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

This is VAERS ID 79959

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Case Details

VAERS ID: 79959 (history)  
Form: Version 1.0  
Age: 49.0  
Sex: Male  
Location: California  
Vaccinated:1995-12-01
Onset:1995-12-02
   Days after vaccination:1
Submitted: 1995-12-06
   Days after onset:4
Entered: 1995-12-11
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DT: DT ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 5H71003 / 2 RA / IM
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA467A6 / 1 LA / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0720H / UNK MO / PO

Administered by: Private       Purchased by: Private
Symptoms: Hypokinesia, Oedema peripheral, Pain, Vasodilatation
SMQs:, Cardiac failure (broad), Angioedema (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: PCN
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: pt states on Saturday morning devel redness, pain & swelling in the rt arm & rt axilla p/DT inj on friday, states it was difficult to move rt arm d/t pain & swelling;pt reported this to MD''s office on 4DEC; MD advised pt to be seen;


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