Age: 0.33
Sex: F
Vaccine: DTAPHEPBIP, HIBV, PNC13, RV5
Symptoms: Agitation, Decreased eye contact, Electrocardiogram normal, Electroencephalogram normal, Fatigue
Clinical narrative: See attached patient summary of events. First event had f/u in clinic. Pt was seen by Neurology had (-) EEG, (-) echo. Patient had her 4 month shots on January 30th at 6:00 pm. She slept a little in her car seat after getting them ant then at 8:00 pm she nursed and then fell asleep while I was holding her. We settled in on the couch. At 10:00 pm she woke up screaming and seemed agitated, so I took her back to the nursery to change her diaper and get her ready for bed. As I laid her down to take off her onesie I noticed she looked really pale with little color even in her lips. She had stopped screaming and was not very alert (no eye contact, limited muscle control... it was like she was a newborn). I took her downstairs to have mu husband assess her, as I thought we needed to call 911. She was very limp with glossy eyes. She also was breathing with more shallow breaths, though she never stopped breathing. My husband also tried a sternum rub and she displayed no pain response. She didn't want to nurse or even hold her head up she was not running a fever at all. At that point we called 911; it was about 10:15 pm. The sheriff arrived and she was still very pale. Her limbs were weak and she was not making eye contact. The fire department and EMT's continued to arrive. They did some basic assessment and agreed that she seemed to be having some sort of minor episode (though reiterated that since they had never met her before it was hard to judge). By the time the paramedics finally got there she was acting more like herself. She started to respond to people around her and even giggled a bit. This was around 10:30 pm. We declined transport to the hospital, as the paramedics seemed confident she was stable and that it could have been a reaction to the vaccines. However, they wanted us to take her back in to the clinic the following day. She nursed normally around 11:30 pm and then slept from about midnight 6:00 am. I took her in to see the doctor the next day at 10:30 am. She did a physical exam and did not see anything of concern. However, the recommendation was for her to have an EKG and EEG. We did both tests on February 4th and results were normal. No other signs, symptoms or repeat issues until the 6 months shots. Second incident. After what happened previously, we decided to split up her 6 months vaccines. She had the Hib and PVC shots at her 6 month well-visit at noon on April 9th. She was behaving normally all day until about 7:45 pm. She was lying on the floor and I was about to change her out of her clothes for her bath. She got really still and I picked her up. She threw up, which was a first for her. it was a moderate amount of breast milk (she had last eaten around 7:00 pm.) She seemed to be a little more tired than normal, but I proceeded to give her a quick bath. Then at 8:15 pm she threw up twice more, with alot more stomach heaving. After that she was whimpering and pale, with no eye contact and limp muscles. It was very similar to her previous state after the 4 month shots. This time she did have a fever of 100.9. We gave her TYLENOL around 8:30 pm and she fell asleep for a couple of hours. When she woke up she was acting like herself, giggling and keeping eye contact and using all her muscles. She nursed normally and then slept fine overnight. No other episodes since that day.