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From the 2/14/2017 release of VAERS data (an older release, current is 11/26/2021):

This is VAERS ID 27825

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Case Details

VAERS ID: 27825 (history)  
Form: Version .0  
Age: 28.0  
Sex: Female  
Location: Georgia  
Vaccinated:1990-11-05
Onset:1990-11-05
   Days after vaccination:0
Submitted: 1990-11-07
   Days after onset:2
Entered: 1991-02-08
   Days after submission:93
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908212 / - A / IM

Administered by: Other       Purchased by: Private
Symptoms: Headache, Injection site pain, Injection site reaction, Malaise, Pharyngitis, Rhinitis
SMQs:, Agranulocytosis (broad), Oropharyngeal infections (narrow), Extravasation events (injections, infusions and implants) (broad), 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? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Developed Pain & swelling @ inject site; headache; sore throat; malaise; rhinitis.


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20170214&IDNUMBER=27825


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