Age: 0.34
Sex: M
Vaccine: DTAP, HBHEPB, IPV, PNC
Symptoms: Decreased appetite, Eczema, Feeling hot, Irritability, Laboratory test abnormal
Clinical narrative: Information has been received from medical records concerning an 11 month old male patient whose mother was vaccinated with varicella virus vaccine live during pregnancy (WAES# 0302USA00317). He had no congenital anomalies and a history of premature birth at 30 weeks, birth weight (3 pounds and 11 ounces), he remained hospitalized for 5 weeks following birth because of respiratory distress and apnea related to prematurity and immature lungs and he required mechanical ventilation, a feeding tube, and a heart monitor, he also has hyerbilirubinemia at birth, he recovered and was discharged. It was noted that the patient received first dose of hepatitis 3 virus vaccine (unspecified) (manufacturer unknown) in the hospital after birth (date not reported). On 02-Dec-2003, the patient was administered a first dose of hepatitis B virus vaccine rHBsAg (yeast) (+) Hib conj vaccine (Lot # 64523/0046M) in the right thigh. Concomitant vaccines administered on the same day included a second dose of Infanrix (Lot #602A2) administered in the right thigh, a second dose of Ipol (Lot #W1440) administered in the left thigh and a second dose of Prevnar (lot # 493303) administered in the left thigh. On 06 Jul 2004, the client visited the physician with a three day history of fever to 103 started on 03-Jul-2004. On exam he had small papules on his trunk and dry cracked skin on the tops of both feet, the assessment was viral syndrome and eczema. The  treatment plan was Tylenol and tepid baths, hydrocortisone for eczema, a CBC was done and instructed to return for a re-check on 07-Jul-2004. On 07 Jul 2004 at the return visit to the physician's office, the patient had a rash on his stomach and face, which was described as a maculopapular rash unevenly disseminated over his body, face, and groin. There were no open lesions, no petechiae, no purpura and no lesions on the palms of his hands or soles of his feet and he did not have lymphadenaopathy. He was noted to have decreased oral intake and decreased urine output. The assessment was rosecla. On 07-Aug-2004 the patient developed a rash which the physician assessed as a vaccine rash. The treatment plan was to offer reassurance. Medical records report that the patient also received the following other vaccines: Infanrix on 02-Oct-2003 (lot# 601A2) in the right thigh, 30-Jan-2004 (Lot # 0622A2) in the left thigh, and on 28-Oct-2004 a dose of Daptacel (lot#01996AA) in the right thigh;ActHIB on 16-Sep-2003 (Lot# UA855AA) in the right thigh and 30-Jan -2004 (Lot # UA87AA) in the right thigh; hepatitis B virus vaccine rHBSAg (yeast) (+) Hib conj vaccine on 28-Jul-2004 (Lot # 647595/0027P) in the right thigh; Ipol on 02-Oct-2003 (Lot# W1156) in the right thigh and 30-Jan-2004 (Lot#X0146) in the left thigh: Prevnar on 16-Sep-2003 (Lot# AV43982) in the right medial thigh; Engerix-B on 02-Oct-2003 (Lot#5374A2) in the left thigh and 28-Apr-2004 (Lot# 5514A2) in the right thigh: measles virus vaccine live (+) mumps virus vaccine live (+) rubella virus vaccine live 28-Jul-2004 (Lot# 647290/1036N) SC in the right thigh; varicella virus vaccine live (Lot # 646817/1063N) administered in the left thigh on 28-Oct-2004 and Fluzone on 28-Oct-2004 (Lot # 01454AA) in the left thigh and 02-Feb-2005 (Lot # U1470AA). Information received on 25-Oct-2005 contained the following adverse experiences: fussy (09-Aug-2005), upper respiratory infection (28-Mar-2005), swollen lymph nodes on neck (23-Mar-2005), hot to touch (25-Mar-2005), fever (23-Jun-2005), laying around (24-Jun-2005), decreased appetite (24-Jun-2005), decreased fluid intake (24-Jun-2005). Additional information is expected.