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This is VAERS ID 1763951

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First Appeared on 10/8/2021

VAERS ID: 1763951
VAERS Form:2
Age:59.0
Sex:Male
Location:Virginia
Vaccinated:2021-08-28
Onset:2021-09-13
Submitted:0000-00-00
Entered:2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / SYR

Administered by: Pharmacy      Purchased by: ??
Symptoms: Computerised tomogram, Facial paralysis, Guillain-Barre syndrome, Lumbar puncture abnormal, Fine motor skill dysfunction, Magnetic resonance imaging

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: protonix, vitamin D
Current Illness: none
Preexisting Conditions: none
Allergies: codiene
Diagnostic Lab Data: I had CT scans, MRI''s 9-13 thru 9 -18-2021. Diagnosed with Guillian-Barre after results of lumbar puncture by Dr. on 10/5/2021.
CDC 'Split Type':

Write-up: I received the vaccine on Aug 28th, 2021. I awoke on the morning on September 13th, 2021 with right side facial paralysis and was immediately taken to ER. I had a stroke work up and was admitted. On September 16th my loss of motor skills had spread to include my right leg.

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