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From the 12/24/2020 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 1.0  
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), Immune-mediated/autoimmune disorders (narrow)

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: ~ ()~~~In patient
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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