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From the 2/14/2017 release of VAERS data (an older release, current is 9/17/2021):

This is VAERS ID 27077



Case Details

VAERS ID: 27077 (history)  
Form: Version .0  
Age: 57.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:1990-11-08
Onset:1990-11-09
   Days after vaccination:1
Submitted: 1990-11-10
   Days after onset:1
Entered: 1990-12-17
   Days after submission:37
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11227 / - LA / IM

Administered by: Public       Purchased by: Public
Symptoms: Injection site reaction
SMQs:

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:
Other Medications: antibiotics
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: OK902

Write-up: local rxn


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20170214&IDNUMBER=27077


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