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

This is VAERS ID 1470745

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Case Details

VAERS ID: 1470745 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Arizona  
   Days after vaccination:85
Submitted: 0000-00-00
Entered: 2021-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood gases normal, Blood lactic acid normal, Blood magnesium normal, Computerised tomogram head normal, Dyspnoea, Endotracheal intubation, Full blood count normal, Guillain-Barre syndrome, Influenza virus test negative, Intensive care, Metabolic function test, Mobility decreased, Muscular weakness, SARS-CoV-2 test negative, Urine analysis normal
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (narrow), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Demyelination (narrow), Respiratory failure (broad), Tendinopathies and ligament disorders (broad), Immune-mediated/autoimmune disorders (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Cetirizine Albuterol Iron supplement (oral) Vit C
Current Illness: Nio
Preexisting Conditions: Iron deficiency anemia GE Reflux 1997: rheumatic heart disease-monthly bicillin Severe obesity, BMI=54
Allergies: Vancomycin
Diagnostic Lab Data: see above
CDC Split Type:

Write-up: Guillain Barre suspected Area Hospital Admitted Admit date: 06/27/2021 Admitting Diagnosis: Worsening generalized weakness-secondary to possible Guillian Barr? Syndrome History of Present Illness: This is a 34-year-old female patient that presented at sells emergency department with a medical history of recent upper respiratory infection, obesity, asthma who stated she is short of breath. She has generalized muscular weakness x3 days and per mother''s report, the patient was unable to get out of bed and required max assist. The patient had a CT of the head, influenza swab, COVID-19 swab, CBC, CMP, magnesium level, lactic acid, venous blood gas and urinalysis. All imaging and diagnostic lab work were negative and within normal limits. Due to worsening weakness, the ED provider in hospital intubated the patient for transfer to Hospital ICU for further evaluation and treatment.

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