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From the 11/12/2021 release of VAERS data:

This is VAERS ID 81055

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Case Details

VAERS ID: 81055 (history)  
Form: Version 1.0  
Age: 16.0  
Sex: Male  
Location: Nebraska  
Vaccinated:1995-10-11
Onset:1995-10-11
   Days after vaccination:0
Submitted: 1995-10-19
   Days after onset:8
Entered: 1996-01-03
   Days after submission:76
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA460A6 / 1 - / IM

Administered by: Private       Purchased by: Other
Symptoms: Dyspnoea, Malaise, Respiratory disorder
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Respiratory failure (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: tuberculin tine
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 950109231

Write-up: pt recvd vax 3-4 hrs later felt funny & could get a super deep breath; 3 hrs later seen by MD;dx as resp react; tx w/ dph & poss epi;resolved w/in 48 hrs;


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