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From the 12/31/2003 release of VAERS data (an older release, current is 1/14/2022):

This is VAERS ID 29149

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Case Details

VAERS ID: 29149 (history)  
Form: Version .0  
Age: 47.9  
Sex: Female  
Location: Minnesota  
Vaccinated:1990-10-26
Onset:1990-10-26
   Days after vaccination:0
Submitted: 1990-11-28
   Days after onset:33
Entered: 1991-03-19
   Days after submission:111
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1990-1991 TYPES A&B WYETH / WYETH 4908211 / 1 LA / IM

Administered by: Public       Purchased by: Unknown
Symptoms: COUGH INC, NAUSEA, PAIN CHEST, RHINITIS
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: In pt; chills, nausea; 35yo; influenza; #1
Other Medications: Synthroid
Current Illness: headache, sinus problem
Preexisting Conditions: thyroid condition, previous histoplasmosis; no egg allergy
Allergies:
Diagnostic Lab Data: MD did throat culture, CBC
CDC Split Type: thyroid condition, previous histoplasmosis; no egg allergy

Write-up: Tightness in chest 10 min p/immun, lasted few min; nausea 90 min; congestion, cough 3 days; pt says still has nausea, cough, & congestion 4 1/2 wks later. No tx initiated @ either of 2 MD visits.


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