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From the 12/31/2003 release of VAERS data (an older release, current is 1/7/2021):

This is VAERS ID 48724

Case Details

VAERS ID: 48724 (history)  
Form: Version .0  
Age: 65.1  
Sex: Male  
Location: Arizona  
Vaccinated:1992-10-19
Onset:1992-10-19
   Days after vaccination:0
Submitted: 1992-12-02
   Days after onset:44
Entered: 1993-01-11
   Days after submission:40
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1992-1993 / WYETH 4928228 / - LA / IM

Administered by: Private       Purchased by: Unknown
Symptoms: ATAXIA, ATROPHY MUSCLE, GUILLAIN BARRE SYND, HYPOKINESIA, MYALGIA
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: NONE
Other Medications: none specified;
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: EMG, nerve conduction velocities, MRI of brain; (specific results unknown);
CDC Split Type: NONE

Write-up: pt recvd flu vax; pt states inject was given directly into ax nerve; pt exp instant severe pain that has persisted over 8 wks; atrophy of the posterior deltoid & impaired function & persistent pain in the lt deltoid & trapezius; poss GBS;


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