chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 74.0
Sex: M
Vaccine: COVID19
Symptoms: Ophthalmological examination, Vision blurred, Vitreous floaters
Clinical narrative: Began developing a fuzzy eye sight in right eye; progressively worse, unable to focus. On Wednesday 2/3/2021 I noticed a large amount of long and moving floaters in the ight eye, swirling, growing and then fading - like someone poured a stream of ink in water. By Friday 2/4/2021 unable to focus from right eye and went to Ophthalmologist for eye exam; He made arrangements to send me to a clinic in and I will see them on Wednesday 2/10/2021. I don't know whether or not this is related to the COVID vaccine but it is the only unusual event that has occurred in the last 45 days.
Age: 34.0
Sex: F
Vaccine: COVID19
Symptoms: Rash papular, Rash pruritic
Clinical narrative: I develop a raised reddened area a little smaller than a quarter that was itchy.
Age: 54.0
Sex: M
Vaccine: COVID19
Symptoms: Arthralgia, Blood glucose increased, Blood test, Blood uric acid increased, Dizziness
Clinical narrative: 21st - swollen big toe and upper part of foot - I had swelling but not as bad as first dose of vaccine; some of my joints sore, too. On 26th of January, I had shortness of breath and a little dizzy. It was tolerable but was there. Toe/foot symptoms resolved around January 31st but I did still have shortness of breath up until the 2nd of February. Dr put me on Colchesine and Alloepurinal
Age: 54.0
Sex: M
Vaccine: COVID19
Symptoms: Dyspnoea, Peripheral swelling
Clinical narrative: 21st - swollen big toe and upper part of foot - I had swelling but not as bad as first dose of vaccine; some of my joints sore, too. On 26th of January, I had shortness of breath and a little dizzy. It was tolerable but was there. Toe/foot symptoms resolved around January 31st but I did still have shortness of breath up until the 2nd of February. Dr put me on Colchesine and Alloepurinal
Age: 39.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site erythema, Injection site inflammation, Injection site swelling
Clinical narrative: Red, raised, inflamed area around and above site of injection, nine days posts injection.
Age: 25.0
Sex: F
Vaccine: COVID19
Symptoms: Chest pain, Computerised tomogram, Fibrin D dimer increased, Headache, Hypoaesthesia
Clinical narrative: On 2/7/21, had minor gnawing chest pain (2-3/10) which progressed to 7/10 chest pain , throbbing headache with positional changes and numbness down both arms (L>R). Went to the ER and was admitted.
Age: 25.0
Sex: F
Vaccine: COVID19
Symptoms: Troponin increased, Ultrasound chest, Ultrasound scan normal, Vertigo positional
Clinical narrative: On 2/7/21, had minor gnawing chest pain (2-3/10) which progressed to 7/10 chest pain , throbbing headache with positional changes and numbness down both arms (L>R). Went to the ER and was admitted.
Age: 46.0
Sex: F
Vaccine: COVID19
Symptoms: Burning sensation, Chills, Feeling drunk, Headache, Hypertension
Clinical narrative: About an hour after receiving the vaccine, my head and face felt tingly and my cheeks felt like they were on fire, I was having to concentrate on what I wanted to say. I felt really drunk. I went back up to the vaccine clinic and the Pharmacist and RN  took my vitals and sat me down. My blood pressure was high. After 15 minutes of sitting in a chair they took my vitals again and had me lay down in a bed with my feet up in hopes of making my blood pressure go down. After about 45 minutes my blood pressure started to go down. After about an hour and a half my head started to clear, but I had developed hives on my face and chest. The pharmacist gave me liquid Benadryl and then monitored me for another half hour. Once my hives started to look better they sent me home, where I slept for the rest of the day.  2/4/21 the next day I woke up with a headache but otherwise felt ok until about 3:00pm when I developed body aches, chills and a fever of 100.8. I took some tylonal and rested  until bed time. When I got up the next morning I felt alright. Just a mild headache.
Age: 46.0
Sex: F
Vaccine: COVID19
Symptoms: Pain, Paraesthesia, Pyrexia, Urticaria
Clinical narrative: About an hour after receiving the vaccine, my head and face felt tingly and my cheeks felt like they were on fire, I was having to concentrate on what I wanted to say. I felt really drunk. I went back up to the vaccine clinic and the Pharmacist and RN  took my vitals and sat me down. My blood pressure was high. After 15 minutes of sitting in a chair they took my vitals again and had me lay down in a bed with my feet up in hopes of making my blood pressure go down. After about 45 minutes my blood pressure started to go down. After about an hour and a half my head started to clear, but I had developed hives on my face and chest. The pharmacist gave me liquid Benadryl and then monitored me for another half hour. Once my hives started to look better they sent me home, where I slept for the rest of the day.  2/4/21 the next day I woke up with a headache but otherwise felt ok until about 3:00pm when I developed body aches, chills and a fever of 100.8. I took some tylonal and rested  until bed time. When I got up the next morning I felt alright. Just a mild headache.
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site induration, Injection site pruritus, Injection site reaction, Injection site warmth, Limb discomfort
Clinical narrative: Two silver dollar size red, perfectly round rash, feverish to touch and hard, slight itch and heavy arm feeling, about 2-3 inches below injection site. Appeared on day after initial injection, then disappeared within 48 hours. The patches reappeared on day 8 after injection and were in exactly the same places on the arm, same appearance and characteristics. Again disappeared within 48 hours. Has not seen anything since.
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: Rash erythematous
Clinical narrative: Two silver dollar size red, perfectly round rash, feverish to touch and hard, slight itch and heavy arm feeling, about 2-3 inches below injection site. Appeared on day after initial injection, then disappeared within 48 hours. The patches reappeared on day 8 after injection and were in exactly the same places on the arm, same appearance and characteristics. Again disappeared within 48 hours. Has not seen anything since.
Age: 55.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Headache, Nausea
Clinical narrative: H/A, nausea, chills
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Fatigue, Headache, Nausea, Pain
Clinical narrative: Fever, chills, aches, headache, neausea, tired
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: Pyrexia
Clinical narrative: Fever, chills, aches, headache, neausea, tired
Age: 56.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Asthenia, Hypoaesthesia, Injection site hypoaesthesia, Injection site reaction, Muscle tightness
Clinical narrative: within 5 minutes of receiving the vaccine,  my left arm became numb & weak & resolved by the next day; 1-2 hours later my legs/feet from the knees down became numb/tingling with tightening muscles; 2 hours later left side entire face became numb with puffy left eye lid which lasted for 8 days;  by the 8th day my symptoms began to resolve only to return with 4 days with left face/throat numbness & left side numbness/tingling with tightening forearm muscles both hands/fingers/arms from elbows down & numbness/tingling/muscle tightening in both legs/feet/toes from the knees down  along with pain in both knees which lasted another 2 days;  I continue to have some residual symptoms of numbness on the left side of my face that comes and goes as well as the same symptoms of numbness/muscle tightening and tingling in both legs/feet that comes & goes.
Age: 56.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Paraesthesia, Periorbital swelling, Pharyngeal hypoaesthesia
Clinical narrative: within 5 minutes of receiving the vaccine,  my left arm became numb & weak & resolved by the next day; 1-2 hours later my legs/feet from the knees down became numb/tingling with tightening muscles; 2 hours later left side entire face became numb with puffy left eye lid which lasted for 8 days;  by the 8th day my symptoms began to resolve only to return with 4 days with left face/throat numbness & left side numbness/tingling with tightening forearm muscles both hands/fingers/arms from elbows down & numbness/tingling/muscle tightening in both legs/feet/toes from the knees down  along with pain in both knees which lasted another 2 days;  I continue to have some residual symptoms of numbness on the left side of my face that comes and goes as well as the same symptoms of numbness/muscle tightening and tingling in both legs/feet that comes & goes.
Age: 56.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Arthralgia, Eyelid disorder, Hypoaesthesia, Muscle tightness, Muscular weakness
Clinical narrative: within 5 minutes of receiving the vaccine,  my left arm became numb & weak & resolved by the next day; 1-2 hours later my legs/feet from the knees down became numb/tingling with tightening muscles; 2 hours later left side entire face became numb with puffy left eye lid which lasted for 8 days;  by the 8th day my symptoms began to resolve only to return with 4 days with left face/throat numbness & left side numbness/tingling with tightening forearm muscles both hands/fingers/arms from elbows down & numbness/tingling/muscle tightening in both legs/feet/toes from the knees down  along with pain in both knees which lasted another 2 days;  I continue to have some residual symptoms of numbness on the left side of my face that comes and goes as well as the same symptoms of numbness/muscle tightening and tingling in both legs/feet that comes & goes.
Age: 56.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Oropharyngeal discomfort, Paraesthesia, SARS-CoV-2 antibody test
Clinical narrative: within 5 minutes of receiving the vaccine,  my left arm became numb & weak & resolved by the next day; 1-2 hours later my legs/feet from the knees down became numb/tingling with tightening muscles; 2 hours later left side entire face became numb with puffy left eye lid which lasted for 8 days;  by the 8th day my symptoms began to resolve only to return with 4 days with left face/throat numbness & left side numbness/tingling with tightening forearm muscles both hands/fingers/arms from elbows down & numbness/tingling/muscle tightening in both legs/feet/toes from the knees down  along with pain in both knees which lasted another 2 days;  I continue to have some residual symptoms of numbness on the left side of my face that comes and goes as well as the same symptoms of numbness/muscle tightening and tingling in both legs/feet that comes & goes.
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Death, Myalgia
Clinical narrative: Patient complained of soreness in muscles morning after receiving the shot.  She went about her day had a smoothie, spoke to people and also went for a walk came home and went into her jacuzzi tub and consequently passed away while in the tub. She was found by her husband at around 545pm, time of death is unknown and cause of death is  currently pending.
Age: 80.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Arthralgia, C-reactive protein increased, Haematocrit decreased, Haemoglobin decreased, Injected limb mobility decreased
Clinical narrative: Pt presented to ED 1/25/2021 with 1 week history of bilateral shoulder pain, started on right, left involved later, wore with movement. NKI. He was given IM ketorolac 30 mg and seen in Clinic by chiropractor with some relief  1 day. PT consult placed and is still pending. Known hx osteoarthritis right shoulder by x-ray 12/10/20  Pt returned to urgent care/walk-in clinic 2/8 with worsening bilateral shoulder pain.  ROM of both shoulders quite limited. NKI. Treated for PMR.
Age: 80.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Injection site pain, Joint range of motion decreased, Pain, Red blood cell sedimentation rate increased, Tendon disorder
Clinical narrative: Pt presented to ED 1/25/2021 with 1 week history of bilateral shoulder pain, started on right, left involved later, wore with movement. NKI. He was given IM ketorolac 30 mg and seen in Clinic by chiropractor with some relief  1 day. PT consult placed and is still pending. Known hx osteoarthritis right shoulder by x-ray 12/10/20  Pt returned to urgent care/walk-in clinic 2/8 with worsening bilateral shoulder pain.  ROM of both shoulders quite limited. NKI. Treated for PMR.
Age: 80.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: X-ray limb abnormal
Clinical narrative: Pt presented to ED 1/25/2021 with 1 week history of bilateral shoulder pain, started on right, left involved later, wore with movement. NKI. He was given IM ketorolac 30 mg and seen in Clinic by chiropractor with some relief  1 day. PT consult placed and is still pending. Known hx osteoarthritis right shoulder by x-ray 12/10/20  Pt returned to urgent care/walk-in clinic 2/8 with worsening bilateral shoulder pain.  ROM of both shoulders quite limited. NKI. Treated for PMR.
Age: 42.0
Sex: F
Vaccine: COVID19
Symptoms: Ageusia, Anosmia, Chills, Headache, Pain
Clinical narrative: I started having shivering, chills,headache, really bad body ache all of symptoms like Covid except lost of taste/smell lasted for 48 hrs.
Age: 60.0
Sex: M
Vaccine: COVID19
Symptoms: Chills, Influenza like illness, Pain, Pain in extremity, Pyrexia
Clinical narrative: Aches, chills, typical flu type symptoms, Fever to 102 F. Lasted till about midnight. Fever broke and felt fine afterwards. Also had pain in arm on both shots. Worse the first night then less each day for about 3 days.
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Decreased appetite, Pain in extremity, Sleep disorder
Clinical narrative: My adverse reaction was about 2-3 hours after I had the vaccine, I expected my arm to be sore but it steadily got more and more sore. It kept waking me up on that night 2/3. I tried not to lay on my left side and I was getting chills like you get when you get the flu, so that lasted for about 30 hours after I had my vaccine. And then about 2:30-3:00 in the afternoon all of the adverse symptoms/reactions I was having just stopped. The only other thing I want to say is that I wasn't hungry at all, i could taste and smell but I didn't want to eat anything. I had soup and everything else but I had no appetite.
Age: 31.0
Sex: F
Vaccine: COVID19
Symptoms: Lymph node pain, Lymphadenopathy
Clinical narrative: Left axillary lymph node swelling and pain, took ibuprofen prn. Still experiencing swollen lymph node, no pain (3 days post vaccine)
Age: 41.0
Sex: F
Vaccine: COVID19
Symptoms: Vaccination complication
Clinical narrative: Covid arm.
Age: 46.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Sleep disorder
Clinical narrative: Severe joint point in both knees, hips, elbows, shoulders and right wrist.  Severity of pain varies but is consistent and significant enough to prevent regular nightly sleep.  Typical approaches to alleviating the pain, which does occur in the knees and hips due to early arthritis, are not effective.  These include OTC rapid release extra strength tylenol and rest.
Age: 55.0
Sex: F
Vaccine: COVID19
Symptoms: Decreased appetite, Diarrhoea, Fatigue, Hypoaesthesia, Lymphadenopathy
Clinical narrative: Fatigue, syncope sensation, Arm pain - scale 10, arm swelling, fingers numbness, tingling, and swelling. Nausea. GI - Diarrhea. Swollen Lymph nodes, chills, fever, no appetite.
Age: 55.0
Sex: F
Vaccine: COVID19
Symptoms: Nausea, Pain in extremity, Paraesthesia, Peripheral swelling, Pyrexia
Clinical narrative: Fatigue, syncope sensation, Arm pain - scale 10, arm swelling, fingers numbness, tingling, and swelling. Nausea. GI - Diarrhea. Swollen Lymph nodes, chills, fever, no appetite.
Age: 55.0
Sex: F
Vaccine: COVID19
Symptoms: Syncope
Clinical narrative: Fatigue, syncope sensation, Arm pain - scale 10, arm swelling, fingers numbness, tingling, and swelling. Nausea. GI - Diarrhea. Swollen Lymph nodes, chills, fever, no appetite.
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Blood pressure increased, Decreased appetite, Headache, Myalgia, Nausea
Clinical narrative: Sore arm and headache started approximately 5 hours after vaccine and resolved within 48 hours.  Poor appetite and nausea started on day 2 post vaccine and lasted for 2-3 days.  Episode of tachycardia and elevated blood pressure 2 days after vaccine, resolved within 24 hours, back to baseline this date.  Muscle aches  started day 7 post vaccine and continue this date.
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Pain in extremity, Tachycardia
Clinical narrative: Sore arm and headache started approximately 5 hours after vaccine and resolved within 48 hours.  Poor appetite and nausea started on day 2 post vaccine and lasted for 2-3 days.  Episode of tachycardia and elevated blood pressure 2 days after vaccine, resolved within 24 hours, back to baseline this date.  Muscle aches  started day 7 post vaccine and continue this date.
Age: 26.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Fatigue, Headache, Pain
Clinical narrative: chills body aches headache tired
Age: 80.0
Sex: M
Vaccine: COVID19
Symptoms: Injection site vesicles, Skin lesion
Clinical narrative: Two weeks after the vaccine he got up and had a nickel sized blister on his arm between the shoulder and elbow, below the injection site.  He pressed on it and it burst open and water came out of it.  The skin then dried up and came off, and left a dime sized sore place under that blister and is still there on Monday 2/8/21 and has not gone away.  It has not scabbed up.  He did not take anything for it.
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Headache, Nausea, Pain, Pyrexia
Clinical narrative: nausea, fever, headache, body aches intense all day on1/13 thru mid-day 1/14/21. 1/15/21 still had slight headache.
Age: 37.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site rash, Pruritus, Urticaria
Clinical narrative: I received the vaccine on 01/13/2021. On 01/21/21, I noticed several hives on the anterior part of my neck along with itching of that area. On 01/22/21, the hives were gone upon waking, but returned that evening in the same spot, anterior portion of neck. I awoke on 01/23/21 and no hives were present. Later in the day I notice a flattened hive like rash by the injection site, on my upper shoulder, and the anterior part of my chest. This rash became more defined on the 01/24/21 and lasted through 01/26/21.
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness, Fatigue, Feeling abnormal, Nausea
Clinical narrative: nausea, tired, light headed, brain fog
Age: 29.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Chills, Fatigue, Headache, Myalgia
Clinical narrative: Starting at 3am I started feeling symptoms of Fatigue, headache, muscle and joint pain, chills, fever of 100.7
Age: 29.0
Sex: F
Vaccine: COVID19
Symptoms: Pyrexia
Clinical narrative: Starting at 3am I started feeling symptoms of Fatigue, headache, muscle and joint pain, chills, fever of 100.7
Age: 91.0
Sex: M
Vaccine: COVID19
Symptoms: Chills, Dizziness, Fatigue, Pain in extremity, Pyrexia
Clinical narrative: SORE ARM, CHILLS, FEVER 102, DIZZINESS, FATIGUE, 72 HOURS WITH SEVER SYMPTOMS GONE IN 48 HOURS
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness, Musculoskeletal stiffness
Clinical narrative: lightheaded dizzy and stiffness of body.    felt better.  dispo home.
Age: 45.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Migraine, Pain, Pyrexia
Clinical narrative: Migraine-type headache Body aches  Low-grade fever  Fatigue
Age: 88.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Dizziness, Dizziness postural, Feeling abnormal, Nausea
Clinical narrative: Very dizzy when I got up at night.  In morning somewhat nauseous, could not get out of bed.  chills and light headed.  general feeling terrible.  felt somewhat better by around 4PM. but still a little headed the next morning.  Took Aleve and 2 Magnesium pills
Age: 32.0
Sex: F
Vaccine: COVID19
Symptoms: Lymph node pain, Lymphadenopathy
Clinical narrative: 4 days post vaccine I started having a painful swollen lymph node under my injected arm. The lymph node increased in size and severity of pain over the following 4-5 days. Then it gradually improved with no residual effects. For this, I consulted my PCP and we treated with Tylenol and warm compresses.
Age: 32.0
Sex: F
Vaccine: COVID19
Symptoms: Flushing, Headache, Lymphadenopathy, Migraine, Nausea
Clinical narrative: Vaccine Tuesday 6 PM Wednesday Afternoon, sore arm, neck, upper back.  As the day went on, felt very flushed, hot ears, felt flu-ish, lower back pain.  Temperature of 100.9. Thursday, small lump above collar bone, sore to touch.   Friday Migraine and nausea, lump going down in size. Saturday, slight headache, symptoms gone by end of day.
Age: 32.0
Sex: F
Vaccine: COVID19
Symptoms: Pain, Pain in extremity, Skin warm
Clinical narrative: Vaccine Tuesday 6 PM Wednesday Afternoon, sore arm, neck, upper back.  As the day went on, felt very flushed, hot ears, felt flu-ish, lower back pain.  Temperature of 100.9. Thursday, small lump above collar bone, sore to touch.   Friday Migraine and nausea, lump going down in size. Saturday, slight headache, symptoms gone by end of day.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Headache, Pain in extremity, Sleep disorder
Clinical narrative: The left arm was sore following the injection, same day. Woke me up during night when I would turn in bed. But not bad (level 3 of a 1-10 chart). Following morning, I had a slight foggy headache, but not bad.  Approximately 9:30, my joints (knees, elbows, hands, shoulders, ankles - started becoming uncomfortable and hurting. I took 800 mg of Ibprofen about 10:00 am and around 12 - 1:00  realized I did not have any more discomfort.  That was it.  It did not come back. No more headache either.
Age: 30.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness, Feeling abnormal, Hypoaesthesia, Nausea, Pallor
Clinical narrative: "Trembling  ,numbness to her upper arm and lower extremities, felt dizzy and near syncopal" vitals 78/55 pulse 58 O2 sat 100% , " patient was pale ,felt uncomfortable reported nausea, was given oral hydration EMS was dispatched and she agreed to be taken to nearest Emergency room repeat BP 100/59 pulse 62
Age: 30.0
Sex: F
Vaccine: COVID19
Symptoms: Presyncope, Tremor
Clinical narrative: "Trembling  ,numbness to her upper arm and lower extremities, felt dizzy and near syncopal" vitals 78/55 pulse 58 O2 sat 100% , " patient was pale ,felt uncomfortable reported nausea, was given oral hydration EMS was dispatched and she agreed to be taken to nearest Emergency room repeat BP 100/59 pulse 62
Age: 39.0
Sex: F
Vaccine: COVID19
Symptoms: Heart rate increased, Hypoaesthesia oral, Injection site hypoaesthesia, Injection site paraesthesia, Injection site reaction
Clinical narrative: Within 30-60 minutes after administration of vaccine, patient began experiencing whelps and swelling of the right arm as well as numbness and tingling.  Benadryl 50mg PO given.  Symptoms worsened.  Began feeling numbness to tongue..  Heart rate elevated at 118.  Patient sent to emergency department for further evaluation and received epinephrine and solumedrol.  Discharged home approximately 4 hours later.
Age: 39.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site swelling, Urticaria
Clinical narrative: Within 30-60 minutes after administration of vaccine, patient began experiencing whelps and swelling of the right arm as well as numbness and tingling.  Benadryl 50mg PO given.  Symptoms worsened.  Began feeling numbness to tongue..  Heart rate elevated at 118.  Patient sent to emergency department for further evaluation and received epinephrine and solumedrol.  Discharged home approximately 4 hours later.
Age: 42.0
Sex: M
Vaccine: COVID19
Symptoms: Pain, Peripheral swelling, Swelling, Tension
Clinical narrative: He feels tense and he there's a bump on the nerves on between his neck and shoulder, and when you press on it hurts.
Age: 36.0
Sex: F
Vaccine: COVID19
Symptoms: Biopsy lymph gland, Lymphadenopathy, Lymphoid tissue hyperplasia, Mammogram, Ultrasound abdomen
Clinical narrative: Developed left axillary lymphadenopathy 48 hours post 2nd dose of vaccine. Lymph node measured 4 cm x 2.9 cm x 3.9 cm and is described as having a thin cortex and fatty hilum. Said lymph node was biopsied via core needle and fine needle aspiration on 02/02/2020 and pathology is consistent with reactive lymphoid changes, with lymphocytes and red blood cells present. Sample was sent to Lab for additional testing and results remain consistent with reactive follicular and paracortical hyperplasia.
Age: 87.0
Sex: F
Vaccine: COVID19
Symptoms: Blood sodium normal, Confusional state, Laboratory test normal, Magnetic resonance imaging head normal, Malaise
Clinical narrative: Moderna COVID 19 vaccine #1 given 2/4/21 at 130pm. Patient had malaise, confusion on 2/5. She then had 3 generalized seizures- status epilepticus- on 2/5 around 4-5pm. MRI brain and labs unremarkable. She recovered 36 hr later - on Keppra.
Age: 87.0
Sex: F
Vaccine: COVID19
Symptoms: Seizure, Status epilepticus, White blood cell count normal
Clinical narrative: Moderna COVID 19 vaccine #1 given 2/4/21 at 130pm. Patient had malaise, confusion on 2/5. She then had 3 generalized seizures- status epilepticus- on 2/5 around 4-5pm. MRI brain and labs unremarkable. She recovered 36 hr later - on Keppra.
Age: 76.0
Sex: M
Vaccine: COVID19
Symptoms: Bed rest, Fatigue, Nausea, Vomiting
Clinical narrative: vomit - once       nausea      tiredness            bed rest
Age: 41.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site discolouration, Injection site plaque, Injection site reaction, Injection site swelling, Injection site warmth
Clinical narrative: Injection site reaction 8 days post. Localized itchy rash with raised plaques and warm to the touch. Treated with oral Allegra and topically with alternating Triamcinolone and Benadryl creams. Rash continued for 5 days before resolving. Area remains hyperpigmented.
Age: 41.0
Sex: F
Vaccine: COVID19
Symptoms: Rash pruritic
Clinical narrative: Injection site reaction 8 days post. Localized itchy rash with raised plaques and warm to the touch. Treated with oral Allegra and topically with alternating Triamcinolone and Benadryl creams. Rash continued for 5 days before resolving. Area remains hyperpigmented.
Age: 46.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site erythema, Pain in extremity
Clinical narrative: Covid Arm-- sore arm, redness around injection site, starting about 9 days after vaccine received
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site rash
Clinical narrative: 2 weeks after the injection i started developing a rash on the inside of both elbows and at the injection site.
Age: 21.0
Sex: M
Vaccine: COVID19
Symptoms: Chest discomfort, Chills, Dizziness, Dry mouth, Heart rate increased
Clinical narrative: Onset of symptoms occurred 10 minutes after vaccination. Symptoms included elevated heart rate, light headed, heart palpitations, dizziness, dry mouth, mild chest discomfort, chills
Age: 21.0
Sex: M
Vaccine: COVID19
Symptoms: Palpitations
Clinical narrative: Onset of symptoms occurred 10 minutes after vaccination. Symptoms included elevated heart rate, light headed, heart palpitations, dizziness, dry mouth, mild chest discomfort, chills
Age: 85.0
Sex: M
Vaccine: COVID19
Symptoms: Death
Clinical narrative: Vaccine was administered on 1/15/2021 and death occurred on 1/31/2021.
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Headache, Lethargy, Nausea, Pain
Clinical narrative: Started to feel achy, then it got worse; very painful. Some nausea, chills, headache, lethargic. Most symptoms gone in 20 hrs. After that a few days feeling sluggish.
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Sluggishness
Clinical narrative: Started to feel achy, then it got worse; very painful. Some nausea, chills, headache, lethargic. Most symptoms gone in 20 hrs. After that a few days feeling sluggish.
Age: 37.0
Sex: M
Vaccine: COVID19
Symptoms: Chills, Headache, Nausea, Pyrexia
Clinical narrative: Woke up at 1am with chills and a fever I didn't check my fever until I woke again at 3:30am with headaches and nausea at which point my fever was  measuring every hour between 101 and 104.5F at which point I took an OTC tylenol which lowered my fever to 98F. I had to take the tylenol every 4 hours to keep my temp below 100 until that evening. Chills persisted until the following afternoon and the headaches ended the day after that.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Bone pain, Chills, Headache, Pain
Clinical narrative: onset was about 36 hrs. started with modest fever and chills, gradually increasing pain that started in my left arm shoulder and down the left side of my body. my right side of my head hurt. The pain was pretty extreme. I ached deep like in the joints and bones. about 10 hours later it stopped
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Pain in extremity, Pyrexia
Clinical narrative: onset was about 36 hrs. started with modest fever and chills, gradually increasing pain that started in my left arm shoulder and down the left side of my body. my right side of my head hurt. The pain was pretty extreme. I ached deep like in the joints and bones. about 10 hours later it stopped
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site reaction, Injection site swelling, Injection site warmth, Muscle tightness, Rash erythematous
Clinical narrative: Itching, slightly raised red rash on upper left arm around injection site. Rash has increased slightly in size over the past 24 hours.  Muscle under rash is tight and rash area is slightly warm.
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Rash pruritic
Clinical narrative: Itching, slightly raised red rash on upper left arm around injection site. Rash has increased slightly in size over the past 24 hours.  Muscle under rash is tight and rash area is slightly warm.
Age: 35.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Chills, Cough, Upper-airway cough syndrome
Clinical narrative: 1st vaccine 12/30/20; 2nd vaccine 1/27/21; seen at on 2/5/21 for postnasal drip, chills, cough onset x 1 day
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal pain upper, Chills, Fatigue, Headache, Injection site pain
Clinical narrative: Extremely sore upper left arm - 5 hours in Fever - 13 hours in Body aches Extremely tired Chills Runny nose Headache Stomach ache Took Tylenol & Ibuprofen alternately every 4 hours Sore arm & headache lasted until about 32 hours in
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Pain, Rhinorrhoea
Clinical narrative: Extremely sore upper left arm - 5 hours in Fever - 13 hours in Body aches Extremely tired Chills Runny nose Headache Stomach ache Took Tylenol & Ibuprofen alternately every 4 hours Sore arm & headache lasted until about 32 hours in
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Pulmonary embolism
Clinical narrative: Patient was admitted to the Hospital with dx of a Pulmonary Embolus 2/9/21 Above  named Hospital
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site pruritus, Injection site reaction, Injection site urticaria, Injection site warmth, Urticaria
Clinical narrative: Received vaccine on 1/25/21. On 2/04/21 started getting itchy at 10:45pm around injection site. Broken out in welts/hives approx 11:10pm around injection site as well as area being slightly warm. Welts/hives gone by morning on 2/05/21.
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Dysphonia, Dyspnoea, Pharyngeal paraesthesia
Clinical narrative: CLIENT C/O TINGLING IN HER THROAT AND SAID SHE WAS HOARSE. STATES FEEL JUST A LITTLE SOB. APN GIVE BENYDRYL 50MG IM IN L. DELTOID. VITAL SIGNS STABLE WITH O2 SAT AT 98% ROOM AIR. CLIENT C/O WORSENING OF SYMPTOMS. APN GIVE 0.5MG OF EPI IM IN L. DELTOID. EMS ARRIVED AND TRANSPORTED CLIENT VIA AMBULANCE TO EMERGENCY ROOM.  ON 01/29/2021 NURSING SUPERVISOR CALLED CLIENT. STATES SHE WAS DOING MUCH BETTER AT THAT TIME.
Age: 89.0
Sex: F
Vaccine: COVID19
Symptoms: Facial paralysis, Hemiparesis, Ischaemic stroke
Clinical narrative: On 2/6/21 at 6:00PM, resident experienced sudden left facial droop, left arm and left leg weakness. She was sent to hospital and they confirmed she had an acute ischemic stroke.
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Headache, Pain
Clinical narrative: Persistent increasing body aches, Muscles/joints, headache and severe fatigue. Received late Wed 2/3. No major issues. Thursday very achey and tired, Friday severe fatigue and body aches. Sat same, still able to do stuff just very slow and painful.  Sun. slept all day and body hurt even more. Monday back to work still fatigued and achey not as bad as yesterday.  Advil taken on Sat. with no benefit. Sunday took an old FLexeril that I had and that did knock some of the pain down. Monday aleve with no benefit.
Age: 95.0
Sex: F
Vaccine: COVID19
Symptoms: Chest pain, Cough, Injection site pain, Ocular hyperaemia
Clinical narrative: Red eyes, developed cough, Right shoulder and chest pain.
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Headache, Influenza like illness, Pain, Pain in extremity, Pyrexia
Clinical narrative: basically flu-like symptons: woke up with splitting headache-lasted approx 22hrs: tylenol 1000mg 2pm,  rizitriptan ODT 10mg  10pm ,  tylenol 1000mg 4:50am injection arm very very sore-hurt to move-lasted all day & night; woke up Sunday am not near as sore & could move. fever 2.2 degrees over normal ( normal 97.2 after injection 99.4) all morning; went down after took tylenol @ 2pm Sat, came back  then went away in evening body very achey  all day after/Sat.-back to normal next day/Sun
Age: 43.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Injection site induration, Injection site pruritus, Injection site rash, Injection site swelling
Clinical narrative: Fever and fatigue started 24 hours after shot, resolved after 48 hours.  Rash, itching, hot. swollen and hardness in skin on upper arm near injection site started after 48 hours, has not yet resolved.
Age: 43.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site warmth, Pyrexia
Clinical narrative: Fever and fatigue started 24 hours after shot, resolved after 48 hours.  Rash, itching, hot. swollen and hardness in skin on upper arm near injection site started after 48 hours, has not yet resolved.
Age: 77.0
Sex: M
Vaccine: COVID19
Symptoms: Dyskinesia, Lip erythema, Lip swelling
Clinical narrative: 2 days after the shot I woke up and I had a hard time moving my mouth and my bottom lip was completely swollen. Its still puffy and very very red.
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Anxiety, Dysphagia, Dyspnoea, Hypertension, Hypoaesthesia oral
Clinical narrative: Pt initially reported feeling tingling sensation of lips and, "eyes feeling tight". Then pt states she had throat tightness. She was given crackers, juice but she said it was difficult to swallow.  Per RN documentation "Pt continued to complain of lips slightly feeling numb and diffuse tingling sensation. IM Benadryl administered at 1840 with improvement, pt reported "numbness improving" and "eyes feeling back to normal".    After further observation, pt c/o difficulty swallowing, rapidly became anxious and reported SOB. EPI pen administered at 1902, supplemental O2 provided with improvement."  Pt brought to the ED by paramedics  Per ED MD   "Upon arrival, patient mildly hypertensive, no stridor, speaking in full sentences, no wheezing, clear lungs bilaterally.  Based on history exam, concern for allergic reaction vaccine"  Tryptase not drawn.Pt discharged in good condition
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Ocular discomfort, Paraesthesia oral, Throat tightness
Clinical narrative: Pt initially reported feeling tingling sensation of lips and, "eyes feeling tight". Then pt states she had throat tightness. She was given crackers, juice but she said it was difficult to swallow.  Per RN documentation "Pt continued to complain of lips slightly feeling numb and diffuse tingling sensation. IM Benadryl administered at 1840 with improvement, pt reported "numbness improving" and "eyes feeling back to normal".    After further observation, pt c/o difficulty swallowing, rapidly became anxious and reported SOB. EPI pen administered at 1902, supplemental O2 provided with improvement."  Pt brought to the ED by paramedics  Per ED MD   "Upon arrival, patient mildly hypertensive, no stridor, speaking in full sentences, no wheezing, clear lungs bilaterally.  Based on history exam, concern for allergic reaction vaccine"  Tryptase not drawn.Pt discharged in good condition
Age: 56.0
Sex: U
Vaccine: COVID19
Symptoms: Hypotension, Nausea, Syncope
Clinical narrative: Syncope after vaccination requiring medical intervention to treat symptomatic hypotension.  Patient also complaining of nausea. Initial vitals 90/50, HR 65, RR 16, SPO2 100.  Given IV fluids, 50mg Benadryl and Solumedrol 125mg . BP recovered to 140/90. Transferred to local hospital via EMS.
Age: 33.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site erythema, Injection site induration, Rash pruritic
Clinical narrative: The patient states she noticed a rash that itches less than 1 inch in diameter on her right forearm that she noticed today. Patient also states the injection site has red ring around it and the injection site feels hard.
Age: 76.0
Sex: M
Vaccine: COVID19
Symptoms: Abdominal discomfort, Dizziness, Dyspnoea exertional, Lethargy
Clinical narrative: LETHARGY, DIZZINESS, SHORTNESS OF BREATH ON EXERTION, MILD ABDOMINAL DISCOMFORT
Age: 5.0
Sex: F
Vaccine: DTAP
Symptoms: Dizziness, Injection site warmth, Insomnia, Irritability, Pain
Clinical narrative: Fever above 102.6 Extreme Swelling in a 4' diameter, heat radiating at the source whole body aches dizzy irritability, inability to sleep for 48 hours
Age: 5.0
Sex: F
Vaccine: DTAP
Symptoms: Pyrexia, Swelling
Clinical narrative: Fever above 102.6 Extreme Swelling in a 4' diameter, heat radiating at the source whole body aches dizzy irritability, inability to sleep for 48 hours
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Pain, Pruritus, Rash erythematous, Swelling
Clinical narrative: Had itching off and on since injection.  Did not have soreness until 2 days after injection and itching off and on.  Became progressively worse until Sunday, February 7.  Noticed very red rash, slight swelling, "knots" in area but only slightly swollen overall. "lumps" in arm.
Age: 62.0
Sex: M
Vaccine: COVID19
Symptoms: Chills, Pyrexia
Clinical narrative: chills, 100.4 fever
Age: 42.0
Sex: F
Vaccine: COVID19
Symptoms: Ageusia, Anosmia
Clinical narrative: Intermittent loss of taste and smell. I was diagnosed with covid Nov 10, 2020 and lost my sense of smell and taste through Nov 24, 2020, since then I have had full taste and smell. About 6 hours after my 2nd shot things began to taste like cigarette ash, but my smell was fine. Then that evening things returned to normal. The next morning through about 1pm I was fine, things began a bit off around 1pm. By 4pm my taste and smell was gone on Sunday. Monday I have some smell and taste but it comes and goes. For instance I could taste the arugula in my salad but not the tomato. I could not taste a tangelo, but could taste a blood orange, eaten one right after the other.  I now have most smell back as of 2pm Monday, but taste is intermitten.
Age: 62.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Flushing, Paraesthesia oral
Clinical narrative: Patient described flushing, lips tingling. No itching, hives or shortness of breath reported. No facial/lip swelling reported. Patient took Benadryl that she brought with her. Event improved within minutes.  No other intervention.
Age: 62.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Erythema, Eye pruritus, Lacrimation increased, Lip swelling, Rash erythematous
Clinical narrative: Patient described flushing, lips tingling. No itching, hives or shortness of breath reported. No facial/lip swelling reported. Patient took Benadryl that she brought with her. Event improved within minutes.  No other intervention.
Age: 45.0
Sex: M
Vaccine: COVID19
Symptoms: Ageusia, Anosmia, Dyspnoea, Headache, Malaise
Clinical narrative: well that night i lost all taste and smell that was Friday today is Monday and still no better - Saturday was the hardest i just tried to sleep the pain away- by Sunday i had full on covid19 symptoms and was very sick - now 4 days in i still have a headache , cant brethe these symptoms arent just mild and i worry about someone older then me taking this
Age: 45.0
Sex: M
Vaccine: COVID19
Symptoms: Pain
Clinical narrative: well that night i lost all taste and smell that was Friday today is Monday and still no better - Saturday was the hardest i just tried to sleep the pain away- by Sunday i had full on covid19 symptoms and was very sick - now 4 days in i still have a headache , cant brethe these symptoms arent just mild and i worry about someone older then me taking this
Age: 78.0
Sex: F
Vaccine: COVID19
Symptoms: Abnormal dreams, Mobility decreased, Myalgia
Clinical narrative: Severe Muscle ache over entire body.  1st day bedridden.  3rd day improving.  1st evening trying to sleep I had very vivid, realistic dreams.
Age: 33.0
Sex: F
Vaccine: COVID19
Symptoms: Cellulitis
Clinical narrative: Cellulitis in whole arm.
Age: 42.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness, Dyspnoea, Immediate post-injection reaction, Injection site mass, Injection site pain
Clinical narrative: Moderna COVID-19 Vaccine EUA 8 days after injection, developed into hot, red, raised, rashy area around injection site. Contacted PCP and was told to use hydrocortisone and OTC allergy medication (Allegra). Prior adverse events: Immediately after injection - some shortness of breath and dizziness. continued for 24 hours. Used albuterol inhaler.  Lump at injection site; painful for 4 days after injection.
Age: 42.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site reaction, Injection site swelling, Injection site warmth, Rash erythematous
Clinical narrative: Moderna COVID-19 Vaccine EUA 8 days after injection, developed into hot, red, raised, rashy area around injection site. Contacted PCP and was told to use hydrocortisone and OTC allergy medication (Allegra). Prior adverse events: Immediately after injection - some shortness of breath and dizziness. continued for 24 hours. Used albuterol inhaler.  Lump at injection site; painful for 4 days after injection.
Age: 82.0
Sex: F
Vaccine: COVID19
Symptoms: Body temperature increased
Clinical narrative: Patient developed an elevated temperature of 102, which resolved.
Age: 72.0
Sex: M
Vaccine: COVID19
Symptoms: Diarrhoea, Dizziness
Clinical narrative: Patient reported dizziness, orthostatic lightheadedness, and diarrhea.
Age: 79.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Eye haemorrhage, Fatigue, Headache, Ocular discomfort, Pain
Clinical narrative: pt stated that she had a little head ache and was achy and tired on day of vax.   On 2/7/21 pt woke up and had pressure in her right eye.  She went to her Retina Specialist and was given a shot since in the eye it was hemorrhaging.  Pt will go back in 4 weeks for FU and another shot.
Age: 79.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Blindness, Eye haemorrhage, Headache, Intraocular pressure increased, Intraocular pressure test
Clinical narrative: pt stated that she had a little head ache and was achy and tired on day of vax.   On 2/7/21 pt woke up and had pressure in her right eye.  She went to her Retina Specialist and was given a shot since in the eye it was hemorrhaging.  Pt will go back in 4 weeks for FU and another shot.
Age: 79.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Ophthalmological examination, Pain
Clinical narrative: pt stated that she had a little head ache and was achy and tired on day of vax.   On 2/7/21 pt woke up and had pressure in her right eye.  She went to her Retina Specialist and was given a shot since in the eye it was hemorrhaging.  Pt will go back in 4 weeks for FU and another shot.
Age: 77.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Injection site erythema, Injection site pain, Injection site swelling
Clinical narrative: Injection site became reddened, swollen and quite painful, including with movement chills lasting  approximately 10 hours
Age: 57.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site bruising, Injection site pain, Pyrexia
Clinical narrative: Fever of 101 starting 14 hours after injection and fever 99-101 lasting 26 hours. Bruise and pain at site of injection
Age: 53.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site erythema, Injection site swelling
Clinical narrative: right arm red in color from shoulder to elbow covering all of arm area and swollen
Age: 75.0
Sex: F
Vaccine: COVID19
Symptoms: Cough, Dizziness, Wheezing
Clinical narrative: Lightheaded, cough, mild wheeze that responded to albuterol Dizziness
Age: 43.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Dyspnoea, Fatigue, Injection site pain, Myalgia
Clinical narrative: 2/6/21 - Began with injection site soreness, then progressed to full body/muscle soreness throughout the night. Fever and chills began the first night (didn't take temperature).  Short of breath on the evening of 2/6/21 with moderate activity.   2/17/21 - Fatigue throughout day. Slightly (less than 2/6) short of breath with mild- moderate activity on 2/7. Fever, chills, and body/muscle aches continued throughout 2/7/21 and were moderate (muscle/body aches severe) until about an hour after taking 1 pill of over the counter ibuprofen at 2 p.m. on 2/7/21. Symptoms returned as the ibuprofen wore off, and I took another 1 pill of ibuprofen at about 9:30 p.m. on 2/7/21. Symptoms then diminished except for some mild back pain.   2/8/21 - the only symptoms are some fatigue and mild back pain (could be unrelated and just due to activity). No medications taken on 2/8/21.
Age: 43.0
Sex: F
Vaccine: COVID19
Symptoms: Pain, Pyrexia
Clinical narrative: 2/6/21 - Began with injection site soreness, then progressed to full body/muscle soreness throughout the night. Fever and chills began the first night (didn't take temperature).  Short of breath on the evening of 2/6/21 with moderate activity.   2/17/21 - Fatigue throughout day. Slightly (less than 2/6) short of breath with mild- moderate activity on 2/7. Fever, chills, and body/muscle aches continued throughout 2/7/21 and were moderate (muscle/body aches severe) until about an hour after taking 1 pill of over the counter ibuprofen at 2 p.m. on 2/7/21. Symptoms returned as the ibuprofen wore off, and I took another 1 pill of ibuprofen at about 9:30 p.m. on 2/7/21. Symptoms then diminished except for some mild back pain.   2/8/21 - the only symptoms are some fatigue and mild back pain (could be unrelated and just due to activity). No medications taken on 2/8/21.
Age: 57.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Lymphadenopathy, Physical examination, Pyrexia, Ultrasound scan
Clinical narrative: Fever of 101.8, chills, swollen under arm where vaccination was the next day.  Fever broke 2 days later after taking Tylenol.  Used a hot compress and heating pad for swollen armpit.  After the 3rd day went to Care Today Clinic for the swollen area.  Since it hadnt sudsided.
Age: 77.0
Sex: M
Vaccine: COVID19
Symptoms: Body temperature increased
Clinical narrative: Patient developed an elevated temperature of 99.4, which resolved.
Age: 51.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Abdominal discomfort, Arthralgia, Dehydration, Electrocardiogram, Extrasystoles
Clinical narrative: Within the first 5 minutes of the covid vaccine (1st dose), I felt warm inside, dehydrated and my heart was pounding. About 30-40 minutes later I experienced numbness and tingling on my entire left side of my body, face, arm and head. My heart was also doing a very shallow, deep skip that I've never felt before. My fingers tingled for about 5 mins. but went then away. Joint pain later that night. The next 2-3 days, heart was getting better as well as the tingling and numbness. My cardiologist has been having me go in for ekg's weekly now, since. Left side of face was a little droopy too afterwards. Found swollen lymph node/ bump above left collarbone days later as well, but has not gone away. Stomach issues since.