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This is VAERS ID 1377954

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History of Changes from the VAERS Wayback Machine

First Appeared on 6/11/2021

VAERS ID: 1377954
VAERS Form:2
Age:53.0
Sex:Female
Location:Virginia
Vaccinated:2021-04-07
Onset:2021-04-13
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

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: 5     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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