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From the 7/16/2021 release of VAERS data:

This is VAERS ID 69853

Case Details

VAERS ID: 69853 (history)  
Form: Version 1.0  
Age: 71.0  
Sex: Female  
Location: Massachusetts  
   Days after vaccination:1
Submitted: 1994-12-11
   Days after onset:39
Entered: 1994-12-27
   Days after submission:16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Unknown
Symptoms: Back pain, Deafness, Laryngitis, Myalgia, Pharyngitis, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Oropharyngeal infections (narrow), Eosinophilic pneumonia (broad), Hearing impairment (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: none;~ ()~~~In patient
Other Medications: ferrous sulfate;
Current Illness: none;
Preexisting Conditions: mild anemia;
Diagnostic Lab Data:
CDC Split Type:

Write-up: pt recvd vax;body aches for 2-3 wks (moving around esp in back); inc t then terrible sore throat x 1 wk then 1 wk of laryngitis & complete deafness;

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