National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

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

This is VAERS ID 1049819



Case Details

VAERS ID: 1049819 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: California  
Vaccinated:2021-01-20
Onset:2021-01-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-02-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029L20A / 1 LA / -

Administered by: Other       Purchased by: ?
Symptoms: CSF protein increased, Gait inability, Guillain-Barre syndrome, Immunoglobulin therapy, Magnetic resonance imaging spinal abnormal, Muscular weakness, Vertebral foraminal stenosis, Vitamin B12 deficiency
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalopathy/delirium (broad), Demyelination (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen 325 mg Tab (Tylenol) 650 mg 2 tab Oral TID PRN: pain capsaicin 0.025% Cream 60 gm (capsaicin 0.025% topical cream) 1 app Topical Daily cholecalciferol 2,000 unit Cap (Vitamin D3) 2,000 unit 1 cap Oral Daily clotrimaz
Current Illness: DM HTN Chronic kidney disease
Preexisting Conditions: DM HTN Chronic kidney disease
Allergies: Penicillin
Diagnostic Lab Data: CSF analysis, showed elevation of serum protein MRI of Lumbar spine showed mild to moderate neural foraminal stenosis. Vitamin B12 was also reported deficient.
CDC Split Type:

Write-up: Patient developed lower extremity weakness, the weakness progressed and after few days he was not able to walk even with help of crutches. Guillain barre syndrome was suspected. He was sent to hospital. Lumbar puncture was performed on him showed elevation of CSF protein. He received IVIG and his weakness improved. He also received Vitamin B12 injection due to Vitamin B12 deficiency


New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=1049819


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166