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From the 9/17/2021 release of VAERS data:

This is VAERS ID 81459



Case Details

VAERS ID: 81459 (history)  
Form: Version 1.0  
Age: 3.0  
Sex: Female  
Location: Arkansas  
Vaccinated:1995-10-28
Onset:1995-10-31
   Days after vaccination:3
Submitted: 1996-01-30
   Days after onset:91
Entered: 1996-01-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4858102 / UNK - / -

Administered by: Public       Purchased by: Other
Symptoms: Coma, Convulsion, Delirium, Diarrhoea, Hyponatraemia, Lung disorder, Pyrexia, Respiratory disorder
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hyponatraemia/SIADH (narrow), Generalised convulsive seizures following immunisation (narrow), Chronic kidney disease (broad), Noninfectious diarrhoea (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

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, 86 days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness: febrile
Preexisting Conditions: premature birth w/trachial tube in place
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type: ALI96031

Write-up: pt recvd vax & exp febrile convuls leading to brain damage p/vax;OCT95 pt exp sz d/t dehydration & low sodium & was adm to hosp x3-4days;28OCT95 exp diarrhea & resp illness including fever;t106;pt exp sz & coma resulted in 3/4 brain damage;


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