Based on additional information received on 28 December 2015, this case became medically confirmed. Initial unsolicited report received from a non-healthcare professional on 23 November 2015. This case involves a 11-year-old female patient who was vaccinated with a dose of MENACTRA (batch number, expiration date, dose, dose number and site of administration were not reported) intramuscularly, a dose of ADACEL (batch number, expiration date, dose, dose number and site of administration were not reported) intramuscularly and a first dose of Hepatitis A (batch number, expiration date, dose, dose number, route and site of administration were not reported) on 17 November 2015. The patient had medical history of Penicillin allergy. The patient had low grade fever at the time of vaccination and no other symptoms, prior to vaccination. Concomitant medication was not reported. On 17 November 2015 in evening, same day following the vaccination, the patient experienced developed fever, cough, nausea, loss of appetite, lethargy. On an unspecified date, the patient also experienced weight loss of about 5 pounds. It was reported that, the physician (pediatrician) stated maybe developed viral infection. The patient's parent stated his daughter will be continuing follow up with physician. The patient was required ER/doctor visit. Laboratory investigation includes, blood work done but no results as of 23 November 2015. Corrective treatment was not reported. As of 23 November 2015, the patient was not recovered from events. Follow up information received from physician (pediatrician) on 28 December 2015. Laboratory data was updated as follows: Platelet count (Plat CT) was 410 TH/mm3, Mean platelet count (MPV) was 10.5 MCM3, Monocytes (MONO) was 11.6 percent, Immature Granulocytes (IMM GRAN) was 0.6, Monocytes (MONO) was 0.76 TH/MM3, Immature Granulocytes (IMM GRAN) was 0.04, sedimentation rate (SED rate) was 70 MM/HR, C-reactive protein 2.41 mg/dL, and suspect flag was present on 23 November 2015. White blood cell count (WBC) was 6.53, Red blood cell count (RBC) was 5.11, hemoglobin test (HGB) was 5.11, hemoglobin test (HGB) was 14.1, Hematocrit (HCT) was 39.9, mean corpuscular volume (MCV) was 78.1, Mean corpuscular hemoglobin (MCH was 27.6), Mean corpuscular hemoglobin concentration (MCHC) was 35.3, renal denervation (RDN) was 11.9, Lymphocytes (LYMPH) was 30.3, granulocyte (GRAN) was 54.7, Eosinophils (EOS) was 1.4, basophils (BASO) was 1.4, Lymphocytes (LYMPH) was 1.98, granulocyte (GRAN) was 3.57, Eosinophils (EOS) was 0.09, basophils (BASO) was 0.09, (all tests were normal) on 23 November 2015. Rapid RVP RES, adenovirus, HKUI coronavirus, NL63 coronavirus, 229E coronavirus, OC43 coronavirus, HMPV, Entero-rhinovir, influenza A, Influenza A/H1, Influenza A/H3, influ A/H1-2009, influenza B were not detected on 21 Nov 2015. It was reported that, the FilmArray RPV Rapid uses polymerase chain reaction (PCR) and melt curve analysis to screen for adenovirus, coronavirus HKUI, NL63, 229 E, OC43, human metapneumovirus (HMPV), human enterovirus/rhinovirus (Entero/RV), Influenza A viruses 1, 2, 3, 4 respiratory syncytial virus, Bordetella pertussis mycoplasma pneumoniae, and Chlamydophilea pneumoniae. Documents held by sender: none.