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From the 8/31/2010 release of VAERS data (an older release, current is 10/8/2021):

This is VAERS ID 97013



Case Details

VAERS ID: 97013 (history)  
Form: Version .0  
Age: 38.2  
Sex: Male  
Location: New York  
Vaccinated:1996-10-23
Onset:1996-10-23
   Days after vaccination:0
Submitted: 1997-02-14
   Days after onset:114
Entered: 1997-04-21
   Days after submission:65
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH - / 0 LA / -

Administered by: Private       Purchased by: Other
Symptoms: Back pain, CSF test abnormal, Encephalitis, Infection, Muscle atrophy, Myositis, Neuropathy, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (narrow), Noninfectious encephalopathy/delirium (broad)

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? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: EMG/Nerve conduction lower extremities: reportedly abn;CPK: reportedly elevated;CSF: reportedly contained protein;
CDC Split Type: 897072001L

Write-up: pt devel back pain p/vax;exp paresthesias, described as band-like feeling around the abd, arms, & legs as well as flip-flop sensation in feet & puffiness in hands;nerve damage;muscle atrophy;encephalomyelitis;myositis;polyneuropathy synd;


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20100831&IDNUMBER=97013

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