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

This is VAERS ID 1043358



Case Details

VAERS ID: 1043358 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-02-14
Onset:2021-02-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-02-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK UN / SYR

Administered by: Private       Purchased by: ?
Symptoms: Guillain-Barre syndrome, Lumbar puncture, Magnetic resonance imaging spinal
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Multivitamin
Current Illness: Viral conjunctivitis Macular papular rash cause unknown
Preexisting Conditions: Breast Cancer Hypothyroidism
Allergies:
Diagnostic Lab Data: MRI Spine Lumbar puncture
CDC Split Type:

Write-up: Guillain Barre Syndrome


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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=1043358


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