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From the 12/8/2009 release of VAERS data (an older release, current is 1/7/2022):

This is VAERS ID 80688

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Case Details

VAERS ID: 80688 (history)  
Form: Version .0  
Age: 14.0  
Sex: Male  
Location: Alabama  
Vaccinated:1995-12-15
Onset:1995-12-22
   Days after vaccination:7
Submitted: 1995-12-24
   Days after onset:2
Entered: 1996-01-03
   Days after submission:10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
CHOL: CHOLERA (USP) / WYETH PHARMACEUTICALS, INC 4958031 / 0 LA / SC
FLU: INFLUENZA (SEASONAL) (FLUSHIELD 95-96) / WYETH PHARMACEUTICALS, INC 4958114 / 0 RA / IM
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 165A2 / 0 LA / IM
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI) / CONNAUGHT LABORATORIES K1160 / 0 RA / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Convulsion, Encephalopathy, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (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:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CT neg, LP neg
CDC Split Type: AL9539

Write-up: 22DEC95 fever x 12k; 28DEC95 sz 9PM-fever encephalopathy


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