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From the 11/26/2021 release of VAERS data:

This is VAERS ID 79876

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Case Details

VAERS ID: 79876 (history)  
Form: Version 1.0  
Age: 6.0  
Sex: Female  
Location: Ohio  
Vaccinated:1995-11-20
Onset:0000-00-00
Submitted: 1995-11-29
Entered: 1995-12-08
   Days after submission:9
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 165A2 / 1 LA / IM
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME) / PFIZER/WYETH 4940176 / 2 RA / SC

Administered by: Public       Purchased by: Unknown
Symptoms: Convulsion, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

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:
CDC Split Type:

Write-up: pt recvd vax & exp sz & passed out;


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