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This is VAERS ID 962567

History of Changes from the VAERS Wayback Machine

First Appeared on 1/29/2021

VAERS ID: 962567
VAERS Form:2
Age:41.0
Sex:Female
Location:Oregon
Vaccinated:2020-12-28
Onset:2021-01-18
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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: 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-Barr? syndrome resulted from vaccine and instructed to not receive 2nd dose of vaccine at this time.


Changed on 5/7/2021

VAERS ID: 962567 Before After
VAERS Form:2
Age:41.0
Sex:Female
Location:Oregon
Vaccinated:2020-12-28
Onset:2021-01-18
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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: Unknown. Hospitalist overseeing inpatient care
Current Illness: Unknown.
Preexisting Conditions: Hypothyroidism. Contact Doctor for more information on past medical history.
Allergies: Tetracycline 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-Barr? Guillain-Barré syndrome resulted from vaccine and instructed to not receive 2nd dose of vaccine at this time.

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Link To This Search Result:

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


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