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From the 9/17/2021 release of VAERS data:

This is VAERS ID 91307



Case Details

VAERS ID: 91307 (history)  
Form: Version 1.0  
Age: 42.0  
Sex: Female  
Location: New Jersey  
Vaccinated:1996-10-15
Onset:1996-10-17
   Days after vaccination:2
Submitted: 1996-10-19
   Days after onset:2
Entered: 1996-10-22
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Other       Purchased by: Public
Symptoms: Injection site oedema, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Prozac
Current Illness: NONE
Preexisting Conditions: pollen-fragile X synd
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: pt exp swelling @ inj site, warm @ inj site;pt perm disabled w/fragile x synd;


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