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From the 12/31/2003 release of VAERS data (an older release, current is 10/8/2021):

This is VAERS ID 27346



Case Details

VAERS ID: 27346 (history)  
Form: Version .0  
Age: 76.6  
Sex: Female  
Location: Michigan  
Vaccinated:1990-11-09
Onset:1990-11-09
   Days after vaccination:0
Submitted: 1991-01-02
   Days after onset:54
Entered: 1991-01-10
   Days after submission:8
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1990-1991 PARKE-DAVIS / PARKE-DAVIS 02070P / - RA / -

Administered by: Private       Purchased by: Unknown
Symptoms: ASTHENIA, INJECT SITE REACT, MYALGIA
SMQs:

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? No
Previous Vaccinations:
Other Medications: Synthroid
Current Illness:
Preexisting Conditions: hypothyroid
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt vaccinated with FLU developed persistent muscle aches, weakness at inject site. Lasting 2 months now - no other hx of injury of other arthritic/rheumatic symptoms.


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=27346

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