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From the 12/31/2003 release of VAERS data (an older release, current is 1/7/2022):

This is VAERS ID 81035

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Case Details

VAERS ID: 81035 (history)  
Form: Version .0  
Age: 66.0  
Sex: Female  
Location: Texas  
Vaccinated:1995-08-23
Onset:1995-08-26
   Days after vaccination:3
Submitted: 1995-12-06
   Days after onset:102
Entered: 1996-01-24
   Days after submission:49
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HAVRIX / SMITHKLINE - / 0 A / IM

Administered by: Other       Purchased by: Unknown
Symptoms: PAIN
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: breast cancer surgeries, elev sugar, pacemaker
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: pt recvd vax & began to feel achy 3 days p/ vax;


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=81035


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