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From the 6/4/2021 release of VAERS data:

This is VAERS ID 43894

Case Details

VAERS ID: 43894 (history)  
Form: Version 1.0  
Age: 62.0  
Sex: Male  
Location: New York  
   Days after vaccination:15
Submitted: 1991-01-04
   Days after onset:755
Entered: 1991-09-03
   Days after submission:241
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Asthenia, Back pain, CSF test abnormal, Electrocardiogram abnormal, Guillain-Barre syndrome, Hypertension, Hyporeflexia, Paraesthesia
SMQs:, Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (narrow), Hypertension (narrow), Cardiomyopathy (broad), Demyelination (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
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: Orudis Capsules
Current Illness: NONE
Preexisting Conditions: pt has known allergy to PCN; inc cholesterol in the past; pos for diabetes mellitus in mom & dad; father also had emphysema;
Diagnostic Lab Data: Spinal fluid analysis-inc spinal fluid protein, nl glucose & w/o leukocytes; Cholesterol 319; Triglycerides 276; EMG & Nerve conduction velocities showed mltifocal conduction abn;
CDC Split Type: B073089012

Write-up: Pt recvd flu vax & was admitted to hosp w/extremity weakness & numbness; approx 4-5 days prior to admission, pt had dorsal & epigastric pain assoc w/tingling in hands & feet;poss GBS; also areflexia; BP 190/100;

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