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From the 12/31/2003 release of VAERS data (an older release, current is 10/15/2021):

This is VAERS ID 27318



Case Details

VAERS ID: 27318 (history)  
Form: Version .0  
Age: 38.7  
Sex: Male  
Location: Illinois  
Vaccinated:1990-11-15
Onset:1990-11-22
   Days after vaccination:7
Submitted: 1990-12-19
   Days after onset:27
Entered: 1991-01-09
   Days after submission:21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1990-1991 TYPES A&B WYETH / WYETH 4908194 / - A / IM

Administered by: Private       Purchased by: Unknown
Symptoms: ASTHENIA, FEVER, LAB TEST ABNORM, MYALGIA, PAIN
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:
Allergies:
Diagnostic Lab Data: SGOT rose to 191 but fell to 36. SGPT rose to 433 but fell to 97 by 17DEC. Hepatitis C. Antibody positive.
CDC Split Type:

Write-up: Pt vaccinated with INFLUENZA developed fever, myalgias, fatigue, pain in the rt arm which later migrated to lt arm. Paresthesias developed in rt hand & rt arm weakness. Symptoms have gradually improved has mild pain.


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=27318

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