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

This is VAERS ID 1388426

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Case Details

VAERS ID: 1388426 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Alabama  
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Basophil count, CSF culture, CSF glucose normal, Eosinophil count, Guillain-Barre syndrome, Haematocrit, Haemoglobin, Immunoglobulin therapy, Lumbar puncture, Lymphocyte count, Magnetic resonance imaging spinal, Mean cell haemoglobin, Mean cell haemoglobin concentration, Mean cell volume, Mean platelet volume, Monocyte count, Neutrophil count, Pain in extremity, Platelet count, Red blood cell count, Red cell distribution width, Rhabdomyolysis, White blood cell count
SMQs:, Rhabdomyolysis/myopathy (narrow), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (narrow), Demyelination (narrow), Tendinopathies and ligament disorders (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations: Shingles Vaccine
Other Medications: Lisinopril, Lipitor, and Amlodipine
Current Illness: Hypertension
Preexisting Conditions: Hypertension
Allergies: No known allergies
Diagnostic Lab Data: MRI L spine 4/28/21 Lumbar puncture CSF culture 4/27/21 WBC, RBC, HGB, HCT, MCV, MCH, MCHC, RDW, PLT, MPV, NEU, LYM, MON, EOS, BAS 4/28/21 CSFGLU 74 4/27/21
CDC Split Type:

Write-up: Admitted with c/o generalized weakness and significant pain to BLE s/p J and J vaccination. Neurology diagnosed pt with Guillain-Barre syndrome and is s/p IVIG and steroids''. Pt improved with IVIG and steroids''. Of note pt. states he has been to the hospital multiple times with these symptoms and told he had rhabdomyolysis 2/2 statin use therefore it was d/c on prior evaluations and he was d/c home. Further evaluation showed pt has Guillain-Barre syndrome.

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