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From the 10/8/2021 release of VAERS data:

This is VAERS ID 28403



Case Details

VAERS ID: 28403 (history)  
Form: Version 1.0  
Age: 60.0  
Sex: Male  
Location: Ohio  
Vaccinated:1990-11-29
Onset:1990-12-13
   Days after vaccination:14
Submitted: 1991-02-14
   Days after onset:63
Entered: 1991-02-22
   Days after submission:8
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11222 / UNK LA / -

Administered by: Public       Purchased by: Public
Symptoms: Conjunctivitis, Furuncle, Paraesthesia, Tenosynovitis
SMQs:, Severe cutaneous adverse reactions (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Conjunctival disorders (narrow), Ocular infections (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (narrow)

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: Metoprolol, nifidipine, isosorbib
Current Illness: NONE
Preexisting Conditions: heart condition, damaged getic nerve
Allergies:
Diagnostic Lab Data: Tendonitis
CDC Split Type: OH91011

Write-up: Numbness lt shoulder to finger tips- neck boil-like rt eye hot & like "hot oil".


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