VAERS ID: 956311

AGE: 50| SEX: M|STATE: WI (United States)

Description

Received fist Moderna Vaccine 12/30/2020. 01/07/2021 Started with bil leg numbness and weakness. By 1/15/2021 numbness constant both legs. Electric shock sensation at times down spine to feet. Weakness both legs started 1/18/2021. Neurologic injury being worked up for transverse myelith.

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Symptoms

Paraesthesia, Hypoaesthesia, Muscular weakness, Nerve injury, Magnetic resonance imaging spinal normal

Vaccines

VAX DATE: 12-30-2020| ONSET DATE: 01-07-2021| DAYS TO ONSET: 8
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (MODERNA)) 1 COVID19 MODERNA 011J20A IM RA

RECVDATE:01-19-2021
RPT_DATE:
CAGE_YR:50
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:N
LAB_DATA:Pt reports total spine MRI no compression.
V_ADMINBY:PVT
OTHER_MEDS:
CUR_ILL:
HISTORY:
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:01-19-2021
BIRTH_DEFECT:U
OFC_VISIT:Y
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:

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