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This is VAERS ID 1078081

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History of Changes from the VAERS Wayback Machine

First Appeared on 3/19/2021

VAERS ID: 1078081
VAERS Form:2
Age:78.0
Sex:Female
Location:Arizona
Vaccinated:2021-02-05
Onset:2021-03-06
Submitted:0000-00-00
Entered:2021-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3427 / 1 OT / IM

Administered by: Private      Purchased by: ??
Symptoms: Diplopia, Gait disturbance, Guillain-Barre syndrome, Lumbar puncture, Speech disorder, Fine motor skill dysfunction

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? No
Previous Vaccinations:
Other Medications: benazapril dystolic hydralazine pantoprazole atorvastin calcium furosemide spririva multiple vitamin calcium, D & magnesium vitamin c vitamin e Glucosamine hci Condroitin Sulfate omega 3 fish oil CoQ-10 Aspirin Metamucil
Current Illness: high blood pressure that is treated, that is monitored
Preexisting Conditions: same as above
Allergies: sulfa gives a gastric reaction
Diagnostic Lab Data: 2/25/21: lumbar puncture
CDC 'Split Type':

Write-up: Guillian Barre reaction (difficulty walking, difficultyusing hands- small motor skills; difficulty speaking; began on 2/7/21 and continued to worsen until hospitalization on 2/24/21 and 5 plasmapheresis treatments. While hospitalized patient has developed double vision.


Changed on 5/7/2021

VAERS ID: 1078081 Before After
VAERS Form:2
Age:78.0
Sex:Female
Location:Arizona
Vaccinated:2021-02-05
Onset:2021-03-06
Submitted:0000-00-00
Entered:2021-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3427 / 1 OT / IM

Administered by: Private      Purchased by: ??
Symptoms: Diplopia, Gait disturbance, Guillain-Barre syndrome, Lumbar puncture, Speech disorder, Fine motor skill dysfunction

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? No
Previous Vaccinations:
Other Medications: benazapril dystolic hydralazine pantoprazole atorvastin calcium furosemide spririva multiple vitamin calcium, D & magnesium vitamin c vitamin e Glucosamine hci Condroitin Sulfate omega 3 fish oil CoQ-10 Aspirin Metamucil
Current Illness: high blood pressure that is treated, that is monitored
Preexisting Conditions: same as above
Allergies: sulfa gives a gastric reaction reaction
Diagnostic Lab Data: 2/25/21: lumbar puncture
CDC 'Split Type':

Write-up: Guillian Barre reaction (difficulty walking, difficultyusing hands- small motor skills; difficulty speaking; began on 2/7/21 and continued to worsen until hospitalization on 2/24/21 and 5 plasmapheresis treatments. While hospitalized patient has developed double vision.


Changed on 5/21/2021

VAERS ID: 1078081 Before After
VAERS Form:2
Age:78.0
Sex:Female
Location:Arizona
Vaccinated:2021-02-05
Onset:2021-03-06
Submitted:0000-00-00
Entered:2021-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3427 / 1 OT / IM

Administered by: Private      Purchased by: ??
Symptoms: Diplopia, Gait disturbance, Guillain-Barre syndrome, Lumbar puncture, Speech disorder, Fine motor skill dysfunction

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? No
Previous Vaccinations:
Other Medications: benazapril dystolic hydralazine pantoprazole atorvastin calcium furosemide spririva multiple vitamin calcium, D & magnesium vitamin c vitamin e Glucosamine hci Condroitin Sulfate omega 3 fish oil CoQ-10 Aspirin Metamucil
Current Illness: high blood pressure that is treated, that is monitored
Preexisting Conditions: same as above
Allergies: sulfa gives a gastric reaction reaction
Diagnostic Lab Data: 2/25/21: lumbar puncture
CDC 'Split Type':

Write-up: Guillian Barre reaction (difficulty walking, difficultyusing hands- small motor skills; difficulty speaking; began on 2/7/21 and continued to worsen until hospitalization on 2/24/21 and 5 plasmapheresis treatments. While hospitalized patient has developed double vision.

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