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

This is VAERS ID 1080751

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Case Details

VAERS ID: 1080751 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-02-24
Onset:2021-02-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 043L20A / 2 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Acute motor-sensory axonal neuropathy, Back pain, Chest pain, Gait inability, Guillain-Barre syndrome, Hypertension, Hypoaesthesia, Musculoskeletal disorder, Nausea, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Guillain-Barre syndrome (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Cardiomyopathy (broad), Demyelination (narrow), Immune-mediated/autoimmune disorders (narrow), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 12 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Amoxicillin 875mg; Hydrochlorothiazide 25mg; Hydrocodone 7.5mg; Letrozole 2.5mg; Losartan Potassium 50mg; Potassium Chloride 20 Meq; Raloxifene Hcl 60mg; Tizanidine Hcl 4mg All daily except hydrocodone and tizanidine
Current Illness: Bronchitis
Preexisting Conditions: High Blood Pressure; Breast Cancer Survivor
Allergies: Unknown at this time
Diagnostic Lab Data: Acute Sensory Axonal Neuropathy a severe/rare case of Guillain-Barre Syndrome.
CDC Split Type:

Write-up: High blood pressure; chest pain; back pain; numbness in limbs; nausea and vomiting.; inability to walk or move legs and feet. Was officially diagnosed on 2/5/2021 wit Acute Sensory Axonal Neuropathy a severe/rare case of Guillain-Barre Syndrome. Unknown time for recovery. Is in the process of being referred to a rehab center.


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