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

This is VAERS ID 1378479

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Case Details

VAERS ID: 1378479 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-10
Onset:2021-04-20
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / N/A LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angiogram, Aphasia, Arthralgia, Balance disorder, CSF protein increased, Central venous catheterisation, Feeding disorder, Guillain-Barre syndrome, Hypoaesthesia, Immunoglobulin therapy, Intensive care, Lumbar puncture abnormal, Magnetic resonance imaging normal, Musculoskeletal disorder, Neck pain, Pain, Pain in extremity, Paraesthesia, Plasmapheresis, Sensory loss, Swelling face, Weight bearing difficulty
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Dementia (broad), Embolic and thrombotic events, venous (narrow), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Demyelination (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 13 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: April 21, 2021 - CT w/Angio and MRI completed - unremarkable April 24, 2021 - Lumbar Puncture showed elevated protein levels in CSF
CDC Split Type:

Write-up: Radiating pain from the right neck, shoulder and arm that spread to the left side. Tingling sensation in fingers, along with pain. Taken to ED, labs and imaging were done that were inconclusive. Tingling and numbness spreading to feet and legs, but however patient was discharged even in worsening condition with no answers, and told to make an appointment with a neurologist the following week. After being brought home, the numbness spread and patient could not support her weight and would lose balance. Ambulance called and taken back to the same facility. Admitted under observation initially, the following day, a lumbar puncture was completed, at the request from our daughter (who is a nurse) to the doctors, that showed elevated protein in the CSF. It was concluded that patient showed clinical signs of Guillian-Barre Syndrome and was subsequently started on IVIG therapy. Her condition worsened and she was upgraded to progressive care and then the neuro ICU when numbness had spread to her face. A central line was placed and patient was started on plasmapheresis. Patient showed loss of feeling and function in her arms and legs, swelling in her face that did not allow her to speak or eat properly. 3 more rounds of IVIG were done after plasmapheresis was completed. Patient was stabilized and transferred to the rehabilitation hospital for rehab and therapy.


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