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This is VAERS ID 1159226

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History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1159226
VAERS Form:2
Age:65.0
Sex:Male
Location:Michigan
Vaccinated:2021-03-12
Onset:2021-03-23
Submitted:0000-00-00
Entered:2021-04-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Areflexia, Asthenia, CSF protein increased, Guillain-Barre syndrome, Paraesthesia, White blood cell count increased, Balance disorder

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: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Voltaren ointment
Current Illness:
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: CSF: protein of 184, WBC 23 (mostly mononuclear). The elevated CSF WBC is uncommon, but reported in AIDP/GBS.
CDC 'Split Type':

Write-up: Slowly progressive tingling, imbalance, and mild weakness, with loss of reflexes, elevated CSF protein, and slightly elevated WBC in CSF. Current diagnosis is probable AIDP/GBS (Guillain Barre Syndrome) beginning about 12 days after vaccination. EXAM: Mild weakness, imbalance, absent reflexes in legs, trace biceps reflexes


Changed on 5/7/2021

VAERS ID: 1159226 Before After
VAERS Form:2
Age:65.0
Sex:Male
Location:Michigan
Vaccinated:2021-03-12
Onset:2021-03-23
Submitted:0000-00-00
Entered:2021-04-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Areflexia, Asthenia, CSF protein increased, Guillain-Barre syndrome, Paraesthesia, White blood cell count increased, Balance disorder

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: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Voltaren ointment
Current Illness:
Preexisting Conditions: None
Allergies: None None
Diagnostic Lab Data: CSF: protein of 184, WBC 23 (mostly mononuclear). The elevated CSF WBC is uncommon, but reported in AIDP/GBS.
CDC 'Split Type':

Write-up: Slowly progressive tingling, imbalance, and mild weakness, with loss of reflexes, elevated CSF protein, and slightly elevated WBC in CSF. Current diagnosis is probable AIDP/GBS (Guillain Barre Syndrome) beginning about 12 days after vaccination. EXAM: Mild weakness, imbalance, absent reflexes in legs, trace biceps reflexes


Changed on 5/21/2021

VAERS ID: 1159226 Before After
VAERS Form:2
Age:65.0
Sex:Male
Location:Michigan
Vaccinated:2021-03-12
Onset:2021-03-23
Submitted:0000-00-00
Entered:2021-04-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Areflexia, Asthenia, CSF protein increased, Guillain-Barre syndrome, Paraesthesia, White blood cell count increased, Balance disorder

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: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Voltaren ointment
Current Illness:
Preexisting Conditions: None
Allergies: None None
Diagnostic Lab Data: CSF: protein of 184, WBC 23 (mostly mononuclear). The elevated CSF WBC is uncommon, but reported in AIDP/GBS.
CDC 'Split Type':

Write-up: Slowly progressive tingling, imbalance, and mild weakness, with loss of reflexes, elevated CSF protein, and slightly elevated WBC in CSF. Current diagnosis is probable AIDP/GBS (Guillain Barre Syndrome) beginning about 12 days after vaccination. EXAM: Mild weakness, imbalance, absent reflexes in legs, trace biceps reflexes

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