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From the 1/14/2022 release of VAERS data:

This is VAERS ID 95859

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Case Details

VAERS ID: 95859 (history)  
Form: Version 1.0  
Age: 67.0  
Sex: Male  
Location: Colorado  
   Days after vaccination:17
Submitted: 1997-03-12
   Days after onset:214
Entered: 1997-03-18
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Public       Purchased by: Private
Symptoms: Bradycardia, Coronary artery disease, Coronary artery occlusion, Hypokinesia, Hypotension, Myalgia, Red blood cell sedimentation rate increased, Vasculitis
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, arterial (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Other ischaemic heart disease (narrow), Vasculitis (narrow), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad), Dehydration (broad), Hypokalaemia (broad), Immune-mediated/autoimmune disorders (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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations: NA~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: Sed rate taken 3JAN97 27;sed rate retaken 20FEB97 now at 5;ultra sound NIVA arteries # hosp 8JAN97;
CDC Split Type:

Write-up: aches & pain in upper arm (muscle area) approx 10-15 days;aches & pain cont in arms (shoulder to hands) extend depends on exertion of arms;unable to get pulse or BP reading either arm;blockage determined in artery;vasculitis;

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