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

This is VAERS ID 1207752

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Case Details

VAERS ID: 1207752 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-20
Onset:2021-04-02
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Guillain-Barre syndrome, Hypoaesthesia, Hypoaesthesia oral, Paraesthesia
SMQs:, Peripheral neuropathy (narrow), Retroperitoneal fibrosis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow), Immune-mediated/autoimmune disorders (narrow), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Symptoms started 4/2/21. Stated as numbness and tingling in lower extremities and progressed to numbness of tongue and upper extremities along with back pain. Patient admitted to Hospital with R/O Guillian Barre Syndrome.


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