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From the 12/8/2009 release of VAERS data (an older release, current is 1/7/2021):

This is VAERS ID 48049

Case Details

VAERS ID: 48049 (history)  
Form: Version .0  
Age: 84.6  
Sex: Female  
Location: New York  
Vaccinated:1992-10-22
Onset:1992-10-22
   Days after vaccination:0
Submitted: 1992-10-23
   Days after onset:1
Entered: 1992-12-14
   Days after submission:52
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME, 92-93) / WYETH PHARMACEUTICALS, INC 4928241 / 5 LA / -

Administered by: Public       Purchased by: Public
Symptoms: Cerebral haemorrhage, Paralysis, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Haemorrhage terms (excl laboratory terms) (narrow), Arrhythmia related investigations, signs and symptoms (broad), Haemorrhagic cerebrovascular conditions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypotonic-hyporesponsive episode (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: NONE
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: dx: intracerebral hemorrhage; no evidence seen by MD of hypersensitivity rxn to vax;
CDC Split Type: BA92001

Write-up: loss of consciousness, paralysis;


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