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From the 11/26/2021 release of VAERS data:

This is VAERS ID 29797

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Case Details

VAERS ID: 29797 (history)  
Form: Version 1.0  
Age: 0.6  
Sex: Male  
Location: Georgia  
Vaccinated:1991-02-22
Onset:1991-03-04
   Days after vaccination:10
Submitted: 1991-03-05
   Days after onset:1
Entered: 1991-04-08
   Days after submission:33
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 271965 / 2 RL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M210EP / 1 LL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. 841024 / 2 RA / SC

Administered by: Public       Purchased by: Public
Symptoms: Agitation, Cough, Otitis media
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: Well
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC Split Type: GA9137

Write-up: Immun given 22FEB91 infant well @ that time;4MAR91 AM when mom noted child became "croupy sounding & fussy" no fever to MD dx w/ear infect mom reported MD vs she remembered this from informal consent form;


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