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

This is VAERS ID 1467302

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Case Details

VAERS ID: 1467302 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-05-12
Onset:2021-06-02
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 UN / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: CSF protein increased, Guillain-Barre syndrome, Immunoglobulin therapy, Magnetic resonance imaging spinal abnormal, Muscular weakness, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Noninfectious encephalopathy/delirium (broad), Demyelination (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lisinopril, Gemfibrozil
Current Illness: None
Preexisting Conditions: HTN, HLD
Allergies: None
Diagnostic Lab Data: MRI lumbar spine showing intrathecal enhancement surrounding the cord and extending to the L5-S1 level CSF protein 828
CDC Split Type:

Write-up: The patient developed paresthesias and weakness in the legs approximately 2 weeks after the vaccine. After the thorough work-up he was diagnosed with Guillain-Barr? syndrome. He was treated with IVIG and has had some improvement.


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