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From the 1/14/2022 release of VAERS data:

This is VAERS ID 1077793

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Case Details

VAERS ID: 1077793 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-01-12
Onset:2021-01-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Dyspnoea, Guillain-Barre syndrome, Heart rate abnormal, Hypoaesthesia, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (narrow), Cardiomyopathy (broad), Demyelination (narrow), Immune-mediated/autoimmune disorders (narrow), Sexual dysfunction (broad)

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? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Medical tests did not show evidence of this.
CDC Split Type:

Write-up: Guillain Barre Syndrome that lasted for 4 weeks. Prickling, pins and needles sensations in arm, fingers, leg, feet numbness/loss of feeling in arm and hand for weeks Difficulty with facial movements, including speaking, chewing or swallowing Severe pain, achy, shooting or cramplike Rapid heart rate Difficulty breathing


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