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From the 2/18/2021 release of VAERS data:

This is VAERS ID 80688

Case Details

VAERS ID: 80688 (history)  
Form: Version 1.0  
Age: 14.0  
Sex: Male  
Location: Alabama  
Vaccinated:1995-12-15
Onset:1995-12-22
   Days after vaccination:7
Submitted: 1995-12-24
   Days after onset:2
Entered: 1996-01-03
   Days after submission:10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
CHOL: CHOLERA (USP) / PFIZER/WYETH 4958031 / 1 LA / SC
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958114 / 1 RA / IM
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 165A2 / 1 LA / IM
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI) / CONNAUGHT LABORATORIES K1160 / 1 RA / IM

Administered by: Public       Purchased by: Public
Symptoms: Convulsion, Encephalopathy, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: CT neg, LP neg
CDC Split Type: AL9539

Write-up: 22DEC95 fever x 12k; 28DEC95 sz 9PM-fever encephalopathy


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