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From the 6/14/2018 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 1.0  
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: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 259958 / UNK - / L
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 598E3936 / UNK MO / PO

Administered by: Private       Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Injection site oedema, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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? No
Previous Vaccinations: ~ ()~~~In patient
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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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20180614&IDNUMBER=25691


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