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

This is VAERS ID 1416421

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Case Details

VAERS ID: 1416421 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Arizona  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Guillain-Barre syndrome
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, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210634361

Write-up: GUILLAIN-BARR? SYNDROME; This spontaneous report received from a patient concerned a patient of unspecified age, sex, race and ethnic origin. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received Covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown and expiry: unknown) dose was not reported of frequency 1 total, administered on MAR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On an unspecified date in 2021, the patient was diagnosed with guillain-barr? syndrome, and has been hospitalized multiple times since April or May 2021. The action taken with Covid-19 vaccine ad26.cov2.s was not applicable. The outcome of guillain-barr? syndrome was not reported. This report was serious (Hospitalization Caused / Prolonged).; Sender''s Comments: V0: This spontaneous report concerns a patient of unspecified age/sex/race/ethnicity was diagnosed with Guillain-Barr? Syndrome (GBS) after an unspecified duration from receiving Janssen COVID-19 vaccine. It was reported that the patient have been hospitalized multiple times. No other details reported. The information available precludes a complete and meaningful assessment. The information regarding other potential etiologies is insufficient, and the occurrence of her symptoms could represent background incidence of such events in the general population. Considering the temporal relationship, the events are assessed to have an indeterminate relationship with vaccination.


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