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From the 5/7/2021 release of VAERS data (an older release, current is 1/14/2022):

This is VAERS ID 1204072

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Case Details

VAERS ID: 1204072 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Massachusetts  
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Anaesthesia oral, Antinuclear antibody positive, Balance disorder, Blood albumin increased, CSF protein increased, Condition aggravated, Dry mouth, Gait disturbance, Guillain-Barre syndrome, Headache, Hyperaesthesia, Hypoaesthesia, Immunoglobulin therapy, Injection site discomfort, Laboratory test abnormal, Limb discomfort, Lumbar puncture abnormal, Magnetic resonance imaging head abnormal, Magnetic resonance imaging spinal abnormal, Malaise, Pruritus, Temperature intolerance
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Systemic lupus erythematosus (narrow), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow), Vestibular disorders (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Creatine, multivitamins
Current Illness: None
Preexisting Conditions: none
Allergies: None
Diagnostic Lab Data: MRI, multiple antibody studies that are positive for antinuclear antibodies n Her 2, positive to dilution 1:40 and 1:160 on 4/6 and 1:40 on 4/9, elevated CDG protein and albumin.
CDC Split Type:

Write-up: Patient had an initial response 2 days after the vaccine, with general malaise, dry mouth, headache and itching hands as well as local discomfort at the injection site that seemed to resolve spontaneously. On April 3rd he had non-specific changes in his hands that he attributed to cold weather that led to discomfort when running them under warm water. By monday APril 5th he was having worsening sensitivity in his hands and feet to heat, touch and experienced numbness. he also began to have difficulty walking. He went to the ER April 6th and was discharged April 7th after undergoing MRI of the brain and spinal cord, labs and lumbar puncture, with a presumptive diagnosis of early Guillain-barre Syndrome. His symptoms continued to worse, loss of gait was more pronounced as well as loss of balance and new off sensations in his tongue. He was admitted to the hospital, continued to undergo diagnostic workout. Results from tests on APril 6th came back positive for Anti nuclear antibodies and high protein in his CSF. He was treated with 3 days of infused Immunoglobolin therapy and was discharged on April 11th with a diagnosis of likely GBS. His symptoms continue to worsen slightly, but with less day to day decline

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