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From the 4/30/2021 release of VAERS data:

Found 153,440 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

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VAERS ID: 1228569 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-07
Onset:2021-04-17
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Computerised tomogram thorax abnormal, Fibrin D dimer increased, Pulmonary embolism
SMQs:, Haemorrhage laboratory terms (broad), 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? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amlodipine, aspirin, atorvastatin, ezetemibe, isosorbide mononitrate, losartan, metoprolol tartrate, omeprazole
Current Illness: Patient did have COVID at the beginning of April 2021
Preexisting Conditions: Hypertension
Allergies: NKA
Diagnostic Lab Data: CT chest revealing small right superior pulmonary arterial PE (4/17/21) D-dimer 630 (4/17/21)
CDC Split Type:

Write-up: Patient received their COVID vaccine on 4/7/21. Recently admitted for COVID (3/24/21 - 4/2/21) discharged on room air, doing well. Returned 4/17/2021 with acute onset and persistent right sided chest pain.


VAERS ID: 1228685 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-16
Onset:2021-04-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Chills, Dizziness, Headache, Influenza like illness, Injection site warmth, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: I had heart issues after my small pox vaccination
Other Medications: None
Current Illness: None
Preexisting Conditions: I have eczema and I had STV
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: I had flu like symptoms. I had a massive headache that still hasn''t gone away. I was very weak and light headed about ten hours after the injection. I had chills that turned into a fever and it last about 24 hours. In addition, the injection site was hot to the touch for two days.


VAERS ID: 1228756 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-04-10
Onset:2021-04-17
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Cerebrovascular accident, Computerised tomogram head abnormal, Laboratory test
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Metformin, lisinopril/HCTZ, Glipizide, gabapentin
Current Illness: Diabetes, hypertension
Preexisting Conditions: Diabetes, hypertension
Allergies: Ultram, hydrocodone
Diagnostic Lab Data: CT head, labs
CDC Split Type:

Write-up: CVA, hospitalized


VAERS ID: 1228884 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-12
Onset:2021-04-17
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Condition aggravated, Headache
SMQs:

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

Write-up: mod-severe headache onset 5 days post vaccine


VAERS ID: 1228964 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-09
Onset:2021-04-17
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Infarction, Magnetic resonance imaging head abnormal
SMQs:, Myocardial infarction (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow)

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

Write-up: MRI showed multiple acute infarcts within left frontal, left parietal, left post central gyrus, left occipital lobe


VAERS ID: 1229029 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-08
Onset:2021-04-17
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram head, Full blood count, International normalised ratio, Metabolic function test, Pain in extremity, Prothrombin time, Rash, Ultrasound Doppler
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Xanax, Xopenex, Simvastatin
Current Illness:
Preexisting Conditions: Anxiety/Depression, Asthma, Hyperlipidemia
Allergies: Avelox, PCN
Diagnostic Lab Data: CT Brain & Venous Doppler of LE both done 4/17/21 CBC, CMP, & PT/INR all done on 4/16/21
CDC Split Type:

Write-up: Leg pain/rash, hand pain/rash Pt treated with Morphine in ER Seen in dr office today & treated with Prednisone for continued symptoms


VAERS ID: 1229057 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-02
Onset:2021-04-17
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, COVID-19 pneumonia, Chest discomfort, Cough, Dyspnoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (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: Unknown
Current Illness: None on file
Preexisting Conditions: None on file
Allergies: No known allergies
Diagnostic Lab Data: 4/17/2021 - Positive for SARS-CoV-2 via PCR NP swab
CDC Split Type:

Write-up: Pt received her 1st and only needed dose of the Janssen COVID-19 vaccine on 4/2/2021. After the 2 weeks needed to be considered fully vaccinated, She presented to the ED with cough, SOB, and chest discomfort on 4/17 and was diagnosed with COVID pneumonia. She was treated but not admitted.


VAERS ID: 1229312 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-03-08
Onset:2021-04-17
   Days after vaccination:40
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Alanine aminotransferase normal, Albumin globulin ratio normal, Aspartate aminotransferase normal, Basophil count decreased, Blood albumin normal, Blood alkaline phosphatase normal, Blood bilirubin normal, Blood calcium normal, Blood chloride normal, Blood creatine phosphokinase MB normal, Blood creatinine normal, Blood glucose increased, Blood magnesium normal, Blood potassium normal, Blood sodium normal, Blood thyroid stimulating hormone normal, Blood urea normal, Carbon dioxide normal, Chest X-ray normal, Differential white blood cell count normal, Eosinophil count normal, Erythroblast count normal, Fibrin D dimer normal, Full blood count, Glomerular filtration rate decreased, Haematocrit normal, Haemoglobin normal, Immature granulocyte count increased, Lymphocyte count, Lymphocyte count normal, Mean cell haemoglobin concentration normal, Mean cell haemoglobin increased, Mean cell volume normal, Mean platelet volume normal, Metabolic function test abnormal, Monocyte count, Monocyte count increased, Neutrophil count, Neutrophil count normal, Platelet count normal, Protein total normal, Red blood cell count normal, Red cell distribution width normal, Tachycardia, Troponin I normal
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Haematopoietic leukopenia (narrow), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Chronic kidney disease (broad), Tumour lysis syndrome (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 Outpatient Medications: ? atorvaSTATin (LIPITOR) 10 MG tablet, Take 10 mg by mouth daily, Disp: , Rfl: ? cholecalciferol (VITAMIN D) 25 MCG (1000 UT) tablet, Take 1,000 Units by mouth daily, Disp: , Rfl: ? metFORMIN (GLUCOPHAG
Current Illness:
Preexisting Conditions:
Allergies: nka
Diagnostic Lab Data: CKMB [247900288] Collected: 04/17/21 0923 Order Status: Completed Specimen: Blood Updated: 04/17/21 1003 Creatine Kinase-MB 0.8 0.0 - 3.6 NG/ML Troponin Series [247900289] Collected: 04/17/21 0923 Order Status: Completed Specimen: Blood Updated: 04/17/21 1003 Troponin I 0.00 0.00 - 0.06 ng/mL Comment: 0.1 to 0.5 ng/mL shows an increased risk of AMI. 0.6 to 1.5 or greater is suggestive of AMI. Comprehensive metabolic panel [247900293] (Abnormal) Collected: 04/17/21 0923 Order Status: Completed Specimen: Blood Updated: 04/17/21 1003 Glucose 147High 65 - 100 MG/DL Blood Urea Nitrogen 18 7 - 18 MG/DL Creatinine 1.2 0.7 - 1.3 MG/DL Sodium 139 136 - 145 MMOL/L Potassium 4.7 3.5 - 5.1 MMOL/L Chloride 104 98 - 107 MMOL/L Co2 28 21 - 32 MMOL/L Calcium 9.2 8.5 - 10.1 MG/DL Protein Total 7.5 6.4 - 8.2 G/DL Albumin 4.0 3.4 - 5.0 G/DL A/G Ratio 1.1 0.8 - 2.0 Alkaline Phosphatase 96 46 - 116 U/L Alt (SGPT) 50 16 - 63 U/L AST(SGOT) 25 15 - 37 U/L Bilirubin, Total 0.7 0.2 - 1.0 MG/DL GFR Comment IF PATIENT IS AFRICAN AMERICAN, MULTIPLY RESULT BY 1.16 Est GFR 67Low $g90 ML/MIN/1.73sq.m Magnesium [247900294] Collected: 04/17/21 0923 Order Status: Completed Specimen: Blood Updated: 04/17/21 1003 Magnesium 2.2 1.8 - 2.4 MG/DL TSH Third Generation [247900299] Collected: 04/17/21 1000 Order Status: Completed Specimen: Blood Updated: 04/17/21 1003 TSH 2.57 0.30 - 3.04 uIU/mL D-dimer, quantitative [247900291] Collected: 04/17/21 0923 Order Status: Completed Specimen: Blood Updated: 04/17/21 1001 D-Dimer <100 0 - 400 NG/ML FEU XR Chest Portable [247900296] Collected: 04/17/21 0935 Order Status: Completed Updated: 04/17/21 1000 Narrative: EXAMINATION: PORTABLE CHEST SINGLE VIEW, 4/17/2021 at 0926 hours CLINICAL INFORMATION: Tachycardia COMPARISON: None FINDINGS: The cardiomediastinal silhouette is upper limits of normal in size. There is no significant consolidation or effusion. Osseous structures are without acute abnormality. IMPRESSION: Negative. CBC w Auto Diff [247900292] Collected: 04/17/21 0923 Order Status: Completed Specimen: Blood Updated: 04/17/21 0938 White Blood Cell Count 7.7 4.8 - 9.6 THOUS/uL Red Blood Cell Count 4.98 4.33 - 5.59 MIL/uL Hemoglobin 15.8 13.1 - 16.8 GM/DL Hematocrit 46.0 38.8 - 49.0 % Mean Corpuscular Volume 92.4 82.7 - 94.4 FL Mean Corpuscular Hemoglobin 31.7 27.7 - 32.6 PG Mean Corpuscular Hemoglobin Conc 34.3 32.4 - 35.7 G/DL Rdwcv 12.7 11.6 - 13.9 % Rdwsd 42.7 36.0 - 46.1 FL Platelet Count 202 154 - 364 THOUS/uL Mean Platelet Volume 9.1 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 60.7 34.0 - 67.9 % Lymphs 27.6 19.1 - 41.2 % Monocytes 9.6 6.1 - 12.3 % Eos 1.3 0.9 - 7.6 % Basos 0.5 0.2 - 1.5 % Neutrophils Absolute Count 4.7 2.7 - 5.8 THOUS/uL Lymphocytes Absolute Count 2.1 1.1 - 3.3 THOUS/uL Monocytes Absolute Count 0.7 0.4 - 0.9 THOUS/uL Eosinophils Absolute Count 0.1 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 0.02 0.0 - 0.1 THOUS/uL
CDC Split Type:

Write-up: 4/17/21 ER HPI: 56 y.o. male who presents with asymptomatic tachycardia. The patient purchased a home blood pressure monitoring device approximately 2 weeks ago and at that time he noted that the machine recorded his pulse at 150-160 beats per minute. The patient has repeatedly taking his blood pressure at home with this device and every time and has recorded his pulse in the same range. He denies fevers chills chest pain palpitations syncope lightheadedness peripheral edema or dyspnea. He presents today for evaluation of this as the machine again indicated that his pulse was 100 50-160 beats per minute


VAERS ID: 1230372 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-09
Onset:2021-04-17
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chills, Dizziness, Injection site pain, Pyrexia, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fenofibrate 160mg, Atorvastatin 80mg, seroqel 400mg, fluoxetine 60mg, alprazolam .5mg
Current Illness: sourness at injection site located in right arm, chills with mild fever day of, and after vaccination.
Preexisting Conditions:
Allergies: Rx: all ciliin related drugs including penicillin Food allergies: peanuts
Diagnostic Lab Data:
CDC Split Type:

Write-up: Received vaccine on 4-9, same day experienced chills, fever, light headedness, and soreness around injection site. Symptoms persisted throughout weekend. On 4-17, broke out in hives on arms, neck, and backs of hands.


VAERS ID: 1230590 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-12
Onset:2021-04-17
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Furuncle, 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient reports getting a stingy boil that''s 3/4ths of an inch that appeared on the same arm as the vaccinated arm on 4/17/21, it popped today on 4/19/21 and a clear substance came out.


VAERS ID: 1230608 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-11
Onset:2021-04-17
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Prolonged pain at injection site in left arm from flu vaccine on 1/06/2021. FLUZONE QUAD/IM/Lot UT7115NA/Sanofi-Pasteur
Other Medications: N/a
Current Illness: N/a
Preexisting Conditions: N/a
Allergies: Amoxicillin
Diagnostic Lab Data: N/a
CDC Split Type:

Write-up: Developed itchy rash all over body 6 days after receiving covid-19 shot. Took Benadryl (25mg) every 4 hours. Rash is starting to diminish on day 3


VAERS ID: 1230895 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-04-07
Onset:2021-04-17
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Headache, Pain, Vital signs measurement
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: The patient is a 28 y.o. male evaluated for left sided body aches and 6/10 head pain that began approximately two weeks ago following the administration of the Johnson and Johnson COVID-19 vaccine. Given the patient''s current presentation on exam and history provided low concern from vaccine complication or infection. He has normal vital signs here and his symptoms were somewhat reproducible, in particular with the tenderness of the midline T-spine and left scapula. Primarily concerned for musculoskeletal strain, likely worsened from his physical labor at work. At this time I do not feel that further emergent workup is warranted and the patient is medically stable for discharge with instructions to rest and ice the area of tenderness. He has significant change in disposition once explained that this was unlikely to be the result of vaccination. The patient was informed of all pertinent findings today. They were informed of their diagnosis and home management plan. They were informed about the importance of close follow up with their primary care doctor. They were told to return to the ED for any new or worsening symptoms. They had an opportunity to ask questions and all questions were answered. They agree with the plan for discharge and management plan.
CDC Split Type:

Write-up: The patient is a 28 y.o. male who presents to the Emergency Department with left sided body aches and 6/10 head pain that began approximately two weeks ago following the administration of the Johnson and Johnson COVID-19 vaccine. The patient is present with a chaperone at bedside who helps provide history and translates for the patient. Since the administration of the vaccine the patient states he''s been experiencing these symptoms. The patient reports that he began experiencing his symptoms approximately 30 minutes following the vaccine administration and have worsened since onset. He reports that he took oral Tylenol yesterday with minimal relief. The patient states that movement and exertion exacerbate his symptoms and reports that he was not able to attend work today secondary to his pain. The patient denies any associated symptoms of fever, chills, nausea, vomiting, diarrhea, constipation, or any visual changes.


VAERS ID: 1231245 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-04
Onset:2021-04-17
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Computerised tomogram head, Fatigue, Headache, Immunoglobulin therapy, Migraine, Petechiae, Platelet count increased
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Brain ct scan for bleeding 4/18 Lots of blood draws 4/18 and 4/19 IV immunoglobulin transfusion 4/19 Steroid (decadron) IV 4/18 and 4/19 and continuing.
CDC Split Type:

Write-up: Headache and tired for three days after shot. Then 14 days after shot I got a migraine. 15 days after shot I broke out in petechiae. Went to the hospital and had blood platelet count of 1,000. Receiving steroids and IV IG. At risk of fatal internal bleeding.


VAERS ID: 1231260 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-06
Onset:2021-04-17
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cerebral venous sinus thrombosis
SMQs:, Embolic and thrombotic events, venous (narrow), Central nervous system vascular disorders, not specified as haemorrhagic or ischaemic (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: Nothing reported
Preexisting Conditions: Unknown
Allergies: NKDA
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: I was contacted by physician assistant who informed us that patient was at HCF being treated for clotting believed to be secondary to having received the Janssen Covid19 vaccination. He said that she was diagnosed as having a focal dural venous thrombosis in the superior sagittal sinus and was being treated with Eliquis. He requested that we report this event to VAERS.


VAERS ID: 1231351 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-09
Onset:2021-04-17
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Amoxicillin 500 mg three times a day Tylenol #3 Prn from a dental procedure Benadryl Women?s one a day Vitamin D
Current Illness: No
Preexisting Conditions: No
Allergies: Nkda
Diagnostic Lab Data:
CDC Split Type:

Write-up: I am starting to have a rash all over my body. It started 8 days after vaccination.


VAERS ID: 1231356 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-04-16
Onset:2021-04-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038B21A / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Chills, Dizziness, Fatigue, Injection site pain, Nausea, Pain, Pyrexia, Sleep disorder, Tinnitus, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hearing impairment (narrow), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Mirena (52mg) - IUD
Current Illness: None
Preexisting Conditions: None
Allergies: None known
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Day of: Hydrated pre-vaccination. Soreness at injection site onset approx. 3 hours after vaccination and has lasted a few days. Refrained from massaging muscle or sleeping on that side. At approx. 5-6 hours post-vaccination, aches and chills onset. No fever throughout the evening. Nausea onset approx. 7-8 hours post-vaccination. Took 1,000mg of NSAID containing acetaminophen and went to bed @9pm to try to sleep it off. Day after: Woke up at 12:15am and 12:45am vomiting. Continued to have aches, chills, and fever (ranging from 99.9? to 101.5?) throughout the day. Took 1,000mg of fast acting Tylenol in the afternoon, drank fluids and rested. Two days after: Woke up @8:30am and felt faint (whistling in ears as well) for approx. 20 minutes. Continued to feel fatigued and weak throughout the day but fever and chills subsided.


VAERS ID: 1231362 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-17
Onset:2021-04-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Dizziness, Feeling hot, Heart rate increased, Hyperhidrosis, Pain in extremity, Vital signs measurement
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Norco-10, taken one pill around 7:00am that morning.
Current Illness: Had cough few weeks prior w runny nose. Tested negative for Covid on 4/3/21
Preexisting Conditions: Chronic lower back problems; smoker, asthma few times year and use provental inhaler when/if necessary.
Allergies: Gabapentin
Diagnostic Lab Data: Monitors my heartbeat, O2, pulse, breathing and blood pressure while watching me. No medications given for weird reaction BG to moderna first shot. Had video visit with my general practitioner this morning about what happened two days ago. Had sore arm from shot for first day and a half and feel fine tonight.
CDC Split Type:

Write-up: About 6 minutes after a got first shot of moderna, I had felt fin. Then within 20-30 seconds I realized that my chest was heavy/pressure on my sternum, arms and torso went warm and sweaty, a bit light headed and had fast heart rate. I asked medical team for assistance. They took blood pressure/O2 levels and listen to my heart and lungs. Had epi pen ready, but never administered. Watched me like this for about hour and a half until my bp came back down to normal levels.


VAERS ID: 1231383 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-16
Onset:2021-04-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Decreased appetite, Diarrhoea, Fatigue, Migraine, Mobility decreased, Nausea, Pain, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Parkinson-like events (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: metoprolol succ er 100mg Losartan potassium 100mg Lunesta 3mg at night Lorazepam 1 mg at night Flonase Wal dryl Tramadol 50mg every 6 hrs as needed Aspirin 81mg Hydrochlorithiazide 25mg
Current Illness:
Preexisting Conditions: IBS High Blood Pressure
Allergies: Codine Latex
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever, extreme body pain (entire body), nausea, diarrhea migraine, fatigue. April 17, progressed throughout day, starting @ 2am with diarrhea and vomiting, Sunday April 18 was unable to move eat nor drink the entire day, Monday April 19th still unable to eat nor drink without throwing up, headache still present slight fatigue, body aches easing up.


VAERS ID: 1231387 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-16
Onset:2021-04-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / 1 RA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0161 / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Burning sensation, Chills, Dizziness, Headache, Heart rate increased, Nausea, Pain, Pruritus, Pyrexia, Rash erythematous, Urticaria
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin Levothyroxine
Current Illness: Nono
Preexisting Conditions: Diabetes Hypothyroidism
Allergies: Not known
Diagnostic Lab Data: None done
CDC Split Type:

Write-up: Nausea, severe rashes (hives) red and burning and itchy throughout the body, second high fever that went up to 102.1 followed by chills and body ache, light headed ness and headache. Rashes occurred 10-12hrs after vaccine and got worse till was treated at a medical clinic and er. Had heavy heart rate of 120+ IV administered with diphenhydramine which is continued even now as slight rashes still exists and prednisone was given on Sunday April 19 2021 at 11:50am Later since rashes still persisted was advised by the urgent clinic to go to ER where hydroxyzine was given


VAERS ID: 1231393 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-17
Onset:2021-04-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001C21A / 2 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Diarrhoea, Fatigue, Injection site rash, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Fever of 101.1, soreness, exhaustion, diarrhea for approximately the first 36 hours; rash at injection site after 48 hours


VAERS ID: 1231446 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-16
Onset:2021-04-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030B21A / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Influenza like illness, Injection site erythema, Injection site induration, Injection site swelling, Injection site warmth, Nausea, Pain, Pyrexia, Sleep disorder
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamins C and D3, hair and nail supplement, Allegra, and Flonase
Current Illness: None
Preexisting Conditions: Seasonal allergies, low-blood sugar, near-sighted, and adult-onset scoliosis. Less frequently, migraines and IBS.
Allergies: Penicillin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Experienced flu like symptoms starting 24 hours after shot, including low grade fever, chills, fatigue, headache, nausea, and body aches. These all started to improve Sunday evening, 4/18,, and I was able to eat a meal. Around 9:00 pm on 4/18, I noticed a red area around the injection site on my arm. It felt warm to the touch. It didn?t seem too swollen, so I went to bed. I woke up around 2:00am on 4/19 and my upper arm had a large, hard swollen lump at injection site. It was still red and hot. I have been taking ibuprofen which is helping with the swelling. I still have some swelling, a red ?sunburned? area around the injection, and warm to the touch. I do not have pain or itching? at least at this point at 11:45pm on 4/19. I was surprised to have a new symptom almost 2.5 days after my shot.


VAERS ID: 1231449 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-09
Onset:2021-04-17
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Tetanus age 48
Other Medications: Lexapro 20 mg 1 time a day
Current Illness: None
Preexisting Conditions: None
Allergies: Severe reactions to bug bites and stings no epipen needed as yet just Benadryl
Diagnostic Lab Data: None
CDC Split Type:

Write-up: ?Covid arm?. Injection site and about 1.5 inch around red and swollen hot and painful to touch Similar reaction to what I get with bug bites but a bit milder


VAERS ID: 1231478 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-15
Onset:2021-04-17
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 044B21A / 2 - / -

Administered by: Other       Purchased by: ?
Symptoms: Epistaxis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Gabapentin, Oxycodone, Acetaminophen
Current Illness: None
Preexisting Conditions: Arthritis
Allergies: None knkwn
Diagnostic Lab Data: None at this time. If condition persists, I will see my doctor.
CDC Split Type:

Write-up: Three (so far) episodes of VERY severe nosebleeds lasting up to 30 minutes. Not normal for me.


VAERS ID: 1231686 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-04-16
Onset:2021-04-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040B21A / UNK RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chills, Fatigue, Hyperhidrosis, Injection site erythema, Injection site nodule, Injection site rash, Injection site swelling
SMQs:, Neuroleptic malignant syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tumeric, vitamin e, vitamin c, amlodipine, and triamterene
Current Illness: none
Preexisting Conditions: Blood pressure, arthritis
Allergies: None
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Woke Saturday morning around 12:00am with patient and bed sweated wet and patient had chills. Extremely tired to point could barely move. Sunday morning still extremely tired, red rash around injection area about three inches around, large knot under armpit of injection site the size of a softball. Monday morning still tired but not as extreme. Still had rash at injection site and entire upper arm swollen. Still had knot below armpit.


VAERS ID: 1231970 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-15
Onset:2021-04-17
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Other       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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Lungs lost a lot of capacity which I was able to gauge by my swimming as well as being easily out of breath which is not normal


VAERS ID: 1232005 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Alaska  
Vaccinated:2021-04-17
Onset:2021-04-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038B21A / 1 - / IM

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

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

Write-up: MODERN 0.5 ML FOR IM LOT 038B21A EPX:09/25/2021 No known adverse events.


VAERS ID: 1232015 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-11
Onset:2021-04-17
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Myocardial infarction
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow)

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

Write-up: Unseen/ unknown reportedly had heart attack 6 days post vaccination. Reported from facility.


VAERS ID: 1232035 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-17
Onset:2021-04-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002B21A / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Dizziness
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: oxybutynin CR 10 mg
Current Illness:
Preexisting Conditions: MS, urge incontinence, osteopenia
Allergies: NKMA
Diagnostic Lab Data: none
CDC Split Type:

Write-up: dizziness and weakness, after $g4 hrs from time of vaccination in pt with active Multiple Sclerosis diagnosis. No treatment sought


VAERS ID: 1232053 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-15
Onset:2021-04-17
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 043B21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blister, Blood test, Herpes zoster, Pruritus, Rash erythematous
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (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: Vyvanse-30mg
Current Illness: N/A
Preexisting Conditions: Psoriasis
Allergies: Morphine
Diagnostic Lab Data: Blood work.
CDC Split Type:

Write-up: On Saturday morning, I woke up with a red rash on the left side of my face. Throughout the day, the rash turned into itchy, blisters. I followed up with my primary care physician who diagnosed me with Shingles. Stating it could have been a correlation to the vaccine that compromised my immune system. I am on methyllpredinsone and valacyclovir HCL.


VAERS ID: 1232085 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-04-16
Onset:2021-04-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 042021A / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure abnormal, Chills, Headache, Heart rate abnormal, Injection site pruritus, Injection site rash, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hypertension (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metoprolol
Current Illness: None
Preexisting Conditions: Arrhythmia
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Fever, body aches, chills, headache, elevated heart rate, elevated blood pressure, itching and rash at injection site


VAERS ID: 1232298 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-07
Onset:2021-04-17
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia
SMQs:, Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: dofetilide, pantrapazole,eliquis, toprol
Current Illness: occasional arrhythmia
Preexisting Conditions: occasional arrhythmia
Allergies: qunidine
Diagnostic Lab Data: none yet
CDC Split Type:

Write-up: Severe shoulder pain


VAERS ID: 1232510 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-05
Onset:2021-04-17
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Dizziness, Electrocardiogram, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: h/o migraine
Allergies: None
Diagnostic Lab Data: EKG normal 4/19/21
CDC Split Type:

Write-up: Chest tightness, heaviness evening of 4/17/21, along with light headed. Tingling in left arm (injection arm). EKG normal 4/19/21. Chest pain continues 4/20/21 , describes as a "zap" or static feeling upper left chest. No SOB.


VAERS ID: 1232561 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-04-10
Onset:2021-04-17
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Full blood count, 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft 50mg Multivitamin
Current Illness: None
Preexisting Conditions: None
Allergies: Amoxicillin Doxycycline
Diagnostic Lab Data: CBC count over next two weeks
CDC Split Type:

Write-up: Hives on arms and legs, not responding to allergy medication and have been continuous for 4 days.


VAERS ID: 1232695 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-09
Onset:2021-04-17
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chills, Dizziness, Pyrexia, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Seroquel 400mg, Fluoxetine 60mg, Alprazolam .5mg
Current Illness:
Preexisting Conditions:
Allergies: Penicillin and all cilin related drugs, peanuts
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Chills, light headedness, fever, the same day as received. Then on 4-17-2021 broke out in hives on arms, legs, and neck.


VAERS ID: 1233157 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-05
Onset:2021-04-17
   Days after vaccination:43
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Cough, Dyspnoea, Nasal congestion, Rhinorrhoea
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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: vaccinated on 3/5/2021 with Janssen Covid vaccine. Developed symptoms of covid (runny nose, congestion, cough, shortness of breath) on 4/17/2021 after an exposure to covid.


VAERS ID: 1233266 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-01
Onset:2021-04-17
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Contusion, Dry skin, Erythema, Fatigue, Full blood count, Hypoaesthesia, Musculoskeletal stiffness, Paraesthesia, Peripheral coldness, Peripheral swelling, Skin discolouration, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: SULFER BASED ANTIBIOTICS, PENICILLIN, ALCOHOL
Diagnostic Lab Data: CBC at emergency room 4/17/21
CDC Split Type:

Write-up: Sudden onset of bruise in left ring finger and on left foot, left of big toe, both appeared at once while eating lunch. Left ring finger went numb, white and cold, with bruise appearing on the middle digit. Other finger tips turned pink. Skin turned red onhands with tingling sentation. Right hand blood vessels came to the surface and began to swell at intersections. Skin on rt. hand looked whiter and dry. The sudden onset sent me to the emergency room, the condition began to fade in 3 hours, not completely. The same reaction occured the next day at 12 noon. I took a hot shower and the condition improved followed by extreme tiredness. *At the time of vaccination, & on both of these events I had a stiff neck/red skin.


VAERS ID: 1233818 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-07
Onset:2021-04-17
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Skin discolouration, Thrombosis
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Hypotonic-hyporesponsive episode (broad)

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

Write-up: Purple , looking like blood clots on the back of her leg


VAERS ID: 1233931 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-09
Onset:2021-04-17
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201HZ1A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chest discomfort, Headache, Hypoaesthesia, Pain in extremity, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NA
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: One week after shot, experiencing an intermittent headache, tingling/numbness in left hand, pain in leg and arm that comes and goes, tingling/numbness in left foot. Chest discomfort that comes and goes


VAERS ID: 1234036 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-04-09
Onset:2021-04-17
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Finasteride .4 mg, Tamsulosin .5mg
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: I called the clinic and all they did was ask a bunch of questions but never told me to take any action. I did take Benadryl (2) tablets which after an hour or so helped reduce the itching and redness.
CDC Split Type:

Write-up: Inflammation of hands and feet, redness and severe itching. Redness and mosquito bite like bumps on the back of legs, small of back and upper arms that itch.


VAERS ID: 1234106 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-11
Onset:2021-04-17
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Headache
SMQs:

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

Write-up: Severe headaches.


VAERS ID: 1234481 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-09
Onset:2021-04-17
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

Administered by: Public       Purchased by: ?
Symptoms: Computerised tomogram head, Dyspnoea, Fatigue, Fibrin D dimer, Full blood count, Headache, Paraesthesia, Paraesthesia oral
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PO iron, hydrochlorothiazide 12.5mg
Current Illness:
Preexisting Conditions: Hypertension
Allergies: NDA
Diagnostic Lab Data: I ordered head CT, d-dimer and CBC , do not have results yet.
CDC Split Type:

Write-up: The patient was vaccinated at an outside clinic. She reports severe HA, tingling sensations in her tongue and face, mild exertional SOB, and fatigue.


VAERS ID: 1235389 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-10
Onset:2021-04-17
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Herpes zoster
SMQs:, Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: lansoprozole 30mg/day, famitodine 40mg/day
Current Illness:
Preexisting Conditions:
Allergies: ceclor
Diagnostic Lab Data:
CDC Split Type:

Write-up: developed shingles around 8/9 days after vaccination. shingles on right lower back. currently still have.


VAERS ID: 1235447 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-22
Onset:2021-04-17
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram cerebral abnormal, Arteriogram carotid abnormal, Ear pain, Headache, Hypoaesthesia, Jugular vein thrombosis, Migraine, Thrombosis, Transverse sinus thrombosis, Vision blurred
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Central nervous system vascular disorders, not specified as haemorrhagic or ischaemic (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Escitalopram 20 mg daily, levothyroxine 125 mcg daily, Vyvanse 60 mg daily, MILI 0.25-0.035 mg 1 tablet daily, buspirone 15 mg 1 tablet twice daily
Current Illness: Office visit on 3/3/21 for concern for bilateral tinnitus and Meniere''s given family history.
Preexisting Conditions: Hypothyroidism, ADHD, mild major depression, tongue anomaly, situational anxiety, obesity BMI 37, menometroorrhagia
Allergies: No Known Allergies
Diagnostic Lab Data: CT head and neck with contrast shows thrombosis of the left transverse and sigmoid sinuses and left internal jugular vein.
CDC Split Type:

Write-up: Patient presented to the ER on 4/20/21 with headache. On Saturday (4/17/2021), the patient had "the worst headache I have ever had" along with severe inner left ear pain. Patient took an ibuprofen which helped with the pain for about an hour then the pain came back. Pain got worse 2 hours later when she drove home from work. She called the RN line and was told to take ibuprofen and follow up in the AM. The next day 4/18/2021, patient went to urgent care and received Toradol and was told it was a migraine. Today 4/20/21, patient still had pain and noted feeling left sided facial numbness and blurry vision that correlated with when she got the headache. Patient went to an urgent care today and CT scan revealed a blood clot. She was then sent to the ED for evaluation. In the ED, she has no headache and facial numbness and has minimal left ear pain. Her headache is localized to the left side of her head. Patient denies fever, chills, and COVID symptoms. Patient was started on argatroban drip per hematology recommendation.


VAERS ID: 1235624 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-04-17
Onset:2021-04-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA Q26B21A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Headache, Injection site pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine 75 mcg Losarton 37.5 mg
Current Illness: None
Preexisting Conditions: Hypertension
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Fever, starting 4/17/21, 5:00 pm, 100.3, reaching a high of 102.9 on 4/18/21 at 6:30 pm, last recording of fever of 99.7 on 4/19/21 at 10:30 am. Very bad headache starting 4/17/21 at 5:00 pm. Very painful at injection site starting 4/17/21 at 2:30 pm.


VAERS ID: 1235632 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-04-08
Onset:2021-04-17
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER2613 / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain upper, Menstruation irregular
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Fertility disorders (broad)

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

Write-up: Extreme stomach cramping and start of painful period despite having birth control that prevents it and not having one for 13 years. Still ongoing.


VAERS ID: 1235645 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-17
Onset:2021-04-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Heart rate increased, Hyperhidrosis, Nausea, Urticaria
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: n/a
Preexisting Conditions: scoliosis
Allergies: amoxicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: immediate reaction; trouble breathing/shortness of breath, sweating, dizziness, hives, nausea, fast heart rate


VAERS ID: 1235648 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-04-16
Onset:2021-04-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Chest discomfort, Decreased appetite, Dyspnoea, Fatigue, Injection site pain, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vyvanse Adderall Abilify Lexapro Benazepril
Current Illness: N/A
Preexisting Conditions: High blood pressure
Allergies: Clyndamyacin Levaquin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever, fatigue, body aches, loss of taste, loss of appetite burning at injection site immediately and hotness around site for three days, heaviness in chest all the way through to back, shortness of breath


VAERS ID: 1235654 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-16
Onset:2021-04-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / -

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

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

Write-up: Very achy the next day but my arm continues to worsen 4 days after vaccine. It?s very red and irritated.


VAERS ID: 1236124 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-03-23
Onset:2021-04-17
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Axillary vein thrombosis, Deep vein thrombosis, Pain in extremity, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 4 days of right upper extremity pain and swelling with diagnosis of right upper extremity axillary vein DVT that was treated with DOAC apixaban.


VAERS ID: 1236311 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-11
Onset:2021-04-17
   Days after vaccination:37
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Amlodipina/Valsartan/HCT 5mg/160mg/12.5mg Ezetimibe/Rosuvastatina 10/10mg
Current Illness: None
Preexisting Conditions: OSA( Obstructive sleep Apnea) in CPAP
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pulmonary embolism


VAERS ID: 1237793 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-17
Onset:2021-04-17
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Breakthrough COVID-19 infection in fully vaccinated individual


VAERS ID: 1237803 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-17
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Chest pain, Computerised tomogram thorax, Gene mutation identification test negative, Hypoaesthesia, Muscular weakness, Myocardial strain, Pulmonary embolism
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Embolic and thrombotic events, venous (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lexapro Trazodone Etonogestrel (implanted progestin)
Current Illness: None
Preexisting Conditions: Asthma GERD Migraines Anxiety Depression Obesity, BMI 31.6
Allergies: NKA
Diagnostic Lab Data: 4/18 CTA shows multifocal PE with right heart strain. Factor v Leiden and factor II mutation analyses were negative. No coagulopathy conditions identified.
CDC Split Type:

Write-up: Presented to ED 4/18 with severe L sided chest pain since 4/17. Arm weakness and numbness 4/18 that lasted a few hours but resolved. No vision changes. O2 sat was 100% on room air. Diagnosed with PE. No recent mobilization. Does not smoke or use illicit drugs. Was admitted to the hospital telemetry unit 4/18-4/20. Discharged on apixaban. I do not have any information on the vaccine Lot number received.


VAERS ID: 1237941 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-03-16
Onset:2021-04-17
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Chest pain, Deep vein thrombosis, Discomfort, Ultrasound Doppler
SMQs:, Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: perforated PUD status post embolization and laparoscopic repair, previous alcohol abuse, alcoholic cirrhosis, hepatitis C, COPD, HTN, anxiety, chronic pain on methadone, chronic DVT/past PE post IVC filter, not on OAC.
Allergies: codeine
Diagnostic Lab Data: High-resolution venous duplex technique was used to investigate the right and left lower extremity venous systems where accessible to study. Chronic appearing thrombus is seen within the proximal, middle and distal portions of the right femoral vein. Clot in this vessel was seen on the prior study. Acute thrombus is present within the left popliteal vein, new from prior. The popliteal thrombus is nearly occlusive.
CDC Split Type:

Write-up: Patient presented to the ER with chest pain, non radiating, heavy weight. Patient was found to have acute DVT.


VAERS ID: 1238288 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-29
Onset:2021-04-17
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 AR / SYR

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: None documented
Allergies:
Diagnostic Lab Data: Positive PCR test for COVID-19. SARS-CoV-2 N gene Resp Ql NAA+probe. Test date is 04/17/21. Sample received 04/18/21. Findings Resulted and Reported on 04/18/21.
CDC Split Type:

Write-up: Client tested positive for COVID-19 on 04/17/21. Client states that they are asymptomatic. Client is being followed by a case manager with the Health Dept.


VAERS ID: 1238580 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-06
Onset:2021-04-17
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Amnesia, Feeling abnormal, Loss of consciousness, Speech disorder
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), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Relenta 50mg acetaminophen PRN gabapentin 600 mg metformin 500mb Ramipril 10 mg ASA 81 mg BP med Hydrochlorothiazide
Current Illness: RA, open wounds on feet
Preexisting Conditions: RA
Allergies: Amoxicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: 4/17/21 around 5 pm lost consciousness and did not knowingly awaken until a friend came to her home and said she was sitting on the bathroom floor and responding inappropriately. Pt has no memory of any events that occurred between Sat evening through Sunday morning . Feeling of being in a fog is slowly improving.


VAERS ID: 1238727 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-02
Onset:2021-04-17
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Burning sensation, Herpes zoster
SMQs:, Peripheral neuropathy (broad), Opportunistic infections (broad)

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

Write-up: I developed a mild case of shingles on the right side of my abdomen. It sometimes burns. It started around April 17th and is ongoing.


VAERS ID: 1238868 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Rhode Island  
Vaccinated:2021-04-10
Onset:2021-04-17
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Herpes zoster
SMQs:, Opportunistic infections (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: Klonopin 2mg nightly, Seroquel 25mg nightly, Venlafaxine ER 225mg daily
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Emergency Room diagnosis of shingles
CDC Split Type:

Write-up: Unsure if related to vaccine but timing is very suspect. I am 25 years old and in good health but developed Shingles on 4/17/2021 (diagnosed at the emergency room on 4/20). Due to the very low likelihood of shingles at the age of 25 and my good health history I figured it could be worth a submission / a data point in the event others are experiencing the same.


VAERS ID: 1239122 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Nevada  
Vaccinated:2021-03-31
Onset:2021-04-17
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Deep vein thrombosis, Muscle strain, Pain in extremity
SMQs:, Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Accidents and injuries (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: Chief complaint of worsening lower leg pain. Initially the patient though that he had pulled a muscle however he had complaints of claudication upon ambulation. Patient reports having J&J COVID vaccination approx 2.5 weeks prior. Patient reported his friend informed him that he might potentially have a blood clot and that he should come to the emergency department. Imaging consistent with acute DVT and patient taken to IR for tPA direct catheter infusion.


VAERS ID: 1239209 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-03
Onset:2021-04-17
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Deep vein thrombosis, Fibrin D dimer increased, Ultrasound scan
SMQs:, Haemorrhage laboratory terms (broad), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (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: No prescriptions, supplements and or herbal remedies unknown
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data: DVT diagnosed by Ultra Sound, D-Dimer2300
CDC Split Type:

Write-up: DVT left leg, pt put on Eliquis by hospital ER


VAERS ID: 1240206 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-08
Onset:2021-04-17
   Days after vaccination:40
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN TO ME / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pain of skin, Rash, Rash erythematous, Rash pruritic, Rash vesicular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None.
Current Illness: None.
Preexisting Conditions: None.
Allergies: None.
Diagnostic Lab Data: I haven''t had any tests done so far. I will go to the emergency room if this doesnt get better soon. I can sleep and I feel nervous.
CDC Split Type:

Write-up: I have a severe rash in multiple large areas on my body including buttocks, legs, and hands. These are extremely itchy, red, blistery, and the area under the skin is hard and painful to the touch. They have been growing every day since since the onset on Saturday (now it is Wednesday). some of them ha


VAERS ID: 1240223 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-04-16
Onset:2021-04-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: School       Purchased by: ?
Symptoms: Deafness unilateral, Tinnitus
SMQs:, Hearing impairment (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Biktarvy, Lipitor, Wellbutrin, Singulair
Current Illness:
Preexisting Conditions: HIV (undetected)
Allergies: None
Diagnostic Lab Data: 5/17: visual inspection by urgent care physician
CDC Split Type:

Write-up: Tinnitus on right ear and partial hearing loss on same ear.


VAERS ID: 1240256 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-15
Onset:2021-04-17
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Intermenstrual bleeding
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

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

Write-up: Got 2nd dose vaccine on 4/15/21. I started to have menstrual bleeding on 4/18/21. My last period JUST ended on 4/10/21. I NEVER had bleeding during ovulation in my entire life. Today is 4/21/21, it is getting heavier than beginning.


VAERS ID: 1240491 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-04-14
Onset:2021-04-17
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Abdominal pain lower, Flatulence, Headache
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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Mirena IUD, Vitamin D, Allegra, Flonase, women?s multivitamin, FLO gummy vitamin
Current Illness:
Preexisting Conditions: Scoliosis, anemia
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: The day of the shot, felt little to no symptoms until developing a slight headache in the evening (around 6:30PM). Fell asleep early at 9PM. Had elevated temp overnight (99.7 at 3am) and chills, woke up with extreme headache that did not resolve until about 4:30PM following day. A few days later on Saturday, developed pain in lower left abdominal area ? felt like cramping or gas. Continued for the next 5 days on and off and is ongoing. Period is not expected for another 10 days and these are unusual symptoms. If pains continue, will seek medical advice.


VAERS ID: 1240701 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-07
Onset:2021-04-17
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Paraesthesia, Rash, Rash erythematous, Rash papular, Tenderness
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: topical finasteride
Current Illness: None
Preexisting Conditions: Childhood asthma, allergic to cats and dogs
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: I think shingles. I have a small patch of red, raised bumps on my right lower back. They don''t hurt but I can constantly feel them. They hurt to touch. My front right torso is also slightly tingly in certain spots to touch. Forget this.


VAERS ID: 1241268 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Arizona  
Vaccinated:0000-00-00
Onset:2021-04-17
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Hay fever; Non-smoker
Preexisting Conditions: Comments: The patient had drug abuse or illicit drug usage
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210436703

Write-up: SORE ARM; ITCHING; GENERALIZED RASH; This spontaneous report received from a patient concerned a 56 year old female. The patient''s weight was 153 pounds, and height was 64 inches. The patient''s concurrent conditions included hay fever, non smoker, and non alcoholic, and other pre-existing medical conditions included the patient had drug abuse or illicit drug usage. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, and batch number: 205A21A expiry: UNKNOWN) dose was not reported, administered on 12-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 17-APR-2021, the subject experienced itching. On 17-APR-2021, the subject experienced generalized rash. On an unspecified date, the subject experienced sore arm. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from generalized rash, and the outcome of itching and sore arm was not reported. This report was non-serious.


VAERS ID: 1241276 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2021-04-17
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Rash maculo-papular
SMQs:, Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Alcohol use (Once a month); Kidney stones; Non-smoker
Preexisting Conditions: Comments: The patient had no known drug allergies and drug abuse or illicit drug use at the time of this report.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210436759

Write-up: MACULOPAPULAR RASH PATCH ON FACE, LEGS, ARMS; This spontaneous report received from a patient concerned a 60 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included tendency kidney stones, alcohol use, and non smoker, and other pre-existing medical conditions included the patient had no known drug allergies and drug abuse or illicit drug use at the time of this report. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, and batch number: 202A21A expiry: UNKNOWN) dose was not reported, administered on 10-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 17-APR-2021 17:00, the subject experienced maculopapular rash patch on face, legs, arms. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from maculopapular rash patch on face, legs, arms. This report was non-serious.


VAERS ID: 1241634 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-10
Onset:2021-04-17
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Blood disorder, Central venous catheterisation
SMQs:, Haematopoietic cytopenias affecting more than one type of blood cell (broad), Embolic and thrombotic events, venous (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic: Blood Disorder (diagnosed by MD)-Severe, Additional Details: Patient had PICC line placed on 4/13/21 and received IV antibiotics for prior infection.


VAERS ID: 1242755 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-12
Onset:2021-04-17
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 2024214 / N/A LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Deep vein thrombosis, Dyspnoea, Pain in extremity, Peripheral swelling, Ultrasound scan
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: otherwise healthy
Allergies: none
Diagnostic Lab Data: Anticoagulation and CT to rule out PE have not been performed as of yet.
CDC Split Type:

Write-up: Developed transient SOB on 4/16 that resolved on 4/18. Developed left leg pain and swelling on 4/19. LE ultrasound revealed extensive DVT. Does report a 4 hour plane ride 4 weeks ago.


VAERS ID: 1242985 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-11
Onset:2021-04-17
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Pharyngeal swelling, Pruritus, Rash, Rash erythematous, Swelling, Swollen tongue, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Haemodynamic oedema, effusions and fluid overload (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: Lisinopril 10mg, glucosamine/chondriton, calcium citrate, fish oil, turmeric
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: I have an appointment with the allergy clinic scheduled for 5/6/21.
CDC Split Type:

Write-up: No events immediately following injection. Six days later I started to experience an allergic reaction for some unknown reason with red welts over body, swelling. and itching. On the 7th day, my tongue and throat started swelling and I went to Urgent Care. I was treated with prednisone and epinephrine on 4/18/21 and released. Prescription given for 5 days of prednisone. No further symptoms after 4/18/21. Physician recommended I file a report with VAERS.


VAERS ID: 1242992 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-07
Onset:2021-04-17
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Chest X-ray, Dyspnoea, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lithium carbonate 300mg Prozac 40mg
Current Illness:
Preexisting Conditions:
Allergies: sulfa antibiotics
Diagnostic Lab Data: chest xray
CDC Split Type:

Write-up: shortness of breath, body pain, fever


VAERS ID: 1243757 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-13
Onset:2021-04-17
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / -

Administered by: Private       Purchased by: ?
Symptoms: Menopause, Postmenopausal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

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

Write-up: Experienced full and ?normal?menstrual period during menopause more than one year since last period.


VAERS ID: 1243846 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Vermont  
Vaccinated:2021-04-10
Onset:2021-04-17
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / UNK LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood cholesterol normal, Coronary artery occlusion, Myocardial infarction
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: none at the time but I had COVID with symptoms in January of 2021.
Preexisting Conditions: none
Allergies: Pennicillan
Diagnostic Lab Data: I had numerous tests while I was in the hospital
CDC Split Type:

Write-up: 6 days after the injection I suffered a massive heart attack of the Left Anterior Descending Artery with no prior heart history, less than a month earlier I had a physical with bloodwork and all cholesterol levels were normal, the doctors have not been able to give a real reason as to why this happen except I had a blockage but no explanation of why as my cholesterol levels are normal.


VAERS ID: 1244373 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-04-10
Onset:2021-04-17
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Diplopia, Dizziness, Fatigue, Headache, Nausea, Vision blurred
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Ocular motility disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prescribed Medications: Heart related: 1. Atotvastatin, 20mg, 1-daily; 2. Olmesartan Medoxomil, 40mg, 1-daily; 3. Amlodipine Besylate, 5mg, 1-daily. Prostate/Bladder: Trospium Chloride 20mg, 1-tablet, twice daily. Various heart and h
Current Illness: None
Preexisting Conditions: Heart disease; LBP, arthritis, obesity (60lbs overweight)
Allergies: Cephalexin and -cillin drugs.
Diagnostic Lab Data: None yet
CDC Split Type:

Write-up: Had mild symptoms of headache, fatigue, nausea, light headedness for starting about 3 hrs. after shot given and lasting into evening of next nigh; No fever or shortness of breath experienced. Except for fatigue was generally OK for next 6 days. Then eyes started blurring down my vision, and started seeing double/triple vision... symptoms are intermittent; worse in evening when eyes are fatigued. Called medical center for info and course of action and was advised to report to medical center emergency Room. Will see what eyes are like in morning


VAERS ID: 1245173 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: California  
Vaccinated:0000-00-00
Onset:2021-04-17
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Lupus erythematosus
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210439032

Write-up: NAUSEA; HEADACHE; TIREDNESS; LIGHT FEVER; BODY ACHES/PAIN; DIARRHEA; This spontaneous report received from a consumer concerned a 52 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included lupus. 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 06-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 17-APR-2021, the subject experienced diarrhea. On an unspecified date, the subject experienced body aches/pain, nausea, headache, tiredness, and light fever. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from body aches/pain, nausea, headache, tiredness, diarrhea, and light fever. This report was non-serious.


VAERS ID: 1245244 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-17
Onset:2021-04-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Condition aggravated, Ehlers-Danlos syndrome, Mobility decreased, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Congenital, familial and genetic disorders (narrow), Parkinson-like events (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Estradiol (patch, 0.1mg), Vitamin D (5000 IU)
Current Illness: None
Preexisting Conditions: Ehlers-Danlos syndrome
Allergies: Gluten intolerance (not yet precisely diagnosed)
Diagnostic Lab Data:
CDC Split Type:

Write-up: Joint and muscle pain that is worse than I think is typical. Joint pain was somewhat similar to that caused by ciprofloxacin, in my knees. Muscle pain was intense enough that it caused mobility problems that lasted a few days after the side-effects themselves disappeared. Basically, the side-effects seemed to trigger an Ehlers-Danlos flareup that lasted several days where I was barely mobile. I''ve since recovered and feel normal again.


VAERS ID: 1245251 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: California  
Vaccinated:2021-02-22
Onset:2021-04-17
   Days after vaccination:54
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, Fatigue, Headache, Pain, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Taste and smell disorders (narrow), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: On April 17th, suspicious of my symptoms, I went and test positive for Covid-19 on a rapid test. To confirm the diagnosis, I got a PCR test. That test was also positive for Covid-19.
CDC Split Type:

Write-up: There was no place to enter the date of the two above vaccines. The 1st 1 was on 2-22-2021, the 2nd dose was on 3-13-2021. On April 17th, I started to have Covid-19 symptoms: runny nose, headache, exhaustion. On the 2nd day, body aches, congestion, headaches, exhaustion. On the third day, all symptoms continue and I lost my sense of smell and taste. No fever ever. On the 4th and 5th day, a runny nose has stopped. all other symptoms continue.


VAERS ID: 1245262 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Ohio  
Vaccinated:0000-00-00
Onset:2021-04-17
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Fibrin D dimer increased, Pain in extremity
SMQs:, Haemorrhage laboratory terms (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 202104191420; Test Name: Fibrin D dimer increased; Result Unstructured Data: Negative
CDC Split Type: USJNJFOC20210440109

Write-up: EXTREME PAIN IN UPPER RIGHT ARM; This spontaneous report received from a consumer. 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, batch number: 042A21A and expiry: UNKNOWN) dose was not reported, administered on 31-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 17-APR-2021, the subject experienced extreme pain in upper right arm. On 19-APR-2021 14:20, Laboratory data included: Fibrin D dimer increased (NR: not provided) Negative. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from extreme pain in upper right arm. This report was non-serious.


VAERS ID: 1245263 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-17
Onset:2021-04-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Lip swelling, Pruritus, Swelling face, 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Penicillin, Sulfa
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient had reaction after second dose of Pfizer- hives, pruritus, facial swelling, and swelling of the lips. Benadryl given and Epi given by EMS. Transported to ED and given Decadron in ED. Monitored for several hours and D/C''ed under stable condition.


VAERS ID: 1245267 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-04-16
Onset:2021-04-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016B21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Feeling abnormal, Gait disturbance, Headache, Joint stiffness, Limb discomfort, Movement disorder, Pain, Pain in extremity
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levoxyl, Flomax, bystolic, vitamin D, calcium, multivitamin, baby aspirin, fish oil, Metamucil
Current Illness:
Preexisting Conditions: Thyroid cancer, IBS, GERD, osteoporosis, irregular heartbeat
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Moderna COVID19 vaccine EUA Woke up at night to go to the bathroom. Had trouble getting out of bed and walking. Joints were stiff. Strangely my right hand was frozen open. Was unable to make a fist or grasp a water bottle. When I tried to close my right hand I had a weird sensation in my hand. It felt like electricity flowing down my hand and into my 4 fingers. Left hand was not effected. Had the same effect when I woke up a couple times during the night. When I got up on Saturday morning the problem with my hand was gone. Still a bit stiff, was fatigued, headache and body aches. Sore arm for a few days.


VAERS ID: 1245298 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-16
Onset:2021-04-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW1053 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Chills, Discomfort, Hyperhidrosis, Lymph node pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Woken from sleep approx 11hrs after shot. Chills, mild fever, uncomfortable, joint pain including wrists and fingers, lymphnode in left armpit sore. As time went on alternated between chills and sweats. Symptoms continued for approx 36hrs. Lympnode soreness lasted approx 3days


VAERS ID: 1246575 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-08
Onset:2021-04-17
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Activated partial thromboplastin time shortened, Blood calcium normal, Blood creatinine normal, Blood fibrinogen increased, Blood potassium normal, Blood sodium normal, Epistaxis, Fatigue, Fibrin D dimer, HIV test negative, Haematocrit normal, Haemoglobin normal, Hepatitis C test negative, Immunoglobulin therapy, International normalised ratio normal, Mean cell volume normal, Mouth haemorrhage, Myalgia, Petechiae, Platelet count decreased, Pyrexia, Vaginal haemorrhage, White blood cell count increased, White blood cell count normal
SMQs:, Rhabdomyolysis/myopathy (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: levonorgestrel-ethinyl estradiol -- one tablet by mouth once daily
Current Illness: None
Preexisting Conditions: None
Allergies: No known allergies
Diagnostic Lab Data: 4/17/21 platelets <1000, INR 1.0, PTT 29. WBC 9.9, Hgb 12.9, HCT 38, MCV 88, fibrinogen 402, d-dimer 0.23, heparin level <0.10 4/18/21 platelets <10,000 (patient given prednisone 80 mg daily and IVIG) 4/19/21 platelets 53,000 (discharged on 4/19), WBC 11.2, Hgb 10.7, HCT 32 4/22/21 platelets 186 (this was taken after dischage) 4/17 Sodium, potassium, creatinine, calcium all within normal range. HIV and Hepatitis C negative Discharged on prednisone 80 mg daily with proton pump inhibitor and bactrim and to obtain daily CBC. Instructed to continue oral contraceptive
CDC Split Type:

Write-up: Patient presented on 4/17 to urgent care afer significant vaginal bleeding (soaking through a pad every 1 hour to 1.5 hours) and petechia on multiple extremeties. She also had a nose bleed and bleeding in mouth earlier in the day that resolved spontaneously. After obtaining CBC, platelets were <1000. She was on oral contraceptives. She is a non smoker. She received work up for thrombosis, not indication of thrombosis. She did have some muscle aches and fever and fatigue the day after vaccine. Histroy notable for mild diffuse petechiae on all 4 extremeties. As inpatient received solumedrol 125 mg (then switched to prednisone 80 mg daily), IVIG 1 g/kg x 2 doses. she was discharged on 4/19 d/t rising platelets, Vaginal bleeding slowing and Petechia much fainter.


VAERS ID: 1247210 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-09
Onset:2021-04-17
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: fluoxitine, rovatasum.
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: None. Consulted with my doctor on April. 22. He said to use benadryl and moisturizers.
CDC Split Type:

Write-up: the next morning and the following two mornings after the shot I had severe headaches. Theu went away without medication fairly quickly the first two days after I got up.. the third day after about an hour I went out and got some advil to get rid of it. About a week after the shot I started getting a rash under my arms and in the ground area. This got worse every dah and spread to .other parts of the body as time went on. Better today (april.23) but still very uncomfortable.


VAERS ID: 1247473 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-09
Onset:2021-04-17
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Pain in extremity
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Nothing diagnosed but per caller she started developing stomach problems after getting the Gardasil vaccine.
Other Medications: none
Current Illness:
Preexisting Conditions:
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: 4/17 Chest pain when she takes deep breath that spreads to her left arm 4/20-Follow up call second attempt - Voicemail not set up yet; unable to leave a message.


VAERS ID: 1247700 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-04-07
Onset:2021-04-17
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram, Arthralgia, Asthenia, Dyspnoea, Electrocardiogram ST segment depression, Electrocardiogram abnormal, Fatigue, Fibrin D dimer, Pulmonary embolism, Pulmonary thrombosis
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Other ischaemic heart disease (broad), Arthritis (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: Synthroid 100, Estarylla 0.25-35mg-mcg, started November 2020
Current Illness:
Preexisting Conditions: Hashimoto thyreotidis Ovarian cyst
Allergies:
Diagnostic Lab Data: April 17: D-Dimer quantitative , slightly elevated ECG: ST depressions in lateral leads CTA chest for PE: segmental and sub segmental PE in right lower lobe US upper extremity venous unilateral: acute basilic vein thrombosis, right
CDC Split Type:

Write-up: Shortness of breath for several days, feeling fatigue and week, pain in right elbow Diagnosed Apr. 17 in ER setting: acute segmental and subsegmental pulmonary embolism without acute cor pulmonale Acute thrombosis of superficial vena basilica right arm


VAERS ID: 1247922 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-09
Onset:2021-04-17
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Alanine aminotransferase normal, Anion gap, Aspartate aminotransferase normal, Basophil count decreased, Blood albumin decreased, Blood alkaline phosphatase normal, Blood bilirubin normal, Blood calcium, Blood chloride normal, Blood glucose increased, Blood iron decreased, Blood magnesium normal, Blood phosphorus normal, Blood potassium normal, Blood sodium normal, Blood urea increased, C-reactive protein increased, Carbon dioxide increased, Dizziness, EGFR status assay, Eosinophil count decreased, Fibrin D dimer, Haematocrit decreased, Haemoglobin decreased, Hypotension, Iron binding capacity total normal, Lymphocyte count, Lymphocyte count decreased, Lymphocyte percentage, Malaise, Mean cell haemoglobin concentration normal, Mean cell haemoglobin decreased, Mean cell volume decreased, Mean platelet volume normal, Monocyte count normal, Neutrophil count, Platelet count normal, Polychromic red blood cells present, Procalcitonin, Protein total decreased, Red blood cell count normal, Red blood cell nucleated morphology, Red cell distribution width increased, Serum ferritin normal, Transferrin saturation decreased, White blood cell count decreased
SMQs:, Acute renal failure (broad), Anaphylactic reaction (broad), Haematopoietic erythropenia (broad), Haematopoietic leukopenia (narrow), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Vestibular disorders (broad), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 325 mg tablet albuterol (PROVENTIL HFA,VENTOLIN HFA) 90 mcg/act inhaler amLODIPine (NORVASC) 5 mg tablet aspirin 81 MG tablet Calcium 280 MG TABS cholecalciferol (VITAMIN D3) 1,000 units tablet clopidogr
Current Illness: Barrett''s esophagus Endocrine Type 2 diabetes mellitus with diabetic polyneuropathy, with long-term current use of insulin (HCC) Respiratory Centrilobular emphysema (HCC) Seasonal allergic rhinitis due to pollen Asthma COPD (chronic obstructive pulmonary disease) (HCC) Chronic obstructive pulmonary disease (HCC) OSA (obstructive sleep apnea) Cardiovascular and Mediastinum Asymptomatic stenosis of right carotid artery Peripheral arteriosclerosis (HCC) PVC (premature ventricular contraction) Atherosclerosis of coronary artery bypass graft of native heart with angina pectoris (HCC) Hypertension Benign essential hypertension CAD (coronary artery disease) Peripheral vascular disease (HCC) Nervous and Auditory Polyneuropathy associated with underlying disease (HCC) ETD (Eustachian tube dysfunction), right Musculoskeletal and Integument Osteopenia Corns Pressure injury of right foot, stage 2 (HCC) Other Elevated liver enzymes Episodic mood disorder (HCC) Insomnia History of right-sided carotid endarterectomy Mixed hyperlipidemia Stented coronary artery History of PTCA with 13 stents Diverticulosis of intestine Erectile dysfunction of non-organic origin Former smoker Memory impairment Status post angioplasty Anemia Enlarged prostate without lower urinary tract symptoms, s/p TURP 3/11/21 COVID-19 virus infection
Preexisting Conditions: Barrett''s esophagus Endocrine Type 2 diabetes mellitus with diabetic polyneuropathy, with long-term current use of insulin (HCC) Respiratory Centrilobular emphysema (HCC) Seasonal allergic rhinitis due to pollen Asthma COPD (chronic obstructive pulmonary disease) (HCC) Chronic obstructive pulmonary disease (HCC) OSA (obstructive sleep apnea) Cardiovascular and Mediastinum Asymptomatic stenosis of right carotid artery Peripheral arteriosclerosis (HCC) PVC (premature ventricular contraction) Atherosclerosis of coronary artery bypass graft of native heart with angina pectoris (HCC) Hypertension Benign essential hypertension CAD (coronary artery disease) Peripheral vascular disease (HCC) Nervous and Auditory Polyneuropathy associated with underlying disease (HCC) ETD (Eustachian tube dysfunction), right Musculoskeletal and Integument Osteopenia Corns Pressure injury of right foot, stage 2 (HCC) Other Elevated liver enzymes Episodic mood disorder (HCC) Insomnia History of right-sided carotid endarterectomy Mixed hyperlipidemia Stented coronary artery History of PTCA with 13 stents Diverticulosis of intestine Erectile dysfunction of non-organic origin Former smoker Memory impairment Status post angioplasty Anemia Enlarged prostate without lower urinary tract symptoms, s/p TURP 3/11/21 COVID-19 virus infection
Allergies: Diphenhydramine Hyzaar [Losartan Potassium-hctz]Other (See Comments) Lipitor [Atorvastatin]Other (See Comments) OtherOther (See Comments) Sudafed [Pseudoephedrine Hcl]Anxiety
Diagnostic Lab Data: Results for pt.(MRN 1414438283) as of 4/23/2021 16:02 4/22/2021 05:48 Sodium: 138 Potassium: 3.7 Chloride: 106 CO2: 24 Anion Gap: 8 BUN: 24 Creatinine: 1.09 Glucose, Random: 107 Calcium: 8.0 (L) CORRECTED CALCIUM: 9.1 AST: 21 ALT: 30 Alkaline Phosphatase: 35 (L) Total Protein: 6.1 (L) Albumin: 2.6 (L) TOTAL BILIRUBIN: 0.37 eGFR: 67 Phosphorus: 4.3 (H) Magnesium: 1.9 Ferritin: 65 WBC: 4.78 Red Blood Cell Count: 4.81 Hemoglobin: 10.8 (L) HCT: 36.1 (L) MCV: 75 (L) MCH: 22.5 (L) MCHC: 29.9 (L) RDW: 17.2 (H) Platelet Count: 216 MPV: 9.8 Platelet Estimate: Adequate nRBC: 0 Segs Relative: 64 Abs Neutrophils: 3.11 Bands Relative: 1 Lymphocytes %: 27 Monocytes: 8 Eosinophils: 0 Basophils Relative: 0 Absolute Eosinophils: 0.00 Basophils Absolute: 0.00 Total Counted: 100 RBC Morphology: Present Polychromasia: Present C-REACTIVE PROTEIN: 15.0 (H) D-Dimer, Quant: 0.44 LYMPHOCYTES ABSOLUTE: 1.29 Monocytes Absolute: 0.38 4/22/2021 05:48 Iron: 21 (L) Ferritin: 66 Iron Saturation: 7 TIBC: 297 Procalcitonin: 0.06 4/22/2021 07:25 POC Glucose: 97 4/22/2021 08:39 Delivery Request Date: 04/22/2021 Delivery Note: Pend Item Description: Supplier Name: Supplier Phone Number: 4/22/2021 POC Glucose: 192 (H)
CDC Split Type:

Write-up: 72-year-old male history multiple medical problems including coronary artery disease with stents Barrett''s esophagus asthma enlarged prostate hypertension presents from the infusion center secondary to being found to have hypotension after receiving his immunoglobulin infusion today for COVID. Patient states he has been feeling ill for the past few days due to COVID he has been eating and drinking much. Patient states that he felt no different during his infusion or after but the blood pressure being low specially felt lightheaded when he stood up he was sent down to the ER for further evaluation. Patient denies any chest pain associated with this no palpitations he is awake alert and not diaphoretic in no significant distress on my evaluation. Patient denies any recent blood in stools. Note is the patient did receive the COVID vaccine Johnson and Johnson approximately 10 days ago. He was diagnosed with COVID infection 4 days after that.


VAERS ID: 1247937 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-04-04
Onset:2021-04-17
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ataxia, Blood test, Confusional state, Dysarthria, Headache, Intensive care, Lethargy, Lumbar puncture, Magnetic resonance imaging head
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Whey protein powder
Current Illness: none
Preexisting Conditions: none
Allergies: Allergic to penicillin and aspirin
Diagnostic Lab Data: 4/18/21 Hospital Admission with many tests and imaging done, including blood work, lumbar puncture and MRI brain
CDC Split Type:

Write-up: Headache Confusion/Lethargy Dysarthria and Ataxia Subsequent presentation to ER and Admission to medical ICU (see below)


VAERS ID: 1248027 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-04-12
Onset:2021-04-17
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Fatigue, Pain in extremity
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: About a week after her vaccine she went to rehab and exercised which she then developed leg pain, she said it only lasted that day and has since gone away. She believes that was from the exercise. A few days later she experienced diarrhea without having any cramping or feeling ill, just out of the blue for about 6 hours and then it went away. She has been tired/ fatigued the entire time.


VAERS ID: 1248564 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-04-11
Onset:2021-04-17
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angiogram cerebral normal, Atelectasis, Blood calcitonin normal, Blood culture negative, Chest X-ray abnormal, Computerised tomogram abdomen, Computerised tomogram thorax abnormal, Echocardiogram abnormal, Electronic cigarette user, Headache, Hunt and Hess scale, Hydrocephalus, Hypoxia, Legionella test, Lung opacity, Oxygen saturation decreased, Oxygen therapy, Pleural effusion, Pulmonary arterial pressure abnormal, Pulmonary congestion, Pulmonary hypertension, Respiratory distress, SARS-CoV-2 test negative, Subarachnoid haemorrhage, Urine analysis normal, Ventricular drainage, Viral test, Viral test negative, Vomiting, Wheezing
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Asthma/bronchospasm (broad), Haemorrhage terms (excl laboratory terms) (narrow), Interstitial lung disease (narrow), Systemic lupus erythematosus (broad), Haemorrhagic central nervous system vascular conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tylenol
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: 4/21 Chest X-Ray - mild pulmonary congestion 4/22 CT chest/abd/pelvis - no pulmonary embolism, bilateral opacities/ground glass, bilateral pleural effusions, bil atelectasis 4/22 ECHO - Ejection Fraction 60-65%, normal biventricular function, mild pulmonary hypertension, PASP 36 4/22 Chest X-ray - diffuse, bilateral pulmonary congestion 4/23 Chest X-ray - improving pulmonary congestion COVID negative x 3 (4/17, 4/22, 4/23) VIRAL PCR negative 4/22 Blood Culture - no growth to date 4/22 Ua - neg 4/22 S. pneumoniae urine - negative 4/22 urine legionella - negative 4/22 procalcitonin < 0.1 (negative)
CDC Split Type:

Write-up: Patient was doing paperwork when he experienced the worst headache of his life on 4/17 with associated emesis. Patient found to have a Hunt Hess 3 Fisher Grade 3 Subarachnoid Hemorrhage with hydrocephalus s/p EVD, s/p cerebral angiogram on 4/18 negative for aneurysm/AVM. On the evening of 4/20, patient became acutely hypoxic with wheezing for which he required oxygen via 10L oxymask. During 4/21, his oxygen requirements continued to increase with increased work of breathing requiring high flow nasal cannula (HFNC) at 50L/60% + pulmonary congestion on imaging and he was treated with diuresis. On 4/22, oxygen needs increased requiring 70L/100% with worsening imaging. He was then started on steroids, antibiotics were broadened, epoprostenal started in addition to diuresis. On 4/23, patient reports improved breathing and is on non-rebreather. Antibiotics, steroids, and epoprostenal were discontinued as patient showed improvement of oxygenation without clear signs of infection. Of note, patient reports vaping in the past 2-3 months. Patient has also been intermittently febrile. Wife was concerned that these symptoms were possibly related to him getting the J&J vaccine on 4/11. Patient is currently still in hospital on day 6 of admission at this time.


VAERS ID: 1249109 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Nevada  
Vaccinated:2021-04-03
Onset:2021-04-17
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Chest pain, Computerised tomogram, Dyspnoea, Echocardiogram, Electrocardiogram, Heart rate increased, Laboratory test, Magnetic resonance imaging, Pulmonary embolism, Ultrasound scan
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Dehydration (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None at time
Current Illness: None
Preexisting Conditions: None
Allergies: Arithmerisn
Diagnostic Lab Data: Echocardiogram, ekg, chest X-ray, full body ultrasound, mri, ct scan. Blood work. More unknown tests
CDC Split Type:

Write-up: Pulmonary embolism. Chest pain, shortness of breath, rapid heart rate.


VAERS ID: 1249159 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-10
Onset:2021-04-17
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

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

Write-up: Dizziness that turned into light headedness


VAERS ID: 1249430 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: North Carolina  
Vaccinated:0000-00-00
Onset:2021-04-17
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Chest pain, Pain in extremity
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210439446

Write-up: BACK PAIN IN SHOULDER BLADES/SEVERE KNEE PAIN; SEVERE FOOT PAIN; CHEST PAIN; This spontaneous report received from a patient concerned a male of unspecified age. 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, batch number: Unknown) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported. Per procedure, no follow up will be requested for this case. No concomitant medications were reported. On 17-APR-2021, the subject experienced chest pain. On an unspecified date, the subject experienced back pain in shoulder blades/severe knee pain, and severe foot pain. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the back pain in shoulder blades/severe knee pain, severe foot pain and chest pain was not reported. This report was non-serious.


VAERS ID: 1249456 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2021-04-17
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: The patient had no known allergies.
Allergies:
Diagnostic Lab Data: Test Name: Body temperature; Result Unstructured Data: 98-99 F
CDC Split Type: USJNJFOC20210440624

Write-up: ACHY; FATIGUE; MILD HEADACHE; SLIGHT FEVER; This spontaneous report received from a patient concerned a 64 year old female. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included the patient had no known allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808609, and expiry: 09-JUN-2021) dose was not reported, administered on 31-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 17-APR-2021, the subject experienced achy. On 17-APR-2021, the subject experienced fatigue. On 17-APR-2021, the subject experienced mild headache. On 17-APR-2021, the subject experienced slight fever. Laboratory data (dates unspecified) included: Body temperature (NR: not provided) 98-99 F. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from mild headache, achy, fatigue, and slight fever. This report was non-serious.


VAERS ID: 1249500 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-04-17
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain upper, Chest pain, Pain in extremity
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Non-smoker
Preexisting Conditions: Comments: The patient did not known allergies and no drug abuse or illicit drug usage
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210442495

Write-up: CHEST PAIN; CHEST PAIN RADIATING TO STOMACH ON AND OFF; PAIN LIKE SENSITIVE TO TOUCH ON LOWER BACK OF LEGS BELOW KNEE (RIGHT LEG IS MORE SENSITIVE TO THE TOUCH THAN LEFT); This spontaneous report received from a patient concerned a 45 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included non-alcohol user, and non-smoker, and other pre-existing medical conditions included the patient did not known allergies and no drug abuse or illicit drug usage. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: UNKNOWN) dose was not reported, administered on 13-APR-2021 for prophylactic vaccination. The batch number was not reported, per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On 17-APR-2021, the subject experienced pain like sensitive to touch on lower back of legs below knee (right leg is more sensitive to the touch than left). On 20-APR-2021, the subject experienced chest pain. On 20-APR-2021, the subject experienced chest pain radiating to stomach on and off. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from pain like sensitive to touch on lower back of legs below knee (right leg is more sensitive to the touch than left), and chest pain, and the outcome of chest pain radiating to stomach on and off was not reported. This report was non-serious.


VAERS ID: 1249502 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Arizona  
Vaccinated:0000-00-00
Onset:2021-04-17
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Neck pain, Pain in extremity
SMQs:, Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210442509

Write-up: PAIN EXTENDING TO THE NECK; FEELING PAIN FROM SHOULDER TO ARM; This spontaneous report received from a patient concerned a 50 year old male. 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, batch number: 202A21A expiry: 23-JUN-2021) dose was not reported, administered on 09-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 17-APR-2021, the subject experienced pain extending to the neck. On 17-APR-2021, the subject experienced feeling pain from shoulder to arm. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from feeling pain from shoulder to arm, and pain extending to the neck. This report was non-serious.


VAERS ID: 1249640 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-04-16
Onset:2021-04-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040B21A / 2 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Chills, Concussion, Limb injury, Loss of consciousness, Nausea, Pyrexia
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), 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), 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: No adverse event (no medical history)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20210

Write-up: blacked out twice in the morning; felt like they got a concussion; scraped their shoulder in the process; felt weaker than normal and weakness; fever; Chills; Nauseous; This spontaneous case was reported by a consumer and describes the occurrence of LOSS OF CONSCIOUSNESS (blacked out twice in the morning) in a 47-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 040B21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included No adverse event (no medical history). On 16-Apr-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 17-Apr-2021, the patient experienced LOSS OF CONSCIOUSNESS (blacked out twice in the morning) (seriousness criterion medically significant), CONCUSSION (felt like they got a concussion), LIMB INJURY (scraped their shoulder in the process), ASTHENIA (felt weaker than normal and weakness), PYREXIA (fever), CHILLS (Chills) and NAUSEA (Nauseous). The patient was treated with Bed rest (Hydration) for Limb injury. At the time of the report, LOSS OF CONSCIOUSNESS (blacked out twice in the morning), CONCUSSION (felt like they got a concussion), LIMB INJURY (scraped their shoulder in the process), ASTHENIA (felt weaker than normal and weakness), PYREXIA (fever), CHILLS (Chills) and NAUSEA (Nauseous) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. no concomitant medication given patient got hydration and taken rest. Based on the current available information and temporal association between the use of the product and the start date of these events, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of these events, a causal relationship cannot be excluded.


VAERS ID: 1249649 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-19
Onset:2021-04-17
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036A21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Gait disturbance, Intentional dose omission, Peripheral nerve lesion, Stress, Urinary tract infection
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: No adverse reaction
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20210

Write-up: Urinary tract infection; sciatic nerve; stressed; can''t walk; Cancelled 2nd dose because sick in hospital; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of URINARY TRACT INFECTION (Urinary tract infection) in a 77-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 036A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included No adverse reaction. On 19-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 17-Apr-2021, the patient experienced URINARY TRACT INFECTION (Urinary tract infection) (seriousness criterion hospitalization). On an unknown date, the patient experienced PERIPHERAL NERVE LESION (sciatic nerve), STRESS (stressed), GAIT DISTURBANCE (can''t walk) and INTENTIONAL DOSE OMISSION (Cancelled 2nd dose because sick in hospital). The patient was hospitalized on 17-Apr-2021 due to URINARY TRACT INFECTION. At the time of the report, URINARY TRACT INFECTION (Urinary tract infection), PERIPHERAL NERVE LESION (sciatic nerve), STRESS (stressed) and GAIT DISTURBANCE (can''t walk) outcome was unknown and INTENTIONAL DOSE OMISSION (Cancelled 2nd dose because sick in hospital) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route), the reporter did not provide any causality assessments. Concomitant product is not provided. treatment includes IV Antibiotics Bactrim Limited information regarding the events has been provided at this time and a causal relationship cannot be excluded; Sender''s Comments: Limited information regarding the events has been provided at this time and a causal relationship cannot be excluded


VAERS ID: 1249650 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-04-16
Onset:2021-04-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Haemoperitoneum
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: No adverse event (No relevant Medical history Reported)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20210

Write-up: Hemoperitoneum; This spontaneous case was reported by an other health care professional (subsequently medically confirmed) and describes the occurrence of HAEMOPERITONEUM (Hemoperitoneum) in a 39-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient''s past medical history included No adverse event (No relevant Medical history Reported). On 16-Apr-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) at an unspecified dose. On 17-Apr-2021, the patient experienced HAEMOPERITONEUM (Hemoperitoneum) (seriousness criterion hospitalization). The patient was hospitalized on 17-Apr-2021 due to HAEMOPERITONEUM. At the time of the report, HAEMOPERITONEUM (Hemoperitoneum) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. On the night of 16-Apr-2021 into the morning of 17-Apr-2021 patient began to experience severe abdominal pain. CT scan was preformed while the patient was in the emergency room and patient was diagnosed with a hemoperitoneum. The nurse practitioner was unsure of where the bleeding is coming from. Nurse practitioner did not have any information on the patient''s first dose of the Moderna vaccine. The patient was admitted to the hospital. Action taken with mRNA-1273 in response to the event was not applicable. No concomitant medications and treatment details were provided. Company comment: Based on the information provided which includes a strong temporal association between the use of mRNA-1273 vaccine and onset of the reported events, a causal relationship cannot be excluded.; Sender''s Comments: Based on the information provided which includes a strong temporal association between the use of mRNA-1273 vaccine and onset of the reported events, a causal relationship cannot be excluded.


VAERS ID: 1249655 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-03-24
Onset:2021-04-17
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Pneumonia, SARS-CoV-2 test, Secretion discharge
SMQs:, Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (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? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Congestive heart failure
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 2021; Test Name: SARS-CoV-2 RT-PCR; Test Result: Positive
CDC Split Type: USMODERNATX, INC.MOD20210

Write-up: Pneumonia; Positive for COVID; Had a lot of mucous; This spontaneous case was reported by a consumer and describes the occurrence of PNEUMONIA (Pneumonia) and COVID-19 (Positive for COVID) in an 88-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Congestive heart failure. On 24-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 17-Apr-2021, the patient experienced PNEUMONIA (Pneumonia) (seriousness criteria hospitalization and medically significant) and COVID-19 (Positive for COVID) (seriousness criterion hospitalization). On an unknown date, the patient experienced SECRETION DISCHARGE (Had a lot of mucous). The patient was hospitalized from 17-Apr-2021 to 19-Apr-2021 due to COVID-19 and PNEUMONIA. At the time of the report, PNEUMONIA (Pneumonia), COVID-19 (Positive for COVID) and SECRETION DISCHARGE (Had a lot of mucous) outcome was unknown. Not Provided DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): In 2021, SARS-CoV-2 test: Positive. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. There was no treatment information provided. Company comment: Limited information regarding the pneumonia and mucus secretion has been provided at this time and a causal relationship cannot be excluded. Positive Covid test unlikely related to vaccine administration; Sender''s Comments: Limited information regarding the pneumonia and mucus secretion has been provided at this time and a causal relationship cannot be excluded. Positive Covid test unlikely related to vaccine administration


VAERS ID: 1249679 (history)  
Form: Version 2.0  
Age: 95.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-03-17
Onset:2021-04-17
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

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: Medical History/Concurrent Conditions: No adverse event (No medical history was reported)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20210

Write-up: Almost blacks out/when the patient bends down to tie their shoe their dizziness get to the point where the patient almost blacks out; Dizziness/when the patient bends down to tie their shoe their dizziness get to the point where the patient almost blacks out; This spontaneous case was reported by a consumer and describes the occurrence of PRESYNCOPE (Almost blacks out/when the patient bends down to tie their shoe their dizziness get to the point where the patient almost blacks out) in a 95-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 040A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included No adverse event (No medical history was reported). On 17-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 14-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 17-Apr-2021, the patient experienced PRESYNCOPE (Almost blacks out/when the patient bends down to tie their shoe their dizziness get to the point where the patient almost blacks out) (seriousness criterion medically significant) and DIZZINESS (Dizziness/when the patient bends down to tie their shoe their dizziness get to the point where the patient almost blacks out). At the time of the report, PRESYNCOPE (Almost blacks out/when the patient bends down to tie their shoe their dizziness get to the point where the patient almost blacks out) and DIZZINESS (Dizziness/when the patient bends down to tie their shoe their dizziness get to the point where the patient almost blacks out) outcome was unknown. The action taken with mRNA-1273 in response to the events was not applicable. Company comment: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1249792 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-10
Onset:2021-04-17
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Atrial fibrillation, Cerebrovascular accident, Disorientation, Electrocardiogram abnormal, Feeling abnormal, Illiteracy, Impaired driving ability, Magnetic resonance imaging abnormal, Visual impairment
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lipitor, Calciuma, Vitamin C, Vitamin D
Current Illness: None, But did have Covid in 1/2021
Preexisting Conditions: Knee replacement 12/20
Allergies: None
Diagnostic Lab Data: MRI revealed stroke. EKG revealed AFib.
CDC Split Type:

Write-up: Patient complained of not being able to read 1 week after vaccine. 1 week and one day, became very disoriented. Taken to ER on 1 week and 2 days after the shot and diagnosed with a stroke in the left occipital lobe of brain. Also diagnosed with atrial fibrillation same day. (for first time.). Patient had no history of blood clotting disorders nor heart problems. This stroke rendered patient with restricted vision. She is now unable to drive, and still quite foggy, though she is likely to recover almost fully.


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