chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 4.0
Sex: M
Vaccine: HEP, HEPA, HIBV, PNC, VARCEL
Symptoms: Cold compress therapy, Discomfort, Oedema peripheral
Clinical narrative: Patient parent reports swelling in R arm starting the morning after vaccination. Patient parent was instructed in the use of cool compress, advil or tylenol to reduce discomfort.
Age: 15.0
Sex: F
Vaccine: HPV4
Symptoms: Pyrexia, Vomiting
Clinical narrative: COMPLAINTS OF FEVER OF 102.0 FOR 2 DAYS AND VOMITING
Age: 13.0
Sex: M
Vaccine: HEP, HEPA, IPV, MMR, MNQ, TDAP, VARCEL
Symptoms: Blister, Pyrexia, Skin lesion
Clinical narrative: Mother and pt in clinic. C/O "fever last night". C/O blister-like lesion on R arm. Currently Afebrile today (6/7/07). Observed 2 lesions on R arm, currently not blistered. Lesions are not on injection sight. Lesions are where the sticky part of the bandaid would have been. Instructed to keep clean and if worsens go to PMD for follow-up.
Age: 18.0
Sex: F
Vaccine: TDAP, VARCEL
Symptoms: Body temperature decreased, Injection site erythema, Injection site pruritus
Clinical narrative: administered on 6-4-07 Client to clinic on 6-7-07 with site of vaccine with red area about the size of a 50c piece. First noticed reaction on 6-5-07. It was itching and red. itches now alone. Clients Temperature 97.6 deg
Age: 0.33
Sex: M
Vaccine: DTAPHEPBIP, HIBV, PNC, RV5
Symptoms: Crying, Pyrexia, Vomiting
Clinical narrative: fever up to 103.7 for 8 hours unconsolable crying for 8 hours vomiting x 20
Age: 0.17
Sex: M
Vaccine: DTAPHEPBIP, HIBV, PNC, RV5
Symptoms: Erythema
Clinical narrative: PT had reaction 30min after injections administered. redness on lower abdomen and forehead. No respiratory distress
Age: 5.0
Sex: M
Vaccine: DTAP, HEPA, IPV, MMRV
Symptoms: Injection site erythema, Injection site swelling
Clinical narrative: 9 cm x 6 cm reddened and swollen area (R) deltoid arm
Age: 9.0
Sex: F
Vaccine: HPV4, VARCEL
Symptoms: Blister, Erythema, Injection site erythema, Injection site induration, Injection site warmth
Clinical narrative: Both HPV (IM) and Varicella (SC) given in (L) upper arm on 5/15/07. Developed slight redness and tenderness and a little blister the day after the vaccine. On 5/17/07 (2 days after vax) developed warm, erythematous, indurated area around injection site-given Rx of Benadryl and Ibuprofen and Calendula cream.
Age: 9.0
Sex: F
Vaccine: HPV4, VARCEL
Symptoms: Tenderness
Clinical narrative: Both HPV (IM) and Varicella (SC) given in (L) upper arm on 5/15/07. Developed slight redness and tenderness and a little blister the day after the vaccine. On 5/17/07 (2 days after vax) developed warm, erythematous, indurated area around injection site-given Rx of Benadryl and Ibuprofen and Calendula cream.
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMRV
Symptoms: Injection site erythema
Clinical narrative: Erythema to area of injection
Age: 1.75
Sex: F
Vaccine: FLU3, HEPA
Symptoms: Gait disturbance, Hypokinesia, Pain
Clinical narrative: Per mom child seemed in pain, gradually guarded her walking, avoided walking at times. Child refuses to bear weight or both legs. Able to crawl and move lower extremities normally. No fever, redness and swelling from IZ sites. Per mom stated better now than 3 days ago.
Age: 14.0
Sex: F
Vaccine: MNQ
Symptoms: Grand mal convulsion
Clinical narrative: upper extremity 10 minute Tonic Clonic seizure suffered in parking lot after appt. transported by paramedics to hospital.
Age: 41.0
Sex: F
Vaccine: TDAP
Symptoms: Injection site cellulitis, Injection site erythema, Injection site swelling
Clinical narrative: cellulitis at/around injection site with swelling and erythema txd with Keflex 500 BID x 14 days
Age: 30.0
Sex: F
Vaccine: TDAP
Symptoms: Headache, Injection site erythema, Injection site warmth
Clinical narrative: Immunization received Thurs. 5/31/07. Next day arm was red and hot from injection site to elbow. Continued for 2 more days. Patient had bad H/A also day after. Mon. 6/14/07 arm was still red with a bump, but not as bad. (No treatment given)
Age: 0.17
Sex: F
Vaccine: DTAPHEPBIP, HIBV, PNC, RV5
Symptoms: Crying
Clinical narrative: Mom describes uncontrolled crying, child was inconsolable for 7 days afterward. She had no fever or injection site reaction.
Age: 21.0
Sex: F
Vaccine: TYP
Symptoms: Medication error
Clinical narrative: Patient took two doses then put the rest in the freezer, restarted course after interruption
Age: 0.5
Sex: U
Vaccine: DTAPHEPBIP, HIBV, PNC
Symptoms: Asthenia, Listless, Pyrexia, Vomiting
Clinical narrative: mom states about 1-2 hrs. after child received imms. fever of 103-104 deg started lasting 4 days. Child also had vomiting and weakness and limp.
Age: 0.16
Sex: M
Vaccine: DTAP, HEP, HIBV, PNC
Symptoms: Irritability
Clinical narrative: Patient received vaccines at approximately 10 AM. Became extremely fussy about 30 minutes later. Parents administered Tylenol .8cc at 11 AM; patient still inconsolable. No other symptoms noted. Patient returned to office at approximately 2 PM, examined by Dr.; Motrin 50 mg and Benadryl 1 1/2 tsp administered. Upon return, patient was resting in mom's arms, not crying but a little fussy.
Age: 6.0
Sex: M
Vaccine: DTAP, IPV, MMRV
Symptoms: Injection site erythema, Injection site swelling
Clinical narrative: Right arm is swollen red. It started about 1 hour after vaccinating him. Parents reported to us on 2nd day afterwards.
Age: 12.0
Sex: M
Vaccine: MNQ, VARCEL
Symptoms: Injection site erythema, Injection site warmth
Clinical narrative: 8x4 area of warmth, redness in left arm
Sex: F
Vaccine: HPV4, HPV4, HPV4, HPV4
Symptoms: Blood glucose decreased, Guillain-Barre syndrome, Laboratory test, Muscular weakness, Red blood cell count normal
Clinical narrative: Information has been received from a physician concerning a female who on 02-MAY-2007 was vaccinated with Gardasil. On 09-MAY-2007, the patient was admitted to the hospital with Guillain-Barre syndrome. At the time of the report, the patient remained in the hospital. She was being treated by a neurologist. No other information was available. Upon internal review it was determined that Guillain-Barre syndrome was an other important medical event. Additional information has been requested.
Sex: F
Vaccine: HPV4, HPV4, HPV4, HPV4
Symptoms: Red blood cells CSF positive
Clinical narrative: Information has been received from a physician concerning a female who on 02-MAY-2007 was vaccinated with Gardasil. On 09-MAY-2007, the patient was admitted to the hospital with Guillain-Barre syndrome. At the time of the report, the patient remained in the hospital. She was being treated by a neurologist. No other information was available. Upon internal review it was determined that Guillain-Barre syndrome was an other important medical event. Additional information has been requested.
Sex: F
Vaccine: HPV4, HPV4, HPV4, HPV4
Symptoms: Muscular weakness
Clinical narrative: Information has been received from a physician concerning a female who on 02-MAY-2007 was vaccinated with Gardasil. On 09-MAY-2007, the patient was admitted to the hospital with Guillain-Barre syndrome. At the time of the report, the patient remained in the hospital. She was being treated by a neurologist. No other information was available. Upon internal review it was determined that Guillain-Barre syndrome was an other important medical event. Additional information has been requested.
Sex: F
Vaccine: HPV4, HPV4, HPV4, HPV4
Symptoms: Asthenia, Autoimmune disorder, Feeling abnormal, Gait disturbance, Guillain-Barre syndrome
Clinical narrative: Information has been received from a physician concerning a female who on 02-MAY-2007 was vaccinated with Gardasil. On 09-MAY-2007, the patient was admitted to the hospital with Guillain-Barre syndrome. At the time of the report, the patient remained in the hospital. She was being treated by a neurologist. No other information was available. Upon internal review it was determined that Guillain-Barre syndrome was an other important medical event. Additional information has been requested.
Sex: F
Vaccine: HPV4, HPV4, HPV4, HPV4
Symptoms: Monoplegia, Muscular weakness, Walking aid user
Clinical narrative: Information has been received from a physician concerning a female who on 02-MAY-2007 was vaccinated with Gardasil. On 09-MAY-2007, the patient was admitted to the hospital with Guillain-Barre syndrome. At the time of the report, the patient remained in the hospital. She was being treated by a neurologist. No other information was available. Upon internal review it was determined that Guillain-Barre syndrome was an other important medical event. Additional information has been requested.
Sex: F
Vaccine: HPV4, HPV4, HPV4, HPV4
Symptoms: Guillain-Barre syndrome
Clinical narrative: Information has been received from a physician concerning a female who on 02-MAY-2007 was vaccinated with Gardasil. On 09-MAY-2007, the patient was admitted to the hospital with Guillain-Barre syndrome. At the time of the report, the patient remained in the hospital. She was being treated by a neurologist. No other information was available. Upon internal review it was determined that Guillain-Barre syndrome was an other important medical event. Additional information has been requested.
Age: 17.0
Sex: F
Vaccine: HPV4, HPV4
Symptoms: Cardiomyopathy, Intensive care, Intubation, Pneumonia
Clinical narrative: (1) ARDS (2) DIC (3) cardiomyopathy (4) Pneumonia Requiring ICU management
Age: 17.0
Sex: F
Vaccine: HPV4, HPV4
Symptoms: Activated partial thromboplastin time, Acute respiratory distress syndrome, Cardiomyopathy, Coronary artery bypass, Disseminated intravascular coagulation
Clinical narrative: (1) ARDS (2) DIC (3) cardiomyopathy (4) Pneumonia Requiring ICU management
Age: 17.0
Sex: F
Vaccine: HPV4, HPV4
Symptoms: Echocardiogram, Intensive care, International normalised ratio, Laboratory test, Pneumonia
Clinical narrative: (1) ARDS (2) DIC (3) cardiomyopathy (4) Pneumonia Requiring ICU management
Age: 17.0
Sex: F
Vaccine: HPV4, HPV4
Symptoms: Prothrombin level, X-ray
Clinical narrative: (1) ARDS (2) DIC (3) cardiomyopathy (4) Pneumonia Requiring ICU management
Age: 16.0
Sex: F
Vaccine: HPV4, HPV4
Symptoms: Arthralgia, Malaise
Clinical narrative: Joint pain sore shoulder next day increased pain 2nd day 3rd day knees, ankles wrist shoulder
Age: 16.0
Sex: F
Vaccine: HPV4, HPV4
Symptoms: Arthralgia, Musculoskeletal pain
Clinical narrative: Joint pain sore shoulder next day increased pain 2nd day 3rd day knees, ankles wrist shoulder
Sex: F
Vaccine: HPV4
Symptoms: Arthralgia, Dysphonia, Haemoglobin normal, Halo vision, Pain
Clinical narrative: Joint Aches, body aches, "Halo around lights"-day of vaccine. Following Am-joints aches, sore throat and hoarse voice.
Sex: F
Vaccine: HPV4
Symptoms: Pharyngolaryngeal pain, Streptococcal identification test
Clinical narrative: Joint Aches, body aches, "Halo around lights"-day of vaccine. Following Am-joints aches, sore throat and hoarse voice.
Age: 5.0
Sex: M
Vaccine: DTAP
Symptoms: Injection site erythema, Injection site swelling
Clinical narrative: Significant erythema and swelling around injection-approx 10 cm in diameter
Age: 2.0
Sex: M
Vaccine: VARCEL
Symptoms: Herpes zoster
Clinical narrative: Zoster outbreak, C5, 6 Left shoulder to tips of thumb, index finger
Age: 15.0
Sex: F
Vaccine: HPV4
Symptoms: Pruritus, Rash
Clinical narrative: Information has been received from a physician concerning a 15 year old female with no pertinent medical history or drug reactions/allergies, who on 21-MAY-2007 was vaccinated intramuscularly with the first dose of Gardasil. There was no concomitant medication. On 21-MAY-2007 the patient developed a rash that started on the belly and spread to the back and both legs. The physician noted that it was unknown whether the rash was already there before the patient received the vaccination, however the patient noticed the rash and mild itching the day that the vaccination was given. The patient was given cetirizine hydrochloride (ZYRTEC). At the time of this report, the patient's rash and itching persisted. The reporting physician felt that the events were serious for another other medical event due to treatment with cetirizine hydrochloride (ZYRTEC). Additional information has been requested.
Age: 14.0
Sex: F
Vaccine: HPV4
Symptoms: Back pain, Myelitis transverse, Pain in extremity
Clinical narrative: Information has been received from a physician, via a company representative, concerning a 14 year old female patient, who on 11-JAN-2007 was vaccinated with the first dose, 0.5ml, of Gardasil, with no adverse events reported, and on 08-MAR-2007 was vaccinated with the second dose, 0.5ml, of Gardasil. There was no concomitant medication. On 08-APR-2007, the patient had experienced "extreme leg and back pain" and was diagnosed with acute transverse myelitis; she was hospitalized. The duration of hospitalization was not known. At the time of this report, the patient had not recovered from the acute transverse myelitis. Additional information has been requested.  6/19/07 Received PCP medical records which included vax records w/lot & dose #s.  VAERS database updated w/same. ALso included was hospital d/c summary which reveals patient admitted 4/17-4/20/07 with severe LE pain which had progressively worsened.  Seen by PCP who sent to neurologist prior to admit .   Admitted for high dose steroids & close observation.  Improved dramatically & d/c to home w/PCP & neuro f/u.  Seen by neuro in f/u on 4/23/07 being transported by ambulance on a gurney due to total paralysis of both LEs.  Also had severe depression.  5/18/07 w/only partial recovery.  Continued to have severe low back & LE pain despite fentanyl patch & PT. Was unable to ambulate & was w/c bound.  Exam revealed severe flaccid hypotonic muscle weakness of LEs w/hyperreflexia.  Bladder & bowel function were intact. Patch increased & was to continue PT.  7/3/07 Received hospital medical records which reveal patient experienced severe LE pain which had progressively worsened.  Admitted 4/17-4/20/07 for IV steroids & pain management.  Patient had URI w/sore throat & fever approx 3-4 wks prior to admit treated w/antibiotics.  Then developed back pain which worsened & LEs also became numb.  Seen by PCP who consulted neurosurgeon & MRI was done which was neg.  Patient continued to worsen & was seen by neurologist who dx w/transverse myelitis & admitted to hospital. FINAL DX: Transverse Myelitis.
Age: 1.5
Sex: M
Vaccine: HIBV, DTAP, HIBV
Symptoms: Body temperature increased, Chills, Pyrexia, Tremor
Clinical narrative: Information has been received from a licensed practical nurse concerning an 18 month old male with no pertinent medical history who on 29-MAY-2007 was vaccinated IM with a 0.5 ml PedvaxHib (lot # 654678/1125F). There was no concomitant medication. Several hours after receiving PedvaxHib the patient experienced a fever of 104 F with shaking chills. The patient became afebrile after alternating treatment with acetaminophen (TYLENOL) and ibuprofen (MOTRIN). On 30-MAY-2007 the fever returned and an evaluation was set up with the physician. After the patient was sent home his fever spiked. The patient was then admitted to the hospital. Overnight, the fever dissipated, and he was released from the hospital the morning of 31-MAY-2007. Additional information has been requested.
Age: 1.5
Sex: M
Vaccine: HIBV, DTAP, HIBV
Symptoms: Body temperature increased, Crying, Culture throat, Dacryostenosis acquired, Full blood count
Clinical narrative: Information has been received from a licensed practical nurse concerning an 18 month old male with no pertinent medical history who on 29-MAY-2007 was vaccinated IM with a 0.5 ml PedvaxHib (lot # 654678/1125F). There was no concomitant medication. Several hours after receiving PedvaxHib the patient experienced a fever of 104 F with shaking chills. The patient became afebrile after alternating treatment with acetaminophen (TYLENOL) and ibuprofen (MOTRIN). On 30-MAY-2007 the fever returned and an evaluation was set up with the physician. After the patient was sent home his fever spiked. The patient was then admitted to the hospital. Overnight, the fever dissipated, and he was released from the hospital the morning of 31-MAY-2007. Additional information has been requested.
Age: 1.5
Sex: M
Vaccine: HIBV, DTAP, HIBV
Symptoms: Tremor
Clinical narrative: Information has been received from a licensed practical nurse concerning an 18 month old male with no pertinent medical history who on 29-MAY-2007 was vaccinated IM with a 0.5 ml PedvaxHib (lot # 654678/1125F). There was no concomitant medication. Several hours after receiving PedvaxHib the patient experienced a fever of 104 F with shaking chills. The patient became afebrile after alternating treatment with acetaminophen (TYLENOL) and ibuprofen (MOTRIN). On 30-MAY-2007 the fever returned and an evaluation was set up with the physician. After the patient was sent home his fever spiked. The patient was then admitted to the hospital. Overnight, the fever dissipated, and he was released from the hospital the morning of 31-MAY-2007. Additional information has been requested.
Age: 65.0
Sex: F
Vaccine: PPV
Symptoms: Injection site cellulitis, Injection site erythema, Injection site swelling, Injection site warmth, Pain in extremity
Clinical narrative: Information has been received from a healthcare worker concerning a 65 year old female patient with allergies to cats and dogs and a lung nodule who on 17-APR-2007 at 10:30 was vaccinated into the left deltoid with a first dose of Pneumovax 23 (Lot # 655588/0883F). On 18-APR-2007, the patient developed cellulitis from injection site to elbow and the left shoulder to the elbow was red, hot and swollen. There was no fever but there was pain in the arm. On 19-APR-2007, the patient stopped in the physician's office and was given moxifloxacin hydrochloride (AVELOX) 400 mg once a day for 10 days. On 25-APR-2007, the patient recovered. Cellulitis from injection site to elbow, left shoulder red, hot and swollen and pain in arm were considered to be other important medical events. This is one of two reports received from the same source. Additional information is not expected.
Age: 70.0
Sex: F
Vaccine: PPV
Symptoms: Cellulitis, Oedema peripheral, Pain in extremity, Skin warm, Tenderness
Clinical narrative: Information has been received from a Registered Nurse (R.N.) concerning a female patient in her 70's with hypertension, penicillin allergy and problem with nerves (undefined) who on 31-MAY-2007 was vaccinated with a second dose of Pneumovax 23, lot 655499/0988F. The patient got the first Pneumovax 23 7-10 years ago. On 31-MAY-2007 the nurse reported that the patient developed cellulitis from her shoulder to elbow after getting the second Pneumovax 23 vaccine. The vaccination arm began to ache after the vaccination and by the next day was swollen, hot and tender. The treatment was diphenhydramine hydrochloride (BENADRYL), levofloxacin (LEVAQUIN) and betamethasone valerate (VALISONE CREAM). The patient was not recovered as of this report date. The reporter felt that the treatment with diphenhydramine hydrochloride (BENADRYL), levofloxacin (LEVAQUIN) and betamethasone valerate (VALISONE CREAM) was to prevent patient from being serious and considered this as a serious other medical event. Additional information has been requested.
Age: 3.0
Sex: M
Vaccine: MMRV
Symptoms: Cellulitis
Clinical narrative: Information has been received from a physician concerning a 36-month-old male with no pertinent medical history and no known allergies who on 17-May-2007 was vaccinated subcutaneously in the left arm with a first dose of ProQuad (lot# 656941/0227U). There was no concomitant medication. On 17-MAY-2007 "the patient experienced cellulitis in left arm from shoulder to elbow receiving ProQuad". The patient was seen in the doctors office on 18-May-2007 for unspecified medical attention. No laboratory/diagnostic tests were performed. At the time of this report the patient was recovering. No product quality complaint was involved. The reporter considered cellulitis to be an other important medical event. Additional information has been requested.
Age: 0.5
Sex: M
Vaccine: DTAP, PNC, RV5
Symptoms: Abdominal X-ray, Barium double contrast, Intussusception, Vomiting
Clinical narrative: Information has been received from a physician concerning a 6 month old male who on 14-MAY-2007 was vaccinated with the third 2 ml oral dose of Rotateq (Lot # 656385/0030U). Concomitant therapy included DTaP (+) Prevnar. On 26-MAY-2007, the patient experienced intussusception. An abdominal x-ray was performed in the emergency room. Intussusception was located in the right upper quadrant and was reduced via of air enema with no difficulty. On 26-MAY-2007, the patient recovered from intussusception. Intussusception was an other important medical event. In follow-up, the physician reported that the patient was "doing fine." The patient started vomiting and went to the emergency room and was diagnosed with intussuception which was reduced successfully via air enema. The physician did not know if the intussusception was related to therapy with Rotateq. The records of testing prior to release of the lot in question has been rechecked and found to be satisfactory. The lot met the requirements and was released. Additional information has been requested.  6/19/07 Received vax record from PCP which confirms RO lot number but was 2nd dose, not 3rd.  VAERS database updated w/same. 6/19/07 Received hospital records via fax from CDC which reveal patient admitted 5/26 & d/c on same day for persistent vomiting & dehydration. FINAL DX: Intussusception, reduced by air enema.
Sex: M
Vaccine: VARZOS
Symptoms: Condition aggravated, Lymphoma
Clinical narrative: Information has been received from a physician concerning a male patient with a history of lymphoma who was vaccinated with a dose of Zostavax. It was reported that "shortly after vaccination", the patient had his lymphoma flare up. Unspecified medical attention was sought. At the time of report, the patient was not recovered. A product quality complaint was not involved. Upon internal review lymphoma flared up was considered to be an other important medical event. Additional information has been requested.
Age: 1.3
Sex: F
Vaccine: HIBV, MMR, PNC, VARCEL
Symptoms: Abnormal behaviour, Convulsion, Death, Dyskinesia, Irritability
Clinical narrative: Information regarding Prevnar vaccine was received from a consumer, the mother of a 16-month-old female patient who on 21-Dec-2006, received a dose of Prevnar along with a dose of Hib (manufacturer unknown), a dose of Varivax (manufacturer unknown), and a dose of M-M-R II (Merck Sharp & Dome). On the same day, the patient experienced lethargy, possible seizure, irritability, was not acting normally, had jerky movements and clenched hands. On 22-Dec-2006, the child would not respond and on 24-Dec-2006, the child died. On 21-Dec-2006, the patient with a history of influenza like illness, pyrexia, virus (unspecified) and tremor of hands, was evaluated at the physician's office for those symptoms and was also administered Prevnar along with Hib, Varivax, and M-M-R II. Later that day, the child was lethargic and experienced a possible seizure, irritability, was not acting normally, had jerky movements and clenched hands. On 22-Dec-2006, child would not respond and was taken to the hospital and placed on life-support for two days. On 24-Dec-2006, the child died. The cause of death was not reported. The reporter stated she "feels that her daughter had an adverse reaction to Prevnar." No additional information was available at the time of this report.
Age: 1.3
Sex: F
Vaccine: HIBV, MMR, PNC, VARCEL
Symptoms: Lethargy, Muscle tightness
Clinical narrative: Information regarding Prevnar vaccine was received from a consumer, the mother of a 16-month-old female patient who on 21-Dec-2006, received a dose of Prevnar along with a dose of Hib (manufacturer unknown), a dose of Varivax (manufacturer unknown), and a dose of M-M-R II (Merck Sharp & Dome). On the same day, the patient experienced lethargy, possible seizure, irritability, was not acting normally, had jerky movements and clenched hands. On 22-Dec-2006, the child would not respond and on 24-Dec-2006, the child died. On 21-Dec-2006, the patient with a history of influenza like illness, pyrexia, virus (unspecified) and tremor of hands, was evaluated at the physician's office for those symptoms and was also administered Prevnar along with Hib, Varivax, and M-M-R II. Later that day, the child was lethargic and experienced a possible seizure, irritability, was not acting normally, had jerky movements and clenched hands. On 22-Dec-2006, child would not respond and was taken to the hospital and placed on life-support for two days. On 24-Dec-2006, the child died. The cause of death was not reported. The reporter stated she "feels that her daughter had an adverse reaction to Prevnar." No additional information was available at the time of this report.
Age: 4.0
Sex: M
Vaccine: DTAP, HEPA, IPV, MMRV
Symptoms: Injection site erythema, Injection site inflammation, Injection site pain, Injection site warmth
Clinical narrative: Erythema, heat, inflam and tenderness at injection site 10 x 13 cm.
Age: 21.0
Sex: F
Vaccine: HPV4, HPV4
Symptoms: Eye pain, Headache, Nausea, Vomiting
Clinical narrative: Pt received Gardasil vaccine at 9AM. Called at 4PM complaining of nausea, vomiting, and left side headache with left orbital pain
Age: 81.0
Sex: F
Vaccine: FLU3
Symptoms: Injection site pain
Clinical narrative: Patient complains of soreness at injection site. Patient says soreness has lasted 6 months. Patient has seen her physician and has tried anti inflammatory medication.
Age: 1.0
Sex: M
Vaccine: MMRV, PNC
Symptoms: Rash
Clinical narrative: Rash x 3 days
Age: 50.0
Sex: M
Vaccine: TDAP
Symptoms: Erythema, Induration
Clinical narrative: Induration and erythema size 5 x 5 cm
Age: 51.0
Sex: F
Vaccine: TDAP
Symptoms: Arthralgia, Body temperature increased, Dizziness, Fatigue, Feeling hot and cold
Clinical narrative: A few hours after receiving vaccine became dizzy and felt hot/cold/sweaty with temp 100.6. Positive myalgias, arthralgias, dental pain, fatigue; sx's lasted 4 days.
Age: 51.0
Sex: F
Vaccine: TDAP
Symptoms: Hyperhidrosis, Myalgia, Toothache
Clinical narrative: A few hours after receiving vaccine became dizzy and felt hot/cold/sweaty with temp 100.6. Positive myalgias, arthralgias, dental pain, fatigue; sx's lasted 4 days.
Age: 4.0
Sex: M
Vaccine: DTAP, IPV, MMRV
Symptoms: Cold compress therapy, Injection site erythema, Injection site induration, Injection site pruritus, Injection site swelling
Clinical narrative: Vaccines received by child 5/8/07. Onset swelling right upper arm yesterday, no fever and 5/13/07 arm also itches and "feels hard". 6/1/07 seen in clinic by MD with findings as large, warm, red, indurated and clearly demarcated area of swelling approximately 6" x 3" over lateral upper arm. MD instruction to parents: Ice pack to the area at 10 min. at a time 3-4 x/day Ibuprofen 200 mg=2 tsp every 6-8 hrs for pain. Benadryl 2 tsp. every 6 hrs. as needed for the itching.
Age: 4.0
Sex: M
Vaccine: DTAP, IPV, MMRV
Symptoms: Injection site warmth
Clinical narrative: Vaccines received by child 5/8/07. Onset swelling right upper arm yesterday, no fever and 5/13/07 arm also itches and "feels hard". 6/1/07 seen in clinic by MD with findings as large, warm, red, indurated and clearly demarcated area of swelling approximately 6" x 3" over lateral upper arm. MD instruction to parents: Ice pack to the area at 10 min. at a time 3-4 x/day Ibuprofen 200 mg=2 tsp every 6-8 hrs for pain. Benadryl 2 tsp. every 6 hrs. as needed for the itching.
Age: 4.0
Sex: F
Vaccine: DTAP, IPV, MMRV
Symptoms: Erythema, Injection site erythema, Injection site oedema, Oedema
Clinical narrative: Erythema, Edema, to (L) leg-proximetry marked to monitor reaction.
Age: 5.0
Sex: M
Vaccine: DTAP, IPV, MMRV
Symptoms: Injection site erythema, Injection site pruritus, Injection site swelling
Clinical narrative: Patient received DTaP and IPV in left arm on 5-23-07 at our office. This morning (5-24-07) patient woke with itchiness, redness and swelling of the left upper arm. No fever, no discharge, no resp distress, not otherwise ill. Area of redness and swelling was 20.5cm; redness blanches.
Age: 73.0
Sex: M
Vaccine: HEP, PNC, VARZOS
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
Clinical narrative: (L) upper outer aspect of tricep is red, swollen, hot, tender to touch
Age: 72.0
Sex: F
Vaccine: HEP, PNC, VARZOS
Symptoms: Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling, Injection site warmth
Clinical narrative: (L) outer aspect of upper arm, above elbow red, swollen, hot, itchy-24 h after shot (R) inside aspect of upper arm-red, swollen, hot, slightly sore. 48hr after shot
Age: 12.0
Sex: F
Vaccine: HPV4, VARCEL
Symptoms: Injection site cellulitis, Injection site induration, Injection site pain, Pain
Clinical narrative: seen 5/31/07 4cm x 5 cm area with induration-severe tenderness (L) deltoid area. Diagnosed with Cellulitis secondary to Gardasil injection. Treated with antibiotic-Augmentin 400 mg chews Ztabs po BID x 10 days. Motrin 2 tabs Q6hrs, as needed for pain.
Age: 6.0
Sex: M
Vaccine: DTAP, HEPA, IPV, MMRV
Symptoms: Cold compress therapy, Injection site erythema, Injection site swelling, Injection site warmth, Pyrexia
Clinical narrative: 5/1/07-Vomiting in evening; fever 103.2 5/2/07-6:00 a.m. Swelling (R) deltoid area 5-6 inches accompanied by redness (beet red) and warm to the touch. Fever controlled with Motrin and cool compress on deltoid area.
Age: 6.0
Sex: M
Vaccine: DTAP, HEPA, IPV, MMRV
Symptoms: Vomiting
Clinical narrative: 5/1/07-Vomiting in evening; fever 103.2 5/2/07-6:00 a.m. Swelling (R) deltoid area 5-6 inches accompanied by redness (beet red) and warm to the touch. Fever controlled with Motrin and cool compress on deltoid area.
Age: 3.0
Sex: M
Vaccine: SMALL
Symptoms: Erythema, Lymph node pain, Pruritus, Pyrexia, Rash papular
Clinical narrative: Smallpox vaccine was administered to patient's mother on April 28, 2007. Mother reports good take with blistering lesions. She kept inoculation site covered as instructed. She developed one satellite lesion about 3 cm from inoculation site. Child developed skin lesion on R forearm approximately 5/27 which developed into multiple pustules; 4-6 days later developed multiple lesions on face, arms and legs. Later lesions were papular, some appeared to be deep pustular lesions but never blistered. The patient had intermittent low grade fever from June 3rd through June 5th. Many of the lesions healed with crusting. On June 4th the primary lesions were becoming scabbed over. On June 6th, the patient was noted to have two posterior auricular lymph nodes on L (same side as facial lesions) which were mildly tender, the skin over one was erythematous. Patient sleeps in bed with mother. Patient has been observed as outpatient; only treatment so far has been Benadryl for itching and calamine lotion.
Age: 3.0
Sex: M
Vaccine: SMALL
Symptoms: Rash pustular, Secondary transmission, Skin lesion
Clinical narrative: Smallpox vaccine was administered to patient's mother on April 28, 2007. Mother reports good take with blistering lesions. She kept inoculation site covered as instructed. She developed one satellite lesion about 3 cm from inoculation site. Child developed skin lesion on R forearm approximately 5/27 which developed into multiple pustules; 4-6 days later developed multiple lesions on face, arms and legs. Later lesions were papular, some appeared to be deep pustular lesions but never blistered. The patient had intermittent low grade fever from June 3rd through June 5th. Many of the lesions healed with crusting. On June 4th the primary lesions were becoming scabbed over. On June 6th, the patient was noted to have two posterior auricular lymph nodes on L (same side as facial lesions) which were mildly tender, the skin over one was erythematous. Patient sleeps in bed with mother. Patient has been observed as outpatient; only treatment so far has been Benadryl for itching and calamine lotion.
Age: 26.0
Sex: F
Vaccine: HPV4
Symptoms: Drug exposure during pregnancy
Clinical narrative: Patient has not experienced any adverse events.  Patient received a positive pregnancy test 25 days after receiving her second dose of Gardisil (HPV).
Age: 5.0
Sex: F
Vaccine: DTAP, HEPA, IPV, MMR
Symptoms: Erythema, Injected limb mobility decreased, Oedema peripheral, Pyrexia, Skin warm
Clinical narrative: 5 y/o received Dtap in the right arm and arm is now is swollen, red and warm to the touch. Pt has also been running a fever. The day after receiving the vaccine pt was unable to move his right arm.
Age: 0.5
Sex: F
Vaccine: DTAP, HBHEPB, PNC, RV5, RV5
Symptoms: Abdominal X-ray, Computerised tomogram, Vomiting
Clinical narrative: Intermittent episodes (5) of vomiting lasting 10 to 15 miniutes.  Episodes began 2 days prior. Todays episode lasted 30 minutes. History of reflux. On Zantac.  Admitted 6/7/07 to Hospital through the ED. Testing includes Abdominal x-ray, US of abdomen ans CT of abdomen.  On IV fluids to rest bowel at this point.  07/30/2007 Hospital records received for DOS 6/8-12/2007 for a Malrotation Correction.  Child initially presented to PCP with persistant emesis and decreased intake.  Sent to ER for eval and treatment.  PE revealed mild dehydration, protruding tongue,2/6 systolic murmur. GI consult  Infant taken to surgery for an exploratory lap, right colectomy, and LADD procedure. D/C Dx: Malrotation.
Age: 0.5
Sex: F
Vaccine: DTAP, HBHEPB, PNC, RV5, RV5
Symptoms: Computerised tomogram, Inappropriate schedule of drug administration, Intestinal operation, Laboratory test, Volvulus
Clinical narrative: Intermittent episodes (5) of vomiting lasting 10 to 15 miniutes.  Episodes began 2 days prior. Todays episode lasted 30 minutes. History of reflux. On Zantac.  Admitted 6/7/07 to Hospital through the ED. Testing includes Abdominal x-ray, US of abdomen ans CT of abdomen.  On IV fluids to rest bowel at this point.  07/30/2007 Hospital records received for DOS 6/8-12/2007 for a Malrotation Correction.  Child initially presented to PCP with persistant emesis and decreased intake.  Sent to ER for eval and treatment.  PE revealed mild dehydration, protruding tongue,2/6 systolic murmur. GI consult  Infant taken to surgery for an exploratory lap, right colectomy, and LADD procedure. D/C Dx: Malrotation.
Age: 13.0
Sex: F
Vaccine: HPV4, MNQ
Symptoms: Borrelia burgdorferi serology, Facial palsy, Thyroid function test normal
Clinical narrative: 2 months following vaccine administration patient developed Bell's Palsy. Treated with Valtrex and prednisone.  7/26/07 Received call from pcp w/additional patient information.  States Lyme test initially reported as neg has now been determined to be positive.  Feels Bells palsy secondary to Lymes disease & not related to vaccine.  8/31/07 Reviewed pcp medical records which included vax records & corrected vax info.  VAERS database updated w/same.  Office note of 4/4/07 reveals patient healthy on day of vax, only concern was acne.  Returned on 6/7/07 w/left side facial weakness x 4 days.  Unable to lift left eyebrow or close left eye.  Unable to smile on left side. Tx w/antiviral & prednisone, eye drops & eye patch at night.  Returned 6/26/07.  Lyme titers had returned (+).  Facial numbness & weakness had improved.  Smile remained slightly asymmetrical but able to lift eyebrow & squeeze eyes shut.  Tx w/antibiotics & received 2nd dose Gardisil.  Returned 7/24/07.  Had completed meds & symptoms had improved & smile now symmetrical. FINAL DX: Bell's Palsy secondary to Lyme's disease.
Age: 1.75
Sex: F
Vaccine: HEP, VARCEL
Symptoms: Vaccination failure, Varicella
Clinical narrative: Patient developed chicken pox (diagnosed by MD) on 04/23/07.  She was given Varicella vaccine  on 6-22-01,, The MD prsecribed Acylovir and Cephalex to treat the chickenpox.
Age: 56.0
Sex: M
Vaccine: PPV
Symptoms: Headache, Lethargy, Nausea, Pyrexia, Vomiting
Clinical narrative: one hr after given, developed nausea/vomiting, fever of 102/headache/lethargy..today, he is still having nausea/vomiting/fever/headache/lethargy and a 12 # wt loss in 2 days     He will be seeing Dr. today at 2PM.
Age: 56.0
Sex: M
Vaccine: PPV
Symptoms: Weight decreased
Clinical narrative: one hr after given, developed nausea/vomiting, fever of 102/headache/lethargy..today, he is still having nausea/vomiting/fever/headache/lethargy and a 12 # wt loss in 2 days     He will be seeing Dr. today at 2PM.
Age: 11.0
Sex: M
Vaccine: TDAP, VARCEL
Symptoms: Fatigue, Pyrexia, Rash pruritic, Skin lesion, Varicella
Clinical narrative: On Friday, May 18, 2007 the child received a varicella and a Tdap vaccination at our public health clinic.  Child's mother did not report any immunocompromising conditions or other contraindications to vaccination at that time.  The mother reports that on Sunday, June 3, 2007 she noticed spots on the child's chest and back.  She thought they were mosquito bites.  On Monday more spots developed and the child was complaining that they itched.  The mother called her family physician who said they thought it was chickenpox and to report to the health dept where he was vaccinated.  Mother reports child had mild fever of 99.8 F and was fatiqued.  Child has approximately 24-25 lesions on chest, back, arms, and legs.  Mother denied him having any exposure to someone with chickenpox.  She reports he is a healthy child, does not have any medical conditions and that he is not taking any medications.  Reports that lesions are beginning to crust over and the last new lesions appeared on Tuesday, June 5, 2007.  Mother did not take child to visit doctor.
Age: 17.0
Sex: M
Vaccine: MNQ, TDAP
Symptoms: Body temperature increased, Chills
Clinical narrative: Pt sent home from school with an elevated temp of 101 F.  Pt is also having chills
Age: 45.0
Sex: U
Vaccine: TDAP
Symptoms: Nausea, Pyrexia
Clinical narrative: Pt reports fever of 102, nausea within 12 hours of receiving vaccine. Advised to take acetominophen, enc cl liqs, bland foods
Age: 6.0
Sex: F
Vaccine: VARZOS
Symptoms: Herpes zoster, Inappropriate schedule of drug administration, Limb discomfort, Medication error, Rash erythematous
Clinical narrative: red sore  itchey arm 7 by 3.5 cm 6/8/7
Age: 6.0
Sex: F
Vaccine: VARZOS
Symptoms: Rash pruritic
Clinical narrative: red sore  itchey arm 7 by 3.5 cm 6/8/7
Age: 19.0
Sex: F
Vaccine: HPV4, HPV4
Symptoms: Lymphadenopathy, Pain, Pruritus, Wrong technique in drug usage process
Clinical narrative: Pt received Gardasil injection in lower right back area on 5/4/07. The next week she noticed enlarged lymphnodes in her right groin area. It was painful when she walked and she noticed some itching in the area. Pt was reassured about the lymphnodes in her right groin area. No info could be found on Lymphandenopathy. Pt will monitor her lymph nodes for the next few weeks. If they increase in size will consider doing an ultrasound. It is most likely they will decrease in size and eventually disappear over the next few months.
Age: 19.0
Sex: F
Vaccine: HPV4, HPV4
Symptoms: Incorrect route of drug administration, Pain, Pruritus
Clinical narrative: Pt received Gardasil injection in lower right back area on 5/4/07. The next week she noticed enlarged lymphnodes in her right groin area. It was painful when she walked and she noticed some itching in the area. Pt was reassured about the lymphnodes in her right groin area. No info could be found on Lymphandenopathy. Pt will monitor her lymph nodes for the next few weeks. If they increase in size will consider doing an ultrasound. It is most likely they will decrease in size and eventually disappear over the next few months.
Age: 74.0
Sex: F
Vaccine: MNQ
Symptoms: Abdominal pain upper, Bundle branch block right, Diarrhoea, Electrocardiogram, Electrocardiogram ST segment abnormal
Clinical narrative: Vaccine received on June 2, 2007, pt observed for 20 minutes after receiving vaccine, pt reported feeling strange one hour after vaccine, developed diarrhea followed by epigastric pain(felt like hole in the stomach) which started at inferior aspect of scapula on left side and radiated towards abdomen, pt felt like something went from her back thru the lower part of her heart to her epigastric area, pt also reports local redness of left deltoid
Age: 74.0
Sex: F
Vaccine: MNQ
Symptoms: Feeling abnormal, Injection site erythema
Clinical narrative: Vaccine received on June 2, 2007, pt observed for 20 minutes after receiving vaccine, pt reported feeling strange one hour after vaccine, developed diarrhea followed by epigastric pain(felt like hole in the stomach) which started at inferior aspect of scapula on left side and radiated towards abdomen, pt felt like something went from her back thru the lower part of her heart to her epigastric area, pt also reports local redness of left deltoid
Age: 18.0
Sex: M
Vaccine: MNQ
Symptoms: Body temperature increased, Chills, Dyspnoea, Fatigue, Myalgia
Clinical narrative: received the vaccine about 3pm 6/7/07 at KSU, at 11 am today, chills and muscle aches, shortness of breath, severe fatigue set in temp elevated to 102degrees, muscle aches worsened, he fell asleep, woke up at 2pm, at 3pm I arrived home he was sleeping, I woke him, 101 fever, aches, called Dr. to report. gave him tylenol,and fluids, aches and fever continue off and on at this time.
Age: 18.0
Sex: M
Vaccine: MNQ
Symptoms: Pyrexia
Clinical narrative: received the vaccine about 3pm 6/7/07 at KSU, at 11 am today, chills and muscle aches, shortness of breath, severe fatigue set in temp elevated to 102degrees, muscle aches worsened, he fell asleep, woke up at 2pm, at 3pm I arrived home he was sleeping, I woke him, 101 fever, aches, called Dr. to report. gave him tylenol,and fluids, aches and fever continue off and on at this time.
Age: 0.4
Sex: M
Vaccine: DTAP, HIBV, IPV, RV5
Symptoms: Dehydration, Diarrhoea haemorrhagic, Gastroenteritis, Intussusception, Occult blood positive
Clinical narrative: Admitted on 5/30/07 after a 2 day history of vomiting, associated with low-grade fever and 2 bouts of bloody diarrhea.  Initial impression was acute gastroenteritis with dehydration.  While kept NPO, he still had one episode of emesis and one episode of watery, pinkish-brown stools which was positive for occult blood. An abdominal series showed signs of obstruction; an abdominal ultrasound diagnosed an intussusception.  The patient was transferred to Hospital on 5/31/07 for further management.  A bowel enema was performed, which was able to reduce the intussusception. The patient was discharged 24 hours after the procedure.  07/02/2007 Hospital records received from both admitting and transfer hospitals. Infant was initially seen and admitted for c/o bloody/mucusy stool and vomiting with each breast feed. PE significant for hypoactive BS, otherwise WNL. Infant transfered to another facility for management.     Intussusception was sucessfully reduced via Hypaque enema. Principal DX:  Intussusception.
Age: 0.4
Sex: M
Vaccine: DTAP, HIBV, IPV, RV5
Symptoms: Pyrexia, Ultrasound abdomen, Vomiting
Clinical narrative: Admitted on 5/30/07 after a 2 day history of vomiting, associated with low-grade fever and 2 bouts of bloody diarrhea.  Initial impression was acute gastroenteritis with dehydration.  While kept NPO, he still had one episode of emesis and one episode of watery, pinkish-brown stools which was positive for occult blood. An abdominal series showed signs of obstruction; an abdominal ultrasound diagnosed an intussusception.  The patient was transferred to Hospital on 5/31/07 for further management.  A bowel enema was performed, which was able to reduce the intussusception. The patient was discharged 24 hours after the procedure.  07/02/2007 Hospital records received from both admitting and transfer hospitals. Infant was initially seen and admitted for c/o bloody/mucusy stool and vomiting with each breast feed. PE significant for hypoactive BS, otherwise WNL. Infant transfered to another facility for management.     Intussusception was sucessfully reduced via Hypaque enema. Principal DX:  Intussusception.
Age: 6.0
Sex: F
Vaccine: DTAP
Symptoms: Injection site inflammation
Clinical narrative: 6cm round, raised inflammation at site of vaccination.
Age: 0.25
Sex: M
Vaccine: DTAPHEPBIP, HIBV, PNC
Symptoms: Diarrhoea, Erythema multiforme, Irritability, Rash, Skin lesion
Clinical narrative: This case was reported by a physician and described the occurrence of erythema multiforme in a 3-month-old male subject who was vaccinated with Pediarix, (GlaxoSmithKline), Prevnar, (Wyeth Labs) and Hib, (manufacturer unknown) for prophylaxis. On an unspecified date the subject received 1st doses of Pediarix (0.5 ml), Prevnar and Hib. At an unspecified time after vaccination with Hib, Pediarix and Prevnar, the subject experienced rash, lesion, irritability and diarrhea. He was later diagnosed with erythema multiforme. This case was assessed as medically serious. At the time of reporting the outcome of the events was unspecified. The physician considered the events were probably related to vaccination with Pediarix, Prevnar and Hib.
Age: 15.0
Sex: F
Vaccine: HPV4
Symptoms: Back pain, Headache, Hypoaesthesia, Paraesthesia
Clinical narrative: paraesthesias bilateral arms upon awakening frontal/temporal headache, lower back pain, thighs and arms numb. -All self resolved with in hours
Age: 11.0
Sex: M
Vaccine: HEPA, TDAP, VARCEL
Symptoms: Injection site erythema, Injection site swelling, Pruritus
Clinical narrative: Pt. rec vaccines went home started having a little itching. The following morning pt had a quarter size amount of redness and swelling at injection site. Child went to school and around 1:30 pm school called mom. Mom brought child in with 19x16 severe redness and 7x7 swollen area on
Age: 17.0
Sex: F
Vaccine: HEPA, MNQ
Symptoms: Loss of consciousness, Syncope
Clinical narrative: At approximately 11:30 am, patient had an episode of syncope following shots given at 11:20 am. Patient had not eaten breakfast (information provided after syncopal episode). Vitals taken at 11:35am, 11:45am, 11:55 am approximately. BP was 100/60 at first and went up to 110/78. Patient regained consciousness within seconds after passing out. No other incident/injury.
Age: 12.0
Sex: F
Vaccine: HPV4, MNQ, TDAP
Symptoms: Decreased appetite, Flushing, Full blood count, Muscular weakness, Nausea
Clinical narrative: fever (102.F), flushed cheeks, leg/arm pain, weakness in legs, nausea, poor appetite x 2 days
Age: 12.0
Sex: F
Vaccine: HPV4, MNQ, TDAP
Symptoms: Pain, Pyrexia
Clinical narrative: fever (102.F), flushed cheeks, leg/arm pain, weakness in legs, nausea, poor appetite x 2 days
Age: 11.0
Sex: M
Vaccine: MNQ, TDAP, VARCEL
Symptoms: Headache, Pyrexia
Clinical narrative: 3 hr post immunization pt had fever of 102 and 24 hr after accompanied by headache
Age: 48.0
Sex: M
Vaccine: TDAP
Symptoms: Headache, Injection site pain, Local swelling, Pain, Pyrexia
Clinical narrative: Fever (99-101 deg) Headache, bodyaches. Local swelling and pain at inj. site.
Age: 4.0
Sex: F
Vaccine: DTAPH, MMRV, PNC
Symptoms: Injection site erythema, Injection site swelling
Clinical narrative: c/o red and swollen at (L) arm right after immunization. Decreased swelling today. no pain
Age: 1.5
Sex: M
Vaccine: DTAP, HEPA, HIBV, MMR
Symptoms: Erythema, Induration, Skin warm, Tenderness
Clinical narrative: Two days following vaccination with DTaP to right thigh, pt. developed 4 x 5 cm area of erythema, 2x3cm area of induration, hot to touch, tender to palpation
Age: 9.0
Sex: F
Vaccine: HEPA, VARCEL
Symptoms: Cold compress therapy, Injection site erythema, Injection site swelling, Injection site warmth
Clinical narrative: (L) arm red, swollen, warm 2 1/2 x 2 in cool compress, Motrin
Age: 0.17
Sex: M
Vaccine: DTAPHEPBIP, HIBV, PNC
Symptoms: Blood culture negative, Pyrexia, White blood cell count increased
Clinical narrative: fever 102 and elevated WBC
Age: 5.0
Sex: F
Vaccine: DTAP, IPV, MMRV
Symptoms: Erythema multiforme, Injection site cellulitis
Clinical narrative: Erythema multiforme on upper thighs, (+) cellulitis (L) thigh
Age: 5.0
Sex: F
Vaccine: DTAP, IPV, MMRV
Symptoms: Injection site erythema, Injection site pruritus, Skin lesion
Clinical narrative: Pt had large erythematous, itchy, hot lesion on left thigh 10 cm in size. No fever or other systemic sx.
Age: 12.0
Sex: M
Vaccine: VARCEL
Symptoms: Cold compress therapy, Urticaria
Clinical narrative: local urticarial/hive type reaction. cold packs and Clarinex