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From the 11/26/2021 release of VAERS data:

This is VAERS ID 926703

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Case Details

VAERS ID: 926703 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2020-12-29
Onset:2020-12-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J202A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood test, Guillain-Barre syndrome, Immunoglobulin therapy, Magnetic resonance imaging, Neuralgia, Neurological examination, Paraesthesia
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Bradycardia at rest. History of Guillain Barre Syndrome/AIDP in 2010.
Allergies: None
Diagnostic Lab Data: MRI and bloodwork, neuro screening and tests.
CDC Split Type:

Write-up: Guillain Barre syndrome/AIDP event. Paresthesia and nerve pain developed in bilateral legs 4 hours after shot and progressed slowly for 4 days in intensity and area involved. Symptoms progressed distally to superior. On the 5th day symptoms progressed rapidly and involved bilateral legs up to the groin, left arm up to lateral shoulder, and right hand. I went to the hospital and was admitted to start IVIG treatment for Guillain Barre Syndrome/AIDP.


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