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This is VAERS ID 1207752

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History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1207752
VAERS Form:2
Age:52.0
Sex:Female
Location:Michigan
Vaccinated:2021-03-20
Onset:2021-04-02
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, Paraesthesia, Hypoaesthesia oral

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: 7     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.


Changed on 5/7/2021

VAERS ID: 1207752 Before After
VAERS Form:2
Age:52.0
Sex:Female
Location:Michigan
Vaccinated:2021-03-20
Onset:2021-04-02
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, Paraesthesia, Hypoaesthesia oral

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: 7     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.


Changed on 5/14/2021

VAERS ID: 1207752 Before After
VAERS Form:2
Age:52.0
Sex:Female
Location:Michigan
Vaccinated:2021-03-20
Onset:2021-04-02
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, Paraesthesia, Hypoaesthesia oral

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: 7     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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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1207752&WAYBACKHISTORY=ON


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