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From the 5/7/2021 release of VAERS data (an older release, current is 10/8/2021):

This is VAERS ID 27317



Case Details

VAERS ID: 27317 (history)  
Form: Version 1.0  
Age: 42.0  
Sex: Female  
Location: Florida  
Vaccinated:1990-10-03
Onset:1990-10-04
   Days after vaccination:1
Submitted: 1990-12-14
   Days after onset:71
Entered: 1991-01-07
   Days after submission:24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02580P / UNK LA / IM

Administered by: Public       Purchased by: Public
Symptoms: Arthralgia, Headache, Neck pain, Osteoarthritis, Pain, Paraesthesia, Pyrexia, Visual field defect
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Optic nerve disorders (broad), Retinal disorders (broad), Arthritis (narrow), 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:
Allergies:
Diagnostic Lab Data:
CDC Split Type: FL9007

Write-up: Pt vaccinated w/FLUOGEN developed joint pain, rash arms, tingling in arms, rt shoulder pain, joints of fingers swollen (no pain), neck sore, numbness of fingers, difficulty in moving wrist, narrowing of visual field, fever, headache.


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20210507&IDNUMBER=27317

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