National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts.org
Search Results

This is VAERS ID 1282816

Government Disclaimer on use of this data

History of Changes from the VAERS Wayback Machine

First Appeared on 5/7/2021

VAERS ID: 1282816
VAERS Form:2
Age:47.0
Sex:Male
Location:California
Vaccinated:2021-04-06
Onset:2021-05-02
Submitted:0000-00-00
Entered:2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / 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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None reported
Current Illness: None reported
Preexisting Conditions: congestive heart failure, hypertension, diabetes type 2, atrial fibrillation, history of sustained ventricular tachycardia, thrombocytopenia
Allergies: No known allergies
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient developed presumptive Guillain-Barré syndrome after receiving the J&J vaccine outside of a hospital.


Changed on 5/21/2021

VAERS ID: 1282816 Before After
VAERS Form:2
Age:47.0
Sex:Male
Location:California
Vaccinated:2021-04-06
Onset:2021-05-02
Submitted:0000-00-00
Entered:2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / 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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None reported
Current Illness: None reported
Preexisting Conditions: congestive heart failure, hypertension, diabetes type 2, atrial fibrillation, history of sustained ventricular tachycardia, thrombocytopenia
Allergies: No known allergies allergies
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient developed presumptive Guillain-Barré Guillain-Barr? syndrome after receiving the J&J vaccine outside of a hospital.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1282816&WAYBACKHISTORY=ON


Copyright © 2022 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166