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From the 4/1/2021 release of VAERS data:

Found 54,527 cases where Vaccine is COVID19 and Patient Did Not Die

Case Details (Reverse Sorted by Onset Date)

This is page 1 out of 546

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VAERS ID: 1146781 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-03-23
Onset:2021-03-30
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-03-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: history of ALL
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient got J&J Covid Vaccine 1 week prior. He now has COVID one week later and has received monoclonal antibodies treatment at our facility. Is there any recommendation to revaccinate?


VAERS ID: 1146974 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-03-29
Onset:2021-03-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER 1805031 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chills, Heart rate increased, Laboratory test normal, Mobility decreased, Muscle spasms, Speech disorder, Swelling, Swollen tongue, Tremor
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: No e
Diagnostic Lab Data: Lab tests came back negative
CDC Split Type:

Write-up: Woke up to severe muscle spasms, swollen tongue, swollen neck, resting heartbeat over 150bmp. Could barely walk or talk due to shaking and chills. This lasted 45 minutes but was nearly gone by the time I reached the ER. Doctors gave me a IV with Pepcid, Benadryl and steroids.


VAERS ID: 1147830 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-30
Onset:2021-03-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER 1805025 / N/A LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Condition aggravated, Fall, Loss of consciousness, Seizure
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: Hx of. Seizure
Allergies: N/A
Diagnostic Lab Data: N/a
CDC Split Type:

Write-up: At approximately 1238 patient was noted to be on floor, experienced fall from chair. 911 called. came to patient. Pt placed in recumbent position. noted to be having seizure regained consciousness. Airway not obstructed no s/s if respiratory destress noted. Regain consciousness after 2 seconds. Vs bp130/82, O298% on RA, HR 72, RR 28. Denies pain or discomfort. Pt alert and oriented able to state his name date location. Mae x34 l neurologically intact. did not give Epi . No s/s of anaphylaxis noted. please patient and become a position. Ambulance and fire department on site at this time.


VAERS ID: 1150540 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-24
Onset:2021-03-30
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-03-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Atrial fibrillation, Coagulation test, Electrocardiogram, Fatigue, Headache, Laboratory test, Myalgia, Rhinorrhoea, Troponin
SMQs:, Rhabdomyolysis/myopathy (broad), Supraventricular tachyarrhythmias (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: EKG''s, baseline labs, troponin, coag''s
CDC Split Type:

Write-up: Pt had J&J vaccine 1 week ago and developed spontaneous afib with RVR rates to 150, difficult to rate control, admitted to hospital for conversion. Reports se felt myalgias, rhinorrhea, headache, and fatigue for several days. Today she is extremely tired.


VAERS ID: 1152218 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-03-30
Onset:2021-03-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Postictal state, Pyrexia, Seizure
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Atenolol, Atorvastatin, Gabapentin, Lisinopril, Zoloft
Current Illness:
Preexisting Conditions: HTN, depression, HLD
Allergies: PCN
Diagnostic Lab Data:
CDC Split Type:

Write-up: went today to get a COVID-19 vaccination (Johnson & Johnson) today. She is here for seizures. Apparently she was fine shortly after the shot and then this afternoon started having chills and fever and then had with the family said was a 30-minute seizure before EMS was called. EMS found her postictal and during the transport they had she had another seizure in route. In the emergency room she had a fever of 101 and was postictal


VAERS ID: 1147356 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-03-13
Onset:2021-03-29
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-03-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bradykinesia, COVID-19, Cough, Mental status changes, Pneumonia, Pyrexia, SARS-CoV-2 test positive, Tachycardia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Dehydration (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: aspirin, glipizide, metformin
Current Illness:
Preexisting Conditions: Diabetic retinopathy of both eyes, hyperlipidemia, leukopenia, kaposi sarcoma, hemorrhoids, diabetes "1.5", managed as type 2, depression, carotid artery disease, AVM (congenital), allergic rhinitis.
Allergies: Shellfish (anaphylaxis), adhesive tape, aluminum, horse derived products (positive during allergy testing), latex
Diagnostic Lab Data: 3/29/2021: Positive SARS-CoV-2 PCR NP
CDC Split Type:

Write-up: Pt received dose of J&J vaccine (Janssen) on 3/13/2021. Symptoms began around 3/27 similar to COVID-19. Pt presented to ED at another local hospital 3/29/2021, tested positive for COVID-19 and was transferred to be admitted to our hospital for treatment of COVID-19. Notes from hospital admission H&P: Patient is a 59 y.o. male with history DM, Who presented to Urgent care then hospital ER with covid positive, PNA, Fever and a cough. Real tachycardic there to 117, temp to 103, confused, moving slow. Altered mental status (slow cognition), 94% on 2L"


VAERS ID: 1149738 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-03-29
Onset:2021-03-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Angiogram cerebral abnormal, Arteriogram carotid abnormal, Cerebral artery occlusion, Cerebrovascular accident, Computerised tomogram head abnormal, Computerised tomogram neck, Fibrin D dimer increased
SMQs:, Haemorrhage laboratory terms (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vitamin D2, loperamide PRN, multivitamin
Current Illness: Breast cancer treated in 20 with partial mastectomy, treated with chemo, radiation
Preexisting Conditions: Breast cancer treated in 20 with partial mastectomy, treated with chemo, radiation
Allergies: None
Diagnostic Lab Data: -CT/CTA of the head and neck demonstrating a large vessel occlusion in the right MCA territory. Patient underwent TPA therapy. Market improvement and examination. Overall currently doing well. Patient?s labs notable for D dimer elevated greater than 21,600 (greater than assay)? She has multiple reasons to have an elevated D dimer including having a stroke, cancer, and recently having receive TPA therapy. Again, unclear to us whether or not these events are causative, coincidental, or otherwise. But we felt it was reasonable to report
CDC Split Type:

Write-up: Patient presented to Medical center with right sided MCA stroke (proximal M1) occlusion. She underwent tPA therapy and is recovering. She has a history of breast cancer that was treated in 2017. It?s unclear to us whether or not these events are related. However, given the thrombosis occurred on the same day as the vaccine was administered, we felt it was a reportable event


VAERS ID: 1152033 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-03-23
Onset:2021-03-29
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-03-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angioedema, Blood glucose normal, Chest X-ray normal, Eczema, Full blood count normal, Influenza A virus test negative, Lip swelling, Metabolic function test, Pruritus, Rash, Respiratory syncytial virus test negative, SARS-CoV-2 test negative, Swelling face, Troponin normal, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: The patient takes a prescription anti-hypertensive but is unsure of the name.
Current Illness: None
Preexisting Conditions: Hay fever, eczema, hypertension, sinusitis
Allergies: Shellfish
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient is a 69-year-old female who reports a history of hayfever who is coming in today after recent Covid vaccination with concerns of facial swelling also complaining of the rash and itching to her chest. On exam the patient has obvious facial swelling. She has what appears to be an urticarial rash on her chest. While she does have swelling around her lips and face otherwise she does not appear to have any obvious signs of airway involvement with no swelling of her tongue or uvula, she has good phonation with normal respirations without difficulty. Does not appear to be having reactive airway disease exacerbation at this time. Does not appear to have impending respiratory distress. She otherwise does have some skin changes in her bilateral lower extremities that she reports is baseline with her history of eczema. Primary concern at this time is for possible allergic reaction. Patient appears to have angioedema. Does not appear to have anaphylaxis. Other abnormalities are considered. Patient will be connected to cardiac and respiratory monitors. IV access will be obtained. The patient will be given a 1 L IV fluid bolus. She will be given Benadryl, Solu-Medrol, and famotidine. Patient be monitored for response. Labs have been ordered to evaluate. EKG as well as chest x-ray will be obtained. We will file VARES report. Chest x-ray obtained. There is no acute cardiac no acute pulmonary pathology on my interpretation. Laboratory evaluation has returned. The patient''s CBC is reassuring. CMP shows a glucose of 78, otherwise reassuring without significant abnormality. Troponin within normal limits. Covid, influenza, RSV testing is negative. On repeat evaluation the patient is resting comfortably. She reports that the itching has resolved. Her face feels less uncomfortable. She has had no progression of the swelling. On repeat examination she continues to have facial swelling as well as swelling around her lips however she has no tongue swelling, no swelling within her posterior oropharynx, and her phonation continues to be normal. She and her friend were informed of the initial findings. Plan at this time is to admit for further evaluation and treatment.


VAERS ID: 1152388 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-03-15
Onset:2021-03-29
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-03-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: CSF cell count, Computerised tomogram spine, Magnetic resonance imaging, Multiple sclerosis, Myelitis transverse, Myelopathy
SMQs:, Peripheral neuropathy (narrow), Optic nerve disorders (broad), Demyelination (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: buproprion,
Current Illness:
Preexisting Conditions:
Allergies: pollen
Diagnostic Lab Data: 3/29/21:MRI C/T spine pre/post; CSF
CDC Split Type:

Write-up: Thoracic myelopathy, likely transverse myelitis, poss. first presentation mult. sclerosis, recent covid vaccine


VAERS ID: 1142457 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-28
Onset:2021-03-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Atrial fibrillation, Cardiac monitoring, Electrocardiogram, Presyncope
SMQs:, Anticholinergic syndrome (broad), Supraventricular tachyarrhythmias (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: omeprazole atovastatin coreg prednisone tylenol colace renvela
Current Illness: congestive heart failure ovarian cancer hypertension malignant ascites
Preexisting Conditions: systemic lupus end stage renal disease on hemodialysis
Allergies: penicillin sulfa codeine
Diagnostic Lab Data: ekgs cardiac monitoring
CDC Split Type:

Write-up: near syncopal episode and new onset of rapid atrial fibrillation


VAERS ID: 1140111 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-03-27
Onset:2021-03-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Angiogram, Blood glucose, Computerised tomogram, Dysarthria, Facial paralysis, Laboratory test, Magnetic resonance imaging, Muscle strength abnormal, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hearing impairment (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: estradiol, gabapentin, mirtazapine, pantoprazole, promethazine, tizanidine
Current Illness: recent hiatal hernia repair recent bells palsy
Preexisting Conditions: anxiety depression
Allergies: ancef, Percocet, reglan
Diagnostic Lab Data: CT, MRI/MRA, labs, glucose, given TPA
CDC Split Type:

Write-up: had syncope approx. 15 mins after injection - after pt aroused she was noted to right have facial droop, slurred speech, dysarthria, 2/5 strength to RLE, 4/5 strength to RUE.


VAERS ID: 1136389 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-25
Onset:2021-03-26
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pain, Tremor, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Involuntary shaking from 12:10 to 1:30 vomiting from 12:10-1:30 only stopped after I took Benadryl. But my body is still recovering from the shaking and vomiting and I am sore all over.


VAERS ID: 1136613 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-03-26
Onset:2021-03-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: UNK
Diagnostic Lab Data: BP 143/90
CDC Split Type:

Write-up: Patient complained of lightheadedness within 15 minutes of receiving vaccine. Patient was still in observation area at time of event. Blood pressure was WNL, gliucose testing was not available. Patient was given high sugar snack (candy bar) and felt better within 30 minutes. EMS was not contacted. No further issue.


VAERS ID: 1136672 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-22
Onset:2021-03-26
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: swelling at the site lasting 1 day
Other Medications: Carvedilol, Topiramate, Buspirone, Aspirin, Fluoxetine, Clopidogrel, Amlodipine, Atrovastatin, Melatonin
Current Illness:
Preexisting Conditions: CHF, Migraines, Depression,
Allergies: Imitrex, Keppra, Compazine, Morphine
Diagnostic Lab Data: no testing
CDC Split Type:

Write-up: Swelling at injection site started within 15 minutes of injection over the next day the site grew to golf ball size with redness and heat very painful. Injection site continues to be golf ball size, hot to touch, and red and purple in the area now day 5.


VAERS ID: 1136826 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-25
Onset:2021-03-26
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dizziness, Fatigue, Headache, Heart rate increased
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Vestibular disorders (broad), Dehydration (broad)

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
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: none listed
Diagnostic Lab Data: none as of this report
CDC Split Type:

Write-up: Patient started experiencing rapid heart rate around 4AM on 3/26/2021, she had reported to the pharmacist she also has had some dizziness and has stayed in bed. She did have some of the other usual side effects of the vaccine - chills, mild headache, tired. The rapid heart rate has not subsided or worsened. She doesn''t have a primary care doctor. The pharmacist recommended she call 911, which is recommended, just in case it is an allergic reaction and it can be treated quickly.


VAERS ID: 1136915 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-03-26
Onset:2021-03-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dyspnoea, Heart rate increased, Paraesthesia, Pruritus
SMQs:, Anaphylactic reaction (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

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: none reported
Current Illness: None Reported
Preexisting Conditions: None Reported
Allergies: IVP Dye; Shellfish
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Complaint of itching and tingling around neck, ears, and face. Felt as if had rapid heart rate and short of breath. Blood Pressure stable at 150/85 and 158/90 and Heartrate 66-80/min. O2 Sat 88% when EMS arrived. Epinephrine .5mg epinephrine administered and Benadryl 50 mg IM; O2 at 2 L NC. EMS called and transported to Medical Center. Stable at time of departure with EMS at 9:34. Reaction started within 15 minutes of receiving vaccine.


VAERS ID: 1136946 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: South Dakota  
Vaccinated:2021-03-25
Onset:2021-03-26
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Diplopia, Headache, Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Ocular motility disorders (broad), Hypoglycaemia (broad)

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
Current Illness: denies
Preexisting Conditions: none
Allergies: none noted
Diagnostic Lab Data: unsure at time of report
CDC Split Type:

Write-up: numbness to left side, headache and double vision


VAERS ID: 1137019 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: New York  
Vaccinated:2021-03-26
Onset:2021-03-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Loss of consciousness, Seizure, Tonic clonic movements
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Keppra
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient passed out and began seizing within 5 minutes of vaccine administration sitting down on chair. Tonic, clonic motions for 5 seconds. No foaming at the mouth. Patient was taken off chair, held on the ground until seizure ended. Patient gained consciousness after a minute. Given water, snacks, air and EMS was called. EMS assessed situation, and allowed patient''s girlfriend to pick him up from site and drive back home.


VAERS ID: 1137049 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-03-26
Onset:2021-03-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Burning sensation, Dizziness, Headache, Nausea
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient experienced nausea, headache, burning sensation in arm, lightheaded, dizziness


VAERS ID: 1137056 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-03-25
Onset:2021-03-26
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever and muscle aches.


VAERS ID: 1137075 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-03-26
Onset:2021-03-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / N/A LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Dizziness, Hyperhidrosis, Pain in extremity, Pallor, Tinnitus
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hearing impairment (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Ringing in ears, sweating, dizziness, arm soreness. Patient appeared pale


VAERS ID: 1137419 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-03-25
Onset:2021-03-26
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Headache, Pain, Pain in extremity, Restlessness
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Akathisia (broad), Noninfectious encephalopathy/delirium (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Aches, restlessness, arm hurts, headache


VAERS ID: 1131813 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-03-24
Onset:2021-03-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain upper, Chills, Dizziness, Pyrexia, Renal pain
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: No medical insurance
CDC Split Type:

Write-up: Whole stomach cramps Aching kidneys Fever Chills Dizzy


VAERS ID: 1131893 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-03-24
Onset:2021-03-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Headache, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Body aches (back, knees, elbows), fever, headache


VAERS ID: 1131971 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-03-10
Onset:2021-03-25
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Injection site pain, Sleep disorder
SMQs:, Extravasation events (injections, infusions and implants) (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Arm was a little sore after injection but exploded into searing stabbing pain at the 2 week mark. The pinpoint soreness was vague and lingering until the middle of the night last night when the intense pain woke me from my sleep. It isn''t bursa pain it is deltoid pain more intense than I ever imagined it could be especially at the two week mark post vaccine!! It is pretty terrible.


VAERS ID: 1132418 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-03-25
Onset:2021-03-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Dizziness, Heart rate decreased, Hyperhidrosis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Allergies: NKA
Diagnostic Lab Data: None monitored VS
CDC Split Type:

Write-up: Couple minutes after receiving the vaccine patient was: diaphoretic heart rate mid 30''s did drop to high 20''s, weak, diazzy. Blood pressure 149/80. Incident lasted approximately 15-20 minutes and symptoms resolved. Action took was monitor patient.


VAERS ID: 1132723 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-03-24
Onset:2021-03-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Diarrhoea, Dizziness, Loss of consciousness, Tinnitus
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hearing impairment (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: birth control pills
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Woke up to strong and painful diarrhea - almost passed out while sitting on the toilet. Had an odd white noise in my ears - not "ringing" but buzzing kind of sound. Lasted for about 3-5 minutes and I ended up lying on the floor for about 15 minutes before I could get back up. Felt like I may blackout. It''s three hours later and I''m ok now.


VAERS ID: 1132803 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-03-25
Onset:2021-03-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Cold sweat, Dizziness, Hyperhidrosis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient stated they felt "lightheaded, clammy and sweaty". BP was 72/48, HR was 44, and O2 sat was 99%. Started about 10 minutes after receiving vaccination. No interventions needed and no transport. Recovered on own and was able to walk out of clinic.


VAERS ID: 1133185 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-03-25
Onset:2021-03-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1085029 / N/A RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Periorbital swelling, Pruritus, Swelling of eyelid
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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:
Current Illness:
Preexisting Conditions:
Allergies: N/a
Diagnostic Lab Data: Employee was escorted to Emergency Room for further evaluation. States that she was given steroid injection and then prescribed oral steroid taper pack.
CDC Split Type:

Write-up: Approximately 15 minutes after receiving dose of vaccine, employee states that she began to itch all over. Eyelids and periorbital area began to swell. She did not experience any shortness of breath or difficulty swallowing.


VAERS ID: 1133268 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-03-25
Onset:2021-03-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 18008978 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cough, Dyspnoea, Pharyngeal swelling, Pruritus
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: no
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data:
CDC Split Type: Pt has never been immuniz

Write-up: Pt complained of SOB, itching, throat swelling and coughing, Pt was given, epi injection, Benadryl and supplemental O2. Vital signs remained stable.


VAERS ID: 1133281 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-03-25
Onset:2021-03-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 4 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Immediate post-injection reaction, Tachypnoea
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Respiratory failure (broad), Hypoglycaemia (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Atenolol, Losartan, Valium, Zyrtec, acetazolamide, Baclofen
Current Illness: Mast cell activation
Preexisting Conditions: Mast cell activation, SVT, dystonia,
Allergies: Compazine
Diagnostic Lab Data: None
CDC Split Type:

Write-up: History of mast cell activation and patient stated she "usually has reactions to everything." Patient experienced tachypnea and anxiety immediately following administration of dose of vaccine. SxS persisted for approximately 45 minutes. EMS was called to the scene to evaluate patient. symptoms decreased after 45 minutes and patient stated she did not want to go to the hospital. Reference EMS Incident for full PCR. Advised patient to contact her primary care physician for follow up.


VAERS ID: 1133284 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-03-25
Onset:2021-03-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Dry mouth, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu vaccine, employee allergic to eggs, must have egg free vaccine
Other Medications: BP pressure medication ( Employee can not remember name of medication) Symbicort Allergic medication (Employee can''t remember the name of the medication)
Current Illness: none
Preexisting Conditions: asthma, HTN
Allergies: Eggs, seafood, dairy, shell fish, iodine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Dizziness, nausea, dry mouth all within two hours of receiving vaccine


VAERS ID: 1133329 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-25
Onset:2021-03-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Fall, Loss of consciousness, Skin abrasion
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Pt began to feel lightheaded. Stood up to call nurse then lost consciousness, falling to the ground, scraping his face on the concrete. Pt had facial abrasions. Was transported to Urgent Care.


VAERS ID: 1133570 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-14
Onset:2021-03-25
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pain in extremity, Rash erythematous, Skin warm
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: sertraline 50mg
Current Illness: none
Preexisting Conditions: none
Allergies: Lortab
Diagnostic Lab Data:
CDC Split Type:

Write-up: Day 11 .. right arm .. red splotchy rash, hot to the touch "Covid Arm" No prior symptoms other than sore arm.


VAERS ID: 1133592 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-25
Onset:2021-03-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chest discomfort, Chest pain
SMQs:, Anaphylactic reaction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Estrodial
Current Illness:
Preexisting Conditions: Atrial Septal Aneurysm
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: received J&J vaccine. after observation period EE left. EE returned at 1124 after 5 minutes to report chest pain / tightness. IMT called for at 1125. Initial Vitals taken . 138/63 P 78 Spo2 100. IMT arrived at 1132. second set of vitals taken 132/72 P 67 Spo2 100. IMT assessed EE. EE declined transport. EE electing to remain and be monitored longer. Next set of vital 108/73 P 60 SPo2 99 at 1145.


VAERS ID: 1133990 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: North Dakota  
Vaccinated:2021-03-17
Onset:2021-03-25
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Headache, Nausea
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE REPORTED
Current Illness: PATIENT DID HAVE COVID BUT MORE THAN A MONTH PRIOR TO RECEIVING THE VACCINATION
Preexisting Conditions: NONE
Allergies: NONE REPORTED
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: HEADACHE, CHILLS, NAUSEA; PATIENT EXPLAINED SYMPTOMS AS BEING EXACTLY HOW SHE FELT WHEN SHE HAD COVID


VAERS ID: 1134178 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-24
Onset:2021-03-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Patient had previous blackout 25yrs ago/did not disclose
Other Medications: UNKNOWN
Current Illness: UNKNOWN
Preexisting Conditions: UNKNOWN
Allergies: UNKNOWN
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Patient experienced a period of unconsciousness while waiting during the post-vaccine period of 15 minutes


VAERS ID: 1134359 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-25
Onset:2021-03-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Blood glucose normal, Dizziness, Fatigue, Hypotension
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid, Cytomel
Current Illness:
Preexisting Conditions: Hypothyroid, Epilepsy
Allergies: Monocin
Diagnostic Lab Data: BP: 78/51, P: 52, Non- fasting Blood Glucose:175. 2nd BP: 111/72
CDC Split Type:

Write-up: Lightheaded, dizzy, fatigue, hypotension


VAERS ID: 1134362 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-24
Onset:2021-03-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Dizziness postural, Influenza, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Woke up around midnight with fever of 102.8 and chills. My normal temp is 97.4. Felt slightly dizzy when standing up. Took Tylenol and started feeling better after about 2-1/2 hours. The next morning, the 25th, felt like I had a mild case of the flu but, again, Tylenol seemed to help. No soreness in arm or other symptoms.


VAERS ID: 1134392 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-03-24
Onset:2021-03-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chills, Dyspnoea, Fatigue, Headache, Muscular weakness, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Cymbalta 60mg
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: On the evening of the day I received the vaccine, I had fatigue and severe chills. The following day, I had severe chills still that were not improving, a headache, vomiting, muscle weakness, and slight shortness of breath. The chills started the evening of the vaccine around 6:30pm, and have not stopped. The vomiting happened the day after my vaccination at 8:30am.


VAERS ID: 1134552 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-03-25
Onset:2021-03-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: none
Preexisting Conditions: none
Allergies: NKA
Diagnostic Lab Data: none available
CDC Split Type:

Write-up: Patient fainted after receiving vaccination.


VAERS ID: 1134642 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-25
Onset:2021-03-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Confusional state, Dry skin, Head injury, Loss of consciousness, Musculoskeletal stiffness, Pallor, Skin warm, Vital signs measurement
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Arthritis (broad), Hypoglycaemia (broad), Dehydration (broad)

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: None per patient
Current Illness: None per patient
Preexisting Conditions: None per patient
Allergies: None per patient
Diagnostic Lab Data: Unknown. Patient transported by EMS to hospital.
CDC Split Type:

Write-up: Patient received Janssen COVID-19 vaccine at 123pm on 3/25/2021. Patient directed to observation area and fell backwards out of chair at 127pm on 3/25/2021. After falling backwards out of chair patient had a full body stiffening episode and was noted to be bleeding from his head. Bleeding controlled with gauze held by an RN. Patient initially GCS 13 and unable to answer questions appropriately, manual blood pressure 118/60 HR 50 SpO2 89% on room air, patient pale and dry. Patients legs raised by RN and pressure to laceration on top of forehead continued to be held by RN. After 5-7 minutes patient GCS increased to 15 and he was alert and oriented x 4, manual blood pressure 114/60 HR 62 SpO2 97% on room air, patient pink warm and dry. Fire arrived on scene at 147pm and Ambulance shortly after. Fire and Ambulance given report by RN on site while other RN on site continued holding pressure to laceration on forehead with gauze.


VAERS ID: 1134845 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-03-25
Onset:2021-03-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Erythema, Fall, Feeling hot, Headache, Hyperhidrosis, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received vaccine while seated and had no problems. She stood up and walked several feet to the observation seating area and had a seat. A few minutes later she fainted and fell out of the chair onto the floor. We helped her up to a sitting position and gave her a bottle of water and an ice pack. The right side of her forehead appeared red from apparent hit on the floor when she fainted. We had her wait on the floor for about 30 minutes to ensure she remained conscious. Patient reported an ache on her forehead at site of hit. She was also sweating and reported feeling hot. Patient had a partner with her who agreed to escort her to an urgent care clinic in the same building as the pharmacy. Store manager in charge took the patient to the urgent care clinic by wheelchair to be examined.


VAERS ID: 1135353 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-25
Onset:2021-03-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / UNK - / IM

Administered by: Other       Purchased by: ?
Symptoms: Hepatitis B immunisation, Inappropriate schedule of product administration
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: none reported
Preexisting Conditions: none reported
Allergies: no known allergies
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Client denied in written format and verbally that he received any other vaccinations 14 days prior to receiving the COVID vaccination. Client had received Hep B (HEPLISAV-B) on 3/18/2021


VAERS ID: 1135423 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-25
Onset:2021-03-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Fatigue, Headache, Vital signs measurement
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Brain Cancer (Pt had brain surgery 6 years ago) Headaches
Allergies: Milk, cheese, Advil
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient reports feeling tired and headaches. No lightheadedness, no hives or flushing. Patient was seen and assessed by EMS. BP 137/91, pulse 78, Spo2 100%, BS 152. Patient reports feeling better (symptoms improved) cleared by EMS


VAERS ID: 1135429 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-03-25
Onset:2021-03-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Anaphylactic reaction, Full blood count normal, Lip swelling, Metabolic function test normal, Swollen tongue
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: vitamin D3 keppra multivitamin
Current Illness: none
Preexisting Conditions: dementia, HTN, Sick sinus syndrome with pacer,
Allergies: sulfa antibiotics
Diagnostic Lab Data: normal CBC and BMP
CDC Split Type:

Write-up: tongue and lip swelling concerning for anaphylaxis


VAERS ID: 1135839 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-25
Onset:2021-03-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient felt dizzy, lightheaded and passed out. Cleared by EMS


VAERS ID: 1135899 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: New York  
Vaccinated:2021-03-25
Onset:2021-03-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Hypoaesthesia, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Vestibular disorders (broad)

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: None known
Current Illness: none reported
Preexisting Conditions: none reported
Allergies: none known
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: 1432hr Pt fell to the ground c/o shortness of breath & dizziness. Dose of J+J vaccine given about 15 minutes prior. B/P 70/50 HR 84 SPO2 100% on R.A., Lungs clear bilateral. Pt complained of tingling in both hands & feet. Pt refused epi but agreed to Benadryl 50MG po Liquid. Benadryl Administered at 1435hrs no improvement, pt feeling more short of breath & Numbness in Lt arm, 1 dose of epi administered at 1440. Pt had no improvement, pt complained of numbness now in right arm. At 1445 a 2nd epi pen was administered. 1447 pt stated he was feeling better. VS taken BP 100/60 R.24 HR 80 SPO2 97% RA. Lungs Clear bilateral. EMS arrived @1448. Pt stable and was transported to the hospital.


VAERS ID: 1136081 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-03-15
Onset:2021-03-25
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: patient received covid vaccine on march 15th. she called today stating she is experiencing tingling and numbness in the arm she received her vaccine in.


VAERS ID: 1136116 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-03-25
Onset:2021-03-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure measurement, Dysphagia, Oral pruritus, Paraesthesia oral, Pharyngeal paraesthesia, Throat irritation
SMQs:, Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad)

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
Current Illness: unknown. none that we were aware of
Preexisting Conditions: unknown
Allergies: prednisone
Diagnostic Lab Data: Has a history of a severe reaction to prednisone. upon inquiring, patient stated it caused insomnia for about a year and was unable to work. No history of any sort of anaphylactic reaction.
CDC Split Type:

Write-up: Within a minute of receiving the vaccine, pt reported itchy/tingly sensation in her mouth and throat. Initially stated she could breathe/swallow just fine but very quickly stated the swallowing was getting more difficult. 911 was called followed by 0.3 mg EpiPen in her right outer thigh and 50mg of oral Benadryl. Her BP was then taken around 4:45 and it was 162/93 at which point EMT arrived and took over.


VAERS ID: 1136330 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-20
Onset:2021-03-25
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blister, Chills, Headache, Immediate post-injection reaction, Injection site erythema, Injection site pain, Lethargy, Myalgia, Pyrexia, Rash pruritic, Skin warm
SMQs:, Rhabdomyolysis/myopathy (broad), Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: At age 26 I received a tetanus vaccine with pertussis and diphtheria and the first vaccine for hepatitis B. That night I went to
Other Medications: Venlafaxine, Amitriptyline, Iron, Multi-Vitamin, Busiprone
Current Illness: No other illnesses
Preexisting Conditions: Complex/Complicated Migraine Headaches (with aura), MDD, GAD
Allergies: Keflex, Septra-DS, Minocycline, Elidel, MAYBE pertussis vaccine
Diagnostic Lab Data:
CDC Split Type:

Write-up: ADVERSE REACTION TODAY: hot, itchy rash on forearms made up of tiny blisters -- $g no tx thus far -- $g OTHER SIDE EFFECTS: Immediate onset: muscle pain at site of injection Onset about 11 hours post-vaccination: fever, chills, muscle aches, site of injection red and in worse pain, headache Onset about 24 hours post-vaccination: earache off and on Onset about 48 hours post-vaccination: fever spiked at 101.8 Onset about 96 hours post-vaccination: lethargic, headache


VAERS ID: 1136359 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-03-24
Onset:2021-03-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Head discomfort, Headache, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No RX/MEDS or any prescriptions
Current Illness: not sick
Preexisting Conditions: A-fib 10 years ago.
Allergies: No allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Muscles started to shake mildly, 8-10 hrs later. Next day Severe HEADACHE. Not pounding, but stiff pressure on both sides of temples. Treatment was 2 IB motrin, Slept for an hour and felt GREAT afterward. By 3 pm I was in great shape, no other issues to report even after 10 hours have past.


VAERS ID: 1136413 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-03-25
Onset:2021-03-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain upper, Chills, Headache, Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: ceclor
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: chills, fever, nausea, body aches, headache, stomach ache.


VAERS ID: 1136438 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-25
Onset:2021-03-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient stated they were feeling "dizzy" and had some "blurred vision" during the first 15 minutes after the vaccination. Vitals were normal, no transport and walked out of building when recovered shortly afterwards.


VAERS ID: 1136447 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-25
Onset:2021-03-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Hot flush
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient stated that they felt "light-headed and had hot flashes" about 10 minutes after vaccine administration. No transport was needed, and patient recovered shortly and walked out of the clinic.


VAERS ID: 1136486 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-03-24
Onset:2021-03-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Ocular hyperaemia, Paranasal sinus hypersecretion, Photophobia
SMQs:, Anaphylactic reaction (broad), Noninfectious meningitis (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Thyroxine,lexapro ,albuterol inhaler
Current Illness: None
Preexisting Conditions:
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Blood shot rt eye, light sensitivity, rt sinus draof mucous , head ache over rt eye


VAERS ID: 1136492 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-03-25
Onset:2021-03-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chills, Headache, Myalgia, Nausea, Somnolence
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: HTN
Allergies: None
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Headache, nausea, chills, myalgia and drowsiness


VAERS ID: 1136533 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-25
Onset:2021-03-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / UNK - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Headache, Myalgia, Nausea, Pain in extremity, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol extra strength 500 mg
Current Illness: None
Preexisting Conditions: None
Allergies: Pineapple
Diagnostic Lab Data: N/a
CDC Split Type:

Write-up: Around 1:00 pm felt nauseous went away. 8:30 pm soreness in arm nausea around food. 9-10 pm chills, fever, muscle aches. 2:30-4:45 am on 3/26/2021 headache, chills, muscle aches. 5:15-6:00 am headache


VAERS ID: 1136622 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: New York  
Vaccinated:2021-03-24
Onset:2021-03-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Cardiac arrest
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Cardiomyopathy (broad), Respiratory failure (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: ESRD on HD. Recent Covid
Preexisting Conditions: H/O of HTN, DM2 on insulin, CAD, HF mrEF, bradycardia s/p ppm, Gout.
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient had cardiac arrest secondary to MI less than 24 hours from receiving the vaccine. Now on 3 pressors. Although due to the patient''s health condition, this may not have been attributed to the vaccine.


VAERS ID: 1136626 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-03-24
Onset:2021-03-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN JANSSEN SARS-CO / 1 LA / SYR
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Chills, Headache, Influenza like illness, Pain, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Low Dose Asprin & Clopedril
Current Illness: Diverticulitis
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Janssen SARS-Covid-2 Vaccine Chills, fever, severe pain in left arm from shoulder to hand, body ache, headache, flu like symptoms.


VAERS ID: 1136645 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-18
Onset:2021-03-25
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: losartan potassium
Current Illness:
Preexisting Conditions: high blood pressure
Allergies: penicillin
Diagnostic Lab Data: I didn''t know medical test as the rash happened last night and the rash seems to be gone today. I did use a cortisone cream and antihistamines.
CDC Split Type:

Write-up: I had a rash develop I might lower extremities from just below the knees to mid thigh. It happened around 4 p.m. I did not know if it was something that I had come in contact with outside so I took a shower and applied cortisone cream to the rash. Around 6 p.m. I developed a rash on the left side of my chest the rash continue to grow across my chest and my abdomen to both sides and my arms. Again applied cortisone cream. Around 9 p.m. I took antihistamines and went to bed in the morning the rash is gone. I''m only reporting this because I''ve only read where the rash is on the arm or the injection site where this one was on my lower extremities and my upper extremities chest an abdomen.


VAERS ID: 1136723 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-03-24
Onset:2021-03-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Fatigue, Headache, Hyperacusis, Photophobia
SMQs:, Anticholinergic syndrome (broad), Noninfectious meningitis (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad), Hearing impairment (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Celexa, Ritalin, multi vitamin, Omega 3, BCAA, Tumeric
Current Illness: none
Preexisting Conditions: asthma
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Headache, sensitivity to light and sound, dizziness, fatigue


VAERS ID: 1136967 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-03-25
Onset:2021-03-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chills, Headache, Hot flush, Nausea, Retching
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril hctz One a day men''s 50+
Current Illness: None
Preexisting Conditions: High blood pressure
Allergies: Coconut
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Headache 6 hours after shot lasting 24 hours Chills and hot flashes unabated Nausea and dry heaves


VAERS ID: 1137101 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-03-24
Onset:2021-03-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 18050519 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Facial pain, Fatigue, Headache, Hyperhidrosis, Neck pain, Pain, Pyrexia, Salivary gland pain
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Glaucoma (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metoprolol Tartrate, Vit D3, vit C, zinc, Ashwaganda, black cohosh, hawthorn berry.
Current Illness: N/A
Preexisting Conditions: Reactive asthma
Allergies: Erythromycin
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Had the typical side effects, started with fatigue then came headache, body aches, fever. Fever went up to 101.4. After the majority of the body aches subsided, I ended up with facial pain from my temples all the was into my neck. This pain occurred on both sides of my face and was so bad that I couldn?t lay on my side with the side of my head on the pillow. The pain felt like severe joint pain, but also felt like it was in my glands. It felt like my salivary glands wanted to burst. I used CBD cream topically to try to help with the pain, also CBD tincture internally. Finally resorted to Acetaminophen 1000mg. The acetaminophen seemed to help the tiniest bit. Then my fever broke. Once I began sweating I could feel the pain in my face almost melting away. This lasted about three hours. When I woke up at 8:00AM the side effects seemed to have all subsided. I still had a very mild headache.


VAERS ID: 1137141 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-03-25
Onset:2021-03-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Chills, Ear swelling, Feeling abnormal, Hyperhidrosis, Injection site pain, Neck pain, Night sweats, Pain, Pain in extremity, Pyrexia, Rhinorrhoea, Skin warm, Swollen tongue
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Topiramate
Current Illness: none
Preexisting Conditions: migraines
Allergies: Latex
Diagnostic Lab Data:
CDC Split Type:

Write-up: Day of injection-Extreme pain/heat in arm that traveled up neck. Runny nose, swollen tongue and ears, sweating, general spacey or brain fog feeling for about 10 minutes. Went home and had to take 3 doses of benadryl, over the course of the evening. Didn''t warrant my epi pen, I didn''t feel. Night of injection-night sweats and pain at injection site and down arm. Next day-fever, chills, joint pain, body aches. Taking tylenol


VAERS ID: 1137168 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-25
Onset:2021-03-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Hyperhidrosis
SMQs:, Neuroleptic malignant syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Felt generally sick from seasonal flu vaccine 3 years ago.
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Had Fatigue, chills, & dull headache @ 7:30pm. Went to bed early. Woke up @ 4:20 am for work and had fatigue, headache, and sweats on forehead. Took 2 Ibuprofen and went back to bed. woke up at 9:15 am and still had slight fatigue & headache. Effects seemed manageable, so didn?t go see a doctor. It?s about 11am & I still have a dull headache,.


VAERS ID: 1137244 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-25
Onset:2021-03-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK UN / UN

Administered by: Private       Purchased by: ?
Symptoms: Anaphylactic reaction, Drooling, Paraesthesia oral, Tachycardia, Throat irritation, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: asthma, obesity, bipolar disorder
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Obtained from patient. Patient is a 37-year-old female with past medical history of asthma, bipolar disorder, history of anxiety and joint pain, came to Emergency Room with above complaints. Patient works as a investigator and getting her first COVID-19 vaccination, Johnson and Johnson. Patient was at work receiving her first dose. After dose, the patient was planned to be observed. The patient is stating that 3 minutes, the patient started getting her tongue started feeling funny. Four minutes into vaccination, patient felt her throat was closing and the patient started drooling. Nurse practitioner immediately gave the patient 2 shots of epinephrine with Benadryl. 911 was called and patient was admitted to the Emergency Room. In the Emergency Room, the patient diagnosed with anaphylactic reaction to COVID-19 vaccination. With the patient''s persistent tachycardia, still having symptoms of throat itching, the patient requested to be admitted for further observation.


VAERS ID: 1138289 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-03-25
Onset:2021-03-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Throat irritation
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient reported known allergy to shellfish. Following injection, patient reported throat felt itchy but had no other symptoms. Pulse ox indicated 98. Patient was given liquid Benadryl 25 cc/10ml. Patient went home and had recovered at time of departure from facility.


VAERS ID: 1138350 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-24
Onset:2021-03-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chills, Diarrhoea, Dyspnoea, Fatigue, Hypoxia, Myalgia, Peripheral swelling, Productive cough, Pyrexia, Rheumatoid arthritis, Rheumatoid factor positive, Sputum discoloured, Urine output increased
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Arthritis (narrow), Noninfectious diarrhoea (narrow), Respiratory failure (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Hypokalaemia (broad), 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? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: With regard to his history,[KE.4] He was admitted 1/15-1/20/21 for an MVA with T3 burst fracture, T4 body fracture, multiple rib fractures, and cervical stenosis with bulging discs that required cervical spinal fusion with decompressive laminectomies and a reduction of T3-4.Course complicated by LUE weakness, but he was transferred to IPR and was overall able to rehab well and was discharged on 2/4/21. Following discharge, he struggled with pain control and insomnia, and was ultimately found out of bed altered on 2/22. He presented to the ED with altered mental status in the setting of hypercarbic respiratory failure and was initially managed with BiPAP and a narcan drip, ultimately thought to be multifactorial in the setting of cocaine ingestion, undiagnosed OHS/OSA, rib fractures, and aspiration pneumonia, and completed a course of zosyn and azithromycin for aspiration pneumonia. He was ultimately discharged to SAR on 3/3/21.[KE.3]
Preexisting Conditions: Bipolar disorder (CMS/HCC) ? CKD (chronic kidney disease) ? Cocaine use ? Depression ? Diabetes mellitus (CMS/HCC) ? Hyperlipidemia ? Hypertension ? Stroke (CMS/HCC) 2016 11/2016 and 05/017
Allergies:
Diagnostic Lab Data: RA positive 3/25 Abbot ID now PCR positive 3/26
CDC Split Type:

Write-up: COVID infection post vaccination 1 day following vaccination, patient experienced fatigue, myalgia and low grade fever. RA test positive. That evening, patient with increasing SOB and increasing oxygen requirement and was admitted for hypoxia + LE swelling. Although SNF where vaccination took place denied symptoms at time of vaccination, per H&P, increasing oxygen requirements were noted 3 days prior to vaccination. See H&P below He is currently residing in a rehab facility following a hospitalization detailed below, but essentially he noted some shortness of breath about 4-5 days ago. They checked his oxygen saturation and noted that he was hypoxic, so started him on oxygen (reportedly 4L NC?). He reports a worsened productive cough; sputum is dark but not bloody in color. He has been fatigued and chilled; he thinks he''s been intermittently febrile. No nausea, vomiting, or constipation. He endorses twice daily diarrhea, but he associates this with his bowel regimen. He also has a fair amount of lower extremity swelling which is bothersome to him; he says this has been ongoing since his MVA in January.[KE.4] He was recently seen in Nephrology clinic, where he was started on lasix 40mg daily and started on a low sodium diet[KE.3]. He is unsure if the lasix is helping his swelling, but does have robust urine output after he takes it


VAERS ID: 1128528 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-03-21
Onset:2021-03-24
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Illness, Pruritus, Rash, Rash erythematous, Rash macular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro 20 mg Fish Oil Supplements GABA Supplements Turmeric Supplements
Current Illness: None
Preexisting Conditions: Asthma
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: I was very sick which is normal but I woke up this morning, 3/24/2021, and have a red splotchy rash on my neck and forearm. My forearm is very itchy.


VAERS ID: 1128584 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-20
Onset:2021-03-24
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / UNK LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 10 mg amLODIPine, 250 mg vitamin C, 81 mg aspirin, 80 mg atorvastatin, 50 mcg vitamin D3, ferrous sulfate 325, 2300 mcg vtamin B12, 180 mg fexofenadine, 50 mg hydroCLOROthiazide, 100 mg losartan, 250 mg magnesium, 750 mg X 2 metFORMIN, 60 m
Current Illness: high blood pressure issues
Preexisting Conditions: diabetes, sleep apnea, mild hypertension
Allergies: cipro,
Diagnostic Lab Data:
CDC Split Type:

Write-up: muscle soreness across the entire body


VAERS ID: 1128608 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-03-24
Onset:2021-03-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cold sweat, Dysarthria, Malaise, Pallor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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: None that we are aware of
Current Illness: None known
Preexisting Conditions: none known
Allergies: Allergy to bee stings
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Pt had history of anaphylaxis related to bee stings. We asked if he had ever had a reaction to another vaccine and he said no. Pt came up saying he wasn''t feeling well during the observation period, within about 5-10 minutes after receiving the vaccination. He look very pale and clammy. I asked if he was ok and he shook his head. Tried to grab a chair for him and he started to collapse. With some help I was able to get him to the ground without injury. We called 911 and I grabbed an epipen. I tried to assess the patient, and he was unable to tell me if he was having any trouble breathing or if his lips/mouth/tongue was swelling. He was conscious but couldn''t speak coherently. I administered the epipen to his right lateral thigh due to his history of anaphylaxis with bee stings. We were able to lay him down while waiting for the ambulance. His color started to return and he was able to respond to questions, but was still slightly confused. He did tell me at this point that he has had similar reactions after vaccines and blood work. The paramedics arrived and took the patients vitals and took him to the hospital.


VAERS ID: 1129025 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-23
Onset:2021-03-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 50MG Atenolol BID , 40 MG Atorvastatin Daily, 25 MG Alogliptin Daily, 81MG baby aspirin Daily , Flecainide 100MG BID, 10 MG Lisinopril daily , 2000 units Vitamin D, Cholecalif,, Daily 12.5 MG Hydrochlorothiazide Daily , 30 MG Pioglita
Current Illness:
Preexisting Conditions: AFIB/ PSVT, Type 2 Diabetic, NHL- history,
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: rash on both arms took pictures


VAERS ID: 1129048 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-03-23
Onset:2021-03-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Headache, Nausea, Pyrexia, Tenderness
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vyvanse 60mg, Singulair 10mg, Xyzal
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Headache, fever 100.2, nausea & arm tenderness. Took Advil.


VAERS ID: 1129073 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-03-23
Onset:2021-03-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 - / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chills, Feeling cold, Feeling of body temperature change, Headache, Hyperhidrosis, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Violent shivers, the feeling of being very cold, low grade fever, chills, body aches, headache hot/cold, sweating. Started around 1 am, still very sore this morning, hot/cold flashes and sweats. As of about 8:30am fever is fluctuating between high 99?s and low 100?s. Took 2 acetaminophen around 8:15am.


VAERS ID: 1129550 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-03-24
Onset:2021-03-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

Administered by: School       Purchased by: ?
Symptoms: Exposure via skin contact, Syringe issue, Underdose
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: medicines
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: $g50% of vaccine leaked down arm - dose repeated


VAERS ID: 1129904 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-24
Onset:2021-03-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / UNK RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Tremor, Visual impairment
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

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: albuterol (PROVENTIL HFA;VENTOLIN HFA;PROAIR HFA) inhaler ALPRAZolam (XANAX) 0.5 MG tablet amLODIPine (NORVASC) 5 MG tablet atorvastatin (LIPITOR) 20 MG tablet busPIRone (BUSPAR) 5 MG tablet diphenhydrAMINE (BENADRYL) 25 mg capsul
Current Illness: none
Preexisting Conditions: Essential hypertension, benign (*) Sleep apnea Migraine headache (*) Asthma (*) Pure hyperglyceridemia (*) Generalized anxiety disorder (*) Controlled type 2 diabetes mellitus with renal manifestation (*) Hyperlipidemia Proteinuria Controlled type 2 diabetes mellitus without complication (*) MDD (major depressive disorder), recurrent severe, without psychosis (*) Panic disorder without agoraphobia (*)
Allergies: CodeineHives Contrast [Iodinated Contrast Media]Hives Darvon [Propoxyphene]Hives ErythromycinNausea And Vomiting Hydrocodone PiroxicamOther (See Comments) Garamycin [Gentamicin]Rash Monistat 1 [Tioconazole]Rash PropranololRash Sulfa (Sulfonamide Antibiotics)Rash
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient experienced lightheadedness, spots in vision, and shakiness approximately 30 mins after receiving the vaccine. Was monitored for 25 mins with no resolution in symptoms and was sent to the emergency room for additional evaluation.


VAERS ID: 1129924 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-22
Onset:2021-03-24
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Malaise, Pallor
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data: none
CDC Split Type:

Write-up: After receiving vaccine, patient complained of not feeling well and feeling faint. Patient laid on floor with feet elevated. Bp 96/58, P 70, R 18. Color was pale with no signs of respiratory distress or other skin changes noted. Given cool compress and juice. Transferred to cot to monitor for half hour. Before leaving patient noted to have pink color back to skin, was tolerating sitting without feeling dizzy, and vitals: Bp 110/80, P 88, R 16.


VAERS ID: 1130008 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-22
Onset:2021-03-24
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain, Dizziness, Hyperhidrosis, Nausea, Pallor
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: 5 minutes following vaccination, patient became pale, sweaty, dizzy, and light headed. Vitals noted to be: Bp 88/60, P 100, R 16 no distress. Patient laid down on cot and given ice pack on neck. Patient also reported having nausea and abdominal cramps. Patient monitored for half hour. Color improved and Bp noted to improve to 110/66. Patient drove home by father.


VAERS ID: 1130047 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-03-15
Onset:2021-03-24
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 - / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)

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: Eliquis combigan vitamin d coq10 vit b12 cardizem cd trusopt lexapro cozaar nitrostat prilosec actos crestor
Current Illness:
Preexisting Conditions:
Allergies: barbituates codeine penicillins
Diagnostic Lab Data: pending
CDC Split Type:

Write-up: 3/24/21 eval of dizziness . States sx started this morning . Was in hospital and transferred approx. 1 week ago for dehydration and a-fib. Denies nausea or vomiting.


VAERS ID: 1130088 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-23
Onset:2021-03-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: School       Purchased by: ?
Symptoms: Chills, Headache, Pain
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache, body aches, chills


VAERS ID: 1130311 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-24
Onset:2021-03-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Wrong product administered
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient filled out consent and release form for Moderna Covid-19 vaccine for her 1st dose but was given Janssen Covid-19 vaccine instead.


VAERS ID: 1130346 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-24
Onset:2021-03-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Hyperhidrosis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient felt slight dizziness about 2 minutes after vaccine. About 8 minutes after his vaccine, he came to the pharmacy counter and almost passed out - he was dizzy and sweating. He felt better after about 40 minutes of resting (and water and protein bar).


VAERS ID: 1130449 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-03-09
Onset:2021-03-24
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 - / IM

Administered by: Other       Purchased by: ?
Symptoms: Alanine aminotransferase increased, Amylase decreased, Aspartate aminotransferase normal, Basophil count decreased, Basophil percentage, Bilirubin urine, Blood albumin normal, Blood alkaline phosphatase normal, Blood bilirubin normal, Blood calcium decreased, Blood chloride normal, Blood creatine phosphokinase MB normal, Blood creatine phosphokinase normal, Blood creatinine normal, Blood glucose normal, Blood magnesium normal, Blood potassium normal, Blood sodium normal, Blood urea normal, Blood urine present, Brain natriuretic peptide increased, Bronchiectasis, Carbon dioxide decreased, Chest discomfort, Chromaturia, Computerised tomogram thorax, Cough, Drug screen negative, Dyspnoea, Eosinophil count decreased, Eosinophil percentage, Eructation, Fibrin D dimer normal, Gastrooesophageal reflux disease, Glomerular filtration rate normal, Glucose urine absent, Haematocrit normal, Haemoglobin normal, Haemoptysis, Influenza virus test negative, Lipase normal, Lung opacity, Lymphocyte count normal, Lymphocyte percentage decreased, Mean cell haemoglobin concentration normal, Mean cell haemoglobin normal, Mean cell volume normal, Mean platelet volume increased, Monocyte count normal, Monocyte percentage increased, Neutrophil count increased, Neutrophil percentage, Nitrite urine absent, Palpitations, Platelet count normal, Protein total normal, Protein urine absent, Red blood cell count normal, Red blood cells urine, SARS-CoV-2 test, Scan with contrast abnormal, Specific gravity urine, Troponin I increased, Urinary sediment present, Urine ketone body absent, Urine leukocyte esterase, Urobilinogen urine increased, White blood cell count increased, pH urine normal
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Haematopoietic leukopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), COVID-19 (broad)

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: Current Outpatient Medications: ? aspirin 81 MG EC tablet, Take 81 mg by mouth Nightly, Disp: , Rfl: ? atorvaSTATin (LIPITOR) 20 MG tablet, Take 20 mg by mouth Nightly, Disp: , Rfl: ? gabapentin (NEURONTIN) 300 MG capsule, Take 1,200 mg by
Current Illness:
Preexisting Conditions:
Allergies: nka
Diagnostic Lab Data: CTA Chest For Pulmonary Embolism w Contrast [245598176] Collected: 03/23/21 0139 Order Status: Completed Updated: 03/23/21 0215 Narrative: EXAM DESCRIPTION: CT CHEST ANGIOGRAPHY WITH IV CONTRAST CLINICAL INFORMATION: Age: 58 years Gender: Male Indication: Shortness of breath Additional history: Hemoptysis COMPARISON: None. TECHNIQUE: Procedure: CT Angiography of the Chest Protocol: Pulmonary embolus Reformats: Coronal and sagittal Intravenous Contrast: 80 mL Omnipaque 300 without documented adverse reaction Image Quality: Adequate Multiple coronal computer generated 3D reconstructions (MIPS) of the pulmonary arteries were included. This exam was performed according to our departmental dose optimization program, which includes automated exposure control, adjustment of the mA and/or kV according to patient size and/or use of iterative reconstruction technique. Dose Range: Up-to-date CT equipment and radiation dose reduction techniques were employed. FINDINGS: Pulmonary arteries: No pulmonary embolus Lungs and pleura: Mild right basilar groundglass airspace opacities and mild bronchiectasis is seen.. Heart: Normal heart size. No pericardial effusion . Aorta: Normal Mediastinum and hila: Normal Chest wall: Normal Lower neck: Normal IMPRESSION: Negative for pulmonary embolus. Mild right basilar bronchiectasis and mild groundglass airspace opacities which may represent atypical infection versus pulmonary contusion in the setting of trauma. Electronically signed by: MD 3/23/2021 2:13 AM CDT Influenza antigen [245598168] Collected: 03/23/21 0149 Order Status: Completed Specimen: Nasopharyngeal Updated: 03/23/21 0214 Influenza A NEGATIVE NEGATIVE Influenza B NEGATIVE NEGATIVE NOVEL CORONAVIRUS SARS-COV-2 BY PCR [245598178] Collected: 03/23/21 0150 Order Status: Sent Specimen: Nasopharyngeal Updated: 03/23/21 0200 Urine Drug Screen Medical - 10 Panel [245598187] Collected: 03/23/21 0118 Order Status: Completed Specimen: Urine Updated: 03/23/21 0143 Amphetamines Screen, Urine NEGATIVE NEGATIVE Barbiturate Screen, Urine NEGATIVE NEGATIVE Benzodiazepine Screen, Urine NEGATIVE NEGATIVE Cocaine Metabolites Urine NEGATIVE NEGATIVE Methamphetamine, UR NEGATIVE NEGATIVE Methadone Screen, Urine NEGATIVE NEGATIVE Opiate Screen, Urine NEGATIVE NEGATIVE Oxycodone Scr Qual,UR NEGATIVE NEGATIVE Phencyclidine Screen Urine NEGATIVE NEGATIVE Propoxyphene NEGATIVE NEGATIVE THC NEGATIVE NEGATIVE TCA - Tricyclic Antidepressants Urine, Qualitative NEGATIVE NEGATIVE Urinalysis with reflex to culture, if indicated [245598186] (Abnormal) Collected: 03/23/21 0119 Order Status: Completed Specimen: URINE,CLEAN CATCH (CCMS) Updated: 03/23/21 0139 Glucose UA NEGATIVE NEGATIVE MG/DL Protein UA NEGATIVE NEGATIVE MG/DL Bilirubin UA NEGATIVE NEGATIVE Urobilinogen UA 0.2 0.2 - 1.0 MG/DL pH UA 5.0 5.0 - 8.0 Blood UA TRACEAbnormal NEGATIVE Ketones UA NEGATIVE NEGATIVE MG/DL Nitrite UA NEGATIVE NEGATIVE Leukocyte Esterase UA NEGATIVE NEGATIVE UR Appearance CLEAR CLEAR Specific Gravity UA <1.006 1.000 - 1.030 Color YELLOW YELLOW Site CCMS Comment, Urine Culture NOT INDICATED RBC Urine 0 to 5 <3 /HPF WBC Urine 0 to 5 <5 /HPF Squamous Epithelial RARE <5 /HPF D-dimer, quantitative [245598173] Collected: 03/23/21 0101 Order Status: Completed Specimen: Blood Updated: 03/23/21 0137 D-Dimer 244 0 - 400 NG/ML FEU Brain Natriuretic Peptide (BNP) [245598172] (Abnormal) Collected: 03/23/21 0101 Order Status: Completed Specimen: Blood Updated: 03/23/21 0137 B-Type Natriuretic Peptide 110High 0 - 100 PG/ML Magnesium [245598167] (Abnormal) Collected: 03/23/21 0101 Order Status: Completed Specimen: Blood Updated: 03/23/21 0136 Magnesium 1.7Low 1.8 - 2.4 MG/DL CKMB [245598170] Collected: 03/23/21 0101 Order Status: Completed Specimen: Blood Updated: 03/23/21 0136 Creatine Kinase-MB 1.7 0.0 - 3.6 NG/ML Troponin Series [245598171] Collected: 03/23/21 0101 Order Status: Completed Specimen: Blood Updated: 03/23/21 0136 Troponin I 0.03 0.00 - 0.06 ng/mL Comment: 0.1 to 0.5 ng/mL shows an increased risk of AMI. 0.6 to 1.5 or greater is suggestive of AMI. Comprehensive metabolic panel [245598164] (Abnormal) Collected: 03/23/21 0101 Order Status: Completed Specimen: Blood Updated: 03/23/21 0136 Glucose 136High 65 - 100 MG/DL Blood Urea Nitrogen 13 7 - 18 MG/DL Creatinine 0.9 0.7 - 1.3 MG/DL Sodium 138 136 - 145 MMOL/L Potassium 3.9 3.5 - 5.1 MMOL/L Chloride 100 98 - 107 MMOL/L Co2 21 21 - 32 MMOL/L Calcium 8.5 8.5 - 10.1 MG/DL Protein Total 7.6 6.4 - 8.2 G/DL Albumin 4.0 3.4 - 5.0 G/DL A/G Ratio 1.1 0.8 - 2.0 Alkaline Phosphatase 64 46 - 116 U/L Alt (SGPT) 43 16 - 63 U/L AST(SGOT) 21 15 - 37 U/L Bilirubin, Total 0.5 0.2 - 1.0 MG/DL GFR Comment IF PATIENT IS AFRICAN AMERICAN, MULTIPLY RESULT BY 1.16 Est GFR $g90 $g90 ML/MIN/1.73sq.m Amylase [245598165] Collected: 03/23/21 0101 Order Status: Completed Specimen: Blood Updated: 03/23/21 0136 Amylase 40 25 - 115 U/L Lipase [245598166] Collected: 03/23/21 0101 Order Status: Completed Specimen: Blood Updated: 03/23/21 0136 Lipase 92 73 - 393 U/L CK (CPK) Creatine Phosphokinase [245598169] Collected: 03/23/21 0101 Order Status: Completed Specimen: Blood Updated: 03/23/21 0136 Creatine Kinase Total 124 39 - 308 U/L CBC w Auto Diff [245598163] (Abnormal) Collected: 03/23/21 0101 Order Status: Completed Specimen: Blood Updated: 03/23/21 0117 White Blood Cell Count 11.7High 4.8 - 9.6 THOUS/uL Red Blood Cell Count 5.18 4.33 - 5.59 MIL/uL Hemoglobin 15.6 13.1 - 16.8 GM/DL Hematocrit 46.0 38.8 - 49.0 % Mean Corpuscular Volume 88.8 82.7 - 94.4 FL Mean Corpuscular Hemoglobin 30.1 27.7 - 32.6 PG Mean Corpuscular Hemoglobin Conc 33.9 32.4 - 35.7 G/DL Rdwcv 12.9 11.6 - 13.9 % Rdwsd 42.5 36.0 - 46.1 FL Platelet Count 198 154 - 364 THOUS/uL Mean Platelet Volume 11.4 8.7 - 11.7 FL Nucleated Red Blood Cells 0.0 0.0 /100 WBC''S Abs NRBC 0.0 0.0 THOUS/uL Differential Type AUTO Neutrophils 68.8High 34.0 - 67.9 % Lymphs 18.0Low 19.1 - 41.2 % Monocytes 10.0 6.1 - 12.3 % Eos 1.7 0.9 - 7.6 % Basos 0.9 0.2 - 1.5 % Neutrophils Absolute Count 8.1High 2.7 - 5.8 THOUS/uL Lymphocytes Absolute Count 2.1 1.1 - 3.3 THOUS/uL Monocytes Absolute Count 1.2High 0.4 - 0.9 THOUS/uL Eosinophils Absolute Count 0.2 0.1 - 0.6 THOUS/uL Basophils Absolute Count 0.1 0.0 - 0.1 THOUS/uL Imm Gran 0.6 0.2 - 0.9 % Abs Imm Gran 0.07 0.0 - 0.1 THOUS/uL
CDC Split Type:

Write-up: 3/24/21 ER HPI: 58 y.o. male who presents with shortness of breath, palpitations, chest pressure, and hemoptysis. Patient has known history of atrial fibrillation and coronary artery disease. Patient reports he was out in his yard approximately 1 hour ago this evening picking up some items when he bent over and started feeling palpitations. Patient states the palpitations caused a pressure in the center of his chest. He then became short of breath. He then states he got into a coughing fit and coughed up some blood. Patient states he knew something was not right so he told his wife to bring him to the ER. Currently here in ER patient continues to complain of palpitations and trash pressure. Patient currently gives his pain as 6/10. It is nonradiating. Patient reports shortness of breath but denies any lightheadedness, dizziness, nausea, vomiting, or diaphoresis. Of note, patient reports he has been having acid reflux and belching tonight. He states his wife had given him two Pepcid earlier.


VAERS ID: 1130546 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Puerto Rico  
Vaccinated:2021-03-23
Onset:2021-03-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Eye swelling, Pain, Pain in extremity, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Montelukast
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Aspirin
Diagnostic Lab Data:
CDC Split Type:

Write-up: During the day that I was administered the vaccine I had pain in my arm (area in where I was vaccinated). The next day, I woke up with general pain in the body, pain in the arm where the vaccine was injected and it swelled up a little the skin under the eyes (hives). As the day goes by, the pain in the arm has diminished, as well as the hives in the eyes.


VAERS ID: 1130574 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-03-24
Onset:2021-03-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Throat irritation
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (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: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Reported sandpaper like feeling in throat, n/v


VAERS ID: 1130655 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-03-24
Onset:2021-03-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 047A21A / 1 LA / ID

Administered by: School       Purchased by: ?
Symptoms: Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxin (50mg), Daily multivitamin
Current Illness:
Preexisting Conditions: Hypothyroidism
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Muscle pain throughout are and left hand cramping through fingers. Mild whole body muscle aches. Approx. 4 hours after injection.


VAERS ID: 1130843 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-24
Onset:2021-03-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Extra dose administered, No adverse event
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient stated that he wanted a vaccine today while staff were in the unit. He denied receiving it prior. He was given the vaccine and upon documenting it was discovered that he receive the Modern vaccine 1st dose on 2/2/21 and 2nd dose on 3/2/21. Today he received Jannsen dose. He has no adverse effects and no complaints.


VAERS ID: 1130931 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-24
Onset:2021-03-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: Hx fainting, cardiac murmur
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt. reported feeling light headed, after sitting experienced a syncopal episode. BP 98/45 p 75. Pt. was revivied after about 35 seconds and stated feeling better. BP 112/72, p 76. Pt. stated has hx of syncope. Pt and family refused to be transferred via squad. Pt. states he will fu with PCP this week.


VAERS ID: 1130953 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-24
Onset:2021-03-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 AR / IM

Administered by: Other       Purchased by: ?
Symptoms: Paraesthesia oral
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: DIABETES, HYPERTENSION
Preexisting Conditions: DIABETES, HYPERTENSION
Allergies:
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: TINGLING IN LIPS, RECEIVED 25MG BENADRYL X 2 DOSES WITH RELIEF. ADVISED TO CALL911 IF LIP OR TONGUE SWELLING OR DIFFICULTY BREATHING.


VAERS ID: 1130990 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-24
Onset:2021-03-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Swelling, Throat irritation
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Xarelto
Current Illness: Per patient - reported multiple pulmonary embolisms
Preexisting Conditions: Pulmonary embolisms
Allergies: Unknown
Diagnostic Lab Data: none known
CDC Split Type:

Write-up: About 30 minutes after receiving COVID-19 vaccine by Janssen, patient reported having an itchy throat and some feeling swollenness in her throat. Pharmacist asked if she could breathe and she confirmed she can. Pharmacist asked if she would like to be administered IM injection or oral version of diphenhydramine and patient requested IM version. Pharmacist administered diphenhydramine 25mg intramuscularly and monitored for response where patient reported feeling better and less swelling and itchiness. Patient requested an additional dose due to incomplete resolution of symptoms and about 2-3 minutes later, pharmacist administered an additional dose of diphenhydramine 25mg intramuscularly. Pt was monitored for about 40 minutes until her spouse came to pick her up. Patient was advised to contact her provider and potentially request and epinephrine pen for on-hand use. Pharmacist found a pharmacy, CVS, that carried the epinephrine pen and informed patient where that was so she could inform her provider where to call in the script. Patient left premises reporting feeling like she could breathe fine and no swelling upon leaving the store. The store also provided patient with a box of diphenhydramine (Benadryl) oral tablets to take with her as well as a bottle of water. Her spouse took her so she would not need to drive after feeling potentially drowsy upon injection of diphenhydramine.


VAERS ID: 1131307 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-24
Onset:2021-03-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: No
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Nausea and lightheadedness, increased blood pressure 155/101 and heart rate 113. Pt monitored and BP down to 134/90 feeling better after monitoring.


VAERS ID: 1131422 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-23
Onset:2021-03-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: atomoxetine
Current Illness: None known
Preexisting Conditions: None
Allergies: None known
Diagnostic Lab Data: N/a
CDC Split Type:

Write-up: Headache around the parietal lobe muscle aches in extremities


VAERS ID: 1131436 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-24
Onset:2021-03-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Dizziness, Feeling hot, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt started to feel hot and nauseous about 5 minutes after injection. Pt said her stomach ''hurt really bad'' and started to vomit a few minutes later. After several minutes, pt started to pass out, so moved her to the floor for safety. Several minutes after that, pt started to feel better. Soon after she was sitting up, and later, able to tolerate an orange juice, then leave on her own.


VAERS ID: 1131437 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Unknown  
Location: Oregon  
Vaccinated:2021-03-23
Onset:2021-03-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient is 16 years of age and should have not received the vaccine.


VAERS ID: 1131489 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-23
Onset:2021-03-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Shot was not approved for this age, only approved for 18+.


VAERS ID: 1131491 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-23
Onset:2021-03-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vaccine was not approved in this age group. Only approved for 18+.


VAERS ID: 1131499 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-03-23
Onset:2021-03-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Fatigue, Feeling cold, Pain
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth control
Current Illness: none
Preexisting Conditions: Osteogenesis imperfecta Asthma
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: 8 hours after I started having severe chills and was freezing and full body aches and fatigue


VAERS ID: 1131609 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-03-24
Onset:2021-03-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Hypoaesthesia oral, Orbital swelling, Paraesthesia oral
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: anaphylaxis - oral sulfas
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt has PMH of anaphylaxis to PO sulfa drugs, red-syndrome to IV vancomycin and multiple food and environmental allergies. Physician and patient underwent shared decision making process in regards to getting vaccination. - 13:10, pt received shot. - 13:20, pt reports L orbital swelling and numbness/tingling in L upper lip. Given 50mg diphenhydramine. Lungs CTAB. Airway non-edematous. No visible abnormalities or facial edema. O2 sat 98%. HR 77. - 13:30, pt states that tingling has not subsided. Reports that symptoms are mild compared to historical allergic reactions. - 13:35 - pt discharged with instructions to take diphenhydramine Q 4-6 hours for 24 hours and to discuss reaction with PCP (pt already had appt scheduled on same day).


VAERS ID: 1131634 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-03-24
Onset:2021-03-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Loss of consciousness, Urinary incontinence
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Allergies to fluconazole and clotrimazole
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received COVID vaccination and was waiting his 15 minutes in the waiting room, a few minutes after injection, his GF called me over because the patient passed out. As I approach, patient was coming to as he was peeing himself. Patient reported that he felt lightheaded and then did not realize what happened. Gave patient some water and took his blood pressure. His DBP was a little low around 49. Had the patient sit there for another 15 minutes and took blood pressure again and it was 104/60.


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