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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 100352



Case Details

VAERS ID: 100352 (history)  
Form: Version .0  
Age: 63.2  
Sex: Female  
Location: Florida  
Vaccinated:1994-09-29
Onset:1994-09-30
   Days after vaccination:1
Submitted: 1997-07-03
   Days after onset:1007
Entered: 1997-07-22
   Days after submission:19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1994-1995 / PARKE-DAVIS - / 1 - / -

Administered by: Private       Purchased by: Unknown
Symptoms: MYELITIS, NEUROPATHY, PARALYSIS
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:
Other Medications: unk
Current Illness: unk
Preexisting Conditions: hx of non-insulin dependent diabetes mellitus, hypothyroidism, chronic back pain synd, prev flu vax 6NOV92;
Allergies:
Diagnostic Lab Data: 12OCT96 EMG
CDC Split Type:

Write-up: pt recv vax & exp transverse myelitis p''/vax;pt has not yet recovered, sx still persits;vax given 29SEP94;pt still exp transverse myelitis on 13OCT94;EMG performed on 12OCT96;3JUL97 related that became paralyzed p/vax;


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=100352

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