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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 84798



Case Details

VAERS ID: 84798 (history)  
Form: Version .0  
Age: 42.6  
Sex: Female  
Location: Massachusetts  
Vaccinated:1992-10-01
Onset:1992-10-01
   Days after vaccination:0
Submitted: 1996-04-09
   Days after onset:1286
Entered: 1996-04-17
   Days after submission:8
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: UNK. INFLUENZA VACCINE / UNCLASSIFIED - / - RA / -

Administered by: Public       Purchased by: Unknown
Symptoms: ARTHRALGIA, EDEMA PERIPH, EXTRAPYR SYND, HYPOKINESIA, JOINT DIS
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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CT scan & MRI both of head were neg;
CDC Split Type: NONE

Write-up: flu shot given OCT92 in rt arm;pt had intermittent pain in muscle for about 1yr;during that time rt arm, hand & shoulder deteriorated to point of diminished functioning;pt had Physical therapy & occupational therapy;lost use of arm and hand


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=84798

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