Age: 1.46
Sex: M
Vaccine: MMR
Symptoms: Abnormal behaviour, Cough, Decreased appetite, Ear infection, Expired drug administered
Clinical narrative: Information has been received from a consumer concerning a her approximately 12 month old son with pertinent medical history reported as none and drug reactions or allergies reported as none who on an unspecified date was vaccinated with a first dose of MMR II (lot # not reported). The vaccine was expired. The patient was to return "several weeks" later to be revaccinated but the dose was postponed since the child had an ear infection. On 29-JUN-2009 he received second dose of MMR II (lot # not reported). There was no concomitant medication. After received the second dose of vaccine the patient developed fever, rash, watery eye and watery runny nose. "He was really sick". The child was seen in the emergency room. The mother stated she was told be the emergency room "he had a viral infection" and he was discharged home with his mother. At the time on the report on 06-JUL-2009 the patient had not recovered. Follow up information has been received from a nurse and medical record concerning a 17 month old patient with pertinent medical history reported as none, drug allergies reported as none and illness at the time of vaccination report as none. On 05-JUL-2009 the patient experienced fever over 102 degrees, cough and no oral intake was taken by his mother to the Emergency Room. The patient had been afebrile and did not received any TYLENOL and his temperature was 37.4 degrees. About 7 days prior to presentation to the Emergency Room, patient received MMR II at his doctor's office. The patient had not been himself according to the mother and had had decreased appetite, however, no vomiting or diarrhea reported. Patient had no sick contacts. The patient was followed by the physician. The patient also had sudden onset of rash involving the neck and torso. That was the reason why mom got the emergency room despite the patient being afebrile. The patient was doing well and had adequate urine output. The patient presented to upset Emergency Room for evaluation and management. In the Emergency Room physical examination was performed: weight: 12.35 kilos, blood pressure: 82/palp, heart rate: 122, respiratory rate: 24, saturation: 99%, temperature: 37.4 degrees. General appearance: Well-appearing kid, not sick at all, not in acute distress. Heent: Mild nasal congestion, clear tympanic membranes, clear throat. Chest: Bilateral equal air entry clear. Heart: S1, S2 normal, no murmur. Abdomen; Soft, nontender, no hepatosplenomegaly. Pulses: 2+, well perfused. Capillary refill less than 2 seconds. Musculoskeletal: No issues. Skin: Morbilliform rash blanching over the neck and trunk, front and back. The patient was diagnosed by physician with viral syndrome. The patient was found well hydrated. The patient tolerated apple juice in the Emergency Room. The patient will be discharged home in good condition with diet regular, activity as tolerated, TYLENOL as need for fever. Follow up with the primary care physician in one day. According to the father the patient recovered on 06-JUL-2009. Additional information is not expected.