chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 31.0
Sex: F
Vaccine: COVID19
Symptoms: Dyspnoea, Extra dose administered, Laboratory test normal
Clinical narrative: Got Booster on 11/11/21, developed SOB on 11/14/21. Went to ER on 11/14/21, work-up negative. Discharged home under stable condition with prescription for inhaler PRN
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, COVID-19 pneumonia, Death, Endotracheal intubation, Hypoxia
Clinical narrative: limited medical information received on patient; pt to ED with a positive COVID test and hypoxic; hx of renal transplant on systemic immunosuppression; COVID pneumonia; required intubation; pt's condition worsened and he died in the hospital
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: limited medical information received on patient; pt to ED with a positive COVID test and hypoxic; hx of renal transplant on systemic immunosuppression; COVID pneumonia; required intubation; pt's condition worsened and he died in the hospital
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: Pain, Pain in extremity
Clinical narrative: chronic left arm pain since shot for now over 9 months.
Age: 66.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Cough, Fatigue, SARS-CoV-2 test positive
Clinical narrative: COVID Breakthrough. Went to urgent care on 11/6/21 for cough and exposure to COVID. Positive test in chart on 11/8/21. Came to ED on 11/16/21 with worsening/ongoing symptoms of cough and fatigue. Patient is on 2-3 L of Oxygen in the ED.
Age: 43.0
Sex: F
Vaccine: COVID19
Symptoms: Anaemia, Blood thyroid stimulating hormone, Full blood count, Oligomenorrhoea, Ultrasound pelvis
Clinical narrative: Menstrual cycle started 10/28/2021 Covid booster given 10/30/2021 Patient menstrual cycle usually lasts around 5 days. as of 11/16/2021, patient was still having continuous vaginal bleeding and worsening anemia.
Age: 43.0
Sex: F
Vaccine: COVID19
Symptoms: Vaginal haemorrhage
Clinical narrative: Menstrual cycle started 10/28/2021 Covid booster given 10/30/2021 Patient menstrual cycle usually lasts around 5 days. as of 11/16/2021, patient was still having continuous vaginal bleeding and worsening anemia.
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site erythema, Injection site induration, Injection site pain, Injection site swelling
Clinical narrative: 6-inch round, red, hard swelling at injection site that started Monday, Nov. 15 at noon and has continued through Wednesday, Nov. 17. Extremely painful. Treating with ice and ibuprofen.
Age: 69.0
Sex: M
Vaccine: COVID19
Symptoms: Malaise, Nasopharyngitis, Paraesthesia
Clinical narrative: Intermittent tingling in fingers, mostly left hand but some on right hand at times. Seemed to get a cold a few days after the booster, but I still feel like I'm fighting something.
Age: 61.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Cough, Diarrhoea, Fatigue, Headache
Clinical narrative: Pt. states that after receiving the 3rd Booster of Phizer 11/12/2021, started experiencing symptoms that evening of loose stool, vomiting, fatigue, headache, muscle ache, sinus pressure, chills, slight cough, fever (100.5), flu-like symptoms, and nausea. 11/14/2021 tested for Covid-19 = Negative, Flu Test = Negative. No noted Primary visit/communications. Still continuing to experience symptoms.
Age: 61.0
Sex: F
Vaccine: COVID19
Symptoms: Influenza like illness, Influenza virus test negative, Myalgia, Nausea, Paranasal sinus discomfort
Clinical narrative: Pt. states that after receiving the 3rd Booster of Phizer 11/12/2021, started experiencing symptoms that evening of loose stool, vomiting, fatigue, headache, muscle ache, sinus pressure, chills, slight cough, fever (100.5), flu-like symptoms, and nausea. 11/14/2021 tested for Covid-19 = Negative, Flu Test = Negative. No noted Primary visit/communications. Still continuing to experience symptoms.
Age: 61.0
Sex: F
Vaccine: COVID19
Symptoms: Pyrexia, SARS-CoV-2 test negative, Vomiting
Clinical narrative: Pt. states that after receiving the 3rd Booster of Phizer 11/12/2021, started experiencing symptoms that evening of loose stool, vomiting, fatigue, headache, muscle ache, sinus pressure, chills, slight cough, fever (100.5), flu-like symptoms, and nausea. 11/14/2021 tested for Covid-19 = Negative, Flu Test = Negative. No noted Primary visit/communications. Still continuing to experience symptoms.
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Computerised tomogram abnormal, Dyspnoea, Pain in extremity, Pulmonary embolism, Ultrasound scan
Clinical narrative: Shortness of breath, slight pain in left calf.
Age: 40.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: There was not an adverse event. The lot number was expired upon administration
Age: 7.0
Sex: M
Vaccine: COVID19
Symptoms: Exposure via skin contact, Incorrect dose administered
Clinical narrative: After giving vaccine, 1 drop of liquid was on arm.  Patient got more than half the dose, so we did not repeat dose.
Age: 43.0
Sex: F
Vaccine: COVID19, FLU4
Symptoms: Chills
Clinical narrative: RIgors starting approximately  15 hours after dose administration and continuing for 3-4 hours
Age: 28.0
Sex: F
Vaccine: COVID19
Symptoms: Axillary pain, Discomfort, Lymph node pain, Lymphadenopathy, Mobility decreased
Clinical narrative: Approximately 14 hours after receiving dose, I experienced pain under my armpit in my lymph node area.  I understand this is a common side effect; however, the severity of the swelling seems a bit extreme.  I have a visible tennis ball size lump under my arm that is tender to the touch.  The lump is the texture of a breast and is not thick or lumpy.  It is extremely uncomfortable to wear a bra or put arm down.  Also extremely uncomfortable to walk/run, as the lump shifts with motion causing discomfort.  I also had severe swelling to the lymph nodes after the first and second doses of the Pfizer vaccine that lasted for approximately 10-14 days.    I am aware this is a reported symptom; however, I wanted to report the severity and extent to which I am experiencing the symptom.  I do not feel the need to contact medical provider as this subsided within 14 days for my first two doses.  Did not have any long term effects.
Age: 40.0
Sex: F
Vaccine: COVID19
Symptoms: Hypoaesthesia, Oropharyngeal discomfort, Pain, Somnolence
Clinical narrative: None stated.
Age: 42.0
Sex: F
Vaccine: COVID19
Symptoms: Asthenia, Dyspnoea, Hypoaesthesia, Throat tightness
Clinical narrative: Numbness along the entire left side of my body:  face, arm, hand, chest, leg, foot Also felt slight tightness in my throat and slight short of breath.  My body still feels weak and slight numbing sensation along the left side of my body I took 25mg of benadryl immediately and also 600 mg of motrin.
Age: 42.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Condition aggravated, Death, Intestinal perforation
Clinical narrative: Patient passed r/t perforated viscus
Age: 41.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Diarrhoea, Dyspnoea, Fatigue, Pain
Clinical narrative: Congestion, fatigue, fever, body aches, diarrhea, shortness of breath
Age: 41.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Pyrexia, Respiratory tract congestion, SARS-CoV-2 test positive
Clinical narrative: Congestion, fatigue, fever, body aches, diarrhea, shortness of breath
Age: 78.0
Sex: F
Vaccine: COVID19, FLU4
Symptoms: Laboratory test, Myalgia, Sleep disorder, X-ray
Clinical narrative: Terrible muscle pain in left leg. Same side as hip replacement surgery in August. Pain was so severe couldn't slept. After 5 days, went to ER. Prescribed oxycodone. Later went to orthopedic surgeon. Surgeon prescribed steroid. Stopped taking oxycodone  because it was causing terrible stomach pain. Steroid finally eliminated pain and allowed her to sleep.
Age: 19.0
Sex: M
Vaccine: HEPA, VARCEL
Symptoms: Erythema, Skin warm, Swelling
Clinical narrative: Localized swelling, hot to touch and redness
Age: 75.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, Vaccine breakthrough infection
Clinical narrative: Fully vaccinated and boosted 11/8/21.  Covid breakthrough.   Inpatient hospital stay.
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Chest pain, Echocardiogram normal, Electrocardiogram, Pericardial effusion, Pericarditis
Clinical narrative: Developed episodes of chest pain on February 25, 2021; received diagnosis of pericarditis and initiated treatment with ibuprofen on March 9..  Ibuprofen was discontinued March 12 because of elevated creatinine; Colchicine begun on March 10, 6 week regimen. Symptoms gradually resolved by mid-May.  Creatinine returned to baseline.
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Red blood cell sedimentation rate increased, Troponin normal, Ultrasound scan abnormal
Clinical narrative: Developed episodes of chest pain on February 25, 2021; received diagnosis of pericarditis and initiated treatment with ibuprofen on March 9..  Ibuprofen was discontinued March 12 because of elevated creatinine; Colchicine begun on March 10, 6 week regimen. Symptoms gradually resolved by mid-May.  Creatinine returned to baseline.
Age: 66.0
Sex: F
Vaccine: COVID19
Symptoms: Alopecia, Blood test
Clinical narrative: My hair started to fall out in hand full all day. These happened for about a few months. I contacted my doctor. She was unsure why my hair was falling out. She did blood work.
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Confusional state, Fall, Imaging procedure, Impaired self-care, Laboratory test
Clinical narrative: History of Present Illness: Pt is a 67 Y F  with PMH  of hypertension, severe obesity, type 2 diabetes with CKD stage III and peripheral neuropathy, coming to the ED after she was found down at home by her sister.  Patient does not recall what happened before the fall or how she fell.  Patient reports that she recently was having multiple falls.  She lives by herself and ambulates with the help of a front wheeled walker.  Patient is able to give a history of medical conditions and the medications he uses at home but states that she cannot recall what happened before the fall or if she hit her head. Attempted to call patient's Sister who did not answer. Per ED note " Patient is a 67-year-old female with a history of type 2 diabetes, hypertension, severe obesity, uses wheelchair at home for mobility issues, is presenting today after being found down at her home.  I spoke to family who called EMS and they gave most of the details.   They report that the patient has some confusion at baseline, she has been living by herself but seems to not be able to take care of herself routinely especially over the last couple of months.  Apparently the patient has needed to call for the fire department for assistance for getting up frequently, and family is concerned that she is not taking care of herself, taking medications that she should consistently, etc.
Age: 70.0
Sex: M
Vaccine: COVID19
Symptoms: Condition aggravated, Discomfort, Dry skin, Erythema, Pruritus
Clinical narrative: Patient experienced eruption following second covid vaccination in March 2021, localized to face & eyelids. Treated at home with emollients, resolved after 1-2 weeks.  Patient recevied pfizer booster on 10/28 with occurrence of similar rash. Rash more widespread to include face, eyes, neck, & chest. Patient experiencing itching, redness, swelling, & discomfort. Significant dryness noted as well. Using aquaphor for nearly 3 weeks without resolution of symptoms.
Age: 70.0
Sex: M
Vaccine: COVID19
Symptoms: Rash, Swelling
Clinical narrative: Patient experienced eruption following second covid vaccination in March 2021, localized to face & eyelids. Treated at home with emollients, resolved after 1-2 weeks.  Patient recevied pfizer booster on 10/28 with occurrence of similar rash. Rash more widespread to include face, eyes, neck, & chest. Patient experiencing itching, redness, swelling, & discomfort. Significant dryness noted as well. Using aquaphor for nearly 3 weeks without resolution of symptoms.
Age: 75.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Rectal haemorrhage, SARS-CoV-2 test positive
Clinical narrative: rectal bleeding
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Influenza like illness, Pain, Pyrexia
Clinical narrative: Had flu like symptoms? fever,?. aches?tiredness  Last year had heart issues like fast heart beat & heart pains
Age: 86.0
Sex: M
Vaccine: COVID19
Symptoms: Aphasia, Facial paralysis, Hypoaesthesia
Clinical narrative: This is an 86-year-old with a history of hypertension, diabetes, and obstructive sleep apnea among others, who presents with expressive aphasia.  He continues to have expressive aphasia, so some of the history is supplemented by his daughter at the bedside and the medical record.  He is also using a note pad to write notes, but his handwriting is difficult to read.  The patient is ordinarily very active and walks several miles a day.  He woke up at 8:00 a.m. this morning and felt fine.  He went to take his daily walk when he noticed right upper extremity numbness.  He then developed expressive aphasia.  Family members noticed right-sided facial drooping as well.  About 5 days ago, the patient received his 3rd COVID vaccine (booster).  Family members noted after receiving his 2nd vaccine, he also had right upper extremity numbness.  Those symptoms lasted a few hours before resolving.
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: C-reactive protein normal, Extra dose administered, Head discomfort, Headache, Red blood cell sedimentation rate normal
Clinical narrative: Around a week after getting the booster of Covid 19, I began getting a headache on the left side of my head with intermittent stabbing pain.   The pain only lasted a few seconds but I always feel mild pressure to the left side of my head.   The headaches would only be a 2-3 times a day but then became more frequent.  I looked up my symptoms and found a clear description of them known as Ice Pick headaches.  Taking Tylenol didn't help relieve them so I went to see my doctor.  I am still getting the headaches and as of yesterday, they are beginning to happen on the right side of my head as well.
Age: 5.0
Sex: F
Vaccine: COVID19
Symptoms: Balance disorder, Blood test, Computerised tomogram, Diet refusal, Fall
Clinical narrative: The night of the vaccine child started having a slight fever, became fatigue and very tired. The next day she started vomiting a lot and wouldn't eat nor drink. Her became unbalance and kept falling down. She started having difficulty speaking. As the days went on her balance became worse and always tired. When she did eat and vomit it all back up. As she was trying to walk she kept falling down. Took child to the ER.
Age: 5.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Magnetic resonance imaging, Pyrexia, Speech disorder, Vomiting
Clinical narrative: The night of the vaccine child started having a slight fever, became fatigue and very tired. The next day she started vomiting a lot and wouldn't eat nor drink. Her became unbalance and kept falling down. She started having difficulty speaking. As the days went on her balance became worse and always tired. When she did eat and vomit it all back up. As she was trying to walk she kept falling down. Took child to the ER.
Age: 5.0
Sex: M
Vaccine: COVID19
Symptoms: Abdominal pain, Chills, Fatigue, Nausea, Pyrexia
Clinical narrative: Fever onset 3-4 hrs after receiving vaccine, varying from 100F to 102.6F for a prolonged period of time (5 days at present); abdominal pain; nausea; fatigue; chills
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness, Ear discomfort, Ear infection, Tinnitus
Clinical narrative: Development of ear pressure, tintinis, ringing sounds, dizziness  4 days after shot. Been 5 weeks nows no change. ENT specialist  show visually high inflamation in the middle ear  upon examination. Sprays, antibiotics, flushing, steaming and OTC meication had no effect. ENT frustrated with not enough studies as he has more than myslf as a patient experiencing same post vacine issues.
Age: 53.0
Sex: M
Vaccine: COVID19
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Pain, Pain in extremity
Clinical narrative: Patient had pain and swelling that started the same day of vaccination. Pain has been sharp with cramping in the hand periodically since. Today, 11/17/21, pain became more frequent and worse and a red, circular swelling appeared at site of injection. Size is about 2 inches in diameter.
Age: 53.0
Sex: M
Vaccine: COVID19
Symptoms: Swelling
Clinical narrative: Patient had pain and swelling that started the same day of vaccination. Pain has been sharp with cramping in the hand periodically since. Today, 11/17/21, pain became more frequent and worse and a red, circular swelling appeared at site of injection. Size is about 2 inches in diameter.
Age: 5.0
Sex: F
Vaccine: COVID19
Symptoms: Immunisation, Scratch
Clinical narrative: Pulled arm away when vaccinating, arm was scratched with needle.  Revaccinated in opposite arm - pt got full dose.
Age: 37.0
Sex: F
Vaccine: COVID19
Symptoms: Axillary pain, Hypoaesthesia, Lymphadenopathy, Paraesthesia, Rash
Clinical narrative: Skin rash, numbness and tingling in arm and hand, swollen painful lymph nodes in armpit
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: Hypoaesthesia, Magnetic resonance imaging spinal, Mobility decreased, Musculoskeletal stiffness, Neck pain
Clinical narrative: Within 15-30 minutes after leaving the pharmacy, I began to have burning pain in the left side of my neck above my injection site.  A day later, it was radiating down my left shoulder. Within days I began having numbness and tingling down my left arm and hand.  In June, my neck became so painful, I could hardly move, get in and out of bed and if anyone bumped me, there was terrible pain.  I treated it with CBD pain cream, increased dosages of Ibuprofen, hot and cold packs, but with little to no relief.  This same event happened again in August and September. I finally consulted my doctor on 9/20/21.  She ordered Gabapentin 300 mg bid.  That has lowered the pain and stiffness, but not completely.    I was treated for these same symptoms back in 2007-2008. I received physical therapy and two epidural injections during that time.  However, the symptoms had completely resolved and I have not received any treatment for this problem since...UNTIL NOW.  It feels like the medication went directly to an area of previous weakness and aggravated it and potentially, made it worse.
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: Pain, Paraesthesia
Clinical narrative: Within 15-30 minutes after leaving the pharmacy, I began to have burning pain in the left side of my neck above my injection site.  A day later, it was radiating down my left shoulder. Within days I began having numbness and tingling down my left arm and hand.  In June, my neck became so painful, I could hardly move, get in and out of bed and if anyone bumped me, there was terrible pain.  I treated it with CBD pain cream, increased dosages of Ibuprofen, hot and cold packs, but with little to no relief.  This same event happened again in August and September. I finally consulted my doctor on 9/20/21.  She ordered Gabapentin 300 mg bid.  That has lowered the pain and stiffness, but not completely.    I was treated for these same symptoms back in 2007-2008. I received physical therapy and two epidural injections during that time.  However, the symptoms had completely resolved and I have not received any treatment for this problem since...UNTIL NOW.  It feels like the medication went directly to an area of previous weakness and aggravated it and potentially, made it worse.
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Vaccine administered beyond the Best Used Date but before expiration date.
Age: 58.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Arthralgia, Hypoaesthesia, Injection site hypoaesthesia, Injection site paraesthesia, Pain in extremity
Clinical narrative: Sporadic pain in left arm behind muscle. Tingling/Numbness from point of injection to fingertips. Pin in front and rear should joint.
Age: 58.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Paraesthesia
Clinical narrative: Sporadic pain in left arm behind muscle. Tingling/Numbness from point of injection to fingertips. Pin in front and rear should joint.
Age: 52.0
Sex: F
Vaccine: PPV
Symptoms: Extra dose administered
Clinical narrative: Patient was administered a second dose of Pneumovax 23 despite receiving an initial dose one year prior
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Headache, Pain, Pyrexia
Clinical narrative: Pt. states that after receiving the 1st dose of Moderna 01/11/2021, started experiencing symptoms of severe headache, fever (lasting 4 days 102.0), body ache, and fatigue. Self-treated with Advil and Tylenol, Primary communications recommendation Observation. 02/11/2021 2nd dose of Moderna resulting in Similar symptoms lasting 4 days. No noted Primary visit/communications.  Arthritis symptoms have worsened since initial dose of Moderna 01/11/2021.
Age: 60.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: Breakthrough COIVD 19 infection not requiring hospitalization
Age: 39.0
Sex: F
Vaccine: COVID19
Symptoms: Bell's palsy, Blood test, Computerised tomogram, Ear pain, Facial paralysis
Clinical narrative: On 10/25, I felt very fatigued. I went to work, but I was feeling hot and cold and having headaches. The back of my right ear started hurting, but it never went into my ear. On 10/28, I was going to go to Urgent Care to have it checked, but I didn't. On 10/29, I woke up and noticed that my face felt swollen. I asked my mom what my face looked like, and she told me it was drooping. She took me to the ER in case I was having a stroke. My one eye was not blinking, and they diagnosed me with Bell's Palsy. I was given prednisone and an antiviral (the generic of Valtrex). Now, I am medicating with Dual Action Advil. I just had my eyes checked today and my vision is still 20/20. My eye is starting to blink now, and I was using eye drops to help with moisture. I am currently using them still. I am able to smile again now too. Last night I felt better and slept better than I have since this started. My doctor told me that my eye is back to normal tracking. It was mildly lagging on 11/09. I have had major improvement between 11/09-11/17 to my eye. My face feels like I've had an extreme workout, but it is noticeable better. There is overall improvement with my face since 10/29.
Age: 39.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Feeling of body temperature change, Headache, Swelling face
Clinical narrative: On 10/25, I felt very fatigued. I went to work, but I was feeling hot and cold and having headaches. The back of my right ear started hurting, but it never went into my ear. On 10/28, I was going to go to Urgent Care to have it checked, but I didn't. On 10/29, I woke up and noticed that my face felt swollen. I asked my mom what my face looked like, and she told me it was drooping. She took me to the ER in case I was having a stroke. My one eye was not blinking, and they diagnosed me with Bell's Palsy. I was given prednisone and an antiviral (the generic of Valtrex). Now, I am medicating with Dual Action Advil. I just had my eyes checked today and my vision is still 20/20. My eye is starting to blink now, and I was using eye drops to help with moisture. I am currently using them still. I am able to smile again now too. Last night I felt better and slept better than I have since this started. My doctor told me that my eye is back to normal tracking. It was mildly lagging on 11/09. I have had major improvement between 11/09-11/17 to my eye. My face feels like I've had an extreme workout, but it is noticeable better. There is overall improvement with my face since 10/29.
Age: 35.0
Sex: F
Vaccine: COVID19
Symptoms: Maternal exposure during breast feeding, Rash, Rash pruritic, Scab, Scratch
Clinical narrative: 1Nov2021, 12 Nov saw the rash, it was itchy by my neck. 13Nov2021 burning rash like hives in the evening on scalp, 14nov it spread on neck, chest, breast and belly, and on right ear. Started scratching and scabbed edotgraphifism. Not on my arms or legs. 14Nov went to doctors, took antihistamine and took Zyrtec for 5 days, 16Nov saw a dermatologist, it could be the vaccine. The rash is starting to come back if I didn't take Zyrtec (5days). PT was breast feeding.
Age: 35.0
Sex: F
Vaccine: COVID19
Symptoms: Skin burning sensation, Urticaria
Clinical narrative: 1Nov2021, 12 Nov saw the rash, it was itchy by my neck. 13Nov2021 burning rash like hives in the evening on scalp, 14nov it spread on neck, chest, breast and belly, and on right ear. Started scratching and scabbed edotgraphifism. Not on my arms or legs. 14Nov went to doctors, took antihistamine and took Zyrtec for 5 days, 16Nov saw a dermatologist, it could be the vaccine. The rash is starting to come back if I didn't take Zyrtec (5days). PT was breast feeding.
Age: 87.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Craniocerebral injury, Death
Clinical narrative: Pt deceased r/t closed head injury
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Influenza like illness, Mobility decreased, Osteopenia, Pain
Clinical narrative: Don't remember any from the first vaccine. But got a wallop from the second. Fever, flu-like symptoms. They passed quickly - within 24 hours or so. Then a  few or more days later I started having aches and tiredness. I didn't associate it with the vaccine. Just thought I was overdoing activities. Rested up. Kept feel worse.  Decided my age had caught up with me. Couldn't stay out of bed. Got so I couldn't put my socks on. Several weeks later I realized something was actually wrong with me beyond aging and I went to doc. She couldn't find anything. I got an appointment with a rheumatologist about a month later. She took a history on me, took blood samples. Believed I might have PMR as a result of the info she gathered. She prescribed 15mg Prednisone daily. I immediately got better. She said I definitely had PMR. That was early October. I'm still taking the Prednisone but she reduced the dosage yesterday to 10mg. I have now been found to have osteopenia.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Polymyalgia rheumatica, Pyrexia
Clinical narrative: Don't remember any from the first vaccine. But got a wallop from the second. Fever, flu-like symptoms. They passed quickly - within 24 hours or so. Then a  few or more days later I started having aches and tiredness. I didn't associate it with the vaccine. Just thought I was overdoing activities. Rested up. Kept feel worse.  Decided my age had caught up with me. Couldn't stay out of bed. Got so I couldn't put my socks on. Several weeks later I realized something was actually wrong with me beyond aging and I went to doc. She couldn't find anything. I got an appointment with a rheumatologist about a month later. She took a history on me, took blood samples. Believed I might have PMR as a result of the info she gathered. She prescribed 15mg Prednisone daily. I immediately got better. She said I definitely had PMR. That was early October. I'm still taking the Prednisone but she reduced the dosage yesterday to 10mg. I have now been found to have osteopenia.
Age: 26.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: Breakthrough COVID 19 infection not requiring hospitalization
Age: 33.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Vaccine administered beyond the Best Used Date but before expiration date.
Age: 2.0
Sex: M
Vaccine: FLU4, MMR, VARCEL
Symptoms: Inappropriate schedule of product administration
Clinical narrative: Vaccine given too early
Age: 24.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Vaccine administered beyond the Best Used Date but before expiration date.
Age: 57.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Tinnitus
Clinical narrative: Ringing in right ear
Age: 23.0
Sex: F
Vaccine: FLUC4, PPV
Symptoms: Blood culture negative, Blood lactic acid, Culture urine positive, Full blood count, Lactic acidosis
Clinical narrative: Admission to hospital for fever, tachypnea, tachycardia, leukocytosis, and lactic acidemia.    Pain and swelling of left arm.  Patient was admitted to the hospital for IV antibiotics, hydration, and supportive care.  LUE duplex was negative.  Discharged after 3 days as in patient.
Age: 23.0
Sex: F
Vaccine: FLUC4, PPV
Symptoms: Leukocytosis, Metabolic function test normal, Pain in extremity, Peripheral swelling, Pyrexia
Clinical narrative: Admission to hospital for fever, tachypnea, tachycardia, leukocytosis, and lactic acidemia.    Pain and swelling of left arm.  Patient was admitted to the hospital for IV antibiotics, hydration, and supportive care.  LUE duplex was negative.  Discharged after 3 days as in patient.
Age: 23.0
Sex: F
Vaccine: FLUC4, PPV
Symptoms: Tachycardia, Tachypnoea, Ultrasound Doppler normal, White blood cell count increased
Clinical narrative: Admission to hospital for fever, tachypnea, tachycardia, leukocytosis, and lactic acidemia.    Pain and swelling of left arm.  Patient was admitted to the hospital for IV antibiotics, hydration, and supportive care.  LUE duplex was negative.  Discharged after 3 days as in patient.
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Infection, SARS-CoV-2 test positive
Clinical narrative: Breakthrough COVID 19 infection not requiring hospitalization
Age: 67.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Arthralgia, Back pain, Joint stiffness, Musculoskeletal stiffness, Pain in extremity
Clinical narrative: FROM MID-SEPTEMBER AFTER TAKING THE SECOND DOSE OF THE VACCINE, MY LEFT HAND AND LEFT SIDE OF MY LOWER BACK AND LEFT KNEE STARTED FEELING STIFF AND PAINING. I HAVE READ SOME ARTICLES AND ABOUT POSSIBLE SIDE EFFECTS OF THE COVID19 VACCINE AND IT MENTIONS REACTIVE ARTHRITIS AS A RARE POSSIBILITY. THIS SEEMS TO BE THE CONDITION IN MY LEFT HAND. I HAVE NEVER HAD ARTHRITIS BEFORE. THE ARTICLE SAYS THAT THIS WAS TREATED BY ADMINISTERING 1 ML COMPOUND BETAMETHASONE FOR LEFT KNEE INFLAMMATION AND WAS CURED IN 2 DAYS. THE LEFT HAND CONTINUES TO BOTHER ME SPECIALLY THE RING FINGER WHICH CANNOT BEND . THE OTHER FINGERS FEEL SWOLLEN.
Age: 67.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Peripheral swelling
Clinical narrative: FROM MID-SEPTEMBER AFTER TAKING THE SECOND DOSE OF THE VACCINE, MY LEFT HAND AND LEFT SIDE OF MY LOWER BACK AND LEFT KNEE STARTED FEELING STIFF AND PAINING. I HAVE READ SOME ARTICLES AND ABOUT POSSIBLE SIDE EFFECTS OF THE COVID19 VACCINE AND IT MENTIONS REACTIVE ARTHRITIS AS A RARE POSSIBILITY. THIS SEEMS TO BE THE CONDITION IN MY LEFT HAND. I HAVE NEVER HAD ARTHRITIS BEFORE. THE ARTICLE SAYS THAT THIS WAS TREATED BY ADMINISTERING 1 ML COMPOUND BETAMETHASONE FOR LEFT KNEE INFLAMMATION AND WAS CURED IN 2 DAYS. THE LEFT HAND CONTINUES TO BOTHER ME SPECIALLY THE RING FINGER WHICH CANNOT BEND . THE OTHER FINGERS FEEL SWOLLEN.
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Heavy menstrual bleeding
Clinical narrative: Extra heavy menstrual flow
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Headache, Pain, Vision blurred, Visual impairment
Clinical narrative: bout 3 to 4 hours after having shot my head started hurting. I woke up in AM with body aches, headache and blurred vision in both eyes. Right worse then left. then I started seeing something in right eye sight.  When this was not better I called Thursday 10/28/21 to Eye DR. They thought best to come for an appt to have eyes examined.
Age: 39.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Diarrhoea, Pain in extremity
Clinical narrative: Chills, pain in legs, diarrhea
Age: 73.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Death
Clinical narrative: Unsure of reason for death
Age: 48.0
Sex: M
Vaccine: COVID19
Symptoms: Chills, Dry mouth, Fatigue, Gait disturbance, Headache
Clinical narrative: This was a booster dose of Moderna 0.25ml I received an email from this employee sent the evening of 11/16/21 and opened this morning by this writer. Symptoms begain 6 hours after vaccination as reported by the patient: Blurry vision, fatigue, dry mouth followed in the next several hours by: Severe headache contained to the right side of the head, Complete numbness of the left side of body very difficult to walk to the bedroom, chills/sweating back and forth throughout the night and next day. No outside medical attention was sought per the patient.
Age: 48.0
Sex: M
Vaccine: COVID19
Symptoms: Hyperhidrosis, Hypoaesthesia, Vision blurred
Clinical narrative: This was a booster dose of Moderna 0.25ml I received an email from this employee sent the evening of 11/16/21 and opened this morning by this writer. Symptoms begain 6 hours after vaccination as reported by the patient: Blurry vision, fatigue, dry mouth followed in the next several hours by: Severe headache contained to the right side of the head, Complete numbness of the left side of body very difficult to walk to the bedroom, chills/sweating back and forth throughout the night and next day. No outside medical attention was sought per the patient.
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Back pain, Hyperaesthesia teeth, Inflammation, Insomnia, Lymphadenitis
Clinical narrative: I noticed inflammation around my right shoulder blade and it was painful to sleep on right side or my back. I noticed my right collar bone had some slightly inflammation around lymph nodes which has last for a little over a month now.  I'm continuing to monitor. A few days after the vaccine, my teeth were sensitive and hurt when i tried to brush them. I also noticed my tongue was a little bigger than usual. I took Tylenol and about 3-4 days after the vaccine the teeth sensitivity and the swelling in tongue went down. However, recently I went to the dentist (about 3 weeks after the 2nd dose) and I noticed my jaw locking a bit (which has not happened during my cleanings before). The slight inflammation around my right collar bone still exists, so I'm continuing to monitor it.
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Pain, Swollen tongue, Toothache, Trismus
Clinical narrative: I noticed inflammation around my right shoulder blade and it was painful to sleep on right side or my back. I noticed my right collar bone had some slightly inflammation around lymph nodes which has last for a little over a month now.  I'm continuing to monitor. A few days after the vaccine, my teeth were sensitive and hurt when i tried to brush them. I also noticed my tongue was a little bigger than usual. I took Tylenol and about 3-4 days after the vaccine the teeth sensitivity and the swelling in tongue went down. However, recently I went to the dentist (about 3 weeks after the 2nd dose) and I noticed my jaw locking a bit (which has not happened during my cleanings before). The slight inflammation around my right collar bone still exists, so I'm continuing to monitor it.
Age: 30.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Infection, SARS-CoV-2 test positive
Clinical narrative: Breakthrough COVID 19 infection not requiring hospitalization
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Rash erythematous
Clinical narrative: Red rash on neck, just right if center; apx 3-4 ? in verticals length and 2-3? wide. Treated with Aquaphor topically.. rash lasted about 6-7 days. ( this also occurred when 2nd dose of same vaccine was received 3/11/21.
Age: 58.0
Sex: F
Vaccine: HEPAB
Symptoms: Headache
Clinical narrative: Headache
Age: 5.0
Sex: F
Vaccine: COVID19
Symptoms: Immunisation, Product administration interrupted
Clinical narrative: Patient pulled away during vaccination.  Revaccinated patient once calm enough to safely immunize.
Age: 40.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Chills, Fatigue, Headache, Heart rate increased
Clinical narrative: 10 hours after: fatigue, headache and injection site pain/redness 30-36 hours after:  mild fever (100), increased heart rate (90-100bpm), chills, hot flashes, skin pain, increased injection site pain/redness, headache, muscle/joint pain 36 hours +: Injection site pain/redness, swollen lymph nodes in arm pit under injection-site arm - other side effects have subsided.
Age: 40.0
Sex: F
Vaccine: COVID19
Symptoms: Hot flush, Injection site erythema, Injection site pain, Lymphadenopathy, Myalgia
Clinical narrative: 10 hours after: fatigue, headache and injection site pain/redness 30-36 hours after:  mild fever (100), increased heart rate (90-100bpm), chills, hot flashes, skin pain, increased injection site pain/redness, headache, muscle/joint pain 36 hours +: Injection site pain/redness, swollen lymph nodes in arm pit under injection-site arm - other side effects have subsided.
Age: 40.0
Sex: F
Vaccine: COVID19
Symptoms: Pain of skin, Pyrexia
Clinical narrative: 10 hours after: fatigue, headache and injection site pain/redness 30-36 hours after:  mild fever (100), increased heart rate (90-100bpm), chills, hot flashes, skin pain, increased injection site pain/redness, headache, muscle/joint pain 36 hours +: Injection site pain/redness, swollen lymph nodes in arm pit under injection-site arm - other side effects have subsided.
Age: 12.0
Sex: M
Vaccine: COVID19
Symptoms: Lip swelling, Myalgia
Clinical narrative: swollen lip - muscle aches
Age: 25.0
Sex: M
Vaccine: COVID19
Symptoms: Muscle spasms, Sleep disorder, Tremor
Clinical narrative: Uncontrollable muscle spasms, whole body shakes. Woke from sleep - unable to walk from shaking. Heart Rate @ 120 bpm. Took normal adult dose of Tylenol, symptoms ceased after 1 hour.
Age: 62.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Asthenia, Cough, Decreased appetite, Dyspnoea, Headache
Clinical narrative: This case meets criteria for vaccine breakthrough review. SxS include a few days PTA of weakness, hypoxia, cough, congestion, severe headache, body aches, SOB, decreased appetite.
Age: 62.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Hypoxia, Pain, Respiratory tract congestion, Vaccine breakthrough infection
Clinical narrative: This case meets criteria for vaccine breakthrough review. SxS include a few days PTA of weakness, hypoxia, cough, congestion, severe headache, body aches, SOB, decreased appetite.
Age: 23.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect dose administered, Urticaria
Clinical narrative: It was just noted that patient received 0.5ml rather than 0.25ml for a booster dose; Patient had no symptoms or reactions since the time of the vaccine administration until 1-2 weeks later she developed urticaria; was seen at urgent care and given a dose of steroids IM and Benadryl but continues with urticaria
Age: 21.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19
Clinical narrative: Breakthrough COVID 19 infection not requiring hospitalization
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Cough, Dyspnoea, Ear pain, Oropharyngeal pain
Clinical narrative: I traveled for meetings. I got there 9/10/2021. On 9/11/2021, I was in a large gathering, but I did wear a mask. While eating though, I did not have a mask. I had a mild cough and a sore throat. At the end of the week, my colleagues had COVID-19 symptoms. I decided to get a test done on 9/21/2021. I tested positive but at that time my symptoms were getting better. I needed to go to an Urgent Care for antibiotics. I had oral antibiotics for the earache. It did not help. I was given another antibiotic which also did not help. I went to an ENT where I was given antibiotics via eardrops in the ear which helped. I have also had some residual irritation in my lungs which has continued since. I have persistent irritation and shortness of breath. When I went to an NP, I was started on Zyrtec because she felt some of my symptoms could've been allergies. I was also given benzonatate for my cough. The benzonatate did not help much. I am still taking Zyrtec currently which seems to help.
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Respiratory tract irritation, SARS-CoV-2 test positive
Clinical narrative: I traveled for meetings. I got there 9/10/2021. On 9/11/2021, I was in a large gathering, but I did wear a mask. While eating though, I did not have a mask. I had a mild cough and a sore throat. At the end of the week, my colleagues had COVID-19 symptoms. I decided to get a test done on 9/21/2021. I tested positive but at that time my symptoms were getting better. I needed to go to an Urgent Care for antibiotics. I had oral antibiotics for the earache. It did not help. I was given another antibiotic which also did not help. I went to an ENT where I was given antibiotics via eardrops in the ear which helped. I have also had some residual irritation in my lungs which has continued since. I have persistent irritation and shortness of breath. When I went to an NP, I was started on Zyrtec because she felt some of my symptoms could've been allergies. I was also given benzonatate for my cough. The benzonatate did not help much. I am still taking Zyrtec currently which seems to help.
Age: 50.0
Sex: M
Vaccine: COVID19
Symptoms: Heart rate increased, Insomnia
Clinical narrative: Patient described that they had a racing heart beat the night following the shot and had trouble sleeping.  The side effects just lasted that night.
Age: 43.0
Sex: F
Vaccine: COVID19
Symptoms: Axillary pain, Blood test normal, Hypoaesthesia
Clinical narrative: On 11/13/2021 later on in the day started getting a pain in my left armpit, felt like whenever I put my left arm down the circulation cut off, there was no lump. The pain lasted for 4 days, and now is gone.
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: There was no adverse event. The lot number was expired upon administration
Age: 9.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness, Headache, Vision blurred
Clinical narrative: Headache on day of vaccine.   Then was fine for 2 days.  Then 3 days later with headache, dizziness and briefly blurred vision.  By 4 days later (day of visit and report) headache is mostly gone, but intermittently returns.
Age: 25.0
Sex: M
Vaccine: COVID19
Symptoms: Computerised tomogram normal, Erythema, Fibrin D dimer increased, Oedema peripheral, Peripheral swelling
Clinical narrative: I woke up with massive edema and swelling in both of my arms. There was a slight redness and pitting to the arm. There was no other significant signs or symptoms. It appeared over night.
Age: 25.0
Sex: M
Vaccine: COVID19
Symptoms: Ultrasound scan normal
Clinical narrative: I woke up with massive edema and swelling in both of my arms. There was a slight redness and pitting to the arm. There was no other significant signs or symptoms. It appeared over night.
Age: 55.0
Sex: M
Vaccine: COVID19
Symptoms: Lymphadenopathy, Pain, Pyrexia
Clinical narrative: Pt had fever and body ache starting 10 PM on 11/15/21 same day as vaccine. Patient also had swollen lymph node
Age: 75.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive, Syncope
Clinical narrative: syncope
Age: 76.0
Sex: M
Vaccine: COVID19
Symptoms: Chronic obstructive pulmonary disease, Condition aggravated, Death, Failure to thrive
Clinical narrative: Covid vaccine #1 given 2/9/2021 Moderna, lot # n/a patient died in the hospital from COPD, failure to thrive, not a covid infection
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: There was no adverse event. The lot number was expired upon administration
Age: 23.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Breakthrough COVID 19 infection not requiring hospitalization
Age: 86.0
Sex: F
Vaccine: COVID19
Symptoms: Asthenia, Limb discomfort, Pain in extremity, Peripheral swelling
Clinical narrative: Low energy.  Swelling of upper arm.  Pain in arm.  Heaviness of arm.
Age: 12.0
Sex: F
Vaccine: COVID19
Symptoms: Underdose
Clinical narrative: 12 year old male patient was given under 12 year old  dose of Pfizer vaccine.   Patient arrived for 2nd dose in series. 1st dose was 12 and up dose given by PCP.   The flow monitor serving as a greeter, did not properly direct the patient to the 12+ Pfizer registration section. Patient was sent to pediatric registrar, with verbal instructions to register the patient for a pediatric dose. Registrar wrote the date of birth and age at the top of the Emergency Use Authorization form, per instructions from site lead.  Registrar sent the patient to the under 12 year old vaccine section.   RN, reports checking age but delivering under 12 year old dose.  When RN checked the lot number, she noticed it did not match the lot number assigned in the chart (which was the lot number for 12 and older Pfizer vaccine).  On site Clinical lead doctor was immediately notified.  The lead doctor notified her supervisor, and informed the patient and parent..
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect dose administered
Clinical narrative: Patient received 0.5ml rather than 0.25ml as a booster dose
Age: 42.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Vaccine administered beyond the Best Used Date but before expiration date.
Age: 11.0
Sex: M
Vaccine: COVID19
Symptoms: Angina pectoris, Chest pain
Clinical narrative: Patient is having heart pain, chest pain all the time and sharp when he steps/walks.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: There was no adverse event. The lot number was expired upon administration
Age: 69.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: There was no adverse event. The lot number was expired upon administration
Age: 79.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Breakthrough COVID 19 infection not requiring hospitalization
Age: 38.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Anosmia, COVID-19, Cough, Fatigue, Headache
Clinical narrative: Patient tested positive 11/13/21 at CVS (nasal swab). Symptoms started 11/11/21; fever >100 on day #1 (resolved 11/16/21), nasal congestion, runny nose, coughing, headaches (main concern), body aches, sore throat (started initially - has now resolved), fatigue, loss of smell, and vomited the first day (has not vomited since). Patient had cancer and chemo 1 year ago (completed chemo 8 months ago).
Age: 38.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Nasal congestion, Oropharyngeal pain, Pain, Pyrexia, Rhinorrhoea
Clinical narrative: Patient tested positive 11/13/21 at CVS (nasal swab). Symptoms started 11/11/21; fever >100 on day #1 (resolved 11/16/21), nasal congestion, runny nose, coughing, headaches (main concern), body aches, sore throat (started initially - has now resolved), fatigue, loss of smell, and vomited the first day (has not vomited since). Patient had cancer and chemo 1 year ago (completed chemo 8 months ago).
Age: 38.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: SARS-CoV-2 test positive, Vomiting
Clinical narrative: Patient tested positive 11/13/21 at CVS (nasal swab). Symptoms started 11/11/21; fever >100 on day #1 (resolved 11/16/21), nasal congestion, runny nose, coughing, headaches (main concern), body aches, sore throat (started initially - has now resolved), fatigue, loss of smell, and vomited the first day (has not vomited since). Patient had cancer and chemo 1 year ago (completed chemo 8 months ago).
Age: 43.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, Cough, Diarrhoea, Exposure to SARS-CoV-2, Malaise
Clinical narrative: This case meets criteria for vaccine breakthrough review. SxS include N/V, malaise, body weakness, nasal congestion, cough, diarrhea, known exposure to COVID+ son.
Age: 43.0
Sex: M
Vaccine: COVID19
Symptoms: Nasal congestion, Nausea, Vaccine breakthrough infection, Vomiting
Clinical narrative: This case meets criteria for vaccine breakthrough review. SxS include N/V, malaise, body weakness, nasal congestion, cough, diarrhea, known exposure to COVID+ son.
Age: 48.0
Sex: M
Vaccine: COVID19
Symptoms: Arthralgia, Blood test, Contusion, Erythema, Hypoaesthesia
Clinical narrative: Immediately felt tingling in left arm and slight numbing.  That night my face swelled and was bright red.   The next day there was a shooting pain in my shoulder, down my arm, and into my hands.  Two of my fingers were tingling and numb.  I also had a bruise on the inner part of my arm with a rash.  After two weeks the pain in my shoulder and arm continued and was severe requiring a trip to the doctor's office.  My fingers are completely numb and the pain continues.