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This is VAERS ID 1043358

History of Changes from the VAERS Wayback Machine

First Appeared on 2/26/2021

VAERS ID: 1043358
VAERS Form:2
Age:72.0
Sex:Female
Location:D.C.
Vaccinated:2021-02-14
Onset:2021-02-15
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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     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


Changed on 5/7/2021

VAERS ID: 1043358 Before After
VAERS Form:2
Age:72.0
Sex:Female
Location:D.C.
Vaccinated:2021-02-14
Onset:2021-02-15
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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     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


Changed on 5/14/2021

VAERS ID: 1043358 Before After
VAERS Form:2
Age:72.0
Sex:Female
Location:D.C.
Vaccinated:2021-02-14
Onset:2021-02-15
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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     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&WAYBACKHISTORY=ON


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