National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 11/19/2021 release of VAERS data:

This is VAERS ID 1309969

Government Disclaimer on use of this data



Case Details

VAERS ID: 1309969 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-13
Onset:2021-04-09
   Days after vaccination:27
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Computerised tomogram head, Guillain-Barre syndrome, Immunoglobulin therapy, Lumbar puncture abnormal, Magnetic resonance imaging spinal abnormal, Magnetic resonance imaging thoracic, Muscular weakness, Subacute inflammatory demyelinating polyneuropathy
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalopathy/delirium (broad), Demyelination (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Multivitamin daily
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Spinal tap, lumbar MRI, Thoracic MRI, Brain CT Scan, numerous neurological clinical exams, other?
CDC Split Type:

Write-up: Acute Inflammatory Demyelinating Polyneuropathy/Guillain-Barre Syndrome, 6-day in-patient hospital admission, IVIG for 5 days, outcome undetermined as yet. Initial symptoms include severe low back pain for a week followed by bilateral leg weakness and ascending paralysis.


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1309969


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