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From the 9/10/2021 release of VAERS data:

This is VAERS ID 1429829



Case Details

VAERS ID: 1429829 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-05-30
Onset:2021-06-04
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054C21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Fatigue, Paralysis
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: umknown
Allergies: nka
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: Per daughter: feeling tired and week, he went to the ER and was sent home. He went back due to worseing of weakness and was eventually sent to Pittsburgh hospital for further testing. His condition escalated to paralysis. Guillain-Barre syndrome was a possible diagnosis.


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