Sex: F
Vaccine: DTAPHEPBIP, HIBV, PNC, RV5
Symptoms: Blood culture negative, Crying, Culture urine negative, Dyskinesia, Electroencephalogram normal
Clinical narrative: Initial unsolicited report received from the literature on 23 May 2018. This case is linked to 2018SA144697, 2018SA144797, 2018SA144640, 2018SA145180, 2018SA145155, 2018SA145075, 2018SA141516, 2018SA144034, 2018SA144049, 2018SA144061, 2018SA144069, 2018SA144075, 2018SA144105, 2018SA144628 (same literature). The following is verbatim from the article: Introduction Aluminum is a frequently utilized adjuvant in childhood vaccines. 1, 2 Among other actions, aluminum facilitates and prolongs the presentation of vaccine antigens to antigen presenting cells, and in the process augments the immune response. 2 However, sterile abscess formation may rarely complicate immunization with aluminum containing vaccines. 3 We report a case of recurrent sterile abscess formation following immunization with aluminum-containing vaccines, followed by the first systematic review of both the literature and the Vaccine Adverse Event Reporting System (VAERS) database in an effort to better characterize this phenomenon. VAERS ID for this case is 317136-1. This case involves a three month old male patient who was vaccinated intramuscularly with second dose of ACT-HIB batch number UF260AA, in left thigh (expiry date was not reported), second dose PEDIARIX (Mfr: glaxosmithkline biologicals, batch number AC21B149AA, intramuscularly in left thigh (expiry date was not reported), second dose of PREVNAR (manufacturer: pfizer/wyeth, batch number C68306, expiry date was not reported) intramuscularly in right leg and second dose of ROTATEQ (manufacturer: merck & co. Inc, batch number 0207X, expiry date was not reported) orally on 17 June 2008. Patient's Preexisting Conditions, Current Illness was reported as none. Concomitant medications were not reported. On 17 June 2008, same day post vaccination (reported as "went to the ER that evening"), the patient experienced seizure (strange twitching), fever 103.3 degree Celsius, sterile abscess to (L) leg and febrile seizure. On 18 June 2018, one-day post vaccination patient was diagnosed with Immunization reaction as subjective fever, crying and jerking this morning and had small sterile abscess right upper thigh. On 17 June 2008 patient was hospitalized. Lab data were reported as normal electroencephalogram (EEG), recovered in 18 hour and on 7 July 08 records received-EEG normal, White blood cells (WBC) 17.8%, neutrophils 56.2% lymphocytes (lymph) 2937, blood and urine cultures no growth. Corrective treatment was not reported. On an unspecified date patient had recovered. On 18 June 2008, patient was discharged from the hospital. Documents held by sender: none. Sender's Comments: This case involves a three months old patient who received ACT-HIB, PEDIARIX, PREVNAR and ROTATEQ vaccines and experienced sterile abscess right upper thigh and to left leg, febrile seizure and strange twitching same day post vaccination. Time to onset is compatible with the role of vaccines. Febrile seizure is expected after ACTHIB vaccine. Lab test reveals increase in WBC count which is suggestive of an infectious etiology. Moreover, patient's birth history, medical condition at the time of vaccination were not provided. Based upon the available information and involvement of two vaccines, the role of an individual vaccine cannot be assessed.