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From the 9/10/2021 release of VAERS data:

This is VAERS ID 90643



Case Details

VAERS ID: 90643 (history)  
Form: Version 1.0  
Age: 47.0  
Sex: Female  
Location: Kentucky  
Vaccinated:1996-10-09
Onset:1996-10-09
   Days after vaccination:0
Submitted: 1996-10-10
   Days after onset:1
Entered: 1996-10-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Private       Purchased by: Private
Symptoms: Asthenia, Chills, Insomnia, Myalgia, Pyrexia, Somnolence
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Estrogen Transdermal
Current Illness: NONE
Preexisting Conditions: codeine allergy
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: chills, temp, muscle ache, up all noc, lethargic & drained;


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=90643


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