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From the 12/31/2003 release of VAERS data (an older release, current is 1/7/2021):

This is VAERS ID 40946

Case Details

VAERS ID: 40946 (history)  
Form: Version .0  
Age: 72.8  
Sex: Male  
Location: Maryland  
Vaccinated:1991-10-22
Onset:1991-10-25
   Days after vaccination:3
Submitted: 1992-03-11
   Days after onset:138
Entered: 1992-04-03
   Days after submission:23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1991-1992 / WYETH 4918151 / 0 LA / IM

Administered by: Public       Purchased by: Unknown
Symptoms: PAIN INJECT SITE
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: bladder cancer
Preexisting Conditions: bladder cancer
Allergies:
Diagnostic Lab Data: x-ray of arm; no fracture 3FEB92;
CDC Split Type:

Write-up: Pt c/o onset of continuous pain in arm @ site of inject;


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=40946


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