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From the 1/7/2022 release of VAERS data:

This is VAERS ID 195123

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Case Details

VAERS ID: 195123 (history)  
Form: Version 1.0  
Age: 82.0  
Sex: Female  
Location: North Carolina  
   Days after vaccination:0
Submitted: 2002-12-17
   Days after onset:33
Entered: 2002-12-18
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Unknown       Purchased by: Unknown
Symptoms: Arthralgia, Injection site pain, Joint range of motion decreased, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Joints in arm became really painful. Couldn''t move arm. Still has soreness where shot was given. *Follow-up report on 3/3/03: Still have pain in arm, especially where punctuated on the upper arm. Barely recovered. Still have some pain in shoulder. Same as when I received the shot last November. Received a flu shot now at doctor''s office and have had no pain whatsoever.

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