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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 81036

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Case Details

VAERS ID: 81036 (history)  
Form: Version .0  
Age: 38.0  
Sex: Male  
Location: Ohio  
Vaccinated:1995-08-08
Onset:1995-08-25
   Days after vaccination:17
Submitted: 1995-09-07
   Days after onset:13
Entered: 1996-01-24
   Days after submission:139
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HAVRIX / SMITHKLINE VHA426A6 / 0 LA / IM

Administered by: Other       Purchased by: Unknown
Symptoms: BILIRUBINEM, LIVER FUNC ABNORM, PHARYNGITIS, SGOT INC, SGPT INC
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: SGOT elev, GGTP elev; BILTOT elev;
CDC Split Type:

Write-up: pt recvd vax; exp elev LFTs & pharyngitis;


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