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

This is VAERS ID 79971

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Case Details

VAERS ID: 79971 (history)  
Form: Version 1.0  
Age: 30.0  
Sex: Female  
Location: California  
Vaccinated:1995-08-30
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 1995-12-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA429A6 / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Macrodantin, Triphasil
Current Illness:
Preexisting Conditions: allergy to PCN & sulfa
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 30AUG95 pt recvd vax & about 5PM that evening had a nap gen itching noticed hives next morning on lt & rt elbow & lt & rt upper thigh;hives lasted til 5SEP when they completely disappeared;hives were localized to areas described above;


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