chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 31.0
Sex: F
Vaccine: COVID19
Symptoms: Abortion spontaneous, Blood creatine, Blood glucose, Blood urea, Exposure during pregnancy
Clinical narrative: Patient had miscarriage after 1st dose of COVID vaccine. Vaginal bleeding and cramping started after routine check at her OB clinic 4/22 showed fetal demise , Miscarriage complete 4/22/21. Seen by provider for pregnancy care per patient. Was around 16 weeks at time of 1st moderna vaccine-  G4P1031. ER visit 4/22 reports she was supposed to be 17 weeks on that date but US confirmed fetal demise at 12w6 days. RH positive
Age: 31.0
Sex: F
Vaccine: COVID19
Symptoms: Foetal death, Full blood count, Metabolic function test, Muscle spasms, Rhesus antigen positive
Clinical narrative: Patient had miscarriage after 1st dose of COVID vaccine. Vaginal bleeding and cramping started after routine check at her OB clinic 4/22 showed fetal demise , Miscarriage complete 4/22/21. Seen by provider for pregnancy care per patient. Was around 16 weeks at time of 1st moderna vaccine-  G4P1031. ER visit 4/22 reports she was supposed to be 17 weeks on that date but US confirmed fetal demise at 12w6 days. RH positive
Age: 31.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test, Second trimester pregnancy, Ultrasound antenatal screen abnormal, Vaginal haemorrhage
Clinical narrative: Patient had miscarriage after 1st dose of COVID vaccine. Vaginal bleeding and cramping started after routine check at her OB clinic 4/22 showed fetal demise , Miscarriage complete 4/22/21. Seen by provider for pregnancy care per patient. Was around 16 weeks at time of 1st moderna vaccine-  G4P1031. ER visit 4/22 reports she was supposed to be 17 weeks on that date but US confirmed fetal demise at 12w6 days. RH positive
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Induration, Lymph node pain, Lymphadenopathy, Sinusitis
Clinical narrative: Since injection have had a sinus infection and swollen, hard, painful lymph nodes in armpit and groin areas.  Armpit nodes are almost gone but the groin lymph nodes are still there.
Age: 45.0
Sex: F
Vaccine: COVID19
Symptoms: Dyskinesia, Loss of consciousness
Clinical narrative: She lost consciousness with the jerky movement. BP- 120/81, HR- 82, O2sat-99%. After couple of seconds she woke up alert and oriented like nothing happened. Advised to go to PCP after declining to go to ED.
Age: 87.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Death
Clinical narrative: Patient presented to the ED on 4/2/21 and was subsequently hospitalized within 6 weeks of receiving COVID vaccination. Patient presented to the ED on 4/9/21 and was subsequently hospitalized within 6 weeks of receiving COVID vaccination. He also presented to the ED on 4/21/21. He died on 4/24/21.
Age: 53.0
Sex: M
Vaccine: COVID19
Symptoms: Chest discomfort, Chest pain, Dizziness, Feeling drunk
Clinical narrative: 40 minutes after vaccination, patient reported feeling dizzy and "drunk." Patient ate a granola bar and drank a bottle of water as we monitored. 80 minutes after patient reported sharp chest pain and heaviness. He took one of his SQ Nitroglycerin pills, still had chest pain five minutes later and took another. After the second Nitroglycerin we called 911 and he continued to take his third Nitroglycerin tablet.
Age: 45.0
Sex: M
Vaccine: COVID19
Symptoms: Pain, Pain in extremity
Clinical narrative: Having issue with my arm. It is painful to lift/raise. From my shoulder to my elbow. I never had any issues with my arm prior to the vaccine shot. (Pain is in the same arm shot was done on)
Age: 53.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Headache, Hot flush, Restlessness
Clinical narrative: Headache, hot flashes, restlessness, fatigue. All symptoms lasted about 12 hours, except hot flashes (which lasted about 16 hours) and fatigue (which continued for a couple of days).
Age: 27.0
Sex: F
Vaccine: COVID19
Symptoms: Peripheral swelling, Skin discolouration, Ultrasound scan
Clinical narrative: PATIENT GOT A SUNBURN ON SUNDAY PRIOR TO WEDNESDAY OF EVENT; HER RIGHT LEG GOT EXTREMELY SWOLLEN; WENT TO URGENT CARE AND WAS SENT TO EMERGENCY ROOM TO CHECK FOR BLOOD CLOT SKIN COLOR WAS PUPLE/RED - NO RASH; BLOOD CLOT NOT FOUND - CAUSE OF SWELLING NOT FOUND SWELLING RESOLVED ITSELF ABOUT 5 DAYS; FRIEND OF PATIENT GOT SWOLLEN FOOT AND SAME RED/PURPLE SKIN TONE AFTER SECOND VACCINE AND SUNBURN - SAME TREATMENT COURSE - WE HAVE PHOTOS OF BOTH EVENTS.
Age: 30.0
Sex: F
Vaccine: COVID19
Symptoms: Bell's palsy, Extraocular muscle paresis, Facial paresis, Tongue disorder
Clinical narrative: Bell's palsy (classic symptoms). Onset on 5/2. Seen in the ED the next day when symptoms worsened. Diagnosed with Bell's palsy (right-side of face). Weakness, asymmetry of smile, inability to completely close eyes and loss of taste on right-side of tongue.
Age: 86.0
Sex: M
Vaccine: COVID19
Symptoms: Angiogram, Deep vein thrombosis, Dyspnoea exertional, Echocardiogram, Pulmonary embolism
Clinical narrative: He developed an unprovoked  DVT in his right leg that led to a pulmonary embolism that led to  severe pulmonary hyperttension that led to dyspnea on exertion.
Age: 86.0
Sex: M
Vaccine: COVID19
Symptoms: Pulmonary hypertension, Ultrasound Doppler
Clinical narrative: He developed an unprovoked  DVT in his right leg that led to a pulmonary embolism that led to  severe pulmonary hyperttension that led to dyspnea on exertion.
Age: 38.0
Sex: F
Vaccine: COVID19, UNK
Symptoms: Blood pressure increased, Dizziness, Electrocardiogram normal, Feeling hot, Full blood count normal
Clinical narrative: 14 minutes after injection I had a heat rise up to my head and I became extremely dizzy,  nausea, headache, extremely high blood pressure/ heart rate, I was rushed o er to the Er and kept there for observation and until the dizziness wore off around 330pm. EKG was normal and blood work looked fine so thegg ugh said nothing was wrong and let me go.
Age: 38.0
Sex: F
Vaccine: COVID19, UNK
Symptoms: Headache, Heart rate increased, Nausea
Clinical narrative: 14 minutes after injection I had a heat rise up to my head and I became extremely dizzy,  nausea, headache, extremely high blood pressure/ heart rate, I was rushed o er to the Er and kept there for observation and until the dizziness wore off around 330pm. EKG was normal and blood work looked fine so thegg ugh said nothing was wrong and let me go.
Age: 33.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Interchange of vaccine products
Clinical narrative: PATIENT HAS RECEIVED TWO DIFFERENT COVID VACCINES. PATIENT CAME IN FOR JANSSEN COVID VACCINE AT OUR STORE AND SAID TO MULTIPLE WORKERS HE HAD NOT RECEIVED ANY OTHER COVID VACCINE. UPON ENTERING THE SHOT INTO MCIR AFTER ADMINISTRATION, WE SAW PATIENT HAD PREVIOUSLY RECEIVED FIRST DOSE OF MODERNA FROM .
Age: 37.0
Sex: F
Vaccine: COVID19
Symptoms: Asthenia, Dizziness, Dyspnoea, Fatigue, Feeling abnormal
Clinical narrative: 1st dose on 5/5 Moderna, more than 4 hours after dose Reports dizziness, weakness and fast heart rate. Called Nurse  line 5.11.21 and reported "had headache and was tired right after vaccine, but on Sunday and Monday developed heart racing, shortness of breath, sharp/brief pains in her head, dizziness, vertigo, and vision changes. Pt. Continues to have vertigo and states "I feel like I'm in a fog." Pt. States she drove yesterday and when she got home she told her husband "I shouldn't have driven."  Reporting for continued vertigo affecting activities of daily living and patient reporting mental status changes or "feeling like she was in a fog" (not safe driving)
Age: 37.0
Sex: F
Vaccine: COVID19
Symptoms: Headache, Heart rate increased, Immediate post-injection reaction, Loss of personal independence in daily activities, Palpitations
Clinical narrative: 1st dose on 5/5 Moderna, more than 4 hours after dose Reports dizziness, weakness and fast heart rate. Called Nurse  line 5.11.21 and reported "had headache and was tired right after vaccine, but on Sunday and Monday developed heart racing, shortness of breath, sharp/brief pains in her head, dizziness, vertigo, and vision changes. Pt. Continues to have vertigo and states "I feel like I'm in a fog." Pt. States she drove yesterday and when she got home she told her husband "I shouldn't have driven."  Reporting for continued vertigo affecting activities of daily living and patient reporting mental status changes or "feeling like she was in a fog" (not safe driving)
Age: 37.0
Sex: F
Vaccine: COVID19
Symptoms: Vertigo, Visual impairment
Clinical narrative: 1st dose on 5/5 Moderna, more than 4 hours after dose Reports dizziness, weakness and fast heart rate. Called Nurse  line 5.11.21 and reported "had headache and was tired right after vaccine, but on Sunday and Monday developed heart racing, shortness of breath, sharp/brief pains in her head, dizziness, vertigo, and vision changes. Pt. Continues to have vertigo and states "I feel like I'm in a fog." Pt. States she drove yesterday and when she got home she told her husband "I shouldn't have driven."  Reporting for continued vertigo affecting activities of daily living and patient reporting mental status changes or "feeling like she was in a fog" (not safe driving)
Age: 56.0
Sex: M
Vaccine: COVID19
Symptoms: Arthralgia, Lymphadenopathy, Paraesthesia
Clinical narrative: Sore Left shoulder around shot site (deltoid mucsle).  Swollen lymph node in underarm (left arm) and tingling in left arm down to fingers.
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Haematuria
Clinical narrative: The morning following my vaccination, I began experiencing gross hematuria. This condition has continued for 24 hours now.
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Decreased appetite, Headache, Pain, Pyrexia
Clinical narrative: Severe, debilitating chills with teeth chattering and overall body shaking, fever, body aches, headache and loss of appetite.
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: Tremor
Clinical narrative: Severe, debilitating chills with teeth chattering and overall body shaking, fever, body aches, headache and loss of appetite.
Age: 36.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal pain upper, Chest pain, Chills, Dizziness, Fatigue
Clinical narrative: 2:00 p.m. - Head felt disconnected/ lightheaded, chills 5:00 p.m. - stomach ache, extremely sore arm 6:00 p.m. - Low grade fever chills, headache, lightheaded 8:00 p.m. - Took 3  ibuprofen 9:00 p.m. - Fever of 101.7, severe chills, headache, chest pains 10:00 p.m. - Elevated resting heart rate (117bpm), pounding heart, chest pains, fever 102, severe chills, headache, lightheaded 10:45 - Took Tylenol 1:00 a.m. - Elevated resting heart rate (woke up and still 108-117bpm), pounding heart, fever down to 100.7, headache, chest pains  Finally fell asleep after this for the night, woke up around 7:30 a.m. and felt mostly back to normal, slight headache & more tired than usual.  I made sure to drink 2x as much water the day before the vaccine and the day of so dehydration was not a factor. I have had anxiety and panic attacks in the past and this did not feel like that whatsoever.
Age: 36.0
Sex: F
Vaccine: COVID19
Symptoms: Headache, Heart rate increased, Pain in extremity, Palpitations, Pyrexia
Clinical narrative: 2:00 p.m. - Head felt disconnected/ lightheaded, chills 5:00 p.m. - stomach ache, extremely sore arm 6:00 p.m. - Low grade fever chills, headache, lightheaded 8:00 p.m. - Took 3  ibuprofen 9:00 p.m. - Fever of 101.7, severe chills, headache, chest pains 10:00 p.m. - Elevated resting heart rate (117bpm), pounding heart, chest pains, fever 102, severe chills, headache, lightheaded 10:45 - Took Tylenol 1:00 a.m. - Elevated resting heart rate (woke up and still 108-117bpm), pounding heart, fever down to 100.7, headache, chest pains  Finally fell asleep after this for the night, woke up around 7:30 a.m. and felt mostly back to normal, slight headache & more tired than usual.  I made sure to drink 2x as much water the day before the vaccine and the day of so dehydration was not a factor. I have had anxiety and panic attacks in the past and this did not feel like that whatsoever.
Age: 36.0
Sex: F
Vaccine: COVID19
Symptoms: Vaccination complication
Clinical narrative: 2:00 p.m. - Head felt disconnected/ lightheaded, chills 5:00 p.m. - stomach ache, extremely sore arm 6:00 p.m. - Low grade fever chills, headache, lightheaded 8:00 p.m. - Took 3  ibuprofen 9:00 p.m. - Fever of 101.7, severe chills, headache, chest pains 10:00 p.m. - Elevated resting heart rate (117bpm), pounding heart, chest pains, fever 102, severe chills, headache, lightheaded 10:45 - Took Tylenol 1:00 a.m. - Elevated resting heart rate (woke up and still 108-117bpm), pounding heart, fever down to 100.7, headache, chest pains  Finally fell asleep after this for the night, woke up around 7:30 a.m. and felt mostly back to normal, slight headache & more tired than usual.  I made sure to drink 2x as much water the day before the vaccine and the day of so dehydration was not a factor. I have had anxiety and panic attacks in the past and this did not feel like that whatsoever.
Age: 24.0
Sex: M
Vaccine: COVID19
Symptoms: Axillary pain, Lymphadenopathy, Myalgia
Clinical narrative: Pain in the muscle. Later in the day, pain and slight swelling developed in the lymph node under left arm pit. Took 200mg Ibuprofen. The pain generally resided the next day.
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site pain
Clinical narrative: Pain at injection site  Took Tylenol
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Condition aggravated, Dyspnoea, Hyperhidrosis, Lymphadenopathy
Clinical narrative: Chronic and debilitating migraines 15 days (consecutive) post injection. Residual headaches post 29 days and counting. Shortness of breath 14 days post injection. Golf ball-sized lymph node in left armpit of injection arm, 12 days post injection. Hyperhidrosis 21 days (consecutive) post injection.  Fever (99-100.6) 8 days post injection. Sharp, piercing joint pain continuing 29 days and counting, post injection.
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: Migraine, Pyrexia
Clinical narrative: Chronic and debilitating migraines 15 days (consecutive) post injection. Residual headaches post 29 days and counting. Shortness of breath 14 days post injection. Golf ball-sized lymph node in left armpit of injection arm, 12 days post injection. Hyperhidrosis 21 days (consecutive) post injection.  Fever (99-100.6) 8 days post injection. Sharp, piercing joint pain continuing 29 days and counting, post injection.
Age: 32.0
Sex: M
Vaccine: COVID19
Symptoms: Dizziness, Dyspepsia, Feeling abnormal, Feeling cold, Nausea
Clinical narrative: Roughly three hours after getting the shot I was very cold and developed a fever of 102.8. I vomited that night. I took an ibuprofen to help reduce the fever then slept. For the next six days I had an on again and off again low grade fever and was nauseas most of the time. Sometime during those 6 days I developed intermitted tingling in my left hand, primarily by index finger. This continues to today happening roughly once a day.  On rare occasion my right had will do the same thing but that is far less often. I never had tingling in either hand prior to my vaccine. I also developed heartburn occurring roughly 1-2 times a day. Prior to the vaccine I rarely (1-2 times a year) had heartburn and I have not changed anything about my diet or lifestyle since my vaccine. Occasionally my head feels "foggy" as well and this began sometime after the vaccine but I can't recall exactly when it started. It's not a headache, more of a slight lightheaded, dull feeling. I had none of these symptoms with any regularity until I was administered the vaccine.
Age: 32.0
Sex: M
Vaccine: COVID19
Symptoms: Paraesthesia, Pyrexia, Vomiting
Clinical narrative: Roughly three hours after getting the shot I was very cold and developed a fever of 102.8. I vomited that night. I took an ibuprofen to help reduce the fever then slept. For the next six days I had an on again and off again low grade fever and was nauseas most of the time. Sometime during those 6 days I developed intermitted tingling in my left hand, primarily by index finger. This continues to today happening roughly once a day.  On rare occasion my right had will do the same thing but that is far less often. I never had tingling in either hand prior to my vaccine. I also developed heartburn occurring roughly 1-2 times a day. Prior to the vaccine I rarely (1-2 times a year) had heartburn and I have not changed anything about my diet or lifestyle since my vaccine. Occasionally my head feels "foggy" as well and this began sometime after the vaccine but I can't recall exactly when it started. It's not a headache, more of a slight lightheaded, dull feeling. I had none of these symptoms with any regularity until I was administered the vaccine.
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: Interchange of vaccine products
Clinical narrative: In error, patient was given 1st dose of Moderna vaccine after receiving the Janssen vaccine on 04/09/2021
Age: 44.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Migraine
Clinical narrative: Extremely intense migraine attack that hasn't decreased since the vaccine was applied (12 days so far)
Age: 32.0
Sex: F
Vaccine: COVID19
Symptoms: Blood glucose normal, Paraesthesia, Paraesthesia oral
Clinical narrative: Pt. reported tingling in arms, fingertips and tongue.  Pt. was seen by Fire Rescue.  Vitals were within range.  No further treatment was given.  Transport to ER was declined.  Symptoms resolved and patient left the park at 1:10pm.
Age: 42.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal pain, Diarrhoea
Clinical narrative: diarrhea for 2 days, abdominal pain for 3 days
Age: 66.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: Patient received first dose Moderna 3/22/21, second dose Pfizer 5/12/2021. Screener did not turn her away on a Pfizer-only day. Scribe and vaccinator did not look at card to see what was given prior. She missed her scheduled second dose appointment (on a Monday where Moderna was being administered) and drove past the "Pfizer today" signs.
Age: 44.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Headache, Injection site pain, Nausea, Pyrexia
Clinical narrative: Fever, headache, tiredness, nausea, pain at injection site. Symptoms except injection site pain lasted a day and a half.  Injection site is still sore 2 days after shot.
Age: 56.0
Sex: M
Vaccine: COVID19
Symptoms: Interchange of vaccine products
Clinical narrative: In error, patient was given 1st dose of the Moderna vaccine after having Janssen vaccine on 04/09/2021
Age: 38.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Herpes zoster, Rash
Clinical narrative: Rash or Shingles.
Age: 59.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, Chills, Feeling cold, Headache, Hyperhidrosis
Clinical narrative: headache, uncrollable shivering and cold, sweats and weakness
Age: 30.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Injection site discolouration, Pain in extremity
Clinical narrative: Other than soreness in my left arm for the first few days, I did not notice anything else (nor did I look at the injection site). However, today (5 days after the 2nd injection) I noticed my left arm is yellow in color (about 1 inch tall by 2 inches wide), but there is no soreness or any other associated complications.
Age: 44.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal pain, Clostridium difficile colitis, Clostridium test positive, Condition aggravated, Gastrointestinal haemorrhage
Clinical narrative: Hospitalized for rectal bleeding  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Abdominal pain, unspecified abdominal location  Gastrointestinal hemorrhage, unspecified gastrointestinal hemorrhage type  COVID-19 virus not detected  GI bleeding  Rectal bleeding    HOSPITAL COURSE: 44 yo female with h/o rheumatoid arthritis on immunomodulator therapy, adrenal insufficiency with chronic steroid use, duodenal and colonic polyposis, and irritable bowel syndrome, who presented on 5/3 with rectal bleeding. One day prior, she noted 2 small drops of blood on her underwear. On day of admission, she went to have a bowel movement and it was mostly blood and it saturated the water in the toilet bowel. She follows with GI Dr., and had EGD and colonoscopy on 2/1 again revealing multiple polyps. She had been referred to a geneticist to rule out familial polyposis syndrome.  She came to the ED for evaluation.  In the ED, she had one BP measurement that was low, 89/62, Hgb is 12.4, down from 14.5 from 3/3. ED performed a rectal exam that showed dried blood around the perineum. No large, palpable hemorrhoids. Pink jelly on exam finger. Possible small posterior anal fissure that was painful. She was given hydrocortisone 100mg IV, 1L IVF, and pantoprazole 80mg.  She was admitted to the IM service with GI consulted, and Hgb remained stable on serial checks.  Stool studies were sent, showing positive C diff PCR and she was started on oral vancomycin.  Over the next few days, she showed gradual improvement of her presenting abdominal cramps and bleeding output.  Her Hgb remained stable and she showed no evidence of uncontrolled infection.  She was tolerating a diet and meeting nutritional requirements.  She was evaluated on 5/7 and deemed stable for discharge.  She is having scant bloody output with her stools still, but this was reviewed with GI on date of discharge and is expected for C diff colitis in ongoing recovery.  She will be prescribed 12 more days of oral vancomycin therapy to complete a total 14-day course, given her history of immunodeficiency.  She is recommended follow-up with her PCP within 1 week of discharge, and with the outpatient GI clinic as directed by their office.  Condition specific return precautions were reviewed with her at length prior to discharge, and she vocalized full understanding of all given instructions and follow-up recommendations.   CONSULTS / RECOMMENDATION: GI   INPATIENT PROCEDURES: None
Age: 44.0
Sex: F
Vaccine: COVID19
Symptoms: Haematochezia, Haemoglobin normal, Hypotension, Rectal examination abnormal, Rectal haemorrhage
Clinical narrative: Hospitalized for rectal bleeding  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Abdominal pain, unspecified abdominal location  Gastrointestinal hemorrhage, unspecified gastrointestinal hemorrhage type  COVID-19 virus not detected  GI bleeding  Rectal bleeding    HOSPITAL COURSE: 44 yo female with h/o rheumatoid arthritis on immunomodulator therapy, adrenal insufficiency with chronic steroid use, duodenal and colonic polyposis, and irritable bowel syndrome, who presented on 5/3 with rectal bleeding. One day prior, she noted 2 small drops of blood on her underwear. On day of admission, she went to have a bowel movement and it was mostly blood and it saturated the water in the toilet bowel. She follows with GI Dr., and had EGD and colonoscopy on 2/1 again revealing multiple polyps. She had been referred to a geneticist to rule out familial polyposis syndrome.  She came to the ED for evaluation.  In the ED, she had one BP measurement that was low, 89/62, Hgb is 12.4, down from 14.5 from 3/3. ED performed a rectal exam that showed dried blood around the perineum. No large, palpable hemorrhoids. Pink jelly on exam finger. Possible small posterior anal fissure that was painful. She was given hydrocortisone 100mg IV, 1L IVF, and pantoprazole 80mg.  She was admitted to the IM service with GI consulted, and Hgb remained stable on serial checks.  Stool studies were sent, showing positive C diff PCR and she was started on oral vancomycin.  Over the next few days, she showed gradual improvement of her presenting abdominal cramps and bleeding output.  Her Hgb remained stable and she showed no evidence of uncontrolled infection.  She was tolerating a diet and meeting nutritional requirements.  She was evaluated on 5/7 and deemed stable for discharge.  She is having scant bloody output with her stools still, but this was reviewed with GI on date of discharge and is expected for C diff colitis in ongoing recovery.  She will be prescribed 12 more days of oral vancomycin therapy to complete a total 14-day course, given her history of immunodeficiency.  She is recommended follow-up with her PCP within 1 week of discharge, and with the outpatient GI clinic as directed by their office.  Condition specific return precautions were reviewed with her at length prior to discharge, and she vocalized full understanding of all given instructions and follow-up recommendations.   CONSULTS / RECOMMENDATION: GI   INPATIENT PROCEDURES: None
Age: 44.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test negative
Clinical narrative: Hospitalized for rectal bleeding  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Abdominal pain, unspecified abdominal location  Gastrointestinal hemorrhage, unspecified gastrointestinal hemorrhage type  COVID-19 virus not detected  GI bleeding  Rectal bleeding    HOSPITAL COURSE: 44 yo female with h/o rheumatoid arthritis on immunomodulator therapy, adrenal insufficiency with chronic steroid use, duodenal and colonic polyposis, and irritable bowel syndrome, who presented on 5/3 with rectal bleeding. One day prior, she noted 2 small drops of blood on her underwear. On day of admission, she went to have a bowel movement and it was mostly blood and it saturated the water in the toilet bowel. She follows with GI Dr., and had EGD and colonoscopy on 2/1 again revealing multiple polyps. She had been referred to a geneticist to rule out familial polyposis syndrome.  She came to the ED for evaluation.  In the ED, she had one BP measurement that was low, 89/62, Hgb is 12.4, down from 14.5 from 3/3. ED performed a rectal exam that showed dried blood around the perineum. No large, palpable hemorrhoids. Pink jelly on exam finger. Possible small posterior anal fissure that was painful. She was given hydrocortisone 100mg IV, 1L IVF, and pantoprazole 80mg.  She was admitted to the IM service with GI consulted, and Hgb remained stable on serial checks.  Stool studies were sent, showing positive C diff PCR and she was started on oral vancomycin.  Over the next few days, she showed gradual improvement of her presenting abdominal cramps and bleeding output.  Her Hgb remained stable and she showed no evidence of uncontrolled infection.  She was tolerating a diet and meeting nutritional requirements.  She was evaluated on 5/7 and deemed stable for discharge.  She is having scant bloody output with her stools still, but this was reviewed with GI on date of discharge and is expected for C diff colitis in ongoing recovery.  She will be prescribed 12 more days of oral vancomycin therapy to complete a total 14-day course, given her history of immunodeficiency.  She is recommended follow-up with her PCP within 1 week of discharge, and with the outpatient GI clinic as directed by their office.  Condition specific return precautions were reviewed with her at length prior to discharge, and she vocalized full understanding of all given instructions and follow-up recommendations.   CONSULTS / RECOMMENDATION: GI   INPATIENT PROCEDURES: None
Age: 61.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal discomfort, Chills, Injection site pain, Myalgia, Pyrexia
Clinical narrative: ?Moderna COVID-19 Vaccine EUA? sore muscles (All over, not just injection site), chills, fever, upset stomach
Age: 17.0
Sex: F
Vaccine: COVID19
Symptoms: Product administered to patient of inappropriate age
Clinical narrative: VACCINE ADMINISTRATION ERROR; UNAUTHORIZED AGE GROUP.
Age: 57.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Bone pain, Headache
Clinical narrative: Severe headaches and bone/joint pain - started about 15 minutes after injection and continues today days at a time then slacks off and reappears
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Chest pain, Dizziness, Dyspnoea, Exposure during pregnancy
Clinical narrative: Shortness of breath, chest pain, dizziness, within 7 weeks of pregnancy
Age: 38.0
Sex: M
Vaccine: COVID19
Symptoms: Lacrimation increased, Middle ear effusion, Somnolence
Clinical narrative: drowsiness, fluid in ears, excess eye tears
Age: 82.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Acute kidney injury
Clinical narrative: N17.9 - Acute kidney failure, unspecified
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Cardiac monitoring normal, Computerised tomogram thorax, Differential white blood cell count normal, Dyspnoea, Electrocardiogram normal
Clinical narrative: Friday evening, 8:45 pm, shortness of breath, Saturday morning woke up and my heart was racing, general unwell feeling, "something feels wrong", around noon, went up a flight of stairs and couldn't catch my breath. The shortness of breath continued, 30 minutes later my husband drove me to the Emergency Room; Apparently the shortness of breath triggered a hyperventilation episode and a panic attack, neither of which I have ever had before.
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Fibrin D dimer normal, Full blood count normal, Hyperventilation, Malaise, Metabolic function test
Clinical narrative: Friday evening, 8:45 pm, shortness of breath, Saturday morning woke up and my heart was racing, general unwell feeling, "something feels wrong", around noon, went up a flight of stairs and couldn't catch my breath. The shortness of breath continued, 30 minutes later my husband drove me to the Emergency Room; Apparently the shortness of breath triggered a hyperventilation episode and a panic attack, neither of which I have ever had before.
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Oxygen saturation, Palpitations, Panic attack, Troponin T normal
Clinical narrative: Friday evening, 8:45 pm, shortness of breath, Saturday morning woke up and my heart was racing, general unwell feeling, "something feels wrong", around noon, went up a flight of stairs and couldn't catch my breath. The shortness of breath continued, 30 minutes later my husband drove me to the Emergency Room; Apparently the shortness of breath triggered a hyperventilation episode and a panic attack, neither of which I have ever had before.
Age: 26.0
Sex: M
Vaccine: COVID19
Symptoms: Joint stiffness, Mobility decreased, Musculoskeletal stiffness, Nausea, Paraesthesia
Clinical narrative: Gradual stiffness and tightening of both shoulder joints. Reduced flexibility in knees the first night and pain during normal range of motion. 5-minute intervals of paresthesia in both hands and wrists every couple of hours. Nausea the next day.
Age: 19.0
Sex: F
Vaccine: COVID19
Symptoms: Nausea, Pain, Photopsia, Photosensitivity reaction, Pyrexia
Clinical narrative: extreme photosensitivity (partial loss of vision appearing ?sparkly? for 5 hours), fever, body aches, nausea
Age: 19.0
Sex: F
Vaccine: COVID19
Symptoms: Visual impairment
Clinical narrative: extreme photosensitivity (partial loss of vision appearing ?sparkly? for 5 hours), fever, body aches, nausea
Age: 51.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Cardiac stress test, Chest X-ray normal, Chest discomfort, Computerised tomogram head normal, Dizziness
Clinical narrative: Received first Pfizer Covid Vaccine on 4/30/21.  She states within 15 minutes of receiving the vaccine she experienced a weird sensation of her tongue, her heart was pounding, she felt flushed like her ears and head were on fire.  She reported it to the nurse observing her.  The nurse advised to wait another 15 minutes.  She reports that BP was 170/110 P 110. Her BP continued to rise and developed tightness in chest and dizziness and RRT was called and she was transported to the ED.  In ED she received Solumedrol, Benadryl, ASA 325mg and Pepcid.  EKG and cardiac enzymes were normal, BP decreased to 130/90 and she was discharge at 9pm. Next day, she experienced the same adverse reactions and was taken to ED. Patient had COVID Infection in January 2021.  Received first Pfizer Covid Vaccine on 4/30/21.  PMHx of HTN receiving treatment. She states within 15 minutes of receiving the vaccine she experienced a weird sensation of her tongue, her heart was pounding, she felt flushed like her ears and head were on fire.  She reported it to the nurse observing her.  The nurse advised to wait another 15 minutes.  She reports that BP was 170/110 P 110. She drank some water and performed deep breathing repeat BP 184/113 P 113.  Drank more water repeat BP 189/130 developed tightness in chest and dizziness and RRT was called and she was transported to the ED.  In ED received Solumedrol, Benadryl, ASA 325mg and Pepcid.  EKG and cardiac enzymes were normal, BP decreased to 130/90 and she was discharged home at 9PM.  The next day 5/1/21 awoke and felt fine however at 1PM experienced heart pounding, head on fire BP 150/104, 170/113, 189/130 took Benadryl, Pepcid and ASA; husband called 911 where she was taken to ED. Felt nauseated and was given Reglan.  CT head was normal, CXR normal and was discharged to home. The next day 5/2/21 again was fine in the morning but again at about 1PM started experiencing the same symptoms and made herself some cucumber juice and went to see her PCP who scheduled her to see a cardiologist on 5/3/21. Cardiac w/u included EKG, Echo, Holter monitor and stress test. All were reported normal except has not received results of Holter monitor yet. The next day she developed 2 lesions on the side of her tongue which she self treated with glycerin and Vitamin C. Her BP has since normalized to 130/80-90 which is her baseline and she has not had any further symptoms.
Age: 51.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Echocardiogram, Electrocardiogram ambulatory, Electrocardiogram normal, Feeling abnormal, Hot flush
Clinical narrative: Received first Pfizer Covid Vaccine on 4/30/21.  She states within 15 minutes of receiving the vaccine she experienced a weird sensation of her tongue, her heart was pounding, she felt flushed like her ears and head were on fire.  She reported it to the nurse observing her.  The nurse advised to wait another 15 minutes.  She reports that BP was 170/110 P 110. Her BP continued to rise and developed tightness in chest and dizziness and RRT was called and she was transported to the ED.  In ED she received Solumedrol, Benadryl, ASA 325mg and Pepcid.  EKG and cardiac enzymes were normal, BP decreased to 130/90 and she was discharge at 9pm. Next day, she experienced the same adverse reactions and was taken to ED. Patient had COVID Infection in January 2021.  Received first Pfizer Covid Vaccine on 4/30/21.  PMHx of HTN receiving treatment. She states within 15 minutes of receiving the vaccine she experienced a weird sensation of her tongue, her heart was pounding, she felt flushed like her ears and head were on fire.  She reported it to the nurse observing her.  The nurse advised to wait another 15 minutes.  She reports that BP was 170/110 P 110. She drank some water and performed deep breathing repeat BP 184/113 P 113.  Drank more water repeat BP 189/130 developed tightness in chest and dizziness and RRT was called and she was transported to the ED.  In ED received Solumedrol, Benadryl, ASA 325mg and Pepcid.  EKG and cardiac enzymes were normal, BP decreased to 130/90 and she was discharged home at 9PM.  The next day 5/1/21 awoke and felt fine however at 1PM experienced heart pounding, head on fire BP 150/104, 170/113, 189/130 took Benadryl, Pepcid and ASA; husband called 911 where she was taken to ED. Felt nauseated and was given Reglan.  CT head was normal, CXR normal and was discharged to home. The next day 5/2/21 again was fine in the morning but again at about 1PM started experiencing the same symptoms and made herself some cucumber juice and went to see her PCP who scheduled her to see a cardiologist on 5/3/21. Cardiac w/u included EKG, Echo, Holter monitor and stress test. All were reported normal except has not received results of Holter monitor yet. The next day she developed 2 lesions on the side of her tongue which she self treated with glycerin and Vitamin C. Her BP has since normalized to 130/80-90 which is her baseline and she has not had any further symptoms.
Age: 51.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Hypertension, Myocardial necrosis marker normal, Nausea, Palpitations, Paraesthesia oral
Clinical narrative: Received first Pfizer Covid Vaccine on 4/30/21.  She states within 15 minutes of receiving the vaccine she experienced a weird sensation of her tongue, her heart was pounding, she felt flushed like her ears and head were on fire.  She reported it to the nurse observing her.  The nurse advised to wait another 15 minutes.  She reports that BP was 170/110 P 110. Her BP continued to rise and developed tightness in chest and dizziness and RRT was called and she was transported to the ED.  In ED she received Solumedrol, Benadryl, ASA 325mg and Pepcid.  EKG and cardiac enzymes were normal, BP decreased to 130/90 and she was discharge at 9pm. Next day, she experienced the same adverse reactions and was taken to ED. Patient had COVID Infection in January 2021.  Received first Pfizer Covid Vaccine on 4/30/21.  PMHx of HTN receiving treatment. She states within 15 minutes of receiving the vaccine she experienced a weird sensation of her tongue, her heart was pounding, she felt flushed like her ears and head were on fire.  She reported it to the nurse observing her.  The nurse advised to wait another 15 minutes.  She reports that BP was 170/110 P 110. She drank some water and performed deep breathing repeat BP 184/113 P 113.  Drank more water repeat BP 189/130 developed tightness in chest and dizziness and RRT was called and she was transported to the ED.  In ED received Solumedrol, Benadryl, ASA 325mg and Pepcid.  EKG and cardiac enzymes were normal, BP decreased to 130/90 and she was discharged home at 9PM.  The next day 5/1/21 awoke and felt fine however at 1PM experienced heart pounding, head on fire BP 150/104, 170/113, 189/130 took Benadryl, Pepcid and ASA; husband called 911 where she was taken to ED. Felt nauseated and was given Reglan.  CT head was normal, CXR normal and was discharged to home. The next day 5/2/21 again was fine in the morning but again at about 1PM started experiencing the same symptoms and made herself some cucumber juice and went to see her PCP who scheduled her to see a cardiologist on 5/3/21. Cardiac w/u included EKG, Echo, Holter monitor and stress test. All were reported normal except has not received results of Holter monitor yet. The next day she developed 2 lesions on the side of her tongue which she self treated with glycerin and Vitamin C. Her BP has since normalized to 130/80-90 which is her baseline and she has not had any further symptoms.
Age: 51.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Tongue ulceration
Clinical narrative: Received first Pfizer Covid Vaccine on 4/30/21.  She states within 15 minutes of receiving the vaccine she experienced a weird sensation of her tongue, her heart was pounding, she felt flushed like her ears and head were on fire.  She reported it to the nurse observing her.  The nurse advised to wait another 15 minutes.  She reports that BP was 170/110 P 110. Her BP continued to rise and developed tightness in chest and dizziness and RRT was called and she was transported to the ED.  In ED she received Solumedrol, Benadryl, ASA 325mg and Pepcid.  EKG and cardiac enzymes were normal, BP decreased to 130/90 and she was discharge at 9pm. Next day, she experienced the same adverse reactions and was taken to ED. Patient had COVID Infection in January 2021.  Received first Pfizer Covid Vaccine on 4/30/21.  PMHx of HTN receiving treatment. She states within 15 minutes of receiving the vaccine she experienced a weird sensation of her tongue, her heart was pounding, she felt flushed like her ears and head were on fire.  She reported it to the nurse observing her.  The nurse advised to wait another 15 minutes.  She reports that BP was 170/110 P 110. She drank some water and performed deep breathing repeat BP 184/113 P 113.  Drank more water repeat BP 189/130 developed tightness in chest and dizziness and RRT was called and she was transported to the ED.  In ED received Solumedrol, Benadryl, ASA 325mg and Pepcid.  EKG and cardiac enzymes were normal, BP decreased to 130/90 and she was discharged home at 9PM.  The next day 5/1/21 awoke and felt fine however at 1PM experienced heart pounding, head on fire BP 150/104, 170/113, 189/130 took Benadryl, Pepcid and ASA; husband called 911 where she was taken to ED. Felt nauseated and was given Reglan.  CT head was normal, CXR normal and was discharged to home. The next day 5/2/21 again was fine in the morning but again at about 1PM started experiencing the same symptoms and made herself some cucumber juice and went to see her PCP who scheduled her to see a cardiologist on 5/3/21. Cardiac w/u included EKG, Echo, Holter monitor and stress test. All were reported normal except has not received results of Holter monitor yet. The next day she developed 2 lesions on the side of her tongue which she self treated with glycerin and Vitamin C. Her BP has since normalized to 130/80-90 which is her baseline and she has not had any further symptoms.
Age: 47.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Acute kidney injury
Clinical narrative: N17.9 - AKI (acute kidney injury) N17.9 - Acute kidney injury
Age: 46.0
Sex: F
Vaccine: COVID19
Symptoms: Hypoaesthesia
Clinical narrative: Right side of body (mostly face) went numb about 20 minutes after shot.  After sleeping, 14 hours later still have minimal signs of numbness.
Age: 52.0
Sex: M
Vaccine: COVID19
Symptoms: Hypoaesthesia, Injection site pain
Clinical narrative: Sharp pain at injection site.  Arm completely numb the following day.
Age: 58.0
Sex: F
Vaccine: COVID19
Symptoms: Asymptomatic COVID-19, COVID-19, SARS-CoV-2 test positive
Clinical narrative: Asymptomatic - preoperative testing
Age: 47.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Acute kidney injury
Clinical narrative: N17.9 - Acute kidney failure, unspecified
Age: 20.0
Sex: M
Vaccine: COVID19
Symptoms: Dizziness, Feeling hot, Immediate post-injection reaction, Malaise, Vomiting
Clinical narrative: Pt reports feeling dizzy and "hot" immediately after injection. Monitoring RN applied ice pack to patient's neck when he reported feeling "like I am going to be sick".  Pt produced significant amount of clear vomit as Fire/EMT arrived. EMTs assumed care of patient, obtained vitals, and provided ongoing assessment. Pt. reported feeling better shortly after vomiting. Color returned & pt. reported "feeling much better" within a few minutes. Pt was reassessed and released from care of Fire/EMS @ 10:15AM. Pt. stayed in monitoring until 10:23 at which time he was free to go, reporting no future symptoms. Pt left POD self ambulating & stating that he left fine.
Age: 40.0
Sex: M
Vaccine: COVID19
Symptoms: Oral herpes
Clinical narrative: (2 cold sores) Herpes on lower lip
Age: 29.0
Sex: F
Vaccine: COVID19
Symptoms: Hyperhidrosis, Maternal exposure during breast feeding, Rash, Rash pruritic, Urticaria
Clinical narrative: Full body hives/rash, began morning of 5/11, progressed to more swelling itchy throughout day more developed following morning 5/12
Age: 16.0
Sex: M
Vaccine: COVID19
Symptoms: Herpes zoster, Varicella virus test
Clinical narrative: On 5/6/2021 Presented to urgent care.  Clinically Dx with Herpes Zoster. PCR testing for Varicella pending.
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Menstruation delayed
Clinical narrative: My last period was on April 10, 2021. I always have my cycle every 26 days. I was scheduled to have it on May 6/7 and I still haven't gotten it. 2 years ago after my second child, I had a tubal litigation. A few months ago my husband also had a vasectomy so there is no way I am pregnant. Also on November 1, 2020, I tested positive for COVID-19. During this time I was late a few days for my period. I am about 7 days late and I do not have any spotting or cramping.
Age: 53.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Acute kidney injury, Hyponatraemia, Hypoosmolar state, Seizure
Clinical narrative: Hypo-osmolality and hyponatremia Acute kidney failure, unspecified Unspecified convulsions Hyponatremia
Age: 49.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Chills, Fatigue, Headache, Injection site pain
Clinical narrative: Injection site pain. Severe chills, nausea, fatigue, muscle and joint pain, headache. Severe symptoms for 6 hours. Treated with rest, hydration, and acetaminophen. Prolonged fatigue and headache for 3 days.
Age: 49.0
Sex: F
Vaccine: COVID19
Symptoms: Myalgia, Nausea
Clinical narrative: Injection site pain. Severe chills, nausea, fatigue, muscle and joint pain, headache. Severe symptoms for 6 hours. Treated with rest, hydration, and acetaminophen. Prolonged fatigue and headache for 3 days.
Age: 17.0
Sex: M
Vaccine: COVID19
Symptoms: Abdominal pain upper, Appendicectomy, Appendicitis, Blood test, Ultrasound scan
Clinical narrative: Extreme stomach pain, appendicitis
Age: 31.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Blood alkaline phosphatase normal, Blood urea decreased, Chills, Fatigue, Haemoglobin normal
Clinical narrative: left underarm lymph nodes swollen, fever, sweats, chills, extreme headache, extreme body aches, excessive tiredness, vaginal bleeding out of cycle
Age: 31.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Headache, Hyperhidrosis, Influenza A virus test negative, Influenza virus test negative, Intermenstrual bleeding
Clinical narrative: left underarm lymph nodes swollen, fever, sweats, chills, extreme headache, extreme body aches, excessive tiredness, vaginal bleeding out of cycle
Age: 31.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Lymphadenopathy, Lymphocyte percentage decreased, Mean cell haemoglobin concentration normal, Monocyte percentage increased, Pain
Clinical narrative: left underarm lymph nodes swollen, fever, sweats, chills, extreme headache, extreme body aches, excessive tiredness, vaginal bleeding out of cycle
Age: 31.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Pyrexia, Red blood cell count normal, SARS-CoV-2 test negative
Clinical narrative: left underarm lymph nodes swollen, fever, sweats, chills, extreme headache, extreme body aches, excessive tiredness, vaginal bleeding out of cycle
Age: 45.0
Sex: M
Vaccine: COVID19
Symptoms: Fatigue, Pain
Clinical narrative: Fatigue; body aches.
Age: 42.0
Sex: M
Vaccine: COVID19
Symptoms: Interchange of vaccine products
Clinical narrative: Patient got 1st dose moderna and 2nd dose pfizer
Age: 35.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Pain, Pyrexia, Somnolence
Clinical narrative: Vaccine given at 9:30am, 05/08/2021 -- Symptoms began at 9:40pm, 05/08/2021 -- Symptoms subsided fully at 9:30pm, 05/09/2021: Just over 12 hours after getting the 2nd dose, within minutes, I had a 103.2 fever and chills. Body was so achy and sore and I could barely keep my eyes open or even move. It lasted about 6 hours until my high fever broke. The following 12 hours, I had a low grade fever and was alternating taking tylendol and motrin every 4 hours.  By 9:30pm the day after the vaccine, I was completely fine.
Age: 61.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Acute kidney injury
Clinical narrative: Acute kidney failure, unspecified.
Age: 30.0
Sex: F
Vaccine: COVID19
Symptoms: Herpes zoster, Pain, Pyrexia
Clinical narrative: Fever and aches for immediate 2 days after injection. Singles developed on forehead within 1-2 days after injection.
Age: 35.0
Sex: M
Vaccine: UNK
Symptoms: Peripheral swelling
Clinical narrative: After I got the shot like one of my arms got all big. Now I got like one giant arm and one tiny arm. What am I supposed to do be a professional arm-wrestler? I suppose I could fight crime under the cover of darkness.
Age: 15.0
Sex: M
Vaccine: COVID19
Symptoms: Inappropriate schedule of product administration, No reaction on previous exposure to drug, Product administered to patient of inappropriate age
Clinical narrative: Patient is only 15 and was given Pfizer in error due to age. Was given first doe on 4/14/21 and second dose was given today 5/12/21  ( due to approval coming through at this time from agency) Patient is not fully vaccinated, had no reactions to first dose.
Age: 32.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site urticaria, Urticaria
Clinical narrative: Hives that began at the injection site (upper left arm) and spread across chest, up neck and face, and onto eyelids. Present for 6 days so far and continuing. Began increased antihistamine treatment on evening of 5/11/21: AM - 5 mg levocetirizine dihydrochloride (Xyzal), PM - 50 mg Benadryl
Age: 43.0
Sex: M
Vaccine: COVID19
Symptoms: Dizziness, Syncope
Clinical narrative: FELT DIZZY AND FAINTED. CALLED 911. WAS ABLE TO RECOVER BEFORE 911 ARRIVED