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This is VAERS ID 1033202

History of Changes from the VAERS Wayback Machine

First Appeared on 2/18/2021

VAERS ID: 1033202
VAERS Form:2
Age:71.0
Sex:Male
Location:California
Vaccinated:2021-01-19
Onset:2021-01-20
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, Spinal X-ray, Magnetic resonance imaging brain

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 27     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


Changed on 5/7/2021

VAERS ID: 1033202 Before After
VAERS Form:2
Age:71.0
Sex:Male
Location:California
Vaccinated:2021-01-19
Onset:2021-01-20
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, Spinal X-ray, Magnetic resonance imaging brain

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 27     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 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


Changed on 5/14/2021

VAERS ID: 1033202 Before After
VAERS Form:2
Age:71.0
Sex:Male
Location:California
Vaccinated:2021-01-19
Onset:2021-01-20
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, Spinal X-ray, Magnetic resonance imaging brain

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 27     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 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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