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From the 12/8/2009 release of VAERS data (an older release, current is 11/12/2021):

This is VAERS ID 134075

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Case Details

VAERS ID: 134075 (history)  
Form: Version .0  
Age: 47.0  
Sex: Female  
Location: Missouri  
Vaccinated:1999-11-02
Onset:1999-11-05
   Days after vaccination:3
Submitted: 2000-02-07
   Days after onset:94
Entered: 2000-02-16
   Days after submission:9
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE 99-00) / CONNAUGHT LABORATORIES U0163AA / 3 RA / IM

Administered by: Public       Purchased by: Public
Symptoms: Arthralgia, Oedema peripheral, Rash
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (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? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: tested for lupus, lyme, etc
CDC Split Type:

Write-up: 1 wk following vax, pt dvlped rash & was dxed w/ poison ivy. 2 wks following vax, pt dvlped pain in joints; tx w/ Celebrex & cortisone. On 11/18, pain was so bad & hands were swollen that pt went to ER.Tx w/ Tylenol w/ codeine.


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20091208&IDNUMBER=134075


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