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This is VAERS ID 1364621

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History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1364621
VAERS Form:2
Age:63.0
Sex:Male
Location:Unknown
Vaccinated:2021-04-08
Onset:2021-04-22
Submitted:0000-00-00
Entered:2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Asthenia, Guillain-Barre syndrome, Lumbar puncture abnormal, Paraesthesia

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: 14     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: LP 5/20/2021
CDC 'Split Type':

Write-up: Patient started with paresthesia and weakness mid April. He was ultimately diagnosed with Guillain-Barre syndrome via lumbar puncture on May 20th after 3 ED visits and 2 hospitalizations.

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