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From the 12/31/2003 release of VAERS data (an older release, current is 1/7/2021):

This is VAERS ID 46496

Case Details

VAERS ID: 46496 (history)  
Form: Version .0  
Age: 82.5  
Sex: Female  
Location: Hawaii  
Vaccinated:1991-11-13
Onset:1992-01-13
   Days after vaccination:61
Submitted: 1992-07-10
   Days after onset:178
Entered: 1992-10-29
   Days after submission:111
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1991-1992 / PARKE-DAVIS 148P / - - / -
PPV: PNU-IMUNE(R)23 / LEDERLE 314914 / - - / -

Administered by: Public       Purchased by: Unknown
Symptoms: MYALGIA
SMQs:

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: NONE
Other Medications: Dioxin, Baby ASA, Seldane, Maxide, Potassium, Premarin
Current Illness: NONE
Preexisting Conditions: arthritis, diverticulitis
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type: arthritis, diverticulitis

Write-up: aching in rt arm began 2 mons p/vax recvd, & still aches @ noc, p/writing/baking; hx of arthritis, rx past 10 yrs Seldane ""this is not an arthritis-like pain;


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=46496


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