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From the 6/14/2018 release of VAERS data (an older release, current is 1/7/2022):

This is VAERS ID 29149

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Case Details

VAERS ID: 29149 (history)  
Form: Version 1.0  
Age: 47.0  
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: 1991-03-15
   Days after submission:107
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908211 / 2 LA / IM

Administered by: Public       Purchased by: Public
Symptoms: Chest pain, Cough, Nausea, Rhinitis
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)

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~ ()~~~In patient
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: MN90001

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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