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From the 1/7/2022 release of VAERS data:

This is VAERS ID 108704

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Case Details

VAERS ID: 108704 (history)  
Form: Version 1.0  
Age: 40.0  
Sex: Male  
Location: New York  
Vaccinated:1996-09-26
Onset:1996-09-26
   Days after vaccination:0
Submitted: 1998-03-17
   Days after onset:537
Entered: 1998-03-19
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 - / -

Administered by: Private       Purchased by: Private
Symptoms: Dizziness, Eye disorder, Muscle twitching
SMQs:, Anticholinergic syndrome (broad), Dyskinesia (broad), Dystonia (broad), Corneal disorders (broad), Retinal disorders (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: blood factor V deficienty, prosthetic aortic heart valve
Allergies:
Diagnostic Lab Data:
CDC Split Type: 19980039171A

Write-up: pt recv vax 26SEP96 & immed p/vax devel eye quivering & also became dizzy;other people recv vax @ the same time as pt & did not exp these sx;


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