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

This is VAERS ID 1381860

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Case Details

VAERS ID: 1381860 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Aphasia, Chest X-ray abnormal, Computerised tomogram abnormal, Eye movement disorder, Feeding disorder, Hydrocephalus, Influenza like illness, Jaw disorder, Mental status changes, Pulmonary oedema, Unresponsive to stimuli, Urinary tract infection, Urine analysis abnormal
SMQs:, Cardiac failure (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Infective pneumonia (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, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tegretol Phenobarbital Clonozepam Diazepam Soma
Current Illness: Epilepsy
Preexisting Conditions: Epilepsy Cerebral Palsy
Allergies: Penicillin
Diagnostic Lab Data: CT scan- hydrocephalus. Chest x-ray -small amount of fluid on one side of lung. Urinalysis -UTI Admitted to Hospital
CDC Split Type:

Write-up: Quick onset of flu like symptoms, progressed to altered mental state, unable to close her eyes. Unable to eat or drink. Her face was frozen with her open eyes fixed to the top of her head, jaw dropped. Unresponsive, unable to verbalize. I have cared for her over 15 years and have never seen anything like this . ER visit.


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