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This is VAERS ID 1156573

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History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1156573
VAERS Form:2
Age:58.0
Sex:Male
Location:Texas
Vaccinated:2021-03-30
Onset:2021-03-30
Submitted:0000-00-00
Entered:2021-04-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Unknown      Purchased by: ??
Symptoms: C-reactive protein increased, Feeling abnormal, Guillain-Barre syndrome, Hypoaesthesia, Hyporeflexia, Muscular weakness, Myelitis transverse, Pain, Sensory loss, Computerised tomogram head normal

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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: amLODIPine (NORVASC), atenoloL (Tenormin), garlic, ibuprofen
Current Illness:
Preexisting Conditions: Degenerative arthropathy, hyperlipidemia, hypertension, psoriasis, psoriatic arthritis, benign essential HTN
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Moderna COVID-19 Vaccine EUA Patient received Moderna second dose on 3/29/21 at 8:30 am and experienced weakness in legs later that day around 3:00 pm. Presented to emergency department on 3/30/21 with complaints of generalized body aches and numbness to both legs and lower arms, feeling like legs had fallen asleep. Initial examination in ED revealed sensory deficit with final diagnosis of myelitis, acute transverse and Guillain-Barre Syndrome after administration of vaccine. On 4/1/21, continuing to experience numbness with some ascending pattern, slight decrease in reflexes.


Changed on 5/7/2021

VAERS ID: 1156573 Before After
VAERS Form:2
Age:58.0
Sex:Male
Location:Texas
Vaccinated:2021-03-30
Onset:2021-03-30
Submitted:0000-00-00
Entered:2021-04-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Unknown      Purchased by: ??
Symptoms: C-reactive protein increased, Feeling abnormal, Guillain-Barre syndrome, Hypoaesthesia, Hyporeflexia, Muscular weakness, Myelitis transverse, Pain, Sensory loss, Computerised tomogram head normal

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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: amLODIPine (NORVASC), atenoloL (Tenormin), garlic, ibuprofen
Current Illness:
Preexisting Conditions: Degenerative arthropathy, hyperlipidemia, hypertension, psoriasis, psoriatic arthritis, benign essential HTN
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Moderna COVID-19 Vaccine EUA Patient received Moderna second dose on 3/29/21 at 8:30 am and experienced weakness in legs later that day around 3:00 pm. Presented to emergency department on 3/30/21 with complaints of generalized body aches and numbness to both legs and lower arms, feeling like legs had fallen asleep. Initial examination in ED revealed sensory deficit with final diagnosis of myelitis, acute transverse and Guillain-Barre Syndrome after administration of vaccine. On 4/1/21, continuing to experience numbness with some ascending pattern, slight decrease in reflexes.


Changed on 5/21/2021

VAERS ID: 1156573 Before After
VAERS Form:2
Age:58.0
Sex:Male
Location:Texas
Vaccinated:2021-03-30
Onset:2021-03-30
Submitted:0000-00-00
Entered:2021-04-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / -

Administered by: Unknown      Purchased by: ??
Symptoms: C-reactive protein increased, Feeling abnormal, Guillain-Barre syndrome, Hypoaesthesia, Hyporeflexia, Muscular weakness, Myelitis transverse, Pain, Sensory loss, Computerised tomogram head normal

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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: amLODIPine (NORVASC), atenoloL (Tenormin), garlic, ibuprofen
Current Illness:
Preexisting Conditions: Degenerative arthropathy, hyperlipidemia, hypertension, psoriasis, psoriatic arthritis, benign essential HTN
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Moderna COVID-19 Vaccine EUA Patient received Moderna second dose on 3/29/21 at 8:30 am and experienced weakness in legs later that day around 3:00 pm. Presented to emergency department on 3/30/21 with complaints of generalized body aches and numbness to both legs and lower arms, feeling like legs had fallen asleep. Initial examination in ED revealed sensory deficit with final diagnosis of myelitis, acute transverse and Guillain-Barre Syndrome after administration of vaccine. On 4/1/21, continuing to experience numbness with some ascending pattern, slight decrease in reflexes.

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