chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Sex: U
Vaccine: FLU4
Symptoms: Malaise
Clinical narrative: Initial unsolicited report received from a pharmacist on 12 October 2016. This case is linked with 2016SA189772, 2016SA189781, 2016SA189791, 2016SA189792, 2016SA189793, 2016SA189794, 2016SA189795, 2016SA189796, 2016SA189797, 2016SA189798, 2016SA189799, 2016SA189800, 2016SA189801, 2016SA189802, 2016SA189803, 2016SA189804, 2016SA189805, 2016SA189806, 2016SA189807, 2016SA189808, 2016SA189809, 2016SA189810, 2016SA189811, 2016SA189812, 2016SA189813, 2016SA189814, 2016SA189815, 2016SA189816, 2016SA189817, 2016SA189818, 2016SA189819, 2016SA189820, 2016SA189821, 2016SA189822, 2016SA189823, 2016SA189824, 2016SA189825, 2016SA189826, 2016SA189827, 2016SA189828, 2016SA189829, 2016SA189830, 2016SA189831, 2016SA189832, 2016SA189833, 2016SA189834, 2016SA189835, 2016SA189836, 2016SA189837, 2016SA189838, 2016SA189839, 2016SA189840, 2016SA189841, 2016SA189843, 2016SA189844, 2016SA189845, 2016SA189846, 2016SA189847, 2016SA189848. (Same vaccine). This case involves a patient of unknown age and gender, who was vaccinated with FLUZONE intramuscularly (batch number: UI669AA, expiry date: 30 June 2017 (dose, dose in series were not reported) in the left arm on 04 October 2016. Patient's pre-existing physician diagnosed allergies, birth defects, medical conditions was unknown. Illness at the time of vaccination was also reported as unknown. No further information regarding medical history was available. Concomitant medications were not reported. Any other vaccinations within four weeks of vaccinations were also not reported. On unspecified date and duration following vaccination, the patient developed left arm, red, swollen down not elbow and raised area approximately 7cm by 6 cm ('6 em'), warm to touch, hurt at injection site. On 05 October 2016, one day post vaccination the patient felt ill. The patient needed ER visit. Laboratory data was not reported. Corrective treatment was reported as 'no'. The outcome of the events inflammation localized and vaccination site reaction was reported as unknown and on 06 October 2016 the patient recovered from illness. List of documents held by sender: none.
Age: 59.0
Sex: U
Vaccine: FLU4
Symptoms: Injection site erythema, Injection site warmth
Clinical narrative: Initial unsolicited report received from a pharmacist (Director of Pharmacy) on 12-OCT-2016. This case is linked with 2016SA189772, 2016SA189781, 2016SA189791, 2016SA189792, 2016SA189793, 2016SA189794, 2016SA189795, 2016SA189796, 2016SA189797, 2016SA189798, 2016SA189799, 2016SA189800, 2016SA189801, 2016SA189802, 2016SA189803, 2016SA189804, 2016SA189805, 2016SA189806, 2016SA189807, 2016SA189808, 2016SA189809, 2016SA189810, 2016SA189811, 2016SA189812, 2016SA189813, 2016SA189814, 2016SA189815, 2016SA189816, 2016SA189817, 2016SA189818, 2016SA189819, 2016SA189820, 2016SA189821, 2016SA189822, 2016SA189823, 2016SA189824, 2016SA189825, 2016SA189826, 2016SA189827, 2016SA189828, 2016SA189829, 2016SA189830, 2016SA189831, 2016SA189832, 2016SA189833, 2016SA189834, 2016SA189835, 2016SA189836, 2016SA189837, 2016SA189838, 2016SA189839, 2016SA189840, 2016SA189841, 2016SA189842, 2016SA189844, 2016SA189845, 2016SA189846, 2016SA189847, 2016SA189848. This case involves a patient (age and gender not reported) who was vaccinated with a dose of FLUZONE (batch number: UI669AA, expiration date: 30-JUN-17, intramuscularly, on an unspecified date (over the past month). Patient's Illness at time of vaccination and Pre-existing physician diagnosed allergies, birth defects, medical conditions was reported as unknown. Concomitant medications were not reported. On an unspecified date (over the past month), following the vaccination, the patient had localized redness and warmth at injection site,"3 days". It was reported that the patient required emergency room/doctor visit. Lab data and corrective treatment were not reported. The outcome of the events was reported as unknown. List of documents held by sender: none.
Sex: U
Vaccine: FLU4
Symptoms: No adverse event, Product label issue
Clinical narrative: A primary care physician practice submitted a report that there is poor labeling on the FLUARIX QUADRIVALENT [GlaxoSmithKline] single dose syringes and other flu injections with similar designs and from previous years. The design flaws on the syringe include: 1) No peel off label on the barrel of the syringe. 2) Cannot easily read NDC # because it is very small and on clear glass. 3). Difficulty in reading the dosing contents of syringes. The other challenging issue that is related to the administration of single dose flu shots is the change to the lot #s and NDC #s, which can be easily overlooked when giving high volumes of the vaccines (the peel off label would be helpful). These issues leads in to delays in administering the vaccines and entering info into the electronic Medical Record. What was the original intended procedure? The original intended procedure is regarding the routine administration of patient's Influenza vaccinations. The request is for the company to consider: 1) Re-designing syringe labels allowing for more contrast against syringe. 2) Increasing the type font size of the NDC (vaccination #). 3) Improve the bar scanning label on the syringe for the vaccine to allow for bar scanning using the QR Code that is on the syringe. Device Usage Problem: Device was hard to use. Other Patient Information. Ethnic Background: Not applicable. Other pertinent info: There are NO patient factors that relate to this reporting. No patient was HARMED as a result of this syringe being difficult to work with; the concern relates more to the workflow challenge of properly documenting the NDC and expiration numbers from the syringe for vaccinations.
Age: 6.0
Sex: F
Vaccine: FLU4
Symptoms: Injection site erythema, Injection site induration, Injection site warmth
Clinical narrative: Patient received Influenza vaccine QUADRIVALENT 10/18/2016. On 10/20/2016 the patients mother contacted the clinic where the patient received the injection stating that at the injection site there was a "golf ball sized" red, hot hardened area, at the injection site.
Age: 47.0
Sex: F
Vaccine: FLU3
Symptoms: Death, Tuberculin test, Urine analysis abnormal
Clinical narrative: Patient received an influenza vaccine on 11/8/2013. Pt had no reported signs or symptoms of an adverse reaction to the vaccine. Staff was informed on 11/10/13 that pt passed away in her sleep.
Age: 20.0
Sex: M
Vaccine: FLU3
Symptoms: Urticaria
Clinical narrative: Urticaria and hives entire body.
Age: 72.0
Sex: F
Vaccine: FLUX
Symptoms: Arthralgia, Musculoskeletal pain
Clinical narrative: Severe shoulder pain for several weeks. Chronic shoulder joint pain for 1 year, ongoing.
Age: 62.0
Sex: F
Vaccine: FLU4
Symptoms: Swelling
Clinical narrative: Patient reported severe swelling, that was abnormal for the typical response, for a few days at the site of injection.
Age: 57.0
Sex: M
Vaccine: FLUX
Symptoms: Headache, Oropharyngeal pain, Pain, Pyrexia
Clinical narrative: Sore  throat, headache, fever, aches.
Age: 51.0
Sex: F
Vaccine: FLU4
Symptoms: Vaccination site pain, Vaccination site swelling
Clinical narrative: Local swelling and pain approximately 4-5 inches distal to deltoid vaccination site, resolved with icing and ibuprofen within another 72 hours.
Age: 44.0
Sex: M
Vaccine: FLUX
Symptoms: Asthenia, Decreased appetite, Feeling of body temperature change, Gait disturbance, Pyrexia
Clinical narrative: Weakness and tightness in throat initially followed by a 103 degree fever around 3 AM. On 10/19/2016, had hot and cold spells and diminished appetite. In the evening, another 103 degree fever. On 10/20/2016, fever continued and even weaker to the point I could not hold anything and barely walking. On the 21st, symptoms diminished but still felt extremely weak. All that was taken was Motrin and weakness still persists after a week now.
Age: 44.0
Sex: M
Vaccine: FLUX
Symptoms: Throat tightness
Clinical narrative: Weakness and tightness in throat initially followed by a 103 degree fever around 3 AM. On 10/19/2016, had hot and cold spells and diminished appetite. In the evening, another 103 degree fever. On 10/20/2016, fever continued and even weaker to the point I could not hold anything and barely walking. On the 21st, symptoms diminished but still felt extremely weak. All that was taken was Motrin and weakness still persists after a week now.
Age: 66.0
Sex: M
Vaccine: FLU4
Symptoms: Injection site swelling
Clinical narrative: Soft swelling below site of injection feels like cystic structure. No erythema or warmth or pain. Several centimeters in diameter.
Age: 70.0
Sex: M
Vaccine: FLU4, PPV, FLU4, PPV
Symptoms: Injection site erythema
Clinical narrative: This spontaneous report as received from a pharmacist refers to a 70-year-old male patient with no drug reactions and no allergies. The patient's medical history an concurrent conditions were not reported. On 24-SEP-2016, the patient was vaccinated with a dose of PNEUMOVAX 23 lot # M013156, expiration date 15-OCT-2017 in the arm (dose and route of administration were not reported) and, on the same date, he was vaccinated with a dose of FLUZONE in the same arm (lot number, expiration date, dose and route of administration were not reported). No concomitant medications were reported. On 24-SEP-2016, the patient developed redness which continued to spread out from the injection site for about 3 days and then it started to clear up on it's own. The pharmacist reported that the patient could not determine which injection site this reaction occurred at because both vaccines were administered in the same arm. There was no treatment given for injection site redness and the patient did not seek medical attention. The outcome of injection site redness was reported as recovered - the reporter stated that the redness was completely gone at the time of this report. The causality assessment was not provided. Additional information has been requested.
Age: 57.0
Sex: F
Vaccine: FLU3
Symptoms: Drug administered to patient of inappropriate age, No adverse event
Clinical narrative: Patient received a FLUZONE HD vaccine when it is indicated for patients over the age of 65. No adverse effect or symptoms reported. No treatment necessary.
Age: 20.0
Sex: F
Vaccine: FLU4, PPV
Symptoms: Drug administered to patient of inappropriate age
Clinical narrative: None stated.
Age: 50.0
Sex: F
Vaccine: FLU4
Symptoms: Headache, Peripheral swelling, Skin reaction
Clinical narrative: Within 12 hours of vaccination, arm became red and swollen, headache.  This lasted for one week.
Age: 37.0
Sex: F
Vaccine: FLU4
Symptoms: Injected limb mobility decreased, Pain
Clinical narrative: After left arm influenza injection patient experiencing pain with range of motion and limited ROM of left shoulder.
Age: 78.0
Sex: M
Vaccine: FLU3
Symptoms: Mobility decreased, Musculoskeletal pain
Clinical narrative: Sore left shoulder; unable to raise above head to put on shirts.
Age: 18.0
Sex: F
Vaccine: FLU4, HEPA
Symptoms: Urticaria
Clinical narrative: 1 day after receiving flu shot in right arm, patient developed large "welts" up to one inch in size all over right arm.  From wrist, up into right neck, with a few on the face. Welts went away, followed by right elbow joint pain that started 1 week after injection and continues.  Patient unable to completely straighten right arm as of today.  Advised office visit for recheck and documentation.
Age: 25.0
Sex: F
Vaccine: FLU3
Symptoms: Blood test, Seizure, Unresponsive to stimuli
Clinical narrative: PATIENT RECVD FLU SHOT (FLUVIRIN-Sequirus) AND FEW MINUTES LATER HAD BLOOD DRAW TO CHECK POST IMMUNITY MMR TITERS. DURING BLOOD DRAW PATIENT BECAME UNRESPONSIVE FOR A FEW SECONDS AND THAN DEVELOPED SEIZURES FOR FEW SECONDS AND THEN RECOVERED. EMERGENCY RESPONSE WAS CALLED AND PATIENT WAS FOUND TO BE STABLE AND DISCHARGED. NO ED VISIT. FOLLOWED WITH PCP.
Age: 11.0
Sex: M
Vaccine: MNQ
Symptoms: Injection site erythema, Injection site induration, Injection site swelling
Clinical narrative: STARTED AS SMALL RED AREA ON 10/19, ON 10/20 AREA BECAME MORE SWOLLEN, AREA 11CM X 13CM AREA INDURATION TO LEFT DELTOID. TREATED WITH BENADRYL AND HYDROCORTISONE 1%.
Age: 65.0
Sex: M
Vaccine: FLUX
Symptoms: Injection site joint pain, Injection site pain
Clinical narrative: Day of shot had extremely sore arm at the point of the shot and above and below area of the shot.  After a couple of days, joint pain in the shoulder area where the shot was administered, that has not yet gone away.
Age: 48.0
Sex: F
Vaccine: FLUX
Symptoms: Facial paralysis, Fatigue, Headache, Nausea
Clinical narrative: Date of vaccine nausea, fatigue, headache, then on 10/20/2016 onset of bell's palsy.
Age: 28.0
Sex: F
Vaccine: FLUX
Symptoms: Asthenia, Blood iron, Blood thyroid stimulating hormone, Chest discomfort, Dyspnoea
Clinical narrative: Face went numb, followed by arms, then a couple days later the legs. With tingling and sharp pains that run down arms and legs. Weakness and fatigue. Chest tightness and shortness of breath.
Age: 28.0
Sex: F
Vaccine: FLUX
Symptoms: Fatigue, Full blood count, Hypoaesthesia, Metabolic function test, Nuclear magnetic resonance imaging brain
Clinical narrative: Face went numb, followed by arms, then a couple days later the legs. With tingling and sharp pains that run down arms and legs. Weakness and fatigue. Chest tightness and shortness of breath.
Age: 28.0
Sex: F
Vaccine: FLUX
Symptoms: Paraesthesia, Thyroxine
Clinical narrative: Face went numb, followed by arms, then a couple days later the legs. With tingling and sharp pains that run down arms and legs. Weakness and fatigue. Chest tightness and shortness of breath.
Age: 48.0
Sex: F
Vaccine: FLU3, FLU3
Symptoms: Dyspnoea, Joint hyperextension, Localised oedema
Clinical narrative: Nurse administered FLUVIRIN lot #1620001, approximately 15 minutes after vaccine administration patient stated shortness of breath, presented with edema to neck, and hyper extension of fingers. EMS activated, and patient was taken to the hospital.
Age: 48.0
Sex: F
Vaccine: FLU3, FLU3
Symptoms: Anxiety, Blood test abnormal, Chest discomfort, Computerised tomogram normal, Dizziness
Clinical narrative: Nurse administered FLUVIRIN lot #1620001, approximately 15 minutes after vaccine administration patient stated shortness of breath, presented with edema to neck, and hyper extension of fingers. EMS activated, and patient was taken to the hospital.
Age: 48.0
Sex: F
Vaccine: FLU3, FLU3
Symptoms: Dyspnoea, Electrocardiogram normal, Hyperhidrosis, Hyperventilation, Lymphadenopathy
Clinical narrative: Nurse administered FLUVIRIN lot #1620001, approximately 15 minutes after vaccine administration patient stated shortness of breath, presented with edema to neck, and hyper extension of fingers. EMS activated, and patient was taken to the hospital.
Age: 48.0
Sex: F
Vaccine: FLU3, FLU3
Symptoms: Nausea, Pallor, Posture abnormal, Visual impairment
Clinical narrative: Nurse administered FLUVIRIN lot #1620001, approximately 15 minutes after vaccine administration patient stated shortness of breath, presented with edema to neck, and hyper extension of fingers. EMS activated, and patient was taken to the hospital.
Age: 48.0
Sex: F
Vaccine: FLU3, FLU3
Symptoms: Dyspnoea, Joint hyperextension, Localised oedema
Clinical narrative: Lymph nodes on both sides of the neck began to swell within seconds, difficulty catching my breath, tightness in the chest. I could not get enough air into lungs. Anxiousness led to hyperventilation. Dizziness, and my vision, its like it would start going black I would shake my head and breath deep trying to stay alert. To not pass out. They gave me epi and I was better within a minutes. I was back to normal within minutes except for the lymph nodes. They continued to get bigger. I was transported to the hospital. They did an EKG which was normal and I was release in less than an hr. As I sat waiting for someone to pick me up I had another episode. I went from giving directions to my friend to what went on to be another attack of some sort. I don't know where it was coming from, my chest or diaphragm or where but it constricted immediately and I again I could not get enough air into my lungs. I went inside the ER and told them something is wrong I can't breathe. Started sweating badly, my hands looked translucent. I don't know what other word to describe it. I felt like I would throw up, my vision would come and go and then I had an episode my hands and feet curled in towards my body. My face pulled back. It was very scary. Took a lot longer to get air into lungs.
Age: 48.0
Sex: F
Vaccine: FLU3, FLU3
Symptoms: Anxiety, Blood test abnormal, Chest discomfort, Computerised tomogram normal, Dizziness
Clinical narrative: Lymph nodes on both sides of the neck began to swell within seconds, difficulty catching my breath, tightness in the chest. I could not get enough air into lungs. Anxiousness led to hyperventilation. Dizziness, and my vision, its like it would start going black I would shake my head and breath deep trying to stay alert. To not pass out. They gave me epi and I was better within a minutes. I was back to normal within minutes except for the lymph nodes. They continued to get bigger. I was transported to the hospital. They did an EKG which was normal and I was release in less than an hr. As I sat waiting for someone to pick me up I had another episode. I went from giving directions to my friend to what went on to be another attack of some sort. I don't know where it was coming from, my chest or diaphragm or where but it constricted immediately and I again I could not get enough air into my lungs. I went inside the ER and told them something is wrong I can't breathe. Started sweating badly, my hands looked translucent. I don't know what other word to describe it. I felt like I would throw up, my vision would come and go and then I had an episode my hands and feet curled in towards my body. My face pulled back. It was very scary. Took a lot longer to get air into lungs.
Age: 48.0
Sex: F
Vaccine: FLU3, FLU3
Symptoms: Dyspnoea, Electrocardiogram normal, Hyperhidrosis, Hyperventilation, Lymphadenopathy
Clinical narrative: Lymph nodes on both sides of the neck began to swell within seconds, difficulty catching my breath, tightness in the chest. I could not get enough air into lungs. Anxiousness led to hyperventilation. Dizziness, and my vision, its like it would start going black I would shake my head and breath deep trying to stay alert. To not pass out. They gave me epi and I was better within a minutes. I was back to normal within minutes except for the lymph nodes. They continued to get bigger. I was transported to the hospital. They did an EKG which was normal and I was release in less than an hr. As I sat waiting for someone to pick me up I had another episode. I went from giving directions to my friend to what went on to be another attack of some sort. I don't know where it was coming from, my chest or diaphragm or where but it constricted immediately and I again I could not get enough air into my lungs. I went inside the ER and told them something is wrong I can't breathe. Started sweating badly, my hands looked translucent. I don't know what other word to describe it. I felt like I would throw up, my vision would come and go and then I had an episode my hands and feet curled in towards my body. My face pulled back. It was very scary. Took a lot longer to get air into lungs.
Age: 48.0
Sex: F
Vaccine: FLU3, FLU3
Symptoms: Nausea, Pallor, Posture abnormal, Visual impairment
Clinical narrative: Lymph nodes on both sides of the neck began to swell within seconds, difficulty catching my breath, tightness in the chest. I could not get enough air into lungs. Anxiousness led to hyperventilation. Dizziness, and my vision, its like it would start going black I would shake my head and breath deep trying to stay alert. To not pass out. They gave me epi and I was better within a minutes. I was back to normal within minutes except for the lymph nodes. They continued to get bigger. I was transported to the hospital. They did an EKG which was normal and I was release in less than an hr. As I sat waiting for someone to pick me up I had another episode. I went from giving directions to my friend to what went on to be another attack of some sort. I don't know where it was coming from, my chest or diaphragm or where but it constricted immediately and I again I could not get enough air into my lungs. I went inside the ER and told them something is wrong I can't breathe. Started sweating badly, my hands looked translucent. I don't know what other word to describe it. I felt like I would throw up, my vision would come and go and then I had an episode my hands and feet curled in towards my body. My face pulled back. It was very scary. Took a lot longer to get air into lungs.
Age: 65.0
Sex: F
Vaccine: PNC13
Symptoms: Injection site erythema, Injection site induration, Injection site nodule, Injection site pruritus, Injection site rash
Clinical narrative: Client reported large hard knot at site of injection, hot and red, and entire upper arm swelling for several days.  As arm swelling went down, a red itchy rash then was noted on entire upper arm started, and has lasted until a return visit 10-24-16.  Client was advised to use a topical cream for the intense itching sensation.
Age: 65.0
Sex: F
Vaccine: PNC13
Symptoms: Injection site swelling, Injection site warmth
Clinical narrative: Client reported large hard knot at site of injection, hot and red, and entire upper arm swelling for several days.  As arm swelling went down, a red itchy rash then was noted on entire upper arm started, and has lasted until a return visit 10-24-16.  Client was advised to use a topical cream for the intense itching sensation.
Age: 88.0
Sex: F
Vaccine: FLU3
Symptoms: Erythema, Urticaria
Clinical narrative: Patient received a FLUZONE HD shot on 10-3-16 and on 10-4-16 presented at the pharmacy with a 2 inch red welt on her arm. Advised patient to take an antihistamine, ice the area and contact doctor if it progressed.
Age: 22.0
Sex: F
Vaccine: FLU4
Symptoms: Cough, Flushing, Rash macular, Throat tightness
Clinical narrative: Minutes after flu vaccine administered developed cough, throat tightness, facial flushing and red blotches on trunk; escorted to E.D. directly adjacent to employee health department; provided with BENADRYL and 4 hours observation; coughing resolved with minutes of initial reaction prior to treatment.
Age: 54.0
Sex: F
Vaccine: FLUX
Symptoms: Erythema, Inflammation, Influenza, Rash
Clinical narrative: On second day: flu symptoms t 100.2. Reaction redness rash inflammation on (L) arm.
Age: 74.0
Sex: F
Vaccine: FLU3
Symptoms: Injected limb mobility decreased, Limb discomfort, Pain in extremity
Clinical narrative: Initial soreness and heavy arm. Now pain from scale 0-10 about 6. Can't raise arm. Right arm.
Age: 60.0
Sex: F
Vaccine: FLUX
Symptoms: Insomnia, Musculoskeletal pain
Clinical narrative: Severe Shoulder pain lasting through the night, without sleep.  Took 500 mg Tylenol around 05:00.  Helped until wears off.  Took Advil at 11:00 to ease pain.
Age: 36.0
Sex: F
Vaccine: FLU4
Symptoms: Injected limb mobility decreased, Injection site pain, Pain
Clinical narrative: Patient complains of pain at injection site, pain with range of motion and limited range of motion left arm.
Age: 66.0
Sex: F
Vaccine: FLUX
Symptoms: Chills, Feeling abnormal, Headache, Injection site pain, Pain
Clinical narrative: Chills, no fever, body ache, severe headache, only slight soreness at injection sight. Had to lie down with blanket. 1 Aleve. Didn't feel good for apx. 15 hours
Age: 24.0
Sex: F
Vaccine: FLUC4
Symptoms: Anxiety, Arthralgia, Chills, Dizziness, Fatigue
Clinical narrative: Sweating, cold/hot alternating, localized pain as well as shooting pain down entire arm and up neck. Joint pains, nausea, dizziness, anxiety, tiredness, shivering, high fever (101 next day).
Age: 24.0
Sex: F
Vaccine: FLUC4
Symptoms: Feeling of body temperature change, Hyperhidrosis, Nausea, Pain, Pain in extremity
Clinical narrative: Sweating, cold/hot alternating, localized pain as well as shooting pain down entire arm and up neck. Joint pains, nausea, dizziness, anxiety, tiredness, shivering, high fever (101 next day).
Age: 24.0
Sex: F
Vaccine: FLUC4
Symptoms: Pyrexia
Clinical narrative: Sweating, cold/hot alternating, localized pain as well as shooting pain down entire arm and up neck. Joint pains, nausea, dizziness, anxiety, tiredness, shivering, high fever (101 next day).
Age: 69.0
Sex: F
Vaccine: FLU3
Symptoms: Chills, Diarrhoea, Headache, Pain, Pyrexia
Clinical narrative: Fever (up to 103.2 degrees F at home), chills, diarrhea, headache, diffuse body aches within 8 hours of vaccine, all resolved by 24 hours after vaccine administration. Testing and dos in ED.
Age: 61.0
Sex: M
Vaccine: FLU4, VARZOS
Symptoms: Cardiac failure, Cardiomegaly, Echocardiogram abnormal, Ejection fraction decreased, Electrocardiogram
Clinical narrative: Patient started wheezing at bedtime. He went to a physician, who did an echocardiogram which showed an EF 15-35%. Diagnosed with viral cardiomegaly.
Age: 61.0
Sex: M
Vaccine: FLU4, VARZOS
Symptoms: Laboratory test, Viral cardiomyopathy, Wheezing
Clinical narrative: Patient started wheezing at bedtime. He went to a physician, who did an echocardiogram which showed an EF 15-35%. Diagnosed with viral cardiomegaly.
Age: 19.0
Sex: F
Vaccine: FLU4, HPV9
Symptoms: Rash
Clinical narrative: On 10/19/2016 mother called to state that patient had rash on back that were white and raised not fluid filled.  Mom told patient to take a dose of Benedryl on 10/18/2016 and rash went away. It returned then in later in evening so mom had her take another dose of Bendryl.  She is at Universit.  She let mom know on 10/19/2016 that the rash resolved.  Mom thought she should report it since she had gotten the vaccination and a flu shot.
Age: 73.0
Sex: F
Vaccine: PNC13, TDAP
Symptoms: Bedridden, Pelvic pain
Clinical narrative: Patient reports severe pelvic pain after the injections, she stated she was bed-ridden for a few days, but did not seek medical care.
Age: 40.0
Sex: F
Vaccine: FLU4
Symptoms: Arthralgia, Muscle spasms, Nausea, Pain in extremity, Vomiting
Clinical narrative: RECEIVED FLU VACCINE IN LEFT DELTOID AT APPROX 10AM.  EXPERIENCED NO ISSUES WITH INJECTION. AS DAY WORE ON, LEFT ARM WAS SORE, NO SURPRISE. BY 4PM NOTED LEFT ELBOW AREA WITH SEVERE PAIN. BY 6PM, LEFT ARM AREA PAIN CONTINUES, PAIN WORSED (SHOOTING PAIN) IF ROTATED ARM INWARD OR OUTWARD. STARTED DROPPING EVERYTHING GRABBED WITH LEFT ARM. THEN HAD SEVERE NAUSEA, STARTED SATURDAY PM, TIL MONDAY AT NOON. VOMITING STARTED SUNDAY ENDED EARLY MONDAY AM.  OCCASSIONAL CRAMPING CONTINUES IN LEFT HAND, WHICH I DROP ITEMS, HAS OCCURED SEVERAL TIMES SINCE THE VACCINE.
Age: 32.0
Sex: F
Vaccine: FLU4
Symptoms: Chest X-ray, Chills, Laboratory test, Nausea, Pyrexia
Clinical narrative: Nausea started about 7:45 PM, followed by vomiting about 9:00 PM. Chills started about 8:00 PM. Took Zofran at 8:00 PM and again at 9:30 for the nausea and vomiting with no relief. Went to ER about 10:15 PM. Arrived in the emergency room with 166 heart rate and fever of 102.7, still vomiting. Admitted to hospital that night.
Age: 32.0
Sex: F
Vaccine: FLU4
Symptoms: Vomiting
Clinical narrative: Nausea started about 7:45 PM, followed by vomiting about 9:00 PM. Chills started about 8:00 PM. Took Zofran at 8:00 PM and again at 9:30 for the nausea and vomiting with no relief. Went to ER about 10:15 PM. Arrived in the emergency room with 166 heart rate and fever of 102.7, still vomiting. Admitted to hospital that night.
Age: 56.0
Sex: F
Vaccine: FLU4
Symptoms: Abdomen scan, Blood test, Chest scan, Dizziness, Electromyogram
Clinical narrative: Paresthesia of all four extremities,  high BP and Pulse, faint, dizziness.
Age: 56.0
Sex: F
Vaccine: FLU4
Symptoms: Endocrine test, Heart rate increased, Hypertension, Lumbar puncture, Paraesthesia
Clinical narrative: Paresthesia of all four extremities,  high BP and Pulse, faint, dizziness.
Age: 56.0
Sex: F
Vaccine: FLU4
Symptoms: Parathyroid scan normal, Scan brain, Scan thyroid gland, Syncope, Urine analysis
Clinical narrative: Paresthesia of all four extremities,  high BP and Pulse, faint, dizziness.
Age: 73.0
Sex: F
Vaccine: FLU3, FLU3
Symptoms: Pain in extremity
Clinical narrative: PATIENT STARTED HAVING PAIN IN HER LEFT ARM A DAY AFTER THE IMMUNIZATION. SHE REPORTED IT TO ME ON 10/18/16. SHE SAID IT CONTINUES TO HURT. SHE VISITED A HOSPITAL ER ON 09/27/16 AND RECEIVED AN RX FOR PREDNISONE 20MG TABLETS #12 TAKE 3 TABS PO DAILY FOR 4 DAYS. SHE IS CURRENTLY SEEING AN ACUPUNCTURIST FOR TREATMENT.
Age: 73.0
Sex: F
Vaccine: FLU3, FLU3
Symptoms: Activities of daily living impaired, Musculoskeletal pain
Clinical narrative: PATIENT STARTED HAVING PAIN IN HER LEFT ARM A DAY AFTER THE IMMUNIZATION. SHE REPORTED IT TO ME ON 10/18/16. SHE SAID IT CONTINUES TO HURT. SHE VISITED A HOSPITAL ER ON 09/27/16 AND RECEIVED AN RX FOR PREDNISONE 20MG TABLETS #12 TAKE 3 TABS PO DAILY FOR 4 DAYS. SHE IS CURRENTLY SEEING AN ACUPUNCTURIST FOR TREATMENT.
Age: 19.0
Sex: F
Vaccine: FLU4, MENB, MNQ, FLUX, MENB, MNQ
Symptoms: Cellulitis, Erythema, Headache, Pain, Pain in extremity
Clinical narrative: This is a spontaneous report from a contactable nurse. A 20-year-old female patient of an unspecified race and ethnicity received the second dose of TRUMENBA (lot M77282, exp.date 30Jun2017) via intramuscular route in the right deltoid at 19 years on 30Sep2016 15:03 at 0.5 ml single for immunisation. On 30Sep2016 15:03, the patient also received MENVEO on the right arm, and on unknown date the fifth dose of influenza vaccine (lot UI684AD, manufacturer Sanofi Pasteur) via intramuscular route on the left arm. Relevant medical history included abdominal pain (problem stress related) from 30Nov2012 to Apr2013. Concomitant medication included amoxicillin, at 500 mg, 3x/day, for sinusitis. Illness at time of vaccination included sinusitis. The patient had received the first dose of TRUMENBA on unknown date in Jul2016 and had experienced swelling and pain in Aug2016. On unknown date the patient experienced cellulitis, arm hurt, swelling arm, redness, hurts to move it, warm to touch, headache. The patient received AUGMENTIN for cellulitis. The events required an emergency room. The patient was not admitted to hospital. The outcome of the events was reported as unknown. Sender's Comments: The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees, as appropriate. The case will be reassessed if additional information becomes available.
Age: 19.0
Sex: F
Vaccine: FLU4, MENB, MNQ, FLUX, MENB, MNQ
Symptoms: Peripheral swelling, Skin warm
Clinical narrative: This is a spontaneous report from a contactable nurse. A 20-year-old female patient of an unspecified race and ethnicity received the second dose of TRUMENBA (lot M77282, exp.date 30Jun2017) via intramuscular route in the right deltoid at 19 years on 30Sep2016 15:03 at 0.5 ml single for immunisation. On 30Sep2016 15:03, the patient also received MENVEO on the right arm, and on unknown date the fifth dose of influenza vaccine (lot UI684AD, manufacturer Sanofi Pasteur) via intramuscular route on the left arm. Relevant medical history included abdominal pain (problem stress related) from 30Nov2012 to Apr2013. Concomitant medication included amoxicillin, at 500 mg, 3x/day, for sinusitis. Illness at time of vaccination included sinusitis. The patient had received the first dose of TRUMENBA on unknown date in Jul2016 and had experienced swelling and pain in Aug2016. On unknown date the patient experienced cellulitis, arm hurt, swelling arm, redness, hurts to move it, warm to touch, headache. The patient received AUGMENTIN for cellulitis. The events required an emergency room. The patient was not admitted to hospital. The outcome of the events was reported as unknown. Sender's Comments: The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees, as appropriate. The case will be reassessed if additional information becomes available.
Age: 19.0
Sex: F
Vaccine: FLU4, MENB, MNQ, FLUX, MENB, MNQ
Symptoms: Peripheral swelling, Skin warm, Tenderness, Vaccination site erythema, Vaccination site pain
Clinical narrative: This is a spontaneous report from a contactable nurse. A 20-year-old female patient of an unspecified race and ethnicity received the second dose of TRUMENBA (lot M77282, exp.date 30Jun2017) via intramuscular route in the right deltoid at 19 years on 30Sep2016 15:03 at 0.5 ml single for immunisation. On 30Sep2016 15:03, the patient also received MENVEO on the right arm, and on unknown date the fifth dose of influenza vaccine (lot UI684AD, manufacturer Sanofi Pasteur) via intramuscular route on the left arm. Relevant medical history included abdominal pain (problem stress related) from 30Nov2012 to Apr2013. Concomitant medication included amoxicillin, at 500 mg, 3x/day, for sinusitis. Illness at time of vaccination included sinusitis. The patient had received the first dose of TRUMENBA on unknown date in Jul2016 and had experienced swelling and pain in Aug2016. On unknown date the patient experienced cellulitis, arm hurt, swelling arm, redness, hurts to move it, warm to touch, headache. The patient received AUGMENTIN for cellulitis. The events required an emergency room. The patient was not admitted to hospital. The outcome of the events was reported as unknown. Sender's Comments: The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees, as appropriate. The case will be reassessed if additional information becomes available.
Age: 19.0
Sex: F
Vaccine: FLU4, MENB, MNQ, FLUX, MENB, MNQ
Symptoms: Vaccination site warmth
Clinical narrative: This is a spontaneous report from a contactable nurse. A 20-year-old female patient of an unspecified race and ethnicity received the second dose of TRUMENBA (lot M77282, exp.date 30Jun2017) via intramuscular route in the right deltoid at 19 years on 30Sep2016 15:03 at 0.5 ml single for immunisation. On 30Sep2016 15:03, the patient also received MENVEO on the right arm, and on unknown date the fifth dose of influenza vaccine (lot UI684AD, manufacturer Sanofi Pasteur) via intramuscular route on the left arm. Relevant medical history included abdominal pain (problem stress related) from 30Nov2012 to Apr2013. Concomitant medication included amoxicillin, at 500 mg, 3x/day, for sinusitis. Illness at time of vaccination included sinusitis. The patient had received the first dose of TRUMENBA on unknown date in Jul2016 and had experienced swelling and pain in Aug2016. On unknown date the patient experienced cellulitis, arm hurt, swelling arm, redness, hurts to move it, warm to touch, headache. The patient received AUGMENTIN for cellulitis. The events required an emergency room. The patient was not admitted to hospital. The outcome of the events was reported as unknown. Sender's Comments: The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees, as appropriate. The case will be reassessed if additional information becomes available.
Age: 76.0
Sex: F
Vaccine: FLU3
Symptoms: Contusion, Erythema, Mobility decreased, Rash
Clinical narrative: Received the FLUZONE HIGH DOSE 2016-1405ml syr. 09/26/16. Next morning rash very larger, below the vaccinated were the shot was given. Above it my arm was a dark blue and black red bruise. Barely could lift my arm. Had no other shots. By the 28th my chest was rash.
Age: 0.5
Sex: M
Vaccine: DTAPHEPBIP, FLU4, HIBV, PNC13, RV5
Symptoms: Pyrexia, Seizure, Skin warm
Clinical narrative: Pt received 6 MO immunizations 10/18/16. Later that night pt started with a fever of 103.7. Mom gave him TYLENOL, pt seen at urgent care 10/19/16. Morning of 10/20/16 mom woke up pt felt very warm was going to give him TYLENOL and pt started to have a seizure, taken to the ER.
Age: 82.0
Sex: F
Vaccine: FLU3
Symptoms: Immediate post-injection reaction, Injection site nodule, Local reaction
Clinical narrative: Local reaction immediately after vaccine given on L. Deltoid. Knot developed 4.5 x 4 cm, soft, no pain reported by patient. Patient was assessed by Dr. and nurse. Pt was instructed to monitor arm and call office on 10-24-16.
Age: 18.0
Sex: M
Vaccine: TYP, YF
Symptoms: Dizziness, Eye movement disorder, Nausea, Pallor, Seizure
Clinical narrative: Patient became pale and reported feeling as though they were about to faint. The patient's eyes rolled to the back of their head and they started convulsing for approximately less than a minute. EMS was called at this time. He awakened pale and nauseous. He reported feeling nauseous for several minutes after he awakened. EMS took vitals (130/50, HR 70) and patient refused to be transported to the emergency room. Mother served as witness.
Age: 1.17
Sex: M
Vaccine: FLU4, VARCEL
Symptoms: Injection site erythema, Injection site nodule, Injection site warmth
Clinical narrative: Patient has subcutaneous 1.5cm nodule with overlying blanching erythema on upper right thigh at site of previous Varicella vaccine administration (left thigh had Influenza vaccine given on same day with no adverse reaction). No tenderness to palpation. The site is slightly warm to touch. No inguinal lymph nodes palpable. Patient able to ambulate normally. No pus, drainage, puncture site, umbilication, open wound, or bleeding from the area.
Age: 76.0
Sex: F
Vaccine: FLU4, PPV
Symptoms: Arthropod sting, Injection site discomfort, Injection site erythema, Injection site swelling, Injection site warmth
Clinical narrative: Site injection area was red, swollen and uncomfortable and feverish until 10/24/2016. Today I received a yellow jacket sting near the injection site, so it reswelled, and became red and swollen.
Age: 64.0
Sex: M
Vaccine: FLU4
Symptoms: Bone pain, Injection site pain
Clinical narrative: At time of injection intense burning. Patient stays the pain has never left and feels like bone pain. When arm is moved it feels like a re-administration of the vaccine.
Age: 63.0
Sex: F
Vaccine: VARZOS
Symptoms: Erythema, Pain in extremity, Peripheral swelling, Skin warm
Clinical narrative: Swelling in left arm, redness, and "fever" present in arm. Slight to moderate soreness.
Age: 36.0
Sex: M
Vaccine: FLU4
Symptoms: Erythema, Feeling abnormal, Headache, Neck pain, Peripheral swelling
Clinical narrative: Left arm redness, swelling. C/O neck and head pain, "not feeling right".
Age: 59.0
Sex: F
Vaccine: FLUX
Symptoms: Mobility decreased, Musculoskeletal pain, Sleep disorder
Clinical narrative: Started with flu shot in 2014, happened each flu shot thereafter. Pain in shoulder for 5 mo in 2014, could not raise shoulder, 2015 pain for 3 months, 2016, could not sleep on arm for 1 yr.
Age: 4.0
Sex: F
Vaccine: FLU4
Symptoms: Abnormal behaviour, Psychomotor hyperactivity
Clinical narrative: Displaying inappropriate behavior, hyperactive, rolling on floor, acting as if she was intoxicated.
Age: 56.0
Sex: M
Vaccine: FLU3
Symptoms: Pain in extremity
Clinical narrative: Patient is having persistant pain in the right arm.
Age: 43.0
Sex: F
Vaccine: PPV
Symptoms: Mobility decreased, Pain, Swelling
Clinical narrative: Patient states she had swelling and pain by end of night.  By the time she returned to the pharmacy swelling improved little bit however, she still had difficulty moving the arm.
Age: 45.0
Sex: F
Vaccine: FLU4
Symptoms: Dysarthria, Feeling abnormal, Injected limb mobility decreased, Paraesthesia
Clinical narrative: Pt reports approximately 20 minutes after vaccination she started experiencing tingling in the arm the vaccine was administered in. She states that she started feeling funny like she was intoxicated and decided to go home from the school she was at. Patient reports that by the time she got home she could no longer lift the affected arm and that she her speech was slurred. Patient reports that she contacted her sister in law who is a nurse and told her to take some benadryl. Pt reports an hour later she had no remaining symptoms.
Age: 69.0
Sex: F
Vaccine: FLU3
Symptoms: Myalgia, Nerve injury
Clinical narrative: Patient complaining of pain in the muscle that radiated down her arm and is still complaining that the pain has not subsided completely as of 10/25/2016.  She thinks a nerve was hit by the needle high on her arm.
Age: 62.0
Sex: M
Vaccine: PNC13
Symptoms: Injection site erythema
Clinical narrative: This is a spontaneous report from a contactable consumer who reported for himself. A 62-year-old male patient of received PREVNAR 13 on  28Sep2016 at single dose for immunization. Medical history included hypertension, diabetes, plastic bronchitis, allergies, acid reflux, cholesterol, high blood pressure and thyroid. Concomitant medication included ongoing metformin tablet for diabetes at 500 mg, 2x/day oral, ongoing VICTOZA for diabetes at 1.8 mg 1x/day injection, ongoing NOVOLOG 3x/day (at breakfast 28, at lunch 20 and at dinner 50) for diabetes injection, ongoing ipratropium bromide/salbutamol sulfate in nebulizer via inhalation 4x/day for plastic bronchitis, ongoing SYMBICORT 160/4.5mg  for plastic bronchitis 2 x/day via inhalation, ongoing furosemide water tablet for high blood pressure at 40 mg, 2x/day oral, ongoing levothyroxine tablet at 34mg 1x/day oral for thyroid, ongoing simvastatin tablet cholesterol at 40 mg, 1x/day oral, ongoing montelukast for allergies tablet at 10 mg 1x/day oral, ongoing omeprazole capsule for acid reflux at 40 mg, 2x/day oral, ongoing prednisone tablet for Plastic bronchitis since a year at 10 mg, 1x/day oral, ongoing TRESIBA injection at 100 mg, 1x/day for diabetes, ongoing spironolactone water tablet at 25 mg, 1x/day oral, ongoing SPIRIVA capsule broken and inhaled for Plastic bronchitis at 18 ug, 1x/day and ongoing heparin for blood thinner via nebulizer with a 9% (later 7%) nebulizer solution of sodium chloride, in a junction with a Vibralung (sound vibrating instrument in lungs). On 28Sep2016 the patient experienced redness at injection site: he had a big red patch on arm with a dot. On the first day it was just low red, then redness continually get bigger. The redness at the injection started to lighten up a little bit, but it got up a little bit darker red as the days went on. He was treated with unspecified medications and steroid. It had been about a week, but the event did not get much better. The final outcome of the event was not recovered.
Sex: F
Vaccine: MENB
Symptoms: Injection site erythema, Injection site pain
Clinical narrative: This is a spontaneous report from Pfizer sponsored program. A  contactable Pharmacist reported that a female patient of an unspecified age and ethnicity suffering from Rosacea received the first TRUMENBA, via an unspecified route of administration on an unspecified date at single dose for immunisation.  The patient medical history and concomitant medications were not reported.  The patient experienced pain and redness at the injection site on an unspecified date with outcome of unknown. The reporter commented that this likely to be worse in patients with Rosacea.
Age: 56.0
Sex: M
Vaccine: FLU4
Symptoms: Angiogram normal, Facial paralysis, Platelet count decreased, Red blood cell count decreased, White blood cell count decreased
Clinical narrative: Right sided Bell's Palsy.
Age: 12.0
Sex: F
Vaccine: HPV9, MNQ
Symptoms: Cellulitis, Erythema, Hypersensitivity, Peripheral swelling
Clinical narrative: Mother reported noticed her left arm was red and swollen the next morning, child went to the ER October 19th, dx with allergic reaction and cellulitis, was given prednisone and Bactrim.
Age: 94.0
Sex: M
Vaccine: FLU4, PPV
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
Clinical narrative: R DELTOID + REDNESS, SWELLING, WARMTH, AND PAIN AT SITE OF INJECTION.
Age: 70.0
Sex: F
Vaccine: FLUX
Symptoms: Dizziness, Nausea
Clinical narrative: Very dizzy and sick to stomach.
Age: 49.0
Sex: F
Vaccine: FLU4
Symptoms: Asthenia, Dizziness, Nausea, Vomiting
Clinical narrative: Dizziness, weakness, nausea, throwing up.
Age: 29.0
Sex: F
Vaccine: HPV9
Symptoms: Dizziness, Loss of consciousness, Nausea
Clinical narrative: Pt stated she felt dizzy,was placed in a reclining patient chair and lost consciousness. Pt regained consciousness, A&O x4, pt stated continued nausea.
Age: 12.0
Sex: M
Vaccine: FLU3, HPV9, MNQ, TDAP
Symptoms: Loss of consciousness
Clinical narrative: Pt was seated in waiting area and lost consciousness. Pt regained consciousness and was A&O x4.
Age: 37.0
Sex: M
Vaccine: FLU4, TDAP
Symptoms: Injection site induration, Injection site mass, Injection site pain, Injection site swelling, Injection site warmth
Clinical narrative: Swollen, warm to touch, hardened, painful mass 4 cm x 4 cm at the site of injection on left upper arm.
Age: 31.0
Sex: F
Vaccine: FLU3
Symptoms: Blister, Rash generalised, Urticaria
Clinical narrative: Full body rash, small hive like, with small blisters. Spread to extremities the next morning, still spreading (getting denser) 4 days later.
Age: 53.0
Sex: F
Vaccine: VARZOS
Symptoms: Arthralgia, Erythema, Mobility decreased, Oedema peripheral, Pain
Clinical narrative: Swelling of upper arm, underarm, upper back. Affected area swollen, red, sore, limits use of arm when lifting. Also pt has sore elbow and wrist.
Age: 53.0
Sex: F
Vaccine: VARZOS
Symptoms: Peripheral swelling
Clinical narrative: Swelling of upper arm, underarm, upper back. Affected area swollen, red, sore, limits use of arm when lifting. Also pt has sore elbow and wrist.
Age: 65.0
Sex: F
Vaccine: FLU3
Symptoms: Arthralgia, Injection site urticaria, Local swelling, Nausea, Vomiting
Clinical narrative: Wheal at injection site, localized swelling, joint aches, nausea and vomiting.
Age: 42.0
Sex: M
Vaccine: FLU4
Symptoms: Diarrhoea, Pyrexia, Retching, Vomiting
Clinical narrative: Fever, vomiting with dry heaving, diarrhea.
Age: 82.0
Sex: M
Vaccine: PPV, PPV
Symptoms: Injection site pain, Injection site swelling
Clinical narrative: Tender enlarged bump 2 inches below the site of injection. Sore to the touch.
Age: 82.0
Sex: M
Vaccine: PPV, PPV
Symptoms: Local swelling
Clinical narrative: Tender enlarged bump 2 inches below the site of injection. Sore to the touch.
Age: 44.0
Sex: M
Vaccine: FLUX
Symptoms: Erythema, Induration, Skin warm
Clinical narrative: Noticed large red hard hot area approximately 7cm x 7 cm continued to spread.
Age: 62.0
Sex: F
Vaccine: FLU3
Symptoms: Injection site reaction, Pain in extremity, Skin tightness
Clinical narrative: Patient describes her arm feels like there is a cuff around her bicep area.  She reports it is constant.  Full range of motion for patient.  No clear discoloration on patient's arm to date (10/25/2016) patient reports no pain on injection site rather arm below injection site.
Age: 48.0
Sex: F
Vaccine: FLU4
Symptoms: Activities of daily living impaired, Joint range of motion decreased, Mobility decreased, Pain, Poor quality sleep
Clinical narrative: Very sore, unable to lift arm, pain wakes me from sleeping etc. Limited range of motion restricts even my activities of daily living still.
Age: 53.0
Sex: F
Vaccine: FLUX
Symptoms: Blood test, Cataplexy, Eyelid function disorder, Face injury, Fall
Clinical narrative: At first episodes of eyes closing the after that happening a few times started having episodes of collapsing.  Knees buckling and falling to ground or face on table if sitting.  ESP IF I LAUGHED.