Information has been received from a physician concerning a 14 week old male with a history of genital petechiae, scalp bruising and hospitalisation for acute sercus otitis media admitted on 03-JUN-2008, who on 24-JUN-2008 was vaccinated with PREVENAR, PEDIARIX and Hib conj vaccine (OMPC) (MSD). On 28-JUL-2008 the patient experienced left eye draining. On 26-AUG-2008 the baby was seen for a 4 month well child visit. Parents had no specific concerns. Eyes appear normal with no drainage noted. Sclerae  were white. Baby was immunized with second doses of PEDIARIX, ROTATEQ (manufacturer unknown), PREVENAR, and Hib conj vaccine (OMPC) (manufacturer unknown). On 26-SEP-2008 the patient experienced URI. On 26-SEP-2008 patient presented to the office with complaints of coughing for the last few days, and waking up crying with  the cough. Onset was gradual. The mother rates the cough as a moderate moist cough nonproductive. Mother denies fever, shortness of breath or tachypnea. The symptoms were worse during the day and at night and has shown no change since the onset. The patient is in a day care every day and there were known cases of strept in the day care. Additionally, mom smokes 1/2 pack per day. Tympanic membranes were normal with no fluid or erythema seen. Nose was a little stuffy with clear drainage. Respiratory rate was normal. No coughing while in the office, no wheezing and his lungs were clear. No ear infection was noted. Supportive care was recommended along with the mother's cessation of smoking. The outcome for the URI was not reported. Additional information is not expected. This is in follow-up to report(s) previously submitted on 11/10/2008.  Information has been received from a physician concerning a 14 week old male with a history of genital petechiae, scalp bruising and hospitalisation for acute serous otitic media admitted on 03-JUN-2008 who on 24-JUN-2008 was vaccinated with ROTATEQ.  Secondary suspect therapy included PEDVAXHIB on 24-JUN-2008.  Concomitant therapy included PREVNAR, and PEDIARIX.  On 28-JUL-2008 the patient experienced left eye draining.  On 26-AUG-2008 the baby was seen for a 4 month well child visit.  Parents had no specific concerns.  Patient appear normal with no drainage noted.  Sclerou were white.  Baby was immunized with PEDIARIX, PREVNAR and PEDVAXHIB.  On 26-SEP-2008 the patient experienced upper respiratory infection (URI).  On 26-SEP-2008 patient presented to the office with complaints of coughing for the last few days, and waking up trying with the cough.  Onset was gradual.  The mother rates the cough as a moderate moist cough, nonproductive.  Mother denies fever, shortness of breath or tachypnea.   The symptoms were worse during the day and at night and has shown no change since the onset.  The patient  is in a day care every day and there were known cases of strept in the day care.  Additionally, mom smokes 1/2 pack per day.  Tympanic membranes were normal with no fluid or erythema seen.  Nose was a little stuffy with clear drainage.  Respiratory rate was normal.  No coughing while in the office, no wheezing and his lungs were clear.  No ear infection was noted.  Supportive care was recommended along with the mother's cosention of smoking.  The outcome for the URI was not reported.  Additional information is not expected.