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From the 9/17/2021 release of VAERS data:

This is VAERS ID 27292



Case Details

VAERS ID: 27292 (history)  
Form: Version 1.0  
Age: 79.0  
Sex: Male  
Location: Ohio  
Vaccinated:1990-11-07
Onset:1990-11-09
   Days after vaccination:2
Submitted: 1990-11-16
   Days after onset:7
Entered: 1991-01-04
   Days after submission:49
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES OF11222 / UNK - / -

Administered by: Public       Purchased by: Public
Symptoms: Amblyopia, Dyspnoea, Dysuria, Face oedema
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Ru-tuss
Current Illness:
Preexisting Conditions: allergies to antihistamines
Allergies:
Diagnostic Lab Data:
CDC Split Type: OH9057

Write-up: Pt vaccinated with Influenza wife stated that her husband is allergic to antihistamines. He took the RU-Tuss from about 9NOV90 t6rough 13NOV90 symptoms were; SOB, swelling around the eyes, blurred vision & difficulty urinating.


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