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From the 9/10/2021 release of VAERS data:

This is VAERS ID 27196



Case Details

VAERS ID: 27196 (history)  
Form: Version 1.0  
Age: 62.0  
Sex: Female  
Location: California  
Vaccinated:1990-11-29
Onset:1990-11-30
   Days after vaccination:1
Submitted: 1990-12-04
   Days after onset:4
Entered: 1990-12-26
   Days after submission:22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH OF11203 / UNK LA / IM

Administered by: Public       Purchased by: Public
Symptoms: Headache, Nausea, Pain
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Premarin, Thyroid, Septra, Micro-K, hydorchlorothiazide
Current Illness:
Preexisting Conditions: Sensitivity to anti-inflamatories, hayfever, variable hypertension
Allergies:
Diagnostic Lab Data:
CDC Split Type: CA9020

Write-up: Pt vaccinated with FLU: developed lft sore arm 2 days following immun.; had nausea for 2 days follwing flu shot; intermittent sharp pains in lft temple began 11/30 kept patient awake and lasted until 12/3/90. Consulted w/ PMD by telephone.


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