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

This is VAERS ID 28575



Case Details

VAERS ID: 28575 (history)  
Form: Version 1.0  
Age: 71.0  
Sex: Male  
Location: Unknown  
Vaccinated:1989-09-18
Onset:1989-09-21
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 1991-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Eczema
SMQs:, Hypersensitivity (narrow)

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: Guarem, Atenol, Digoxin, Euglucon N, Diformin retard
Current Illness:
Preexisting Conditions: not available
Allergies:
Diagnostic Lab Data: not available
CDC Split Type: CO3375

Write-up: Ezema allergicum; No known egg allergy; Previous vaccinations w/Fluzone 2x in''86, 1x in ''87, 1x in"88;


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=28575

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