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

This is VAERS ID 1475203

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Case Details

VAERS ID: 1475203 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-03-30
Onset:2021-04-12
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram, Cardiac monitoring, Chest X-ray, Computerised tomogram abdomen, Computerised tomogram thorax, Differential white blood cell count, Electrocardiogram, Full blood count, Guillain-Barre syndrome, Laboratory test, Metabolic function test, Troponin, Troponin I
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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown-received information via essence reporT
Current Illness: unknown-received information via essence report
Preexisting Conditions: unknown-received information via essence report
Allergies: unknown-received information via essence report
Diagnostic Lab Data: LAB1748 CBC WITH AUTO DIFFERENTIAL;LAB17 COMPREHENSIVE METABOLIC PANEL;RIS1259 XR CHEST 1V PORTABLE;ECG1 EKG 12-LEAD;IVT3 INSERT PERIPHERAL IV;NUR586 CONTINUOUS PULSE OXIMETRY;NUR342 ED NASAL CANNULA OXYGEN;NUR7021 CARDIAC MONITORING;LAB6953 TROPONIN 0; 1; 3 HR HIGH SENSITIVITY;LAB6386 *CBC WITH AUTO DIFFERENTIAL; LAB GENERATED ORDER;LAB6896 *TROPONIN I HS 0 HR (LAB GENERATED ORDER);LAB6956 *TROPONIN I HS 1 HOUR (LAB GENERATED ORDER);LAB1778 LIGHT GREEN TOP;RIS3218 CTA CHEST ABDOMEN PELVIS;LAB6957 *TROPONIN I HS 3 HOUR (LAB GENERATED ORDER)
CDC Split Type:

Write-up: Admitted for HTN, diagnosed with GBS and discharged on 13 April.


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