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This is VAERS ID 1172339

History of Changes from the VAERS Wayback Machine

First Appeared on 4/16/2021

VAERS ID: 1172339
VAERS Form:2
Age:59.0
Sex:Male
Location:Virginia
Vaccinated:2021-03-11
Onset:2021-03-18
Submitted:0000-00-00
Entered:2021-04-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / 1 UN / IM

Administered by: Private      Purchased by: ??
Symptoms: Guillain-Barre syndrome, Hypoaesthesia, Lumbar puncture, Muscular weakness

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: amLODIPine aspirin 81 mg Tablet, diazePAM gabapentin hydroCHLOROthiazide losartan nitroglycerin omeprazole oxyCODONE-acetaminophen potassium chloride SA (K-DUR) tiZANidine
Current Illness:
Preexisting Conditions: Type 2 DM, GERD, Chronic low back pain
Allergies: NKA
Diagnostic Lab Data: Lumbar puncture on 04/03/21
CDC 'Split Type':

Write-up: A week after the patient had the vaccine he developed weakness with numbness in the lower extremities. Patient continued to get worse and was admitted on 04/03 with concerns for Guillain-Barr? syndrome ( GBS). Patient is currently getting treatment for GBS.


Changed on 5/7/2021

VAERS ID: 1172339 Before After
VAERS Form:2
Age:59.0
Sex:Male
Location:Virginia
Vaccinated:2021-03-11
Onset:2021-03-18
Submitted:0000-00-00
Entered:2021-04-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / 1 UN / IM

Administered by: Private      Purchased by: ??
Symptoms: Guillain-Barre syndrome, Hypoaesthesia, Lumbar puncture, Muscular weakness

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: amLODIPine aspirin 81 mg Tablet, diazePAM gabapentin hydroCHLOROthiazide losartan nitroglycerin omeprazole oxyCODONE-acetaminophen potassium chloride SA (K-DUR) tiZANidine
Current Illness:
Preexisting Conditions: Type 2 DM, GERD, Chronic low back pain
Allergies: NKA NKA
Diagnostic Lab Data: Lumbar puncture on 04/03/21
CDC 'Split Type':

Write-up: A week after the patient had the vaccine he developed weakness with numbness in the lower extremities. Patient continued to get worse and was admitted on 04/03 with concerns for Guillain-Barr? Guillain-Barré syndrome ( GBS). Patient is currently getting treatment for GBS.


Changed on 5/14/2021

VAERS ID: 1172339 Before After
VAERS Form:2
Age:59.0
Sex:Male
Location:Virginia
Vaccinated:2021-03-11
Onset:2021-03-18
Submitted:0000-00-00
Entered:2021-04-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / 1 UN / IM

Administered by: Private      Purchased by: ??
Symptoms: Guillain-Barre syndrome, Hypoaesthesia, Lumbar puncture, Muscular weakness

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: amLODIPine aspirin 81 mg Tablet, diazePAM gabapentin hydroCHLOROthiazide losartan nitroglycerin omeprazole oxyCODONE-acetaminophen potassium chloride SA (K-DUR) tiZANidine
Current Illness:
Preexisting Conditions: Type 2 DM, GERD, Chronic low back pain
Allergies: NKA NKA
Diagnostic Lab Data: Lumbar puncture on 04/03/21
CDC 'Split Type':

Write-up: A week after the patient had the vaccine he developed weakness with numbness in the lower extremities. Patient continued to get worse and was admitted on 04/03 with concerns for Guillain-Barré Guillain-Barr? syndrome ( GBS). Patient is currently getting treatment for GBS.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1172339&WAYBACKHISTORY=ON

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