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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 25691



Case Details

VAERS ID: 25691 (history)  
Form: Version .0  
Age: 0.3  
Sex: Male  
Location: Colorado  
Vaccinated:1990-06-04
Onset:1990-06-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 1990-08-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 259958 / - L / -
OPV: ORIMUNE / LEDERLE 598E3936 / - - / PO

Administered by: Private       Purchased by: Unknown
Symptoms: EDEMA INJECT SITE, FEVER, HYSN INJECT SITE
SMQs:

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:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Lumbar puncture WNL
CDC Split Type:

Write-up: Pt vaccinated with DTP/OPV developed fever of 104 and site swelling, rash. MD reported mild fever following DTP on 9-APR-90


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