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From the 8/31/2010 release of VAERS data (an older release, current is 11/26/2021):

This is VAERS ID 27078

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Case Details

VAERS ID: 27078 (history)  
Form: Version .0  
Age: 67.3  
Sex: Male  
Location: Oklahoma  
Vaccinated:1990-11-13
Onset:1990-11-13
   Days after vaccination:0
Submitted: 1990-11-15
   Days after onset:2
Entered: 1990-12-17
   Days after submission:32
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11217 / - LA / IM
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES 253978 / 0 RA / IM

Administered by: Public       Purchased by: Public
Symptoms: Arthralgia, Vasodilatation
SMQs:

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:
Other Medications:
Current Illness:
Preexisting Conditions: has only one kidney
Allergies:
Diagnostic Lab Data:
CDC Split Type: OK903

Write-up: felt hot, arthralgia


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