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From the 6/14/2018 release of VAERS data (an older release, current is 10/8/2021):

This is VAERS ID 105751



Case Details

VAERS ID: 105751 (history)  
Form: Version 1.0  
Age: 34.0  
Sex: Female  
Location: California  
Vaccinated:1995-10-03
Onset:1995-10-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 1997-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61113 / 3 LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Condition aggravated, Laboratory test abnormal, Malaise, Myasthenic syndrome, Paraesthesia, Rheumatoid arthritis, Tenosynovitis, Thrombocytopenia
SMQs:, Haematopoietic thrombocytopenia (narrow), Peripheral neuropathy (broad), Systemic lupus erythematosus (broad), Malignancy related conditions (narrow), Guillain-Barre syndrome (broad), Arthritis (narrow), Tendinopathies and ligament disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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:
Current Illness: NONE
Preexisting Conditions: rheumatoid arthritis;
Allergies:
Diagnostic Lab Data: low blood platelets;elevated rheumatoid factor;carpal tunnel synd
CDC Split Type:

Write-up: muscle fatigue/overall malaise poss rheumatoid arthritis recently dx;


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20180614&IDNUMBER=105751

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