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From the 12/31/2003 release of VAERS data (an older release, current is 1/15/2021):

This is VAERS ID 46528

Case Details

VAERS ID: 46528 (history)  
Form: Version .0  
Age: 94.0  
Sex: Female  
Location: Michigan  
Vaccinated:1992-10-06
Onset:1992-10-07
   Days after vaccination:1
Submitted: 1992-10-13
   Days after onset:6
Entered: 1992-10-30
   Days after submission:17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1992-1993 / WYETH - / - - / -

Administered by: Other       Purchased by: Unknown
Symptoms: FEVER, FIBRILLAT ATR, HALLUCIN, HERPES ZOSTER, HYPERTENS
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt recvd flu vax the next evening devel a rash & some blisters on breasts & back; dx w/herpes zoster; tx Zovirax & DPH; also exp inc BP & hallucinations; adm to hosp 12OCT92;


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=46528


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