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This is VAERS ID 1198191

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History of Changes from the VAERS Wayback Machine

First Appeared on 4/16/2021

VAERS ID: 1198191
VAERS Form:2
Age:72.0
Sex:Male
Location:Ohio
Vaccinated:2021-03-30
Onset:2021-04-04
Submitted:0000-00-00
Entered:2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Acute respiratory failure, Asthenia, Guillain-Barre syndrome, Lumbar puncture abnormal, Muscular weakness, Intervertebral disc degeneration, Scan with contrast abnormal, Mechanical ventilation, Endotracheal intubation, Immunoglobulin therapy, White matter lesion, Magnetic resonance imaging spinal abnormal, Magnetic resonance imaging head abnormal

Life Threatening? Yes
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: Atorvastatin, esomeprazole, folic acid, glyburide, Hydroxychloroquine, Januvia, metformin, methotrexate,
Current Illness: None
Preexisting Conditions: HTN, Type II DM, RA
Allergies: Morphine (hives/urticaria)
Diagnostic Lab Data: (4/10/2021) LP: albuminocytologic dissociation MRI brain: chronic white matter changes MRI C/T/L spine: lumbosacral nerve root enhancement, moderate degenerative changes
CDC 'Split Type':

Write-up: Patient developed progressive weakness and was diagnosed with Guillain-Barre Syndrome based on physical exam findings (ascending muscular weakness), lumbar puncture, and MRI findings. Disease course complicated by acute hypoxic respiratory failure which required endotracheal intubation and mechanical ventilation. He was treated with intravenous immunoglobulin x4 days.


Changed on 5/7/2021

VAERS ID: 1198191 Before After
VAERS Form:2
Age:72.0
Sex:Male
Location:Ohio
Vaccinated:2021-03-30
Onset:2021-04-04
Submitted:0000-00-00
Entered:2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Acute respiratory failure, Asthenia, Guillain-Barre syndrome, Lumbar puncture abnormal, Muscular weakness, Intervertebral disc degeneration, Scan with contrast abnormal, Mechanical ventilation, Endotracheal intubation, Immunoglobulin therapy, White matter lesion, Magnetic resonance imaging spinal abnormal, Magnetic resonance imaging head abnormal

Life Threatening? Yes
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: Atorvastatin, esomeprazole, folic acid, glyburide, Hydroxychloroquine, Januvia, metformin, methotrexate,
Current Illness: None
Preexisting Conditions: HTN, Type II DM, RA
Allergies: Morphine (hives/urticaria) (hives/urticaria)
Diagnostic Lab Data: (4/10/2021) LP: albuminocytologic dissociation MRI brain: chronic white matter changes MRI C/T/L spine: lumbosacral nerve root enhancement, moderate degenerative changes
CDC 'Split Type':

Write-up: Patient developed progressive weakness and was diagnosed with Guillain-Barre Syndrome based on physical exam findings (ascending muscular weakness), lumbar puncture, and MRI findings. Disease course complicated by acute hypoxic respiratory failure which required endotracheal intubation and mechanical ventilation. He was treated with intravenous immunoglobulin x4 days.


Changed on 5/14/2021

VAERS ID: 1198191 Before After
VAERS Form:2
Age:72.0
Sex:Male
Location:Ohio
Vaccinated:2021-03-30
Onset:2021-04-04
Submitted:0000-00-00
Entered:2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Acute respiratory failure, Asthenia, Guillain-Barre syndrome, Lumbar puncture abnormal, Muscular weakness, Intervertebral disc degeneration, Scan with contrast abnormal, Mechanical ventilation, Endotracheal intubation, Immunoglobulin therapy, White matter lesion, Magnetic resonance imaging spinal abnormal, Magnetic resonance imaging head abnormal

Life Threatening? Yes
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: Atorvastatin, esomeprazole, folic acid, glyburide, Hydroxychloroquine, Januvia, metformin, methotrexate,
Current Illness: None
Preexisting Conditions: HTN, Type II DM, RA
Allergies: Morphine (hives/urticaria) (hives/urticaria)
Diagnostic Lab Data: (4/10/2021) LP: albuminocytologic dissociation MRI brain: chronic white matter changes MRI C/T/L spine: lumbosacral nerve root enhancement, moderate degenerative changes
CDC 'Split Type':

Write-up: Patient developed progressive weakness and was diagnosed with Guillain-Barre Syndrome based on physical exam findings (ascending muscular weakness), lumbar puncture, and MRI findings. Disease course complicated by acute hypoxic respiratory failure which required endotracheal intubation and mechanical ventilation. He was treated with intravenous immunoglobulin x4 days.

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