From the 6/14/2018 release of VAERS data (an older release, current is 1/7/2021):

This is VAERS ID 26605

Case Details

VAERS ID:	26605 (history)
Form:	Version 1.0
Age:	75.0
Sex:	Male
Location:	Virginia

Vaccinated:	1990-10-30
Onset:	1990-10-30
Days after vaccination:	0
Submitted:	1990-11-01
Days after onset:	2
Entered:	1990-11-09
Days after submission:	8

Vaccination / Manufacturer	Lot / Dose	Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES	OF11200 / UNK	RA / IM

Administered by: Private Purchased by: Private
Symptoms: Chills, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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:
Current Illness:
Preexisting Conditions: Diabetes
Allergies:
Diagnostic Lab Data: WBC 9000; BS 370; UA - negative
CDC Split Type:

Write-up: Pt vaccinated with Influenza vaccine developed temp 103; chills, Seen in ER that PM given Tylenol and labs done.

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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20180614&IDNUMBER=26605