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From the 12/24/2020 release of VAERS data (an older release, current is 4/30/2021):

This is VAERS ID 25492



Case Details

VAERS ID: 25492 (history)  
Form: Version 1.0  
Age: 0.3  
Sex: Male  
Location: Iowa  
Vaccinated:1990-06-15
Onset:1990-06-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 279947 / UNK - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 275933 / UNK - / -

Administered by: Private       Purchased by: Unknown
Symptoms: Agitation, Hypotonia, Pallor
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (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? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Preemie- twin
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: limp, pale, excessive irritability hypotonic


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20201224&IDNUMBER=25492


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