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From the 11/26/2021 release of VAERS data:

This is VAERS ID 1155731

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Case Details

VAERS ID: 1155731 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-03-23
Onset:2021-03-29
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Basal ganglia stroke, Cerebral microhaemorrhage, Cerebrovascular accident, Hypotonia, Internal capsule infarction, Magnetic resonance imaging head abnormal, Motor dysfunction, Product administered to patient of inappropriate age
SMQs:, Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Medication errors (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, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: wafarin, sotalol
Current Illness: none
Preexisting Conditions: Truncus Arteriosus s/p repair, migraines
Allergies: none
Diagnostic Lab Data: MRI (3/30/21) - Acute infarcts in anterior limb of right internal capsule and right basal ganglia. Findings suggestive of embolic microhemorrhages throughout bilateral cerebral hemispheres and bilateral cerebellar lobes. Hypertensive microangiopathic changes would be unusual in this age group.
CDC Split Type:

Write-up: Patient had a CVA (stroke) to the R internal capsule and basal ganglia while therapeutic on warfarin. She has a history of Truncus Arteriosus s/p repair and has been anticoagulated for $g10 years without issue. Stroke occurred 1 week after vaccine. She now has L sided motor deficits which are likely permanent. Left arm is flaccid. L leg with poor motor function.


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