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This is VAERS ID 1163209

History of Changes from the VAERS Wayback Machine

First Appeared on 4/8/2021

VAERS ID: 1163209
VAERS Form:2
Age:57.0
Sex:Male
Location:Connecticut
Vaccinated:2021-03-05
Onset:2021-03-17
Submitted:0000-00-00
Entered:2021-04-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Guillain-Barre syndrome, Hypoaesthesia, Paralysis, Pneumonia, Vaccination complication

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 10     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Numbness in extremities, paralysis full body. Pneumonia left lung. Now diagnosed with Guillain-Barre syndrome, due to reaction to covid-19 vaccine


Changed on 5/7/2021

VAERS ID: 1163209 Before After
VAERS Form:2
Age:57.0
Sex:Male
Location:Connecticut
Vaccinated:2021-03-05
Onset:2021-03-17
Submitted:0000-00-00
Entered:2021-04-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Guillain-Barre syndrome, Hypoaesthesia, Paralysis, Pneumonia, Vaccination complication

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 10     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Numbness in extremities, paralysis full body. Pneumonia left lung. Now diagnosed with Guillain-Barre syndrome, due to reaction to covid-19 vaccine


Changed on 5/14/2021

VAERS ID: 1163209 Before After
VAERS Form:2
Age:57.0
Sex:Male
Location:Connecticut
Vaccinated:2021-03-05
Onset:2021-03-17
Submitted:0000-00-00
Entered:2021-04-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Guillain-Barre syndrome, Hypoaesthesia, Paralysis, Pneumonia, Vaccination complication

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 10     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Numbness in extremities, paralysis full body. Pneumonia left lung. Now diagnosed with Guillain-Barre syndrome, due to reaction to covid-19 vaccine

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1163209&WAYBACKHISTORY=ON

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