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From the 2/14/2017 release of VAERS data (an older release, current is 10/8/2021):

This is VAERS ID 86284



Case Details

VAERS ID: 86284 (history)  
Form: Version .0  
Age: 64.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:1995-10-11
Onset:1995-10-16
   Days after vaccination:5
Submitted: 1996-05-01
   Days after onset:198
Entered: 1996-05-23
   Days after submission:22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958113 / 0 - / IM

Administered by: Other       Purchased by: Other
Symptoms: Apnoea, Electroencephalogram abnormal, Encephalopathy, Hallucination, Myoclonus, Paranoia, Pneumonia, Stupor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (narrow), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Hostility/aggression (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Haldol
Current Illness: unk
Preexisting Conditions: pt was described as prev healthy;has hx of depression
Allergies:
Diagnostic Lab Data: MRI''s- nondiagnostic; EEG''s-abnormal;Spinal Tap- nondiagnostic
CDC Split Type: 896127001L

Write-up: pt recv vax 11OCT95&4 days later pt devel hallucinations¶noid ideation;pt hosp w/resp arrest&required mechanical ventilation;pt is now vegetative state;poss creutzfeldt-Jakob disease;also therapy for depression;


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20170214&IDNUMBER=86284

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