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From the 4/30/2021 release of VAERS data:

This is VAERS ID 25174



Case Details

VAERS ID: 25174 (history)  
Form: Version 1.0  
Age: 0.9  
Sex: Female  
Location: Indiana  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 202634 / UNK - / -

Administered by: Private       Purchased by: Private
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)

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:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 8902565.01

Write-up: PT WITH POS DIRECT FLUORESCENT ANTIBODY& HAD RECEIVED 3 DTP''S.HOSP AS A PRECAUTION. PT ATTENDS DAYCARE WHERE INDEX CASE HAD PERTUSSIS.(INDEX NEVER RECEIVED DTP); PROBABLY 4-5 MORE CASES OF PERTUSSIS AT CENTER.


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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=25174


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