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This is VAERS ID 1478150

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History of Changes from the VAERS Wayback Machine

First Appeared on 7/23/2021

VAERS ID: 1478150
VAERS Form:2
Age:49.0
Sex:Male
Location:Texas
Vaccinated:2021-04-12
Onset:2021-06-21
Submitted:0000-00-00
Entered:2021-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / IM

Administered by: Private      Purchased by: ??
Symptoms: Guillain-Barre syndrome, Lumbar puncture

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 7     Extended hospital stay? No
Previous Vaccinations:
Other Medications: gemfibrozil metoprolol metformin losartan fiorcet asa coQ10 magnesium zyrtec
Current Illness:
Preexisting Conditions: hypertension hyperglycemia hyperlipidemia migrains hx of melanoma
Allergies: no known allergies
Diagnostic Lab Data: spinal tap proved dx
CDC 'Split Type':

Write-up: pt was diagnosed with Guillian Barre syndrome 06/22/2021

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