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From the 2/18/2021 release of VAERS data:

This is VAERS ID 108781

Case Details

VAERS ID: 108781 (history)  
Form: Version 1.0  
Age: 48.0  
Sex: Male  
Location: Virginia  
Vaccinated:1997-10-16
Onset:1997-12-30
   Days after vaccination:75
Submitted: 1998-02-15
   Days after onset:47
Entered: 1998-03-23
   Days after submission:36
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, Pleural disorder, Pneumonia
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Immune-mediated/autoimmune disorders (narrow)

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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: pt recv vax 16OCT97 & dx w/GBS on 30DEC97 to 17FEB98;prior to GBS dx in good health;no med problems;NKDA;started w/course of ATB on 22DEC97 for pneumonia P pleurisy;


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