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From the 1/14/2022 release of VAERS data:

This is VAERS ID 89769

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Case Details

VAERS ID: 89769 (history)  
Form: Version 1.0  
Age: 56.0  
Sex: Male  
Location: North Carolina  
Vaccinated:1996-05-01
Onset:1996-05-12
   Days after vaccination:11
Submitted: 1996-08-27
   Days after onset:107
Entered: 1996-09-10
   Days after submission:14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA488A6 / UNK - / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. L1108 / UNK - / IM
TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF) / BERNA BIOTECH, LTD. 1402116 / UNK MO / PO

Administered by: Private       Purchased by: Private
Symptoms: Bone disorder, Dermatitis bullous, Gait disturbance, Guillain-Barre syndrome, Hypokinesia, Laboratory test abnormal, Myasthenic syndrome, Vasodilatation
SMQs:, Severe cutaneous adverse reactions (narrow), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Malignancy related conditions (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (narrow), Demyelination (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Gamma GLobulin by Armour lot# P9101 given 1MAY96;
Current Illness: NONE
Preexisting Conditions: NKDA
Allergies:
Diagnostic Lab Data: CSF oligoclonal banding;EMG consistent w/GBS
CDC Split Type:

Write-up: 1MAY96 pt recv vax & devel blistered red spots on lt foot;12MAY96 diff carrying luggage & being slow-also having diff walking;to MD found multilevel degenerative spondylosis & herniated disc-did not improve w/surgery;EMG consistent w/GBS


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