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From the 10/15/2021 release of VAERS data:

This is VAERS ID 28362



Case Details

VAERS ID: 28362 (history)  
Form: Version 1.0  
Age: 77.0  
Sex: Male  
Location: California  
Vaccinated:1990-11-08
Onset:1990-11-18
   Days after vaccination:10
Submitted: 1991-01-25
   Days after onset:68
Entered: 1991-02-18
   Days after submission:24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11203 / 1 LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 285909 / 1 RA / SC

Administered by: Public       Purchased by: Public
Symptoms: Arthralgia, Cough, Gait disturbance, Headache, Influenza, Pain, Pharyngitis, Rhinitis
SMQs:, Anaphylactic reaction (broad), Agranulocytosis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal infections (narrow), Guillain-Barre syndrome (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: none~ ()~~~In patient
Other Medications: none
Current Illness: none
Preexisting Conditions: hx of prostate CA
Allergies:
Diagnostic Lab Data: xray hip-showed arthritis
CDC Split Type: CA9118

Write-up: 8-10 days /p vax pt felt cold sxss, sneezing,"sick all over",10 days /p that aching in lt arm &rt hip.2 wks later aching in lt hip &rt arm, ache cont''s, difficult to raise arm &walk, Seen by MD TX:Cortisone & meds, Still has cold


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=28362

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