National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 11/19/2021 release of VAERS data:

This is VAERS ID 1280230

Government Disclaimer on use of this data



Case Details

VAERS ID: 1280230 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Alaska  
Vaccinated:2021-03-22
Onset:2021-04-07
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-05-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / N/A UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Guillain-Barre syndrome
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow), Immune-mediated/autoimmune disorders (narrow)

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, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: atorvaSTATin (LIPITOR) 20 mg tablet (Taking) Take 20 mg by mouth nightly. lisinopril (PRINIVIL, ZESTRIL) 10 mg tablet (Taking) Take 10 mg by mouth Daily. omeprazole (PRILOSEC) 20 mg capsule (Taking) Take 20 mg by mouth every morning (b
Current Illness: Hypertension, osteoarthritis
Preexisting Conditions:
Allergies: PCN, cipro
Diagnostic Lab Data:
CDC Split Type:

Write-up: Developed Gullain Barre Syndrome approximately 2 weeks after vaccination


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1280230


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166