chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 51.0
Sex: M
Vaccine: COVID19
Symptoms: Dyspnoea, Paraesthesia, Vital signs measurement
Clinical narrative: Progress Notes  3/24/2021     Date:  3/24/2021                                                                                               Subjective Patient is a 51 y.o. male who was seen at COVID Vaccine Clinic today for his first dose of the COVID 19 vaccination.    He was given the Pfizer vaccination in the right deltoid muscle.   During his 15 minute waiting period after the injection, the patient began to experience "funny feeling in his face" and difficulties breathing.  He denied rash, difficulty swallowing, wheezing, throat tightness, dizziness and facial swelling.   This provider was notified of patient reaction and he was then assessed in the emergency bay area.   Monitored patient for severe reaction symptoms, including but not limited to rapid progression of symptoms, respiratory distress and skin changes.     ALLERGY REVIEW OF SYSTEMS:  Patient denies chills, fever, facial swelling, cough, chest tightness, shortness of breath, wheezing, dizziness and headaches       Previous Reactions: Denies.    Objective    Vitals Vitals:   03/24/21 0825 BP: (!) 132/90 Pulse: 89 SpO2: 100%      Physical Exam Vitals reviewed.  Constitutional:      Appearance: Normal appearance.  HENT:     Head: Normocephalic and atraumatic.     Mouth/Throat:     Mouth: Mucous membranes are moist.     Pharynx: Oropharynx is clear. No posterior oropharyngeal erythema.     Comments: No swelling or lips or tongue.  Cardiovascular:     Rate and Rhythm: Normal rate and regular rhythm.  Pulmonary:     Effort: Pulmonary effort is normal. No respiratory distress.     Breath sounds: Normal breath sounds. No wheezing or rales.  Skin:    General: Skin is warm and dry.  Neurological:     General: No focal deficit present.     Mental Status: He is alert and oriented to person, place, and time.        Assessment/Plan  Treatment included: antihistamines, water and snacks Follow up response to treatment: good. Patient discharge: Stable to go home and follow up with PCP.  Differential Diagnosis: Vaccine-Related Anxiety (include misc mental health) and Systemic reaction (hypoglycemia, hypotension, generalized rash)    3/24/2021 9:12 AM
Age: 27.0
Sex: M
Vaccine: COVID19
Symptoms: Blood pressure decreased, Heart rate decreased, Presyncope
Clinical narrative: Pt had vasovagal event after injection.  HR fell to 43, BP  fell to approx. 60/40.  Pt given water, snacks, coca cola, and monitored vitals for 10 minutes.  BP increased to 95/65 and HR increased to 65 bpm.  Pt monitored until felt well.
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Diarrhoea, Headache, Nausea, Pain
Clinical narrative: Nauseous, diarrhea, chills, aches, headaches, sinus, could not turn off my brain.  Awake till 3 am.
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Sinus disorder
Clinical narrative: Nauseous, diarrhea, chills, aches, headaches, sinus, could not turn off my brain.  Awake till 3 am.
Age: 16.0
Sex: F
Vaccine: COVID19
Symptoms: Product administered to patient of inappropriate age
Clinical narrative: Janssen vaccine given to a 16 year old.
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: Erythema, Skin irritation
Clinical narrative: Redness and pinchy feeling in her face.  Given allegra and watched for 30 minutes post injection.
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: Back pain, Chills, Fatigue, Feeling abnormal, Headache
Clinical narrative: Began to feel funny 3 1/2 hours later. By 5 hours later I had terrible chills and was in bed. I was bedridden until 45 hours after the shot. Besides the chills and fatigue, I had a headache and backache.
Age: 64.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Inappropriate schedule of product administration
Clinical narrative: The second dose was given a week early.
Age: 87.0
Sex: M
Vaccine: COVID19
Symptoms: Death, Hypophagia
Clinical narrative: received vaccine on 2/11/2021, stopped eating on 2/18/2021,  expired on 03/06/2021
Age: 26.0
Sex: M
Vaccine: COVID19
Symptoms: Lip swelling
Clinical narrative: Approximately 12hrs after 2nd dose patient woke at 01:30 noted swelling of lower lip. He took 5Omg Benadryl PO at home and came to clinic Urgent Care. He was seen and noted to have large swelling of lower lip without tongue or throat involvement. Vitals stable. Given Solu-Medellin 40mg IM x1 monitored and discharged with Zyrtec10mg BID AND 1 week follow up.
Age: 44.0
Sex: F
Vaccine: COVID19
Symptoms: Body temperature increased, Chills
Clinical narrative: More than 24 hours after receiving the first dose of the vaccine, chills suddenly crept up on me.  Upon arriving home, I took my temperature which registered at 101.5.
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Chills, Fatigue, Headache, Injection site induration
Clinical narrative: 3:00 a.m. (11 hrs after injection) I was awakened from sleep by uncontrollable shivers and chills that lasted over 2 hours.  By 6:00 I had a fever and was aching all over.  I finally went back to sleep until around 9:30.  Fever broke and I ate almost all of a piece of toast, though I wasn't hungry really and couldn't taste it much.  I slept a total of 17 hours from 6:00 a.m. Saturday to 6:00 a.m. Sunday.  Still achy, feverish, and tired on Sunday.  Rested most of the day.  Monday morning I woke up with icepick headaches in the top left side of my head and the left temple.  These were frequent and intense throughout the day.  No fever but extreme fatigue and still achy in joints.  Injection site is a hard knot and is warm.  Headaches continued Tuesday (yesterday) in same locations in my head.  Still can't taste much, and now have 2 fever blisters on my lips and sores inside on the roof of my mouth.  Wednesday (today) I finally have not had any of the headaches and am slowly regaining my energy.  Still have the sore inside my mouth and can't taste food as it should taste.  Feel much better but not 100% yet.
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site warmth, Oral herpes, Pain, Pyrexia, Stomatitis
Clinical narrative: 3:00 a.m. (11 hrs after injection) I was awakened from sleep by uncontrollable shivers and chills that lasted over 2 hours.  By 6:00 I had a fever and was aching all over.  I finally went back to sleep until around 9:30.  Fever broke and I ate almost all of a piece of toast, though I wasn't hungry really and couldn't taste it much.  I slept a total of 17 hours from 6:00 a.m. Saturday to 6:00 a.m. Sunday.  Still achy, feverish, and tired on Sunday.  Rested most of the day.  Monday morning I woke up with icepick headaches in the top left side of my head and the left temple.  These were frequent and intense throughout the day.  No fever but extreme fatigue and still achy in joints.  Injection site is a hard knot and is warm.  Headaches continued Tuesday (yesterday) in same locations in my head.  Still can't taste much, and now have 2 fever blisters on my lips and sores inside on the roof of my mouth.  Wednesday (today) I finally have not had any of the headaches and am slowly regaining my energy.  Still have the sore inside my mouth and can't taste food as it should taste.  Feel much better but not 100% yet.
Age: 18.0
Sex: F
Vaccine: COVID19
Symptoms: Chest X-ray, Chest pain, Electrocardiogram, Fatigue, Urine analysis
Clinical narrative: I started having the symptoms in the afternoon. I was really fatigued and throwing up multiple times (nothing left in my stomach); had chest pain. My boyfriend rushed me to the hospital. While I was at the hospital (about 3:00 am) I threw up again at the hospital. They monitored me and put an IV on me. When I was able to hold down water and stop throwing up they let me go home - which was about 7. Prescribed Zofran and Pepsin.  And they put me on a clear liquid diet for a day.  They told me to Zofran, Pepsin and Benadryl before the second dose and told me to eat a meal before getting the second dose and I had no symptoms at all with second dose.
Age: 18.0
Sex: F
Vaccine: COVID19
Symptoms: Vomiting
Clinical narrative: I started having the symptoms in the afternoon. I was really fatigued and throwing up multiple times (nothing left in my stomach); had chest pain. My boyfriend rushed me to the hospital. While I was at the hospital (about 3:00 am) I threw up again at the hospital. They monitored me and put an IV on me. When I was able to hold down water and stop throwing up they let me go home - which was about 7. Prescribed Zofran and Pepsin.  And they put me on a clear liquid diet for a day.  They told me to Zofran, Pepsin and Benadryl before the second dose and told me to eat a meal before getting the second dose and I had no symptoms at all with second dose.
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Blood test, Chromaturia, Haemorrhage urinary tract, Micturition urgency, Urinary tract discomfort
Clinical narrative: I woke up at 1 am and needed to urinate. I did but then immediately felt the urge to go again but I could only go a small amount. This continued on for every 5 to 10 minute until 2am. My urine was tinged pink and then continued to get worse. By 2am, it was the color of tomato juice with several clots. I went the the emergency room and was given 1 liter of IV solution and an IV antibiotic. I was released around 4am and returned home. I was prescribed a 7 day regimen of oral antibiotics. I did not feel any pain, only the discomfort from the urge to urinate which lasted about 18 hours. By 9am, my urine was clear and in normal amounts. I have never had a UTI in my life which is why I am reporting this.
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Urinary tract infection, Urine analysis abnormal, White blood cell count increased
Clinical narrative: I woke up at 1 am and needed to urinate. I did but then immediately felt the urge to go again but I could only go a small amount. This continued on for every 5 to 10 minute until 2am. My urine was tinged pink and then continued to get worse. By 2am, it was the color of tomato juice with several clots. I went the the emergency room and was given 1 liter of IV solution and an IV antibiotic. I was released around 4am and returned home. I was prescribed a 7 day regimen of oral antibiotics. I did not feel any pain, only the discomfort from the urge to urinate which lasted about 18 hours. By 9am, my urine was clear and in normal amounts. I have never had a UTI in my life which is why I am reporting this.
Age: 32.0
Sex: M
Vaccine: COVID19
Symptoms: Throat irritation
Clinical narrative: Reported sandpaper like feeling in throat, n/v
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness, Fatigue, Gait disturbance, Hallucination, Headache
Clinical narrative: Severe headaches, tiredness, fatigue, difficulty walking w/o assistance, lightheadedness, hallucinations that disappeared 3 nights after the vaccination.
Age: 40.0
Sex: F
Vaccine: COVID19
Symptoms: Anaphylactic reaction, Dyspnoea, Immediate post-injection reaction
Clinical narrative: 1:39 PM - Vaccine administered 1:40PM - Anaphylactic reaction began (difficulty breathing) 1:40PM - First dose epinephrine administered with patient supply 1:45PM - Second dose epinephrine administered with patient supply 1:50PM - Third dose epinephrine administered with patient supply, EMS arrived, nasal cannula oxygen started 1:55PM - Fourth (PARTIAL... EMS did not remove locking mechanism, not certain how much patient received) dose epinephrine administered with store supply by EMS 2:00PM - Transported by EMS to Emergency Dept.
Age: 44.0
Sex: F
Vaccine: COVID19
Symptoms: Rash
Clinical narrative: Per pt she applied Hydrocortisone cream that she was currently using for another rash. Rash subsided after 2 days.
Age: 34.0
Sex: F
Vaccine: COVID19
Symptoms: Maternal exposure before pregnancy, No adverse event
Clinical narrative: no adverse events at this time. I received covid vaccine - Pfizer- on 1/15/2021.  Received covid vaccine #2 on 2/5/2021. My Last menstrual period was Feb. 2, 2021. I am now pregnant. Just wanted to report this for data.
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: Blood test, Chills, Computerised tomogram head, Dizziness, Fatigue
Clinical narrative: I had chills, fever, headache, extreme tiredness, almost passed out and  tingling on right side arm/leg. When I almost passed out felt like tunnel vision.
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: Headache, Paraesthesia, Pyrexia, Tunnel vision
Clinical narrative: I had chills, fever, headache, extreme tiredness, almost passed out and  tingling on right side arm/leg. When I almost passed out felt like tunnel vision.
Age: 28.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site movement impairment, Injection site pain, Pain in extremity
Clinical narrative: Patient stated she had injection yesterday and it began to hurt around 11 pm. She now  has limited mobility and pain in her left arm.
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Interchange of vaccine products
Clinical narrative: Pt informed vaccinator that he received Moderna as first dose. Pt was given Pfizer as second dose. Pt aware of incident. no treatment needed
Age: 43.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site pain, Pain, Pain in extremity
Clinical narrative: lower arm shooting pain in the side that was injected. nerve type shooting pain from the elbow to the wrist, pain mostly in the thumb
Age: 27.0
Sex: M
Vaccine: COVID19
Symptoms: Underdose
Clinical narrative: Employee received .2 cc of Pfizer instead of .3 cc which was inadvertently administrated by vaccine nurse.   NO ADVERSE REACTION, just reporting medication error.   Our Vaccine Task Force, after speaking with CDC and PA DOH, decided to offer the employee an additional COVID-19 vaccine dose.  Thanks.
Age: 50.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Patient was vaccinated at a Medical Center in January 2021. She tested for COVID-19 on Friday 3/19 for personal purposes (she is asymptomatic) and the test resulted positive on Monday 3/22/21. She confirmed that her towns health dept. has been in contact with her and that she did have a PCR test done. Her information is as follows:1st Dose: 1/4/21; Pfizer EL0140  2nd Dose: 1/25/21; Pfizer EL1284
Age: 76.0
Sex: M
Vaccine: COVID19
Symptoms: Decreased appetite, Fatigue, Injection site erythema, Injection site induration, Injection site pain
Clinical narrative: Patient and caregiver report redness 7" x 4" around site, hardness, heat to left deltoid with tenderness that developed 3/18 accompanied with low appetite, muscle weakness, and fatigue. Arm symptoms were reported on 3/22 and improving by 3/23. Other symptoms reported on 3/23. They report that on 3/23 symptoms were still present but starting to improve.
Age: 76.0
Sex: M
Vaccine: COVID19
Symptoms: Injection site warmth, Muscular weakness
Clinical narrative: Patient and caregiver report redness 7" x 4" around site, hardness, heat to left deltoid with tenderness that developed 3/18 accompanied with low appetite, muscle weakness, and fatigue. Arm symptoms were reported on 3/22 and improving by 3/23. Other symptoms reported on 3/23. They report that on 3/23 symptoms were still present but starting to improve.
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Pain in extremity, Peripheral swelling
Clinical narrative: ?Moderna COVID-19 Vaccine  Swollen gland or lymph node in left armpit area. Slightly painful if touched or arm raise. Letter arm is where I got the shot.
Age: 81.0
Sex: F
Vaccine: COVID19
Symptoms: Incomplete course of vaccination
Clinical narrative: She was in the hospital during her second dose time frame. She did not get released from the hospital until after the 42 day recommended time frame for the second dose, therefore she missed her second dose
Age: 63.0
Sex: M
Vaccine: COVID19
Symptoms: Herpes zoster
Clinical narrative: a week after vaccine I got shingles
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness
Clinical narrative: Major dizzy spells off and on for first two hours
Age: 12.0
Sex: F
Vaccine: HPV9, HPV9
Symptoms: Anxiety, Arthralgia, Asthenia, Dizziness, Glucose tolerance impaired
Clinical narrative: Shortly after second dose, Patient noticed spells of dizziness and pre-syncope as well as syncope episodes. Patient generally felt weak and as time passed more symptoms appeared (vertigo, anxiety, rashes, joint pain, migraines, heavy periods, etc) sending patient to multiple visits with various specialists. In 2018 patient was finally diagnosed with SLE/Lupus.
Age: 12.0
Sex: F
Vaccine: HPV9, HPV9
Symptoms: Heavy menstrual bleeding, Migraine, Presyncope, Rash, Syncope
Clinical narrative: Shortly after second dose, Patient noticed spells of dizziness and pre-syncope as well as syncope episodes. Patient generally felt weak and as time passed more symptoms appeared (vertigo, anxiety, rashes, joint pain, migraines, heavy periods, etc) sending patient to multiple visits with various specialists. In 2018 patient was finally diagnosed with SLE/Lupus.
Age: 12.0
Sex: F
Vaccine: HPV9, HPV9
Symptoms: Systemic lupus erythematosus, Vertigo
Clinical narrative: Shortly after second dose, Patient noticed spells of dizziness and pre-syncope as well as syncope episodes. Patient generally felt weak and as time passed more symptoms appeared (vertigo, anxiety, rashes, joint pain, migraines, heavy periods, etc) sending patient to multiple visits with various specialists. In 2018 patient was finally diagnosed with SLE/Lupus.
Age: 52.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Dizziness, Electrocardiogram normal, Hypoaesthesia, Hypoaesthesia oral
Clinical narrative: Complained of numbness in right leg, face and lips. lightheadedness
Age: 52.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Back pain, Blood pressure increased, Dizziness, Heart rate increased, Injection site swelling
Clinical narrative: Complained of numbness in right leg, face and lips. lightheadedness
Age: 52.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Palpitations, Speech disorder
Clinical narrative: Complained of numbness in right leg, face and lips. lightheadedness
Age: 74.0
Sex: M
Vaccine: COVID19
Symptoms: Facial paralysis, Herpes zoster, Rash, Tinnitus
Clinical narrative: Shingles in left eye, left nose, rash/blisters on left nose/eye/scalp.  Left eye droop.  Left ear tinnitus.
Age: 32.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness, Fatigue, Headache, Hypoaesthesia, Pyrexia
Clinical narrative: headache 1 hr after fatigue after 24 hours numbness in left arm after 24 hours fever after 24 hours dizziness after 24 hours
Age: 41.0
Sex: F
Vaccine: COVID19
Symptoms: Syncope
Clinical narrative: Patient has a history involving fear of neeedles and experienced a near syncopal episoide.  Patient laid down and felt better.  Refused transport to the hospital.
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: Body temperature increased, Pain
Clinical narrative: Body aches 101.8 temperature Started at 2:00 pm..took 2 Tylenol Fever receded to normal by 6:00 pm Went to bed at 8:00 pm Woke up the next day feeling fine, went on my Dailey 5 mile walk
Age: 39.0
Sex: F
Vaccine: COVID19
Symptoms: Oral pruritus, Pruritus
Clinical narrative: Within 15 minutes post second vaccine, patient developed itching of mouth, arms, and "full body" per EMS. Paramedic administered 50 mg Benadryl IM. Patient accepted transport to hospital via EMS for additional assessment and monitoring.
Age: 40.0
Sex: M
Vaccine: COVID19
Symptoms: Fall, Feeling hot, Hyperhidrosis
Clinical narrative: Shortly after receiving the vaccine, the patient stood up from his chair and approached the pharmacy counter. He told the pharmacist he was starting to feel funny and immediately fell on his back. I ran out to around the counter and he was conscious and sweaty. He was responsive, knew his name and where he was. He described feeling very hot. He did not have any rash or swelling visible.
Age: 41.0
Sex: F
Vaccine: COVID19
Symptoms: Lacrimation increased, Swelling face, Swelling of eyelid
Clinical narrative: Swelling to the entire right side of my face, including eye lid being nearly swollen shut and watering profusely.  Swelling subsided around 5 hours later after taking Benadryl
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal discomfort, Arthralgia, Asthenia, Diarrhoea, Fatigue
Clinical narrative: Received the first vac on 3/12 at 8:30 a.m.. I started feeling achy and tired by 4pm. By the next day, I had diarrhea and stomach upset starting by mid day.  Since then, I have had daily diarrhea, lethargy, weakness, off and on headache, body aches (especially joints) and overall feeling of unwell.
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Headache, Lethargy, Malaise, Pain
Clinical narrative: Received the first vac on 3/12 at 8:30 a.m.. I started feeling achy and tired by 4pm. By the next day, I had diarrhea and stomach upset starting by mid day.  Since then, I have had daily diarrhea, lethargy, weakness, off and on headache, body aches (especially joints) and overall feeling of unwell.
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness, Feeling hot, Muscular weakness
Clinical narrative: Progress Notes Healthcare Provider Cosign Needed Expand AllCollapse All        Subjective Patient is a 56 y.o. female who was seen at healthcare facility today for her first  dose of the COVID 19 vaccination.    She was given the Pfizer vaccination in the left deltoid muscle.   During her 15 minute waiting period after the injection, the patient began to experience dizziness and hot. Patient has a history of multiple sclerosis and complained of a weakness in her legs that she experiences during her flares. She does mention having to be on 2L oxygen at times when she has a flare. O2 is 100% at rest today. She denied rash, difficulty breathing, difficulty swallowing, throat tightness and facial swelling.   This provider was notified of patient reaction and she was then assessed.   Monitored patient for severe reaction symptoms, including but not limited to rapid progression of symptoms, respiratory distress and increased weakness.     ALLERGY REVIEW OF SYSTEMS:  Patient complains of dizziness   Patient denies chills, fever, facial swelling, cough, chest tightness, shortness of breath, wheezing and headaches       Previous Reactions: Denies reactions to prior vaccines    Objective    Vitals Vitals:   03/24/21 1202 03/24/21 1219 03/24/21 1232 BP: (!) 155/92 (!) 145/78 136/76 Pulse: 86 79 80 SpO2: 100% 100% 100%      Physical Exam Constitutional:      Appearance: Normal appearance.  HENT:     Head: Normocephalic and atraumatic.     Mouth/Throat:     Mouth: Mucous membranes are moist.     Pharynx: Oropharynx is clear. No posterior oropharyngeal erythema.     Comments: No swelling of lips or tongue.  Cardiovascular:     Rate and Rhythm: Normal rate and regular rhythm.  Pulmonary:     Effort: Pulmonary effort is normal. No respiratory distress.     Breath sounds: Normal breath sounds. No wheezing or rales.  Skin:    General: Skin is warm and dry.  Neurological:     General: No focal deficit present.     Mental Status: She is alert and oriented to person, place, and time.        Assessment/Plan  Treatment included: Water and lying patient in trendelenburg position. Follow up response to treatment: good. Patient discharge: Stable to go home and follow up with PCP.  Differential Diagnosis: Vaccine-Related Anxiety (include misc mental health) and Systemic reaction (hypoglycemia, hypotension, generalized rash)
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Dysgeusia, Paraesthesia
Clinical narrative: Metallic taste after shot. Pins/Needles on left side of face - continually near eye, every few hours rest of face.
Age: 55.0
Sex: F
Vaccine: COVID19
Symptoms: Diarrhoea, Dizziness, Headache, Nausea, SARS-CoV-2 test negative
Clinical narrative: On 01-12-2021, I began to feel dizzy, had  headaches and felt nauseated while at work. On the following morning, I felt nauseated and had diarrhea and while driving to work I continued to feel dizzy.  I went to work for a few hours only because I still felt nauseated, dizzy and continued with the diarrhea. This lasted three days. I missed work due to my diarrhea and how I was feeling. I saw a who prescribed nausea medication and anti-diarrhea medications. I also had a Covid-19 test which was negative.
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling
Clinical narrative: 10 days after first vaccine shot, a red, swollen area has appeared around injection site. The area itches and is painful to the touch. It is about 2 inches long and 1 inch wide.
Age: 56.0
Sex: M
Vaccine: COVID19
Symptoms: Chills, Headache, Nausea, Pain
Clinical narrative: Began getting chills at *8 p.m. , body aches, headache, and nausea.  Temperature hit a high of 104 at 2 a.m. on 3/7/2021.  Symptoms continued until around 8 a.m. on 3/7/2021 and was left with dull headache for remainder of the day.
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, Dyspnoea, Fatigue, Headache, Hilar lymphadenopathy
Clinical narrative: Shortness of breath, on bending over, or exertion, low PO2, headache, fatigue, low energy,   Worsening symptoms afer 2nd. dose 3/1/21
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: PO2 decreased, Ventilation/perfusion scan
Clinical narrative: Shortness of breath, on bending over, or exertion, low PO2, headache, fatigue, low energy,   Worsening symptoms afer 2nd. dose 3/1/21
Age: 57.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal discomfort, Chills, Fatigue, Hypersomnia, Pain
Clinical narrative: Body aches, fever, upset stomach, chills, very tired. I basically slept the whole next day. Tylenol seemed to help.
Age: 57.0
Sex: F
Vaccine: COVID19
Symptoms: Pyrexia
Clinical narrative: Body aches, fever, upset stomach, chills, very tired. I basically slept the whole next day. Tylenol seemed to help.
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Back pain, Cough, Diarrhoea, Fatigue, Headache
Clinical narrative: headache, sweating, tiredness,low back pain,fever, nadseau, diarrhea, coughing, taste off
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Hyperhidrosis, Nausea, Pyrexia, Taste disorder
Clinical narrative: headache, sweating, tiredness,low back pain,fever, nadseau, diarrhea, coughing, taste off
Age: 90.0
Sex: M
Vaccine: COVID19
Symptoms: Gastrointestinal haemorrhage, Rectal haemorrhage
Clinical narrative: received vaccine on 01/20/2021, on 02/03/2021 rt noted to be actively bleeding from rectum, sent to hospital with GI bleed
Age: 48.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Impaired work ability, Migraine, Pyrexia
Clinical narrative: Both times I received  the COVID-19 vaccincations I instantly had a migranie and a fever when I got howm.  The first time my migraine lasted 4 days and I was out of work which has almost cost me my job.  The second times I had a migraine and a fever of over 104 last evening. I was able to break the fever in the middle of the night but it lasted a long time.
Age: 66.0
Sex: F
Vaccine: COVID19
Symptoms: Cough, Feeling cold, Throat irritation
Clinical narrative: About two weeks and two days after I had the second vaccine, I felt a little chill  and had a very slight scratchy throat and a very slight cough on and off for about five days and I was wondering if what I had experienced was a delayed reaction to the vaccine even though it was two weeks and two days after I had received it?  I had associated the reaction to being ?better? than having a cold because when I get colds, it would start with a very bad sore throat and then would become a full-blown cold with very bad coughing and sometimes I would develop bronchitis. I thought that the reaction that I had was quite mild.
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Pain, Paraesthesia
Clinical narrative: Tingles in hand, aches. Assessed RMA  . no transport
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site erythema, Injection site pain, Injection site reaction, Urticaria
Clinical narrative: My arm was painful at the injection site for several days but Tylenol and ice/warm compress alleviated that. Since then, 2 large, red, round welts - one at the injection site, and a larger one below it, have come up and are getting bigger over the week since.  Pictures available
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: Dyspnoea, Hypersensitivity, Swollen tongue
Clinical narrative: EMS narrative: NARRATIVE  RESPONDED TOFE FIELD FOR A 54 YEAR OLD FEMALE HAVING ALLERGIC REACTION. ARRIVED ON SCENE TO FIND PT SITTING UPWRITE ON A BED. PT IS ALERT AND ORIENTED. PT DOES NOT APPEAR TO BE IN DISTRESS. STAFF MEDIC CLAIMS THE PT RECEIVED HER FIRST VACCINATION AND BEGAN TO HAVE A REACTION. PT STATES HER TONGUE BEGAN TO SWELL UP AND HAD DIFFICULTY BREATHING. STAFF STATES THEY GAVE THE PT BENADRYL AND SOLU-MEDROL. PT HAS ALREADY IMPROVED WITH THE MEDICATIONS. PT STATES SHE FEELS MUCH BETTER AND HAS NO SHORTNESS OF BREATH. PT SHOWS NO SIGNS OF ALLERGIC REACTION. PT WANTS TO BE TRANSPORTED. PT WAS ABLE TO STAND AND SIT ON THE COT WHERE ALL STRAPS AND RAILS WERE APPLIED. PT WAS BROUGHT TO THE AMBULANCE WHERE VITALS WERE ASSESSED AND MONITORED. PT WAS TRANSPORTED WITHOUT INCIDENT.T PT WAS BROUGHT INTO THE FACILITY WHERE CARE WAS TRANSFERRED TO RN.
Age: 17.0
Sex: M
Vaccine: COVID19
Symptoms: No adverse event, Product administered to patient of inappropriate age
Clinical narrative: No adverse events noted to date.  Client is 17 and received Moderna vaccine.  Person completing form is not the person that administered vaccine.
Age: 49.0
Sex: F
Vaccine: COVID19, UNK
Symptoms: Death, Myocardial infarction, Unresponsive to stimuli
Clinical narrative: Community partner reported that they found her unresponsive on the 17th (so she may have died on the 16th) from what they believe was a heart attack. The family has requested an autopsy.
Age: 49.0
Sex: F
Vaccine: COVID19, UNK
Symptoms: Cerebral haemorrhage, Death
Clinical narrative: Community partner reported that they found her unresponsive on the 17th (so she may have died on the 16th) from what they believe was a heart attack. The family has requested an autopsy.
Age: 57.0
Sex: F
Vaccine: COVID19
Symptoms: Dysphonia, Dyspnoea, Pruritus
Clinical narrative: Horseness,  SOB and  itching
Age: 17.0
Sex: F
Vaccine: COVID19
Symptoms: No adverse event, Product administered to patient of inappropriate age
Clinical narrative: Patient was placed on our schedule through the local health departments registration site even though she wasn't 18.  Our staff failed to notice that she wasn't 18 yet.  There were no adverse events experienced by the patient.
Age: 34.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Erythema, Pain in extremity, Peripheral swelling, Pruritus
Clinical narrative: My left arm began to itch the morning of 3/18/21 (8 days after the vaccination). There was a small lump under my skin. The longer the day went on, the larger and warmer (and more tender) the lump got. It was also red. I began to run a fever, which I attributed to this, but I was diagnosed with Covid-19 4 days later (on 3/22/21), so the fever could have been unrelated to ?Covid Arm.? I applied topical Benadryl to my arm and took Benadryl, orally, that night. The next morning, the swelling, redness, and tenderness of the lump had gone down. By the 24-hour mark, all symptoms were gone.
Age: 34.0
Sex: F
Vaccine: COVID19
Symptoms: Pyrexia, SARS-CoV-2 test positive, Skin warm
Clinical narrative: My left arm began to itch the morning of 3/18/21 (8 days after the vaccination). There was a small lump under my skin. The longer the day went on, the larger and warmer (and more tender) the lump got. It was also red. I began to run a fever, which I attributed to this, but I was diagnosed with Covid-19 4 days later (on 3/22/21), so the fever could have been unrelated to ?Covid Arm.? I applied topical Benadryl to my arm and took Benadryl, orally, that night. The next morning, the swelling, redness, and tenderness of the lump had gone down. By the 24-hour mark, all symptoms were gone.
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: Chest X-ray, Dyspnoea, Fatigue, Laboratory test
Clinical narrative: Shortly after the patient received the vaccine, she felt short of breath.    The symptoms lasted > 7 days.  The patient also had significant fatigue.
Age: 44.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site erythema, Injection site pruritus, Injection site rash, Injection site warmth, Skin tightness
Clinical narrative: Starting on about 3/13 (about a week after the 1st injection) my left arm right near the injection site started itching. At first I thought it was a bug bite as I realized there were a few little bumps on my skin. Not painful just a bit itchy. By 3/14 my upper left arm felt very tight and swollen and looked red and felt hot to the touch. That went away within 3 days. No other reaction.
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: Flushing, Pruritus
Clinical narrative: Patient reported at about 25 minutes after 1st dose of pfizer covid vaccine  she began to feel facial itching and flushing, similar to what she felt with previous anaphylaxis due to allergy immunotherapy. She was brought to the medical tent and given 50mg benadryl po and observed x 1 hour. No progression of symtpoms, vitals stable. No angioedema, throat or tongue swelling, difficulty breathing or speaking, sob, or wheezing. Symptoms had completely resolved prior to discharge. She was driven home by her husband.
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: Rash papular, Skin burning sensation, Skin warm
Clinical narrative: Raised itchy rash that feels like a burn and is hot to the touch. Upon research, it looks like covid arm.
Age: 33.0
Sex: F
Vaccine: COVID19
Symptoms: Dyspnoea, Hypoaesthesia oral, Lip swelling
Clinical narrative: PT COMPLAIN OF SWELLING  AND NUMBNESS OF LIPS AND HAD TROUBLE BREATHING.  V/S B.P 154/99  HR 98 R-19 TRMP. 96.0  EPI PEN WAS ADMINISTERED AND STARTED ON O2 NC  PARAMEDICS WERE CALLED AND WAS TRANSPORTED TO THE HOSPITAL.
Age: 69.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Asthenia, Chills, Dizziness, Fatigue, Headache
Clinical narrative: Took the 1st shot Thurs. Feb 25, no effects, 21 days later took 2nd shot on Thursday 3/18/21. That night my arm was sore, came down with aches, headache, tiredness, then chills, fever, weakness, dry heaves, light headedness but did not passout.  Stayed in bed for two days, Friday n Saturday. Got up Sunday layed around all day. Got up Monday, Tuesday and today, Wednesday the 24th with headache and feelilng blah, no energy. Vaccine site still slightly sore and itches too. still not feeling myself, today is Wed. Mar 24.  May not have any bearing on vaccine but too much of a coincidence.
Age: 69.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Injection site pain, Injection site pruritus, Lethargy, Malaise, Pain
Clinical narrative: Took the 1st shot Thurs. Feb 25, no effects, 21 days later took 2nd shot on Thursday 3/18/21. That night my arm was sore, came down with aches, headache, tiredness, then chills, fever, weakness, dry heaves, light headedness but did not passout.  Stayed in bed for two days, Friday n Saturday. Got up Sunday layed around all day. Got up Monday, Tuesday and today, Wednesday the 24th with headache and feelilng blah, no energy. Vaccine site still slightly sore and itches too. still not feeling myself, today is Wed. Mar 24.  May not have any bearing on vaccine but too much of a coincidence.
Age: 69.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Pyrexia, Retching
Clinical narrative: Took the 1st shot Thurs. Feb 25, no effects, 21 days later took 2nd shot on Thursday 3/18/21. That night my arm was sore, came down with aches, headache, tiredness, then chills, fever, weakness, dry heaves, light headedness but did not passout.  Stayed in bed for two days, Friday n Saturday. Got up Sunday layed around all day. Got up Monday, Tuesday and today, Wednesday the 24th with headache and feelilng blah, no energy. Vaccine site still slightly sore and itches too. still not feeling myself, today is Wed. Mar 24.  May not have any bearing on vaccine but too much of a coincidence.
Age: 40.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Fatigue, Influenza like illness, Injection site bruising, Injection site induration
Clinical narrative: My arm began to hurt again 7 days after the first shot. I noticed a small bump at the injection. Within hours it had enlarged to 5 inches down by almost 2 inches across in a raised, hot and hard line. My arm was very sore, my lymph nodes started to swell under the arm, and in my throat and lower back. By the night fatigue had set in, chills and soreness all over. It lasted 2 days and the arm is still hot, but not hard just looking like a large bruised area and my ending with cold-like symptoms after the first night of flu-like symptoms.
Age: 40.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site swelling, Injection site warmth, Lymphadenopathy, Nasopharyngitis, Pain
Clinical narrative: My arm began to hurt again 7 days after the first shot. I noticed a small bump at the injection. Within hours it had enlarged to 5 inches down by almost 2 inches across in a raised, hot and hard line. My arm was very sore, my lymph nodes started to swell under the arm, and in my throat and lower back. By the night fatigue had set in, chills and soreness all over. It lasted 2 days and the arm is still hot, but not hard just looking like a large bruised area and my ending with cold-like symptoms after the first night of flu-like symptoms.
Age: 40.0
Sex: F
Vaccine: COVID19
Symptoms: Pain in extremity
Clinical narrative: My arm began to hurt again 7 days after the first shot. I noticed a small bump at the injection. Within hours it had enlarged to 5 inches down by almost 2 inches across in a raised, hot and hard line. My arm was very sore, my lymph nodes started to swell under the arm, and in my throat and lower back. By the night fatigue had set in, chills and soreness all over. It lasted 2 days and the arm is still hot, but not hard just looking like a large bruised area and my ending with cold-like symptoms after the first night of flu-like symptoms.
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Flushing, Neck pain, Swelling face, Throat irritation
Clinical narrative: After 30 minutes histimine reaction, itching in throat. Pain in neck, Flush and swollen face within 1 hr, noted by others in my home.
Age: 20.0
Sex: F
Vaccine: COVID19
Symptoms: Blindness transient, Cold sweat, Dyschromatopsia, Vomiting
Clinical narrative: temporary loss of vision, seeing black, cold-sweating, vomiting
Age: 40.0
Sex: M
Vaccine: COVID19
Symptoms: Dizziness, Head injury
Clinical narrative: Within one minute of receiving the vaccination, he developed lightheadedness. He single pies from the sitting position and struck the left side of his forehead. He was taken to a private section of the arena and monitored. Initial blood pressure was 75/50s, and subsequent monitoring show that his blood pressure was in the  136/85. No itching, rashes, shortness of breath, facial swelling, tongue swelling, or anaphylaxis.
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: Feeling hot, Pruritus, Urticaria
Clinical narrative: Within 10 minutes of receiving the vaccine, my skin broke out in hives, was itchy and hot.  I took over the counter Benadryl about an hour later.  The hives subsided but the itching lasted approximately 24 hours after injection.  I called the clinic and spoke to a nurse who in turn recommended my primary physician contact me.  My primary physician and I spoke by phone the next day.  No office visit was scheduled.
Age: 30.0
Sex: M
Vaccine: COVID19
Symptoms: Chills, Fatigue, Night sweats, Pain, Pyrexia
Clinical narrative: Chills, fatigue, aches and pains, fever, and night sweats beginning approximately 14 hours after the vaccine and starting to subside approximately 18 hours after onset (took Tylenol)
Age: 70.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Blood creatine phosphokinase increased, Hypoaesthesia, Magnetic resonance imaging, Pain in extremity, Paraesthesia
Clinical narrative: Severe pain in the upper arm in which she received the vaccine which started 8 days after administration. Associated symptoms include numbness and tingling in the right 1st and 2nd digits. fingers also turned white. Color change and pain improved with a medrol dosepak but pain has recurred off steroids.
Age: 70.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Skin discolouration, Ultrasound Doppler normal
Clinical narrative: Severe pain in the upper arm in which she received the vaccine which started 8 days after administration. Associated symptoms include numbness and tingling in the right 1st and 2nd digits. fingers also turned white. Color change and pain improved with a medrol dosepak but pain has recurred off steroids.
Age: 70.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Biopsy, Biopsy bone marrow, Biopsy muscle, Blood test normal, Carpal tunnel syndrome
Clinical narrative: Severe pain in the upper arm in which she received the vaccine which started 8 days after administration. Associated symptoms include numbness and tingling in the right 1st and 2nd digits. fingers also turned white. Color change and pain improved with a medrol dosepak but pain has recurred off steroids.
Age: 70.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Condition aggravated, Electrocardiogram normal, Hypertension, Hypoaesthesia, Magnetic resonance imaging
Clinical narrative: Severe pain in the upper arm in which she received the vaccine which started 8 days after administration. Associated symptoms include numbness and tingling in the right 1st and 2nd digits. fingers also turned white. Color change and pain improved with a medrol dosepak but pain has recurred off steroids.
Age: 70.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Mononeuropathy multiplex, Nerve stimulation test, Neuropathy peripheral, Pain in extremity, Peroneal nerve injury
Clinical narrative: Severe pain in the upper arm in which she received the vaccine which started 8 days after administration. Associated symptoms include numbness and tingling in the right 1st and 2nd digits. fingers also turned white. Color change and pain improved with a medrol dosepak but pain has recurred off steroids.
Age: 70.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Peroneal nerve palsy, Polyneuropathy, Sensory loss, Ultrasound Doppler, X-ray normal
Clinical narrative: Severe pain in the upper arm in which she received the vaccine which started 8 days after administration. Associated symptoms include numbness and tingling in the right 1st and 2nd digits. fingers also turned white. Color change and pain improved with a medrol dosepak but pain has recurred off steroids.
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: Bell's palsy, Eyelid ptosis, Facial paralysis, Magnetic resonance imaging
Clinical narrative: Left eye began to droop on 3-17. By 3/20 the entire left side of my face had started to drop. Went to dr on Monday, 3/23 and was diagnosed with Bell?s Palsey
Age: 34.0
Sex: F
Vaccine: COVID19
Symptoms: Loss of consciousness, Presyncope
Clinical narrative: Patient passed out 5 minutes after vaccination. States she has vasovagal syndrome and has passed out before after procedures.
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Deep vein thrombosis, Embolism venous, Pulmonary embolism
Clinical narrative: Developed right lower extremity DVT and pulmonary emboli after travel out of state where vaccine was administered. Presented to ED and diagnosed with VTE, placed on rivaroxaban and referred to hematologist.
Age: 24.0
Sex: F
Vaccine: COVID19
Symptoms: Rash pruritic
Clinical narrative: Rash, Approximately 2 inches in diameter, itchy
Age: 40.0
Sex: M
Vaccine: COVID19
Symptoms: Immediate post-injection reaction, Seizure
Clinical narrative: Patient had a seizure/convulsion immediately after the vaccination. I did not personally see them have the convulsion, but his wife observed this. By the time I had made it to the vehicle he had come to and was fine. Patient was also extremely anxious about receiving the vaccination. We believe his anxiety may have manifested as a seizure/convulsion in some way. No other issues or allergic reactions.
Age: 16.0
Sex: F
Vaccine: COVID19
Symptoms: No adverse event, Product administered to patient of inappropriate age
Clinical narrative: No adverse event noted at this time.  Patient was a 16 year old that was administered Moderna vaccine.  Person completing this form was not the person that administered the vaccine.
Age: 28.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Anaphylactic reaction
Clinical narrative: Anaphylactic reaction requiring epinepharine
Age: 28.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Anaphylactic reaction, Confusional state, Headache, Pharyngeal swelling, Swollen tongue
Clinical narrative: Anaphylactic reaction requiring epinepharine
Age: 49.0
Sex: M
Vaccine: COVID19
Symptoms: Back injury, Blood pressure normal, Fall, Feeling abnormal, Loss of consciousness
Clinical narrative: 9 hours after shoot woke up feeling very poorly and feverish.  Went to take Tylenol and passed out.  Came to with wife shaking my arm.  Suffered trauma to noise and back during fall as a result of passing out including laceration from hitting face on counter.  After coming to sever body shakes.  Temperature was taken twice and recorded 92.5 and 93.0.  Blood pressure and pulse after moving to couch to lie sit down was normal.  Next day couldn't do much and was very tired.  By second day I was recovered but sealing with injuries from the fall.
Age: 49.0
Sex: M
Vaccine: COVID19
Symptoms: Nasal injury, Pyrexia, Skin laceration, Tremor
Clinical narrative: 9 hours after shoot woke up feeling very poorly and feverish.  Went to take Tylenol and passed out.  Came to with wife shaking my arm.  Suffered trauma to noise and back during fall as a result of passing out including laceration from hitting face on counter.  After coming to sever body shakes.  Temperature was taken twice and recorded 92.5 and 93.0.  Blood pressure and pulse after moving to couch to lie sit down was normal.  Next day couldn't do much and was very tired.  By second day I was recovered but sealing with injuries from the fall.
Age: 53.0
Sex: F
Vaccine: COVID19
Symptoms: Paraesthesia oral
Clinical narrative: My tongue feels asleep - pins and needles all day long.
Age: 44.0
Sex: F
Vaccine: COVID19
Symptoms: Anxiety, Dizziness, Dyspnoea, Panic attack
Clinical narrative: Patient was extremely anxious prior to receiving Pfizer IM injection. Once she received the vaccination she reported that she was having ?trouble breathing?. She stated she has asthma and that she needed her inhaler. She pulled a benadryl from her pocket and took it. Patient denied feeling any swelling in her throat. Two nurses stayed with the patient until she stated she was feeling better. Nurse escorted the patient to the observation area. After sitting in the observation area for several minutes the patient had used her inhaler and stated that she felt like she was going to pass out. 911 was called, the patient was assisted to the floor, vitals were monitored BP 170/90 HR 148 R16; Spo2 100%. Both Nurses stayed with the patient until EMS arrived to educate relaxation techniques and deep breathing. Patient was taken to the hospital via ambulance.  While waiting for EMS that patient had called her daughter and stated she was having a ?panic attack? her daughter stated ?what is wrong with you, you need to get help?. Patient reports having a long history with anxiety.
Age: 48.0
Sex: M
Vaccine: COVID19
Symptoms: Disturbance in attention, Feeling abnormal, Mental impairment
Clinical narrative: Brain fog, loss of concentration, unable to think clearly. Rest when possible, step away from computer, walk briefly. Still unable to concentrate for 24 hours. Mainly noticed while trying to focus on work, creative thinking necessary to do work, coordinating activities, multi-step mental steps are difficult. The symptom lasted approximately 24 hours the first time (3/22/21), and again at least for 8 hours on 3/24/21.
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Acoustic stimulation tests, Deafness neurosensory, Tinnitus
Clinical narrative: tinnitus bilateral 2 days after injection
Age: 58.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Dizziness, Dyspnoea, Flushing, Paraesthesia
Clinical narrative: Patient got second dose at 845am this morning. Around 9am, patient started feeling light headed and flushed, with tingly fingers. Patient was given water and juice, started to recover. At 0945am, client started feeling that her "breathing" was "off", and was having chills. Medics called over to assess patient, vital signs taken and listed below. Client was able to safely ambulate and began to feel better with walking. Client was reassured. Client was deemed stable/recovered and discharged home without the need for additional care.