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From the 9/10/2021 release of VAERS data:

Found 7,242 cases where Vaccine is COVID19 and Manufacturer is JANSSEN and Emergency Room/Doctor Visit



Case Details

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VAERS ID: 1177951 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Illinois  
Vaccinated:0000-00-00
Onset:2021-03-28
Submitted: 0000-00-00
Entered: 2021-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Culture stool, Diarrhoea, Nausea
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

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: PENICILLIN VK
Current Illness: Abstains from alcohol; Abstains from recreational drugs; Food allergy; Latex allergy; Non-smoker
Preexisting Conditions: Medical History/Concurrent Conditions: Blind; Colostomy; Craniopharyngioma benign (Patient took medications.); Neoplasm of unspecified nature of brain; Rectal fissure; Shunt malfunction NOS
Allergies:
Diagnostic Lab Data: Test Date: 20210328; Test Name: Stool culture; Result Unstructured Data: Negative for C-Diff; Test Date: 20210328; Test Name: Blood test; Result Unstructured Data: Negative for C-Diff
CDC Split Type: USJNJFOC20210401297

Write-up: DIARRHEA; NAUSEA; This spontaneous report received from a patient concerned a 55 year old male. The patient''s weight was 390 pounds, and height was 68 inches. The patient''s past medical history included benign cranial pherengioma, legally blind, history of multiple shunt revision., sigmoid colostomy, rectal fissure, and neoplasm of unspecified nature of brain, and concurrent conditions included latex allergy, allergy to strawberry, non alcohol user, non smoker, and non drug user. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular) dose, start therapy date were not reported for prophylactic vaccination at right deltoid on approximately 26/Mar/2021. The batch number was not reported and has been requested. Concomitant medications included phenoxymethylpenicillin potassium. On 28-MAR-2021, the subject experienced diarrhea. On 28-MAR-2021, the subject experienced nausea. Laboratory data included: Blood test (NR: not provided) Negative for C-Diff, and Stool culture (NR: not provided) Negative for C-Diff. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from diarrhea, and nausea on 29-MAR-2021. This report was non-serious.; Sender''s Comments: V0: Medical assessment comment not required as per standard procedure, since case assessed as non serious


VAERS ID: 1177962 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Illinois  
Vaccinated:0000-00-00
Onset:2021-03-31
Submitted: 0000-00-00
Entered: 2021-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Blood pressure measurement, Chest discomfort, Dizziness, Ear pruritus, Palpitations, Swelling face, Throat tightness, Wheezing
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ZYRTEC [CETIRIZINE HYDROCHLORIDE]; FLONASE [FLUTICASONE PROPIONATE]
Current Illness: Abstains from alcohol; Non-smoker; Penicillin allergy; Sulfonamide allergy
Preexisting Conditions: Comments: The patient had anaphylaxis with tetanus booster shot 4 years ago.
Allergies:
Diagnostic Lab Data: Test Date: 20210331; Test Name: Blood pressure; Result Unstructured Data: Unknown
CDC Split Type: USJNJFOC20210401432

Write-up: DIZZINESS; FACE SWELLED; THROAT CLOSING; CHEST TIGHTNESS; ITCH IN EAR; HEART BEAT RACING; WHEEZING; WEAKNESS; This spontaneous report received from a patient concerned a 63 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included non-smoker, non alcoholic, penicillin allergy, and sulfonamide allergy, and other pre-existing medical conditions included the patient had anaphylaxis with tetanus booster shot 4 years ago. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808980, expiry: unknown) dose was not reported, administered on 31-MAR-2021 at 12:18 p.m. vaccinated on left arm for prophylactic vaccination. Concomitant medications included cetirizine hydrochloride for allergy, and fluticasone propionate for allergy. On 31-MAR-2021, the subject experienced dizziness. On 31-MAR-2021, the subject experienced face swelled. On 31-MAR-2021, the subject experienced throat closing. On 31-MAR-2021, the subject experienced chest tightness. On 31-MAR-2021, the subject experienced itch in ear. On 31-MAR-2021, the subject experienced heart beat racing. On 31-MAR-2021, the subject experienced wheezing. On 31-MAR-2021, the subject experienced weakness. Laboratory data included: Blood pressure (NR: not provided) Unknown. Treatment medications (dates unspecified) included: diphenhydramine hydrochloride. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from dizziness, face swelled, throat closing, chest tightness, heart beat racing, wheezing, and weakness on 31-MAR-2021, and had not recovered from itch in ear. This report was non-serious.; Sender''s Comments: V0: Medical Assessment comment not required as per standard procedure as the case assessed as non-serious


VAERS ID: 1178044 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-06
Onset:2021-04-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK AR / SYR

Administered by: School       Purchased by: ?
Symptoms: Chills, Migraine, Muscle spasms
SMQs:, Dystonia (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: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Intense Migraine, chills, intense muscle spasms


VAERS ID: 1178073 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2021-04-07
Onset:2021-04-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Fall, Hypoaesthesia, Loss of consciousness, Pain in extremity
SMQs:, Torsade de pointes/QT prolongation (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (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), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Sexual dysfunction (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: none
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient recieved vaccine and was moved to observation area. Patient suddenly lost conciousness and fell from chair to the ground. Pt regained conciousness within 30 seconds. Patient was alert and orient upon regaining conciousness. Patient verbalized he was having no trouble breathing and vitals were taken. Patient vital signs were within normal ranges. Patient verbalized that his left arm hurt and fingers were numb on that side. Patient was taken to urgent care clinic and evaluated by physician. Patient signed an AMA form and was released from hospital. Patient encouraged to follow up with primary care doctor.


VAERS ID: 1178091 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-03-13
Onset:2021-03-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / N/A LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Appendicectomy, Appendicitis perforated, Feeling abnormal, Scan abnormal
SMQs:, Acute pancreatitis (broad), Dementia (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Gastrointestinal perforation (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (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, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: OTC - Vitamins and Minerals; Carvedilol and Enalapril for my heart
Current Illness: no
Preexisting Conditions: no
Allergies: I had knee surgery - Epidural reaction once
Diagnostic Lab Data: Hospital - scan for checking appendix and Surgery
CDC Split Type: vsafe

Write-up: At first right after vaccine it just felt like an invasion of something, I knew I had something I had that was different. March17, I got sick - I had a bad stomach ache. Friday, I thought the doctors would be gone. March 21st, I went to the clinic and they sent me right to the hospital for a scan and I had emergency surgery to remove my appendix - but it did get put off from when I went in because of all the emergencies in front of me with the ambulances coming in from accidents. He said it had burst by the time the surgeon got to me with the surgery and they gave me antibiotics and he said he poked three holes in my belly. Still recovering - I have follow up tomorrow. I am doing real well. My stomach doesn''t hurt and I am not taking pain medication any longer.


VAERS ID: 1178107 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-07
Onset:2021-04-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Asthenia, Blindness, Dyspnoea, Pain in extremity, Ulnar nerve palsy
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Retinal disorders (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Employee came at 1:30 to get vaccinated. Three to five minutes after administering the Johnson & Johnson vaccine, I asked the patient if he is feeling ok because he seemed nervous and sweaty. He responnded "yes, but I have a mental anxiety from vaccines, needls, doctors". one minute later he started complaining of pain in his left arm and feeling weak. . He then asked to sit on the floor and said that he can hardly breath, and lost vision. I administered Epipen injection to his left thigh while the store director was calling 911. He then complained about not being able to move his hand fingers. The ambulance came and took him to the ER. later in the day, his manager said that he spoke to hid family and they told him that he has been having anxiety from doctors, needls, and shots ever since he was little. He is feeling better now and the hospital will keep him for tomorrow.


VAERS ID: 1178114 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-07
Onset:2021-04-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood pressure increased, Chest discomfort, Dyspnoea, Pharyngeal swelling, Tachycardia
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Hypertension (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), 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
Current Illness: None
Preexisting Conditions: None
Allergies: Codeine, antihistamines
Diagnostic Lab Data:
CDC Split Type:

Write-up: Shortness of breath, chest discomfort, patient states feeling throat swelling, no visible swelling. Blood pressure elevated and tachycardia.


VAERS ID: 1178160 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Mississippi  
Vaccinated:0000-00-00
Onset:2021-04-01
Submitted: 0000-00-00
Entered: 2021-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Fall, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210404291

Write-up: SYNCOPE ONCE VACCINE ADMINISTERED/FAINTED; FALLING OUT OF CHAIR; This spontaneous report received from a pharmacist concerned an adult female. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, and batch number: 043A21A expiry: unknown) dose was not reported, administered on 01-APR-2021 for prophylactic vaccination. No concomitant medications were reported. Patient was not pregnant at the time of reporting. On 01-APR-2021, the patient experienced syncope once vaccine administered/fainted and falling out of chair. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from syncope once vaccine administered/fainted, and falling out of chair on 01-APR-2021. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0- 20210404291-covid-19 vaccine ad26.cov2.s-Syncope once vaccine administered/Fainted. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).


VAERS ID: 1178221 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-06
Onset:2021-04-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Body temperature increased, Cold sweat, Erythema, Malaise, Retching, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ?Pravastatin Sodium 40 MG Tablet 1 tablet Orally Once a day ?Fluticasone Propionate 50 MCG/ACT Suspension 1 spray in each nostril Nasally Twice a day ?Ibuprofen 600 MG Tablet 1 tablet with food or milk as needed Orally Three times a d
Current Illness: none
Preexisting Conditions: Hypertension, OSA, Obesity, Tobacco Use, GERD, Depression, Hyperlipidemia
Allergies: Hydrochlorothiazide: boils over body - Allergy
Diagnostic Lab Data: Client returned to the residential program 8:30am and is in stable condition with no new symptoms. Client was discharged with no medications.
CDC Split Type:

Write-up: At 12:05 am client came to the staff office treatment facility stating he feels sick and has been throwing up. He stated he had the Johnson & Johnson vaccine Tuesday 4/6/21 in the morning and around 6 pm on Tuesday he started to feel sick. The staff took his temperature and it was 100.9 degrees. The client was dry heaving and red in the face and having cold sweats. Staff monitored him while 911 was called and paramedics showed up within 10 minutes. The Program Manager was notified and the client was given instructions for when going to the hospital.


VAERS ID: 1178339 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-07
Onset:2021-04-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Headache
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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: The patient got really red immediately following vaccination, she started to become woozy and have a headache. We gave her water and a dose of benadryl. We called the ambulance because symptoms kept worsening instead of resolving.


VAERS ID: 1178351 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-06
Onset:2021-04-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Asthma, Chest X-ray, Dizziness, Dyspnoea, Electrocardiogram, Injection site pain, Nausea, Pain, Pharyngeal swelling, Swollen tongue, Wheezing
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Asthma/bronchospasm (narrow), Anticholinergic syndrome (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: It was reported to me by the pharmacist who was on duty on April 6, 2021 that the patient presented to the pharmacy on April 6, 2021 for her COVID-19 vaccination and was anxious prior to the appointment. The patient stated that immediately after receiving the vaccination, she felt a shooting pain in the injection site. The patient stated that within a few minutes, she felt lightheaded and nauseous. The patient then stated that within 20 minutes, she felt like she was having an asthma attack and had to use her rescue inhaler (albuterol HFA). It was reported that the patient left the pharmacy about 45 minutes after receiving the vaccination and the patient stated she was feeling better. The patient the reported to the pharmacy that the morning of April 7, 2021 that her symptoms of shortness of breath and wheezing returned and she went to an emergency room for treatment. The patient stated that after admission into the ER, the medical staff performed two EKGs and one chest X-ray, which were unremarkable. The patient stated she received treatment with Duoneb because she was wheezing and and treatment with IV methylprednisolone because her throat and tongue appeared swollen. The patient stated she was discharged on April 7, 2021 and was prescribed albuterol solution for nebulization and prednisone 10 mg tablets.


VAERS ID: 1178384 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-07
Onset:2021-04-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Chest pain, Dizziness, Headache, Throat irritation
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: At ~3:10pm, patient received his vaccination for COVID (Janssen brand). Patient was directed to sit in waiting area for 15 minutes for monitoring; during this time, patient started to complain of the following: chest/abdominal pain, "pounding in his head", felt faint, and "scratchy throat" that was not improving. Around 3:35pm, 9-1-1 was called due to worsening chest pain and scratchy throat. EMTs directed me to administer 25mg of diphenhydramine (which as give at 3:46pm) to patient. EMTs arrived shortly thereafter, noting elevated BP (~154/90). Patient left pharmacy area ~4:10pm and was brought to ER via paramedics for further evaluation.


VAERS ID: 1178409 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-04-07
Onset:2021-04-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Computerised tomogram
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: No other illnesses at the time
Preexisting Conditions: None
Allergies: NKDA
Diagnostic Lab Data: CT 4/7/2021
CDC Split Type:

Write-up: Patient got home after vaccination and said he was having abdominal cramping. He is getting a CT at the hospital and will report results


VAERS ID: 1178490 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-07
Onset:2021-04-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Dizziness, Dyspnoea, Hypersensitivity, Nausea, Oropharyngeal pain, Vertigo
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (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:
Current Illness:
Preexisting Conditions:
Allergies: Lyrica, Lamictal, penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: She had no history of anaphylaxis from any cause, she had no history of reactions to vaccines or components. After about 5 minutes I checked on her and she said she was feeling very dizzy. I called management for assistance and got her ice packs for neck and forehead. I took her blood pressure and it was 150/90, HR 73. We laid her down and elevated her legs. She said that she felt some pressure in her chest but she had pulled a muscle there the day before and wasn''t sure if it was related. She said the room was spinning as she continued to lay on the ground and it was not improving. Her blood pressure was taken about 5 minutes later and it was 143/85 HR 73. She said it is usually low. She had no signs of local reaction, hives, or swelling. She complained of nausea. After a few more minutes she said she was not feeling any better and was having pain in her throat and difficulty breathing. I asked her to try to take a deep breath and she was gasping for air, unable to breathe deeply. I administered epinephrine (one dose) and called 911. I rechecked blood pressure while waiting for paramedics and it was 125/80. She was taken to hospital when they arrived. Her mom arrived shortly before the ambulance and went with her. Pt never lost consciousness. Management followed up with patient this evening and patient is home and well, but the ER did classify the event as an allergic reaction.


VAERS ID: 1178563 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-03-08
Onset:2021-03-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 RA / IM

Administered by: School       Purchased by: ?
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Migraine
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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Venlafaxine, attenolal, magnesium, b vitamins, vitamin C and D3
Current Illness: None
Preexisting Conditions: Migraine
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: From March 8 th through March 18, I experienced very severe level 10, out of a scale from 1 to 10, migraine pain and related usual symptoms day and night. I also experienced swelling of a 5 in area ,,soreness and redness ,around the injection site for the same amount of days. I normally suffer from chronic migraine.


VAERS ID: 1178668 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-06
Onset:2021-04-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dehydration, Electrocardiogram, Heart rate increased, Laboratory test, Sinus tachycardia, Swelling face, Urine analysis
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (narrow)

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: None
Diagnostic Lab Data: Blood test, EKG, chest x-ray, urine test severe dehydration and sinus tachycardia
CDC Split Type:

Write-up: increased heartrate (130-140BPM); severe dehydration


VAERS ID: 1178753 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-04-07
Onset:2021-04-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Pruritus, 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: SAME AS THIS EVENT "PER PATIENT"
Other Medications: UNKNOWN
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: UNKNOWN - HOWEVER PATIENT REPORTED ALLERGIC REACTION TO "ALL VACCINATIONS" THAT HAVE BEEN ADMINISTERED
Diagnostic Lab Data: UNKNOWN
CDC Split Type:

Write-up: PATIENT DEVELOPED RED SPLOTCHES ON NECK AND FACE, COMPLAINED OF ITCHING, GIVEN 2 DOSES OF 25MG BENADRYL ORAL (50MG TOTAL), THEN REQUESTED TRANSPORT TO HOSPITAL VIA AMBULANCE


VAERS ID: 1178759 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-04-05
Onset:2021-04-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Headache, Influenza like illness, Nausea, Pain, Pyrexia, Syncope, Vital signs measurement, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin, vitamin d, omega 3
Current Illness: None
Preexisting Conditions: None
Allergies: Latex allergy
Diagnostic Lab Data: Blood pressure, pulse, oxygen
CDC Split Type:

Write-up: Was waiting in the after injection parking lot for about 10 minutes, felt fine, and then it was like a fainting switch had been flipped without much warning. Was able to roll down my window and honk horn for emt in parking lot before fainting. Woke up to emt checking blood pressure, pulse and putting oxygen mask on. Then had to throw up, continue oxygen, sat and waited about 45 minutes until I felt like I could safely drive home. Had mild flu like symptoms starting about 3 hours later, became more moderate symptoms about 8 hours after injection - headache, fatigue, fever, body aches, nausea. Slept all next day, only remained. Still feel fatigue on Wednesday


VAERS ID: 1178783 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-07
Onset:2021-04-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Hot flush, Hyperhidrosis, Laboratory test normal, Nausea, Pallor, Pyrexia, Seizure, Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (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), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: I take the following supplements regularly: Vitamin C + D3 + Zinc + Cod Liver Oil
Current Illness: none
Preexisting Conditions: none
Allergies: Cardamom allergy, especially fresh cardamom pods
Diagnostic Lab Data: Blood tests were done and nothing abnormal was found.
CDC Split Type:

Write-up: I had an intense fever within 5 minutes of the administration of the shot. I was sweating profusely, experience nausea and then fainted and had a mild seizure. After coming to consciousness, I vomited and the pharmacy staff called the paramedics. I was extremely pale and the fever persisted for several minutes while waiting for the paramedics. I recovered and felt mostly normal after being given saline solution and anti-nausea medication. Hours after being released from the hospital, I have waves of cold chills and hot flashes.


VAERS ID: 1178799 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-07
Onset:2021-04-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Mental impairment, Pallor, Somnolence
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: NKDA
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: At approximately 4 pm, I gave the patient a Janssen covid-19 vaccination. I asked the patient to sit for 15 minutes for observation. About 10 minutes later I was notified someone wasn''t doing well. I went to the patient and he was hunched down and looked pale and he stated he was very dizzy. I asked him if he had trouble breathing and he stated he had not. He appeared like he was about to pass out, I was asking him questions about his state and he wasn''t being coherent. I told him I was going to give an EpiPen and call 911. I gave him the EpiPen in his outer thigh. EMS came 5 minutes later. A few hours later I got a call from a close by asking if I had given him a Benadryl because he was feeling drowsy. I asked his status and the nurse stated he was doing fine.


VAERS ID: 1178881 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-03-24
Onset:2021-03-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 18050185121 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Dizziness, Ear pain, Fatigue, Hypoaesthesia, Limb discomfort, Lymph node pain, Muscle spasms, Pain in extremity, Paraesthesia, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

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? No
Previous Vaccinations:
Other Medications: Midodrine, flovent, levoxyl, proair inhaler, epi pen prn, Zinc, garlic, probiotics, turmeric, ginger, B complex, vit c, magnesium, omega 3, vit D, MCT oil, cacao powder
Current Illness: migraine
Preexisting Conditions: asthma, hypothyroid, TBI/post concussion syndrome, autonomic dysfunction, neurocardiogenic pre syncope, chronic fatigue, sleep apnea, migraines
Allergies: sulfa, erythromycin, ibuprofen, aspirin, NSAIDS, betadine, chloraprep, latex, avocados, banana, most fruit except citrus, peanuts/nuts, sea food.
Diagnostic Lab Data: none at this point. I have a follow up with my PCP on April 14, 2021
CDC Split Type:

Write-up: The night of my injection I woke up with extreme left arm and scapular pain. It radiated down to my fingers. It all was heavy and number and tingling. That continued most of the day. The next day I was extremely fatigued and weak and stayed in bed. I think had left ear and lymph node pain on the left side of my face and neck. This continued for days. By the 1 week mark after my injection, I ended up at the urgent care with facial swelling and extreme lymph node pain. They stated it was an adverse reaction to the vaccine. As of yesterday, I continue to have some swelling in my jaw and occipital region as noted by the PTA where I go for physical therapy. I continue to experience extreme fatigue, worse than normal and dizziness. My left pinky still has some tingling and vibration feeling. I also still get cramping on this finger and on the ulnar side of my palm.


VAERS ID: 1179000 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-31
Onset:2021-04-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Bell's palsy, Facial paralysis
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad)

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? No
Previous Vaccinations:
Other Medications: lipitor, lisinopril, tylenol, calcium, glipizide, metformin, vitamin D
Current Illness: none
Preexisting Conditions: DM2, HTN, fatty liver, dyslipidemia
Allergies: no known allergies
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Bell''s palsy: left facial droop started the following morning around 8AM


VAERS ID: 1179023 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-04-06
Onset:2021-04-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Blood test, Burning sensation, Chest X-ray, Hypoaesthesia, Leptospirosis, Magnetic resonance imaging head, Magnetic resonance imaging spinal, Paraesthesia, Urine analysis
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Arthritis (broad), Sexual dysfunction (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
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Blood panel, Urinalysis, Chest x-ray, MRI to head and cervical spine, Leptospirosis blood work
CDC Split Type:

Write-up: About 6 hours after vaccine injection I began to have weakness, numbness, tingling, and burning from my hips down. From the top of my legs all the way to my feet. Also numbness in my hands. Went to the ER approximately 15 hours after receiving my vaccination. Was discharged, awaiting on leptospirosis bloodwork and if conditions do not improve I will return to the ER to get a lumbar puncture to check for Guillain Barre Syndrome.


VAERS ID: 1179040 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-07
Onset:2021-04-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Hypoaesthesia oral, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (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: Asthma
Allergies: Stevia
Diagnostic Lab Data: No test where administer other than doctors self check up.
CDC Split Type:

Write-up: In a time span of 40 minutes after been provided with the Jansen vaccine, my tongue began to felt asleep and my throat became to feel very tight. An hour after having been administer the vaccine I took 50mg of Benadryl and went to my nearest emergency room where they provided a decahedron syringe 2 hours after vaccine administration.


VAERS ID: 1179363 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-07
Onset:2021-04-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Tachycardia, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic: Shakiness-Severe, Systemic: Tachycardia-Severe, Additional Details: uncontrolable shaking. patient stated that benadryl has helped her in the past with this type of reaction. gave benadryl. patient has a history of having reactions to vaccines. 911 was called and brought her to the hospital.


VAERS ID: 1179381 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-14
Onset:2021-04-01
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Bell's palsy, Corneal reflex decreased, Facial paralysis, Insomnia, Loss of personal independence in daily activities, Mobility decreased, Paraesthesia, Tinnitus, Visual impairment
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Corneal disorders (narrow), Retinal disorders (broad), Hearing impairment (narrow), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic: Bell''s Palsy-Severe, Systemic: Tingling (specify: facial area, extemities)-Mild, Systemic: Tinnitus-Severe, Systemic: Unable to Sleep-Severe, Systemic: Visual Changes/Disturbances-Severe, Additional Details: Patients'' entire right face is drooping, with lack of mobility. Patient cannot blink which is causing additional issues, such as the visual changes. As of this morning patient has experienced some tingling to her face but she states it has not state consistent. She has difficulty eating and sleeping. Patient is also experiencing moderate to severe anxiety about the entire ordeal. Ringing in ear is constant and has not subsided since thursday (4/1). still experiencing symptoms since last week


VAERS ID: 1179594 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-07
Onset:2021-04-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blindness, Body temperature decreased, Cyanosis, Dizziness, Feeling hot, Hyperhidrosis, Tremor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Noninfectious encephalopathy/delirium (broad), Glaucoma (broad), Optic nerve disorders (broad), Retinal disorders (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient felt dizziness, shaking and light headed few minutes after getting the shot, forehead was hot to touch but temperature was 97F, upper lip was sweating and hands were turning blue, and patient reported temporary loss of vison, patient was conscious the entire time called 911 and patient was taken to Emergency Room, Patient was later discharged and 4 hours later patient came to the pharmacy to pickup the car and drove home.


VAERS ID: 1179656 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-22
Onset:2021-04-04
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 18015025 / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Colitis, Diarrhoea, Full blood count, Gastrointestinal inflammation, White blood cell count increased
SMQs:, Neuroleptic malignant syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific inflammation (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: metroprolol, Amlodipine
Current Illness: no
Preexisting Conditions: Hypertension
Allergies: tramadol, lisinopril
Diagnostic Lab Data: CBC-wbc elevated
CDC Split Type: vsafe

Write-up: After the vaccine I woke up about 3am throwing up and had diarrah all day. I felt so bad all day that by 9pm I went to the ER and was advised my intestines were inflamed and diagnosed with Colitis. I was prescribed Augumentin to take for 7 days and tylenol for pain and to follow up with my PCP.


VAERS ID: 1179758 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-07
Onset:2021-04-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Confusional state, Fall, Head injury, Loss of consciousness, Syncope
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), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Cardiomyopathy (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? 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: NKA
Diagnostic Lab Data: Patient left hospital AMA to get CT scan
CDC Split Type:

Write-up: Syncopal episode appearing as a vasovagal response from receiving the vaccine. Patient fainted and fell back onto her head. Unconscious. When patient woke up she was very confused and alarmed. EMS was called and brought her to the hospital. BP, O2, resp normal


VAERS ID: 1179946 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-27
Onset:2021-03-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Headache, Heart rate increased, Hypoaesthesia, Paraesthesia, Skin warm
SMQs:, Anaphylactic reaction (broad), 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), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Dehydration (broad), Sexual dysfunction (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: prednisone
Diagnostic Lab Data:
CDC Split Type:

Write-up: Passenger in car going home. 30-40 minutes after injection had pounding headache, warm feeling all over, shortness of breath, difficulty breathing, rapid heart rate, chest pain, numbness and tingling in legs and arms


VAERS ID: 1180018 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: methotrexate , others
Current Illness: RA, asthma
Preexisting Conditions:
Allergies: none
Diagnostic Lab Data: called 911 and patient was taken to hospital
CDC Split Type:

Write-up: patient shortly passed out


VAERS ID: 1180066 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-03-08
Onset:2021-04-06
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Alanine aminotransferase increased, Albumin globulin ratio, Aspartate aminotransferase increased, Basophil count decreased, Basophil percentage, Blood albumin decreased, Blood alkaline phosphatase normal, Blood bilirubin normal, Blood calcium decreased, Blood chloride decreased, Blood creatinine increased, Blood glucose normal, Blood potassium normal, Blood sodium decreased, Blood urea normal, Brain natriuretic peptide normal, Chest X-ray normal, Dyspnoea, Electrocardiogram, Eosinophil count decreased, Eosinophil percentage decreased, Fibrin D dimer increased, Glomerular filtration rate decreased, Haematocrit decreased, Haemoglobin normal, Immature granulocyte count, Lymphocyte count normal, Lymphocyte percentage, Mean cell haemoglobin concentration increased, Mean cell haemoglobin increased, Mean cell volume normal, Mean platelet volume normal, Monocyte count normal, Monocyte percentage increased, Neutrophil count decreased, Neutrophil percentage decreased, Platelet count normal, Protein total normal, Red blood cell count decreased, Red cell distribution width normal, Rhinorrhoea, SARS-CoV-2 test negative, White blood cell count normal
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Agranulocytosis (broad), Haematopoietic erythropenia (narrow), Haematopoietic leukopenia (narrow), Haemorrhage laboratory terms (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Hyponatraemia/SIADH (narrow), Cardiomyopathy (broad), Chronic kidney disease (broad), Tumour lysis syndrome (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? No
Previous Vaccinations:
Other Medications: Current Outpatient Medications: ? aspirin 325 MG tablet, Take 325 mg by mouth daily Takes 1/2 tablet, Disp: , Rfl: ? Cholecalciferol (VITAMIN D) 1000 UNITS CAPS, Take 5,000 Units by mouth daily, Disp: , Rfl: ? lisinopril-hydrochloroth
Current Illness:
Preexisting Conditions:
Allergies: Allergen Reactions ? Novocain
Diagnostic Lab Data: Comprehensive metabolic panel [200568102] (Abnormal) Collected: 04/06/21 2105 Order Status: Completed Specimen: Blood Updated: 04/06/21 2214 Glucose 128High 65 - 100 MG/DL Blood Urea Nitrogen 17 7 - 18 MG/DL Creatinine 1.6High 0.7 - 1.3 MG/DL Sodium 132Low 136 - 145 MMOL/L Potassium 3.5 3.5 - 5.1 MMOL/L Chloride 95Low 98 - 107 MMOL/L Co2 26 21 - 32 MMOL/L Calcium 8.4Low 8.5 - 10.1 MG/DL Protein Total 7.1 6.4 - 8.2 G/DL Albumin 3.4 3.4 - 5.0 G/DL A/G Ratio 0.9 0.8 - 2.0 Alkaline Phosphatase 49 46 - 116 U/L Alt (SGPT) 50 16 - 63 U/L AST(SGOT) 46High 15 - 37 U/L Bilirubin, Total 0.4 0.2 - 1.0 MG/DL GFR Comment IF PATIENT IS AFRICAN AMERICAN, MULTIPLY RESULT BY 1.16 Est GFR 42Low $g90 ML/MIN/1.73sq.m NOVEL CORONAVIRUS SARS-COV-2 BY PCR [200568111] Collected: 04/06/21 2116 Order Status: Completed Updated: 04/06/21 2205 SARS-COV-2 Source NASOPHARYNGEAL SARS-COV-2 By PCR Not Detected Not Detected Comment: THIS TEST HAS BEEN VALIDATED BUT FDA''S INDEPENDENT REVIEW OF THE VALIDATION IS PENDING. THIS TEST IS PERFORMED AS A LABORATORY DEVELOPED TEST, INDEPENDENT REVIEW OF THE VALIDATION UNDER THE FDA''S EMERGENCY USE AUTHORIZATION (EUA) AUTHORITY WILL BE PERFORMED ACCORDING TO CURRENT GUIDANCE REQUIREMENTS. ********** WE WILL CONTINUE TO FOLLOW FEDERAL AND STATE REQUIREMENTS FOR BOTH NOTIFICATION OF RESULTS AND ANY CONFIRMATORY TESTING D-dimer, quantitative [200568107] (Abnormal) Collected: 04/06/21 2105 Order Status: Completed Specimen: Blood Updated: 04/06/21 2148 D-Dimer 402High 0 - 400 NG/ML FEU EKG [200568103] Resulted: 04/06/21 Order Status: Completed Updated: 04/06/21 2142 XR Chest 2 View [200568105] Collected: 04/06/21 2107 Order Status: Completed Updated: 04/06/21 2139 Narrative: XR CHEST 2 VIEWS CLINICAL INFORMATION: Shortness of breath TECHNIQUE: PA and lateral views. 2 images. COMPARISON: Chest radiograph October 27, 2014 FINDINGS: Lungs and pleura: Normal lung inflation. No focal consolidation, pleural effusion or pneumothorax Heart and mediastinum: Cardiomediastinal silhouette is normal size. Normal pulmonary vasculature Bones and chest wall: No suspicious osseous abnormalities Lines and tubes: None. IMPRESSION: No acute cardiopulmonary disease. Electronically signed by: MD 4/6/2021 9:38 PM : 109-1082 Brain Natriuretic Peptide (BNP) [200568104] Collected: 04/06/21 2105 Order Status: Completed Specimen: Blood Updated: 04/06/21 2137 B-Type Natriuretic Peptide 13 0 - 100 PG/ML CBC w Auto Diff [200568101] (Abnormal) Collected: 04/06/21 2105 Order Status: Completed Specimen: Blood Updated: 04/06/21 2113 White Blood Cell Count 3.9Low 4.8 - 9.6 THOUS/uL Red Blood Cell Count 4.09Low 4.33 - 5.59 MIL/uL Hemoglobin 13.5 13.1 - 16.8 GM/DL Hematocrit 37.3Low 38.8 - 49.0 % Mean Corpuscular Volume 91.2 82.7 - 94.4 FL Mean Corpuscular Hemoglobin 33.0High 27.7 - 32.6 PG Mean Corpuscular Hemoglobin Conc 36.2High 32.4 - 35.7 G/DL Rdwcv 12.2 11.6 - 13.9 % Rdwsd 40.6 36.0 - 46.1 FL Platelet Count 165 154 - 364 THOUS/uL Mean Platelet Volume 9.9 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 47.2 34.0 - 67.9 % Lymphs 35.2 19.1 - 41.2 % Monocytes 15.5High 6.1 - 12.3 % Eos 0.8Low 0.9 - 7.6 % Basos 1.0 0.2 - 1.5 % Neutrophils Absolute Count 1.8Low 2.7 - 5.8 THOUS/uL Lymphocytes Absolute Count 1.4 1.1 - 3.3 THOUS/uL Monocytes Absolute Count 0.6 0.4 - 0.9 THOUS/uL Eosinophils Absolute Count 0.0Low 0.1 - 0.6 THOUS/uL Basophils Absolute Count 0.0 0.0 - 0.1 THOUS/uL Imm Gran 0.3 0.2 - 0.9 % Abs Imm Gran 0.01 0.0 - 0.1 THOUS/uL
CDC Split Type:

Write-up: 4/6/12 ER HPI: 74 y.o. male who presents with complaint of shortness of breath that is worse after eating for 3 weeks. Patient said he had received a his copied vaccine 3 weeks ago. No cough, no chest pain, no abdominal pain nausea vomiting, no palpitations and no fever or chills Shortness of Breath: Started 3 weeks ago and getting worse. Received covid vaccine 3 weeks ago and started then. No cough. Dyspnea on exertion. No fever. Early am he has had runny noses. No inhalers or nebs. Not smoker


VAERS ID: 1180078 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-01
Onset:2021-04-07
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram, Dysphagia, Fall, Headache, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), 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), Accidents and injuries (narrow), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Unknown
Diagnostic Lab Data: IV and stomach scan
CDC Split Type:

Write-up: 4/7- headache, nausea, vomiting, couldn''t drink, 4/8- picked up of the floor, ER


VAERS ID: 1180149 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-03
Onset:2021-04-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Diarrhoea, Full blood count, Headache, Hypoaesthesia, Immediate post-injection reaction, Lethargy, Magnetic resonance imaging, Paraesthesia, Somnolence
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad), Sexual dysfunction (broad)

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? No
Previous Vaccinations: unknown-Pneumonia-skin infection
Other Medications: folic acid, ometrosol, unisom, vit C,Methylphenidate
Current Illness: no
Preexisting Conditions: Crest Syndrome, RA
Allergies: gluten, cipro, vpack, floxin, amoxicillin, bactrium
Diagnostic Lab Data: CBC MRI-clear Multiple test not really sure of all of them
CDC Split Type: vsafe

Write-up: Moments after the vaccine my arm and hands started tingling and becoming numb in various spots which continued all over my entire face. I was monitored and was given a shot of benedryl and was sent home after a while. The next day I felt really groggy, latargic and had diarreah. That monday the numbness went up to my ear and I reached out to my PCP who prescribed a steroid. Later that evening I got a really bad headache and the tingling and numbness hit my feet then went up my legs, my arms and up and down my body. Its a feeling as if my body has fallen asleep.


VAERS ID: 1180172 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-07
Onset:2021-04-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Fatigue, Feeling abnormal, Feeling hot, Immediate post-injection reaction, Injection site pain, Pain in extremity, Retching, Slow speech, Somnolence, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: None
Diagnostic Lab Data: Pt reports EKG and states results normal.
CDC Split Type:

Write-up: Patient rec''d Janssen COVID-19 vaccine at 0912. Immediately started vomiting. Stated "arm burned all the way to her hand with injection". Reported felt dizzy, lightheaded, hot". BP 98/62. Assisted to cot and side-lying position. Continued to vomit/dry heave. At 0921, pt stated she was "really tired" and couldn''t keep her eyes open. Able to answer questions, but not always able to finish sentence. EMS called. BP returned to normal limits within about 5-10 minutes. Patient contiued to dry heave and c/o feeling cold and nauseous, as well as "really tired" until EMS transported her. 4/8/2021: Nurse called patient. Patient stated she "feels foggy today". States her arm is "extremely sore".


VAERS ID: 1180214 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood glucose, Seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: Occasional heat related syncope
Preexisting Conditions:
Allergies: none
Diagnostic Lab Data: Blood Glucose 87mg/dL
CDC Split Type:

Write-up: Patient had a witnessed seizure while in observation area. Patient seizure activity lasted approximately 15 seconds. Patient became conscious, alert, and oriented, within 5 minutes of seizure activity starting.


VAERS ID: 1180218 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / IM

Administered by: Private       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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lamotigrine Klonopin Lexapro
Current Illness:
Preexisting Conditions: bipolar disorder
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Two minutes after vaccination, pt reported feeling dizzy and became diaphoretic. Blood pressure measured at 63/22, heart rate of 60 bpm. Ambulance was called. Patient placed in supine position and reported feeling better, BP recovered to 98/66.


VAERS ID: 1180220 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-03-09
Onset:2021-03-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest X-ray, Chest discomfort, Chest pain, Dyspnoea, Dysuria, Electrocardiogram, Fatigue, Laboratory test, Pain, SARS-CoV-2 test, Urinary retention, Urine analysis
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), COVID-19 (broad)

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? No
Previous Vaccinations:
Other Medications: TRILEPTAL, SEROQUEL, SERTRALINE, STELARA INJ, MVI
Current Illness: CHROANS, URINARY RETENTION
Preexisting Conditions: CHROANS
Allergies: NKA
Diagnostic Lab Data: ER on 19th of March chest xray, urinalysis, ekg and bloodwork and covid test
CDC Split Type:

Write-up: achiness and fatigue followed by chest pain/pressure and extreme shortness of breath. Pt also experiencing urinary retention and pain when urinating


VAERS ID: 1180341 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-03-07
Onset:2021-04-02
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Bursitis, Pain in extremity
SMQs:, Tendinopathies and ligament 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine
Current Illness: None
Preexisting Conditions: Hypothyroidism Juvenile Rheumatoid Arthritis as child Hyperlipidemia
Allergies: None
Diagnostic Lab Data: ER visit IV antibiotics - Rocephin 4/2, 4/3, 4/4, 4/5 PO antibiotics - cefadroxil 4/6 x 7 days planned.
CDC Split Type:

Write-up: Moderate left deltoid pain the day after vaccine - pain is persisting through today 4/8/21 - a month later. Olecranon Bursitis in left arm - same as vaccine - 4/2/21 - seen at ER and given IV antibiotics, then outpatient oral antibiotics


VAERS ID: 1180402 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-07
Onset:2021-04-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Blood test, Chills, Computerised tomogram head, Cyanosis, Dizziness, Electrocardiogram normal, Headache, Loss of consciousness, Nausea, Tinnitus, Vomiting, White blood cell count increased
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (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), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Bcp
Current Illness: None
Preexisting Conditions: None
Allergies: Sulfa
Diagnostic Lab Data: Ct head scan - negative, ekg - negative, blood work - elevated white blood cell. All done on 4/7.
CDC Split Type:

Write-up: Started with chills, then dizziness, nausea and passed out until was found by another person. Had ringing in ears either right before passing out or when coming to consciousness. Vomited after waking up. Chills returned, fever of 100.3, blue lips. Headache came later


VAERS ID: 1180469 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-07
Onset:2021-04-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Hyperhidrosis, Skin discolouration, Tachycardia, Throat tightness, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (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:
Current Illness:
Preexisting Conditions:
Allergies: PCN
Diagnostic Lab Data: EpiPen 0.3
CDC Split Type:

Write-up: C/O throat tightness, upper chest tightness, tachycardia, sweating, discoloration upper neck, jaw, vomiting


VAERS ID: 1180559 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-07
Onset:2021-04-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Public       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? 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: Tree Nut allergy that resulted in anaphylaxis in the past
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: Patient was given the Janssen Covid 19 vaccine on 4/7/21 around 11:55am in her left deltoid. She was accompanied by her husband at the clinic. After the immunization she was seated in the waiting area to be observed for 30 minutes after her vaccine. Approx. 5 mins after the vaccine was given, the patient passed out in the chair and I (the pharmacist) was alerted. The patient came back to when I arrived at her seat and was able to talk and asked for water. Her husband stayed by her side while I went to obtain water and I heard her husband say she passed out again and then regained consciousness. He layed her on the floor while I called 911. An ambulance came and took the patient to the hospital.


VAERS ID: 1180630 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Senior Living       Purchased by: ?
Symptoms: Asthenia, Dyspnoea, Heart rate increased, Myalgia, Nausea, Pyrexia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever, Nausea, Vomiting, Weakness, Muscle Aches, Increased Heart Rate, Shortness of Breath


VAERS ID: 1180658 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Unknown  
Location: Washington  
Vaccinated:2021-04-01
Onset:2021-04-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Hyperhidrosis, Pallor, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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: Unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data: code team called, patient woke up and started responding right before epi injection administration Transferred to ED
CDC Split Type:

Write-up: unresponsive, pale, diaphoretic, SBP 80s HR 50s


VAERS ID: 1180670 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure decreased, Dyskinesia, Fall, Heart rate decreased, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dyskinesia (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient passed out fell to ground and started with jerking motions. Pateinet was taking by ambulance to the emergency room. Pateints blood pressure and pulse where low when checked by paramedics.


VAERS ID: 1180681 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-13
Onset:2021-03-01
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Hypertension, Laboratory test, Magnetic resonance imaging head, Vertigo
SMQs:, Neuroleptic malignant syndrome (broad), Hypertension (narrow), Vestibular 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? Yes
Hospitalized? No
Previous Vaccinations: Influenza
Other Medications: None
Current Illness: None
Preexisting Conditions: Lupus Valley Fever
Allergies: Iodine Azithromyacin
Diagnostic Lab Data: Mri of brain Blood
CDC Split Type:

Write-up: Vertigo High blood pressure


VAERS ID: 1180696 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Lethargy, Nausea, Yawning
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient appeared lethargic, nauseated, yawning, dizzy Patient seen by medical team, and was transferred to The hospital


VAERS ID: 1180744 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Dysphagia, Headache, Pain in jaw
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), Vestibular disorders (broad), Osteonecrosis (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: Metformin; Blood pressure medication
Current Illness:
Preexisting Conditions: Diabetes
Allergies: Losartan
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient reported feeling pain in the base of the head, difficulty swallowing, jaw pain, and dizziness Patient seen by medical team and ambulance was called Patient stated symptoms improved a little Patient refused medical transport because ?it?s too expensive? and signed AMA form Patient stated she will be driven by husband to ER


VAERS ID: 1180791 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-07
Onset:2021-04-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure increased, Blood pressure measurement, Dizziness, Pharyngeal swelling, Rash macular, Tachycardia, Throat tightness, Tremor
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalopathy/delirium (broad), Hypertension (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid, Vit. D, Vit. B, Omega
Current Illness: none
Preexisting Conditions: Thyroid
Allergies: Erythromiacyn
Diagnostic Lab Data:
CDC Split Type:

Write-up: Throat closing, tongue swelling, splotty skin, rapid heart rate, dizziness, extreme body shaking uncontrolably. Stopped at fire station. Admistered benydrl, Heart rate high and blood pressure 200/178, put IV port, transferred to ER at hospital. Hospital through IV gave more benydrl and Decadron, monitored, after three hours blood pressure down and released. Instructed to take prednisone for five days


VAERS ID: 1180803 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-03-27
Onset:2021-03-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Feeling hot, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Unknown
Preexisting Conditions: None
Allergies: Aspirin
Diagnostic Lab Data: No test or laboratories performed.
CDC Split Type:

Write-up: After 15 minutes from receiving the vaccine, patient complained of pruritus at her face and warm sensation at her upper extremeties, oral mucosa was within normal limits. Patient denied chest pain, shortness of breaths, palpitations, nor was sweating, no rash nor skin or mucosal lesions. She was calm able to talk incomplete sentences. Only remarkable previous history of allergy to Aspirin. Patient was send to ER and ER Physician Assessment was pruritus . She was treated at ER with Methylprednisolone and Diphenydramine IV; symptoms resolved. Discharged home with hydroxyzine as needed for itchiness.


VAERS ID: 1180807 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Hyperhidrosis, Tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (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
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: patient was vaccinated at 10:55 by 11:00 was anxious and pacing with tachycardia and sweating. at 11:05 patient was given 50mg diphenhydramine in liquid form (20cc) and EMT personnel arrived at 11:15 to evaluate patient. Patient chose to go hospital for evaluation


VAERS ID: 1180819 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Hyperhidrosis, Nasopharyngitis, Pallor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (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? 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
Diagnostic Lab Data: Per paramedics: tests were ran inside ambulance. Blood pressure, blood glucose, and heart rate were all normal.
CDC Split Type:

Write-up: Vaccine was given at 11:30AM. Approx. 5 minutes after dose given, patient was lightheaded, broke out into a sweat, pale, cold, and fainted twice in the course of 15 minutes. 911 was called and arrived at 11:45AM.


VAERS ID: 1180833 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-03-29
Onset:2021-03-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blister, Disturbance in attention, Fatigue, Headache, Injection site bruising, Injection site erythema, Injection site irritation, Injection site mass, Injection site pain, Injection site swelling, Injection site warmth, Mobility decreased, Urticaria
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Depression (excl suicide and self injury) (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? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Flu shot = hives for 3 months
Other Medications: Trazadone, Tri-Sprintec, Prozac, Hydroxyine
Current Illness: None
Preexisting Conditions: Asthma and allergies and anxiety
Allergies: Pollen, lactose, dust, thc, cbd, Tylenol brand, penicillin, bunnies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Day 1-Day 3:Sore arm, swollen, hot to the touch, red irritation at injection site, tiredness, trouble concentrating. Day 4-6: arm swollen more, hot to touch, irritation at Injection site, mobility of arm impaired. Day 5: massaged arm to get swelling to go down. Day 6: woke up with massive headache and swelling went down. Day 7: broke out in hives that turned into blisters, taken to ER and given prednisone and antihistamine. Day 8-10: arm is black and blue bruised at injection site, small lump at site, continuous rotating hives and blisters with Prednisone 160mg and antihistamine and creams.


VAERS ID: 1180848 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-06
Onset:2021-04-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Disturbance in attention, Dizziness, Fatigue, Feeling abnormal, Spinal pain
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Arthritis (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Descovy
Current Illness: not specified
Preexisting Conditions: not specified
Allergies: nka
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: Pt was in the store for observation post vaccine. About 10 minutes after the shot, she came back to the pharmacy and reported she was not feeling right. She was extremely tired, weak, and dizzy. She was told to sit down for further observation and given a bottle of water. About 5 minutes later, she said she was still feeling really bad. She said she was not thinking clearly and didn''t feel right. She was also experiencing moderate pain down her spine. She said her thinking was so affected that she wanted to seek treatment. Patient declined offer to call EMS, and proceeded to an urgent care clinic next door. Urgent care later called the pharmacy to inform us that patient had been transported to the hospital by ambulance.


VAERS ID: 1180863 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-07
Onset:2021-04-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / N/A RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling hot, Flushing, Headache, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (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:
Diagnostic Lab Data:
CDC Split Type:

Write-up: patient complained of a headache about 2 minutes after vaccination. She became hot and flushed and soon began vomiting. Patient''s mother contacted ems which took her to the local emergency department. Patient was given ondansetron and diphenhydramine and sent home.


VAERS ID: 1180891 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-06
Onset:2021-04-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Pruritus, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (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: An hour b4 I broke out in hives, I took an Ibuprofen. The next day when I awoke I was covered from head to toe in hives. This continued until the night when I was recommended by my doctor to go to e.r. None on face
Current Illness: None
Preexisting Conditions: None
Allergies: Cillin family
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Itchy burning hives covering my entire body 12-36 hours after being vaccinated. Between those hours I took benadryl and used cortisone cream, which helped slightly. I went to e.r.in the night as advised by my doctor, where I received a steroid, some benadryl and pepcid. I woke up the next morning feeling much better with little to no signs of hives


VAERS ID: 1180895 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-14
Onset:2021-04-03
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Completed suicide, Condition aggravated, Mental disorder, Overdose
SMQs:, Suicide/self-injury (narrow), Dementia (broad), Drug abuse and dependence (broad), Medication errors (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-03
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: death Narrative: Pt with hx substance use disorder (on suboxone), depression, PTSD, SI and grief following her son''s suicide. Pt received COVID vaccine 3/14/21. Clinic notified of pt''s death on 4/6, for which it HAS NOT BEEN VERIFIED but reported death date of 4/3. Pt was scheduled for MH f/u appt 4/5, but no-showed it. Unclear report or cause of death, however, suspected via suicide or drug overdose given risk factors and worsening of mental illnesses. Was pt previously covid positive? No Are there any predisposing factors (i.e. PMH, HPI, allergy history etc) for patient experiencing adverse drug event? No Any occurrence of an ADR at time of administration or during time of observation? No Did patient recover from event? N/A - pt died but does not appear related to vaccine Was there an ADR between observation period and date of death? No Was patient hospitalized prior to vaccination? No Was patient hospitalized between vaccination and date of death? No Was patient hospitalized prior to death No What are the possible cause of death? Suicide, illicit drug overdose


VAERS ID: 1181249 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / N/A LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, SARS-CoV-2 test negative, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), COVID-19 (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: See medical record.
Current Illness: None. Chronic migraines which she received botox for on 4/6.
Preexisting Conditions: See medical record.
Allergies: See medical record.
Diagnostic Lab Data: POCT BG that was wnl. Monitoring.
CDC Split Type:

Write-up: Within 10 min of receiving the vaccine, patient began feeling lightheaded, vomited after being given juice by staff.


VAERS ID: 1181258 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Unknown  
Vaccinated:2001-03-31
Onset:2021-03-31
   Days after vaccination:7305
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Blood lactic acid increased, Chills, Myalgia, Palpitations, Pyrexia, Sinus tachycardia
SMQs:, Rhabdomyolysis/myopathy (broad), Lactic acidosis (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Sinus tachycardia probably related to immunologic reaction to COVID-19 vaccination. He started experiencing tachypalpitations about 30 minutes after receiving Johnson & Johnson COVID-19 vaccine. He reports having associated low- grade fever, chills, and myalgias. He was noted to have elevated lactate levels which resolved on follow-up labs.


VAERS ID: 1181273 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic: Seizure-Severe


VAERS ID: 1181300 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-02
Onset:2021-04-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Condition aggravated, Seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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? Yes
Hospitalized? No
Previous Vaccinations: Unsure of vaccine types or dates, patient did state that this has happened 2x before in relation to vaccines, typically due to l
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: Has previously experienced seizures to 2 other vaccinations, all syncopal in nature. Neurologist cleared pt to receive COVID-19 vaccination prior to appointment.
Allergies: N/A
Diagnostic Lab Data: Pulse: 60 (radial - weak, apical - strong), respiratory rate of 21, airway was patent, patient was alert (A&Ox3 after seizure activity), skin colored appeared slightly pale
CDC Split Type:

Write-up: RN saw seizure activity for 30-45 approximately 3 minutes after receiving the Janssen Vaccine. Pt had an arched back and slid down in his chair. LOC occurred during the seizure event. Approximately, 10 minutes after the event (1:56pm), the patient was A&Ox3 and PERRLA. Called EMS to advise. They arrived at 2:15pm, checked in on the pt and decided not to transport. No further action was necessary. Patient went home under his own power.


VAERS ID: 1181341 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-06
Onset:2021-04-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chest X-ray, Computerised tomogram head, Ear pain, Fatigue, Hypoaesthesia, Pain
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Arthritis (broad), Sexual dysfunction (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: Vitamin D 50,000 weekly
Current Illness: none
Preexisting Conditions: Fatty liver and vitamin D deficiency
Allergies: none
Diagnostic Lab Data: Chest xray: negative CT head: negative
CDC Split Type:

Write-up: On night of vaccine (4/6) she reported severe body aches and fatigue. On 4/7, she also had her ears and collar bone hurt. Then 4/8, She had numbness to forehead and back of head with shoulder pain.


VAERS ID: 1181355 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Hyperhidrosis, Hyperventilation, Paraesthesia, Tachycardia, Tremor
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Eosinophilic pneumonia (broad), Vestibular disorders (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: Patient reported that she takes no medications.
Current Illness: Patient reports she is in good health. Patient reports a past history of syncope.
Preexisting Conditions: Patient reports she is in good health.
Allergies: Patient reported no allergies, including any history of severe allergic reactions or prophylaxis.
Diagnostic Lab Data: Not applicable.
CDC Split Type:

Write-up: Approximately 13 minutes after the vaccine was administered patient reported feeling faint. She was sweaty, shaky, hyperventilating, tingling in her fingers and reported a rapid heart rate. Patient was able to speak in full sentences and answer questions. The pharmacy team immediately called 911. The pharmacist assessed the patients symptoms and determined the patient was not experiencing anaphylaxis as she was not experiencing swelling or throat closure. No emergency medications were administered. The patient layed down on her back and elevated her feet. The EMT arrived within 5 minutes and assessed the patient. Patient was taken to the emergency department.


VAERS ID: 1181365 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Hypotension, Lethargy
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (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
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient reported feeling dizzy, lethargic, shortness of breath Patient seen by medical team, patient has low blood pressure and provided with iv fluid Ambulance called for medical transport to hospital


VAERS ID: 1181410 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypopnoea, Hypotension, Pallor, Unresponsive to stimuli
SMQs:, Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Respiratory failure (narrow), Hypoglycaemia (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: none
Diagnostic Lab Data: Blood pressure was taken after the epipen was administered it was 110/52 on 4/8/2021
CDC Split Type:

Write-up: The patient received the vaccine, proceeded to the observation chair to wait for 15 minutes. The wife informed us: "He is having a reaction" we immediately went over to assess the situation. The patient was shallow breathing, unresponsive, low blood pressure, and very pale. The patient was slumped in the chair and then brought to the ground. An EpiPen was administered and 911 was called. The EMTs then came and did an assessment as the patient was able to then sit up. They took him to the hospital for further observation.


VAERS ID: 1181417 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / IM

Administered by: School       Purchased by: ?
Symptoms: Dizziness, Hypoaesthesia oral, Metamorphopsia, Nausea, Palpitations, Paraesthesia oral, Vital signs measurement
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Retinal disorders (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Amoxicillin, Diflucan
Diagnostic Lab Data: Patient transferred to ED via EMS.
CDC Split Type:

Write-up: Patient approached this RN stating that she felt lightheaded and nausous. Assisted patient to floor, lying flat with feet elevated. Pt began complaining of "dark vision," swelling sensation and tingling in tongue, numbness and tingling in bilateral upper extremities and heart racing. Alerted physician. EMS notified for transport. Vitals obtained 1212- BP 90/48; HR 139; o2 98%; RR 22. Epipen 0.3mg LOT 0FM400 EXP 12/31/21 administered to R thigh at 1215 per physician order. 20g IV inserted into R-AC. 125mg Solumedrol LOT DA6800 EXP 6/2022 (administered 1217) and 25mg Diphenhydramine LOT 049343 EXP 4/2021 (administered 1220) administered IV push per order. Vitals obtained 1220- BP 122/50; HR 123; o2 99%. EMS arrived at 1225 to transport patient to ED.


VAERS ID: 1181526 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Sertraline 25mg
Current Illness:
Preexisting Conditions:
Allergies: Cephalosporins
Diagnostic Lab Data:
CDC Split Type:

Write-up: Shortly after receiving vaccination patient fainted while sitting on bench. Paramedics were called and patient was transported to hospital for evaluation.


VAERS ID: 1181661 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-03-29
Onset:2021-03-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / UNK LA / SYR

Administered by: Senior Living       Purchased by: ?
Symptoms: Anaphylactic shock, Dysphonia, Dyspnoea, SARS-CoV-2 test negative, Tachycardia, 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), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Dehydration (broad), COVID-19 (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: Vyvanse, Spironolactone, Saxenda, Aciphex, Levothyroxine,
Current Illness: Low white blood cell count, High Prolactin, high DHEA levels,
Preexisting Conditions: PCOS, Fructose Intolerance, gastroparesis, hashimoto disease, ADHD, Osteoarthritis, Osteoma frontal sinuses, Non-ossofying fybromia femur, Uterine fibroid, Other undiagnosed G.I. issues, low sodium (still not sure what causes this yet), endocrine issues still trying to diagnose, chronic edema,
Allergies: Penicillin, Percocet, Morphine, Cortisone, Benadryl, Fructose, Bamboo,
Diagnostic Lab Data: Covid-19 neg
CDC Split Type:

Write-up: Tachycardic and anaphylactic shock. Heart beat over 140 out of the blue while laying on couch, throat felt like something was lodged in it, Voice became very raspy, felt out of breath.


VAERS ID: 1181735 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye movement disorder, Glassy eyes
SMQs:, Ocular motility 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: Observer noticed patient eyes glazed , Call pharmacist over - pharmacist spoke with patient, he noticed eyes rolling up and yelled to call 911 -then asked patient her name And where she was - did Not answer - pharmacist administered epi pen. Paramedics arrived


VAERS ID: 1181746 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Electrocardiogram, Fall, Head injury, Skin laceration
SMQs:, Anticholinergic syndrome (broad), Accidents and injuries (narrow), Hostility/aggression (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 Reported
Current Illness: None Reported
Preexisting Conditions: Asthma
Allergies: Cats, pollen, and weeds.
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Janssen dose given at 11:38am. At 11:45am Patient c/o feeling dizzy while sitting in the chair post vaccine (5 Min Jassen). Patient fell backward onto the ground hitting his head and sustaining a posterior head laceration. Vitals taken B/P 101/52 HR 58 RR 16 SPO2 100% RA..... EKG completed and fluids N/S given. Transferred out to ED


VAERS ID: 1181828 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-04-02
Onset:2021-04-04
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Swollen tongue
SMQs:, Anaphylactic reaction (broad), Angioedema (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? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: not know
Current Illness: not known
Preexisting Conditions: not known
Allergies: not known
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Patient was given vaccine at Community Outreach event on 04/2/21. Mother was contacted on 4/6/21 concerning incomplete name on her consent. She advised that her son received the covvid vaccine and had gone to the ER on 4/6/21 with a swollen tongue. She stated that he was treated with Tylenol and Benadryl and released to come home that day. Spoke with mom on 4/7/21 and she stated that the patient was stable and his entire tongue was not swollen just a small area. She denied any issues with his airway or breathing from time of vaccine to time of follow up call.


VAERS ID: 1181839 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / UNK - / IM

Administered by: Public       Purchased by: ?
Symptoms: Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (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? Yes
Hospitalized? No
Previous Vaccinations: Flu Vaccine
Other Medications: HTN Meds and High Cholesterol Meds
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Patient reported history of adverse reaction to Flu Vaccine in the past and now reporting Shortness of Breath post 15 mins after vaccine administration. Patient transported to local ER for further evaluation.


VAERS ID: 1181909 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Presyncope
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient reported walking to restroom, feeling dizzy and had pre-syncopal episode witnessed by staff and brought to floor Patient stated symptoms improved Patient seen by medical team and ambulance was called and patient sent to hospital


VAERS ID: 1181911 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-04-07
Onset:2021-04-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Headache, Nausea, Pain, Palpitations, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth control
Current Illness: None
Preexisting Conditions: None. Division 1 Athlete. Very healthy.
Allergies: Penacillan
Diagnostic Lab Data: Not yet.
CDC Split Type:

Write-up: Racing heart for about 3 hours post vaccination. Heart stopped racing, but turned into a severe headache, fever, vomitting, nausea, full body aches and dizziness. This has been going on for 24 hours.


VAERS ID: 1181913 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-07
Onset:2021-04-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205AZIA / N/A LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure increased, Chills, Headache, Nausea, Pain, Pyrexia, Tachycardia, Vital signs measurement
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), 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: ElinestM
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data: Presented at Emergency room Vitals taken and EKG was normal Given prescription meds for Nausea
CDC Split Type:

Write-up: Nausea Fever Chills Body Aches Elevated Blood Pressure Rapid Heart rate Severe Headaches


VAERS ID: 1181915 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-06
Onset:2021-04-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Dry mouth, Dry throat, Dysphagia, Electrocardiogram, Feeling hot, Heart rate increased, Lip swelling, Swollen tongue, Vision blurred
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal allergic conditions (narrow), 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), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Hypersensitivity (narrow), 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:
Current Illness:
Preexisting Conditions: "Long Covid" Positive for Covid 4 months ago
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt received Janssen vaccine at approx 1040. Within five minutes she began to experience a racing pulse, and c/o a "hot neck." She was taken to a treatment room and a provider was notified. 1049 diphenhydramine 50mg IM given 1053 c/o swollen lips, dry mouth, blurred vision, possible swollen tongue 1109 epinephrine 0.3mg IM given 1111 c/o throat dry, difficulty swallowing 1116 NS 0.9% bolus started 1121 pt reports feeling "much better. Denies swollen lips/tongue, denies difficulty swallowing, states her vision is clearer 1202 c/o "hot neck and face," dry mouth and difficulty swallowing 1208 epinephrine 0.5mg IM given 1211 diphenhydramine 12.5mg IVP given 1212 c/o chest pain 1225 EKG done 1239 taken via stretcher to ED


VAERS ID: 1181925 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Delaware  
Vaccinated:2021-03-15
Onset:2021-03-20
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / N/A LA / UN

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, CSF protein, Computerised tomogram, Condition aggravated, Death, Gait disturbance, Guillain-Barre syndrome, Immunoglobulin therapy, Magnetic resonance imaging, Mechanical ventilation, Muscular weakness, Pain, Paraesthesia, X-ray
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalopathy/delirium (broad), Demyelination (narrow), Respiratory failure (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-04-06
   Days after onset: 17
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: See additional space, Long list.
Current Illness: Car accident on 2/26, so neck and Lumbar pain.
Preexisting Conditions: Heart Failure ~ 2017, Stroke ~ 2019, Hypertension, Diabetes.
Allergies: N/A
Diagnostic Lab Data: I know they did an MRI and a CAT scan, an X-Ray, and they did a protein test on his spinal fluid. He also completed a course of Immunoglobulin therapy for GBS.
CDC Split Type:

Write-up: Patient started complaining of extreme back pain and trouble walking within days after receiving the vaccine. His pain got increasingly worse. On the 23rd he had to be taken into the hospital in an ambulance. He said he felt as if his lower body was separated from his torso, and visible was having trouble walking. They prescribed him Valium, preformed an x-ray, and sent him home. On the 27th he was taken back to the hospital due to leg weakness, tingling in his hands and feet, and extreme pain. He was diagnosed with Guillain-Barre Syndrome. He passed away April 6, 2021 after spending 11 days in the hospital, and 6 days on a ventilator.


VAERS ID: 1181947 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-01
Onset:2021-04-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood test, Computerised tomogram, Dysarthria, Fall, Fatigue, Gait disturbance, Magnetic resonance imaging, Memory impairment, Muscular weakness, Nightmare, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Depression (excl suicide and self injury) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: no
Current Illness: broken foot right Septmeber 2020
Preexisting Conditions: Nond
Allergies: penicillin and codeine (40 plus years ago)
Diagnostic Lab Data: April 5, 2021 went to Hospital due to above adverse symptoms. Was admitted for 3 days. Had CT scans, MRI and bloodwork. Added Lovenox, Lipitor and baby aspirin due to the possibility of stroke. Lipitor was discontinued. along with Lovenox. Continues with baby aspirin.
CDC Split Type:

Write-up: Night of shot experienced fever of 101, nightmares and slurred speech. The following day experienced fatigue. By the second day post vaccination memory impairemt. By the third day post vaccination has gait unsteadiness and fell six times. The 4th day post vaccination left arm weakness and could not use arm. accompanied by slurred speech.


VAERS ID: 1181973 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-04-01
Onset:2021-04-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Adverse event, Asthenia, Dizziness, Headache, Heart rate increased, Hypertension, Lip swelling, Pyrexia, Red blood cell abnormality, Skin swelling, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), 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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Adverse event(s): Hives/red swollen skin(arms, legs, abdomen, back), fever, swelling of lips, fast heartbeat, high blood pressure, dizziness, weakness, headache Treatment: Prescribed Medrol (Pak) 4mg tablets, OTC antihistamine Zyrtec daily x 2 weeks, Benadryl at night Outcome: N/A. side effects have been reduced, occasional flare of hives.


VAERS ID: 1182005 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / 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? Yes
Hospitalized? No
Previous Vaccinations: Fainted from vaccines in the past
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: Patient fainted 5 minutes after receiving the vaccine


VAERS ID: 1182034 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Emotional distress, Loss of consciousness, Muscle spasms, Nausea
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Not known
Current Illness: No illnesses
Preexisting Conditions: None
Allergies: None reported by pt.
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: Pt was give vaccine and was not nervous or anxious. About 1 to 2 minutes after receiving the shot pt passed out for about 20 seconds. The technician held the pt up and supported her head and neck while asking pt if she was OK. When pt came to she was happy and said "hi" to the technician. Soon after she laid on the floor and started crying and saying her hands were cramping and in pain. She also stated she was very nauseous and felt like she was going to throw up. Pts husband agreed that we should call an ambulance which we did. When paramedics arrived pt was feeling better and refused a ride to the ER. Pt''s husband took her to the car and drove her to the ER.


VAERS ID: 1182044 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-07
Onset:2021-04-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Fall, Nausea, Seizure, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (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), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: At 11:32 patient noted to faint in chair and fall to the flood and begin seizing about 1 to 2 min post vaccine. Seizure lasted about 15 seconds. RN supported patients head at time of seizure. Patient was aware of where they were and noted that they were feeling nauseous and dizzy. Patient was eventually helped to a seated position where EMS transported patient.


VAERS ID: 1182045 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eyelid rash, Injection site rash, Rash
SMQs:, Anaphylactic reaction (broad), 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: N/A
Current Illness: none
Preexisting Conditions: n/a
Allergies: Penicillin, shellfish
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Patient had rash on arm, chest, and under eyes, she self administered liquid benadryl 50 mg, and 911 was called, EMS took patient to hospital, patient never had trouble breathing or speaking


VAERS ID: 1182049 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / N/A LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Fall, Head injury, Seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: SEIZURES
Allergies: NONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: PATIENT HAD A SEIZURE AND FELL. SHE DID HIT HER HEAD. FALL WAS NOT WITNESSED BY THE RESPONDERS. VITAL SIGNS WERE TAKEN: BP 142/88, PULSE 98, O2 SATS 100%, RESPIRATIONS 20, BLOOD SUGAR LEVEL 84. HELPED PATIENT TO WHEELCHAIR AND SECURED HER TO THE FIRST AID AREA. AMBULANCE WAS CALLED AND SHE WAS TRANSPORTED TO THE ER.


VAERS ID: 1182057 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-05
Onset:2021-03-12
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Computerised tomogram normal, Culture urine, Gastric emptying study, Lipase, Liver function test, Metabolic function test, Nausea, Pregnancy test urine negative, Urine analysis, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific dysfunction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Extreme nausea for extended period of time that started on 3/12 and didnt go away until 4/5. Urgent care blood (Hemogram/PLTS) and urine test (UA w/ microscope) that came back normal on 3/21. ER visit with blood test (Hemogram/ PLTS/DIFF, liver panel- hepatic function panel, Lipase panel, basic metabolic panel), urine culture, UA conditional UC, Pregnancy test urine, CT w/ contrast all came back normal on 3/24. Surgical pathology via microscopic examination w/ biopsy results were A. Duodenum, second part, biopsy: No diagnostic abnormality, B. Stomach, antrum, biopsy: Changes consistent with reactive gastropathy, Negative for Helicobacter pylori all came back normal on 3/25. Fecial CALPROTECTIN CONCENTRATION and ENTERIC PARASITE MOLECULAR DETECTION (GIARDIA, CRYPTOSPORIDIUM, E.HISTOLYTICA) all came back normal on 4/6. And finally Gastric Emptying Scan/ study came back normal on 4/5. 40 yo female for evaluation of early satiety, nausea and vomiting. Gastric emptying study: Normal at 1 hour (70% in stomach with < 90 being normal) Normal at 2 hours (25% with goal being less than 60%) Normal at 4 hours (3.1% with less than 10 %)
CDC Split Type:

Write-up: Extreme nausea for extended period of time that started on 3/12 and didnt go away until 4/5. Urgent care blood (Hemogram/PLTS) and urine test (UA w/ microscope) that came back normal on 3/21. ER visit with blood test (Hemogram/ PLTS/DIFF, liver panel- hepatic function panel, Lipase panel, basic metabolic panel), urine culture, UA conditional UC, Pregnancy test urine, CT w/ contrast all came back normal on 3/24. Surgical pathology via microscopic examination w/ biopsy results were A. Duodenum, second part, biopsy: No diagnostic abnormality, B. Stomach, antrum, biopsy: Changes consistent with reactive gastropathy, Negative for Helicobacter pylori all came back normal on 3/25. Fecial CALPROTECTIN CONCENTRATION and ENTERIC PARASITE MOLECULAR DETECTION (GIARDIA, CRYPTOSPORIDIUM, E.HISTOLYTICA) all came back normal on 4/6. And finally Gastric Emptying Scan/ study came back normal on 4/5. 40 yo female for evaluation of early satiety, nausea and vomiting. Gastric emptying study: Normal at 1 hour (70% in stomach with < 90 being normal) Normal at 2 hours (25% with goal being less than 60%) Normal at 4 hours (3.1% with less than 10 %)


VAERS ID: 1182060 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Wyoming  
Vaccinated:2021-04-06
Onset:2021-04-08
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Computerised tomogram, Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow), 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? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Ventolin, Lipitor, Symbicort, Depakote, Neurontin, Vistaril, Melatonin, Metformin, Zyprexa, Invega, Paxil, Trazadone, Propanolol.
Current Illness: Pt was hospitalized on 3/25/2021 due to acute respiratory failure caused by accidental overdose on patient''s medications. Pt reports being on a ventilator during her stay.
Preexisting Conditions: Bipolar disorder, schizophrenia, autism, DM type II, COPD, Asthma, HTN, and hypercholesterolemia.
Allergies: Ketorolac, geodon, haldol, seroquel. These medications cause increased anxiety and suicidal ideation for patient - not true allergy.
Diagnostic Lab Data: CT Scan 04/08/2021
CDC Split Type:

Write-up: Pt hospitalized today 04/08/2021 with chest pain and was found to have a pulmonary embolism.


VAERS ID: 1182069 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Loss of consciousness, Skin laceration
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), Hostility/aggression (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? 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: Unknown
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient passed out and hit his head on the floor cause a laceration above left eyebrow which needed medical attention at local hospital. Also may have needed a concussion test done.


VAERS ID: 1182108 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-03-09
Onset:2021-04-03
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 AR / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Areflexia, Facial paralysis, Facial paresis, Guillain-Barre syndrome, Immunoglobulin therapy, Magnetic resonance imaging head abnormal
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Demyelination (narrow), Hearing impairment (broad), 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? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: lorazepam prn
Current Illness:
Preexisting Conditions: Anxiety
Allergies: None
Diagnostic Lab Data: MRI brain WWO 4/8/2021: "The subtle enhancement of the 7th and 8th nerve complex is unusual in that it is bilateral. It does, however, correlate with the reported consultation note of Dr. in the electronic medical record. An inflammatory process is favored."
CDC Split Type:

Write-up: Patient developed bilateral facial weakness starting on 4/3/2021, progressed over the course of five days until she presented to the emergency department on 4/8/2021. Exam with bilateral CN VII palsy and lower extremity areflexia. MRI brain shows enhancement of bilateral CN VII and VIII. Suspect GBS, treating with IVIG.


VAERS ID: 1182125 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-04-05
Onset:2021-04-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / N/A RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Injection site pruritus, Throat tightness, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), 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? 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: unknown
CDC Split Type:

Write-up: per patient - about 2 hours after her injection she began to experience itching and hives and tightness in her throat. she sought treatment at the emergency department where she states she was given Benadryl and steroids and discharged after observation.


VAERS ID: 1182286 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 - / IM

Administered by: Other       Purchased by: ?
Symptoms: Dyskinesia, 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), Dyskinesia (narrow), 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: seizure history
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient post Johnson and Johnson vaccination and in observation period when EMS and Nursing staff noticed patient to be unresponsive with 10-20 seconds of mild jerking movements. Patient able to regain consciousness and state that he has a history of seizures Blood pressure124/80, blood glucose 63. Patient transported by EMS to hospital.


VAERS ID: 1182293 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Amnesia, Fall, Headache, 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), Dementia (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), 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: NA
Current Illness: none known
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: na
CDC Split Type:

Write-up: Patient left pharmacy and passed out on the sidewalk. Unknown if vaccine or fall caused Nausea, Headache, Memory loss.


VAERS ID: 1182382 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Ohio  
Vaccinated:0000-00-00
Onset:2021-03-18
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1608609 *CALLER / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Fatigue, Pyrexia, Rash pruritic, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210318; Test Name: Body temperature; Result Unstructured Data: 98.8(not reported); Test Date: 20210318; Test Name: Body temperature; Result Unstructured Data: 99.3(not reported)
CDC Split Type: USJNJFOC20210349790

Write-up: ITCHY BUMPS AND RASH ON THE CHEST AND EXTENDED ALL OVER THE ANTERIOR, POSTERIOR, LATERAL TORSO, LOWER ABDOMEN, ABOVE THE PUBIC AREA AND LOWER ABDOMEN AND BILATERAL THIGHS; HIVES ITCHY/RED WELTS; FEVER; FATIGUE; This spontaneous report received from a patient concerned a 67 year old female. The patient''s weight was 132 pounds, and height was 65 inches. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1608609 expiry: UNKNOWN) dose was not reported, administered on 17-MAR-2021 for prophylactic vaccination in left arm. No concomitant medications were reported. On 18-MAR-2021, the subject experienced fever. On 18-MAR-2021, the subject experienced fatigue. Laboratory data included: Body temperature (NR: not provided) 99.3 (not reported), 98.8 (not reported). On 22-MAR-2021, the subject experienced itchy bumps and rash on the chest and extended all over the anterior, posterior, lateral torso, lower abdomen, above the pubic area and lower abdomen and bilateral thighs. On 22-MAR-2021, the subject experienced hives itchy/red welts. On 23-MAR-2021, treatment medications included: diphenhydramine hydrochloride, and famotidine. On 24-MAR-2021 06:30, treatment medications included: prednisone. On 24-MAR-2021 07:30, treatment medications included: diphenhydramine hydrochloride. On 25-MAR-2021 07:30, treatment medications included: prednisone. On 25-MAR-2021 08:30, treatment medications included: cetirizine hydrochloride. On 25-MAR-2021 12:45, treatment medications included: diphenhydramine hydrochloride. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from hives itchy/red welts on MAR-2021, fever on 18-MAR-2021, and fatigue on 19-MAR-2021, and was recovering from itchy bumps and rash on the chest and extended all over the anterior, posterior, lateral torso, lower abdomen, above the pubic area and lower abdomen and bilateral thighs. This report was non-serious.


VAERS ID: 1182437 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Kansas  
Vaccinated:0000-00-00
Onset:2021-03-31
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Adrenocortical insufficiency acute, Chills, Headache, Pain
SMQs:

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? No
Previous Vaccinations:
Other Medications:
Current Illness: Addison''s disease; Hyperpituitarism; Hypogonadism; Hypothyroidism
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210407359

Write-up: ADDISONIAN CRISIS AND EXTREME FATIGUE; ACHE; CHILLS; HEADACHE; This spontaneous report received from a consumer concerned a 43 year old white male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included addison disease, hyperpituitarism, hypogonadism, and hypothyroidism. The patient experienced drug allergy when treated with baclofen, and pseudoephedrine. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: UNKNOWN, expiry: UNKNOWN) dose was not reported, 1 total, administered on 31-MAR-2021 to right arm for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 31-MAR-2021, in the evening the patient began to experience addisonian crisis and extreme fatigue, ache, chills and headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from chills on 2021, and was recovering from headache, addisonian crisis and extreme fatigue, and ache. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0: 20210407359-JANSSEN COVID-19 VACCINE Ad26.COV2.S- Addisonian crisis. This event is considered not related. The event has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event than the drug. Specifically: MEDICAL HISTORY, UNDERLYING DISEASE.


VAERS ID: 1182501 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea, Flushing, Muscular weakness, Nausea, Swollen tongue, Throat tightness
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Peripheral neuropathy (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), 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), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Descovy, isentress, valtrex, isosorbide mononitrate, asa, loratadine, synthroid, protonix took all those med prior to getting vaccine. I took them at 8am / 9am
Current Illness: None I got the J & J vaccine and then went to ER
Preexisting Conditions: Hiv, peripheral neuropathy, gastritis, hypothyroidism, migraines, vertigo, variant angina, h/o hemturia
Allergies: Percocet, codeine, morphine, euflexxa, adhesives, Topamax, Zanaflex, spiders, augmentin, eliquis, cardiac, Cardizem, isosorbide mononitrate, eucrissa, tropical, solumedrol, depomedrol, and PEG
Diagnostic Lab Data: None just given decadrom IM, benadryl and famotudine in 0.9% sodium chloride at 11:39 am, 11:40 am, respectively and pepcid stopped at 11:54am
CDC Split Type:

Write-up: Body flush like when getting CT scan dye, leg weakness,, nausea,, swollen tongue, feeling like throat closed over difficulty breathing. Happened immediately after getting J & J covid vaccine.


VAERS ID: 1182506 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-24
Onset:2021-04-06
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / UNK RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Bell's palsy, Computerised tomogram, Facial paralysis, Hypoaesthesia, Hypoaesthesia oral, Lacrimation increased, Paralysis, Sensitive skin
SMQs:, Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hearing impairment (broad), Lacrimal disorders (narrow), Sexual dysfunction (broad)

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? No
Previous Vaccinations:
Other Medications: ibuprofen
Current Illness: n/a
Preexisting Conditions: managed high blood pressure allergies year round recently diagnosed diabetic seafood allergy sensitive skin/allergies
Allergies: all seafood products and products derived zoloft dexilant
Diagnostic Lab Data: CT Scan was performed confirming no stroke had occurred. The doctor did diagnose me with Bell''s Palsy and I have been placed on medication. The drooping has worsened and I continue with the same conditions. I am hopeful these will improve but I wanted to share the information with you all for your research purposes and to hopefully help others.
CDC Split Type:

Write-up: 4/6/21 I awoke with symptoms of numbness/paralysis on left side of face limited to upper lip and cheek area and both eyes would not stop watering. Movements to drink or make facial expressions were limited due to the numbness. Because I have sensitive skin I thought I may have had some type of reaction to something. So I waited to see if it would clear up through the day. I was not experiencing any other symptoms. By that evening it was apparent that I was not getting better and possibly getting worse because I began to experience some noticeable drooping in my cheek area. I decided to call my doctor in the morning. Because I am currently out of town, my home doctor suggested I see a local ER to rule out a stroke and determine if I was experiencing Bell''s Palsy. I went to an ER clinic on 4/7/21


VAERS ID: 1182520 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-03-01
Onset:2021-03-13
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 18050301 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Back pain, Blood pressure increased, Burning sensation, Cold sweat, Feeling hot, Headache, Heart rate increased, Hyperaesthesia, Hyperhidrosis, Impaired work ability, Insomnia, Nausea, Neuropathy peripheral, Pain in extremity, Paraesthesia, Sticky skin
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Dehydration (broad), Immune-mediated/autoimmune 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lotrel 10-20mg Rosuvastatin 10mg every other day Zinc 50mg Vitamin D3 CoQ10 Multivitamin
Current Illness: No
Preexisting Conditions: Hypertension
Allergies:
Diagnostic Lab Data: Blood work done at doctor on 3/22/2021 HgBAIC within normal limits Vitamin levels normal.
CDC Split Type:

Write-up: 3/13/2021 began having right forearm wrist was sensitive to touch and skin clammy. 3/14/2021 still clammy in both hands. 3/15/2021 whole body clammy and sticky. Both shins and ankles had burning sensation. 3/17/2021 both ankles painful mostly at night. 3/18/2021 both ankles, shins and legs painful all day. Unable to sleep at night. 3/19/2021 left work early due to nauseated, headache and pain and burning both legs. Blood pressure elevated. 3/20/2021 head pounding and elevated rate and nauseated. Went to ER for continued leg/shins burning and pain. ABI was normal. Diagnosed with neuropathy. 3/23/2021 blood pressure elevated due to pain 3/24/2021 pain to legs and shins continue below know. pain scale 5. 3/26/2021 pain to legs and shins pain scale 7 3/27/2021 pain to legs and shins pain scale 3 3/29/2021 burning and sensitive legs. Sensitivity now present in both arms. 3/30/2021 burning to forearms and legs 4/1/2021 pain scale 3 burning pain to forearms and legs. 4/4/2021 improved pain 4/5/2021 tingling resumed to legs and calves. Pain scale 4. 4/6/2021 sensitive/burning bilateral forearm and wrist and bilateral legs. 4/7/2021 left leg burning more and feels warm. Back ache began 4/8/2021 both legs still burning and tingling. Heart rate elevated. Back pain continues.


VAERS ID: 1182521 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Rash, Urticaria, Wheezing
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (broad), Eosinophilic pneumonia (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: BP 142/84 P 78 RR 24
CDC Split Type:

Write-up: hives, wheezing, hx of compromised lungs. Benadryl and EpiPen administered. Hives on left and right side of neck and anterior chest


VAERS ID: 1182540 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Confusional state, Lip swelling, Skin tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypersensitivity (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: BP 130/96 P 77 POx 97%
CDC Split Type:

Write-up: Swelling of lips and confusion, feeling of lip and cheek tightness. EMS called


VAERS ID: 1182563 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-04-07
Onset:2021-04-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / N/A RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Cold sweat, Dizziness, Dyspnoea, Loss of consciousness, Rash, Speech disorder
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Acute central respiratory depression (broad), Psychosis and psychotic disorders (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Athlete; softball
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received vaccine at clinic but unsure as to the time. She left the clinic feeling fine, but shortly after started to develop a rash. EMS was called to assess and felt it did not warrant ED visit, however, she went to softball practice and began to have lightheadedness, trouble speaking, in and out of consciousness, trouble breathing, clammy. A rescue squad was summoned and taking patient. Awaiting further word on her condition


VAERS ID: 1182615 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Eye movement disorder, Hyperhidrosis, Loss of consciousness, Muscular weakness, Seizure
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (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), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Ocular motility disorders (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: none
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient at Vaccination table, just received dose of vaccine when patient''s arm went limp. Also developed generalized weakness. Mother stood in front of him and held his head with both hands. Patient then passed out with eyes rolling in back of head. Also had convulsions for a few seconds that mimicked seizure. Patient soon became alert. Vitals obtained with BP 92/52, HR 34, O2 96% on RA. Patient also diaphoretic to touch. EMS activated and arrived at 1:30pm. Placed in reclining wheelchair and taken to private area. Started to feel better after given cold water. Suggested ER due to having seizure first time. Declined ambulance but mother will take to ER in private car. Patient and mother left with no further incident.


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