
Clinical narrative: "Patient is a 94 YO female patient with a history of mild mitral stenosis, macular degeneration, arthritis, peripheral neuropathy, and severe AS. She is a patient of a Dr. and has known severe AS for a couple of years, but without symptoms and at her advanced age, she had elected to not undergo further testing/intervention. Recent TTE demonstrates critical AS - AVA 0.5cm2, mean gradient 71mmHg, peak velocity 5.4m/s.  She was seen initially in the valve clinic on 6/15/23 and agreed to complete the CTA.  She then developed acute on chronic systolic heart failure with the HA class IV symptoms of DOE and leg swelling, leading her to a hospitalization.  A shared decision making model was used with the Heart Team and it was agreed upon that the patient would undergo urgent inpatient TAVR after CHF optimization.  She required bilateral thoracentesis with pigtail placement.  On 7/26/23, she underwent successful TAVR (Medtronic Evolut FX 26 mm) via right percutaneous approach with MAC anesthesia.  Coronary angiography performed prior to TAVR confirmed no CAD.  The patient tolerated the procedure well and was transported to a HCF then another facility in stable condition.  .  The patient's post procedure EKG was compared to the pre procedure EKG and demonstrated no significant changes at time of discharge but she did have new onset atrial fibrillation that was treated with Amiodarone and Metoprolol.  She converted to NSR prior to discharge - continue Metoprolol 12.5mg BID.  Decision against anticoagulation at this time as it was a singular episode in close proximity to her valve procedure and increased risk due to age/frailty.  She ambulated without difficulty with a walker and will continue PT/OT at a SNF.  Her bilateral groin access sites are clean, dry, and intact, without hematoma.  The patient will remain on Plavix for 1 month and then transition to ASA 81mg.  All other home medications were resumed appropriately.  Continue Lasix 20mg QD for CHF.  Follow up in 2 weeks.  Discharged to a SNF with PT/OT on 7/30/23.  Referral to cardiac rehab."
Age: 91.0
Sex: F
Vaccine: COVID19
Symptoms: Condition aggravated, Dyspnoea exertional, Echocardiogram abnormal, Electrocardiogram abnormal, Left ventricular failure
Clinical narrative: "Patient is a 94 YO female patient with a history of mild mitral stenosis, macular degeneration, arthritis, peripheral neuropathy, and severe AS. She is a patient of a Dr. and has known severe AS for a couple of years, but without symptoms and at her advanced age, she had elected to not undergo further testing/intervention. Recent TTE demonstrates critical AS - AVA 0.5cm2, mean gradient 71mmHg, peak velocity 5.4m/s.  She was seen initially in the valve clinic on 6/15/23 and agreed to complete the CTA.  She then developed acute on chronic systolic heart failure with the HA class IV symptoms of DOE and leg swelling, leading her to a hospitalization.  A shared decision making model was used with the Heart Team and it was agreed upon that the patient would undergo urgent inpatient TAVR after CHF optimization.  She required bilateral thoracentesis with pigtail placement.  On 7/26/23, she underwent successful TAVR (Medtronic Evolut FX 26 mm) via right percutaneous approach with MAC anesthesia.  Coronary angiography performed prior to TAVR confirmed no CAD.  The patient tolerated the procedure well and was transported to a HCF then another facility in stable condition.  .  The patient's post procedure EKG was compared to the pre procedure EKG and demonstrated no significant changes at time of discharge but she did have new onset atrial fibrillation that was treated with Amiodarone and Metoprolol.  She converted to NSR prior to discharge - continue Metoprolol 12.5mg BID.  Decision against anticoagulation at this time as it was a singular episode in close proximity to her valve procedure and increased risk due to age/frailty.  She ambulated without difficulty with a walker and will continue PT/OT at a SNF.  Her bilateral groin access sites are clean, dry, and intact, without hematoma.  The patient will remain on Plavix for 1 month and then transition to ASA 81mg.  All other home medications were resumed appropriately.  Continue Lasix 20mg QD for CHF.  Follow up in 2 weeks.  Discharged to a SNF with PT/OT on 7/30/23.  Referral to cardiac rehab."
Age: 91.0
Sex: F
Vaccine: COVID19
Symptoms: Peripheral swelling, SARS-CoV-2 test positive, Sinus rhythm, Transcatheter aortic valve implantation, Walking aid user
Clinical narrative: "Patient is a 94 YO female patient with a history of mild mitral stenosis, macular degeneration, arthritis, peripheral neuropathy, and severe AS. She is a patient of a Dr. and has known severe AS for a couple of years, but without symptoms and at her advanced age, she had elected to not undergo further testing/intervention. Recent TTE demonstrates critical AS - AVA 0.5cm2, mean gradient 71mmHg, peak velocity 5.4m/s.  She was seen initially in the valve clinic on 6/15/23 and agreed to complete the CTA.  She then developed acute on chronic systolic heart failure with the HA class IV symptoms of DOE and leg swelling, leading her to a hospitalization.  A shared decision making model was used with the Heart Team and it was agreed upon that the patient would undergo urgent inpatient TAVR after CHF optimization.  She required bilateral thoracentesis with pigtail placement.  On 7/26/23, she underwent successful TAVR (Medtronic Evolut FX 26 mm) via right percutaneous approach with MAC anesthesia.  Coronary angiography performed prior to TAVR confirmed no CAD.  The patient tolerated the procedure well and was transported to a HCF then another facility in stable condition.  .  The patient's post procedure EKG was compared to the pre procedure EKG and demonstrated no significant changes at time of discharge but she did have new onset atrial fibrillation that was treated with Amiodarone and Metoprolol.  She converted to NSR prior to discharge - continue Metoprolol 12.5mg BID.  Decision against anticoagulation at this time as it was a singular episode in close proximity to her valve procedure and increased risk due to age/frailty.  She ambulated without difficulty with a walker and will continue PT/OT at a SNF.  Her bilateral groin access sites are clean, dry, and intact, without hematoma.  The patient will remain on Plavix for 1 month and then transition to ASA 81mg.  All other home medications were resumed appropriately.  Continue Lasix 20mg QD for CHF.  Follow up in 2 weeks.  Discharged to a SNF with PT/OT on 7/30/23.  Referral to cardiac rehab."
Age: 52.0
Sex: M
Vaccine: COVID19
Symptoms: Cerebrovascular accident
Clinical narrative: ACUTE STROKE, UNSPECIFIED TYPE AND ARTERY
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Hypotension
Clinical narrative: PATIENT RECEIVED VACCINE FROM OUTSIDE SOURCE HYPOTENSION
Age: 49.0
Sex: F
Vaccine: COVID19
Symptoms: Discontinued product administered
Clinical narrative: administered Monovalent vaccine after the recall of this vaccine on 04/18/2023 Pt did not report any side effects
Age: 19.0
Sex: F
Vaccine: COVID19
Symptoms: Discontinued product administered
Clinical narrative: administered Monovalent vaccine after the recall of this vaccine on 04/18/2023 Pt did not report any side effects
Age: 22.0
Sex: F
Vaccine: COVID19
Symptoms: Discontinued product administered
Clinical narrative: administered Monovalent vaccine after the recall of this vaccine on 04/18/2023 Pt did not report any side effects
Age: 49.0
Sex: M
Vaccine: UNK
Symptoms: Hypoaesthesia
Clinical narrative: Numbness to face and extremities one week after vaccine.
Age: 12.0
Sex: M
Vaccine: MNQ
Symptoms: Rash erythematous, Swelling
Clinical narrative: Patient developed a red rash, similar to hives that was slightly swollen. Patient denied any itching and there was no tenderness.
Age: 85.0
Sex: M
Vaccine: COVID19
Symptoms: Breakthrough COVID-19
Clinical narrative: Covid Breakthrough infection
Age: 2.0
Sex: M
Vaccine: HEPA
Symptoms: Ear swelling, Rash, Skin swelling, Swelling, Swelling face
Clinical narrative: Hives that are still ascending after 24 hours, swelling around rash, swelling and puffiness on ears and face.
Age: 2.0
Sex: M
Vaccine: HEPA
Symptoms: Urticaria
Clinical narrative: Hives that are still ascending after 24 hours, swelling around rash, swelling and puffiness on ears and face.
Age: 81.0
Sex: M
Vaccine: COVID19
Symptoms: Acute respiratory failure, Coagulopathy, Hypoxia
Clinical narrative: COAGULOPATHY, UNSPECIFIED TYPE ACUTE HYPOXEMIC RESPIRATORY FAILURE HYPOXIA
Age: 87.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: Breakthrough case admission after 3 vaccines  Pfizer 1/14/21 lot# EL3249;  Pfizer 2/4/21 lot# EM9810;  Pfizer 12/2/21 lot# FH8027
Age: 81.0
Sex: M
Vaccine: COVID19
Symptoms: Breakthrough COVID-19
Clinical narrative: Covid Breakthrough Infection
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: Breakthrough case admission after 3 vaccines Pfizer 3/11/21 lot# EN6207;  Pfizer 4/1/21 lot# ER8730;  Pfizer 4/12/22 Lot# FJ9943
Age: 12.0
Sex: F
Vaccine: MNQ, TDAP
Symptoms: Dizziness
Clinical narrative: PATIENT GOT LIGHTHEADED AND PALE. PARENTS SAID SHE HAD NOT EATEN BREAKFAST. SHE DID NOT FALL DOWN. SHE SAT DOWN NEXT TO PARENTS. SHE DID NOT LOSE CONSCIOUSNESS. NURSE APPLIED COLD PACK TO BACK OF HEAD AND GAVE HER A LOLLIPOP TO EAT. FANNED PATIENT AND ASKED HER ORIENTATING QUESTIONS. AFTER 10 MINUTES HER COLOR TO FACE WAS BETTER THAN BEFORE AND STATED FEELING BETTER. WALKED UNASSISTED OUT OF THE CLINIC WITH PARENTS.
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: Breakthrough case admission after 4 vaccines Pfizer 4/2/21 lot# ER8730;  Pfizer 4/3/21 lot# Ew0162;  Pfizer 11/24/21 lot# FJ1620;  Pfizer 6/24/22 lot# FN2908
Age: 89.0
Sex: F
Vaccine: COVID19-2
Symptoms: COVID-19, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: Breakthrough case admission after 4 vaccines Pfizer 4/19/21 Lot# Ew0162;  Pfizer 5/0/21 lot# EW0164;  Pfizer 4/14/22 Lot# FJ9943;  Pfizer 10/24/22 Lot# GH9703
Age: 56.0
Sex: M
Vaccine: COVID19
Symptoms: Breakthrough COVID-19, SARS-CoV-2 test positive
Clinical narrative: Breakthrough case admission after 2 vaccines Pfizer 5/25/21 lot# Ew0172;  Pfizer 6/17/21 lot# Ew0179
Age: 95.0
Sex: F
Vaccine: COVID19
Symptoms: Breakthrough COVID-19
Clinical narrative: Covid Breakthrough Infection
Age: 13.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered, Incorrect product formulation administered
Clinical narrative: Bivalent Moderna vaccine ordered, but expired monovalent vaccine was administered.
Age: 78.0
Sex: M
Vaccine: HEPAB
Symptoms: C-reactive protein normal, Decreased appetite, Erythema, Full blood count normal, Peripheral swelling
Clinical narrative: Onset:  1 day later:  red ears and hands, swollen hands.  interrupting sleep and decreased appetite.  seen at urgent care and ER.  Rx'd antihistamines Benadryl and Claritin, topical triamcinolone, and Tylenol, didn't help.  7/3/2023 I rx'd prednisone 40mg for 5d (but stopped it after 2d since didn't seem to help and I was worried about triggering delirium), aloe, and cool compresses.  They tried gold bond powder and aleve.  I added aspercream. They told me whenever he went near heat the hands and ears would get red and swollen again and it progressed through the day.  2 weeks later noted gets worse as soon as sun comes up.  I recommended they try to see dermatology through clinic since there's a long wait otherwise.  I also recommended cotton gloves or the kind impregnated with aloe esp if sits on the porch in the sun.  (since also on doxycycline for LYME).  7/20/2023 wife requested "labs to see if anything else going on".  I ordered a CBC and CRP.  Essentially normal but sl elev abs N's (8554 cells/uL where normal was up to 7800) with normal %N's.  Wife called again today 8/2/2023 stating patient's hands are swollen (still?  again?) so I referred to Immunology.    I am suspicious about the Lyme dis affect on his immune system in the setting of melanoma and the doxycycline RX for 1months with sun exposure possibly causing photodermatitis so I thought once the doxycycline was out of his system for a week he'd improve.  But he has not improved.
Age: 78.0
Sex: M
Vaccine: HEPAB
Symptoms: Sleep disorder
Clinical narrative: Onset:  1 day later:  red ears and hands, swollen hands.  interrupting sleep and decreased appetite.  seen at urgent care and ER.  Rx'd antihistamines Benadryl and Claritin, topical triamcinolone, and Tylenol, didn't help.  7/3/2023 I rx'd prednisone 40mg for 5d (but stopped it after 2d since didn't seem to help and I was worried about triggering delirium), aloe, and cool compresses.  They tried gold bond powder and aleve.  I added aspercream. They told me whenever he went near heat the hands and ears would get red and swollen again and it progressed through the day.  2 weeks later noted gets worse as soon as sun comes up.  I recommended they try to see dermatology through clinic since there's a long wait otherwise.  I also recommended cotton gloves or the kind impregnated with aloe esp if sits on the porch in the sun.  (since also on doxycycline for LYME).  7/20/2023 wife requested "labs to see if anything else going on".  I ordered a CBC and CRP.  Essentially normal but sl elev abs N's (8554 cells/uL where normal was up to 7800) with normal %N's.  Wife called again today 8/2/2023 stating patient's hands are swollen (still?  again?) so I referred to Immunology.    I am suspicious about the Lyme dis affect on his immune system in the setting of melanoma and the doxycycline RX for 1months with sun exposure possibly causing photodermatitis so I thought once the doxycycline was out of his system for a week he'd improve.  But he has not improved.
Age: 12.0
Sex: M
Vaccine: HPV9, MNQ, TDAP
Symptoms: Syncope, Vomiting
Clinical narrative: After receiving the vaccines client had an episode of syncope lasting 1 minute. Client place flat on exam table. After 1 minute, client regained consciousness & place on left side in recovery position. Client vomited small amount of clear mucous. Mother states client did not eat prior to apointment. Client monitored for 10 minutes & offered soda. Client's color returned & able to ambulate without difficulty to parent's vehicle. Mother with client during the appointment.
Age: 44.0
Sex: M
Vaccine: COVID19
Symptoms: Arrhythmia, Arteriogram coronary normal, COVID-19, Cardiac assistance device user, Cardiac failure
Clinical narrative: In Nov of 21 I had my third covid vaccine, Moderna for all 3.  In December of 21 I started to have an occasional heart flutter.  I went to a cardiologist and did a stress test and echo, both show ok, and the occasional flutter was attributed to stress.  They occasionally continued .  They were showing up as PVC's.  Went back to the cardiologist for a follow up in June of 23.  Did another stress test and echo and again it was ok.  Shortly after (a couple days) in June of 23, the arrythemias intensified.  I called the cardiologist and they put me on a halter monitor.  in the middle of that, I was experiencing extreme arrythmias at home and went to the ER.  I was having PVC's, bi and tri gemini, and unsustained vtac and was admitted.  Was given a variety of medications and a battery of tests, to include an Echo that shoed my EF went from a normal 55 about 2 weeks prior to 37.  Went home the next day and saw the cardiologist and was put on a variety of other meds.  The next day the arrythmias got unbearable and I returned to the ER, and was again admitted for a night.  I was sent home that afternoon with a life vest.  3 hours later, the life vest went off trying to shock me, and I again returned to the ER.  I was admitted in heart failure and was diagnosed with myocarditis.  I had an angiogram and a cardiac echo, both were clean.  I was scheduled for an EP study but then sent home on strong medication.  I am now awaiting an ablation, just under 3 months later.  No other cause could be found other than viral.  As a note, I had covid shortly before the events increased dramatically.  I can only attribute the events to the vaccine and covid
Age: 44.0
Sex: M
Vaccine: COVID19
Symptoms: Cardiac flutter, Cardiac stress test normal, Echocardiogram abnormal, Ejection fraction decreased, Electrocardiogram ambulatory abnormal
Clinical narrative: In Nov of 21 I had my third covid vaccine, Moderna for all 3.  In December of 21 I started to have an occasional heart flutter.  I went to a cardiologist and did a stress test and echo, both show ok, and the occasional flutter was attributed to stress.  They occasionally continued .  They were showing up as PVC's.  Went back to the cardiologist for a follow up in June of 23.  Did another stress test and echo and again it was ok.  Shortly after (a couple days) in June of 23, the arrythemias intensified.  I called the cardiologist and they put me on a halter monitor.  in the middle of that, I was experiencing extreme arrythmias at home and went to the ER.  I was having PVC's, bi and tri gemini, and unsustained vtac and was admitted.  Was given a variety of medications and a battery of tests, to include an Echo that shoed my EF went from a normal 55 about 2 weeks prior to 37.  Went home the next day and saw the cardiologist and was put on a variety of other meds.  The next day the arrythmias got unbearable and I returned to the ER, and was again admitted for a night.  I was sent home that afternoon with a life vest.  3 hours later, the life vest went off trying to shock me, and I again returned to the ER.  I was admitted in heart failure and was diagnosed with myocarditis.  I had an angiogram and a cardiac echo, both were clean.  I was scheduled for an EP study but then sent home on strong medication.  I am now awaiting an ablation, just under 3 months later.  No other cause could be found other than viral.  As a note, I had covid shortly before the events increased dramatically.  I can only attribute the events to the vaccine and covid
Age: 44.0
Sex: M
Vaccine: COVID19
Symptoms: Laboratory test, Magnetic resonance imaging heart, Stress, Ventricular extrasystoles, Ventricular tachycardia
Clinical narrative: In Nov of 21 I had my third covid vaccine, Moderna for all 3.  In December of 21 I started to have an occasional heart flutter.  I went to a cardiologist and did a stress test and echo, both show ok, and the occasional flutter was attributed to stress.  They occasionally continued .  They were showing up as PVC's.  Went back to the cardiologist for a follow up in June of 23.  Did another stress test and echo and again it was ok.  Shortly after (a couple days) in June of 23, the arrythemias intensified.  I called the cardiologist and they put me on a halter monitor.  in the middle of that, I was experiencing extreme arrythmias at home and went to the ER.  I was having PVC's, bi and tri gemini, and unsustained vtac and was admitted.  Was given a variety of medications and a battery of tests, to include an Echo that shoed my EF went from a normal 55 about 2 weeks prior to 37.  Went home the next day and saw the cardiologist and was put on a variety of other meds.  The next day the arrythmias got unbearable and I returned to the ER, and was again admitted for a night.  I was sent home that afternoon with a life vest.  3 hours later, the life vest went off trying to shock me, and I again returned to the ER.  I was admitted in heart failure and was diagnosed with myocarditis.  I had an angiogram and a cardiac echo, both were clean.  I was scheduled for an EP study but then sent home on strong medication.  I am now awaiting an ablation, just under 3 months later.  No other cause could be found other than viral.  As a note, I had covid shortly before the events increased dramatically.  I can only attribute the events to the vaccine and covid
Age: 44.0
Sex: M
Vaccine: COVID19
Symptoms: Viral myocarditis
Clinical narrative: In Nov of 21 I had my third covid vaccine, Moderna for all 3.  In December of 21 I started to have an occasional heart flutter.  I went to a cardiologist and did a stress test and echo, both show ok, and the occasional flutter was attributed to stress.  They occasionally continued .  They were showing up as PVC's.  Went back to the cardiologist for a follow up in June of 23.  Did another stress test and echo and again it was ok.  Shortly after (a couple days) in June of 23, the arrythemias intensified.  I called the cardiologist and they put me on a halter monitor.  in the middle of that, I was experiencing extreme arrythmias at home and went to the ER.  I was having PVC's, bi and tri gemini, and unsustained vtac and was admitted.  Was given a variety of medications and a battery of tests, to include an Echo that shoed my EF went from a normal 55 about 2 weeks prior to 37.  Went home the next day and saw the cardiologist and was put on a variety of other meds.  The next day the arrythmias got unbearable and I returned to the ER, and was again admitted for a night.  I was sent home that afternoon with a life vest.  3 hours later, the life vest went off trying to shock me, and I again returned to the ER.  I was admitted in heart failure and was diagnosed with myocarditis.  I had an angiogram and a cardiac echo, both were clean.  I was scheduled for an EP study but then sent home on strong medication.  I am now awaiting an ablation, just under 3 months later.  No other cause could be found other than viral.  As a note, I had covid shortly before the events increased dramatically.  I can only attribute the events to the vaccine and covid
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Angina pectoris
Clinical narrative: STABLE ANGINA ANGINA, UNSPECIFIED
Age: 13.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Patient received vaccine which expired 2/6/2023
Age: 27.0
Sex: F
Vaccine: COVID19
Symptoms: Hypotension
Clinical narrative: HYPOTENSION
Age: 29.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: Breakthrough case admission after 2 vaccines ; Pfizer 10/11/21 lot# FE3590;  Pfizer 10/31/21 lot# FH8020
Age: 17.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Vaccine which expired 2/6/23 administered to patient.
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Respiratory failure
Clinical narrative: ACUTE ON CHRONIC HYPOXEMIC RESPIRATORY FAILURE
Age: 51.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Expired product administered
Clinical narrative: Patient received vaccine after BUD
Age: 51.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Product storage error
Clinical narrative: Patient received vaccine after BUD
Age: 96.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: Breakthrough case admission after 3 vaccines Moderna 1/19/21 lot# 011L20A;  Moderna 2/16/21 lot# 004M20A;  Moderna 3/26/22 lot# 027L21A
Age: 42.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: Breakthrough case admission after one Janssen vaccine
Age: 51.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Patient received vaccine after BUD
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure
Clinical narrative: ACUTE HYPOXEMIC RESPIRATORY FAILURE
Age: 57.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: Breakthrough case admission after 3 vaccines Moderna 5/18/21 lot# 023C21A;  Moderna 6/15/21 lo# 050C21A; Moderna 1/12/22 lot# 033H21A
Age: 32.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Expired product administered
Clinical narrative: Patient received vaccine after BUD
Age: 32.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Product storage error
Clinical narrative: Patient received vaccine after BUD
Age: 13.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered, Incorrect product formulation administered
Clinical narrative: Bivalent Moderna vaccine was ordered. A monovalent Moderna vaccine which expired 2/6/23 was given instead.
Age: 74.0
Sex: M
Vaccine: COVID19
Symptoms: Breakthrough COVID-19, Death, SARS-CoV-2 test positive
Clinical narrative: Breakthrough case admission after 3 vaccines; patient expired
Age: 72.0
Sex: F
Vaccine: COVID19-2
Symptoms: Fear, Hyperhidrosis, Musculoskeletal stiffness, Pain
Clinical narrative: She got her vaccine, she had no issues.  Then at 3:30 AM Tuesday morning she was sweating, stiff as a board and lives alone.  She took a Tylenol, and drank a bottle of water and started walking around.  She was achy and stiff, scared.  Then she started thinking that she had the shot, and decided to call the office today.  She gave her our website to go on, and copied the phone # and called us.  She told her what symptoms she was having and was told to stay hydrated.  She is feeling better today, got up and did her chair exercises, etc.  She has the stinging feeling under arm still today.
Age: 34.0
Sex: F
Vaccine: MMR
Symptoms: Expired product administered
Clinical narrative: VACCINE EXPIRED 06/18/2023.
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Breakthrough COVID-19
Clinical narrative: Covid Breakthrough infection
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: Breakthrough case admission after 4 vaccines moderna 2/12/21 lot# 015M20A;  Moderna 3/2/21 lOt# 002B21A;  Moderna 11/8/21 lot# 034F21A;  Moderna 4/5/22 lot# 048L21A
Age: 90.0
Sex: F
Vaccine: COVID19
Symptoms: Hypotension, Shock
Clinical narrative: HYPOTENSION SHOCK, UNSPECIFIED
Age: 4.0
Sex: M
Vaccine: HEPA
Symptoms: No adverse event
Clinical narrative: No signs or symptoms have occured at this time
Age: 43.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Abdominal discomfort, Joint swelling, Pain, Urticaria
Clinical narrative: hives size of golf balls- swells all joints  - gives stomach issues - worst pain ever for all
Age: 13.0
Sex: M
Vaccine: HEPA
Symptoms: Incorrect dose administered
Clinical narrative: Adult dose given to pediatric client. No treatment, no adverse reaction noted. Medical director noted, no expected adverse reactions, no adverse reactions expected.
Age: 53.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Expired product administered
Clinical narrative: Patient received vaccine after BUD
Age: 53.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Product storage error
Clinical narrative: Patient received vaccine after BUD
Age: 5.0
Sex: M
Vaccine: COVID19-2
Symptoms: Incorrect dose administered
Clinical narrative: The correct vaccine was ordered, but the bivalent Moderna vaccine for ages 6-11 years at a dose of 0.25 mL/25 mg was administered.
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Acute respiratory failure, Chronic respiratory failure, Cor pulmonale acute, Hypoxia, Respiratory failure
Clinical narrative: ACUTE COR PULMONALE ACUTE HYPOXEMIC RESPIRATORY FAILURE CHRONIC HYPOXEMIC RESPIRATORY FAILURE ACUTE ON CHRONIC HYPOXEMIC RESPIRATORY FAILURE HYPOXEMIA
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Hypotension, Symptom recurrence
Clinical narrative: HYPOTENSION 10/11/2022  --  RECURRENCE OF HOSPITALIZATION WITH SAME SYMPTOMS
Age: 96.0
Sex: F
Vaccine: COVID19
Symptoms: Breakthrough COVID-19
Clinical narrative: Breakthrough Covid-19 Infection
Age: 72.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Expired product administered
Clinical narrative: PATIENT RECEIVED VACCINE AFTER BUD
Age: 72.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Product storage error
Clinical narrative: PATIENT RECEIVED VACCINE AFTER BUD
Age: 11.0
Sex: M
Vaccine: MNQ
Symptoms: Local reaction, Papule, Pruritus
Clinical narrative: local reaction 2 days following.  wide spread grouped pruritic papules on trunk, limbs
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Patient received vaccine after BUD
Age: 69.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Expired product administered
Clinical narrative: Patient received vaccine after BUD
Age: 69.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Product storage error
Clinical narrative: Patient received vaccine after BUD
Age: 57.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Hypertension
Clinical narrative: J96.01 ACUTE HYPOXEMIC RESPIRATORY FAILURE 3/26/2023 HTN (HYPERTENSION)
Age: 69.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Patient received vaccine after BUD
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: Breakthrough COVID-19
Clinical narrative: Breakthroguh Covid-19 Infection
Age: 62.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: PATIENT RECEIVED VACCINE AFTER BUD
Age: 36.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Expired product administered
Clinical narrative: Patient received vaccine after BUD
Age: 36.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Product storage error
Clinical narrative: Patient received vaccine after BUD
Age: 53.0
Sex: M
Vaccine: COVID19
Symptoms: Hypersensitivity, Transient ischaemic attack
Clinical narrative: TRANSIENT CEREBRAL ISCHEMIA ALLERGIC REACTION, INIT
Age: 40.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Expired product administered
Clinical narrative: PATIENT RECEIVED VACCINE AFTER BUD
Age: 40.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Product storage error
Clinical narrative: PATIENT RECEIVED VACCINE AFTER BUD
Age: 40.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: PATIENT RECEIVED VACCINE AFTER BUD
Age: 49.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Expired product administered
Clinical narrative: PATIENT RECEIVED VACCINE AFTER BUD
Age: 49.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Product storage error
Clinical narrative: PATIENT RECEIVED VACCINE AFTER BUD
Age: 30.0
Sex: M
Vaccine: HEP, MMR
Symptoms: No adverse event
Clinical narrative: Patient arrived with no flu like symptoms and had no complaints of illness or discomfort.  After the injection the patient was observed and had no signs of adverse affects.
Age: 49.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: PATIENT RECEIVED VACCINE AFTER BUD
Age: 81.0
Sex: F
Vaccine: VARZOS
Symptoms: Diarrhoea, Malaise, Myalgia
Clinical narrative: Diarrhea started on July 29, 2023.  Also had slight muscle aches prior.  Diarrhea lasted 3 days, but I'm still not feeling back to normal.  Have just been taking  tylenol and eating very light bland foods.
Age: 35.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Expired product administered
Clinical narrative: PATIENT RECEIVED VACCINE AFTER BUD
Age: 35.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Product storage error
Clinical narrative: PATIENT RECEIVED VACCINE AFTER BUD
Age: 94.0
Sex: F
Vaccine: COVID19
Symptoms: Cerebrovascular accident, Hypoxia
Clinical narrative: ACUTE STROKE, UNSPECIFIED TYPE AND ARTERY HYPOXIA
Age: 81.0
Sex: M
Vaccine: VARZOS
Symptoms: Ophthalmic herpes zoster
Clinical narrative: Pt reportedly had shingles the next day after vaccination, in face (eye)
Age: 66.0
Sex: F
Vaccine: COVID19
Symptoms: Obstructive sleep apnoea syndrome
Clinical narrative: ADULT OBSTRUCTIVE SLEEP APNEA, MILD
Age: 40.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Incorrect dose administered
Clinical narrative: PATIENT RECEIVED VACCINE AFTER BUD
Age: 15.0
Sex: M
Vaccine: COVID19-2
Symptoms: No adverse event, Underdose
Clinical narrative: 15yo was given Pfizer bivalent vaccine for 5-11yo 10mcg/0.2ml as ordered. No adverse reaction was noted. Ordering doctor was informed; father of patient was informed.
Age: 40.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: PATIENT RECEIVED VACCINE AFTER BUD