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

This is VAERS ID 1467184

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Case Details

VAERS ID: 1467184 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Idaho  
Vaccinated:2021-06-21
Onset:2021-06-30
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Guillain-Barre syndrome, Hyperhidrosis, Hypoaesthesia, Hypoaesthesia oral, Peripheral coldness, Pruritus, Temperature intolerance
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (narrow), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: PEANUT, TOMATO, WHEAT, BARLEY, RYE
Diagnostic Lab Data: N/A. PATIENT CURRENTLY AT MEDICAL CENTER AWAITING TO BE SEEN BY A NEUROLOGIST (07/13/21). SUSPECT GUILLIAN BARRE FROM NURSE AT DOCTOR''S OFFICE.
CDC Split Type:

Write-up: NUMB FACE INITIALLY, NUMBNESS DOWN BOTH LEGS. NO FEELING OF HOT OR COLD ON THIGHS, ARMS. LIPS CURRENTLY NUMB. ICY-HOT SENSATION WHEN WIND HITS BODY WHEN SWEATING. HANDS IN COLD WATER FEELS "ICE, ICE, ICE FREEZING COLD". HEAT FROM SUN IS SIGNIFICANTLY ENHANCED AS IF THE SKIN WERE BURNING


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