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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 25664



Case Details

VAERS ID: 25664 (history)  
Form: Version 1.0  
Age: 0.5  
Sex: Female  
Location: Delaware  
Vaccinated:1990-07-18
Onset:1990-07-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 1990-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0F11081 / 3 - / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Convulsion, Hypokinesia, Hypotonia, Muscle twitching, Pallor, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (narrow), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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, 5 days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Premie 32 wk gestation
Allergies:
Diagnostic Lab Data: Normal EEG
CDC Split Type:

Write-up: Pt received 3rd DTP at noon 18-JUL-90 approx 24 hrs later temp 103, episode of poor color, staring expression, hypotonia. Twitching & color change cleared in seconds, hypotonia & expressionless face for minutes. More details see WORM.


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20201224&IDNUMBER=25664


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