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From the 4/30/2021 release of VAERS data:

This is VAERS ID 36611



Case Details

VAERS ID: 36611 (history)  
Form: Version 1.0  
Age: 56.0  
Sex: Female  
Location: Missouri  
Vaccinated:1991-10-31
Onset:1991-11-09
   Days after vaccination:9
Submitted: 1991-11-15
   Days after onset:6
Entered: 1991-11-25
   Days after submission:10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918146 / 1 LA / IM

Administered by: Public       Purchased by: Public
Symptoms: Dysphagia, Guillain-Barre syndrome, Hypokinesia, Myalgia, Myasthenic syndrome, Paraesthesia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Malignancy related conditions (narrow), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Demyelination (narrow), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Advil, Cardizem
Current Illness: NONE
Preexisting Conditions: arthritis; hyperderssion sinc 3; hypothyroidism, allergic to PCN
Allergies:
Diagnostic Lab Data: CBC-normal; p-3.6; otherwise chem normal; Electormogram; CSF; GM slain-neg; smear fangus-neg; glucose; protein, APT; electrolytes, SGPT, total CPK, sigmoid; LP revealed mild inc in portein in spinal fluid & GBS dx; CXR-normal
CDC Split Type: MO9190

Write-up: 9NOV91 numbness & tingling lower extremities; 10NOV91 could no longer stand; arms have movement but weak;grasp weak, vomiting, muscular pain, some difficulty swallowing;


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