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From the 1/14/2022 release of VAERS data:

This is VAERS ID 195476

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Case Details

VAERS ID: 195476 (history)  
Form: Version 1.0  
Age: 3.0  
Sex: Female  
Location: California  
Vaccinated:2002-12-09
Onset:2002-12-12
   Days after vaccination:3
Submitted: 2002-12-18
   Days after onset:6
Entered: 2002-12-26
   Days after submission:8
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4020034 / 1 - / IM

Administered by: Private       Purchased by: Private
Symptoms: Guillain-Barre syndrome, Neuropathy, Paralysis
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Demyelination (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Immune-mediated/autoimmune disorders (narrow)

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? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Guillain Barre type neuropathy with paralysis of lower limbs. 60 DAY FOLLOW UP STATES THAT IT IS UNKNOWN IF PT HAS RECOVERED. THIS PT DOES NOT COME TO OUR OFFICE ANYMORE SINCE THE INCIDENT. SHE HAS CHANGED HER PRIMARY CARE PHYSICIAN.


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