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From the 5/7/2021 release of VAERS data (an older release, current is 11/26/2021):

This is VAERS ID 28570

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Case Details

VAERS ID: 28570 (history)  
Form: Version 1.0  
Age: 8.0  
Sex: Unknown  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:1990-11-21
Submitted: 0000-00-00
Entered: 1991-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES - / UNK - / -

Administered by: Private       Purchased by: Private
Symptoms: Abnormal dreams, Hallucination
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad)

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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: asthmatic
Allergies:
Diagnostic Lab Data:
CDC Split Type: CO3716

Write-up: Hallucinations & night terrors in asthmatic;


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20210507&IDNUMBER=28570


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