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

This is VAERS ID 1358035

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Case Details

VAERS ID: 1358035 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-05-07
Onset:2021-05-22
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Guillain-Barre syndrome, Immunology test, Lymphocyte count increased, Protein total increased
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: possible Lyme
Preexisting Conditions: anxiety
Allergies: pollen
Diagnostic Lab Data: LP 5/27. Patient had elevated protein with very mild lymphocytic pleocytosis in CSF. There was a presumptive positive Lyme test prior, which has not been confirmed. A repeat Lyme screen in the hospital was negative. The causality to the vaccine is not clear, but is plausible.
CDC Split Type:

Write-up: Guillain Barre syndrome.


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