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From the 11/19/2021 release of VAERS data:

This is VAERS ID 1764038

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Case Details

VAERS ID: 1764038 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-08-13
Onset:2021-09-11
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002F21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Hemiparesis, Limb discomfort, Pain
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Noninfectious encephalitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of HEMIPARESIS (The left side of her body was not functioning.) in a 24-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 002F21A and 002F21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 13-Aug-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 10-Sep-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 11-Sep-2021, the patient experienced HEMIPARESIS (The left side of her body was not functioning.) (seriousness criterion medically significant), LIMB DISCOMFORT (She could not use her arm/She kept her arm at a 50 degree angle) and LIMB DISCOMFORT (She could not use her leg). On 16-Sep-2021, the patient experienced PAIN (Had a shooting pain from her fingertips to the very beginning of her neck). At the time of the report, HEMIPARESIS (The left side of her body was not functioning.), PAIN (Had a shooting pain from her fingertips to the very beginning of her neck) and LIMB DISCOMFORT (She could not use her arm/She kept her arm at a 50 degree angle) outcome was unknown and LIMB DISCOMFORT (She could not use her leg) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No concomitant medication was given. Laboratory data was mentioned as patient done the bloodwork on 24 Sep 2021 but results were not given. No treatment medication was given. It was reported that on 11 Sep 2021, the left side of her body was not functioning. She could not use her leg or arm. She kept her arm at a 50 degree angle because if she moved it, she had a shooting pain from her fingertips to the very beginning of her neck. The leg got better around 16 Sep 2021. She saw her doctor on 24 Sep 2021 and would have bloodwork done and was being sent to a neurologist to see if a nerve was hit. Date of end of reaction/event for the event the left side of her body was not functioning and she could not use her leg was reported as 16 Sep 2021. Company Comment: This case concerns a 24-year-old, female patient with no previous relevant medical history reported, who experienced the unexpected event of hemiparesis. The event occurred 1 days after the second dose of mRNA-1273. The rechallenge was not applicable since the event happened after the second dose. The benefit-risk relationship of mRNA-1273 is not affected by this report. Further information was requested.; Sender''s Comments: This case concerns a 24-year-old, female patient with no previous relevant medical history reported, who experienced the unexpected event of hemiparesis. The event occurred 1 days after the second dose of mRNA-1273. The rechallenge was not applicable since the event happened after the second dose. The benefit-risk relationship of mRNA-1273 is not affected by this report. Further information was requested.


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