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From the 8/31/2010 release of VAERS data (an older release, current is 10/15/2021):

This is VAERS ID 27347

Case Details

VAERS ID: 27347 (history)  
Form: Version .0  
Age: 69.0  
Sex: Male  
Location: Illinois  
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 1991-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Unknown       Purchased by: Unknown
Symptoms: Petechiae, Stomatitis, Thrombocytopenia
SMQs:, Severe cutaneous adverse reactions (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Oropharyngeal lesions, non-neoplastic, non-infectious and non-allergic (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? No
Previous Vaccinations:
Other Medications: Mantle radiation.
Current Illness:
Preexisting Conditions: Stage I Hodgkin''s receiving mantle irradiation.
Diagnostic Lab Data: Platelet CT on 9NOV90 - 2000 per cubic millimeter
CDC Split Type: 904090010

Write-up: Pt vaccinated w/FLUOGEN developed thrombocytopenia & petechiae, sore mouth, CBC & platelet count revealed a platelet count of 2000 per cubic mm. Diffuse petechial hemorrhages. MD feel prob unrelated to the FLUOGEN to do bone marrow analysis

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