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From the 12/24/2020 release of VAERS data (an older release, current is 11/12/2021):

This is VAERS ID 28572

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Case Details

VAERS ID: 28572 (history)  
Form: Version 1.0  
Age: 52.0  
Sex: Female  
Location: Montana  
Vaccinated:0000-00-00
Onset:1990-11-14
Submitted: 0000-00-00
Entered: 1991-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0J11163 / UNK - / A

Administered by: Unknown       Purchased by: Unknown
Symptoms: Hypertonia, Oedema, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypokalaemia (broad)

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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: not available
Allergies:
Diagnostic Lab Data: not available
CDC Split Type: CO3723

Write-up: Arm hot to touch, muscle stiffness & swelling; No tx to date; Had flu shot 5 yrs ago w/similar rxn; Pt stated she could not raise her arm laterally for over a year;


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