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From the 12/30/2020 release of VAERS data (an older release, current is 9/10/2021):

This is VAERS ID 71204



Case Details

VAERS ID: 71204 (history)  
Form: Version 1.0  
Age: 49.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:1994-11-04
Onset:1994-11-28
   Days after vaccination:24
Submitted: 1995-01-26
   Days after onset:59
Entered: 1995-02-01
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4948104 / UNK - / -

Administered by: Private       Purchased by: Unknown
Symptoms: Delirium, Dementia, Headache, Laboratory test abnormal, Multiple sclerosis, Neuropathy, Paraesthesia, Speech disorder
SMQs:, Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Optic nerve disorders (broad), Demyelination (narrow), Dehydration (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 16 days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Theo-24, aldactone, Captopril, Premarin, Alupent & Beclovelt inhaler
Current Illness: NONE
Preexisting Conditions: asthma-HTN-hyperaldosteronis
Allergies:
Diagnostic Lab Data: MRI of head-multiple brian lesions; brian biopsy showed demyelinating disease-multiple sclerosis-many test in hosp;
CDC Split Type:

Write-up: on arising had difficulty speaking, h/a, numb rt arm & leg w/pins & needles sensation in hop; had IV Solumedrol & Pred taper-little improvement;


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20201230&IDNUMBER=71204


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