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This is VAERS ID 1267914

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History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1267914
VAERS Form:2
Age:45.0
Sex:Male
Location:Wisconsin
Vaccinated:2021-04-06
Onset:2021-04-18
Submitted:0000-00-00
Entered:2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Bulbar palsy, Guillain-Barre syndrome, Hypoaesthesia

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)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: URI started on 3/31
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Guillain Barre syndrome- symptoms of BLE numbness with ascending bulbar weakness developed 4/18 and diagnosed on 4/27


Changed on 5/7/2021

VAERS ID: 1267914 Before After
VAERS Form:2
Age:45.0
Sex:Male
Location:Wisconsin
Vaccinated:2021-04-06
Onset:2021-04-18
Submitted:0000-00-00
Entered:2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Bulbar palsy, Guillain-Barre syndrome, Hypoaesthesia

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)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: URI started on 3/31
Preexisting Conditions: N/A
Allergies: N/A N/A
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Guillain Barre syndrome- symptoms of BLE numbness with ascending bulbar weakness developed 4/18 and diagnosed on 4/27


Changed on 5/14/2021

VAERS ID: 1267914 Before After
VAERS Form:2
Age:45.0
Sex:Male
Location:Wisconsin
Vaccinated:2021-04-06
Onset:2021-04-18
Submitted:0000-00-00
Entered:2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Bulbar palsy, Guillain-Barre syndrome, Hypoaesthesia

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)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: URI started on 3/31
Preexisting Conditions: N/A
Allergies: N/A N/A
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Guillain Barre syndrome- symptoms of BLE numbness with ascending bulbar weakness developed 4/18 and diagnosed on 4/27

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1267914&WAYBACKHISTORY=ON


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