chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Loss of consciousness, Pallor
Clinical narrative: Not sure if it was related but wanted to let someone know in case others have experienced. Patient has Parkinson?s and gets low blood pressure. However, his blood pressure and temp were taken immediately after incident and both were normal. At 8:30 this morning, he went into the kitchen to make breakfast and blacked out, grabbed the counter and made it to the floor. Never fully fainting. He was extremely pale and had to call for help to get up. The remainder of the day, he has taken it easy but felt fine and normal.
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: Dry mouth, Dry throat, Throat tightness
Clinical narrative: Dry, tight throat, dry mouth
Age: 43.0
Sex: F
Vaccine: COVID19
Symptoms: Disorientation, Dizziness, Fatigue, Hot flush, Myalgia
Clinical narrative: dizzy & groggy, fatigue, mild full body muscle soreness started feeling dizzy, groggy and fatigue about 12 pm same day, 2/4 My arm also started feeling sore around the same time - took 2 Aleve when arm starting hurting and 2 Aleve at night  - second day, 2/5 felt even more dizzy, groggy and fatigued, if I moved too much got a little disoriented. Full body muscle soreness started in the afternoon and also would get heat flashes but no temp. took 2 Aleve in the morning and 1 at night  2/6 - slept heavier than usual and longer than usual, felt a little better as day went on felt still a little groggy. Arm is still sore but didn't feel body aches any more
Age: 43.0
Sex: F
Vaccine: COVID19
Symptoms: Pain, Pain in extremity, Somnolence
Clinical narrative: dizzy & groggy, fatigue, mild full body muscle soreness started feeling dizzy, groggy and fatigue about 12 pm same day, 2/4 My arm also started feeling sore around the same time - took 2 Aleve when arm starting hurting and 2 Aleve at night  - second day, 2/5 felt even more dizzy, groggy and fatigued, if I moved too much got a little disoriented. Full body muscle soreness started in the afternoon and also would get heat flashes but no temp. took 2 Aleve in the morning and 1 at night  2/6 - slept heavier than usual and longer than usual, felt a little better as day went on felt still a little groggy. Arm is still sore but didn't feel body aches any more
Age: 58.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Fatigue, Headache, Injection site pain, Pain
Clinical narrative: Fever 100.9, started about 10 hours after vaaccine.  Lasted all night and most of next day.   I finally took Tylenol about 24 hours after vaccine.   chills, started about 10 hrs after vaccine and lasted 5 hours.  aches all over body, lasted from 10 hrs after to 30 hours after Extremely sore arm at injection site.   Started about 8 hrs after vaccine and lasted til 24 hrs after vaccine headache, fatigue, started 8 hrs after vaccine and lasted for 36 hrs after vaccine.
Age: 58.0
Sex: F
Vaccine: COVID19
Symptoms: Pyrexia
Clinical narrative: Fever 100.9, started about 10 hours after vaaccine.  Lasted all night and most of next day.   I finally took Tylenol about 24 hours after vaccine.   chills, started about 10 hrs after vaccine and lasted 5 hours.  aches all over body, lasted from 10 hrs after to 30 hours after Extremely sore arm at injection site.   Started about 8 hrs after vaccine and lasted til 24 hrs after vaccine headache, fatigue, started 8 hrs after vaccine and lasted for 36 hrs after vaccine.
Age: 32.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site pruritus, Injection site rash
Clinical narrative: I have a large circular rash at the injection site that itches. It?s been itchy for about 4 days now. Tonight I decided to look at my arm in the mirror and noticed the rash. I don?t know when the rash developed.
Age: 41.0
Sex: M
Vaccine: COVID19
Symptoms: Glossodynia, Oral pain, Swollen tongue
Clinical narrative: Moderna COVID-19 vaccine EUA, slightly swollen tongue, painful mouth and tongue sores
Age: 39.0
Sex: M
Vaccine: COVID19
Symptoms: Injection site pain
Clinical narrative: Pain at injection site
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Administration site reaction
Clinical narrative: Covid Arm
Age: 24.0
Sex: F
Vaccine: COVID19
Symptoms: Axillary mass, Axillary pain, Gait disturbance, Induration, Injection site pain
Clinical narrative: I got the first dose of the Moderna COVID-19 vaccine at 3pm 1/13/21. I was fine for the 30 minutes after, not even sore at the injection site.  Around 6pm, my muscles started aching, but not painful enough to be concerned.  At 3am 1/14/21, I woke up in pain in every muscle. Enough to wake me, but not terrible.  At 7am, I noticed a pinpoint pain in my armpit, and my muscles still ached.  At 9:30am, I took ibuprofen to attempt to curb the pain a bit.  Around 10am, it got so painful I was limping, and having trouble bending down or reaching above shoulder height.  At 11:30am, I noticed the pinpoint pain in my armpit had gotten worse, and there is a hard, approximately quarter-sized round lump in this spot. Very painful.  At 2:30, I went to move my shirt sleeve and the pain at the injection site was so intense I screamed when I touched it.  This pain continued until 1/16/21 when I woke up feeling entirely normal.  Since 1/16/2021, my hands have been randomly stiffening, either completely stretched out and dropping anything in them, or closing tight enough to leave fingernail marks on my palms. I will also reach to grab things and my hands will sometimes bend into odd shapes, instead of what I intended for them to do. This began at 1-2 times a day, and is becoming more often. It is now up to 2-4 times daily.
Age: 24.0
Sex: F
Vaccine: COVID19
Symptoms: Mobility decreased, Musculoskeletal stiffness, Myalgia
Clinical narrative: I got the first dose of the Moderna COVID-19 vaccine at 3pm 1/13/21. I was fine for the 30 minutes after, not even sore at the injection site.  Around 6pm, my muscles started aching, but not painful enough to be concerned.  At 3am 1/14/21, I woke up in pain in every muscle. Enough to wake me, but not terrible.  At 7am, I noticed a pinpoint pain in my armpit, and my muscles still ached.  At 9:30am, I took ibuprofen to attempt to curb the pain a bit.  Around 10am, it got so painful I was limping, and having trouble bending down or reaching above shoulder height.  At 11:30am, I noticed the pinpoint pain in my armpit had gotten worse, and there is a hard, approximately quarter-sized round lump in this spot. Very painful.  At 2:30, I went to move my shirt sleeve and the pain at the injection site was so intense I screamed when I touched it.  This pain continued until 1/16/21 when I woke up feeling entirely normal.  Since 1/16/2021, my hands have been randomly stiffening, either completely stretched out and dropping anything in them, or closing tight enough to leave fingernail marks on my palms. I will also reach to grab things and my hands will sometimes bend into odd shapes, instead of what I intended for them to do. This began at 1-2 times a day, and is becoming more often. It is now up to 2-4 times daily.
Age: 26.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Arthralgia, Hypoaesthesia, Pain
Clinical narrative: Total of three separate occupancies of body aches/joint pain along with numbing sensation from legs to feet. First time being within 24 hours of vaccination, second time occurring around JAN 30, and third occurrence happening today FEB 06. 1000mg acetaminophen was taken once symptoms onset, that provided relief until symptoms eventually subset.
Age: 33.0
Sex: F
Vaccine: COVID19
Symptoms: Headache, Hypoaesthesia, Pain in extremity, Paraesthesia, Swelling face
Clinical narrative: Tingly/numbness down right arm to fingers on right side. Tingly/numbness feeling up shoulder/neck, cheek, lips, tongue. Mostly on right side. Cheek a little swollen. Sore arm. Headache on right side.
Age: 63.0
Sex: M
Vaccine: UNK
Symptoms: Blood test, Seizure
Clinical narrative: approximately 4 hours after vaccine I suffered a seizure and was taken to Hospital. I will have an MRI Monday
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: Cellulitis, Full blood count, Hypersensitivity, Injection site erythema, Injection site oedema
Clinical narrative: Pain, Edema, redness, limited range of motion to upper left arm.  Diagnosis of cellulitis and allergic reaction.  Bactrim twice a day, Tylenol #3 as needed for pain, Benadryl  Follow up with primary care physician in 48hours.
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site pain, Joint range of motion decreased
Clinical narrative: Pain, Edema, redness, limited range of motion to upper left arm.  Diagnosis of cellulitis and allergic reaction.  Bactrim twice a day, Tylenol #3 as needed for pain, Benadryl  Follow up with primary care physician in 48hours.
Age: 47.0
Sex: F
Vaccine: COVID19
Symptoms: Lymphadenopathy
Clinical narrative: Axillary lymph node under right arm swollen to the size of a cue ball
Age: 87.0
Sex: M
Vaccine: COVID19
Symptoms: Nightmare, Sleep terror
Clinical narrative: Nightmares/Night Terrors after sleeping for a couple of hours.  His friend who received the vaccine the day before had the same reaction.  Very vivid and scary dreams.
Age: 72.0
Sex: M
Vaccine: COVID19
Symptoms: Chills, Pyrexia
Clinical narrative: 24 hours after vaccination patient started running a fever.  Temperature went to 102.5.  Chills. Next day temperature was elevated all day.  Took Tylenol,.
Age: 36.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Cough, Headache, Neck pain, Oropharyngeal pain
Clinical narrative: PATIENT STATED SHE RECEIVED HER 2ND DOES THEN LATER DEVELOPED "SEVERE" SIDE EFFECTS OF COUGH, HEADACHE, SORE THROAT, LEFT SIDE NECK PAIN AND FEVER OF 102.2, CHILLS, BODY ACHES, AND SORENESS.
Age: 36.0
Sex: F
Vaccine: COVID19
Symptoms: Pain, Pyrexia
Clinical narrative: PATIENT STATED SHE RECEIVED HER 2ND DOES THEN LATER DEVELOPED "SEVERE" SIDE EFFECTS OF COUGH, HEADACHE, SORE THROAT, LEFT SIDE NECK PAIN AND FEVER OF 102.2, CHILLS, BODY ACHES, AND SORENESS.
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Decreased appetite, Diarrhoea, Dizziness, Fatigue
Clinical narrative: Diarrhea vomiting fever chills muscle aches dizziness fatigue loss of appetit. Like having extreme flu for 16 hrs. I took no medication. Sipped diet sprite and ice
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Influenza immunisation, Myalgia, Pyrexia, Vomiting
Clinical narrative: Diarrhea vomiting fever chills muscle aches dizziness fatigue loss of appetit. Like having extreme flu for 16 hrs. I took no medication. Sipped diet sprite and ice
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Pain
Clinical narrative: Sudden inset of searing pain right side of body, from breast to arm pit to elbow, along a specific line.  Hypothesize - brachial neuritis.  Onset - 10:00 pm.  severe pain for 15 minutes, painful for 2 hours. Some low level pain at right elbow on 2/6/2021.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Erythema, Peripheral swelling, Pruritus
Clinical narrative: My left arm became red, swollen, and  itchy below the injection site 9 days after the injection.  It is day 4 days after the irritation and there is still slightly red.
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Nausea, Seizure
Clinical narrative: Nausea, seizure
Age: 83.0
Sex: F
Vaccine: COVID19
Symptoms: Blood test, Diarrhoea, Dyspnoea, Potassium chloride sensitivity test
Clinical narrative: Extreme shortness of breath that lasted overnight and resulted in trip to ER, diarrhea the night of injection
Age: 94.0
Sex: F
Vaccine: COVID19
Symptoms: Diarrhoea, Full blood count, Metabolic function test, Nausea, Pallor
Clinical narrative: Patient began feeling nauseated on 1/18/21  around 6pm, and had uncontrolled diarrhea, reported that she did not feel right.  Staff reported to this writer, that her skin tone was gray in tone and she just didn't look good.  She was transferred to the HOSPITAL ER VIA AMBULANCE.
Age: 94.0
Sex: F
Vaccine: COVID19
Symptoms: Urine analysis
Clinical narrative: Patient began feeling nauseated on 1/18/21  around 6pm, and had uncontrolled diarrhea, reported that she did not feel right.  Staff reported to this writer, that her skin tone was gray in tone and she just didn't look good.  She was transferred to the HOSPITAL ER VIA AMBULANCE.
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling, Injection site warmth
Clinical narrative: I was given the first dose of the  Moderna vaccine on 1/15/21. Eight days later on 1/23/21, the site of the injection became red, hot, itchy, painful, slightly swollen and my entire left arm hurt. I used over the counter hydrocortisone for 3 days.  I called my allergist and she told me to take Zyrtec (I am taking 5mL liquid because the 10 is too strong and I fall asleep at work) and to use Mometasone Furoate Ointment USP, 0.1%  twice daily. I have taken the Zyrtec and used the ointment daily since. My arm continues to be very red, but not swollen, or itchy two weeks later. I have the next vaccine scheduled for 2/12/21 and am concerned about whether I should take it, if this reaction  continues?  Is it normal for a reaction to last this long? I would appreciate a response as I am very worried about the second dose and the reaction I might have if this one continues.
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: Pain in extremity
Clinical narrative: I was given the first dose of the  Moderna vaccine on 1/15/21. Eight days later on 1/23/21, the site of the injection became red, hot, itchy, painful, slightly swollen and my entire left arm hurt. I used over the counter hydrocortisone for 3 days.  I called my allergist and she told me to take Zyrtec (I am taking 5mL liquid because the 10 is too strong and I fall asleep at work) and to use Mometasone Furoate Ointment USP, 0.1%  twice daily. I have taken the Zyrtec and used the ointment daily since. My arm continues to be very red, but not swollen, or itchy two weeks later. I have the next vaccine scheduled for 2/12/21 and am concerned about whether I should take it, if this reaction  continues?  Is it normal for a reaction to last this long? I would appreciate a response as I am very worried about the second dose and the reaction I might have if this one continues.
Age: 29.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness
Clinical narrative: 10:20am  reports feeling "lightheaded" post vaccination; BP 90/50  P 78  rest, snack and juice given, monitored x 30 minutes No additional complaints / symptoms subside released from facility/ home with mom
Age: 24.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Paraesthesia, Pruritus, Skin burning sensation, Skin warm
Clinical narrative: After second shot (EL9265) left arm got hot and burning sensations began. Within 24-48 hours it became very itchy and tingling feelings took over. The entire arm is itchy from the inside out and burning from the inside out.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Headache, Pyrexia
Clinical narrative: fever, chills, headache
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: Hypoaesthesia, Paraesthesia
Clinical narrative: Tingling and numbness in left hand and fingers, same arm as injection site. Began on Friday, February 5, 2021 at about 7pm,  approximately 35 - 40 min after injection. Arm at injection site iced 20 minutes on 40 minutes off each hour for 4 hours before bed. Tingling and numbness didn?t interrupt sleep, but adverse effect returned in the late morning of Saturday, February 6, 2021, increasing in intensity in the afternoon and remaining constant in the evening.  Doctor advised to continue icing. Doctor also advised to seek additional treatment if symptoms, constant tingling and numbness, didn?t relieve or got worse or other symptoms presented. Told to report a adverse effect here by doctor.
Age: 41.0
Sex: F
Vaccine: COVID19
Symptoms: Pruritus, Rash
Clinical narrative: RASH NOTED IN BILAERAL AXILLARY REGIONS. NOTICED THIS MORNING. CONCERNED BECAUSE JUST RECEIVED 1ST COVID INJECTION 5 DAYS AGO. RASH DOES ITCH AT TIMES. DENIES ANY OTHER AREAS OF BODY INVOLVEMENT. RASH COMES AND GOES. DENIES NIEW SOPAS OR ALLERGENS. NO SHORTNESS OF BREATH, SENSATION OF TONGUE OR THROAT SWELLING.
Age: 39.0
Sex: M
Vaccine: COVID19
Symptoms: Bell's palsy
Clinical narrative: Symptoms of Bells Palsy that have gotten progressively worse since 2/3 til today 2/6. TX with Valtrex and prednisone. Outcome- TBD
Age: 39.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site erythema, Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth
Clinical narrative: Itching at injection site, hard, hot to touch, red the size of a dollar coin. No treatment.
Age: 71.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Abdominal pain, Appendicitis, Blood electrolytes normal, Computerised tomogram abnormal, Full blood count normal
Clinical narrative: Acute appendicitis began with abdominal pain, vomiting on 2/3/21,  surgery on 2/5/21. Confirmee by CT scan and operative procedure.
Age: 71.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Surgery, Urine analysis normal, Vomiting
Clinical narrative: Acute appendicitis began with abdominal pain, vomiting on 2/3/21,  surgery on 2/5/21. Confirmee by CT scan and operative procedure.
Age: 70.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Flushing, Headache, Swollen tongue, Throat tightness
Clinical narrative: Severe headache, face flushing, swollen tongue, throat closing off
Age: 70.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Dysphonia, Dyspnoea, Pharyngeal swelling, Rash, Swollen tongue
Clinical narrative: Severe headache, face flushing, swollen tongue, throat closing off
Age: 82.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Dizziness
Clinical narrative: Patient got up at 4:30 am and nearly fell he was so dizzy. This dizziness had lasted from Thursday to Saturday and he has improved but not completely back to normal
Age: 57.0
Sex: M
Vaccine: COVID19
Symptoms: Chills, Fatigue
Clinical narrative: signifcant fatigue for 48 hours followed two days later by 19 hours of chills
Age: 39.0
Sex: F
Vaccine: COVID19
Symptoms: Asthenia, Coordination abnormal, Fatigue, Muscle strength abnormal, Muscular weakness
Clinical narrative: 2 weeks after I received injection, I started experiencing a weakness in the left arm. This began Jan 26, 2021. The same evening I experienced an uncontrollable shake in the left thumb. The feeling of weakness/tiredness in my left arm has persisted and has gotten progressively worse. I am currently experiencing feelings of muscle abnormality, reduced strength, and diminished coordination of the left fingers. I have a doctor appointment for this issue scheduled for Feb8, 2021.
Age: 39.0
Sex: F
Vaccine: COVID19
Symptoms: Tremor
Clinical narrative: 2 weeks after I received injection, I started experiencing a weakness in the left arm. This began Jan 26, 2021. The same evening I experienced an uncontrollable shake in the left thumb. The feeling of weakness/tiredness in my left arm has persisted and has gotten progressively worse. I am currently experiencing feelings of muscle abnormality, reduced strength, and diminished coordination of the left fingers. I have a doctor appointment for this issue scheduled for Feb8, 2021.
Age: 34.0
Sex: F
Vaccine: COVID19
Symptoms: Anxiety, Loss of consciousness, Stridor, Syncope
Clinical narrative: Patient arrived anxious.  While standing in line to book her second appointment she suffered a syncopal event.  There was concern about potential airway stridor with LOC.  She was transferred to ED by EMS.  Treated for anxiety with complete resolution to baseline.
Age: 47.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site erythema, Injection site pruritus, Injection site swelling
Clinical narrative: On the 9th day of receiving the vaccine I developed redness, swelling  near the injection spot.  The redness is about 3inches by 2 inches. It is a little itchy.
Age: 29.0
Sex: M
Vaccine: COVID19
Symptoms: Chills, Decreased appetite, Fatigue, Headache, Pyrexia
Clinical narrative: Low grade fever (99.8 F), chills, fatigue, headache, sleep disturbance, loss of appetite
Age: 29.0
Sex: M
Vaccine: COVID19
Symptoms: Sleep disorder
Clinical narrative: Low grade fever (99.8 F), chills, fatigue, headache, sleep disturbance, loss of appetite
Age: 32.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site erythema, Injection site pruritus, Injection site rash
Clinical narrative: Red rash that has become itchy and increased in size day 5 post injection underneath injection site
Age: 31.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site pain, Injection site swelling, Injection site warmth, Pain, Pyrexia
Clinical narrative: Body aches, low grade and fatigue starting 21 hours following 2nd Moderna COVID vaccination. extreme pain, swelling, redness, warmth 2 inches below injection site approximately 3 inches in diameter starting approximately 30 hours following injection. currently 48+ hours out from vaccine, no improvement in skin reaction.
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site erythema, Injection site pruritus
Clinical narrative: Itching and redness at injection site
Age: 32.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Fatigue, Headache, Nausea
Clinical narrative: chills, headache, nausea, fatigue
Age: 76.0
Sex: M
Vaccine: COVID19
Symptoms: Chills, Injection site discomfort, Rhinorrhoea
Clinical narrative: About 4 or 5 hours  after the shot I had mild discomfort at the injection site, mild chills followed. On February 6th today I had a runny nose like one would have with a mild cold, slight chills. As I type this report at 9:20 PM Feb 6th,  my nose has stopped running, and I don't seem to be having any chills. Definitetly worth having the vaccine
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site pruritus
Clinical narrative: Injection site on arm became itchy after 6 days, on day 8 a red patch appeared... Patch is about 3-4 inches wide. Have read online that this reaction is now called Covid Arm, mainly related to Moderna Vaccine. Others report the red patch will go away in a few days.
Age: 47.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia
Clinical narrative: Pain behind left scapula (shoulder blade) has persisted since about an hour after the vaccine being administered. No chest pain but shoulder blade pain becomes worse with deep breathes.  So about 10 hours later, my wife still has bad enough pain to require a heating pad. Pain level is a 6 on a 1-10 scale even with the pain medications she takes every day for chronic pain.
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Discomfort, Dizziness, Headache, Impaired driving ability, Palpitations
Clinical narrative: Immediately light headed, heart raced, felt very heavy, became dizzy and was unable to drive home for 2 hours!
Age: 39.0
Sex: F
Vaccine: COVID19
Symptoms: Body temperature increased, Chills, Diarrhoea, Mobility decreased, Nausea
Clinical narrative: Reported signs and symptoms of aches and chills same as after first does. Significant nausea and diarrhea, arm pain and warmth, unable to turn neck without pain, temperature 100.5.
Age: 39.0
Sex: F
Vaccine: COVID19
Symptoms: Pain, Pain in extremity, Skin warm
Clinical narrative: Reported signs and symptoms of aches and chills same as after first does. Significant nausea and diarrhea, arm pain and warmth, unable to turn neck without pain, temperature 100.5.
Age: 45.0
Sex: F
Vaccine: COVID19
Symptoms: Body temperature increased, Chills, Injection site mass, Injection site urticaria, Pain
Clinical narrative: 2/4 4am fever 101. Lasted until 2/5 around 8pm. 2/5 chills, body aches. (Lasted only a few hours) 2/6 hives at and around injection site. Large lump at injection site.
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Palpitations
Clinical narrative: Reports "f eels like heart racing" post vaccination (2nd dose); assessed HR 102 Monitored x 30 minutes, rest w/ no additional complaints  symptoms resolve, released from facility home
Age: 83.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Asthenia, Bowel movement irregularity, Dizziness, Injection site erythema, Injection site pruritus
Clinical narrative: On January 29,2021 at about 9 am I experienced extreme total body weakness as though I was about to faint. I managed to lie down. Concurrent with the extreme weakness I felt intense nausea. The weakness and nausea lasted for approximately 45 minutes to one hour when I had to rush to the toilet for a bowel movement. Within an hour to an hour and one half I was totally asymptomatic. There was no recurrence of the GI symptoms or exteme weakness. At the same time I felt itching at the site of the Covid 19 vaccination. When the GI symptoms and weaknes subdided and I looked at my upper left arm, there was swelling and redness surrounding the vaccination site and around the side of my left arm. The itching, swelling and redness lasted for 24 hours and began to subsdide until it was only faintly recognizable as a light pink discoloration around the original vaccination site. Today, February 6th, 2021 the redness has almost completely faded.
Age: 83.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Injection site swelling, Nausea
Clinical narrative: On January 29,2021 at about 9 am I experienced extreme total body weakness as though I was about to faint. I managed to lie down. Concurrent with the extreme weakness I felt intense nausea. The weakness and nausea lasted for approximately 45 minutes to one hour when I had to rush to the toilet for a bowel movement. Within an hour to an hour and one half I was totally asymptomatic. There was no recurrence of the GI symptoms or exteme weakness. At the same time I felt itching at the site of the Covid 19 vaccination. When the GI symptoms and weaknes subdided and I looked at my upper left arm, there was swelling and redness surrounding the vaccination site and around the side of my left arm. The itching, swelling and redness lasted for 24 hours and began to subsdide until it was only faintly recognizable as a light pink discoloration around the original vaccination site. Today, February 6th, 2021 the redness has almost completely faded.
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Erythema, Feeling hot, Pain, Pruritus, Rash
Clinical narrative: Rash, redness, itchy, swollen, hot and soreness. Felt fine otherwise
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Swelling
Clinical narrative: Rash, redness, itchy, swollen, hot and soreness. Felt fine otherwise
Age: 41.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Pruritus
Clinical narrative: Generalized itch while being observed after vaccination.  No hives or rashes seen.  Resolved with dose of benadryl.
Age: 41.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Abdominal pain, Activated partial thromboplastin time, Alanine aminotransferase normal, Anion gap normal, Aspartate aminotransferase increased
Clinical narrative: Generalized itch while being observed after vaccination.  No hives or rashes seen.  Resolved with dose of benadryl.
Age: 41.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Basophil percentage decreased, Bilirubin conjugated, Blood albumin normal, Blood alkaline phosphatase increased, Blood bicarbonate decreased
Clinical narrative: Generalized itch while being observed after vaccination.  No hives or rashes seen.  Resolved with dose of benadryl.
Age: 41.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Blood bilirubin increased, Blood bilirubin unconjugated increased, Blood calcium decreased, Blood chloride increased, Blood chloride normal
Clinical narrative: Generalized itch while being observed after vaccination.  No hives or rashes seen.  Resolved with dose of benadryl.
Age: 41.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Blood creatinine normal, Blood glucose increased, Blood glucose normal, Blood magnesium normal, Blood phosphorus decreased
Clinical narrative: Generalized itch while being observed after vaccination.  No hives or rashes seen.  Resolved with dose of benadryl.
Age: 41.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Blood potassium decreased, Blood sodium normal, Blood urea decreased, Blood urine absent, Constipation
Clinical narrative: Generalized itch while being observed after vaccination.  No hives or rashes seen.  Resolved with dose of benadryl.
Age: 41.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Differential white blood cell count normal, Eosinophil percentage decreased, Haematocrit normal, Haemoglobin normal, Immunosuppression
Clinical narrative: Generalized itch while being observed after vaccination.  No hives or rashes seen.  Resolved with dose of benadryl.
Age: 41.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Lipase normal, Lymphocyte percentage decreased, Magnetic resonance cholangiopancreatography, Mean cell volume normal, Monocyte count increased
Clinical narrative: Generalized itch while being observed after vaccination.  No hives or rashes seen.  Resolved with dose of benadryl.
Age: 41.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Monocyte percentage, Neutrophil percentage increased, Nitrite urine absent, Platelet count decreased, Protein urine absent
Clinical narrative: Generalized itch while being observed after vaccination.  No hives or rashes seen.  Resolved with dose of benadryl.
Age: 41.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Prothrombin time prolonged, Red blood cell count normal, Splenomegaly, Urine analysis normal, White blood cell count normal
Clinical narrative: Generalized itch while being observed after vaccination.  No hives or rashes seen.  Resolved with dose of benadryl.
Age: 57.0
Sex: F
Vaccine: COVID19
Symptoms: Pain in extremity, Peripheral swelling
Clinical narrative: RUE 4 in x 4 in large, painful, raised area that has decreased in size and pain but still remains.
Sex: F
Vaccine: COVID19
Symptoms: Abdominal pain upper, Chills, Dizziness, Dyspnoea, Influenza like illness
Clinical narrative: At 4:45 in the morning , A very sharp pain in the stomach woke me up , it was very quick maybe 5 seconds. I realized at that moment that my left arm was very painful like the feeling of getting 2 tetanus shot at the same time . I usually have a very high threshold on pain Right after that I experienced flu kind of side effects , aches , light fever and chills, shortness of breath light headaches and some nausea,
Sex: F
Vaccine: COVID19
Symptoms: Nausea, Pain, Pyrexia
Clinical narrative: At 4:45 in the morning , A very sharp pain in the stomach woke me up , it was very quick maybe 5 seconds. I realized at that moment that my left arm was very painful like the feeling of getting 2 tetanus shot at the same time . I usually have a very high threshold on pain Right after that I experienced flu kind of side effects , aches , light fever and chills, shortness of breath light headaches and some nausea,
Age: 39.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness, Dyspnoea, Feeling hot, Lip pruritus, Nausea
Clinical narrative: Facial swelling, neck swelling, dizziness, shortness of breath, nausea, warm feeling, lips itchy, face itchy
Age: 39.0
Sex: F
Vaccine: COVID19
Symptoms: Pruritus, Swelling, Swelling face
Clinical narrative: Facial swelling, neck swelling, dizziness, shortness of breath, nausea, warm feeling, lips itchy, face itchy
Age: 28.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Blindness transient, Fatigue, Hypoaesthesia, Injection site hypoaesthesia
Clinical narrative: The second dose was very painful, compared to no pain when the first dose was given one month ago. My arm was immediately hot and tender after administration. The area around the injection site had less feeling than the rest of my arm - it felt almost numb. My arm was very sore and warm the rest of the evening. I began having fatigue, muscle aches, and joint pain last night as well. I woke up around 6 this morning and the room was spinning. I was also nauseous. I tried to roll over in bed but was unable to feel my arms and legs. I was also temporarily unable to see. Right after, I passed out and lost urinary continence. I regained consciousness a minute later and had normal functioning again. I have not had any more dizziness today but am still sore and fatigued.
Age: 28.0
Sex: F
Vaccine: COVID19
Symptoms: Loss of consciousness, Mobility decreased, Myalgia, Nausea, Pain
Clinical narrative: The second dose was very painful, compared to no pain when the first dose was given one month ago. My arm was immediately hot and tender after administration. The area around the injection site had less feeling than the rest of my arm - it felt almost numb. My arm was very sore and warm the rest of the evening. I began having fatigue, muscle aches, and joint pain last night as well. I woke up around 6 this morning and the room was spinning. I was also nauseous. I tried to roll over in bed but was unable to feel my arms and legs. I was also temporarily unable to see. Right after, I passed out and lost urinary continence. I regained consciousness a minute later and had normal functioning again. I have not had any more dizziness today but am still sore and fatigued.
Age: 28.0
Sex: F
Vaccine: COVID19
Symptoms: Pain in extremity, Skin warm, Tenderness, Urinary incontinence, Vertigo
Clinical narrative: The second dose was very painful, compared to no pain when the first dose was given one month ago. My arm was immediately hot and tender after administration. The area around the injection site had less feeling than the rest of my arm - it felt almost numb. My arm was very sore and warm the rest of the evening. I began having fatigue, muscle aches, and joint pain last night as well. I woke up around 6 this morning and the room was spinning. I was also nauseous. I tried to roll over in bed but was unable to feel my arms and legs. I was also temporarily unable to see. Right after, I passed out and lost urinary continence. I regained consciousness a minute later and had normal functioning again. I have not had any more dizziness today but am still sore and fatigued.
Age: 34.0
Sex: F
Vaccine: COVID19
Symptoms: Nausea, Vomiting
Clinical narrative: Client was sitting at waiting area post vaccine when she alerted EMT  she was feeling nauseous. At 1009 EMT gave emesis bag in case she needed to vomit and client did shortly after. Client informed EMT this normally occurs to her after being vaccinated. EMT gave water and client kept in observation. At 1022 client stated feeling better and prior complaint had resolved. Vitals taken prior to leaving: pulse 59, alert and oriented, skin color normal, pupils equal and reactive to light. Client left facility with a steady gait at 1025
Age: 40.0
Sex: F
Vaccine: COVID19
Symptoms: Anxiety, Dizziness
Clinical narrative: Reports feeling "dizzy"  and "anxious" post vaccination, Monitored x 40 minutes w/symptom improvement; BP 136/93 P 88, Released from facility home.
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Erythema, Peripheral swelling, Pruritus, Skin warm
Clinical narrative: My left arm became red, swollen, itchy and hot to the touch eight days after receiving the Moderna vaccine.  The red area was approximately 8" long by 4" wide and was on my upper arm around the location of the injection site.  I treated it with lynocaine and aloe to relieve the itching.  After 2 days the swelling started to go down but the redness looked more like a rash.  It took about 6 days for it to completely go away.  I did not seek medical attention during the event and I have had no further problems.
Age: 26.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth
Clinical narrative: Itchy red bump at injection site started at about 7 days after shot. Initially size of a quarter, grew to be slightly larger. Red spot was also warm to the touch. Used Benadryl to help with itching and redness. Symptoms resolved about 3-4 days of initial symptoms.
Age: 43.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Chills, Dysgeusia, Headache, Injection site rash
Clinical narrative: Received dose #2. Within 10 minutes, developed metallic taste. 4 hours later severe nausea and vomiting. Began alternating Tylenol and Ibuprofen 800mg. 6 hours to the following day- severe headaches, chills, body aches, all over joint pain. Around midnight on 1/6/21 pain in the arm that radiated up her neck. 1/7- fever of 101. Small rash around injection site and slightly down arm. Stiff neck and arm pain.
Age: 43.0
Sex: F
Vaccine: COVID19
Symptoms: Musculoskeletal stiffness, Nausea, Neck pain, Pain, Pain in extremity
Clinical narrative: Received dose #2. Within 10 minutes, developed metallic taste. 4 hours later severe nausea and vomiting. Began alternating Tylenol and Ibuprofen 800mg. 6 hours to the following day- severe headaches, chills, body aches, all over joint pain. Around midnight on 1/6/21 pain in the arm that radiated up her neck. 1/7- fever of 101. Small rash around injection site and slightly down arm. Stiff neck and arm pain.
Age: 43.0
Sex: F
Vaccine: COVID19
Symptoms: Pyrexia, Vomiting
Clinical narrative: Received dose #2. Within 10 minutes, developed metallic taste. 4 hours later severe nausea and vomiting. Began alternating Tylenol and Ibuprofen 800mg. 6 hours to the following day- severe headaches, chills, body aches, all over joint pain. Around midnight on 1/6/21 pain in the arm that radiated up her neck. 1/7- fever of 101. Small rash around injection site and slightly down arm. Stiff neck and arm pain.
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Lip swelling
Clinical narrative: During 30 minute observation period, patient c/o lip swelling which was progressive when evaluated by APP on-site; Administered Epipen and benadryl; EMS transported to ED
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site erythema, Injection site induration, Injection site pruritus, Injection site reaction, Injection site warmth
Clinical narrative: covid arm - large red welt, hard and hot.  slightly itchy - no pain
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Urticaria
Clinical narrative: covid arm - large red welt, hard and hot.  slightly itchy - no pain
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness, Dysstasia, Vertigo
Clinical narrative: The day after the vaccine when I woke up and tried to stand up I felt dizzy and couldn't stand on my feet because the spinning sensation, I had been like that for 3 days and recently decided to call to the doctor and the nurse told me to take some pills for the dizziness, on Friday I spoke with a doctor, I was on scale of 10/10 and now are on 2/10.
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Back pain, Diarrhoea, Pain, Pain in extremity
Clinical narrative: Extreme pain in right hand from wrist to end of little finger.  No pain with hand relaxed extreme pain when flexing. On scale 1-10 about 8. Starting at 5:30. Gradually subsiding until the morning of 2/6  Extreme pain in left foot from heel several inches up the back of leg. No pain when relaxed but extreme pain if I tried to Stand or walk. 0n scale 1-10 a 10. Gradually subsiding until midday 2/5.  Pain in lower back mostly toward the left. Starting gradually late 2/4 increasing through 2/5 then decreasing through 2/6. No pain when relaxed increased pain when standing up. On scale 1-10 about 4.  Diarrhea for several days.
Age: 61.0
Sex: F
Vaccine: COVID19
Symptoms: Unevaluable event
Clinical narrative: Client had completed 15 minute wait post vaccine when EMT  approached her to ask how she was feeling prior to allowing her to leave. Client wanted to leave without being assessed and EMT informed lead RN. Lead RN assessed client and convinced client to allow staff to take vital signs prior to her leaving. Vitals at 1302: blood pressure 132/80, pulse 66, oxygen 98. Per client no shortness of breath, chest pain, nausea, changes in vision, or headache. Client alert and oriented. No known allergies and current medication trazodone. Per client was feeling well enough to go home, someone was driving her home. Declined to wait a few more minutes. Emergency room precautions given. Client left facility with a steady gait at 1304
Age: 41.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness, Dysstasia, Vertigo
Clinical narrative: Severe dizziness out of nowhere. Worst vertigo I?ve ever had.  Started at 3:30 on 2/6/21. I thought I?d have to go to the ER, except I couldn?t stand up without falling. Just as quickly as it came, it stopped at 8:35 p.m. that same night.
Age: 31.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site erythema, Injection site mass, Injection site pain, Injection site pruritus, Injection site warmth
Clinical narrative: Arm muscle soreness for 48 hours,  ping pong ball size lump with redness, hot to the touch and tenderness at injection site for 72 hours, red circle patch on skin started as ping pong ball size and increased to softball size with redness and itching persisting until February 4 (13 days later).
Age: 31.0
Sex: F
Vaccine: COVID19
Symptoms: Myalgia, Pain in extremity
Clinical narrative: Arm muscle soreness for 48 hours,  ping pong ball size lump with redness, hot to the touch and tenderness at injection site for 72 hours, red circle patch on skin started as ping pong ball size and increased to softball size with redness and itching persisting until February 4 (13 days later).
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Dizziness, Hyperhidrosis, Nausea
Clinical narrative: Sweating, chills, extreme dizziness, nausea
Age: 41.0
Sex: F
Vaccine: COVID19
Symptoms: Hypoaesthesia
Clinical narrative: Received 2nd dose vaccine. Experienced numbness in arm.
Age: 44.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness, Paraesthesia, Vital signs measurement
Clinical narrative: Patient stated feeling lightheaded and tingling sensation on left leg after receiving second dose of Pfizer Covid vaccine. Client was sitting on waiting area post vaccine for 15 minutes. EMT responded and alerted lead RN. Vitals taken at 1310: blood pressure 116/82, pulse 72, oxygen 99. Alert and oriented, stated symptoms began after vaccine. No prior history of tingling sensation in extremities. Stated tingling on left leg, mobility intact, no radiation or pain past leg. Allergies to amoxicillin and no current medications. Client given water and instructed to drink small sips. Per client no breakfast this morning and had two cups of coffee. Client denied chest pain, shortness of breath, palpitations, vision changes, headache. RN client asked to stay under observation longer and that EMT would recheck vitals prior to her leaving. EMT reassessed at 1325. Per client feeling better, was returning to work after leaving facility. Instructed to get food and rest. Last set of vitals: blood pressure 120/80, pulse 62, oxygen 99. Client left facility with a steady gait.
Age: 40.0
Sex: F
Vaccine: COVID19
Symptoms: Heavy menstrual bleeding, Menstrual disorder, Thrombosis
Clinical narrative: I started my menstrual cycle about one week early, experienced dark, brown tinged spotting for 2 days followed by  heavy flow with more clotting than I have ever experienced before.  Cycle lasted about  8 days, versus my normal 4 days.  These symptoms concern me due to several reports of miscarriages while receiving vaccine.
Age: 28.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site pruritus, Injection site swelling, Injection site warmth
Clinical narrative: Left arm at injection site became raised, swollen, itchy and warm to touch about 5 days after vaccination.
Age: 95.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site pain, Insomnia, Nausea, Rhinorrhoea, Vomiting
Clinical narrative: nausea, vomiting, insomnia, runny  nose--started 1:00 AM 21.  /Left arm sore at injection site.  Still have runny nose
Age: 79.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Pain
Clinical narrative: EXTREME BODY AND JOINT PAIN, CONSTANT,
Age: 25.0
Sex: M
Vaccine: COVID19
Symptoms: Dizziness, Headache, Nausea, Pain in extremity, Pyrexia
Clinical narrative: Sore arm all day today. Small headache. Starting around 5pm, I became dizzy, nauseated, and feverish.
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Headache, Hyperhidrosis, Mobility decreased, Muscle spasms
Clinical narrative: 2/2 severe headache, left hand cramped/closed, body pain, severe fatigue,, severe right arm pain, unable to move..Tues, no cramping or body pain but started with .right side head pain (above my ear at temple level) 4 days straight without any relief, no sleep. Fevers started 2/3, everyday at the same time, between 4-5pm, I get a wave of nausea and sweaty, 99.6,99.8, 99.9. Today 2/6 10am 99.6, 99.8 by noon 100.1...again at 5pm fever 110.1 wave of nausea and sweaty. Head pain has lessened and I have stopped taking OTC meds because NOTHING made a difference
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: Nausea, Pain, Pain in extremity, Pyrexia
Clinical narrative: 2/2 severe headache, left hand cramped/closed, body pain, severe fatigue,, severe right arm pain, unable to move..Tues, no cramping or body pain but started with .right side head pain (above my ear at temple level) 4 days straight without any relief, no sleep. Fevers started 2/3, everyday at the same time, between 4-5pm, I get a wave of nausea and sweaty, 99.6,99.8, 99.9. Today 2/6 10am 99.6, 99.8 by noon 100.1...again at 5pm fever 110.1 wave of nausea and sweaty. Head pain has lessened and I have stopped taking OTC meds because NOTHING made a difference
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: Chest discomfort, Dizziness, Fatigue, Headache, Musculoskeletal chest pain
Clinical narrative: Received dose #2. That evening, developed headache and dizziness, arm pain. 1/7-arm pain radiating down the ribs, extreme fatigue, body aches, dull headaches. 1/8- chest tightness, temp 99.8, body aches, fatigue, dull headache. Only able to dose with Tylenol.  1/12-follow up: states doing well and all symptoms subsided.
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: Pain, Pain in extremity
Clinical narrative: Received dose #2. That evening, developed headache and dizziness, arm pain. 1/7-arm pain radiating down the ribs, extreme fatigue, body aches, dull headaches. 1/8- chest tightness, temp 99.8, body aches, fatigue, dull headache. Only able to dose with Tylenol.  1/12-follow up: states doing well and all symptoms subsided.
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site pain, Injection site pruritus, Injection site reaction, Injection site swelling, Injection site warmth
Clinical narrative: Covid arm. On day 8 I developed an itchy red rash with swelling, heat, and tenderness at the injection site. I have a picture if needed.
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Rash erythematous
Clinical narrative: Covid arm. On day 8 I developed an itchy red rash with swelling, heat, and tenderness at the injection site. I have a picture if needed.
Age: 38.0
Sex: M
Vaccine: COVID19
Symptoms: Chills, Fatigue, Headache, Injection site induration, Injection site pain
Clinical narrative: Received second dose 2/4/21 0830 hours. Left arm. At around 1300 hours in same day, developed fatigue and headache. Those persisted into evening where chills developed and headache worsened.  2/5/21 woke up to very sore arm. Tender to touch. Fatigue and nausea and headache persisted through day. End of day, more chills developed and into the night.  2/6/21: headache lingered in day. Developed itchy and painful warm to the touch/firm rash around injection site.
Age: 38.0
Sex: M
Vaccine: COVID19
Symptoms: Injection site pruritus, Injection site warmth, Nausea, Pain in extremity
Clinical narrative: Received second dose 2/4/21 0830 hours. Left arm. At around 1300 hours in same day, developed fatigue and headache. Those persisted into evening where chills developed and headache worsened.  2/5/21 woke up to very sore arm. Tender to touch. Fatigue and nausea and headache persisted through day. End of day, more chills developed and into the night.  2/6/21: headache lingered in day. Developed itchy and painful warm to the touch/firm rash around injection site.
Age: 39.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site erythema, Injection site induration, Injection site pain, Injection site swelling, Injection site warmth
Clinical narrative: One week after injection, now the area on my arm has swollen, turned dark red, and is relatively hard. The area feels warm to the touch. Slight pain, but nothing like this has ever happened before.
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling
Clinical narrative: Had mild-mod Covid Arm for a few days after shot, then everything was fine.  But on the ninth day, my arm symptoms of redness, swelling, soreness and especially itchiness came on with a vengeance; triple the prior symptoms right after the injection.  So it?s 2 weeks today since my injection, and for the last 6 days, including today, my arm has had a repeat of Covid Arm much worse  (@3x) than the initial symptoms.