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From the 4/30/2021 release of VAERS data:

This is VAERS ID 26401



Case Details

VAERS ID: 26401 (history)  
Form: Version 1.0  
Age: 0.5  
Sex: Male  
Location: Indiana  
Vaccinated:1990-10-11
Onset:1990-10-11
   Days after vaccination:0
Submitted: 1990-10-24
   Days after onset:13
Entered: 1990-10-29
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0M11148 / 3 LL / -

Administered by: Private       Purchased by: Private
Symptoms: Anorexia, Intracranial pressure increased, Pyrexia, Somnolence, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Prematurity 35-36 wks, transient RDs, jaundice, asthma, otitis media.
Allergies:
Diagnostic Lab Data: CBD - WBc 10,400; HGB 9.7, HCt 33.5%; LP -clera CSF, CSF culture neg, glucose 74 MG%, 4 WBC, 22 RBC, Protein 22 Gram Stain neg
CDC Split Type:

Write-up: Pt vaccinated with DTP developed fever, vomiting, lethargy, and bulging fontanelle. Observed closely. No antibiotics given. Bulging fontanelle subsided within hrs after LP. Fever persisted 5 days. Poor appetite for 5-6 days. Full recovery.


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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=26401


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