Received Feb 18, 2026
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| DTPPVHBHPB | DTAP+IPV+HIB+HEPB (VAXELIS) | MSP VACCINE COMPANY | 2 | 48313aa | IM / RL |
| PNC20 | PNEUMO (PREVNAR20) | PFIZER\WYETH | 2 | mj3262 | IM / LL |
| RV1 | ROTAVIRUS (ROTARIX) | GLAXOSMITHKLINE BIOLOGICALS | 2 | 94a72 | PO / MO |
Vaccines were given, patient did spit out a little bit of the rotavirus vaccine. After the shots were given parents noticed that the feet looked blue with a blue streak going up the back of the leg so I was called back into the room. Initial photos were at 2:30 PM cyanosis had resolved by the time I was in the room and we just had erythema going up to the knee initially I saw 1 hive on the left foot dorsal surface near the great toe, and as the color improved over the next few minutes I did see 2 other hives toe up on the right foot dorsal surface lateral aspect. Photos were obtained that you can see attached. She was otherwise well-appearing so I did recommend for mom to breast-feed her and monitor. I rechecked on them 5 minutes later and the hives look like they had resolved and the color appeared to be normal still. Mom finished breast-feeding around 245 and took another photo that she is planning to send us through portal that did show cyanosis up to the knee with some erythematous lesions going up the right lateral leg. By the time I evaluated the patient at 3 PM the color was back to normal but I could see some very residual faint erythematous lesions at the lateral aspect of the leg. -- > I had finished my note by the time the concern came up so I am unable to attach the images that I took the but they are in the clinical media Gallery My initial thought since she did well with the 2-month vaccines and this happened on both legs is that this is not a vaccine reaction, but discussed that I still think it should be reported to VAERS. It did resolve without intervention which I think is reassuring. Recommended for mom to leave the legs open and to monitor over the next few hours before bedtime and hopefully we do not see it recur. If it is recurring especially we are seeing hives that are persisting and not going away they should consider giving her a dose of Benadryl 1.25 to 2.5 mL and they can continue this every 6-8 hours as needed. If the discoloration returns and is persisting or spreading, she is not getting good blood flow to the leg and they are returning cold or other concerns, and may need to be seen in the ER. Otherwise, we will plan to touch base with family in the morning to make sure she does not need a follow-up visit in the office. Discussed we could do a referral to immunology but I also think it would be appropriate to just see her back for 6-month well visit and consider separating the vaccines. Prevnar is already separate but we could also break down Vaxelis into the individual components if mom would be interested. She is going to think about it over the next few months and let me know. At 1 point I did hear the gasp that they were demonstrating it seemed like she was more excited looking at something brother was doing, did not seem in distress, at this point I think we can just monitor
none
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Vitamin D drops
No Known Medication Allergies