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From the 12/14/2016 release of VAERS data (an older release, current is 10/8/2021):

This is VAERS ID 27302

Case Details

VAERS ID: 27302 (history)  
Form: Version .0  
Age: 66.0  
Sex: Female  
Location: Illinois  
   Days after vaccination:18
Submitted: 1990-12-06
   Days after onset:752
Entered: 1991-01-04
   Days after submission:29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Public       Purchased by: Unknown
Symptoms: Myalgia, Myasthenic syndrome, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Malignancy related conditions (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

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? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Polymyalgia Rehumatica
Preexisting Conditions: Polymyalgia Rheumatica
Diagnostic Lab Data: chest x-ray - Normal, no malignancy; Breast Exam: no malignancy; Sed rate: 75 (NL = 0-20 MM/1HR.) Nomocytic Anemia (MCHC):11.5 gms
CDC Split Type: 890341001B

Write-up: Pt vaccinated w/Influenza developed aggravation reaction. This involved exacerbation of her polymyalgia rheumatica. Admitted to hosp w/severe painful weakness in her proximal muscles. Given steroidal therapy approx six months later, weaned.

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