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

This is VAERS ID 30860

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Case Details

VAERS ID: 30860 (history)  
Form: Version 1.0  
Age: 0.3  
Sex: Female  
Location: Pennsylvania  
Vaccinated:1991-04-22
Onset:1991-04-22
   Days after vaccination:0
Submitted: 1991-05-09
   Days after onset:17
Entered: 1991-05-28
   Days after submission:19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0B21044 / 2 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M115HA / 2 RL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. 841212 / 2 - / SC A

Administered by: Private       Purchased by: Private
Symptoms: Agitation, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever to 106 & mild irritability several hrs p/immun; Given acetaminophen; In office the following morning temp 101, exam otherwise normal;


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