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From the 12/31/2003 release of VAERS data (an older release, current is 9/10/2021):

This is VAERS ID 71379



Case Details

VAERS ID: 71379 (history)  
Form: Version .0  
Age: 37.6  
Sex: Female  
Location: California  
Vaccinated:1994-11-08
Onset:1994-12-14
   Days after vaccination:36
Submitted: 1995-01-24
   Days after onset:41
Entered: 1995-02-14
   Days after submission:21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUSHIELD 1994-1995 / WYETH 4948195 / - LA / IM

Administered by: Private       Purchased by: Unknown
Symptoms: AMBLYOPIA, CSF ABNORM, LYMPHADENO, MENINGITIS, MYALGIA
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt 20-30 years old had photophobia p/measles vax;
Other Medications: none
Current Illness: unk
Preexisting Conditions: asthma--stable;
Allergies:
Diagnostic Lab Data: MRI nl; LP white cells in CSF, ""suggestive of meningitis""; visual field testing--unspecified visual field defect;
CDC Split Type: asthma--stable;

Write-up: pt recvd vax;devel fever 101;myalgia,ha & noc sweats;stiff neck,swollen glands lt axilla;4th wk began to abate,devel pain over both eyes;c/o blurred vision,saw ophtalmologist who saw a ""central blind spot in rt eye"" dx:papilledema,cause vax


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