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

This is VAERS ID 1040844



Case Details

VAERS ID: 1040844 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-01-16
Onset:2021-01-30
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-02-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Blood potassium decreased, Blood pressure fluctuation, Blood sodium decreased, Blood test normal, CSF protein increased, Chest pain, Computerised tomogram normal, Dysstasia, Echocardiogram normal, Electrocardiogram normal, Electroencephalogram normal, Fine motor skill dysfunction, Gait inability, Guillain-Barre syndrome, Hypoaesthesia, Injection site pain, Lumbar puncture, Magnetic resonance imaging normal, Muscular weakness, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hyponatraemia/SIADH (narrow), Hypertension (broad), Cardiomyopathy (broad), Demyelination (narrow), Chronic kidney disease (broad), Hypokalaemia (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, 11 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lisinopril 40 mg tablet Hydrochlorothiazide 25 mg tablet asprin 81 mg Glucosamine JCL 1500 with MSM 600+D3 Calcium a
Current Illness: None
Preexisting Conditions: Elevated BP - Nothing else
Allergies: None
Diagnostic Lab Data: 1/30-2/2 - EKG, Between 2/2 - 2/12 - Echocardiogram, 2 C Scans, MRI, multiple Blood tests - all were negative but his Sodium and Potassium level were very low, particularly the sodium level. Given IV treatment for that. 2/15 - EEG - Negative, Spinal Tap - Protein level I believe was 113. Diagnosed Guillain Barre Syndrome -
CDC Split Type:

Write-up: 1/30/2021 Began with spiking BP and extreme pain in right shoulder - taken to ER. Given pain med, BP came down and sent home. 2/2/2021 - Spiking BP and chest pain, numbness and tingling in hands and feet. - taken to Medical Center. Admitted. Series of heart and brain assessments done. Each day he got weaker until he could no longer stand, walk, arm and hand strength depleted and dexterity issues. Spinal Tap on 2/8/2021 revealed Guillain Barre Syndrome 2/12 Admitted to Rehabilitation Center, 2/15 at Hospital plummeting BP, 2/18 return to Rehabilitation Center


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