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From the 9/10/2021 release of VAERS data:

This is VAERS ID 80107



Case Details

VAERS ID: 80107 (history)  
Form: Version 1.0  
Age: 58.0  
Sex: Female  
Location: Maine  
Vaccinated:1995-10-26
Onset:1995-11-03
   Days after vaccination:8
Submitted: 1995-11-29
   Days after onset:26
Entered: 1995-12-18
   Days after submission:19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01285P / 1 - / A

Administered by: Private       Purchased by: Unknown
Symptoms: CSF test abnormal, Guillain-Barre syndrome, Neuropathy
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Demyelination (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? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: bronchitis
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: inc CSF protein; abnormal neuro condition;
CDC Split Type:

Write-up: pt recvd vax; devel GBS;


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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=80107


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