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From the 5/7/2021 release of VAERS data (an older release, current is 10/8/2021):

This is VAERS ID 105113



Case Details

VAERS ID: 105113 (history)  
Form: Version 1.0  
Age:   
Sex: Male  
Location: Florida  
Vaccinated:1993-11-25
Onset:0000-00-00
Submitted: 1997-11-03
Entered: 1997-11-25
   Days after submission:22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / MEDEVA PHARMA, LTD. E2253HA / UNK - / IM

Administered by: Other       Purchased by: Other
Symptoms: Asthenia, Condition aggravated, Coordination abnormal, Guillain-Barre syndrome, Personality disorder
SMQs:, Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Demyelination (narrow), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (narrow)

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? Yes, 90 days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness: unk
Preexisting Conditions: this plaintiff may have had a prev episode of GBS
Allergies:
Diagnostic Lab Data:
CDC Split Type: 897308014L

Write-up: pt alleges devel GBS & suffered an aggravation of a pre-existing disease or condition;hosp for 3mo;month which was spent in ICU;22OCT96 has not recovered balance & strength;severe psychological problems which has drastically curtailed work


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20210507&IDNUMBER=105113

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