A report was received on 10/2/02, concerning a 50 year old female pt who experienced capsulitis of the shoulder and a small sensitive lump in the armpit after receiving Fluvirin vaccine in November 2001. On an unknown date, the pt initially complained that the right arm at injection site was tender several weeks after receiving Fluvirin in November 001. On an unknown date, a small sensitive lump developed in the right armpit. More recently, the pt complained of restricted movement in the right arm and in September 2002 approximately the pt was diagnosed with capsulitis of the shoulder. At the time of reporting the pt had not recovered and was receiving physiotherapy. There was insufficient info to determine the reporter's causality assessment. Follow up on 02/12/2003: "Follow up report was received from a health care professional, concerning a 52 year old vaccinee which stated that the vaccines had no history of trauma.  Within 24 hours of receiving the vaccination there was pain at the site of the injection and the vaccinee had an inability to throw objects.  There were small painful lumps in the right armpit.  Over 10 months there was increasing severity of pain, which the reporter considered to be temporarily disabling.  The pain increased particularly when the muscle was jarred and used as in, for example, attempting to throw or in chopping actions.  There was periodic throbbing pain, which was apparently spontaneous.  The vaccinee experienced sleep disturbance due to pressure on the upper arm when lying on the right side.  There was increasing, though not very severe, loss of power in the arm.  there were increasing difficulties over 10 months with the shoulder, although the reporter was unsure if this was directly related as the vaccinee had had a history of difficulties with the other shoulder.  Examination of the vaccinee on 09/16/2002, showed there was limitation of abduction of the right shoulder to 70 and some limitation of external rotation, other movements were normal.  The health care professional felt that this indicated a degree of capsulitis resulting from a chronic painful shoulder which had stiffened up because it was not being used due to pain.  It was presumed the injection was the cause of that pain, which may have become self-perpetuating as the shoulder stiffened up.  The health care professional did not feel that the vaccine would have had a direct toxic effect on the joint capsule, as the injection would have been administered in the muscle some distance from the capsule.  On 12/01/2002, the vaccinee was still unable to throw, although the pain had lessened.  There was a small indentation in the upper arm at the injection site and the vaccinee experienced sensitivity in this immediate area.  The shoulder pain and range of movement had improved due to targeted exercise.  On 01/22/2003 the vaccinee's condition had improved greatly, and her recovered almost 90% of the range of movement.  The vaccinee was still unable to throw objects without pain, but this pain was less.  There was no loss of power to the arm.  The vaccinee received a tetanus booster (brand unspecified) in 2001 and 2 hepatitis B vaccinations, one in December 2001 and the other in May 2002.