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From the 11/26/2021 release of VAERS data:

This is VAERS ID 1377954

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Case Details

VAERS ID: 1377954 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-07
Onset:2021-04-13
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / UNK - / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood glucose normal, Guillain-Barre syndrome, Lumbar puncture abnormal, Protein total increased, Red blood cell count increased, White blood cell count normal
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: pantoprazole (PROTONIX) 40 mg Tablet, Delayed Release (E.C.) levothyroxine (SYNTHROID) 50 mcg Tablet ibuprofen (IBU) 800 mg Tablet amLODIPine (NORVASC) 5 mg Tablet lisinopriL (PRINIVIL) 10 mg Tablet cyclobenzaprine (FLEXERIL) 10 mg Tablet m
Current Illness: Gastroesophageal reflux disease Pelvic floor dysfunction Hyperlipidemia, mixed Hypothyroidism (acquired) Vitamin D deficiency Hyperkalemia Adenomatous polyp of colon H/O hemorrhoids Midline low back pain without sciatica Chronic idiopathic constipation Routine general medical examination at a health care facility Essential hypertension Osteopenia of multiple sites
Preexisting Conditions: Gastroesophageal reflux disease Pelvic floor dysfunction Hyperlipidemia, mixed Hypothyroidism (acquired) Vitamin D deficiency Hyperkalemia Adenomatous polyp of colon H/O hemorrhoids Midline low back pain without sciatica Chronic idiopathic constipation Routine general medical examination at a health care facility Essential hypertension Osteopenia of multiple sites
Allergies: HydrocodoneNausea and Vomiting Codeine
Diagnostic Lab Data: lumbar puncture was performed on 5/17/2021, and CSF analysis showed unremarkable cell count (WBCs 0, RBCs 14), glucose 71. Protein highly elevated to 145. Albumino-cytological dissociation. Hospitalization 5-2021
CDC Split Type:

Write-up: Guillain-Barre


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