chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 15.0
Sex: M
Vaccine: COVID19
Symptoms: Product administered to patient of inappropriate age
Clinical narrative: The parent was present with his son during his entire visit to our pharmacy for the vaccine.  On the Covid-19 vaccine questionnaire, the date of birth was listed .  My pharmacy technician,  greeted the patient and his father.  She confirmed the date of birth 3 separate times that the patient verbally confirmed.  My vaccinating pharmacy technician, , reviewed information with the patient and his father by verbally confirming the date of birth again just before vaccination.  At the end of the day, we processed the claim thru to the patient's insurance who rejected the claim, stating that we had the wrong date of birth.  The insurance stated that the patient's date of birth according to their records was .  We called the parent to see if they could confirm that the insurance had their records wrong.  The parent admitted to pharmacist, , RPh on 4/28/21 at 11:30 am that he falsified the document and knowingly used the wrong date of birth so he could get the vaccine for his son.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Unevaluable event
Clinical narrative: Patient had an ED visit and/or hospitalization within 6 weeks of receiving COVID vaccine.
Age: 50.0
Sex: M
Vaccine: COVID19
Symptoms: Dry eye, Eye disorder, Facial paralysis
Clinical narrative: Patient presented to the emergency room with right sided facial droop including foreheady, +bells sign, no sensation deficits, no other focal numbness or weakness.  Patient also reports  dry eye which cannot close.  In rhe ER he received 60mg prednisone and, 1000mg valtrex.  He received prescription for prednisone (60mg/day for 5 days), valtrex (3 grams/day for 7 days) and hypromellose artifical tear drops).  He as instructed to with PCP and neurology.
Age: 33.0
Sex: M
Vaccine: COVID19
Symptoms: Abdominal discomfort, Nausea, Oropharyngeal discomfort, Pain, Paraesthesia
Clinical narrative: Patient received his 2nd Moderna dose at approx 3:30. He waited 15 minutes and was feeling fine. He reports 5-10 minutes after leaving, he began to have nausea, his neck/jaw area felt very hot, tingling and itchy. He called and reported this to the County Health Department receptionist. She instructed him to return to the vaccination site as EMS is available there.  He returned to the vaccination site and was checked out by County Ambulance Department personnel. Patient was reporting a tickle in his throat. Personnel administered 50mg of oral Benadryl (from Health departments supply). Patient reports about 30 minutes after getting the benadryl, he felt better with no symptoms. This nurse spoke with him on the phone and he reports "feeling fine now". He stated had some stomach upset this morning and slightly ache but otherwise fine.
Age: 33.0
Sex: M
Vaccine: COVID19
Symptoms: Pruritus, Skin hyperpigmentation
Clinical narrative: Patient received his 2nd Moderna dose at approx 3:30. He waited 15 minutes and was feeling fine. He reports 5-10 minutes after leaving, he began to have nausea, his neck/jaw area felt very hot, tingling and itchy. He called and reported this to the County Health Department receptionist. She instructed him to return to the vaccination site as EMS is available there.  He returned to the vaccination site and was checked out by County Ambulance Department personnel. Patient was reporting a tickle in his throat. Personnel administered 50mg of oral Benadryl (from Health departments supply). Patient reports about 30 minutes after getting the benadryl, he felt better with no symptoms. This nurse spoke with him on the phone and he reports "feeling fine now". He stated had some stomach upset this morning and slightly ache but otherwise fine.
Age: 36.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site pain, Urticaria
Clinical narrative: No symptoms day of or following, maybe the slightest soreness at injection site. 6 days later (Tues 4/27) I began developing severe hives all over my legs, butt, up on hips. Benadryl helped quell, but they keep flaring up. Went to Urgent Care on 4/28 she instructed me to take 2 Benadryl or Vistaril 3X daily, 2-Pepcid OTC 20 mg  daily, and gave me 5 days of two pills daily 40 mg Prednisone.
Age: 54.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Antinuclear antibody, Antithrombin III, Brain natriuretic peptide normal, Cardiolipin antibody negative, Computerised tomogram abnormal
Clinical narrative: Patient is a lovely 54 year old- year old male initially seen 4/5/2021, kindly referred by Dr. History of COVID pneumonia in 4/2020 which was complicated by ARF and shingles, Ramsay Hunt Syndrome, with subsequent post-herpetic pain on right side of scalp.He recently received his COVID-19 Pfizer vaccine 3/20/2021 11 days prior to presentation to the hospital with shortness of breath, worsening dypnea on exertion which started 2 days after vaccine. Before this he was biking twice a week, and swimming nearly daily. He did report any medical problems before COVID, was on no meds.    3/31/2021-CT PE protocol showed multiple bilateral PEs without right heart strain. Pulmonary Vasculature: Bilateral filling defects consistent with pulmonary emboli are visualized involving the following: Distal right main pulmonary artery extending to the right lower lobar, segmental, and subsegmental branches, right middle lobar, segmental, and subsegmental branches and proximal right upper lobe artery.  Left lower lobar, segmental, and subsegmental arteries.  The right heart is not dilated.COVID/flu swab neg, trop x2 neg, BNP wnl. - Started on therapeutic lovenox then plan to transition on discharge to PO xarelto 15 mg bid x21 days then continue with xarelto 20 mg daily.   He was seen by Dr. and referred to me for follow up. He had US 4/5/2021- which showed Right Lower Extremity: There is acute thrombus of the femoral proximal vein.Right Lower Extremity: There is no evidence of deep or superficial venous thrombosis in the  common femoral, popliteal, posterior tibial, peroneal, GSV and SSV veins. Left Lower Extremity: There is no evidence of deep or superficial venous thrombosis.'   4/5/2021: Initial hematology visit  Currently does not have any pain in legs, swelling. Reports that he still is not back to 100%, he got on peloton yesterday and was only able to go 5-6 miles at a slower pace. Denies fevers, chills, sweats. He has some intermittent pain where his previous zoster scalp lesions were. He has been undergoing facial PT. Thrombophilia workup sent which was grossly negative.
Age: 54.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Deep vein thrombosis, Dyspnoea, Dyspnoea exertional, Influenza virus test negative, Protein C
Clinical narrative: Patient is a lovely 54 year old- year old male initially seen 4/5/2021, kindly referred by Dr. History of COVID pneumonia in 4/2020 which was complicated by ARF and shingles, Ramsay Hunt Syndrome, with subsequent post-herpetic pain on right side of scalp.He recently received his COVID-19 Pfizer vaccine 3/20/2021 11 days prior to presentation to the hospital with shortness of breath, worsening dypnea on exertion which started 2 days after vaccine. Before this he was biking twice a week, and swimming nearly daily. He did report any medical problems before COVID, was on no meds.    3/31/2021-CT PE protocol showed multiple bilateral PEs without right heart strain. Pulmonary Vasculature: Bilateral filling defects consistent with pulmonary emboli are visualized involving the following: Distal right main pulmonary artery extending to the right lower lobar, segmental, and subsegmental branches, right middle lobar, segmental, and subsegmental branches and proximal right upper lobe artery.  Left lower lobar, segmental, and subsegmental arteries.  The right heart is not dilated.COVID/flu swab neg, trop x2 neg, BNP wnl. - Started on therapeutic lovenox then plan to transition on discharge to PO xarelto 15 mg bid x21 days then continue with xarelto 20 mg daily.   He was seen by Dr. and referred to me for follow up. He had US 4/5/2021- which showed Right Lower Extremity: There is acute thrombus of the femoral proximal vein.Right Lower Extremity: There is no evidence of deep or superficial venous thrombosis in the  common femoral, popliteal, posterior tibial, peroneal, GSV and SSV veins. Left Lower Extremity: There is no evidence of deep or superficial venous thrombosis.'   4/5/2021: Initial hematology visit  Currently does not have any pain in legs, swelling. Reports that he still is not back to 100%, he got on peloton yesterday and was only able to go 5-6 miles at a slower pace. Denies fevers, chills, sweats. He has some intermittent pain where his previous zoster scalp lesions were. He has been undergoing facial PT. Thrombophilia workup sent which was grossly negative.
Age: 54.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Protein S normal, Prothrombin time, Pulmonary embolism, SARS-CoV-2 test negative, Troponin
Clinical narrative: Patient is a lovely 54 year old- year old male initially seen 4/5/2021, kindly referred by Dr. History of COVID pneumonia in 4/2020 which was complicated by ARF and shingles, Ramsay Hunt Syndrome, with subsequent post-herpetic pain on right side of scalp.He recently received his COVID-19 Pfizer vaccine 3/20/2021 11 days prior to presentation to the hospital with shortness of breath, worsening dypnea on exertion which started 2 days after vaccine. Before this he was biking twice a week, and swimming nearly daily. He did report any medical problems before COVID, was on no meds.    3/31/2021-CT PE protocol showed multiple bilateral PEs without right heart strain. Pulmonary Vasculature: Bilateral filling defects consistent with pulmonary emboli are visualized involving the following: Distal right main pulmonary artery extending to the right lower lobar, segmental, and subsegmental branches, right middle lobar, segmental, and subsegmental branches and proximal right upper lobe artery.  Left lower lobar, segmental, and subsegmental arteries.  The right heart is not dilated.COVID/flu swab neg, trop x2 neg, BNP wnl. - Started on therapeutic lovenox then plan to transition on discharge to PO xarelto 15 mg bid x21 days then continue with xarelto 20 mg daily.   He was seen by Dr. and referred to me for follow up. He had US 4/5/2021- which showed Right Lower Extremity: There is acute thrombus of the femoral proximal vein.Right Lower Extremity: There is no evidence of deep or superficial venous thrombosis in the  common femoral, popliteal, posterior tibial, peroneal, GSV and SSV veins. Left Lower Extremity: There is no evidence of deep or superficial venous thrombosis.'   4/5/2021: Initial hematology visit  Currently does not have any pain in legs, swelling. Reports that he still is not back to 100%, he got on peloton yesterday and was only able to go 5-6 miles at a slower pace. Denies fevers, chills, sweats. He has some intermittent pain where his previous zoster scalp lesions were. He has been undergoing facial PT. Thrombophilia workup sent which was grossly negative.
Age: 54.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Troponin normal, Ultrasound scan abnormal
Clinical narrative: Patient is a lovely 54 year old- year old male initially seen 4/5/2021, kindly referred by Dr. History of COVID pneumonia in 4/2020 which was complicated by ARF and shingles, Ramsay Hunt Syndrome, with subsequent post-herpetic pain on right side of scalp.He recently received his COVID-19 Pfizer vaccine 3/20/2021 11 days prior to presentation to the hospital with shortness of breath, worsening dypnea on exertion which started 2 days after vaccine. Before this he was biking twice a week, and swimming nearly daily. He did report any medical problems before COVID, was on no meds.    3/31/2021-CT PE protocol showed multiple bilateral PEs without right heart strain. Pulmonary Vasculature: Bilateral filling defects consistent with pulmonary emboli are visualized involving the following: Distal right main pulmonary artery extending to the right lower lobar, segmental, and subsegmental branches, right middle lobar, segmental, and subsegmental branches and proximal right upper lobe artery.  Left lower lobar, segmental, and subsegmental arteries.  The right heart is not dilated.COVID/flu swab neg, trop x2 neg, BNP wnl. - Started on therapeutic lovenox then plan to transition on discharge to PO xarelto 15 mg bid x21 days then continue with xarelto 20 mg daily.   He was seen by Dr. and referred to me for follow up. He had US 4/5/2021- which showed Right Lower Extremity: There is acute thrombus of the femoral proximal vein.Right Lower Extremity: There is no evidence of deep or superficial venous thrombosis in the  common femoral, popliteal, posterior tibial, peroneal, GSV and SSV veins. Left Lower Extremity: There is no evidence of deep or superficial venous thrombosis.'   4/5/2021: Initial hematology visit  Currently does not have any pain in legs, swelling. Reports that he still is not back to 100%, he got on peloton yesterday and was only able to go 5-6 miles at a slower pace. Denies fevers, chills, sweats. He has some intermittent pain where his previous zoster scalp lesions were. He has been undergoing facial PT. Thrombophilia workup sent which was grossly negative.
Age: 29.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Lymphadenopathy, Nausea, Pyrexia, Temporomandibular joint syndrome
Clinical narrative: after 2nd dose, pt. developed fever 102+, nausea, vomiting, fatigue, swollen lymph glands under arsm and in throat, lost tase sensation in "parts of mouth reports must be genetic b because mother and grandmother had some similar reactions after first vacc pt. developed TMJ pain and 3 day "hive rash" on torso
Age: 29.0
Sex: F
Vaccine: COVID19
Symptoms: Urticaria, Vomiting
Clinical narrative: after 2nd dose, pt. developed fever 102+, nausea, vomiting, fatigue, swollen lymph glands under arsm and in throat, lost tase sensation in "parts of mouth reports must be genetic b because mother and grandmother had some similar reactions after first vacc pt. developed TMJ pain and 3 day "hive rash" on torso
Age: 44.0
Sex: F
Vaccine: COVID19
Symptoms: Erythema, Pruritus
Clinical narrative: 10 minutes after the vaccine shot, complained of itching to arms and neck. Arms were red, but no hives visible. 10 minutes later, she was still itchy.  Given Benadryl. Relieved 20 minutes later. Wanted to go home with husband.
Age: 33.0
Sex: F
Vaccine: UNK
Symptoms: Rash
Clinical narrative: Rash  on the chest, abdomen, back and bilateral upper thigh.
Age: 49.0
Sex: F
Vaccine: COVID19
Symptoms: Condition aggravated, Hypoaesthesia, Paraesthesia
Clinical narrative: C/O anxiety admits to having increased anxiety. Also c/o numbness and tingling to l arm. Sent to ems for further eval.
Age: 79.0
Sex: F
Vaccine: COVID19
Symptoms: Thrombosis
Clinical narrative: Patient stated that her doctor says she has blood clots and believe it could be due to the vaccine.
Age: 43.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Injection site rash, Pyrexia
Clinical narrative: Chills, Fever, Rash on left arm around the injection site. symptoms lasted one day
Age: 41.0
Sex: M
Vaccine: COVID19
Symptoms: Headache, Heart rate increased, Pyrexia
Clinical narrative: Pt called call center. Pt c/o fever since 04/22/2021 and headache since 04/23/2021.Also c/o rapid heartbeat. Stated sometimes not able to feel heartbeat on left side,sometimes very rapid. Pt concerned stated might be possible s/e from covid vaccine Pfizer he got on 04/19/2021This writer recommended pt to go to nearest ED/Express care for further evaluation as experiencing rapid heartbeat. Pt assure understanding s
Age: 17.0
Sex: F
Vaccine: COVID19
Symptoms: Blood pressure decreased, Syncope
Clinical narrative: Pt had an episode of syncope for 10 seconds after getting vaccinated . Blood pressure dropped to 90/50, Hr 48. After repositioning the pt and giving some fluid Blood pressure raised to 113/96 Hr 72.
Age: 91.0
Sex: F
Vaccine: COVID19
Symptoms: Death
Clinical narrative: Patient presented to the ED and was subsequently hospitalized twice within 6 weeks of receiving COVID vaccination. First visit was 2/23/2021 and second visit was 3/14/2021. Patient died on 4/8/2021
Age: 28.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site pruritus, Pruritus
Clinical narrative: Itching near site of Injection.  Itching then spread down the arm to the elbow area. Itching on neck and side of face. Itching also on back and legs. Itching persistent for 30+ minutes
Age: 25.0
Sex: F
Vaccine: COVID19
Symptoms: Erythema, Herpes simplex test negative, Labia enlarged, Tenderness, Vulval disorder
Clinical narrative: The right labia minora swollen with some erythema. Lesion on the right labia. Multiple lesions around the area of the posterior fourchette and introitus; tender to the touch, do not have classic herpetic appearance.  There are 6-8 lesions varying in size, largest on the right labia minora is 1 cm and the largest on the left is about 0.5 cm.  Treat with an antiviral medication VALACYCLOVIR 1 gram BID for 7-10 days. Herpes test performed which was negative.
Age: 34.0
Sex: F
Vaccine: COVID19
Symptoms: Chest pain, Heart rate decreased, Pyrexia, Tachycardia
Clinical narrative: Mild Fever around 6-7pm, tachycardia, chest pain. For about 10-15 mins. Thought I was going to die so I took a nap. Woke up chest pain gone, heart rate lowered, fever gone after 6-7 hours
Age: 24.0
Sex: F
Vaccine: COVID19
Symptoms: Asthenia, Chills, Headache, Influenza like illness, Pain
Clinical narrative: Flu-like symptoms: 100.4 degree fever, headache, body ache, chills, weakness
Age: 24.0
Sex: F
Vaccine: COVID19
Symptoms: Pyrexia
Clinical narrative: Flu-like symptoms: 100.4 degree fever, headache, body ache, chills, weakness
Age: 28.0
Sex: F
Vaccine: COVID19
Symptoms: Heavy menstrual bleeding, Intermenstrual bleeding, Menstruation irregular
Clinical narrative: Irregular menstrual cycle. Breakthrough bleeding/spotting starting 3 days after vaccine.  Bleeding comes intermittently & is randomly heavy then stops. Seems like I?m on my period every 2 hours or so. Not due for the start of period for 1.5 weeks from today. Usually VERY regular and have never once had spotting before. 0% chance of pregnancy at the time of vaccine or currently.
Age: 75.0
Sex: F
Vaccine: COVID19
Symptoms: Angiogram cerebral abnormal, Cardiac telemetry abnormal, Cerebral infarction, Computerised tomogram head abnormal, Echocardiogram normal
Clinical narrative: Patient presents on 4/21 with  sudden onset of severe headache start about 4 days ago and has been persistent since.  The pain is all over her head with no particular focal area. CT head: RIGHT PARIETAL CORTICAL INFARCT  She had an echo on 4/21/2021 showed normal LV size and function with LVEF 55-60% with no regional wall motion abnormalities. Normal RV structure and function. 1+ AI. No PFO by color doppler. No valvular issues. No history of atrial fibrillation. Patient then had two episodes of seizure on telemetry unit on 4/23/2021 followed by post-ictal phase  Patient was discharge 5/26/21 to home with neurology follow-up scheduled in 2-4 weeks. Patient will also receive a Holter for 2 weeks.
Age: 75.0
Sex: F
Vaccine: COVID19
Symptoms: Electrocardiogram ambulatory, Headache, Magnetic resonance imaging head abnormal, Postictal state, Seizure
Clinical narrative: Patient presents on 4/21 with  sudden onset of severe headache start about 4 days ago and has been persistent since.  The pain is all over her head with no particular focal area. CT head: RIGHT PARIETAL CORTICAL INFARCT  She had an echo on 4/21/2021 showed normal LV size and function with LVEF 55-60% with no regional wall motion abnormalities. Normal RV structure and function. 1+ AI. No PFO by color doppler. No valvular issues. No history of atrial fibrillation. Patient then had two episodes of seizure on telemetry unit on 4/23/2021 followed by post-ictal phase  Patient was discharge 5/26/21 to home with neurology follow-up scheduled in 2-4 weeks. Patient will also receive a Holter for 2 weeks.
Age: 75.0
Sex: F
Vaccine: COVID19
Symptoms: Ultrasound Doppler normal
Clinical narrative: Patient presents on 4/21 with  sudden onset of severe headache start about 4 days ago and has been persistent since.  The pain is all over her head with no particular focal area. CT head: RIGHT PARIETAL CORTICAL INFARCT  She had an echo on 4/21/2021 showed normal LV size and function with LVEF 55-60% with no regional wall motion abnormalities. Normal RV structure and function. 1+ AI. No PFO by color doppler. No valvular issues. No history of atrial fibrillation. Patient then had two episodes of seizure on telemetry unit on 4/23/2021 followed by post-ictal phase  Patient was discharge 5/26/21 to home with neurology follow-up scheduled in 2-4 weeks. Patient will also receive a Holter for 2 weeks.
Age: 24.0
Sex: M
Vaccine: COVID19
Symptoms: Fall
Clinical narrative: When vaccine was administered patient stared off into the distance and started to fall forward. I caught him and sat him up, checking respirations and pulse which were normal. Patient came back to in about 1.5min and felt better. Stated that this "always happens when I get shots or IVs". I double checked the consent and this was not disclosed to the pharmacist prior to injection. Held patient for 45 min, he refused an ambulance or more medical care, and he left. At time he left he stated he felt back to normal completely.
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered, No adverse event
Clinical narrative: Patient administered Pfizer vaccine on 3/8/2021 and given Moderna vaccine on 4/16/2021. Patient has not reported any adverse events.
Age: 44.0
Sex: F
Vaccine: COVID19
Symptoms: Lymph node pain, Lymphadenopathy
Clinical narrative: Swollen and painful lymph nodes and left under arm
Age: 41.0
Sex: F
Vaccine: COVID19
Symptoms: Nausea, Paraesthesia, Vision blurred
Clinical narrative: 0922 C/O tingling, blurred vision and nausea. BP 120/70,HR 69,SATs 100%. 1015 HR 68, SATs 100%.Left ambulating reported symptoms improved.
Age: 60.0
Sex: U
Vaccine: COVID19
Symptoms: Paraesthesia oral, Vital signs measurement
Clinical narrative: 15 minutes after receiving vaccine pt complained of tingling around mouth similar to reaction experienced after the first dose. Pt was monitored by EMS for 1 hour post vaccine. Vital signs remained stable with no worsening of symptoms, No difficulty breathing or swelling noted, lungs clear. Pt released to home after one hour with instructions to seek medical attention with any worsening of symptoms
Age: 32.0
Sex: F
Vaccine: COVID19
Symptoms: Heavy menstrual bleeding, Menstruation irregular
Clinical narrative: Call center received call from pt on 4/26/21. Pt states she has her regular menstrual period from 3/31/21-4/2/21. On 4/7/21 pt got her Janssen vaccine at the vaccine site. Pt states on 4/7/21, her menstrual period started again and has been heavy, with some pieces still ongoing today. Advised pt to go to ED.
Age: 45.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Asymptomatic COVID-19, SARS-CoV-2 test positive
Clinical narrative: No symptoms
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness, Injection site pain, Paraesthesia
Clinical narrative: tingling on fingers, pain  experienced at injection  site,  dizziness
Age: 18.0
Sex: F
Vaccine: COVID19
Symptoms: Syncope
Clinical narrative: Patient received her first Pfizer Covid vaccine, sat down for the waiting period and fainted 1-2 minutes afterwards. She states she thinks she was only out for about a minute. Came to on her own. Pulse checked by personnel at the vaccine clinic. Patient then called her PCP's office (me) to report the event.
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Acoustic stimulation tests, Deafness, Ear discomfort, Ear pain, Headache
Clinical narrative: Fullness in ear and headache that led to ear pain and ringing and now told have hearing loss and constant ringing
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Tinnitus
Clinical narrative: Fullness in ear and headache that led to ear pain and ringing and now told have hearing loss and constant ringing
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: Biopsy skin, Blood test, Pityriasis rubra pilaris, Pruritus, Rash
Clinical narrative: 3/13/21 Red rash on neck   3/23/21 Rash Worse  3/31/21 Rash Worse and Spreading  4/16/21 Rash Head to Thighs, Peeling, Itching, Swollen Eyelids - diagnosed as Pityriasis Rubra Pilaris
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: Rash erythematous, Skin exfoliation, Swelling of eyelid
Clinical narrative: 3/13/21 Red rash on neck   3/23/21 Rash Worse  3/31/21 Rash Worse and Spreading  4/16/21 Rash Head to Thighs, Peeling, Itching, Swollen Eyelids - diagnosed as Pityriasis Rubra Pilaris
Age: 42.0
Sex: F
Vaccine: COVID19
Symptoms: Hypoaesthesia
Clinical narrative: Pointer finger on left hand is numb. It started about 1 hour after the injection and has not changed.
Age: 48.0
Sex: M
Vaccine: UNK
Symptoms: Incorrect product administration duration, Incorrect route of product administration
Clinical narrative: Was given 2nd dose  12 days after 1st dose   Patient states he feels fine  no complaints @ all. They had recieved email to come in today for 2nd dose, and I gave 2nd dose, , then I realized  it was only 12 days apart, I immediately notified Provider here ., who came and spoke with patient.   I had given the 2nd dose too early.
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Decreased appetite, Fatigue, Loss of personal independence in daily activities, Rash, Rash pruritic
Clinical narrative: She got her vaccine, went home and has been real sleepy, drained and tired.  She has a rash on her neck real bad and itchy, patchy type which grew to other parts of her neck.  She cannot get anything done due to the fatigue and loss of appetite.  These reactions still continue as of 4/28/21.   She has not taken anything for this reaction.  She is going to call her PCP today.
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Somnolence, Vaccination complication
Clinical narrative: She got her vaccine, went home and has been real sleepy, drained and tired.  She has a rash on her neck real bad and itchy, patchy type which grew to other parts of her neck.  She cannot get anything done due to the fatigue and loss of appetite.  These reactions still continue as of 4/28/21.   She has not taken anything for this reaction.  She is going to call her PCP today.
Age: 58.0
Sex: F
Vaccine: COVID19
Symptoms: Blood glucose fluctuation, Chills, Dizziness, Lymphadenopathy, Pruritus
Clinical narrative: after vaccine working arm, all blood in head rushed to feet, lightheadedness, felt like she was going to drop or die, tremors, body felt like it was growing fur, lymph nodes under tongue, fingers, toes, started to swell.teeth chattering, restless legs, itching legs, sugar swings
Age: 58.0
Sex: F
Vaccine: COVID19
Symptoms: Restless legs syndrome, Tremor
Clinical narrative: after vaccine working arm, all blood in head rushed to feet, lightheadedness, felt like she was going to drop or die, tremors, body felt like it was growing fur, lymph nodes under tongue, fingers, toes, started to swell.teeth chattering, restless legs, itching legs, sugar swings
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Blood calcium normal, Blood potassium decreased, Blood sodium decreased, Computerised tomogram head normal, Dysarthria
Clinical narrative: ER report 3/16/21:patient is a 67 y.o. female who presents to the ED for evaluation of slurred speech. Onset of symptoms was last night with symptoms resolving within approximately a minute. Patient denies any associated numbness or weakness or blurred vision. Patient additionally states that she has been having increasing muscle spasms at night when laying down predominantly in her lower extremities.  Clinical Impression 1. TIA (transient ischemic attack)  2. Hyponatremia  3. Hypokalemia
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Echocardiogram, Full blood count normal, Glomerular filtration rate, Hypokalaemia, Hyponatraemia
Clinical narrative: ER report 3/16/21:patient is a 67 y.o. female who presents to the ED for evaluation of slurred speech. Onset of symptoms was last night with symptoms resolving within approximately a minute. Patient denies any associated numbness or weakness or blurred vision. Patient additionally states that she has been having increasing muscle spasms at night when laying down predominantly in her lower extremities.  Clinical Impression 1. TIA (transient ischemic attack)  2. Hyponatremia  3. Hypokalemia
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Metabolic function test, Muscle spasms, Transient ischaemic attack, Ultrasound Doppler normal, Urine analysis abnormal
Clinical narrative: ER report 3/16/21:patient is a 67 y.o. female who presents to the ED for evaluation of slurred speech. Onset of symptoms was last night with symptoms resolving within approximately a minute. Patient denies any associated numbness or weakness or blurred vision. Patient additionally states that she has been having increasing muscle spasms at night when laying down predominantly in her lower extremities.  Clinical Impression 1. TIA (transient ischemic attack)  2. Hyponatremia  3. Hypokalemia
Age: 33.0
Sex: F
Vaccine: COVID19
Symptoms: Chest discomfort, Heart rate increased, Oxygen saturation, Respiratory rate increased
Clinical narrative: Symptoms: Tightness in front of chest.  Signs: elevated heart rate (over 120), respiratory rate was high, O2 levels stayed above 90 Time course: 60 minutes
Age: 68.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Abdominal pain upper, Chills, Decreased appetite, Diarrhoea, Dyspnoea
Clinical narrative: Chills, stomachache, headache, nausea, no appetite,  extreme fatigue. Next day diarrhea, runny nose, extremely high blood pressure never had numbers so high, along with the first day symptoms..shortness of breath which I did have became worse.
Age: 68.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Fatigue, Headache, Hypertension, Nausea, Rhinorrhoea
Clinical narrative: Chills, stomachache, headache, nausea, no appetite,  extreme fatigue. Next day diarrhea, runny nose, extremely high blood pressure never had numbers so high, along with the first day symptoms..shortness of breath which I did have became worse.
Age: 68.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Abdominal pain upper, Arthralgia, Blood test, Chest X-ray, Chills
Clinical narrative: Chills, stomachache, headache, nausea, no appetite,  extreme fatigue. Next day diarrhea, runny nose, extremely high blood pressure never had numbers so high, along with the first day symptoms..shortness of breath which I did have became worse.
Age: 68.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Constipation, Decreased appetite, Diarrhoea, Dizziness, Dyspnoea
Clinical narrative: Chills, stomachache, headache, nausea, no appetite,  extreme fatigue. Next day diarrhea, runny nose, extremely high blood pressure never had numbers so high, along with the first day symptoms..shortness of breath which I did have became worse.
Age: 68.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Electrocardiogram, Fatigue, Feeling of body temperature change, Headache, Heart rate increased
Clinical narrative: Chills, stomachache, headache, nausea, no appetite,  extreme fatigue. Next day diarrhea, runny nose, extremely high blood pressure never had numbers so high, along with the first day symptoms..shortness of breath which I did have became worse.
Age: 68.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Hypertension, Insomnia, Lacrimation increased, Myalgia, Nasal congestion
Clinical narrative: Chills, stomachache, headache, nausea, no appetite,  extreme fatigue. Next day diarrhea, runny nose, extremely high blood pressure never had numbers so high, along with the first day symptoms..shortness of breath which I did have became worse.
Age: 68.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Nausea, Oropharyngeal pain, Pain, Pyrexia, Rhinorrhoea
Clinical narrative: Chills, stomachache, headache, nausea, no appetite,  extreme fatigue. Next day diarrhea, runny nose, extremely high blood pressure never had numbers so high, along with the first day symptoms..shortness of breath which I did have became worse.
Age: 68.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: SARS-CoV-2 test, Sneezing, Urine analysis
Clinical narrative: Chills, stomachache, headache, nausea, no appetite,  extreme fatigue. Next day diarrhea, runny nose, extremely high blood pressure never had numbers so high, along with the first day symptoms..shortness of breath which I did have became worse.
Age: 26.0
Sex: M
Vaccine: COVID19
Symptoms: Dizziness, Head injury, Headache, Hypotension, Loss of consciousness
Clinical narrative: The patient wanted to go to the restroom after getting the vaccine.  He said he felt a little nauseous and had a slight headache but felt ok to walk to the bathroom.  After returning from the bathroom, the patient informed he gotten a little dizzy in the bathroom and passed out.  His head was bleeding. Patient informed his head was hurting at hit sit, feeling nauseous, vision a bit blurry and did throw up a bit. He was able to state his name, address, DOB, and was cognizant.  There was no signs of SOB or allergic reaction.  The EMS was called and it was detected his BP was a little low. Patient did feel a little better but it was advised to go to the hospital to make sure he did not have a concussion.  Patient was then escorted by EMS to the hospital.
Age: 26.0
Sex: M
Vaccine: COVID19
Symptoms: Nausea, Vision blurred, Vomiting
Clinical narrative: The patient wanted to go to the restroom after getting the vaccine.  He said he felt a little nauseous and had a slight headache but felt ok to walk to the bathroom.  After returning from the bathroom, the patient informed he gotten a little dizzy in the bathroom and passed out.  His head was bleeding. Patient informed his head was hurting at hit sit, feeling nauseous, vision a bit blurry and did throw up a bit. He was able to state his name, address, DOB, and was cognizant.  There was no signs of SOB or allergic reaction.  The EMS was called and it was detected his BP was a little low. Patient did feel a little better but it was advised to go to the hospital to make sure he did not have a concussion.  Patient was then escorted by EMS to the hospital.
Age: 61.0
Sex: F
Vaccine: COVID19
Symptoms: Anxiety, Chills, Dizziness, Pyrexia
Clinical narrative: Pt called call center. Pt c/o on/off dizziness since 04/26/2021 and also feeling slight anxious. Pt also stated she had fever and chills on 04/22/021 after she got covid 19 vaccine Moderna on 04/22 but fever, chills went away and was feeling ok till yesterday. Pt advised to go to urgent care or ED.
Age: 57.0
Sex: M
Vaccine: COVID19
Symptoms: Tinnitus
Clinical narrative: BILATERAL TINNITUS WITHOUT HEARING LOSS
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site erythema, Injection site rash
Clinical narrative: Red rash around injection site on upper arm
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: Hypoacusis
Clinical narrative: Pt states 1.5 hours after 1st dose of moderna vaccine her ears started to feel muffled and could not hear as well
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: Rash
Clinical narrative: rash developed on arms and lower legs 6 days after obtaining dose 1
Age: 53.0
Sex: F
Vaccine: COVID19
Symptoms: Epistaxis, Thrombosis
Clinical narrative: The patient came in for her second dose of Moderna and had concerns because she stated that she developed a nose bleed the day after she received her first dose. She stated that she also passed clots and her nose bled for more than 1 day. She stated that she went to the ER but was only given a nasal spray to use. She denied a history of nosebleeds and does not take blood thinners.
Age: 46.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal pain, Loss of personal independence in daily activities, Mobility decreased
Clinical narrative: SEVERE level 10 abdominal PAIN. totally bedridden except for crawling to bathroom. completely incapacitated and unable to do any normal daily activities for 3 days now. Completely disabled. I am hoping this goes away
Age: 22.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, Neuropathy peripheral, Pain, Pyrexia
Clinical narrative: Woke up the next morning feeling weak, with full body aches, and sensitivity to coldness. I may have had a slight fever. These symptoms were gone by 2-3pm.
Age: 47.0
Sex: F
Vaccine: COVID19
Symptoms: Diarrhoea, Rash, Vomiting
Clinical narrative: Severe diarrhea, vomiting, and rash
Age: 56.0
Sex: M
Vaccine: COVID19
Symptoms: CSF protein increased, Lumbar puncture, Magnetic resonance imaging thoracic normal, Paraesthesia, Sensory level abnormal
Clinical narrative: Tingling, thoracic sensory level loss, urinary retention.  CSF protein elevated to 90.   Started approximately 3 weeks from time of vaccine.   Drug store  provided vaccine 04/06/2021 Admitted to hospital 04/27/21
Age: 56.0
Sex: M
Vaccine: COVID19
Symptoms: Serology test, Urinary retention
Clinical narrative: Tingling, thoracic sensory level loss, urinary retention.  CSF protein elevated to 90.   Started approximately 3 weeks from time of vaccine.   Drug store  provided vaccine 04/06/2021 Admitted to hospital 04/27/21
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Headache, Lymphadenopathy, Nausea, Night sweats, Pyrexia
Clinical narrative: Main concern: Arm pit lymph nodes. Both arms. Significantly worse same arm as vaccination.  Bad arm swollen to size of small/med tomato.  Took 2  days for lymph issues to start.  Have also had feeling of fever(none registers), cold sweats at night, nausea. These 80% better 4 days out. Also, head aches. Continue 4days out. Ibuprofen helpful. Iced coffee makes the headaches feel better.
Age: 61.0
Sex: M
Vaccine: COVID19
Symptoms: Agitation, Autoscopy, Feeling abnormal, Nausea
Clinical narrative: On  04/28/2021 - started feeling brain fog.  Nausea. Several times I felt like I am having an out of body experience and I become easily agitated
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Computerised tomogram, Magnetic resonance imaging, Neck pain, Pain in extremity, X-ray
Clinical narrative: chronic neck, shoulder and arm pain
Age: 47.0
Sex: M
Vaccine: COVID19
Symptoms: Tinnitus
Clinical narrative: Tinnitus started in the early morning after the shot. Was loud for about 24 hours. The second day after,  I woke up, and it has subsided a bit. As I type this at 01:23 PM on 4/28/2021, it seems to be getting louder again. Primary care doctor said there was nothing they could do.
Age: 37.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Injection site rash, Pyrexia
Clinical narrative: Joint aches and low grade fever, started 12 hours after dose, lasted approximately 24 hours  Rash at injection site, started 48 hours after dose
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: Mobility decreased, Pain
Clinical narrative: Pt reported for 2nd dose of vaccine and stated that when she received her first dose, she felt that it was given "at a downward angle"  in her left upper deltoid, closer to her shoulder. she had difficulty moving her arm for at least a week - and at 4 weeks out still has some "twinges" of pain when she moves her arm a certain way.
Age: 80.0
Sex: F
Vaccine: COVID19
Symptoms: Dementia, Fall, Lumbar puncture normal
Clinical narrative: At 1:30am on 4/2/21, my mother had fallen at home and was transported to the hospital. She was not injured from the fall however by 4/4/21, she was showing signs of end stage dementia.  Her symptoms literally came on as if switching on a light.  Through testing ruled out stroke, cancer, seizure as well as a lumbar puncture was negative for infection. She remains hospitalized and is transitioning to a specialized care facility that will provide 24/7 care.
Age: 27.0
Sex: F
Vaccine: COVID19
Symptoms: Abnormal dreams, Chills, Dizziness, Headache, Hyperhidrosis
Clinical narrative: A very vivid nightmare woke me up at 3:30 am - 13 hrs after I had received the first dose of the vaccine. I stood up and got lightheaded. I started sweating,  felt very nauseous and vomited.  I had a fever. Spent the rest of the night with very bad chills. Next day had a headache and fever.
Age: 27.0
Sex: F
Vaccine: COVID19
Symptoms: Nausea, Nightmare, Pyrexia, Sleep disorder, Vomiting
Clinical narrative: A very vivid nightmare woke me up at 3:30 am - 13 hrs after I had received the first dose of the vaccine. I stood up and got lightheaded. I started sweating,  felt very nauseous and vomited.  I had a fever. Spent the rest of the night with very bad chills. Next day had a headache and fever.
Age: 17.0
Sex: F
Vaccine: COVID19
Symptoms: Influenza like illness, Product administered to patient of inappropriate age
Clinical narrative: Give Moderna at age 17-going to be 18 in 6 days.  Had flu like symptoms after shot but resolved in 24hrs-was Covid positive in the past.
Age: 39.0
Sex: M
Vaccine: COVID19
Symptoms: Headache, Nausea, Vomiting
Clinical narrative: Headache, nausea, vomitting
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: Nausea
Clinical narrative: Patient is feeling nauseous about 15 after taking. The vaccine. Patient is diabetic. Snack provide. Called 911 patient is about to be ltransfered to the hospital.
Age: 15.0
Sex: F
Vaccine: COVID19
Symptoms: No adverse event, Product administered to patient of inappropriate age
Clinical narrative: PATIENT WAS GIVEN MODERNA (1ST DOSE)  AT THE AGE 15 1/2 YEARS OLD. PATIENT DID NOT EXPERIENCE ANY ADVERSE EFFECTS SUCH AS FEVER, RASH OR ANY ALLERGIC REACTIONS. PATIENT IS TOLEARBLE OF THE MODERNA VACCINE.
Age: 76.0
Sex: M
Vaccine: UNK
Symptoms: Electrocardiogram, Paraesthesia, Scan brain
Clinical narrative: On March 20/2021 I went for emergency with tingle and mouth filling  ) Paranesthesia's
Age: 19.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Headache, Heart rate increased, Paraesthesia, Paraesthesia oral
Clinical narrative: Hives, tingling in fingers, toes and on my tongue, fast heart rate, severe fatigue, headache
Age: 19.0
Sex: F
Vaccine: COVID19
Symptoms: Urticaria
Clinical narrative: Hives, tingling in fingers, toes and on my tongue, fast heart rate, severe fatigue, headache
Age: 70.0
Sex: M
Vaccine: COVID19
Symptoms: Biopsy skin abnormal, Dermatitis bullous, Linear IgA disease, Rash
Clinical narrative: severe facial bullous skin eruption diagnosed as Linear IGA Bullous Dermatosis by biopsy
Age: 86.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Cough, Dyspnoea, Hypotension, Infection
Clinical narrative: 86y.o. male with history of hypertension, Diabetes mellitus type II, OSA (uses 2L of O2 at home), CAD, cardiomyopathy, CVA with right hemiparesis, gout, GERD, and depression who presents to the hospital on 4/27/2021 for shortness of breath that has been worsening over the past week. Patient positive for COVID on 4/26/21 when he presented to the ED with fever, cough, and chronic toe infection. Patient had no hypoxia or increased work of breathing and was discharged from ED with doxycyline for his toe infection. Patient reports that he returned to ED due to family concern over symptoms. In ED, patient became hypotensive and was given 30 mL/kg bolus by ideal body weight. Patient remained hypotensive and central line placed in ED for possible vasopressors. Patient is on his home oxygen of 2L and has no increased requirements. Patient in ICU for sepsis and hypotension that responded to IV fluids.
Age: 86.0
Sex: M
Vaccine: COVID19
Symptoms: Intensive care, Pyrexia, SARS-CoV-2 test positive, Sepsis
Clinical narrative: 86y.o. male with history of hypertension, Diabetes mellitus type II, OSA (uses 2L of O2 at home), CAD, cardiomyopathy, CVA with right hemiparesis, gout, GERD, and depression who presents to the hospital on 4/27/2021 for shortness of breath that has been worsening over the past week. Patient positive for COVID on 4/26/21 when he presented to the ED with fever, cough, and chronic toe infection. Patient had no hypoxia or increased work of breathing and was discharged from ED with doxycyline for his toe infection. Patient reports that he returned to ED due to family concern over symptoms. In ED, patient became hypotensive and was given 30 mL/kg bolus by ideal body weight. Patient remained hypotensive and central line placed in ED for possible vasopressors. Patient is on his home oxygen of 2L and has no increased requirements. Patient in ICU for sepsis and hypotension that responded to IV fluids.
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: Anxiety, Nausea
Clinical narrative: Pt c/o nausea 14 mins after receiving first dose of the vaccine. She denies any past medical Hx and noted that she ate this AM. She was assessed and monitored by NP, EMT, and paramedic. Initial BP - 142/101, HR - 90, O2 sat 97% on RA. She had mild anxiety.
Age: 40.0
Sex: F
Vaccine: COVID19
Symptoms: Body temperature increased, Chills, Decreased appetite, Menstruation irregular
Clinical narrative: Fever of 102.2, chills, loss of appetite lasting for approximately 24 hours.  Ibuprofen 800 given at showing of fever and throughout the symptom process.  Menstrual cycle started a week after vaccine which was considered early in my cycle.
Age: 56.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Tested Covid-19 positive after being fully vaccinated
Age: 26.0
Sex: M
Vaccine: COVID19
Symptoms: Headache, Pain, Pruritus
Clinical narrative: Pt called , experiencing symptoms after 2nd dose Pfizer vaccine on Saturday 4/24/21. Rec'd 2nd dose outside of facility sites at a school site . Pt stated experienced minor body aches and headache. Took Tylenol Saturday and symptoms were relieved. Today 4/27 pt began experiencing itchiness on chest, back and arms. Pt works at a vaccination site and was advised by pharmacist he should call for an MD appt for an rx stronger than benadryl.   Pt denied experiencing emergency symptoms at time of call. Pt stated only symptoms are itchiness. No swelling or itchiness of face, lip, or throat, and denied difficulty breathing.  Advised to go to nearest ED or call 911 if symptoms worsen or trouble breathing or any signs of severe allergic reaction. Pt verbalized understanding.  Scheduled  telephone provider visit 4/28  confirmed phone number on file. Pt aware of appt.
Age: 49.0
Sex: M
Vaccine: COVID19
Symptoms: Central nervous system lesion, Guillain-Barre syndrome, Inflammation, Lumbar puncture, Magnetic resonance imaging head abnormal
Clinical narrative: Developed ascending paralysis, currently hospitalized and being worked up, but felt to be inflammatory with extensive spinal lesions and brain lesion.
Age: 49.0
Sex: M
Vaccine: COVID19
Symptoms: Magnetic resonance imaging spinal abnormal, Spinal cord neoplasm
Clinical narrative: Developed ascending paralysis, currently hospitalized and being worked up, but felt to be inflammatory with extensive spinal lesions and brain lesion.
Age: 23.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site erythema, Injection site swelling, Pruritus, Rash, Urticaria
Clinical narrative: After injection, red/purple welt with swelling at site, lasted 3-4 days. one week after injection, same instance except with itching, more like a rash.
Sex: F
Vaccine: COVID19
Symptoms: Blood pressure measurement, Heart rate, Oropharyngeal discomfort, Oxygen saturation, Respiratory rate
Clinical narrative: Patient complained of her "throat feeling funny" and itchy after receiving first dose of COVID-19 vaccine, Patient was taken to triage area for assessment. Vitals: B/P 162/84, HR 101, SAO2 99-100%, RR 20 @ 0740. BP 148/82, HR 104, PAO2 100%, RR 20 @ 0754-0759. Symptoms improved while patient being observed in triage, patient was given 25 mg po diphenhydramie, and released around 0800.
Sex: F
Vaccine: COVID19
Symptoms: Throat irritation, Vital signs measurement
Clinical narrative: Patient complained of her "throat feeling funny" and itchy after receiving first dose of COVID-19 vaccine, Patient was taken to triage area for assessment. Vitals: B/P 162/84, HR 101, SAO2 99-100%, RR 20 @ 0740. BP 148/82, HR 104, PAO2 100%, RR 20 @ 0754-0759. Symptoms improved while patient being observed in triage, patient was given 25 mg po diphenhydramie, and released around 0800.
Age: 57.0
Sex: F
Vaccine: COVID19
Symptoms: Burning sensation, Herpes zoster, Pain, Pruritus, Rash
Clinical narrative: Herpes zoster without complication, rash, itchy/burning/painful. Treated with Benadryl, hydrocortisone cream, Valacyclovir 1 g 3 times daily for 7 days, dermatology consult to confirm (confirmed)
Age: 22.0
Sex: M
Vaccine: COVID19
Symptoms: Cold sweat, Feeling hot, Tinnitus
Clinical narrative: Pt reports becoming warm, clammy, with minor tinnitus in left ear. No hx of allergy. Placed in semifowler position on cot. BP 110/80 HR 60, RR 14 SPO2  98%. at 10:05 SPO2 up to 99% and he reports being asymptomatic. He stood up with no vagal response.