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This is VAERS ID 1290037

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History of Changes from the VAERS Wayback Machine

First Appeared on 5/7/2021

VAERS ID: 1290037
VAERS Form:2
Age:30.0
Sex:Female
Location:Connecticut
Vaccinated:2021-04-08
Onset:2021-04-27
Submitted:0000-00-00
Entered:2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / IM

Administered by: Private      Purchased by: ??
Symptoms: Guillain-Barre syndrome, Lumbar puncture abnormal, Paraesthesia, Rash, Facial paresis, Neurological symptom, Exposure during pregnancy

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: prenatal vitamins, Zoloft
Current Illness: none
Preexisting Conditions: depression, factor V Leiden heterozygous
Allergies: No known allergies
Diagnostic Lab Data: Lumbar puncture with elevated protein
CDC 'Split Type':

Write-up: Patient is 30 yo G1P0 at approximately 27 weeks gestation. Her pregnancy was complicated by depression on Zoloft. She reported an all-over body rash a week after the vaccine. Approximately 2 weeks later, she presented with neurological symptoms with L facial weakness, now with significant bifacial paresis and bilateral hand paresthesias concerning for Guillain Barre Syndrome which was confirmed on lumbar puncture.


Changed on 5/14/2021

VAERS ID: 1290037 Before After
VAERS Form:2
Age:30.0
Sex:Female
Location:Connecticut
Vaccinated:2021-04-08
Onset:2021-04-27
Submitted:0000-00-00
Entered:2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / IM

Administered by: Private      Purchased by: ??
Symptoms: Guillain-Barre syndrome, Lumbar puncture abnormal, Paraesthesia, Rash, Facial paresis, Neurological symptom, Exposure during pregnancy

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: prenatal vitamins, Zoloft
Current Illness: none
Preexisting Conditions: depression, factor V Leiden heterozygous
Allergies: No known allergies allergies
Diagnostic Lab Data: Lumbar puncture with elevated protein
CDC 'Split Type':

Write-up: Patient is 30 yo G1P0 at approximately 27 weeks gestation. Her pregnancy was complicated by depression on Zoloft. She reported an all-over body rash a week after the vaccine. Approximately 2 weeks later, she presented with neurological symptoms with L facial weakness, now with significant bifacial paresis and bilateral hand paresthesias concerning for Guillain Barre Syndrome which was confirmed on lumbar puncture.

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