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From the 12/24/2020 release of VAERS data (an older release, current is 9/10/2021):

This is VAERS ID 27095



Case Details

VAERS ID: 27095 (history)  
Form: Version 1.0  
Age: 64.0  
Sex: Male  
Location: Oregon  
Vaccinated:1990-11-02
Onset:1990-12-10
   Days after vaccination:38
Submitted: 1990-12-14
   Days after onset:4
Entered: 1990-12-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908208 / UNK LA / IM

Administered by: Public       Purchased by: Other
Symptoms: Asthenia, Guillain-Barre syndrome
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow), 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: Ventolin, Synthroid, Mevacor
Current Illness: sick about 1 wk prior to onset of GBS
Preexisting Conditions: Hypothyroid, Asthma, Hyperlipidemia
Allergies:
Diagnostic Lab Data: nerve conduction studies slowing /w evidence of conduction block, CSF protein normal
CDC Split Type:

Write-up: Guillain Barre Synd-progressive quadriparesis onset of weakness on 10Dec90, had febrile illness 1 wk prior this /w nausea & diarrhea treated /w Augmentin for a lt lower lobe infiltrate on CXR


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20201224&IDNUMBER=27095


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