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From the 7/7/2013 release of VAERS data (an older release, current is 10/8/2021):

This is VAERS ID 94613



Case Details

VAERS ID: 94613 (history)  
Form: Version .0  
Age: 72.3  
Sex: Female  
Location: Virginia  
Vaccinated:1996-11-25
Onset:1997-01-06
   Days after vaccination:42
Submitted: 1997-01-22
   Days after onset:16
Entered: 1997-02-03
   Days after submission:12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4968170 / 6 RA / IM

Administered by: Public       Purchased by: Public
Symptoms: CSF test abnormal, Myelitis, Paraesthesia, Paraplegia
SMQs:, Peripheral neuropathy (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)

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? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations: NONE
Other Medications: Cordizen, Insulin, Trental
Current Illness: diabetes, HTN, periph vasc disease
Preexisting Conditions: diabetes, HTN, peripheral vascular disease
Allergies:
Diagnostic Lab Data: CSF w/elevated protein otherwise negative x/for few WACS;MRI w/ inc signal for T5-T10;
CDC Split Type: VA97036

Write-up: dx w/acute transverse myelitis-hosp from 9JAN97-17JAN97 then transported to a rehab facility w/lower extremities paraplegic & numbness up to T4/t% level;


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20130707&IDNUMBER=94613

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