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

This is VAERS ID 44800

Case Details

VAERS ID:	44800 (history)
Form:	Version .0
Age:	40.3
Sex:	Female
Location:	Massachusetts

Vaccinated:	1991-11-21
Onset:	1991-12-01
Days after vaccination:	10
Submitted:	1992-09-06
Days after onset:	279
Entered:	1992-09-14
Days after submission:	8

Vaccination / Manufacturer	Lot / Dose	Site / Route
FLU: INFLUENZA VACCINE 1991-1992 / WYETH	4918152 / 0	A / IM
IPV: IPV / MERIEUX INST	C1150 / 0	A / SC
MEN: MENOMUNE A/C/Y/W / CONNAUGHT LABS	0M21074 / 0	A / SC

Administered by: Private Purchased by: Unknown
Symptoms: CHORIORETINITIS, CONJUNCTIVITIS, NEURITIS OPTIC, PHOTOPHOBIA, PUPIL DIS
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
Extended hospital stay? No
Previous Vaccinations: NONE
Other Medications: NONE prior to onset began Nafaralin 1DEc & 14DEc d/c
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: inflammation resolved showed multiple bilat retinal defects;
CDC Split Type: NONE

Write-up: 1DEC91 h/a, photophobia; 7DEC91 paralysis of rt pupil, adie''s pupil; pt seen in ER for unequal pupils to r/o aneurysm; inc chemosis; 20DEC91 impaired central vision, bilat, retinas showed mutiple serous detachments, bilat opic disc edema;

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