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

This is VAERS ID 90836

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Case Details

VAERS ID: 90836 (history)  
Form: Version 1.0  
Age: 17.0  
Sex: Male  
Location: California  
Vaccinated:1996-09-04
Onset:1996-09-24
   Days after vaccination:20
Submitted: 1996-10-03
   Days after onset:9
Entered: 1996-10-22
   Days after submission:19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA498A2 / 1 - / IM A

Administered by: Private       Purchased by: Private
Symptoms: Anaemia, Haemolytic anaemia, Hypochromic anaemia, Jaundice
SMQs:, Cholestasis and jaundice of hepatic origin (narrow), Haemolytic disorders (narrow), Acute pancreatitis (broad), Haematopoietic erythropenia (broad), Systemic lupus erythematosus (broad), Biliary system related investigations, signs and symptoms (narrow), Biliary tract disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CBC, serum hemoglobin, haptoglobin, bili, LDH, retic, coombs tests;
CDC Split Type:

Write-up: autoimmune hemolytic anemia w/avid IgG warm antibody;jaundice;hgb down to 4.8;hct to 14.0;


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