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

This is VAERS ID 92612



Case Details

VAERS ID: 92612 (history)  
Form: Version 1.0  
Age: 67.0  
Sex: Female  
Location: Louisiana  
Vaccinated:1996-10-21
Onset:1996-10-21
   Days after vaccination:0
Submitted: 1996-11-13
   Days after onset:23
Entered: 1996-12-09
   Days after submission:26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4968175 / UNK RA / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 1626B / UNK LA / IM

Administered by: Public       Purchased by: Public
Symptoms: Apnoea, Cardiac arrest, Hypertension, Myelitis, Paralysis, Quadriplegia
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Hypertension (narrow), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Respiratory failure (narrow), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
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: unk
Current Illness: NONE
Preexisting Conditions: hypertension, hyperlipidemia, hypercholesterolemia and smoking 1.5 packs per day for 13 years
Allergies:
Diagnostic Lab Data:
CDC Split Type: 896323001L

Write-up: pt recv vax & devel transverse myelitis, & was hosp, & is a quadriplegic;reporter was notified of this event as part of litigation proceedings;


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