chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 50.0
Sex: M
Vaccine: MNQ
Symptoms: Chills, Muscle spasms, Pyrexia
Clinical narrative: muscle spasms; chills; slight fever; Initial information was received from (Privacy) on 08-Mar-2024 regarding an unsolicited valid non-serious case received from a nurse.  This case involves a 50 years old male patient who experienced muscle spasms, slight fever and chills after receiving meningococcal A-C-Y-W135 (T CONJ) vaccine [Menquadfi].  The patient's past medical history, medical treatment(s), vaccination(s) and family history were not provided.  Concomitant medications included rabies vaccine (Imovax).  On 06-Mar-2024, the patient received a 0.5 ml, total (once) (dose 1) of suspect meningococcal A-C-Y-W135 (T CONJ) vaccine (Solution for injection) (lot U7450AA, expiry date: unknown, strength: standard) via intramuscular route in the right deltoid (right arm) for Immunization.  On an unknown date in Mar-2024, the patient had muscle spasms, slight fever (pyrexia) and chills (Latency: same month approximately) following the administration of meningococcal A-C-Y-W135 (T CONJ) vaccine.  Reportedly, He missed one day at work on 07MAR2024 due to symptoms.  Action taken: not applicable.  An corrective treatment (recommended hot and or cold packs) was received for the events.  At time of reporting, the outcome was Unknown for the events.
Age: 0.33
Sex: M
Vaccine: FLU4
Symptoms: No adverse event, Product administered to patient of inappropriate age
Clinical narrative: child who was 4 months old and received the FLUZONE QUADRIVALENT, with no reported adverse event; Initial information received on 11-Mar-2024 regarding an unsolicited valid non-serious case received from a consumer/non-hcp.  This case involves a 4 months old male patient received the Influenza Quadrival A-B Vaccine [Fluzone Quadrivalent] with no reported adverse event.  The patient's past medical history, medical treatment(s), vaccination(s) and family history were not provided.   On an unknown date, the 4 months old male patient received a unknown dose of suspect Influenza Quadrival A-B Vaccine Suspension for injection (strength, expiry date and lot number not reported) via unknown route in unknown administration site as Prophylactic vaccination (immunization) (product administered to patient of inappropriate age) (same day latency). Information on the batch number was requested.   This suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holder's compliance with the requirements set out in the Directive 2001/83/EC and Module VI of the Good Pharmacovigilance Practices. The classification as a medical error is in no way intended, nor should it be interpreted or construed as an allegation or claim made by the marketing authorization holder that any third party has contributed to or is to be held liable for the occurrence of this medication error.
Age: 9.0
Sex: M
Vaccine: IPV
Symptoms: No adverse event, Product storage error
Clinical narrative: post excursion IPOL was administered to patient after it was no longer suitable for use with no reported adverse event; Initial information received on 11-Mar-2024 regarding an unsolicited valid non-serious case received from an Other health professional.  This case is linked to case 2024SA081647.  This case involves a 9 years old male patient who experienced post excursion IPV (Vero) [IPOL] was administered to patient after it was no longer suitable for use with no reported adverse event.  The patient's past medical history, medical treatment(s), vaccination(s) and family history were not provided.  Concomitant medications included diphtheria vaccine toxoid, pertussis vaccine acellular, tetanus vaccine toxoid (tdap); hepatitis b vaccine (Hepatitis B vaccine) and measles vaccine, mumps vaccine, rubella vaccine (MMR vaccine) for Prophylactic vaccination.  On 27-Feb-2024, the patient received 0.5 ml dose of suspect IPV (VERO) Suspension for injection (lot- W1C751M and expiry date- 18-Nov-2025) via intramuscular route in unknown administration site (strength: not provided) for Prophylactic vaccination (poor quality product administered) (latency- same day).  This suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holder's compliance with the requirements set out in the Directive 2001/83/EC and Module VI of the Good Pharmacovigilance Practices. The classification as a medical error is in no way intended, nor should it be interpreted or construed as an allegation or claim made by the marketing authorization holder that any third party has contributed to or is to be held liable for the occurrence of this medication error.
Age: 5.0
Sex: F
Vaccine: IPV
Symptoms: No adverse event, Product storage error
Clinical narrative: temperature excursion as the vaccine got to 9.4 C for 9 minutes, with no reported adverse event; IPOL was administered to patient after it was no longer suitable for use, with no reported adverse event; Initial information received on 11-Mar-2024 regarding an unsolicited valid non-serious case received from a other health professional.  This case involves a 5 years (and 9 months) old female patient who had temperature excursion as the IPV (VERO) [IPOL] got to 9.4 c for 9 minutes, with no reported adverse event and IPOL was administered to patient after it was no longer suitable for use, with no reported adverse event.  The patient's past medical history, medical treatment(s), vaccination(s) and family history were not provided.  Concomitant medications included varicella zoster vaccine (Varicella Vaccine) for Prophylactic vaccination.  Caller reported that IPV (VERO) was exposed to temperature excursion as the vaccine got to 9.4 c for 9 minutes, with no reported adverse event (product storage error) (unknown latency) and On 27-Feb-2024, the patient was administered standard dose of 0.5 mL once of suspect IPV (VERO) Suspension for injection (lot W1C751M, expiry date- 18-NOV-2025) via intramuscular route in the right arm for Immunization after it was no longer suitable for use, with no reported adverse event (poor quality product administered) (latency- same day).  Reportedly, the caller was not aware of any adverse reactions or treatment post administration. No doctor/ER (emergency room) visit necessary post administration.  This suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holder's compliance with the requirements set out in the Directive 2001/83/EC and Module VI of the Good Pharmacovigilance Practices. The classification as a medical error is in no way intended, nor should it be interpreted or construed as an allegation or claim made by the marketing authorization holder that any third party has contributed to or is to be held liable for the occurrence of this medication error.; Sender's Comments:  US-SA-2024SA074397:01968661 (Master case)
Age: 1.17
Sex: M
Vaccine: UNK
Symptoms: Extra dose administered, No adverse event
Clinical narrative: inadvertently administered a 5th dose of heamophilus influenza to a 14 month old using pentacel with no reported adverse event; Initial information received on 11-Mar-2024 regarding an unsolicited valid non-serious case received from a physician.  This case involves 14 months old male patient who was inadvertently administered a 5th dose of heamophilus influenza using diphtheria/tetanus/5 hybrid AC pertussis/IPV(VERO)/HIB(PRP/T) vaccine [Pentacel (Vero)] with no reported adverse event.  The patient's past medical history, medical treatment(s), vaccination(s) and family history were not provided. List concomitant or no other vaccines: None   On 08-Mar-2024, the patient had 5th dose of heamophilus influenza using a standard total dose 0.5 ml of suspect diphtheria/tetanus/5 hybrid AC pertussis/IPV(VERO)/HIB(PRP/T) vaccine Suspension for injection (lot UJ848AA, expiry date- 16-APR-2024) via intramuscular route in the right thigh for Immunization with no reported adverse event (extra dose administered) (latency- same day).  This suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holder's compliance with the requirements set out in the Directive 2001/83/EC and Module VI of the Good Pharmacovigilance Practices. The classification as a medical error is in no way intended, nor should it be interpreted or construed as an allegation or claim made by the marketing authorization holder that any third party has contributed to or is to be held liable for the occurrence of this medication error.
Age: 10.0
Sex: F
Vaccine: IPV
Symptoms: No adverse event, Poor quality product administered
Clinical narrative: medication errors for the inappropriate administration of IPOL that was no longer suitable for use to patients with no reported adverse event; Initial information received on 11-Mar-2024 regarding an unsolicited valid  non-serious case received from  a other health professional via call center.  This case is linked to cases 2024SA074397, 2024SA082816, 2024SA082981, 2024SA082167, 2024SA083118, 2024SA082723 and 2024SA081647.  This case involves a 10 years old female patient who was administered with of ipol that was no longer suitable for use to patients with no reported adverse event.  The patient's past medical history, medical treatment(s), vaccination(s) and family history were not provided.  Concomitant medications included Diphtheria Vaccine Toxoid, Pertussis Vaccine Acellular, Tetanus Vaccine Toxoid and Measles Vaccine Live (Enders-Edmonston) Mumps Vaccine Live (Jeryl Lynn) Rubella Vaccine Live (Wistar RA 27/3) (MMRVAXPRO); both for for Prophylactic vaccination.  On 27-Feb-2024, the patient had received 0.5 ml (dose: 1) of suspect IPV (VERO) (Suspension for injection) that was no longer suitable for use to patients with no reported adverse event (lot W1C751M, expiry date: 18-11-2025, strength not reported) via intramuscular route in unknown administration site for prophylactic vaccination (poor quality product administered).   This suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holder's compliance with the requirements set out in the Directive 2001/83/EC and Module VI of the Good Pharmacovigilance Practices. The classification as a medical error is in no way intended, nor should it be interpreted or construed as an allegation or claim made by the marketing authorization holder that any third party has contributed to or is to be held liable for the occurrence of this medication error.
Sex: U
Vaccine: HIBV
Symptoms: Expired product administered, No adverse event
Clinical narrative: ACTHIB was one month past its expiration date when it was administered to patient with no reported adverse event.; Initial information received on 12-Mar-2024 regarding an unsolicited valid non-serious case received from a other health professional.  This case involves an unknown age and unknown gender patient who was administered HIB (PRP/T) Vaccine [ACT-HIB] one month past its expiration date with no reported adverse event.   The patient's past medical history, medical treatment(s), vaccination(s) and family history were not provided.   On an unknown date, the patient administered HIB (PRP/T) Vaccine (Powder and solvent for solution for injection) one month past its expiration date with no reported adverse event (expired product administered) (latency: same day) (lot number, expiry date and strength not reported) via unknown route in unknown administration site for Immunization.Information regarding batch number will be requested in this case.  This suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holder's compliance with the requirements set out in the Directive 2001/83/EC and Module VI of the Good Pharmacovigilance Practices. The classification as a medical error is in no way intended, nor should it be interpreted or construed as an allegation or claim made by the marketing authorization holder that any third party has contributed to or is to be held liable for the occurrence of this medication error.
Age: 76.0
Sex: M
Vaccine: COVID19
Symptoms: Bladder cancer, Chromaturia
Clinical narrative: Started urinating bright red blood.  Eventually diagnosed with bladder cancer
Sex: U
Vaccine: COVID19, DTPPVHBHPB, FLUC3, PNC15, RV5
Symptoms: Nausea, Pyrexia
Clinical narrative: Fever; Nausea; This spontaneous case from the was received on 12-Mar-2024 from other healthcare professional via Med Communications (reference number: SEQW24-00881) and concerned a patient of unreported age and gender.   The patient's medical history and concomitant medications were not reported. The patient did not have any chronic or long-standing health condition.  On 26-Oct-2023, the patient was vaccinated with non-company, co-suspects COVID-19 vaccine (reported as mRNA-1273.815 Moderna COVID-19 vaccine 2023-2024 (andusomeran)) (dose: 0.5 ml (it was reported that the patient was given 0.5 ml when it needed to be 0.25 ml), route of administration: intramuscular, batch number: AU5558B and anatomical location: not reported) for Covid-19 prophylaxis, and Vaxneuvance (pneumococcal vaccine conj 15v (crm197); dose: reported as 'one dosage form (1 DF)'; route of administration: intramuscular, batch number: X020316, anatomical location and indication: not reported).  On 26-Dec-2023, the patient was vaccinated with Flucelvax Quadrivalent (influenza vaccine inact sag 4v; dose: reported as 'one dosage form (1 DF)', route of administration: intramuscular, anatomical location and indication: not reported). The reported batch number was 373546.   On same day, the patient was vaccinated with non-company, co-suspects Vaxelis (diphtheria vaccine toxoid, hepatitis b vaccine rhbsag (yeast), hib vaccine conj (menigococcal protein), pertussis vaccine acellular 5-component, polio vaccine inact 3v (vero), tetanus vaccine toxoid; dose: reported as 'one dosage form (1 DF)', route of administration: intramuscular, batch number: V7295AA, indication and anatomical location: not reported) and Rotateq (rotavirus vaccine live reassort oral 5v; dose: reported as 'one dosage form (1 DF)'; route of administration: oral, and batch number: X007337, anatomical location and indication: not reported).  On unspecified date in Dec-2023, an unknown amount of time after receiving Flucelvax Quadrivalent and non-company, co-suspects Moderna Covid-19 vaccine, Vaxneuvance, Vaxelis and Rotateq, the patient experienced fever for two days and nausea.   The outcome of the events was unknown.  The reporter did not provide the causality assessment.   The case was assessed as non-serious.  Company comment: The events of fever and nausea are assessed as possibly related to Flucelvax Quadrivalent due to plausible temporal relationship, although causality was confounded by the administration of the co-suspect vaccines Moderna Covid-19 vaccine, Vaxneuvance, Vaxelis and Rotateq.; Sender's Comments: The events of fever and nausea are assessed as possibly related to Flucelvax Quadrivalent due to plausible temporal relationship, although causality was confounded by the administration of the co-suspect vaccines Moderna Covid-19 vaccine, Vaxneuvance, Vaxelis and Rotateq.
Age: 23.0
Sex: F
Vaccine: RAB
Symptoms: Injection site erythema, Injection site pain
Clinical narrative: donor presented to center on Mar.15,2024. Regarding a Rabies Vaccine she received on Mar 13,2024, that she had localized redness and pain to injection site.
Age: 55.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: The patient received an expired vaccine in error. The date on the box was mis-interpreted as the fridge or thaw-out date instead of the expiration date.
Age: 38.0
Sex: F
Vaccine: TD
Symptoms: Arthralgia, Immediate post-injection reaction, Injected limb mobility decreased, Injection site pain, Muscular weakness
Clinical narrative: My PCM recommended I receive a tetanus shot after I had been treated by him for a cut on my finger. I went ahead and got the vaccine. The technician placed it high up on my right arm near my shoulder blade. It burned going into my skin. A few hours later my upper arm and shoulder were sore, tender, and weak. I couldn't fully raise my arm even to get dressed, not due to pain but due to weakness in my right shoulder.  It has been two days since I got the vaccine; I have some more range of motion but not full range of motion.
Age: 38.0
Sex: F
Vaccine: TD
Symptoms: Product administered at inappropriate site
Clinical narrative: My PCM recommended I receive a tetanus shot after I had been treated by him for a cut on my finger. I went ahead and got the vaccine. The technician placed it high up on my right arm near my shoulder blade. It burned going into my skin. A few hours later my upper arm and shoulder were sore, tender, and weak. I couldn't fully raise my arm even to get dressed, not due to pain but due to weakness in my right shoulder.  It has been two days since I got the vaccine; I have some more range of motion but not full range of motion.
Age: 21.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Blood test, Computerised tomogram abdomen abnormal, Lymphangioma, Mass, Splenic cyst
Clinical narrative: April 4, 2023 CT pelvis and abdomen with contrast and without contrast. 1.5 cm coarse calcification in the IVC at the level of the right renal vein with suggestion of an associated filling defect. This could represent partially calcified IVC thrombus. SPLEEN: 1.9 cm splenic cyst or lymphangioma . : No abdominal aortic aneurysm. 1.5 x 1.3 cm calcified mass within the IVC at the level of the right renal vein. There is suggestion of a filling defect associated with the calcification (coronal image 86 and axial image 39).
Age: 21.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Ultrasound Doppler abnormal, Vascular calcification, X-ray
Clinical narrative: April 4, 2023 CT pelvis and abdomen with contrast and without contrast. 1.5 cm coarse calcification in the IVC at the level of the right renal vein with suggestion of an associated filling defect. This could represent partially calcified IVC thrombus. SPLEEN: 1.9 cm splenic cyst or lymphangioma . : No abdominal aortic aneurysm. 1.5 x 1.3 cm calcified mass within the IVC at the level of the right renal vein. There is suggestion of a filling defect associated with the calcification (coronal image 86 and axial image 39).
Age: 69.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Asthenia, Atrial fibrillation, COVID-19, Death, Decreased appetite
Clinical narrative: Reported Symptoms: 10011906:DEATH; 10054112: HOSPITALISATION; 10084268: COVID-19; Narrative: 71 yo male w/ PMH for newly dx diffuse large B lymphoma 2/6/23, multi-vessel CAD (s/p PCI w/ DES in RCA 2015, s/p Balloon angioplasty to dRCA 2017), Afib, DM2, HLP, and HTN presented to ED on 02/12/2023 with 2-3 wks of decreased appetite, dysphagia and fatigue/weakness. Pt COVID positive in ED and admitted to hospital. Pt received remdesivir (02/12-02/16) and dexamethasone (02/13-02/16). Pt was admitted to ICU on 2/15 for Afib w/RVR. Pt decompensated w/ etiology unclear but suspected 2/2 primarily to diffuse large B lymphoma 2/6/23, multi-vessel CAD (s/p PCI w/ DES in RCA 2015, s/p Balloon angioplasty to dRCA 2017), Afib, DM2, HLP, and HTN. Other: Covid Infection W/ hospitalization
Age: 69.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Dysphagia, Fatigue, General physical health deterioration, Intensive care, SARS-CoV-2 test positive
Clinical narrative: Reported Symptoms: 10011906:DEATH; 10054112: HOSPITALISATION; 10084268: COVID-19; Narrative: 71 yo male w/ PMH for newly dx diffuse large B lymphoma 2/6/23, multi-vessel CAD (s/p PCI w/ DES in RCA 2015, s/p Balloon angioplasty to dRCA 2017), Afib, DM2, HLP, and HTN presented to ED on 02/12/2023 with 2-3 wks of decreased appetite, dysphagia and fatigue/weakness. Pt COVID positive in ED and admitted to hospital. Pt received remdesivir (02/12-02/16) and dexamethasone (02/13-02/16). Pt was admitted to ICU on 2/15 for Afib w/RVR. Pt decompensated w/ etiology unclear but suspected 2/2 primarily to diffuse large B lymphoma 2/6/23, multi-vessel CAD (s/p PCI w/ DES in RCA 2015, s/p Balloon angioplasty to dRCA 2017), Afib, DM2, HLP, and HTN. Other: Covid Infection W/ hospitalization
Age: 74.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Aspiration pleural cavity, COVID-19, Chemotherapy, Death, Effusion
Clinical narrative: Reported Symptoms: 10011906:DEATH; 10054112:HOSPITALISATION; 10084258;COVID-19; Narrative: 75 year old MALE patient with significant PMH of metastatic prostate cancer undergoing chemotherapy (last appt 6/17/22) s/p bilateral nephrostomy tube placement (4/2022), T2DM, HTN, HLD, R carotid artery stenosis 86-99%, and PVD who presented to ED on 6/28/22 with complicated Klebsiella UTI. Pt tested COVID-19 positive on 7/20/2022 during hospitalization. Respiratory failure (7/22) likely due to pneumonia NOT COVID so stopped COVID therapies on 7/22 including dexamethasone (7/21-7/22) and remdesivir (7/21-7/22). Admitted to ICU for worsening effusions and increased O2 requirements. Dexamethasone restarted on 07/25, Remdesivir not restarted due to GFR <38. Thoracentesis attempted 7/27. Pt downgraded to floor 7/28 as O2 requirements stabilized. Pt discharged to home on hospice care on 07/31/2022. Pt expired 08/12/2022. Other Relevant HX: 75 year old MALE patient with significant PMH of metastatic prostate cancer undergoing chemotherapy (last appt 6/17/22) s/p bilateral nephrostomy tube placement (4/2022), T2DM, HTN, HLD, R carotid artery stenosis 80-99%, and PVD. Other: Covid Infection w/ hospitalization
Age: 74.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Glomerular filtration rate decreased, Intensive care, Klebsiella urinary tract infection, Nephrostomy, Pneumonia
Clinical narrative: Reported Symptoms: 10011906:DEATH; 10054112:HOSPITALISATION; 10084258;COVID-19; Narrative: 75 year old MALE patient with significant PMH of metastatic prostate cancer undergoing chemotherapy (last appt 6/17/22) s/p bilateral nephrostomy tube placement (4/2022), T2DM, HTN, HLD, R carotid artery stenosis 86-99%, and PVD who presented to ED on 6/28/22 with complicated Klebsiella UTI. Pt tested COVID-19 positive on 7/20/2022 during hospitalization. Respiratory failure (7/22) likely due to pneumonia NOT COVID so stopped COVID therapies on 7/22 including dexamethasone (7/21-7/22) and remdesivir (7/21-7/22). Admitted to ICU for worsening effusions and increased O2 requirements. Dexamethasone restarted on 07/25, Remdesivir not restarted due to GFR <38. Thoracentesis attempted 7/27. Pt downgraded to floor 7/28 as O2 requirements stabilized. Pt discharged to home on hospice care on 07/31/2022. Pt expired 08/12/2022. Other Relevant HX: 75 year old MALE patient with significant PMH of metastatic prostate cancer undergoing chemotherapy (last appt 6/17/22) s/p bilateral nephrostomy tube placement (4/2022), T2DM, HTN, HLD, R carotid artery stenosis 80-99%, and PVD. Other: Covid Infection w/ hospitalization
Age: 74.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Respiratory failure, SARS-CoV-2 test positive, Urinary tract infection
Clinical narrative: Reported Symptoms: 10011906:DEATH; 10054112:HOSPITALISATION; 10084258;COVID-19; Narrative: 75 year old MALE patient with significant PMH of metastatic prostate cancer undergoing chemotherapy (last appt 6/17/22) s/p bilateral nephrostomy tube placement (4/2022), T2DM, HTN, HLD, R carotid artery stenosis 86-99%, and PVD who presented to ED on 6/28/22 with complicated Klebsiella UTI. Pt tested COVID-19 positive on 7/20/2022 during hospitalization. Respiratory failure (7/22) likely due to pneumonia NOT COVID so stopped COVID therapies on 7/22 including dexamethasone (7/21-7/22) and remdesivir (7/21-7/22). Admitted to ICU for worsening effusions and increased O2 requirements. Dexamethasone restarted on 07/25, Remdesivir not restarted due to GFR <38. Thoracentesis attempted 7/27. Pt downgraded to floor 7/28 as O2 requirements stabilized. Pt discharged to home on hospice care on 07/31/2022. Pt expired 08/12/2022. Other Relevant HX: 75 year old MALE patient with significant PMH of metastatic prostate cancer undergoing chemotherapy (last appt 6/17/22) s/p bilateral nephrostomy tube placement (4/2022), T2DM, HTN, HLD, R carotid artery stenosis 80-99%, and PVD. Other: Covid Infection w/ hospitalization
Age: 89.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, Lung infiltration, SARS-CoV-2 test positive
Clinical narrative: ** Please see overflow section on last page **
Age: 55.0
Sex: M
Vaccine: HEPA
Symptoms: Extra dose administered, No adverse event
Clinical narrative: Reported Symptoms: 10067492:NO ADVERSE EVENT; Narrative: Other Relevant HX: Patient received two doses of hepatitis A vax inadvertently Other: none
Age: 88.0
Sex: M
Vaccine: VARZOS
Symptoms: Hypertension, Hypotension
Clinical narrative: Reported Symptoms: 10021097:HYPERTENSION; Narrative: 90 YOM experienced hypotension after receiving recombinant zoster vaccine during home visit on 1/31/23. After receiving the vaccine, BP decreased to 70/40 for 10 minutes, then returned to baseline. Other Relevant HX: PMH: TIA, HTN, CAD, COPD, chronic pain, dementia, GERD Other:
Sex: M
Vaccine: COVID19-2
Symptoms: Diarrhoea, Fatigue, Myalgia
Clinical narrative: Reported Symptoms: 10012727: DIARRHEA; 10016256: FATIGUE; 10020322:MUSCLE PAIN;  Narrative: Other Relevant HX: Other: DIARRHEA (12/27/22 @ 6:46:26); FATIGUE (12/27/22@06:46:26); MUSCLE PAIN (12/27/22@06:46:26)
Age: 72.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19-2
Symptoms: Brain natriuretic peptide increased, COVID-19, COVID-19 pneumonia, Cardiac failure, Cardiac failure congestive
Clinical narrative: Reported Symptoms: 10054112:HOSPITALISATION; 10084268:COVID-19; Narrative: 72 yo male patient w/past medical history for paroxysmal atrial fibrillation, CKD stage III, COPD, OSA, DM 2, HTN, HLD, vitamin D deficiency, HTN, heart failure, CAD s/p CABG, duodunal AVM s/p APC who presented to ED on 11/28/22 with cough, myalgias, fever and peripheral edema. Pt w/ elevated BNP and procalcitonin, white count of 18. Pt admitted to hospital for COVID-19 and CHF exacerbation. Pt treated for acute exacerbation diastolic heart failure and COVID PNA. Pt received dexamethasone (11/29-12/6), ceftriaxone (11/29-12/5) and azithromycin (11/29-12/6). Patient improved and discharged to rehab for physical therapy on 12/08/22. Other Relevant HX: 72 yo old male patient w/ past medical history of diabetes, CHF, CAD, and CKD. Other: COVID Infection w/ hospitalization
Age: 72.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19-2
Symptoms: Condition aggravated, Cough, Left ventricular failure, Myalgia, Oedema peripheral
Clinical narrative: Reported Symptoms: 10054112:HOSPITALISATION; 10084268:COVID-19; Narrative: 72 yo male patient w/past medical history for paroxysmal atrial fibrillation, CKD stage III, COPD, OSA, DM 2, HTN, HLD, vitamin D deficiency, HTN, heart failure, CAD s/p CABG, duodunal AVM s/p APC who presented to ED on 11/28/22 with cough, myalgias, fever and peripheral edema. Pt w/ elevated BNP and procalcitonin, white count of 18. Pt admitted to hospital for COVID-19 and CHF exacerbation. Pt treated for acute exacerbation diastolic heart failure and COVID PNA. Pt received dexamethasone (11/29-12/6), ceftriaxone (11/29-12/5) and azithromycin (11/29-12/6). Patient improved and discharged to rehab for physical therapy on 12/08/22. Other Relevant HX: 72 yo old male patient w/ past medical history of diabetes, CHF, CAD, and CKD. Other: COVID Infection w/ hospitalization
Age: 72.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19-2
Symptoms: Procalcitonin increased, Pyrexia, SARS-CoV-2 test positive, White blood cell count normal
Clinical narrative: Reported Symptoms: 10054112:HOSPITALISATION; 10084268:COVID-19; Narrative: 72 yo male patient w/past medical history for paroxysmal atrial fibrillation, CKD stage III, COPD, OSA, DM 2, HTN, HLD, vitamin D deficiency, HTN, heart failure, CAD s/p CABG, duodunal AVM s/p APC who presented to ED on 11/28/22 with cough, myalgias, fever and peripheral edema. Pt w/ elevated BNP and procalcitonin, white count of 18. Pt admitted to hospital for COVID-19 and CHF exacerbation. Pt treated for acute exacerbation diastolic heart failure and COVID PNA. Pt received dexamethasone (11/29-12/6), ceftriaxone (11/29-12/5) and azithromycin (11/29-12/6). Patient improved and discharged to rehab for physical therapy on 12/08/22. Other Relevant HX: 72 yo old male patient w/ past medical history of diabetes, CHF, CAD, and CKD. Other: COVID Infection w/ hospitalization
Age: 76.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19-2
Symptoms: COVID-19, Dysuria, Fatigue, Headache, SARS-CoV-2 test positive
Clinical narrative: Reported Symptoms: 10054112:HOSPITALISATION; 10084268:COVID-19; Narrative: 76 you male patient with PMH significant for diabetes, prostate cancer status post radiation, irritable bowel syndrome, cauda equina syndrome with neurogenic bladder presented to ED on 08/17/2022 with dysuria, headache and fatigue. Patient positive for UTI and COVID 19. Patient with history of frequent UTI's and self-cath's admitted to hospital for IV abx and further evaluation. No hypoxia and mild COVID symptoms noted. Patient given remdesivir (8/18-8/20) due to risk of severe disease. Pt improved and discharged to home on 08/20/2022. Other Relevant HX: 76 yo male patient with PMH significant for diabetes, prostate cancer status post radiation, irritable bowel syndrome, cauda equina syndrome with neurogenic bladder. Other: Covid 19 infection w/ hospitalization
Age: 76.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19-2
Symptoms: Urine analysis abnormal
Clinical narrative: Reported Symptoms: 10054112:HOSPITALISATION; 10084268:COVID-19; Narrative: 76 you male patient with PMH significant for diabetes, prostate cancer status post radiation, irritable bowel syndrome, cauda equina syndrome with neurogenic bladder presented to ED on 08/17/2022 with dysuria, headache and fatigue. Patient positive for UTI and COVID 19. Patient with history of frequent UTI's and self-cath's admitted to hospital for IV abx and further evaluation. No hypoxia and mild COVID symptoms noted. Patient given remdesivir (8/18-8/20) due to risk of severe disease. Pt improved and discharged to home on 08/20/2022. Other Relevant HX: 76 yo male patient with PMH significant for diabetes, prostate cancer status post radiation, irritable bowel syndrome, cauda equina syndrome with neurogenic bladder. Other: Covid 19 infection w/ hospitalization
Age: 58.0
Sex: M
Vaccine: PNC20, VARZOS
Symptoms: Erythema, Vaccination site erythema, Vaccination site pain
Clinical narrative: Reported Symptoms: 10040842:SKIN ERYTHEMA; Narrative: 58 yo male with PMH of HTN, DM2, HLD, obesity, chronic back pain, OSA, BPH, PTSD, and anxiety. Patient received pneumococcal and shingles vaccines on 02/10/2023. Patient contacted telephone care line on 02/13/2023 to report redness and tenderness on LUE where vaccinations were received. Patient then reported to the ED to be further assessed and received cetirizine tablet. Other Relevant HX: Per discharge summary on 02/15/2023, patient with history of Syncope with multiple vaccinations. Denies syncope with current vaccines listed. Other: Skin erythema
Age: 75.0
Sex: M
Vaccine: COVID19, COVID19-2
Symptoms: Atrial fibrillation, Heart rate irregular, Palpitations
Clinical narrative: Reported Symptoms:  10033556:PALPITATION;  Narrative: Patient received COVID 19 Vaccine on 2/23/21. After receiving the vaccine, the patient experienced and irregular heart rate. The cardiologist diagnosed the paitent with the new onset afib.  The patient is treated with metoprolol 25mg daily.   Other Relevant HX:  Other:
Age: 35.0
Sex: M
Vaccine: HPV9
Symptoms: Bradycardia, Dizziness, Hyperhidrosis, Hypotension, Malaise
Clinical narrative: Reported Symptoms: 10006093:BRADYCARDIA; 10017703:DIAPHORESIS; 10013573:DIZZINESS; 10021097:HYPOTENSION; Narrative: 13:15 HPV vaccine dose #1 given 13:21 After patient vaccination, was alerted by the front staff that patient was not feeling well. Found seated at waiting area diaphoretic stating feeling dizzy. Patent brought back to clinic via wheelchair and evaluate v/s, b/p=81/44 P-44 R-20 Sat-99% T98F. Patient report is dizzy, denies any SOB, LOC, chest pain, palpitation or numbness. Patient states just ate prior to this appointment and is not diabetic. 13:23 code assist activated. 13:35 V/s reevaluated b/p-116/77, P=53, R=17, Sat=96%, code assist team offered to be transported to ED for further evaluation in multiple times, patient refuse to go. 13:40 patient at clinic states feels well. 13:50 Patient left clinic walking in steady gait. Other Relevant HX: Other: diaphoretic
Age: 75.0
Sex: M
Vaccine: COVID19, COVID19-2
Symptoms: Anaemia, COVID-19, Diastolic dysfunction, Dyspnoea, Echocardiogram abnormal
Clinical narrative: Reported Symptoms: 10002272:NEMIA; 10039897:SEDATION; 10043888:TACHYPNEA; 10076201:CHRONIC INFECTION;   Narrative: The patient received the COVID 19 vaccine (Pfizer) on 4/7/21.  Soon after the patient experienced persistent shortness of breath. In May 2022, the patient then tested positive for COVID 19. Since then, the patient has been experiencing persistent fatigue.  Lab work shows chronic anemia and hyponatremia. The patient also has evidence of diastolic dysfunction and left ventricular hypertrophy on the echocardiogram. The patient has also experienced chronic infection. The patient has possible long COVID. Other Relevant HX:  Other: chronic infection
Age: 75.0
Sex: M
Vaccine: COVID19, COVID19-2
Symptoms: Fatigue, Hyponatraemia, Infection, Laboratory test abnormal, Left ventricular hypertrophy
Clinical narrative: Reported Symptoms: 10002272:NEMIA; 10039897:SEDATION; 10043888:TACHYPNEA; 10076201:CHRONIC INFECTION;   Narrative: The patient received the COVID 19 vaccine (Pfizer) on 4/7/21.  Soon after the patient experienced persistent shortness of breath. In May 2022, the patient then tested positive for COVID 19. Since then, the patient has been experiencing persistent fatigue.  Lab work shows chronic anemia and hyponatremia. The patient also has evidence of diastolic dysfunction and left ventricular hypertrophy on the echocardiogram. The patient has also experienced chronic infection. The patient has possible long COVID. Other Relevant HX:  Other: chronic infection
Age: 75.0
Sex: M
Vaccine: COVID19, COVID19-2
Symptoms: SARS-CoV-2 test positive, Sedation, Tachypnoea
Clinical narrative: Reported Symptoms: 10002272:NEMIA; 10039897:SEDATION; 10043888:TACHYPNEA; 10076201:CHRONIC INFECTION;   Narrative: The patient received the COVID 19 vaccine (Pfizer) on 4/7/21.  Soon after the patient experienced persistent shortness of breath. In May 2022, the patient then tested positive for COVID 19. Since then, the patient has been experiencing persistent fatigue.  Lab work shows chronic anemia and hyponatremia. The patient also has evidence of diastolic dysfunction and left ventricular hypertrophy on the echocardiogram. The patient has also experienced chronic infection. The patient has possible long COVID. Other Relevant HX:  Other: chronic infection
Age: 75.0
Sex: M
Vaccine: VARZOS
Symptoms: Formication, Injection site erythema, Injection site rash, Pain in extremity, Pruritus
Clinical narrative: Reported Symptoms: 10037844:RASH; 10037844:RASH; Narrative: Patient reports since receiving the vaccine, he has had a generalized intermittent skin rash. On assessment on 1/10/2023, the patient's right deltoid is noted to be slightly blotched and pink on the patient's lower back noted to have scratch marks from the itching sensation. Patient reports it feels as if ants are crawling on his body. The patient also reports the rash appears mainly before bedtime. Patient denies any pain except for a sore arm for three days after receiving the vaccine. Patient he not had any new changes in his laundry detergent or his diet. Patient denies any use of medications or known allergies. Other Relevant HX: Other:
Age: 75.0
Sex: M
Vaccine: VARZOS
Symptoms: Rash, Rash macular, Scratch
Clinical narrative: Reported Symptoms: 10037844:RASH; 10037844:RASH; Narrative: Patient reports since receiving the vaccine, he has had a generalized intermittent skin rash. On assessment on 1/10/2023, the patient's right deltoid is noted to be slightly blotched and pink on the patient's lower back noted to have scratch marks from the itching sensation. Patient reports it feels as if ants are crawling on his body. The patient also reports the rash appears mainly before bedtime. Patient denies any pain except for a sore arm for three days after receiving the vaccine. Patient he not had any new changes in his laundry detergent or his diet. Patient denies any use of medications or known allergies. Other Relevant HX: Other:
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Arthritis, Back pain, Diarrhoea, Headache
Clinical narrative: Reported Symptoms: 10003239:ARTHRALGIA; 10012717:DIARRHEA; 10019211:HEADACHE;   Narrative: 01/27 COVID vaccine dose #1 01/28 Pt c/o sore arm, headache, diarrhea 01/29 Pt woke up with bad headache, viral symptoms, worse arm soreness, back pain, bad diarrhea 01/30 Pt c/o sneezing, worsening joint pain, headache 01/31 Pt c/o  knee pain & swelling, headache, worsening arthritis pain 02/01 Pt c/o stiff all over from head to toe, neck, knee and ankle pain, headache 02/02 Pt c/o stiff neck, body knee, ankle, improvement in sneezing imaging showed arthritis, no other diagnosed adverse effects found in record Other Relevant HX:  Other:
Sex: F
Vaccine: COVID19
Symptoms: Imaging procedure abnormal, Joint stiffness, Joint swelling, Musculoskeletal stiffness, Neck pain
Clinical narrative: Reported Symptoms: 10003239:ARTHRALGIA; 10012717:DIARRHEA; 10019211:HEADACHE;   Narrative: 01/27 COVID vaccine dose #1 01/28 Pt c/o sore arm, headache, diarrhea 01/29 Pt woke up with bad headache, viral symptoms, worse arm soreness, back pain, bad diarrhea 01/30 Pt c/o sneezing, worsening joint pain, headache 01/31 Pt c/o  knee pain & swelling, headache, worsening arthritis pain 02/01 Pt c/o stiff all over from head to toe, neck, knee and ankle pain, headache 02/02 Pt c/o stiff neck, body knee, ankle, improvement in sneezing imaging showed arthritis, no other diagnosed adverse effects found in record Other Relevant HX:  Other:
Sex: F
Vaccine: COVID19
Symptoms: Pain in extremity, Sneezing
Clinical narrative: Reported Symptoms: 10003239:ARTHRALGIA; 10012717:DIARRHEA; 10019211:HEADACHE;   Narrative: 01/27 COVID vaccine dose #1 01/28 Pt c/o sore arm, headache, diarrhea 01/29 Pt woke up with bad headache, viral symptoms, worse arm soreness, back pain, bad diarrhea 01/30 Pt c/o sneezing, worsening joint pain, headache 01/31 Pt c/o  knee pain & swelling, headache, worsening arthritis pain 02/01 Pt c/o stiff all over from head to toe, neck, knee and ankle pain, headache 02/02 Pt c/o stiff neck, body knee, ankle, improvement in sneezing imaging showed arthritis, no other diagnosed adverse effects found in record Other Relevant HX:  Other:
Age: 75.0
Sex: M
Vaccine: VARZOS
Symptoms: Formication, Pain in extremity, Rash, Rash erythematous, Rash macular
Clinical narrative: Reported Symptoms:  10037844:RASH:  10037844:RASH;    Narrative:  Patient reports since receiving the vaccine, he has had a generalized intermittent skin rash. On assessment on 1/10/2023, the patient's right deltoid is noted to be slightly blotched and pink on the patient's lower back noted to have scratch marks from the itching sensation. Patient reports it feels as if ants are crawling on his body.  The patient also reports the rash appears mainly before bedtime.  Patient denies any pain except for a sore arm for three days after receiving the vaccine.  Patient he not had any new changes in his laundry detergent or his diet.  Patient denies any use of medications or known allergies.  Other Relevant HX:  Other:
Age: 75.0
Sex: M
Vaccine: VARZOS
Symptoms: Rash pruritic, Scratch
Clinical narrative: Reported Symptoms:  10037844:RASH:  10037844:RASH;    Narrative:  Patient reports since receiving the vaccine, he has had a generalized intermittent skin rash. On assessment on 1/10/2023, the patient's right deltoid is noted to be slightly blotched and pink on the patient's lower back noted to have scratch marks from the itching sensation. Patient reports it feels as if ants are crawling on his body.  The patient also reports the rash appears mainly before bedtime.  Patient denies any pain except for a sore arm for three days after receiving the vaccine.  Patient he not had any new changes in his laundry detergent or his diet.  Patient denies any use of medications or known allergies.  Other Relevant HX:  Other:
Age: 69.0
Sex: M
Vaccine: COVID19, COVID19-2, COVID19-2
Symptoms: COVID-19, Gastroenteritis
Clinical narrative: Reported Symptoms: 10054112:HOSPITALIZATION;  Narrative: Patient hospitalized for COVID-19 infection. Received treatment with dexamethasone and albuterol. Also, developed acute gastroenteritis secondary to COVID treated with lactobacillus and IV hydration. Patient discharged after two days of hospital stay.  Other Relevant HX:  Other: Hospitalization
Sex: M
Vaccine: FLUA4
Symptoms: Cough, Dermatitis atopic, Dyspnoea, Rash, Wheezing
Clinical narrative: Reported Symptoms: 10011232:COUGHING; 10037844:RASH; Narrative: 1 week after taking the flu vaccine he reported wheezing and shortness of breath at night and was given albuterol. Per provider assessment, the skin rash on the forehead seem to be atopic dermatitis skin rash 1 months after the vaccine. Unclear if there was any other cause but there was no new medication Other Relevant HX: Other:
Age: 71.0
Sex: M
Vaccine: COVID19-2, FLUA4
Symptoms: Pruritus, Rash, Urticaria
Clinical narrative: Reported Symptoms: 10037087:PRURITUS; 10037844:RASH; Narrative:  Nursing documentation was reviewed and the following timeline is noted.   He was in the woods on Tuesday 11/1 Wednesday 11/2 in the morning he received both his influenza and covid booster  (Moderna). Wednesday 11/2 in the evening (about 12 hour later) he developed hives on arms   and legs.  Of note, he has received influenza vaccine and Moderna covid vaccination on multiple occasions in the past without documentation of reaction.   Also noted history of reaction (rash) to Tegaderm Transparant dressings. Nurse note indicates reaction to gel from Tegaderm.  It is unclear what kind of Tegaderm dressing caused the reaction.   Transparent films do not appear to contain polyethylene glycol, but other Tegaderm dressings may contain polyethylene glycol. (which is on Moderna and Pfizer covid vaccines) Unsure how accessible allergy testing is to polyethylene glycol, but that could be considered if desired. Polyethylene glycol is also in Miralax and Systane eye drops. Reaction to either of those products would increase suspicion of polyethylene glycol related reaction to covid vaccine.  It is very difficult to determine if the hives were a reaction to either vaccine, related to his time in the woods, or completely unrelated.  Adverse reaction to both vaccines will be added to his profile; however, based on successful past use and type of reaction, it is reasonable to consider future vaccination. Other Relevant HX:  Other:
Age: 74.0
Sex: M
Vaccine: COVID19
Symptoms: Breakthrough COVID-19, Hypoxia, Intensive care, Pneumonia, SARS-CoV-2 test positive
Clinical narrative: Reported Symptoms: 10054112:HOSPITALISATION; 10067923:VACCINE BREAKTHROUGH INFECTION; 10084355:COVID-19 POSITIVE; Narrative: Hospitalization- COVID positive, fully vaccinated .Admission to ICU with PNA and hypoxia. Treated with ceftriaxone and dexamethasone.Discharged home with dexamethasone 5 day course. Other Relevant HX: Other: Hospitalization- COVID positive, fully vaccinated
Age: 74.0
Sex: M
Vaccine: COVID19
Symptoms: Vaccine breakthrough infection
Clinical narrative: Reported Symptoms: 10054112:HOSPITALISATION; 10067923:VACCINE BREAKTHROUGH INFECTION; 10084355:COVID-19 POSITIVE; Narrative: Hospitalization- COVID positive, fully vaccinated .Admission to ICU with PNA and hypoxia. Treated with ceftriaxone and dexamethasone.Discharged home with dexamethasone 5 day course. Other Relevant HX: Other: Hospitalization- COVID positive, fully vaccinated
Age: 57.0
Sex: M
Vaccine: COVID19-2
Symptoms: Tachycardia
Clinical narrative: Reported Symptoms: 10043071:TACHYCARDIA; Narrative: Other Relevant HX: Other:
Sex: M
Vaccine: COVID19
Symptoms: Idiopathic urticaria, Urticaria
Clinical narrative: Reported Symptoms: Narrative: per information 01/14/21 COVID dose #1 02/16/21 COVID dose #2 -02/23/21 Hives started 10/04/21 Seen by allergist, dx: idiopathic urticaria Persistent hives-antihistamines are not helpful Other Relevant HX: Other:
Age: 53.0
Sex: M
Vaccine: COVID19
Symptoms: Periorbital swelling, Swelling of eyelid
Clinical narrative: Reported Symptoms: Narrative: On December 5, 2023 PCC attending physician reported the patient had a historical ADR of swelling around the lacrimal glands of the eye. The patient reported having swollen eyelids x 4 hrs the morning after the Covid-19 (moderna) Mrna Lnp-5, Pf, 50 mcg/0.5ml and Flu vaccination. no prior reaction to either vaccinations. CCC triage nurse advised patient to be seen in the ER. The ADR reporting physician also updated patient's allergy/ADR profile Other Relevant HX: Other: Swelling near lacrimal gland (eye)
Sex: M
Vaccine: COVID19
Symptoms: Myalgia
Clinical narrative: Reported Symptoms: 10028411:MYALGIA; Narrative: Other Relevant HX:
Age: 62.0
Sex: M
Vaccine: COVID19
Symptoms: Rash
Clinical narrative: Reported Symptoms: 10037844:RASH; Narrative: Other Relevant HX: Other:
Age: 61.0
Sex: M
Vaccine: PPV
Symptoms: Dizziness
Clinical narrative: Reported Symptoms: 10013573:DIZZINESS; 10024490:LIGHT-HEADED; Narrative: Patient c/o feeling dizzy in the primary care waiting area. Patient's vital signs were obtained, which are stable. Patient stated he ate lunch prior to getting the immunization. Patient started feeling better after vitals were within range: 136/84, HR 85, O2 sat 100. Patient also stated he felt the same way after his previous covid vaccination. Code assist was called by staff and patient requested no further evaluation to staff. Other Relevant HX: Other LIGHTHEADEDNESS
Sex: M
Vaccine: COVID19
Symptoms: Rash
Clinical narrative: Reported Symptoms: 10037844:RASH; Narrative: Other Relevant HX: Other: RASH (12/27/22@09:04:36)
Age: 68.0
Sex: M
Vaccine: COVID19-2
Symptoms: Extra dose administered
Clinical narrative: Reported Symptoms: 10064366: EXTRA DOSE ADMINISTERED; Narrative: Other Relevant HX: Other: extra dose given
Sex: M
Vaccine: COVID19-2, COVID19-2
Symptoms: Extra dose administered
Clinical narrative: Reported Symptoms: 10064366:EXTRA DOSE ADMINISTERED; Narrative:  Other Relevant HX:  Other: Patient received 2nd bivalent vaccine
Age: 75.0
Sex: M
Vaccine: COVID19-2
Symptoms: Aldolase normal, Bursal fluid accumulation, Cartilage injury, Injection site pain, Injection site reaction
Clinical narrative: Reported Symptoms: 10028322:MUSCLE PAIN; 10028411:MYALGIA; Narrative: Patient is a 76-year-old male patient with past medical history of pulmonary embolism, basal cell carcinoma of auricle of ear, hyperlipidemia, gastric ulcer, hiatal hernia, diverticulosis, and restless leg syndrome. Patient received 4 Pfizer COVID-19 vaccinations on 1/12/21, 02/02/21, 11/29/21, and 7/8/22. Patient received their 5th Pfizer COVID-19 vaccination as a booster dose at the facility on 10/26/2022 with no acute reaction. On 12/19/2022, the patient contacted the primary care provider reported atrophy of the left deltoid. The patient reported the area was getting larger and tender. He described it to be 2 inches in length x 1 inch wide. An aldolase level was measured on 1/6/23 and was found to be within normal limits. An MRI of the left shoulder was also done. Mild atrophy of the deltoid muscle was noted. No further evaluation was required. Other Relevant HX: Patient is a 76-year-old male patient with past medical history of pulmonary embolism, basal cell carcinoma of auricle of ear, hyperlipidemia, gastric ulcer, hiatal hernia, diverticulosis, and restless leg syndrome. Patient received 4 Pfizer COVID-19 vaccinations on 1/12/21, 02/02/21, 11/19/21, and 7/8/22. Patient received their 5th Pfizer COVID-19 vaccination as a booster dose at the facility on 10/26/2022 with no acute reaction. Other: MUSCLE Pain.