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From the 12/31/2003 release of VAERS data (an older release, current is 4/30/2021):

This is VAERS ID 25619

Case Details

VAERS ID: 25619 (history)  
Form: Version .0  
Age: 0.5  
Sex: Male  
Location: New York  
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 262913 / - - / IM

Administered by: Private       Purchased by: Unknown

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:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: LP- 70- RBC, 0- WBC, 35- protein, 75- glucose, Culture no growth, CBC- WBC 20,300, Het- 33, PHS- normal, blood culture no grwoth, EEG- normal
CDC Split Type:

Write-up: 6 hrs p/ 3rd DPT generalized tonic clonic seizure approx. 45 min. assoc. /w fever. Taken to hospital & then to MD for evaluation.

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