chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 67.0
Sex: F
Vaccine: VARZOS
Symptoms: Cough, Erythema, Inappropriate schedule of product administration, Influenza like illness, Injection site pain
Clinical narrative: Drug dose administration interval too long; Injection site reaction; redness from her shoulder to her elbow; Deep cough in chest; Flu-like symptoms; This case was reported by a pharmacist via call center representative and described the occurrence of injection site pain in a 67-year-old female patient who received Herpes zoster (Shingrix) (batch number 99D9F, expiry date unknown) for prophylaxis.   Previously administered products included Shingrix with an associated reaction of injection site reaction (received 1st dose on 8th October 2018, refer case US2019107209).   On 4th June 2019, the patient received the 2nd dose of Shingrix. On 4th June 2019, unknown after receiving Shingrix, the patient experienced drug dose administration interval too long. In June 2019, the patient experienced injection site pain, erythema, cough and influenza-like symptoms. Rechallenge with Shingrix was positive. On an unknown date, the outcome of the injection site pain, erythema, cough, influenza-like symptoms and drug dose administration interval too long were unknown.   It was unknown if the reporter considered the injection site pain, erythema, cough and influenza-like symptoms to be related to Shingrix.  Additional details were provided as follows: The age at vaccination was not reported. The patient received Shingrix in left arm. The pharmacist stated that the patient experienced injection site reactions. The reaction was worse with redness from her shoulder to her elbow; the redness was still ongoing at the site and developed a deep cough in her chest and flu-like symptoms.  The pharmacist notes the injection was given by a rotating pharmacist.  She states the patient gives permission for GlaxoSmithKline to reach out to her.  The patient provided the pharmacist with a phone number if safety needs to follow up directly. The pharmacist also consents to follow up.
Age: 67.0
Sex: F
Vaccine: VARZOS
Symptoms: Vaccine positive rechallenge
Clinical narrative: Drug dose administration interval too long; Injection site reaction; redness from her shoulder to her elbow; Deep cough in chest; Flu-like symptoms; This case was reported by a pharmacist via call center representative and described the occurrence of injection site pain in a 67-year-old female patient who received Herpes zoster (Shingrix) (batch number 99D9F, expiry date unknown) for prophylaxis.   Previously administered products included Shingrix with an associated reaction of injection site reaction (received 1st dose on 8th October 2018, refer case US2019107209).   On 4th June 2019, the patient received the 2nd dose of Shingrix. On 4th June 2019, unknown after receiving Shingrix, the patient experienced drug dose administration interval too long. In June 2019, the patient experienced injection site pain, erythema, cough and influenza-like symptoms. Rechallenge with Shingrix was positive. On an unknown date, the outcome of the injection site pain, erythema, cough, influenza-like symptoms and drug dose administration interval too long were unknown.   It was unknown if the reporter considered the injection site pain, erythema, cough and influenza-like symptoms to be related to Shingrix.  Additional details were provided as follows: The age at vaccination was not reported. The patient received Shingrix in left arm. The pharmacist stated that the patient experienced injection site reactions. The reaction was worse with redness from her shoulder to her elbow; the redness was still ongoing at the site and developed a deep cough in her chest and flu-like symptoms.  The pharmacist notes the injection was given by a rotating pharmacist.  She states the patient gives permission for GlaxoSmithKline to reach out to her.  The patient provided the pharmacist with a phone number if safety needs to follow up directly. The pharmacist also consents to follow up.
Age: 6.0
Sex: M
Vaccine: VARZOS
Symptoms: No adverse event, Wrong product administered
Clinical narrative: The Shingrix vaccine was given in error in place of Flucelvax. His grandmother was supposed to get the shingrix. He was crying, kicking and giving a really hard time prior to vaccine being giving. To calm him down the correct vaccine I place back in the bin and it took 3 adults to hold him down to get the vaccine bc his mom was inisting to give it and during that time is when I grabbed the wrong vaccine and gave it to him in error. I noticed the mistake right after vaccine was injected. Pt has experienced no adverse effects known to date, have followed up with his mom 2-3 times since event.
Age: 52.0
Sex: F
Vaccine: VARZOS
Symptoms: Abnormal behaviour, Aphasia, Confusional state, Dyskinesia, Echocardiogram normal
Clinical narrative: On 7/8/19 while preparing for vacation, patient began acting a bit unlike her usual self the night before leaving.  The morning (4:30am) of the trip she said she was not feeling great but we all seemed to think this was due to lack of sleep.  When we drove to the airport about 2 hours later she began showing signs of confusion and had obvious trouble with word finding. She also had some occasional "tick like" jerking of her arms/legs.  She could not tell what year it was.   We were taken to hospital.  Stroke was ruled out from MRI.  An abnormal EEG indicated a weakness toward seizure activity. A lumber puncture the next day indicated inflammation in the spinal fluid with an slightly abnormal high viral count.  After 24 hours her symptoms had cleared completely.  She was released from the hospital after 2 nights.
Age: 52.0
Sex: F
Vaccine: VARZOS
Symptoms: Electroencephalogram abnormal, Feeling abnormal, Lumbar puncture abnormal, Magnetic resonance imaging normal, Scan with contrast normal
Clinical narrative: On 7/8/19 while preparing for vacation, patient began acting a bit unlike her usual self the night before leaving.  The morning (4:30am) of the trip she said she was not feeling great but we all seemed to think this was due to lack of sleep.  When we drove to the airport about 2 hours later she began showing signs of confusion and had obvious trouble with word finding. She also had some occasional "tick like" jerking of her arms/legs.  She could not tell what year it was.   We were taken to hospital.  Stroke was ruled out from MRI.  An abnormal EEG indicated a weakness toward seizure activity. A lumber puncture the next day indicated inflammation in the spinal fluid with an slightly abnormal high viral count.  After 24 hours her symptoms had cleared completely.  She was released from the hospital after 2 nights.
Age: 52.0
Sex: F
Vaccine: VARZOS
Symptoms: Seizure, Viral load increased
Clinical narrative: On 7/8/19 while preparing for vacation, patient began acting a bit unlike her usual self the night before leaving.  The morning (4:30am) of the trip she said she was not feeling great but we all seemed to think this was due to lack of sleep.  When we drove to the airport about 2 hours later she began showing signs of confusion and had obvious trouble with word finding. She also had some occasional "tick like" jerking of her arms/legs.  She could not tell what year it was.   We were taken to hospital.  Stroke was ruled out from MRI.  An abnormal EEG indicated a weakness toward seizure activity. A lumber puncture the next day indicated inflammation in the spinal fluid with an slightly abnormal high viral count.  After 24 hours her symptoms had cleared completely.  She was released from the hospital after 2 nights.
Age: 26.0
Sex: F
Vaccine: MMR, VARCEL
Symptoms: Pruritus, Urticaria
Clinical narrative: 1 hive on cheek developed shortly after receiving both vaccines, also reported itching face resolved on own without intervention
Age: 41.0
Sex: M
Vaccine: FLU4, HEP, HEPA, PPV, TDAP
Symptoms: Hypersomnia, Pyrexia
Clinical narrative: pt called to state he had developed a fever that night after the vaccine.  He called the next morning and stated his fever was 102 that day and that he had taken 650mg of APAP. Pt has kidney failure so he could not take any NSAIDs. He was told to have a cool bath and continue APAP every 6 hours.  Called pt the next day, his fever had reduced to 100 that day.  He said he had been resting and sleeping a lot to try to combat the fever.  Spoke the the patient 3 days later and he said his temperature returned to normal the 3rd day.
Age: 64.0
Sex: M
Vaccine: HEPA
Symptoms: No adverse event, Wrong product administered
Clinical narrative: Patient was given a pediatric dose of Hepatitis A for his second dose in the series.  He did not have any adverse reaction to this vaccine.  The incident was caught immediately and discussed with patient.  The office was out of adult Hepatitis A, so patient was instructed that he would be given the adult Hep A, 2nd dose, at his next office visit.
Age: 64.0
Sex: M
Vaccine: PPV
Symptoms: Dizziness, Peripheral swelling, Rash
Clinical narrative: PATIENT CALLED THE DAY AFTER VACCINE ADMINISTRATION COMPLAINING OF A SWOLLEN ARM WITH A RASH AS WELL.HE WAS ADVISED TO TAKE BENADRYL AND TYLENOL AND GO TO THE HOSPITAL,URGENT CARE OR HIS DOCTOR.A COUPLE OF HOURS LATER PATIENT REPORTED HE WAS FEELING NO BETTER AND WAS ALSO FEELING LIGHT HEADED. HE HAD TO GO TO THE MERGENCY ROOM AND LAST I SPOKE WITH THE PATIENT'S WIFE HE WAS ON IV STEROIDS AND WAS BEING MONITORED
Age: 3.0
Sex: M
Vaccine: HEP, IPV
Symptoms: Decreased appetite, Fatigue, Retching, Vomiting
Clinical narrative: Three days after his vaccine, my son woke up not very hungry and before he ate breakfast, he started to vomit everything that was in his stomach. That began at 8:00. We gave him some oat milk after that and within five minutes he'd thrown it up. We then tried water and within five minutes he'd thrown that up too. He was tired and dry heaving every fifteen minutes until about 900. Then he only vomited if he drank water. By 10:00 he was asleep again. he woke up at 1:00 he drank  some water, threw it up, but he seemed more awake. We waited a half hour, so 130 we tried water again and he didn't throw it up. By 2:00 I gave him a banana and he didn't throw up again. By 3:00 he was eating regularly again.
Age: 73.0
Sex: F
Vaccine: PPV
Symptoms: Erythema, Pain, Skin irritation, Swelling
Clinical narrative: A few hrs. after administration of vaccine patient reported local pain and irritation.  Next day she came in and had local pain, swelling and redness.
Age: 18.0
Sex: F
Vaccine: MENB
Symptoms: Expired product administered, No adverse event
Clinical narrative: EXPIRED VACCINE  8/31/2019  WAS GIVEN BY ACCIDENT AT AROUND 2:45PM. PATIENT DID NOT REPORT ANY ADVERSE EVENT AT THIS MOMENT
Age: 1.0
Sex: F
Vaccine: MMR, PNC13, VARCEL
Symptoms: Pyrexia, Urticaria
Clinical narrative: About 6 days after my daughter received  her routine 12 month shots, she developed hives all over her body. Spots included: belly button, inner thighs, arm pits, eye lids, back of her neck, and torso. I figured it was just a normal reaction to the measles shot so I took her to the pediatrician just to be sure. They informed me it was not a normal reaction to MMR shot, but that it was hives. The told me it was something she came in contact with, food or household items that she was allergic to. However, all the food or other products she has had since then or before that date and never had hives. She had the hives for a fee weeks. We visited the pediatrician twice during that time and the urgent care once due to the hives and a strong fever. Nothing they prescribed worked. They prescribed benadryl and hydrocortisone ointment. Every time we visited for this matter, they said it was nuts, eggs, shellfish, milk. Since she was 12 months, we have given her these food items on a regular basis, weekly, and no hives. Hives have not come back since this time period.
Age: 65.0
Sex: M
Vaccine: VARZOS
Symptoms: Arthralgia, Diarrhoea, Fatigue, Feeling abnormal, Headache
Clinical narrative: Patient was down from the shot for 4-5days in bed. He didn't take any OTC supplements and complained of nausea,extreme fatigue, joint pain, severe headaches and diarhea
Age: 65.0
Sex: M
Vaccine: VARZOS
Symptoms: Nausea
Clinical narrative: Patient was down from the shot for 4-5days in bed. He didn't take any OTC supplements and complained of nausea,extreme fatigue, joint pain, severe headaches and diarhea
Age: 0.33
Sex: M
Vaccine: DTAPHEPBIP, HIBV, PNC13, RV1
Symptoms: Crying, Hypotonia, Lethargy, Pallor
Clinical narrative: The baby reportedly was well prior to his vaccines. Cried briefly after vaccinations (20 seconds). Feel asleep in his mother's arms, but approx. 5-10min after she noted he was pale and lethargic with poor tone. He improved with stimulation and at time of clinic visit approx. 20min after his vaccines had recovered back to baseline.
Age: 78.0
Sex: F
Vaccine: VARZOS
Symptoms: Alanine aminotransferase increased, Arthralgia, Aspartate aminotransferase increased, Bacteraemia, Bilirubin conjugated increased
Clinical narrative: Patient was in her usual state of health at home on 02 Sep 2019, when she developed fairly sudden onset of severe R shoulder and arm pain.  Evaluated in ED and found to have low-grade fever, swelling and redness extending from right chest area thru right shoulder and arm, and severe R arm pain, limiting any movement.  Admitted to Internal Medicine on 03 Sep 2019.    Initial concern for infxn prompted empiric abx.  Tx resulted in resolution of swelling and redness, and reduction in pain - although 8/10 R shoulder and R wrist pain persist.  Care team questioned whether Shingrix vaccine (RZV, dose #1, administered IM in R deltoid on 09 Aug 2019) could be related to persistent R arm pain.  Immunization Healthcare team consulted.
Age: 78.0
Sex: F
Vaccine: VARZOS
Symptoms: Blood albumin decreased, Blood alkaline phosphatase increased, Blood bilirubin increased, Blood calcium decreased, Blood culture negative
Clinical narrative: Patient was in her usual state of health at home on 02 Sep 2019, when she developed fairly sudden onset of severe R shoulder and arm pain.  Evaluated in ED and found to have low-grade fever, swelling and redness extending from right chest area thru right shoulder and arm, and severe R arm pain, limiting any movement.  Admitted to Internal Medicine on 03 Sep 2019.    Initial concern for infxn prompted empiric abx.  Tx resulted in resolution of swelling and redness, and reduction in pain - although 8/10 R shoulder and R wrist pain persist.  Care team questioned whether Shingrix vaccine (RZV, dose #1, administered IM in R deltoid on 09 Aug 2019) could be related to persistent R arm pain.  Immunization Healthcare team consulted.
Age: 78.0
Sex: F
Vaccine: VARZOS
Symptoms: Blood glucose increased, Blood potassium decreased, C-reactive protein increased, Computerised tomogram abdomen abnormal, Computerised tomogram head abnormal
Clinical narrative: Patient was in her usual state of health at home on 02 Sep 2019, when she developed fairly sudden onset of severe R shoulder and arm pain.  Evaluated in ED and found to have low-grade fever, swelling and redness extending from right chest area thru right shoulder and arm, and severe R arm pain, limiting any movement.  Admitted to Internal Medicine on 03 Sep 2019.    Initial concern for infxn prompted empiric abx.  Tx resulted in resolution of swelling and redness, and reduction in pain - although 8/10 R shoulder and R wrist pain persist.  Care team questioned whether Shingrix vaccine (RZV, dose #1, administered IM in R deltoid on 09 Aug 2019) could be related to persistent R arm pain.  Immunization Healthcare team consulted.
Age: 78.0
Sex: F
Vaccine: VARZOS
Symptoms: Echocardiogram abnormal, Erythema, Fibrin D dimer increased, Gram stain positive, Injected limb mobility decreased
Clinical narrative: Patient was in her usual state of health at home on 02 Sep 2019, when she developed fairly sudden onset of severe R shoulder and arm pain.  Evaluated in ED and found to have low-grade fever, swelling and redness extending from right chest area thru right shoulder and arm, and severe R arm pain, limiting any movement.  Admitted to Internal Medicine on 03 Sep 2019.    Initial concern for infxn prompted empiric abx.  Tx resulted in resolution of swelling and redness, and reduction in pain - although 8/10 R shoulder and R wrist pain persist.  Care team questioned whether Shingrix vaccine (RZV, dose #1, administered IM in R deltoid on 09 Aug 2019) could be related to persistent R arm pain.  Immunization Healthcare team consulted.
Age: 78.0
Sex: F
Vaccine: VARZOS
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Mitral valve incompetence, Monocyte count increased
Clinical narrative: Patient was in her usual state of health at home on 02 Sep 2019, when she developed fairly sudden onset of severe R shoulder and arm pain.  Evaluated in ED and found to have low-grade fever, swelling and redness extending from right chest area thru right shoulder and arm, and severe R arm pain, limiting any movement.  Admitted to Internal Medicine on 03 Sep 2019.    Initial concern for infxn prompted empiric abx.  Tx resulted in resolution of swelling and redness, and reduction in pain - although 8/10 R shoulder and R wrist pain persist.  Care team questioned whether Shingrix vaccine (RZV, dose #1, administered IM in R deltoid on 09 Aug 2019) could be related to persistent R arm pain.  Immunization Healthcare team consulted.
Age: 78.0
Sex: F
Vaccine: VARZOS
Symptoms: Neutrophil count decreased, Pain in extremity, Peripheral swelling, Platelet count decreased, Protein total decreased
Clinical narrative: Patient was in her usual state of health at home on 02 Sep 2019, when she developed fairly sudden onset of severe R shoulder and arm pain.  Evaluated in ED and found to have low-grade fever, swelling and redness extending from right chest area thru right shoulder and arm, and severe R arm pain, limiting any movement.  Admitted to Internal Medicine on 03 Sep 2019.    Initial concern for infxn prompted empiric abx.  Tx resulted in resolution of swelling and redness, and reduction in pain - although 8/10 R shoulder and R wrist pain persist.  Care team questioned whether Shingrix vaccine (RZV, dose #1, administered IM in R deltoid on 09 Aug 2019) could be related to persistent R arm pain.  Immunization Healthcare team consulted.
Age: 78.0
Sex: F
Vaccine: VARZOS
Symptoms: Pyrexia, Red blood cell sedimentation rate increased, Swelling, Thrombosis, Ultrasound scan normal
Clinical narrative: Patient was in her usual state of health at home on 02 Sep 2019, when she developed fairly sudden onset of severe R shoulder and arm pain.  Evaluated in ED and found to have low-grade fever, swelling and redness extending from right chest area thru right shoulder and arm, and severe R arm pain, limiting any movement.  Admitted to Internal Medicine on 03 Sep 2019.    Initial concern for infxn prompted empiric abx.  Tx resulted in resolution of swelling and redness, and reduction in pain - although 8/10 R shoulder and R wrist pain persist.  Care team questioned whether Shingrix vaccine (RZV, dose #1, administered IM in R deltoid on 09 Aug 2019) could be related to persistent R arm pain.  Immunization Healthcare team consulted.
Age: 78.0
Sex: F
Vaccine: VARZOS
Symptoms: X-ray limb abnormal
Clinical narrative: Patient was in her usual state of health at home on 02 Sep 2019, when she developed fairly sudden onset of severe R shoulder and arm pain.  Evaluated in ED and found to have low-grade fever, swelling and redness extending from right chest area thru right shoulder and arm, and severe R arm pain, limiting any movement.  Admitted to Internal Medicine on 03 Sep 2019.    Initial concern for infxn prompted empiric abx.  Tx resulted in resolution of swelling and redness, and reduction in pain - although 8/10 R shoulder and R wrist pain persist.  Care team questioned whether Shingrix vaccine (RZV, dose #1, administered IM in R deltoid on 09 Aug 2019) could be related to persistent R arm pain.  Immunization Healthcare team consulted.
Age: 50.0
Sex: M
Vaccine: VARZOS
Symptoms: Chills, Dermatitis bullous, Photosensitivity reaction, Pyrexia, Skin burning sensation
Clinical narrative: Phototoxicity -Severe burning to sun exposed areas esp areas not previously having tanned.  Fever and chills for 24 hrs and severe pain lasting over 1 week and multiple day long dermal reaction consisting of numerous evenescent  vesiculo  bullous lesion that responded well to antihistamines and steroid
Age: 50.0
Sex: M
Vaccine: VARZOS
Symptoms: Skin reaction
Clinical narrative: Phototoxicity -Severe burning to sun exposed areas esp areas not previously having tanned.  Fever and chills for 24 hrs and severe pain lasting over 1 week and multiple day long dermal reaction consisting of numerous evenescent  vesiculo  bullous lesion that responded well to antihistamines and steroid
Age: 79.0
Sex: F
Vaccine: VARZOS
Symptoms: Injected limb mobility decreased, Injection site erythema, Injection site pain, Injection site swelling
Clinical narrative: redness/swelling/pain at the injection site after the injection. The patients husband said she was having trouble lifting her arm and was only able to lift her arm using her other arm. The patients husband said he has given her tylenol.
Age: 69.0
Sex: M
Vaccine: FLUA3
Symptoms: Urticaria
Clinical narrative: Hives all over my body, took some Benadryl, and a few hours later it subsided
Age: 78.0
Sex: M
Vaccine: PNC13
Symptoms: Extra dose administered, Wrong product administered
Clinical narrative: The patient came to the pharmacy requesting to receive a pneumococcal vaccine.  We administered Prevnar 13, in accordance with ACIP guidelines, because the patient is over age 65 and confirmed he had never received a pneumococcal vaccine before.  After sending the vaccine administration record to the patient's primary care provider, I received a call from nurse.  She also administered Prevnar 13 earlier that day.  The patient was supposed to ask for Shingrix, but he thought that was the one administered at his doctor's office.  I followed up with the patient and encouraged him to monitor and report adverse effects.  The patient will come in at a later date to receive the intended Shingrix vaccination.
Age: 67.0
Sex: F
Vaccine: VARZOS
Symptoms: Chills, Loss of consciousness
Clinical narrative: Pt came in about 2 months later and said that after the shot they got chills that night and then the next morning  ended up passing out on the bathroom floor for an entire day, woke up and was fine
Age: 57.0
Sex: F
Vaccine: VARZOS
Symptoms: Chills, Pain, Pain in extremity, Pyrexia
Clinical narrative: Fever, chills, body aches,, soreness in right arm
Age: 71.0
Sex: M
Vaccine: VARZOS
Symptoms: Fatigue, Injection site pain
Clinical narrative: Woke up at 6 am  (9/10/2019) and felt fine, not even any pain at the injection site. BY 10 am I was feeling totally exhausted/tired, and the injection site started to get painful. The level of exhaustion was extreme and kept getting worse so I came home and tried to take nap..unsuccessfully.  It is now 4 pm and I am still exhausted and my injection site is painful.
Age: 65.0
Sex: F
Vaccine: VARZOS
Symptoms: Chills, Dizziness, Dry mouth, Mean cell haemoglobin increased, Mean cell volume increased
Clinical narrative: Intense chills and nausea. Dizziness. Dry-mouth and thirst. 101 temperature began around 9 PM, about 12 hours after the vaccine was administered, spiked at 101.6 around 3AM and stayed over 101 until about 8AM the next day. Continued slight nausea and low-grade fever (99) for another 6 hours.
Age: 65.0
Sex: F
Vaccine: VARZOS
Symptoms: Nausea, Neutrophil count decreased, Pyrexia, Thirst, White blood cell count decreased
Clinical narrative: Intense chills and nausea. Dizziness. Dry-mouth and thirst. 101 temperature began around 9 PM, about 12 hours after the vaccine was administered, spiked at 101.6 around 3AM and stayed over 101 until about 8AM the next day. Continued slight nausea and low-grade fever (99) for another 6 hours.
Age: 11.0
Sex: M
Vaccine: MNQ, TDAP
Symptoms: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth
Clinical narrative: right upper arm swelling and itching noted 12 hours after injection. 4.5inx5in of erythema, warmth. No fluctuance or drainage from injection site. OTC treatment cold packs, hydrocortisone cream for itch, oral OTC benadryl if worsening itch. Monitor for signs of systemic allergic reaction or infection and follow up as needed.
Age: 73.0
Sex: F
Vaccine: VARZOS
Symptoms: Erythema, Injection site erythema, Injection site pain, Injection site rash, Rash macular
Clinical narrative: patient states the day after the vaccination she experienced rash and spots at site of injection and states they are painful and red but not itchy.    I followed up with her today 3 days post vaccination and she states the arm is blotchy with a red color but that it is fading and getting better.  She claims no issue with movement or pain today.
Age: 4.0
Sex: M
Vaccine: MMRV
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth, Pruritus, Rash
Clinical narrative: Redness , warmth and some slight swelling at the injections site, rash on face, itchy skin. No fever and child was active at school and had an appetite. Dr. contacted regarding this matter and per Dr. ok for client  to take some ibuprofen or  Benadryl and ice the area of swelling.  Parents to monitor child and if symptoms persist or get worse then they are to follow up with PCP.  Parents verbalized understanding and agreement.   Nurse to call parents tomorrow morning and follow up.
Age: 23.0
Sex: M
Vaccine: FLUR4
Symptoms: Dyspnoea, Hyperhidrosis, Peripheral swelling
Clinical narrative: Swollen hand, heavy breathing, sweaty (also thought he might be having a panic attack)
Age: 72.0
Sex: M
Vaccine: FLU3, PNC13
Symptoms: Abdominal discomfort, Chills, Headache, Pain, Pyrexia
Clinical narrative: Chills - Fever (101.4) - Upset Stomach - Body Ache - Head Ache - Tinnitus Symptoms subsided after 12 hours.
Age: 72.0
Sex: M
Vaccine: FLU3, PNC13
Symptoms: Tinnitus
Clinical narrative: Chills - Fever (101.4) - Upset Stomach - Body Ache - Head Ache - Tinnitus Symptoms subsided after 12 hours.
Age: 11.0
Sex: F
Vaccine: TDAP
Symptoms: Headache, Influenza like illness, Nausea, Pyrexia
Clinical narrative: Woke up with a headache. Went to school and the headache got worse throughout the day. Was feeling so bad by the end of school she was unable to ride the bus because she was so nauseated. Displaying flu like symptoms.  Slept 3 hrs after school and still has headache. Dispensed Tylenol for headache and Mild fever.
Age: 58.0
Sex: F
Vaccine: VARZOS
Symptoms: Blood test normal, Fatigue, Headache, Pyrexia
Clinical narrative: I had very high fever the first night, and high fever for the next five days, with headache and fatigue. I am approaching a month since the vaccine and I still have almost constant headache, fatigue, and fever between 99.3 and 99.5 (axillary).
Age: 32.0
Sex: F
Vaccine: FLUC4
Symptoms: Pruritus generalised, Pyrexia
Clinical narrative: Patient stated that she had a slight fever and was itching all over.  I did not see a full rash on her body.
Age: 73.0
Sex: F
Vaccine: VARZOS
Symptoms: Rash
Clinical narrative: small, non painful rash that lasted about 2 days
Age: 23.0
Sex: F
Vaccine: FLU4
Symptoms: Dizziness, Hyperhidrosis, Pallor, Tremor
Clinical narrative: After receiving vaccination, patient reported feeling light headed.  She was visibly pale, sweating and shaking.  We gave her ice water, candy, put an ice pack on her neck and within 15 minutes the patient was fine.  We rechecked her in 45 minutes and the patient was not having any recurring symptoms.
Age: 61.0
Sex: M
Vaccine: VARZOS
Symptoms: Chills, Headache, Myalgia, Nausea, Poor quality sleep
Clinical narrative: about 13 hours after getting vaccine, pt woke up shivering/shaking violently--reported as "almost felt like convulsions" lasting more than 1 hour.  he almost called 911 ----pt was extremely nauseous and took pepto-bismol.  never vomited.  also had a massive headache.  felt like he had a fever, but took no temp.  went back to bed.  did not sleep well.  reported every muscle in his body being very sore, from head to toe for the next few days.
Age: 61.0
Sex: M
Vaccine: VARZOS
Symptoms: Pyrexia, Seizure like phenomena, Tremor
Clinical narrative: about 13 hours after getting vaccine, pt woke up shivering/shaking violently--reported as "almost felt like convulsions" lasting more than 1 hour.  he almost called 911 ----pt was extremely nauseous and took pepto-bismol.  never vomited.  also had a massive headache.  felt like he had a fever, but took no temp.  went back to bed.  did not sleep well.  reported every muscle in his body being very sore, from head to toe for the next few days.
Age: 67.0
Sex: M
Vaccine: FLU3
Symptoms: Erythema, Pain, Peripheral swelling, Skin warm
Clinical narrative: I've never had a reaction to a flu shot, other than minor soreness lasting a few hours. In this case, I had significant soreness for 48 hours, and swelling that has yet to cease (78 hours after injection). The swelling was originally in the upper arm.  It is now also in the lower arm (forearm).  The arm is warm to the touch and the skin is red.  As for treatment, I've been putting an ice-pack on it. That seems to help. The side effects warning mentioned soreness and swelling for 1 - 2 days. It's been 3.25 days so far, so I thought I'd report it.
Age: 57.0
Sex: M
Vaccine: VARZOS, VARZOS, VARZOS
Symptoms: Asthenia, Fibromyalgia, Laboratory test abnormal, Lethargy, Pain
Clinical narrative: PAIN THROUGHOUT MY BODY/ESPECIALLY IN MY SHOULDERS, BACK, GROIN, HIPS, LEGS AND UPPER ARMS. LETHARGIC, LOWER BODY/HIP WEAKNESS. PAIN IN ELBOWS/SHOULDERS WHEN TRYING TO GET OUT OF CHAIRS, TO NAME BUT A FEW.POSSIBLE SHINGLES ISSUES ARE MENTIONED PER NOTES IN , JAN 2019, JULY 2019, JUNE 2019  AND I COMPLAINED ABOUT THE SIDE EFFECTS I WAS HAVING FROM APRIL 2019 TO THE PRESENT DAY.
Age: 57.0
Sex: M
Vaccine: VARZOS, VARZOS, VARZOS
Symptoms: Condition aggravated, Hepatic enzyme increased, Herpes zoster, Hyperhidrosis, Myalgia
Clinical narrative: PAIN THROUGHOUT MY BODY/ESPECIALLY IN MY SHOULDERS, BACK, GROIN, HIPS, LEGS AND UPPER ARMS. LETHARGIC, LOWER BODY/HIP WEAKNESS. PAIN IN ELBOWS/SHOULDERS WHEN TRYING TO GET OUT OF CHAIRS, TO NAME BUT A FEW.POSSIBLE SHINGLES ISSUES ARE MENTIONED PER NOTES IN , JAN 2019, JULY 2019, JUNE 2019  AND I COMPLAINED ABOUT THE SIDE EFFECTS I WAS HAVING FROM APRIL 2019 TO THE PRESENT DAY.
Age: 57.0
Sex: M
Vaccine: VARZOS, VARZOS, VARZOS
Symptoms: Pyrexia, Rash, Urticaria, Vaccination failure, Vision blurred
Clinical narrative: PAIN THROUGHOUT MY BODY/ESPECIALLY IN MY SHOULDERS, BACK, GROIN, HIPS, LEGS AND UPPER ARMS. LETHARGIC, LOWER BODY/HIP WEAKNESS. PAIN IN ELBOWS/SHOULDERS WHEN TRYING TO GET OUT OF CHAIRS, TO NAME BUT A FEW.POSSIBLE SHINGLES ISSUES ARE MENTIONED PER NOTES IN , JAN 2019, JULY 2019, JUNE 2019  AND I COMPLAINED ABOUT THE SIDE EFFECTS I WAS HAVING FROM APRIL 2019 TO THE PRESENT DAY.
Age: 72.0
Sex: M
Vaccine: VARZOS
Symptoms: Rash
Clinical narrative: On Sept 3, 2019.  3 days after the vaccination rashes in front and back part of  the body was developed. When he came to the Pharmacy to show it to me I told him to take Benadryl over the counter. He made an appointment to his Doctor on Thursday and showed it to his MD and was told to continue taking the Beandryl. Today, 9-10-2019 all the rashes was all cleared.
Age: 79.0
Sex: M
Vaccine: FLU4
Symptoms: Abdominal pain
Clinical narrative: Extreme abdominal pain for approximately 90 minutes.
Age: 95.0
Sex: F
Vaccine: FLU3
Symptoms: Contusion, Injection site warmth, Swelling
Clinical narrative: Swelling and bruising in a semi-circle 3 inches in diameter.  Pt claims there is a little warmth from the site but no pain or discomfort.
Age: 77.0
Sex: M
Vaccine: VARZOS
Symptoms: Injection site reaction, Muscle swelling, Ultrasound scan abnormal
Clinical narrative: PATIENT NOTICED 2 BULGED MUSCLES NEAR THE SITE OF VACCINATION A FEW DAYS AFTER. IT IS NOT OBVIOUS FROM FRONTAL VIEW BUT ON SIDE VIEW ONE BULGE IS ON TOP LEFT SHOULDER AND ANOTHER ONE A THE BACK OF THE ARM. HE EXPERIENCES NO PAIN, NO SWELLING NOR REDNESS AT SITE. PATIENT TO TO SEE HIS PCP ON 8/9/2019 TO ASSESS  WHAT MAY BE THE CAUSE OF BULGES MUSCLES. DR ORDERED ULTRASOUND SCAN.
Age: 21.0
Sex: M
Vaccine: ANTH, JEV1, SMALL
Symptoms: Dyspnoea, Full blood count, Herpes simplex test, Injection site scab, Metabolic function test
Clinical narrative: Pt received Smallpox vaccination on 16AUG19 on the left upper arm and had first check up on 29AUG19 at Immunization. Pt had normal reaction on the vaccination site without any remarkable symptoms or adverse reactions at the check up. Pt started to have rash spreading out all aver left arm with itching from 7SEP19. Pt currently has a scab in normal process on the vaccination site and has 2 additional pruritic lesions sized less than 1cm on left upper arm distal to the vaccination site. Pt also has pruritic rash spreading out on both arms and both thighs. V/S with in normal range, no fever. Pt denied any other symptoms, chest congestion or pain and difficulty breathing. Pt denied any medical history related to skin condition or weaken immunity but there is Agency encounters documented in AUG and SEP2016 that  state he was prescribed oral antibiotics and doxycycline for acne vulgaris but had possible allergic reaction(or dermatitis) after using those medications. Denied CP/SOB/abd pain/fever/chills/N/V.  Completed Smallpox Screening sheet by Pt on 19AUG is not in the website. .
Age: 21.0
Sex: M
Vaccine: ANTH, JEV1, SMALL
Symptoms: Pruritus, Rash, Rash pruritic, Skin lesion, Vaccination site reaction
Clinical narrative: Pt received Smallpox vaccination on 16AUG19 on the left upper arm and had first check up on 29AUG19 at Immunization. Pt had normal reaction on the vaccination site without any remarkable symptoms or adverse reactions at the check up. Pt started to have rash spreading out all aver left arm with itching from 7SEP19. Pt currently has a scab in normal process on the vaccination site and has 2 additional pruritic lesions sized less than 1cm on left upper arm distal to the vaccination site. Pt also has pruritic rash spreading out on both arms and both thighs. V/S with in normal range, no fever. Pt denied any other symptoms, chest congestion or pain and difficulty breathing. Pt denied any medical history related to skin condition or weaken immunity but there is Agency encounters documented in AUG and SEP2016 that  state he was prescribed oral antibiotics and doxycycline for acne vulgaris but had possible allergic reaction(or dermatitis) after using those medications. Denied CP/SOB/abd pain/fever/chills/N/V.  Completed Smallpox Screening sheet by Pt on 19AUG is not in the website. .
Age: 21.0
Sex: M
Vaccine: ANTH, JEV1, SMALL
Symptoms: Varicella virus test
Clinical narrative: Pt received Smallpox vaccination on 16AUG19 on the left upper arm and had first check up on 29AUG19 at Immunization. Pt had normal reaction on the vaccination site without any remarkable symptoms or adverse reactions at the check up. Pt started to have rash spreading out all aver left arm with itching from 7SEP19. Pt currently has a scab in normal process on the vaccination site and has 2 additional pruritic lesions sized less than 1cm on left upper arm distal to the vaccination site. Pt also has pruritic rash spreading out on both arms and both thighs. V/S with in normal range, no fever. Pt denied any other symptoms, chest congestion or pain and difficulty breathing. Pt denied any medical history related to skin condition or weaken immunity but there is Agency encounters documented in AUG and SEP2016 that  state he was prescribed oral antibiotics and doxycycline for acne vulgaris but had possible allergic reaction(or dermatitis) after using those medications. Denied CP/SOB/abd pain/fever/chills/N/V.  Completed Smallpox Screening sheet by Pt on 19AUG is not in the website. .
Age: 65.0
Sex: F
Vaccine: FLUA3, VARZOS
Symptoms: Dermatitis contact, Erythema, Peripheral swelling, Rash vesicular
Clinical narrative: -Rash similar to poison oak or chicken pox. -Swelling + redness -both legs + some arm areas.   After patient saw MD on 9/5/19 it was determined the pt had poison oak + was prescribed Medrol + Lidex cream. Pharmacy still wanted to report the adverse reaction in case there was a link.
Age: 48.0
Sex: F
Vaccine: HEPAB
Symptoms: Musculoskeletal pain, X-ray limb
Clinical narrative: -Patient experienced pain in the shoulder that did not go away for 2 months.  -Ibuprofen 600 mg, Cyclobenazeprine 5mg, Tizanidine 2mg
Age: 65.0
Sex: F
Vaccine: PNC13
Symptoms: Erythema, Pain in extremity, Skin warm
Clinical narrative: Patient came to clinic 9/10/19 with complaint of redness & warmth that started on left arm 35mm below where vaccine had been given. Area 70mm x 50mm irregular shaped & warm. Pt also reported this started 3 days after shot given but pain in arm started 1 day after shot.
Age: 55.0
Sex: F
Vaccine: VARZOS
Symptoms: Mass excision, Neck mass, Neck pain
Clinical narrative: Patient received Shingrix vaccine on 9/06/19. And three days later, on 9/09/19, she noticed of small and painful lump forming on her left lower side of the neck. Patient was advised to contact the PCP and monitor for any worsening of symptoms
Age: 15.0
Sex: M
Vaccine: HEPA, HPV9
Symptoms: Blood glucose normal, Contusion, Craniocerebral injury, Fatigue, Loss of consciousness
Clinical narrative: closed Head injury; Blood glucose normal; Contusion; Somnolence; Syncope; Fatigue; This spontaneous report as received from a regulatory authority refers to a 15 year old male patient. The patient's concurrent condition included neurofibromatosis. The patient's concomitant therapies included sertraline hydrochloride.On 26-MAY-2018 the patient was vaccinated with hpv rl1 6 11 16 18 31 33 45 52 58 vlp vaccine (yeast)(GARDASIL 9) (lot # N017686, Expiry date : 02-FEB-2020 ) dose 3, intramuscular in the left arm for prophylaxis. On the same day, the patient was also vaccinated with hepatitis a vaccine, inactivated(VAQTA) (lot # 255P3, Expiry date was not reported) dose 3, intramuscular in the left arm for prophylaxis. On 26-MAY-2018, the patient experienced blood glucose normal, syncope, somnolence, head injury, fatigue and contusion.    The outcome of blood glucose normal, syncope, somnolence, head injury, fatigue and contusion was reported as recovered/resolved. The relatedness between the events and suspect therapies was not provided.  Lot number (255P3) is an invalid lot number for hepatitis a vaccine, inactivated (VAQTA).  Follow up information has been received from health care professional via agency on 08-AUG-2019. The patient had no known drug allergies and no illness at the time of vaccination and up to one month prior vaccination. On 26-MAY-2018, the patient experienced syncope without loss of consciousness which lasted 25 minutes until back to baseline. Patient hit head against wall while fainting which caused a superficial bruise without evidence of intracranial injury. It was reported that the patient was tired and somnolent but oriented to person, place, time and condition. All vitals were normal including heat rate (HR) and Blood pressure (BP). A Point-of-care testing (POCT) glucose was normal. Patient was kept in a supine position until back to baseline and was able to walk out of the clinic unassisted. There was no medical tests and laboratory results related to the adverse event.  Follow up information has been received from a health care professional on 04-SEP-2019. The patient's demographics was added. The vaccine administrator was added. The event term was updated from head injury to closed head injury.  Upon internal review, closed head injury was determined to be medically significant.
Age: 15.0
Sex: M
Vaccine: HEPA, HPV9
Symptoms: Somnolence, Syncope
Clinical narrative: closed Head injury; Blood glucose normal; Contusion; Somnolence; Syncope; Fatigue; This spontaneous report as received from a regulatory authority refers to a 15 year old male patient. The patient's concurrent condition included neurofibromatosis. The patient's concomitant therapies included sertraline hydrochloride.On 26-MAY-2018 the patient was vaccinated with hpv rl1 6 11 16 18 31 33 45 52 58 vlp vaccine (yeast)(GARDASIL 9) (lot # N017686, Expiry date : 02-FEB-2020 ) dose 3, intramuscular in the left arm for prophylaxis. On the same day, the patient was also vaccinated with hepatitis a vaccine, inactivated(VAQTA) (lot # 255P3, Expiry date was not reported) dose 3, intramuscular in the left arm for prophylaxis. On 26-MAY-2018, the patient experienced blood glucose normal, syncope, somnolence, head injury, fatigue and contusion.    The outcome of blood glucose normal, syncope, somnolence, head injury, fatigue and contusion was reported as recovered/resolved. The relatedness between the events and suspect therapies was not provided.  Lot number (255P3) is an invalid lot number for hepatitis a vaccine, inactivated (VAQTA).  Follow up information has been received from health care professional via agency on 08-AUG-2019. The patient had no known drug allergies and no illness at the time of vaccination and up to one month prior vaccination. On 26-MAY-2018, the patient experienced syncope without loss of consciousness which lasted 25 minutes until back to baseline. Patient hit head against wall while fainting which caused a superficial bruise without evidence of intracranial injury. It was reported that the patient was tired and somnolent but oriented to person, place, time and condition. All vitals were normal including heat rate (HR) and Blood pressure (BP). A Point-of-care testing (POCT) glucose was normal. Patient was kept in a supine position until back to baseline and was able to walk out of the clinic unassisted. There was no medical tests and laboratory results related to the adverse event.  Follow up information has been received from a health care professional on 04-SEP-2019. The patient's demographics was added. The vaccine administrator was added. The event term was updated from head injury to closed head injury.  Upon internal review, closed head injury was determined to be medically significant.
Age: 1.0
Sex: F
Vaccine: HEPA, MMR, PNC13, VARCEL
Symptoms: Injection site erythema, Injection site reaction, Poor quality sleep, Pyrexia, Rash
Clinical narrative: ON 5-17-19 AT 10:25 AM MOM CALLED AND SAID PT HAD RED WELTS ON LEG, HASN'T BEEN SLEEPING WELL FOR 4 DAYS, BUMPS ALL OVER BODY, RUNNING A FEVER, GOES AWAY WITH MOTRIN. ON 5/17/2019 AT 11:35:22 AM > PER MOM THE RASH IS GETTING BETTER & HER FEVER HAS NOT GONE OVER 102 (MOTRIN BRINGS IT DOWN). MOM JUST WANTED TO LET US KNOW WHAT HAPPENED. PT'S MOM WASN'T WORRIED BECAUSE DR TOLD HER THESE COULD HAPPEN. I TOLD MOM TO TAKE PICTURES OF THE RASH & TO CALL BACK IF ANY CHANGES. MOM AGREED.
Age: 1.0
Sex: F
Vaccine: HEPA, MMR, PNC13, VARCEL
Symptoms: Urticaria
Clinical narrative: ON 5-17-19 AT 10:25 AM MOM CALLED AND SAID PT HAD RED WELTS ON LEG, HASN'T BEEN SLEEPING WELL FOR 4 DAYS, BUMPS ALL OVER BODY, RUNNING A FEVER, GOES AWAY WITH MOTRIN. ON 5/17/2019 AT 11:35:22 AM > PER MOM THE RASH IS GETTING BETTER & HER FEVER HAS NOT GONE OVER 102 (MOTRIN BRINGS IT DOWN). MOM JUST WANTED TO LET US KNOW WHAT HAPPENED. PT'S MOM WASN'T WORRIED BECAUSE DR TOLD HER THESE COULD HAPPEN. I TOLD MOM TO TAKE PICTURES OF THE RASH & TO CALL BACK IF ANY CHANGES. MOM AGREED.
Age: 67.0
Sex: F
Vaccine: VARZOS, VARZOS
Symptoms: Herpes zoster, Rash
Clinical narrative: 2 days after receiving the vaccine, a3"X3"  red, hot, rash developed.  The patient left the original band-aid on for  a week.  When she removed it, there was a lesion under the sticky part of the band-aid.  She went to see her Doctor and received a prescriptions for Valtrex.
Age: 67.0
Sex: F
Vaccine: VARZOS, VARZOS
Symptoms: Injection site reaction, Rash erythematous, Skin lesion, Skin warm
Clinical narrative: 2 days after receiving the vaccine, a3"X3"  red, hot, rash developed.  The patient left the original band-aid on for  a week.  When she removed it, there was a lesion under the sticky part of the band-aid.  She went to see her Doctor and received a prescriptions for Valtrex.
Age: 33.0
Sex: M
Vaccine: TDAP, TDAP
Symptoms: Neurological symptom, Neuropathy peripheral, Pain in extremity
Clinical narrative: 8/19/19 1600- warm/hot sensation in left leg. 1700 numbess/tingling in left foot. 1900 shower, water felt like fire.  8/20/19-numbness tingling sensation to mid calf. Feels like fire. 0800. Reported at work; where tdap shot was given. Went to ER. Waited for hours. Told if I began to have problems breathing go to the ER. 8/20/19- 1700. Out of work. Numbness/tingling/fire pain now past knee. Went to Urgent Care. ER Doctor didn?t know what to do; said yes it was adverse reaction and prescribed 100 mg Gabapentin. 8/21/19- Numbness/tingling/fire now to left thigh.  8/22/19- Contacted ER Doctor who sent STAT orders to a local Neurologist; no appointments available. Said to follow up with PCP.  8/23/19 0845: PCP appointment, Dr. Dr. did a complete physical and neuro exam and called to the nearest Trauma Center. He sent us straight to the ER. Placed in Trauma 2. 10:30 am Admitted to hospital on NeuroScience unit at 1200 noon. Numbness/tingling/fire now from left foot to lower back. Tingling/numbess beginning in right leg. 8/24/19 Neuro rounds, family attending and residents. Begin treating with high dose IV steroids. All labs are normal. MRI full spinal and brain. shows c3 demyelination, NEW. Ordered a LP. 3 attempts at LP by Dr., unsuccessful. Will continue steroids and wait until Monday 8/26/19 8/26/19 IR did LP. Numbness tingling and fire pain now in both legs toe to hips, and left side to mid back. Still IV steroids 8/27/19- Neuro insisting on doing plasmapheresis. Central line placed. Tingling/numbness/fire in right hand beginning 8/28/19-1st Plasmapheresis 8/30/19- 2nd plasmapheresis 9/1/19- 3rd plasmapheresis; all labs in LP NORMAL 9/3/19- 4th plasmapheresis 9/5/19- 5th plasmapheresis 9/7/19- 6th plasmapheresis 9/9/19- 7th plasmapheresis 9/10/19- central line removed. Transferred to Rehabilitation center. Minimal use of legs. Cant feel pressure. Vistibular system off. Brachial Neuritis. ADEM. Transverse Myelitis. NSHL. 9/11/19- told weeks of inpatient at facility.  Unknown Recovery time frame, if recovery possible.
Age: 33.0
Sex: M
Vaccine: TDAP, TDAP
Symptoms: Acute disseminated encephalomyelitis, Adverse reaction, Burning sensation, Central venous catheterisation, Deafness
Clinical narrative: 8/19/19 1600- warm/hot sensation in left leg. 1700 numbess/tingling in left foot. 1900 shower, water felt like fire.  8/20/19-numbness tingling sensation to mid calf. Feels like fire. 0800. Reported at work; where tdap shot was given. Went to ER. Waited for hours. Told if I began to have problems breathing go to the ER. 8/20/19- 1700. Out of work. Numbness/tingling/fire pain now past knee. Went to Urgent Care. ER Doctor didn?t know what to do; said yes it was adverse reaction and prescribed 100 mg Gabapentin. 8/21/19- Numbness/tingling/fire now to left thigh.  8/22/19- Contacted ER Doctor who sent STAT orders to a local Neurologist; no appointments available. Said to follow up with PCP.  8/23/19 0845: PCP appointment, Dr. Dr. did a complete physical and neuro exam and called to the nearest Trauma Center. He sent us straight to the ER. Placed in Trauma 2. 10:30 am Admitted to hospital on NeuroScience unit at 1200 noon. Numbness/tingling/fire now from left foot to lower back. Tingling/numbess beginning in right leg. 8/24/19 Neuro rounds, family attending and residents. Begin treating with high dose IV steroids. All labs are normal. MRI full spinal and brain. shows c3 demyelination, NEW. Ordered a LP. 3 attempts at LP by Dr., unsuccessful. Will continue steroids and wait until Monday 8/26/19 8/26/19 IR did LP. Numbness tingling and fire pain now in both legs toe to hips, and left side to mid back. Still IV steroids 8/27/19- Neuro insisting on doing plasmapheresis. Central line placed. Tingling/numbness/fire in right hand beginning 8/28/19-1st Plasmapheresis 8/30/19- 2nd plasmapheresis 9/1/19- 3rd plasmapheresis; all labs in LP NORMAL 9/3/19- 4th plasmapheresis 9/5/19- 5th plasmapheresis 9/7/19- 6th plasmapheresis 9/9/19- 7th plasmapheresis 9/10/19- central line removed. Transferred to Rehabilitation center. Minimal use of legs. Cant feel pressure. Vistibular system off. Brachial Neuritis. ADEM. Transverse Myelitis. NSHL. 9/11/19- told weeks of inpatient at facility.  Unknown Recovery time frame, if recovery possible.