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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 80190



Case Details

VAERS ID: 80190 (history)  
Form: Version .0  
Age: 34.9  
Sex: Female  
Location: Missouri  
Vaccinated:1993-11-04
Onset:1993-11-04
   Days after vaccination:0
Submitted: 1995-12-21
   Days after onset:777
Entered: 1995-12-28
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: UNK. INFLUENZA VACCINE / UNCLASSIFIED 2243GC / - - / -

Administered by: Other       Purchased by: Unknown
Symptoms: ASTHENIA, DEPRESSION, GUILLAIN BARRE SYND, INJURY ACCID, NAUSEA
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: none reported
Other Medications: unk
Current Illness: none
Preexisting Conditions: none reported
Allergies:
Diagnostic Lab Data: none reported;07Oct96-MFR f/u-nerve conduction tests showed a severe polyarthropathy,CSF exam - nl protein;
CDC Split Type: none reported

Write-up: pt recvd vax; exp abdo cramping,pain,nausea,vomiting p/ flu vax;hosp on 24dec93 & dx w/ acute GBS;exp full paralysis for 5 mo & then partial paralysis since may94;


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=80190

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