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From the 6/14/2018 release of VAERS data (an older release, current is 10/15/2021):

This is VAERS ID 99365

Case Details

VAERS ID: 99365 (history)  
Form: Version 1.0  
Age: 72.0  
Sex: Female  
Location: Georgia  
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 1997-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Unknown       Purchased by: Unknown
Symptoms: Asthenia, Guillain-Barre syndrome, Hyperchloraemia, Hyperglycaemia, Hypoxia, Laboratory test abnormal, Quadriplegia
SMQs:, Asthma/bronchospasm (broad), Peripheral neuropathy (narrow), Hyperglycaemia/new onset diabetes mellitus (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (narrow), Demyelination (narrow), Eosinophilic pneumonia (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Tubulointerstitial diseases (broad), Respiratory failure (broad), Infective pneumonia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: upper resp sx 3wk prior to admission;
Preexisting Conditions: PMH x/hysterectomy 50yrs PTA;
Diagnostic Lab Data: CBC WNL; 9.3/39.1;13.5;321; 138/3.7/108/23.4/6/0.7;139;
CDC Split Type:

Write-up: pt recv vax & became weaker during the day,upon admission was markedly quadraparetic;could move head & speaks w/diff;CBC WNL;adm w/GBS;intubated on ventilator;tracheostomy performed 24NOV96;

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