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This is VAERS ID 1286779

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History of Changes from the VAERS Wayback Machine

First Appeared on 5/7/2021

VAERS ID: 1286779
VAERS Form:2
Age:64.0
Sex:Male
Location:Florida
Vaccinated:2021-03-24
Onset:2021-04-04
Submitted:0000-00-00
Entered:2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Back pain, Blood glucose normal, Electromyogram abnormal, Guillain-Barre syndrome, Hypoaesthesia, Paraesthesia, Red blood cell count decreased, Restlessness, White blood cell count decreased, Protein total

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: EMG/NCS 4/23/2021 - Suggestive of an early/acute demyelinating polyradiculopathy. Abnormal/absent F responses, paraspinal fibrillations, conduction block/temporal dispersion maybe the only early signs at this point. CSF protein 148 CSF glucose 69 CSF wbc 2 in tube #1 CSF wbc 0 in tube #4 CSF rbc 21 in tube #1 CSF rbc 1 in tube #4
CDC 'Split Type':

Write-up: Guillain-Barre Syndrome - mild case. Tingling, numbness up entire legs more prominent in feet. Mild back pain. No weakness. Some numbness and paresthesias hands. Restlessness.


Changed on 5/14/2021

VAERS ID: 1286779 Before After
VAERS Form:2
Age:64.0
Sex:Male
Location:Florida
Vaccinated:2021-03-24
Onset:2021-04-04
Submitted:0000-00-00
Entered:2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Back pain, Blood glucose normal, Electromyogram abnormal, Guillain-Barre syndrome, Hypoaesthesia, Paraesthesia, Red blood cell count decreased, Restlessness, White blood cell count decreased, Protein total

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None None
Diagnostic Lab Data: EMG/NCS 4/23/2021 - Suggestive of an early/acute demyelinating polyradiculopathy. Abnormal/absent F responses, paraspinal fibrillations, conduction block/temporal dispersion maybe the only early signs at this point. CSF protein 148 CSF glucose 69 CSF wbc 2 in tube #1 CSF wbc 0 in tube #4 CSF rbc 21 in tube #1 CSF rbc 1 in tube #4
CDC 'Split Type':

Write-up: Guillain-Barre Syndrome - mild case. Tingling, numbness up entire legs more prominent in feet. Mild back pain. No weakness. Some numbness and paresthesias hands. Restlessness.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1286779&WAYBACKHISTORY=ON


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