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

This is VAERS ID 1041155



Case Details

VAERS ID: 1041155 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-02-11
Onset:2021-02-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-02-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Ataxia, Blood electrolytes, CSF test, Full blood count, Guillain-Barre syndrome, Hypoaesthesia, Immunoglobulin therapy, Magnetic resonance imaging brain, Magnetic resonance imaging spinal, Nausea, Pain, Paraplegia
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Demyelination (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), 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, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ATORVASTSTIN 10 MG q DAY
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data: CSF MRI BRAIN MRI SPINE CBC/ELECTROLYTES
CDC Split Type:

Write-up: ACUTE LEFT SIDED COSTOPHRENIC PAIN AND NAUSEA WITH RAPID DEVELOPMENT OF BILATERAL NUMBNESS WITH ATAXIA STARTING AT FEET RISING TO GROIN IMMEDIATELY. NUMBNESS AND PARAPLEGIA PERSISTED AND AROSE TO RIBS WITHIN 12 HOURS TWO ER VISITS. HOSPITALIZED AND MONITORED FOR FOUR DAYS DX: ACUTE GUILLAIN-BARRE SYNDROME per NEUROLOGY Received 4 infusions of IViG. 1 infusion per day X 4 days.


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