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From the 1/14/2022 release of VAERS data:

This is VAERS ID 90122

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Case Details

VAERS ID: 90122 (history)  
Form: Version 1.0  
Age: 5.0  
Sex: Male  
Location: Mississippi  
Vaccinated:1996-05-08
Onset:1996-05-25
   Days after vaccination:17
Submitted: 1996-06-10
   Days after onset:16
Entered: 1996-09-23
   Days after submission:105
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 - / IM A

Administered by: Public       Purchased by: Other
Symptoms: Drug ineffective, Hepatitis, Infection
SMQs:, Hepatitis, non-infectious (narrow), Lack of efficacy/effect (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: NKA
Allergies:
Diagnostic Lab Data:
CDC Split Type: 960080641

Write-up: pt recv vax & 17 days post vax pt presented w/hep A & was hospitalized for tx;pt did not recv immunoglobulin;reporter stated that this case represents an exposure to hep A a/vax rather than a failure of therapy;sx cont;


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