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This is VAERS ID 1700857

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History of Changes from the VAERS Wayback Machine

First Appeared on 9/17/2021

VAERS ID: 1700857
VAERS Form:2
Age:27.0
Sex:Male
Location:California
Vaccinated:2021-04-28
Onset:2021-09-14
Submitted:0000-00-00
Entered:2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 UN / UN

Administered by: Private      Purchased by: ??
Symptoms: Full blood count normal, Hypoaesthesia, Muscular weakness, Tongue movement disturbance, Drug screen negative, Angiogram cerebral normal, Laboratory test normal, Hypoaesthesia oral, Scan with contrast normal, SARS-CoV-2 test negative, Magnetic resonance imaging head normal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 9/14/21 CBC and chem panel - all within normal 9/14/21 SARS-CoV-2 PCR - negative 9/14/21 Drug of Abuse test (Ethanol, Barbituate, Benzodiazepine, TCA, Phenytoin, Acetaminophen, Salicylate, Cannabinoid, Cocaine, Opiate, PCP, Methamphetamine) - All negative 9/14/21 CT Angio Head with IV contrast and whole brain perfusion - No acute intracranial large vessel occlusion, no focal perfusion deficit 9/15/21 MRI of the brain without contrast - Negative MRI of brain without contrast
CDC 'Split Type':

Write-up: 28 year old male with no past medical history who presents to the hospital with acute onset right arm and leg weakness and numbness, and weakness and numbness of the tongue, given alteplase for concern for stroke, now returned to baseline neuro function with no deficits.

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