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From the 11/19/2021 release of VAERS data:

This is VAERS ID 75868

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Case Details

VAERS ID: 75868 (history)  
Form: Version 1.0  
Age: 37.0  
Sex: Male  
Location: Maryland  
Vaccinated:1995-05-25
Onset:1995-06-18
   Days after vaccination:24
Submitted: 1995-07-11
   Days after onset:23
Entered: 1995-07-13
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 425A6 / UNK LA / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 659A / UNK RA / SC
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 4E61168 / UNK RA / -

Administered by: Public       Purchased by: Unknown
Symptoms: Encephalitis, Herpes zoster
SMQs:, Noninfectious encephalitis (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data:
CDC Split Type: MD95025

Write-up: pt recv vax; devel shingles on 18jun95;dx w/ encephalitis; adm to hosp;felt vax rxn;discharged 29jun95


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