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From the 12/31/2003 release of VAERS data (an older release, current is 1/7/2022):

This is VAERS ID 29121

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Case Details

VAERS ID: 29121 (history)  
Form: Version .0  
Age: 75.5  
Sex: Male  
Location: Oregon  
Vaccinated:1990-10-01
Onset:0000-00-00
Submitted: 1991-03-04
Entered: 1991-03-18
   Days after submission:14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1990-1991 TYPES A&B WYETH / WYETH - / 0 A / -

Administered by: Private       Purchased by: Unknown
Symptoms: PAROSMIA, TASTE LOSS
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: Amoxicillin; Phenergan w/cod
Current Illness: NONE
Preexisting Conditions: Hx of allergic rhinitis
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: Loss of sense of taste & smell.


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