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From the 1/14/2022 release of VAERS data:

This is VAERS ID 195704

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Case Details

VAERS ID: 195704 (history)  
Form: Version 1.0  
Age: 62.0  
Sex: Male  
Location: New York  
Vaccinated:2002-11-25
Onset:2002-11-25
   Days after vaccination:0
Submitted: 2002-12-19
   Days after onset:24
Entered: 2003-01-02
   Days after submission:14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR 40956AA / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Conjunctival haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Conjunctival disorders (narrow)

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: NONE
Current Illness:
Preexisting Conditions: Hearing loss October 2002. Otherwise reportedly healthy male. No allergies reported. Social history unavailable.
Allergies:
Diagnostic Lab Data: Patient was told to report to eye clinic for evaluation on 11/27/02 but lost to follow up.
CDC Split Type:

Write-up: Patient developed right subconjuctival hemorrhage 3 hours after receiving vaccine. Patient reportedly received no other medication prior to event. Patient was given artificial tears to keep eyes moist. 60 day follwow up states assume yes that pt has recovered.


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