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This is VAERS ID 1283058

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History of Changes from the VAERS Wayback Machine

First Appeared on 5/7/2021

VAERS ID: 1283058
VAERS Form:2
Age:59.0
Sex:Male
Location:Minnesota
Vaccinated:2021-04-08
Onset:2021-04-27
Submitted:0000-00-00
Entered:2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private      Purchased by: ??
Symptoms: CSF protein, Guillain-Barre syndrome, Lumbar puncture, White blood cell count decreased, Magnetic resonance imaging head abnormal

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? No
Previous Vaccinations:
Other Medications: Eliquis, amlodipine, carvedilol, chlorthalidone, lisinopril, rosuvastatin
Current Illness: hypertension, atrial fibrillation,
Preexisting Conditions: hypertension, nephrolithiasis, atrial fib
Allergies: none
Diagnostic Lab Data: Lumbar puncture 5/3/21 CSF protein 240, WBC 3. MRI brain Enhancement of left facial nerve 5/1/2021
CDC 'Split Type':

Write-up: facial diplegia/Guillain Barre Varient.


Changed on 5/14/2021

VAERS ID: 1283058 Before After
VAERS Form:2
Age:59.0
Sex:Male
Location:Minnesota
Vaccinated:2021-04-08
Onset:2021-04-27
Submitted:0000-00-00
Entered:2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private      Purchased by: ??
Symptoms: CSF protein, Guillain-Barre syndrome, Lumbar puncture, White blood cell count decreased, Magnetic resonance imaging head abnormal

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? No
Previous Vaccinations:
Other Medications: Eliquis, amlodipine, carvedilol, chlorthalidone, lisinopril, rosuvastatin
Current Illness: hypertension, atrial fibrillation,
Preexisting Conditions: hypertension, nephrolithiasis, atrial fib
Allergies: none none
Diagnostic Lab Data: Lumbar puncture 5/3/21 CSF protein 240, WBC 3. MRI brain Enhancement of left facial nerve 5/1/2021
CDC 'Split Type':

Write-up: facial diplegia/Guillain Barre Varient.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1283058&WAYBACKHISTORY=ON


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