Information has been received from medical records concerning a 4 week old female with a history of premature birth (36 weeks) and jaundice (recovered) and no Known drug allergies, who on March 18,2004, was vaccinated with a first dose of hepatitis B virus vaccine rHBsAg (yeast) (manufacturer unknown). The child was delivered following her mother's vaccination with varicella virus vaccine live (Oka/Merck) during pregnancy (WAES 0403USA00618). On April 19, 2004, the patient was seen in the physician's office with complaints of phlegm and cough for for 2 days. Diagnosis was an upper respiratory infection and the patient was treated with bulb suctioning with saline drops, vaporizer and frequent feeds. On April 28, 2004, the patient was seen in the office with complaints of oral thrush and mild cough. She was treated with Mycostatin. On May 20,2004, the patient still had thrush and was treated with Nystatin. Other growth and development at that visit was normal. On September 20, 2004, the patient was seen in the office with a cough for 5 days with nasal congestion. Patient was diagnosed with an upper respiratory infection. On November 30,2004, the patient was seen in the office with a red rash on her body and head that was itchy. She also had eye discharge. She was diagnosed with scalp dermatitis and conjunctivitis. She was treated with hydrocortisone cream and an ophthalmic ointment. On December 22, 2004, the patient was seen with a 2 day history of cough, runny nose and decreased appetite. At this visit eczema was also noted. She was treated with normal saline nasal drops and pimecroliumus (Elidel).  On January 25, 2005, the patient was seen in the office with cold symptoms and was diagnosed with an upper respiratory infection. Treatment included suctioning, vaporizer, fluids and prn diphenhydramine HCL (Benadryl). On March 17, 2005, the patient was seen with complaints of a diaper rash that did not improve with cod liver oil (+) zinc oxide (Desitin) and constipation. A nutrition referral was given and nystatin was prescribed. Other vaccine history included a second and third dose of Hepatitis B virus vaccine rHBsAg (yeast) (manufacturer unknown) on May 20, 2004 and July 20, 2004 respectively; a first, second, third and fourth dose of diphtheria toxoid (+) pertussis vaccine (unspecified) (+) tetanus toxoid on May 20,2004, July 20, 2004, September 20, 2004 and October 10, 2005 respectively; a first, second, third and fourth dose of poliovirus vaccine on May 20, 2004, July 20, 2004, September 20, 2004 and October 10, 2005; and dose of measles virus vaccine live (Enders-Edmonston) (+) mumps virus vaccine live (Jeryl Lynn) (+) rubella virus vaccine live (Wistar RA 27/3) (MSD) on March 17, 2005, a first second and third dose of Hib conj vaccine (OMPC) (MSD) on May 20, 2004, July 20, 2004 and September 20, 2004; a dose of varicella virus vaccine live (Oka/Merck) (MSD) on March 17,2005; a first, second, third and fourth dose of pneumococcal 4B 9V 14 18C 19F 23F conj vaccine (CRM197) (Prevnar) on May 20, 2004, July 20, 2004,  September 20, 2004 and October 10, 2005: a first and second dose of influenza vaccine on September 20, 2004 and October 10, 2005. No additional information was provided.