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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 168021

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Case Details

VAERS ID: 168021 (history)  
Form: Version .0  
Age: 53.0  
Sex: Male  
Location: West Virginia  
Vaccinated:2001-01-05
Onset:2001-01-05
   Days after vaccination:0
Submitted: 2001-03-07
   Days after onset:61
Entered: 2001-04-03
   Days after submission:26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (FLUSHIELD 00-01) / WYETH 4008181 / 0 LA / IM

Administered by: Other       Purchased by: Unknown
Symptoms: BLIND
SMQs:

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

Write-up: Lost sight in left eye.


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=168021


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