National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1280230

Government Disclaimer on use of this data

History of Changes from the VAERS Wayback Machine

First Appeared on 5/7/2021

VAERS ID: 1280230
VAERS Form:2
Age:67.0
Sex:Male
Location:Alaska
Vaccinated:2021-03-22
Onset:2021-04-07
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

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: 5     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


Changed on 5/14/2021

VAERS ID: 1280230 Before After
VAERS Form:2
Age:67.0
Sex:Male
Location:Alaska
Vaccinated:2021-03-22
Onset:2021-04-07
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

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: 5     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 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&WAYBACKHISTORY=ON


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