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From the 10/8/2021 release of VAERS data:

This is VAERS ID 308620



Case Details

VAERS ID: 308620 (history)  
Form: Version 1.0  
Age: 54.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2007-10-18
Onset:2007-12-01
   Days after vaccination:44
Submitted: 2008-03-27
   Days after onset:116
Entered: 2008-03-31
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUARIX) / GLAXOSMITHKLINE BIOLOGICALS AFUA05288 / UNK UN / IM

Administered by: Private       Purchased by: Other
Symptoms: Abasia, CSF protein increased, Guillain-Barre syndrome, Hypoaesthesia, Lymphoma, Mechanical ventilation
SMQs:, Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Dystonia (broad), Acute central respiratory depression (broad), Guillain-Barre syndrome (narrow), Demyelination (narrow), Malignant lymphomas (narrow), Respiratory failure (broad), Haematological malignant tumours (narrow), Immune-mediated/autoimmune disorders (narrow), Sexual dysfunction (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2008-05-16
   Days after onset: 166
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 30 days
   Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: CSF - 153 protein on 2/25/08
CDC Split Type:

Write-up: Patient had influenza vaccine on 10-18-07. Complaints on 1/9/08 of numbness for 1-2 wks in arms/feet. 2/22/08 unable to ambulate. 3/2 Placed on vent. (1/21/08 had malignant lymphoma removed from tonsil). MD diagnosis Guillain barre, 2 lymphoma. 6/24/08 Death certificate states COD as respiratory failure with Guillain-Barre Syndrome & lymphoma. as underlying cause. 6/13/08 Reviewed hospital medical records for 2/23-5/16/2008. FINAL DX: diffuse large B cell lymphoma Records reveal patient experienced paresthesias of hands/feet, sore throat. Had lump on tonsils removed & found to have diffuse large B cell lymphoma. Weakness & paresthesias worsened & dx w/GBS. Had very prolonged extensive hospital course complicated by multiple issues: chronic ventilator dependent respiratory failure; tracheostomy; PEG feeding tube; multiple septic episodes; pulmonary embolism; chemotherapy. Condition worsened, developoed MRSA septicemia, became unresponsive. Family requested comfort measures only, patient was extubated & expired 5/16/2008. Patient had cancer and was undergoing chemo and radiation. This was cause of death.


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