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From the 5/7/2021 release of VAERS data:

This is VAERS ID 962567



Case Details

VAERS ID: 962567 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Oregon  
Vaccinated:2020-12-28
Onset:2021-01-18
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-01-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK9231 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Guillain-Barre syndrome, Neuropathy peripheral
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? No
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: Unknown. Hospitalist overseeing inpatient care
Current Illness: Unknown.
Preexisting Conditions: Hypothyroidism. Contact Doctor for more information on past medical history.
Allergies: Tetracycline
Diagnostic Lab Data: Unknown, please contact Doctor
CDC Split Type:

Write-up: Employee received first dose of Pfizer-BioNTech Covid-19 Vaccine on 12/28/20. Per Employee''s manager: Patient began experiencing symptoms of neuropathy and was admitted to the hospital as an inpatient on 1/18/21. Informed from neurologist that most likely Guillain-Barré syndrome resulted from vaccine and instructed to not receive 2nd dose of vaccine at this time.


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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=962567


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