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From the 12/31/2003 release of VAERS data (an older release, current is 10/15/2021):

This is VAERS ID 27204



Case Details

VAERS ID: 27204 (history)  
Form: Version .0  
Age: 58.0  
Sex: Male  
Location: Florida  
Vaccinated:1990-10-30
Onset:1990-11-01
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 1991-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLU-IMUNE 1990-1991 LEDERLE / LEDERLE 287973 / - - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: APNEA, ASTHENIA, DYSPHAGIA, DYSPNEA, GUILLAIN BARRE SYND
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Following vax 62 yo male c/o weakness & difficulty swallowing&talking came to ER-hospitalized for 8 days Developed quadriplegia & resp difficulty,15Nov resp arrest. preliminary DX was Guillian Barre Synd.Final DX: GBS & resp failure


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=27204

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