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This is VAERS ID 1041155

History of Changes from the VAERS Wayback Machine

First Appeared on 2/26/2021

VAERS ID: 1041155
VAERS Form:2
Age:70.0
Sex:Female
Location:Minnesota
Vaccinated:2021-02-11
Onset:2021-02-12
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, Full blood count, Guillain-Barre syndrome, Hypoaesthesia, Nausea, Pain, Paraplegia, CSF test, Blood electrolytes, Immunoglobulin therapy, Magnetic resonance imaging brain, Magnetic resonance imaging spinal

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: 4     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.


Changed on 5/7/2021

VAERS ID: 1041155 Before After
VAERS Form:2
Age:70.0
Sex:Female
Location:Minnesota
Vaccinated:2021-02-11
Onset:2021-02-12
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, Full blood count, Guillain-Barre syndrome, Hypoaesthesia, Nausea, Pain, Paraplegia, CSF test, Blood electrolytes, Immunoglobulin therapy, Magnetic resonance imaging brain, Magnetic resonance imaging spinal

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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: ATORVASTSTIN 10 MG q DAY
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE 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.


Changed on 5/14/2021

VAERS ID: 1041155 Before After
VAERS Form:2
Age:70.0
Sex:Female
Location:Minnesota
Vaccinated:2021-02-11
Onset:2021-02-12
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, Full blood count, Guillain-Barre syndrome, Hypoaesthesia, Nausea, Pain, Paraplegia, CSF test, Blood electrolytes, Immunoglobulin therapy, Magnetic resonance imaging brain, Magnetic resonance imaging spinal

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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: ATORVASTSTIN 10 MG q DAY
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE 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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