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From the 6/11/2021 release of VAERS data:

This is VAERS ID 1033202



Case Details

VAERS ID: 1033202 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: California  
Vaccinated:2021-01-19
Onset:2021-01-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-02-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: CSF protein increased, Guillain-Barre syndrome, Magnetic resonance imaging brain, Spinal X-ray
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? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 27 days
   Extended hospital stay? No
Previous Vaccinations: Pneumococcal Vaccine
Other Medications: ? clonazePAM (KLONOPIN) 0.5 mg Oral Tab Take 1 and one-half tablets by mouth daily at bedtime ? Mirtazapine (REMERON) 15 mg Oral Tab Take 1 tablet by mouth daily at bedtime ? metFORMIN (GLUCOPHAGE XR) 500 mg Oral 24hr SR Tab Take 2 tablets
Current Illness: STROKE. 2008 ? ATHEROSCLEROSIS OF AORTA cxr 8/11 ? BIPOLAR 1 DISORDER, UNSPECIFIED EPISODE ? ? CAD (CORONARY ARTERY DISEASE) ? ? DM 2 ? ? GERD (GASTROESOPHAGEAL REFLUX DISEASE) ? ? HYPOTHYROIDISM ? ? PPD POSITIVE. s/p cataract surgery s/p tonsillectomy
Preexisting Conditions: As above, CAD, prior stroke (no deficits), bipolar disorder, and DM
Allergies: Pneumococcal Vaccine Quinine NSAIDs
Diagnostic Lab Data: MRI brain and c-spine, both unrevealing for acute changes. CSF analysis showed normal parameters except elevated CSF protein.
CDC Split Type:

Write-up: Patient was hospitalized for Guillain-Barre syndrome


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