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From the 7/7/2013 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: 1996-04-15
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - RA / -

Administered by: Public       Purchased by: Other
Symptoms: Arthralgia, Arthropathy, Extrapyramidal disorder, Hypokinesia, Myalgia, Oedema peripheral, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad)

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:

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=20130707&IDNUMBER=84798

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