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

This is VAERS ID 1487115



Case Details

VAERS ID: 1487115 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: New Hampshire  
Vaccinated:2021-05-26
Onset:2021-07-01
   Days after vaccination:36
Submitted: 0000-00-00
Entered: 2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 041C21A / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Balance disorder, Balance test, Fatigue, Memory impairment
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Escitalopram, valium, naltrexone, vitamin D supplement, OTC anti-allergy
Current Illness:
Preexisting Conditions: Fibromyalgia, benign joint hypermobility syndrome
Allergies: Latex, walnuts, cats (all very mild)
Diagnostic Lab Data: Basic neurology/balance test conducted by doctor. Doctor noted impaired balance and requested for me to make a neurology appointment, which is currently scheduled for December of 2021.
CDC Split Type:

Write-up: Beginning roughly May 15th, I began tapering off of diazepam to stop taking the medication at 0.5 mg a week (from original 5 mg dose); beginning around the week of July 5th, I started experiencing significant fatigue, balance issues, and memory problems. This has not resolved, but has not gotten worse. I strongly suspect this is due to withdrawal, but got the CDC phone call and decided it was worth reporting anyway, in case the vaccine increased the severity of my withdrawal symptoms.


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