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From the 10/8/2021 release of VAERS data:

Found 7,946 cases where Vaccine is COVID19 and Manufacturer is JANSSEN and Emergency Room/Doctor Visit



Case Details

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VAERS ID: 1182619 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-02
Onset:2021-04-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anaphylactic reaction, Laboratory test normal, Pharyngeal swelling, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Thyroxine 75 mcg qd Selenium 200 mg qd B Complex qd Vitamin D 1000 IU qd
Current Illness: Hashimoto''s
Preexisting Conditions:
Allergies: Azithromycin, Erythromycin, Biaxin, Amoxicillin, Ceclor, percocet, ibuprofen
Diagnostic Lab Data: Full blood work was run by the emergency room and normal.
CDC Split Type:

Write-up: Anaphylaxis with throat swelling and hives.


VAERS ID: 1182730 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain, Activated partial thromboplastin time shortened, Blood culture negative, Blood lactic acid normal, Chest X-ray normal, Chest pain, Chills, Differential white blood cell count normal, Dyspnoea, Electrocardiogram normal, Fibrin D dimer normal, Full blood count normal, Hyperventilation, International normalised ratio increased, Metabolic function test, N-terminal prohormone brain natriuretic peptide, Prothrombin time prolonged, Tremor, Troponin I, Urine analysis normal
SMQs:, Liver-related coagulation and bleeding disturbances (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: acetaminophen 500 mg TID PRN pain; albuterol 90 mcg/inhalation 2 puffs QID PRN chlorhexidine topical 4% BID PRN folliculitis fluticasone-salmeterol 500 mcg-50 mcg inhalation 1 puff BID lisinopril 10 mg daily warfarin 5 mg daily warfarin 2 m
Current Illness: none
Preexisting Conditions: Factor V Leiden mutation asthma obstructive sleep apnea hypertension morbid obesity folliculitis
Allergies: soy products
Diagnostic Lab Data: 04/08/2021 at emergency room: INR 2.0, PT 21.3, PTT 31 Blood culture x 2 = negative Urinalysis normal lactic acid, comprehensive metabolic panel, CBC with differential, NT proBNP, troponin I ultra sensitive, D-dimer, - all normal chest x-ray unremarkable electrocardiogram 12-lead normal
CDC Split Type:

Write-up: 1:22 AM: chest pain, abdominal cramps, chills, difficulty breathing, hyperpnea, bilateral upper extremity trembling VS: pulse 112, respirations 22, temperature 37.0 Celsius, BP 156/103, O2 sat 99% on room air has history of deep vein thrombosis, pulmonary embolism 1:30 AM sent to emergency room via ambulance 4:00 AM report from emergency room: patient is stable and reported feeling better and breathing easier shortly after arriving to ER. Patient received 500cc NS bolus IV. Labs findings unremarkable. INR 2.0, PT 21.3, PTT 31. Last taken VS -BP 127/71, P109, R20, O2 93%RA. Patient will be discharging with Dx: reaction to COVID vaccine.


VAERS ID: 1182816 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Unresponsive to stimuli
SMQs:, Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: after a couple of minutes of administration of vaccine , patient had difficulty breathing. , became unresponsive. was administered epipen 0.3mg autoinjector , a second dose was administered 5 minutes later. patient became conscious. paramedics took patient to ER


VAERS ID: 1182914 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pharyngeal swelling, Swollen tongue
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: throat swelling, tongue swelling


VAERS ID: 1182928 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-07
Onset:2021-04-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea, Electrocardiogram, Palpitations, Paraesthesia, Tachycardia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Dehydration (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: multivitamin
Current Illness: none
Preexisting Conditions: endometriosis
Allergies: none
Diagnostic Lab Data: EKG
CDC Split Type:

Write-up: at 9 pm after getting J and J covid vaccine, started getting a fast heart rate aound 130bpm, some shortness of breath and tingling. seen by me in urgent care next day, EKG with juntional tachycardia, sent to ED


VAERS ID: 1182937 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-03-27
Onset:2021-03-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Body temperature increased, Cough, Haemoptysis, Respiratory tract congestion, X-ray
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 2 Urgent Care visits, XRay.
CDC Split Type:

Write-up: 103.5 temp for first 4 days. Coughing and chest congestion. Blood with coughing. Urgent Care administered XRay, and listened to lungs, was told unusual sounds coming from bottom of left lung. Temp stayed 102-102.5 even after taking 600 mg ibuprofen for every 6 hours. It has been almost 2 weeks, temp is now 99.4-100.


VAERS ID: 1182980 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Hyperhidrosis, Loss of consciousness, Pallor, Tonic clonic movements
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), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

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

Write-up: The patient had symptoms of light-headedness, diaphoresis, and was pale approximately 8 minutes after administration. No signs or symptoms of anaphylaxis were identified so the patient was observed and monitored. The patient then became unconscious for approximately 10-15 seconds with small jerking movements identified during this time. 911 was called and the patient was monitored until EMS arrived. Epinephrine was prepared and ready during this whole time but was not administered because the patient didn''t show symptoms of anaphylaxis (trouble breathing or talking, trouble swallowing, hives, flushing etc). The time from vaccine administration to EMS arrival was approximately 20-25 minutes. The patient was able to talk and communicate clearly the entire time except during the brief unconscious period.


VAERS ID: 1182996 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-05
Onset:2021-04-07
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood magnesium normal, Fatigue, Full blood count, Haematemesis, Headache, Hunger, Impaired work ability, Lipase normal, Metabolic function test, Nausea, Oropharyngeal pain, Pain in extremity, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Gastrointestinal haemorrhage (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Flonase Breo inhaler Xyzal Ibuprofen
Current Illness: Seasonal allergies
Preexisting Conditions: Asthma Prone to headaches
Allergies: Amoxycilin
Diagnostic Lab Data: All on April 7, 2021: CBC w/Differential Comprehensive Metabolic Panel Lipase Magnesium level POCT Pregnancy Urine, Qualitative All results were normal
CDC Split Type:

Write-up: Vaccination appointment was at 1:30 pm on Monday, April 5. I received the shot at around 2:00pm in my left arm. It hurt going in, but quickly dissipated as I moved my arm. I felt fine for the rest of the day. I felt normal the following morning (April 6), but started to feel tired in the early afternoon. I took a nap around 3:00-4:30pm, and woke up feeling slightly hungry. I went to bed around 11:00pm. I woke up the next day (April 7) with a headache. I called in sick to work and stayed in bed as my headache grew worse and nausea began to appear. I threw up for the first time at 11:00am, then again around 11:30am. I emptied my bowels in between these bouts of vomiting, and my stomach was very obviously empty after the second bout. I took a nap from 12:00-2:00pm, after which I threw up at 2:30pm and then again at 3:00pm and again at 3:30pm. I took another nap from 4:00-5:00pm, then threw up again around 5:30pm. I threw up a seventh time around 6:00pm and saw a couple flecks of blood in my vomit. Each bout was sudden in onset and violent but quick. I think I burst some of the blood vessels in my throat, because it was sore. I called a friend to take me to the ER, and threw up once or twice more while waiting. On the way to the ER, I threw up for the last time. The ER gave me Toradol, Zofran, and two bags of IV fluids. This improved all my symptoms. The next morning, April 8, I felt much better until 12:00pm, when I laid down for a nap and couldn''t get out of bed until 4:30. My headache had returned so I took Advil, then ate some rice. I felt better from 6:00pm onwards.


VAERS ID: 1183032 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-07
Onset:2021-04-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dysphonia, Dyspnoea, Electrocardiogram abnormal, Erythema, Flushing, Hypertension, Paraesthesia oral, Swollen tongue, Throat tightness, Wheezing
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Hypertension (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: MMR vaccine (malaise) age 13. TB SQ test (Hives) last test age 32
Other Medications: At time of vaccine: 04/06/2021 took Topamax 100mg HS @ 2000. 04/07/2021 took Protonix 40mg am @ 0550.
Current Illness: None
Preexisting Conditions: GERD, Migraine (controlled by Topamax)
Allergies: PNC (Hives, SOB), TB SQ test ( Hives), MMR shot (malaise and fatigue), Bumble Bee sting (SOB).
Diagnostic Lab Data: Just ECG monitoring, Blood pressure, O2 sats. No concerns for any other issues due to being able to move air yet.
CDC Split Type:

Write-up: I was held for approx 30 minutes. Drove out and when driving home started to get short of breath, so turned towards the hospital rather than home and called them. My significant other also had his shot, so we switched spots driving at that time. I called the hospital on my way when I started to feel my throat start to close at exactly 1829 on my phone (6:29 pm.). Appointment was at 6pm for shot. Hospital was 13 minutes away. Half way there my tongue started to swell and my lips slightly with tingle. My breathing was more labored to keep up effort as I could not expand my lungs to capacity. I was always able to breath and speak, my voice did become more raspy. Upon ER, Blood Pressure was very Hypertensive around 140s/120s with my respiratory effort to get in. Pulse was stable around 70-80. O2 was 97-99. I was able to lay down and relax my breathing which relaxed my blood pressure to 140s/ 80s. I was given IV Benadryl, IV Dexadron, PO Pepcid with a liter of fluid. Monitor up until after 8pm when I was released with still mild tonge swelling but breathing ok. Continue Benadryl at home with my Epi pen for bees stings available. Did go to work today 07/08/2021. Was wheezy, SOB, no throat swelling, tongue swelling at base. Kept up with Benadryl. Made it 1/2 day and went home. Walking and movement makes increase lung workload. My staff concerned with effort and flush skin while getting supplies. But flush and redness does subside some with rest. When talking need to take a break to breath. But can today notice when Benadryl kicks in. No history of Asthma ever or breathing issues ever. Very active on my farm and at work.


VAERS ID: 1183063 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-03-29
Onset:2021-03-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / SYR
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Fatigue, Headache, Hypoaesthesia, Injection site pain, Laboratory test, Limb discomfort, Mononucleosis heterophile test positive, Muscle spasms, Muscular weakness, Nausea, Neurological symptom, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Mono prev. diagnosed in Dec. 2020. Unaware still had in blood.
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Blood lab work done at the hospital Lab. 3/29/2021. Mono still indicated on blood tests. (Although symptoms of mono were long gone.)
CDC Split Type:

Write-up: He mentioned feeling lightheaded in the car & severe arm pain at the injection site. 5 minutes later experienced cramping sensation in his facial cheeks on both sides. Within 10 more min encountered numbness in his face & his arms began to have sensation of, "dead weight" along w/nausea & unable to move rt. hand. VERY lightheaded all along. We had to travel due to limited supply. His symptoms mimiced a stroke; however, it was determined that it was a severe nuerological reaction & not a stroke. After arrival at the hospital his face felt fully numb & he was unable to smile, like normal. Lower extremities were fine. 102.5 fever next a.m. w/headaches, fatigure and aches that week.


VAERS ID: 1183071 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: we administer Janssen Covid-19 Vaccine , 5 to 10 minutes later the patient fainted in the waiting area. the associate who is watching our patient notified me that the patient is dizzy. I went outside and I noticed that the patient is leaning on the table and he fainted i put him down on the floor and lifted his feet up. he woke up in few seconds we also called 911 and they took the patient to the ER


VAERS ID: 1183160 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / IM

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

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

Write-up: Patient is a 60 year old male who has completed a 45-minute observation period with the following signs and symptoms of an adverse reaction: tingling and numbness around lips area, left arm and bilateral lower extremities 30 minutes after Janssen/J&J COVID-19 vaccine# 1 in series administered. Action(s) taken: Vital sign at 1626 blood pressure ; 153/95, heart rate: 70, respiration ; 16, Spo2: 98 % Repeat Vital sign at 1635: blood pressure ;148/101, heart rate:69, respiration ; 16, Spo2: 98 % - Patient denies chest pain ,shortness of breath, nausea vomiting, diarrhea, abdominal pain, difficulty swallow, headache, dizziness, or vision changes. Action(s) taken: Transferred to higher level of care/urgent care, report given to doctor. Doctor states that he is going to prescribed benadryl and will observed for 30 minutes. Patient advised to follow up with Primary Care Physician


VAERS ID: 1183180 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-07
Onset:2021-04-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Electrocardiogram, Full blood count normal, Palpitations, Tachycardia, Troponin
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal vitamins
Current Illness: No acute illness
Preexisting Conditions: Endometriosis, possible undifferentiated mixed connective tissue disorder
Allergies: None
Diagnostic Lab Data: EKG (4/8/21) - Junctional tachycardia, HR 129 CBC (4/8/21) - within normal limits Pregnancy test neg (4/8/21) TSH/T4 (4/8/21) - normal CMP (4/8/21) - pending Troponin - (4/8/21) - pending
CDC Split Type:

Write-up: Patient reports receiving vaccination at 13:00. At 21:00 she reported feeling heart racing and feeling dizzy and light headed. Went to Urgent care and found to have heart rate 130s-140s. Referred to ER. In ER EKG showed Junctional Tachycardia. She has no previous cardiac history. Did not respond to vagal maneuvers. Gave 1L normal saline and 5mg of metoprolol with return to sinus rhythm with HR of 70. Monitored for any return to arrhythmia.


VAERS ID: 1183208 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chest discomfort, Dizziness, Dysarthria, Dyspnoea, Fatigue, Feeling hot, Flushing, Hypoaesthesia oral, Immediate post-injection reaction, Moaning, Nausea, Retching
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Vestibular disorders (broad), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Pt reported history of anaphylaxis to oral aspirin.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Event took place at an off-site event, in a detention facility. Pt received Janssen COVID vaccine around 4:00 pm. Pt immediately reported nausea. Nurse accompanied pt to the restroom about 2 minutes after receiving vaccine, where she gagged into the sink and spit up a little clear fluid. Pt reported feeling hot and sat down in a chair available in the restroom. Pt and nurse joined by a second nurse. Shortly after sitting down pt complained of feeling dizzy and was moved to the floor to lay down. When laying down, pt appeared flushed under her chin and complained of chest tightness. She requested to sit up to help with breathing. Called 911 and first dose of epinephrine (0.5 mL of 1mg/1mL) administered, both at 4:10 pm. Pt reported no change in chest tightness following epi, but continued to respond to questions. She said she felt tired and wanted to go to sleep. Pt continued to report difficulty breathing, and another dose of epinephrine administered at 4:15 pm. A physician at GEO arrived and administered oxygen. He listened to pt''s heart and lungs and reported that there was air movement in her lungs. Pt ceased to respond coherently to questions, slurring and moaning, but did not lose consciousness. Pt started tapping her lips and, upon questioning, said they felt numb. Third dose of epinephrine administered at 4:20 pm. Nurse continued to jostle patient and ask her questions, and patient continued to respond with short, slurred answers. EMS arrived at 4:23 pm and transported patient to the hospital.


VAERS ID: 1183213 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-04-06
Onset:2021-04-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram, Concussion, Full blood count, Loss of consciousness, Nausea, Neck injury, Skin laceration
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), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid Multivitamin
Current Illness: None
Preexisting Conditions: History of thyroid cancer
Allergies: None
Diagnostic Lab Data: CT of spine CT neck Cbc
CDC Split Type:

Write-up: Next day Nausea then passing out resulting in large facial laceration (multiple stitches needed), neck injury and concussion


VAERS ID: 1183324 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-07
Onset:2021-04-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Amnesia, Blood pressure decreased, Chest X-ray, Heart rate increased, Laboratory test, Pallor, Syncope, Vital signs measurement
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown to reporter but client had said he took a tablet of aspirin that morning
Current Illness: unknown to reporter , client had not stated any
Preexisting Conditions: unknown to reporter
Allergies: unknown to reporter client said he had never had any reaction of any kind to any medication
Diagnostic Lab Data: EMS TOOK PATIENT TO THE HOSPITAL. WHEN I SPOKE WITH HIM LATER THAT DAY, HE SAID HIS CHEST XRAY, AND ALL OTHER TESTS AT THE HOSPITAL WERE REPORTED NORMAL
CDC Split Type:

Write-up: PATIENT WAS SITTING IN A CHAIR, HEAD BENT FORWARD, AND HE WAS PALE, WITH A 50 PULSE AS READ FROM HIS PHONE THEN WENT BACK UP TO 80 . (PATIENT REPORTS HE FELT A ''RUSH" AFTER THE SHOT, THE LAST THING HE REMEMBERED WAS SEEING HIS HR SHOOT UP TO 100 . HIS BLOOD PRESSURE WAS 97/70


VAERS ID: 1183405 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chest pain, Dizziness, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness:
Preexisting Conditions: Hypothyroidism
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt received the vaccine where patient started to have Chest Pain, sob, and dizziness. Ems was called to pt''s bedside. Pts symptoms continue and patient wished to be seen in ER. EMS took patient as requested.


VAERS ID: 1183437 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-14
Onset:2021-03-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Anxiety, Feeling hot, Hyperhidrosis, Tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: tachycardia, hot sweats, anxiety Patient was hospitalized


VAERS ID: 1183462 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-03-19
Onset:2021-04-01
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blue toe syndrome, Computerised tomogram, Epistaxis, Erythema, Fatigue, Headache, Immune thrombocytopenia, Immunoglobulin therapy, Migraine, Miliaria, Mouth haemorrhage, Oral mucosal blistering, Platelet count increased, Platelet transfusion, Rash, Rash macular, Tongue blistering
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (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: N/a
Current Illness: N/a
Preexisting Conditions: N/a
Allergies: N/a
Diagnostic Lab Data: At the emergency room on 4/4/21 I was given a CAT scan to rule out bleeding in the brain. Bloodwork was done and platelet count was 8,000. I was confined to a bed and told I was too high risk to walk, as a fall or even the slightest injury could have been catastrophic. I have never had any blood disorders in the past or issues prior. I was admitted to the hospital and diagnosed with ITP (Acute Thrombocytopenia). I was given 3 platelet transfusions each lasting 2.5 hours and two rounds of immunoglobulin (4 hours each round). Steroid 40mg a day for 4 days. I was in the hospital until Wednesday the 7th. When I was released my platelet levels were back up to 69,000 still a long way from normal. I still have to go in every couple days for bloodwork to monitor platelet levels.
CDC Split Type:

Write-up: Headaches, migraines, and tired after vaccine for 2 weeks. 14th day after vaccine noticed some red spots on leg that looked similar to a heat rash and over the next 24 hours entire legs were covered in red dots and feet were almost solid purple. On the morning of 16th day constant nose bleed and multiple blood blisters in mouth inside cheeks and all over tongue. Blood was coming from mouth. At that point legs were covered in dark red almost purple and spreading to chest, back, and arms.


VAERS ID: 1183538 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-03-25
Onset:2021-04-08
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Chest X-ray normal, Chest pain, Cyanosis, Dyspnoea, Electrocardiogram normal, SARS-CoV-2 test, Troponin normal
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none reported
Current Illness: none
Preexisting Conditions: asthma per chart review (patient denies)
Allergies: no known allergies
Diagnostic Lab Data: 3/28 - ECG, chest x-ray, troponin, COVID swab. No abnormal findings. 4/5 - ECG with no abnormal findings.
CDC Split Type:

Write-up: Cyanosis to fingers and hands bilaterally with blueness noted lasting an hour on two separate occasions - 4/5/2021 and 4/8/2021. Patient monitored with no signs of central cyanosis or other problems. Discharged home to follow-up with PCP. Patient also reported chest pain and dyspnea on 3/28/2021, 3 days after vaccine with no emergent findings.


VAERS ID: 1183546 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-03-31
Onset:2021-04-07
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin HCL 500MG Lisinopril/HCTZ 10-12.5
Current Illness:
Preexisting Conditions: High blood pressure pre diabetes over weight
Allergies: Amoxicillin, rash and upset stomach
Diagnostic Lab Data:
CDC Split Type:

Write-up: Rash, Hives


VAERS ID: 1183564 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-07
Onset:2021-04-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Dizziness, Dyspnoea, Vision blurred
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Brief minor light headednes for about 10-15 minutes after receiving the flu shot
Other Medications: Vyvanse , lamotragin, vitamin d
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Dizzy, light headed, blurred vision, weakness, difficulty breathing: these lasted more severely about 2 hours after the vaccination and then got worse again the next day which is when I ended up going to the emergency room. I was given benadryl a steroid and a antihistamine there.


VAERS ID: 1183597 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-11
Onset:2021-03-20
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / N/A LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Depressed mood, Dyspnoea, Oropharyngeal pain, Pyrexia, SARS-CoV-2 test negative, Streptococcus test negative
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Depression (excl suicide and self injury) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Thyroid supplement, multivitamins, Vit D3
Current Illness: None
Preexisting Conditions: Sarcoidosis
Allergies: Allergic to Propylene Glycol, Sulpha drugs, Erythromycin
Diagnostic Lab Data: General vitals, covid test, strep test. Vitals looked good except for low grade fever, covd and strep test came negative
CDC Split Type:

Write-up: Continued fever, heaviness in my chest, breathlessness, sore throat, feeling really down


VAERS ID: 1183605 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / UNK AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D.
Current Illness: unknown. Possibly Graves disease
Preexisting Conditions: unknown. Possibly Graves disease
Allergies: Bee Sting, Iodine, Vicodin
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: N/V immediately post vaccination 1:13 pm. Paramedics consulted. BP 151/103 ~1:18 pm Pt in some distress/SOB and showing inc RR. Reports no other symptoms. Continues to vommit. A/O. Diphenhydramine 50 mg IM RD administered, no improvement. Patient remains SAME, sxs neither improved or worsened. BP: 106 / 78 1:24 pm Pulse 48 1:24 pm Hx allergy: Norco, Bee Sting, Iodine PHI: possibly Graves, patient unable to verbally verify Meds: Vitamin D. Transport to ER at 1:28 pm


VAERS ID: 1183607 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2020-04-08
Onset:2020-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Feeling cold, Pain, Pain in extremity
SMQs:, 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: Pulmonary stenosis
Allergies: None
Diagnostic Lab Data: None at the moment
CDC Split Type:

Write-up: About 12:30 AM on 04/09/2020 patient started shivering and the intensity has increased since then. She started feeling really cold around 12:45 AM and started having pain in both legs and the right side of her torso around that same time. We are currently headed to the ER.


VAERS ID: 1183642 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: MELATONIN AND ABILIFY
Current Illness: NONE
Preexisting Conditions: OBESITY AND ACNE
Allergies: PEANUTS, LACTOSE, GLUTEN
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: CHILLS. FATIGUE, HEADACHE, FEVER 101.5 F


VAERS ID: 1183644 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-03-19
Onset:2021-03-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 180518 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Arterial occlusive disease, Arthralgia, Asthenia, Atrial fibrillation, Blood culture, Burning sensation, Chest X-ray, Computerised tomogram, Dyspnoea, Headache, Hyperhidrosis, Hypertension, Hypoxia, Infection, Laboratory test, Pain, Peripheral vascular disorder, Pyrexia, Rash, Skin discolouration, Sputum culture, Tachycardia, Thrombosis, Tunnel vision, Ultrasound scan, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Hypertension (narrow), Optic nerve disorders (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Retinal disorders (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Arthritis (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (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, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Plavix 75mg daily Aspirin 81 mg daily
Current Illness: None
Preexisting Conditions: COPD CAD
Allergies: Xanax
Diagnostic Lab Data: Multiple lab tests sputum culture Blood cultures Chest x-rays multiple CT scans multiple Ultrasounds
CDC Split Type:

Write-up: Shortness of breath, hypertension, hypoxia, tachycardia, lips and fingers turn blue, high fever, rash, hives, joint pain, whole body aches, left lower leg burning, artery blockages, infection, weakness, dizziness, tunnel vision, sweating, headache, new onset atrial fibrillation with rvr All of the above symptoms first occurred 30 minutes after injection of vaccine The atrial fibrillation occurred 6 days after injection Left lower leg started burning 15 days after injection The artial blockages and thrombus 18 days after injection by medical diagnosis due to instantaneous shut off of blood to left leg


VAERS ID: 1183746 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-04-03
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Malaise, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210407320

Write-up: VOMITING; FEELING SICK; This spontaneous report received from a consumer 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 was not reported, administered on 03-APR-2021 for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On 03-APR-2021, the subject experienced vomiting. On 03-APR-2021, the subject experienced feeling sick. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from vomiting, and the outcome of feeling sick was not reported. This report was non-serious.; Sender''s Comments: V0: Medical assessment comment is not required as per standard procedure as case assessed as non-serious.


VAERS ID: 1183867 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain upper, Dizziness, Hypoaesthesia oral, Lip swelling, Oropharyngeal pain, Somnolence, Swelling face, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: bupropion 150mg - 1 tablet daily Vitamin D 5000 units -- 1 tablet daily Claritin - 1 tablet daily
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Medications: Levaquin, Zithromax, Augmentin, Percocet, Vicodin, Tramadol Seasonal allergies - Trees, grass, pollen, hay Cat allergy
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: 4/8/2021 3:00pm, 1 hour after vaccine stomach ache, drowsiness, and dizziness/lightheaded 4/8/2021 8:00pm, 6 hours after vaccine numb tongue, swollen face - allergic reaction -- took 1 25mg Benadryl 4/8/2021 10:00pm, 8hours after vaccine swollen face, throat tightness, swollen face, sore throat- allergic reaction -- went to ER given Pepcid, Benadryl, and steroid -- also prescribed these items for next 3 days. 4/9/2021 6:20am - following morning lips swelling - took 1 25mg benadryl


VAERS ID: 1184020 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-01
Onset:2021-04-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, Dizziness, Fatigue, Nausea, Nightmare, Pyrexia, Sleep disorder, Tremor, Urticaria, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth control (Drospirenone and Ethinyl Estradiol Tablets, USP 3 mg/0.02 mg), Aller-Fex
Current Illness: None
Preexisting Conditions: Menorrhagia, PTSD
Allergies: Allergies to amoxycillin, dairy, animals, and environmental allergies such as dust mites and pollen
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hives on my arms and stomach developed within 15 minutes of receiving the vaccine at 2:16. I left the facility after 30 minutes because the hives did not get any worse and I did not experience any other symptoms. At home about 8 hours later, I started feeling exhausted, weak, and my body was literally shaking whenever I stood. Overnight, I felt feverish, I had the worst nightmares, and woke up every few hours. On Friday (next day) I felt dizzy whenever I moved, nauseous whenever I stood, and once when I was standing too long I started vomiting. On Friday evening I went to a local ER (all the urgent cares were closed) at my primary care Dr?s suggestion to ensure that I wasn?t having an allergic reaction to the vaccine. The ER determined that the hives were likely an allergic reaction but all other symptoms were reactions due to the vaccine.


VAERS ID: 1184028 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

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

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

Write-up: Systemic: Confusion-Medium, Systemic: Dizziness / Lightheadness-Medium, Systemic: Shakiness-Medium, Systemic: Visual Changes/Disturbances-Medium, Additional Details: patient was taken by ambulance to ER


VAERS ID: 1184181 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

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

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

Write-up: She needed some air . Stepped out of the store and while talking to her she was dizzy lightheaded and had nausea . no problem with allergies . Just dizzy . takes a few seconds to respond to questions. Paramedics came and took over.


VAERS ID: 1184193 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-03-17
Onset:2021-03-24
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 10805031 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Anaphylactic reaction, Dizziness, Dyspnoea, Headache, Rash, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Anticholinergic syndrome (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: ER visit. Sent home and told to take Benadryl ER visit 12 hours later, received IV with a Steroid and a Pepcid.
CDC Split Type:

Write-up: At roughly 6 days after vaccination my body developed Hives head to toe. Roughly 18 or so hours after initial hive development I sought treatment for a anaphylactic reaction in my throat and face area. I received a steroid and a Pepcid to calm it down, and was given an epi pen and sent on my way. The following now two plus weeks since then I''ve had episodes of dizziness, shortness of breath and headaches that seem to be constant. There has been almost no relief from these symptoms, however the rash has completely resided. I''ve taken an Aspirin in the mornings to deal with the headaches but strenuous activity seems to bring these on much more prominently.


VAERS ID: 1184254 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Confusional state, Dizziness, Fall, Flushing, Head injury, Hyperhidrosis, Nausea, Neck injury, Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Dizziness / Lightheadness-Mild, Systemic: Fainting / Unresponsive-Mild, Systemic: Flushed / Sweating-Mild, Systemic: Nausea-Mild, Systemic: Vomiting-Mild, Additional Details: After administration of vaccine, patient was still seated in the waiting area. I went back and checked on him after 5mins of waiting, then came back to the pharmacy. But heard a big bang shortly after. Some how, he had fallen out of his chair and bumped his head and neck on an end camp. He seemed a little confused, when I ran over, but was awake, a little sweaty and nauseated. EMS was called. They transported him to ER to have his head checked, since he bumped it.


VAERS ID: 1184260 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-03
Onset:2021-04-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain lower, Blood test normal, Malaise, Pain in extremity, Pyrexia, Ultrasound abdomen normal, Urine analysis normal
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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:
Current Illness:
Preexisting Conditions:
Allergies: shelfish ondansetron bactroban ointment veregen ointment apexicon cream
Diagnostic Lab Data: Ultrasound 4/3 and CT 4/4 Negative for appendicitis, Blood work normal 4/3, Urinalysis normal 4/3.
CDC Split Type:

Write-up: fever 102.9 bilateral arm pain severe lower right abdominal pain feels unwell IV hidration, advil, tylenol, ultrasound abdominal, CT scan, were given. Patient is better except for continued temperature of 100.4 in the evenings.


VAERS ID: 1184261 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chills, Cold sweat, Dizziness, Flushing, Hyperhidrosis, Hypotension, Pyrexia, Syncope, Tremor, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: Systemic: Chills-Severe, Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Medium, Systemic: Fever-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Hypotension-Medium, Systemic: Shakiness-Medium, Systemic: Weakness-Medium, Additional Details: Shortly after administration of the vaccine (~3 min) pt started shaking, sweating, looking flushed, feeling clammy, dizziness, lightheaded and briefly fainted. Pt was put on the floor and legs were elevated, given water and a snack and started feeling better. 911 was called and an evaluation was done.


VAERS ID: 1184280 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-07
Onset:2021-04-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Cold sweat, Computerised tomogram normal, Pallor, Seizure, Tonic clonic movements
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

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

Write-up: After vaccination, nurse observed seizure activity while patient sitting in chair. Tonic-clonic motion in arms. Seizure activity lasted approximately 3-4 minutes. Skin pale, cool and clammy. Blood pressure 94/72, pulse 68. Respirations 16. O2 sat 97%. EMS called and patient was transported for evaluation. Follow up phone call to patient 4/7 at approx. 5 pm. Patient resting. Stated she had negative CT at the hospital and has neurology appointment tomorrow, 4/8. Follow up phone call will be placed 4/8 after neuro appointment.


VAERS ID: 1184304 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-07
Onset:2021-04-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Apnoeic attack, Electrocardiogram normal, Feeling abnormal, Pallor, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Dementia (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Respiratory failure (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none known
Current Illness: none
Preexisting Conditions: none
Allergies: none known
Diagnostic Lab Data: Patient had an EKG that was normal, and was held for observation for 1 1/2 hours
CDC Split Type:

Write-up: Within 3 minutes after vaccine patient expressed she was going to "pass out" medics guided her to the floor. Medics and local EMS were present. Patient was unresponsive and apneic w/ ashen color skin, EMS began stimulation efforts. Patient began to arouse and breathe within 3 minutes of efforts. Patient was transported to hospital.


VAERS ID: 1184327 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-03-06
Onset:2021-03-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthma, Chills, Condition aggravated, Dyspnoea, Injection site pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Breo ellipta, Albuterol (for asthma)
Current Illness: N/A
Preexisting Conditions: Asthma Allergies
Allergies: Augmentin
Diagnostic Lab Data: March 15 - covid test, xray
CDC Split Type:

Write-up: Typical side effects of fever, chills, injection site pain began 12 hours after the shot. 24 hours after the shot, my breathing got gradually worse. It was like an asthma attack, but normally my asthma attacks are caused by a sinus infection. This was just shortness of breath and gasping for air. I used my rescue inhaler with increasing frequency over the course of the following week. By March 12, I had to use my nebulizer. I used the nebulizer once on March 12, twice on March 13, twice on March 14, and I finally went to urgent care on March 15 when the nebulizer stopped helping. Urgent care was unable to help due to covid protocols, so they put me on oxygen for 5 minutes and transferred me to the ER. At the ER, by the time I got to the ER, my breathing had normalized. I was given prednisone on site, as well as a prescription for 5 days. I had a chest xray done that returned completely normal.


VAERS ID: 1184426 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-03-14
Onset:2021-03-28
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Computerised tomogram neck, Herpes ophthalmic, Herpes virus infection, Herpes zoster, Lymphadenopathy, Neck mass, Pain in jaw, Skin lesion, Viral rash, Viral test
SMQs:, Osteonecrosis (broad), Ocular infections (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Citalopram 20 mg, pantoprazole 40 mg
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: CT scan w/contrast, blood work at er on 4/2/21- CT determined that the lump is a lymphoid. . Swab of forehead lesions on 4/5/21 - waiting on results.
CDC Split Type:

Write-up: 3/28/21 started to have jaw pain. 4/2/21 a lump started to form in neck. 4/3/21 lump in the neck and evening broke out with lesions on the left side of forehead, nose and temple. Went to ER for evaluation, CT scan with contrast. CT confirmed lump was swelling of lymphoid. ER thought maybe shingles, but it crosses over slightly over to the right with lesions.They determined maybe a virus and follow up with a dermatologist. 4/4/21 lesions now on left eye lid. ER visit again to ensure eye is ok, the ER dr. believes its shingles. 4/5/21 visit to dermatology and swab of lesions on face taken (still waiting on results). Dermatology believes some kind of herpes, but not sure. Went to Eye specialist to ensure eye does not have virus on same day. Eye dr believes shingles. Virus is not in the eye, but on left eyelid.


VAERS ID: 1184575 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Wyoming  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: COVID-19, Dyspnoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Infective pneumonia (broad), 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
Preexisting Conditions: Hx TIA, Memory loss, dizziness, COPD/Emphysema, chronic respiratory failure with hypoxia, anxiety, depression
Allergies: None
Diagnostic Lab Data: COVID-19 test, unknown others
CDC Split Type:

Write-up: The patient had already received a dose of Moderna vaccine on 01/28/21- Lot #030L20A The patient tolerated vaccine well during observation period. No signs/symptoms of adverse reaction. Assisted Living Facility reported on 4/9/21 that the patient was seen at ER the night of immunization with increased shortness of breath and was diagnosed with COVID-19 and released back to facility


VAERS ID: 1184672 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Disorientation, Dyspnoea, Eye movement disorder, Heart rate decreased, Hyperhidrosis, Loss of consciousness, Malaise, Posture abnormal, Presyncope, Pulse abnormal
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: HIGH BLOOD PRESSURE
Allergies: NONE
Diagnostic Lab Data: HEART MONITORING AND BLOOD WORK DONE AT ER. PULSE NEVER GOT OUT OF THE 60''S PER WIFE AND NEVER HAD A MAJOR BP INCREASE EVEN AFTER EPI ADMINISTRATION. PATIENT STATES HE HAS PASSED OUT BEFORE WHEN CONSTRICTED BEHIND A MASK. PATIENT DID NOT HAVE A MASK ON AT ADMINISTRATION OF SHOT.
CDC Split Type:

Write-up: PATIENT LOOKED AT WIFE AND SAID I DON''T FEEL RIGHT, AS I WAS CALLED BACK TO THE CAR HIS HEAD BEGAN TO ROLE FORWARDS, THEN IN A CIRCULAR MOTION. HIS EYES ROLLED BACK IN HIS HEAD AND HE MADE A GASP FOR BREATH THEN PASSED OUT. EPI PEN WAS IMMEDIATELY ADMINISTERED. PATIENT BECAME MORE RESPONSIVE, LAID SEAT BACK IN CAR. PATIENT SWEATING , COULD NOW SPEAK TO ME BUT STILL SOMEWHAT DISORIENTED. VERY FAINT PULSE. 911 WAS CALLED AND COOL WET PAPER TOWEL PLACED ON HIS NECK AND OBSERVED UNTIL 911 ARRIVED WITHIN 5-10 MINUTES. PATIENT TRANSPORTED TO ER DUE TO VERY LOW PULSE EVEN AFTER EPI ADMINISTRATION. PATIENT REMAINED AT ER UNTIL 1:30 PM FOR MONITORING. THEY TRULY FELT IS WAS A VASOVAGUL REACTION. PATIENT WAS OUTSIDE WORKING IN YARD AT 6:30PM WHEN I CALLED TO CHECK ON HIM, HAS NO RECOLLECTION OF RECEIVING SHOT OR EPI PEN, JUST SAID HE REMEMBERS MEDICINE FEELING "HOT" GOING DOWN HIS ARM.


VAERS ID: 1184725 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-04-01
Onset:2021-04-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Electrocardiogram, Headache, Nausea, Pain, Palpitations, Pyrexia, Sleep disorder
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), 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: Multivitamin 50+, digestive enzymes
Current Illness: No
Preexisting Conditions: ITP, Raynaud''s syndrome
Allergies: adhesives, gluten sensitivity(will induce pancreatitis)
Diagnostic Lab Data: EKG x2- Southern Maine Medical Center April 2, 2022
CDC Split Type:

Write-up: Eight hours post injection very rapid of fever, severe headache, aches and nausea. At 12 hours, I awoke with HR above 150. After it not resolving within 5 minute, I went to the ER. Rate had gone down by arrival but EKG showed depressed ST waves. By second EKG, two hours later., it looked normal. I since have had bouts of a racing heart both during day and awaking from sleep.


VAERS ID: 1184758 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Blood pressure measurement, Heart rate, Oxygen saturation, Oxygen therapy, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Hypersensitivity (broad), Respiratory failure (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: citalopram 20 mg tablet Take 0.5 tablets every day by oral route for 30 days. losartan 50 mg tablet
Current Illness:
Preexisting Conditions: chronic anemia microcytosis - constipation essential hypertension gastroduodenitis generalized anxiety disorder lump on finger mild intermittent asthma obesity paroxysmal vertigo posttraumatic stress disorder
Allergies: Penicillins - anaphylaxis
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was observed by staff after receiving Janssen COVID19 Vaccination. During observation patient reported: Other: pt reported throat tightness approx. 10" after Janssen Covid-19 vaccine injection, anxious it may be an allergic reaction; pt. moved to stretcher, head down, feet up, oxygen 4L via NC applied, 9:15am Epinephrine 0.3mL administered IM to left glut., BP 130/104, pulse 76, pulse ox 99; 9:20 am ambulance called, BP 128/94-74, pulse ox 99; ambulance arrived at 9:30am, 9:34 am pt. transferred to ambulance stretcher with head at ~90 degrees, patient was continuously monitored by FNP, RN. and CNA -- until patient transferred to ambulance at 9:35am for transport to hospital. Pt. has hx of similar symptoms to PCN.


VAERS ID: 1184767 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: New Hampshire  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hyperhidrosis, Loss of consciousness, Seizure like phenomena
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), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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

Write-up: Patient passed out within a couple minutes of injection, had seizure like activity, was sweating. He was alert shortly after. Ambulance came and took the patient


VAERS ID: 1184820 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Loss of consciousness, Nausea, Pallor
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), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Patient reported getting dizzy and nauseous with a influenza vaccine a few years ago
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: None
Diagnostic Lab Data: EMT checked blood pressure and vitals and they were stable. Patient went to emergency room for further evaluation and was cleared.
CDC Split Type:

Write-up: After vaccine he reported being nauseous and dizzy. He got very pale and about 5 minutes after the vaccine he passed out. He came back after about a minute. EMT was called to check patient. Vitals were stable.


VAERS ID: 1184886 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

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

Write-up: pt states she developed chest pain and pressure last evening after receiving Johnson and Johnson covid vaccine and worse today -- pressure and sharp pains - and hurts to breathe


VAERS ID: 1184931 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dry mouth, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Per patient, reaction to influenza. Date unknown.
Other Medications: Zyrtec, Vit D3, Tolteridine Tartrate ER, Synthroid, Nexium, Lisinopril, Hydrixizine, HCTZ, gabapentin, fluoxetidine, fluconazole, fentanyl patch, estradiol, ergocalciferol, diazapam, advair discus, flonase.
Current Illness: None
Preexisting Conditions: Unknown
Allergies: Propulsid, Iodine, latex, bee stings, steroids, tomatoes, shellfish, oral contrast, gatorade, amocicillin, avelox, baclofen, elmiron, erythromycin, hydrocodone, acetaminophen, mucinex, naratriptan, nasonex, oxycontin, prednisone, rizatriptan benzoate, sumatriptan, tetracycline, tramadol, zanaflex, influenza vaccine, higher dose penicillins.
Diagnostic Lab Data: Unknown, as patient was brought to the emergency department.
CDC Split Type:

Write-up: Patient complained of feeling a dry mouth and blurry vision. She felt that this was a sign of an allergic reaction. EPI pen was administered and patient was brought to the emergency room.


VAERS ID: 1184942 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-04-01
Onset:2021-04-04
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / N/A - / SYR

Administered by: Other       Purchased by: ?
Symptoms: Oropharyngeal pain, Streptococcus test negative
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Multi-Vitamin - daily
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: strep culture - negative - 4/4/201
CDC Split Type: vsafe

Write-up: Severe sore throat - sharp pain; viral in nature of unknown origin. Nurse Practitioner at the Urgent Care - April 4th- said it looked like a stress reaction possibly to the vaccine - ant-viral was prescribed. The anti-viral resolved the symptoms.


VAERS ID: 1184971 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-06
Onset:2021-04-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Burning sensation, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Ibuprofen 1 hr before allergic reaction. Hives covering most of body.
Current Illness: 1 week b4 receiving vaccine I had a root canal, and filling replaced
Preexisting Conditions: None
Allergies: Cillin family
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Hives start forming 12 hours after receiving vaccine. When I woke up in the morning my body was covered in hives. I went to e.r. in the night as advised by my doctor. They gave me a oral steroid, a pepcid and some benadryl, also gave me prescriptions. When I woke up the next morning hives had mostly gone away, but returned later that evening due to not picking up prescription from pharmacy. I have it now and am taking them. I still get itchy and have some burning but it''s very minor and a little more tolerable with the medications.


VAERS ID: 1185043 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-03-08
Onset:2021-03-14
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Lymphadenopathy, Pain, Tenderness
SMQs:, 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: clonidine, minoxidil, spironolactone, metoprolol
Current Illness:
Preexisting Conditions: hbp
Allergies: irbestarn
Diagnostic Lab Data:
CDC Split Type:

Write-up: sore to touch, lympnodes swollen


VAERS ID: 1185109 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-03-10
Onset:2021-03-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blister, Facial paralysis, Herpes zoster, Herpes zoster oticus, Lip pain, Oral pain, Pain
SMQs:, Severe cutaneous adverse reactions (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad), Hypersensitivity (broad), Opportunistic infections (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: I take vitamins everyday.
Current Illness: No
Preexisting Conditions: No
Allergies: I am allergic to tetnis.
Diagnostic Lab Data: No
CDC Split Type: vsafe

Write-up: Friday morning after the shot, I noticed I had a sore on the roof of my mouth and on my lip. As the day went on, I had more sore in my mouth. Saturday morning, I had more blisters. On Tuesday, I went to my PCP, he felt like I was turning the corner and thanked me for coming in. Tuesday night, it was bad. I called the pharmacy and they advised calling my doctor. I called the doctor and talked to the nurse but my doctor was out of town. Late Wednesday night, I picked up a script to rinse my mouth with. On Friday, I went to the ED and was diagnosed with Shingles and went to a different doctor for treament and was given medicine. I had pain even when using the ear drops. I stopped the ear drops as directed. I developed paralysis on the right side of my face. I went to an UC you was diagnosed with Ramsey Hunt Syndrome.


VAERS ID: 1185168 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-04-01
Onset:2021-04-07
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chills, Full blood count, Headache, Hypersensitivity, Metabolic function test, Nausea, Petechiae, Skin warm, Tenderness, Vasculitis
SMQs:, Acute pancreatitis (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vasculitis (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NA
Current Illness: NA
Preexisting Conditions: Intermittent Asthma
Allergies: Amoxicillin Erythromycin Shellfish hazelnuts cashews
Diagnostic Lab Data: At ER - CBC CHEM 7 Standard inflammatory marker panel. All returned Normal.
CDC Split Type:

Write-up: Visited ER as I thought I was having an allergic reaction. Treated with Pepcid, prescribed prednisone and streeted. Visited personal allergy physician 4/9/21. per MD Allergist/Immunologist DXd = systemic immunological vasculitis. Most probably a delayed hyper immune response to my vaccine. Legs, arms and sides covered in innumerable petechial eruptions beginning 6 days post vaccination and 3 days post vaccination side effects (chills, headache nausea) subsided. Eruptions spread consistently for 36 hours and are constant not intermittent. They are hot, painful to the touch, and do not blanch. I?m on 60mgs of prednisone for 5 days (the highest dose given outside a hospital) and then 40 for 5 days and then 20 for 4 days. If I get any mouth nose or eye or interior genital irritation I have to go to the hospital and be admitted for higher dose steroids and constant monitoring. Dr advised this will take weeks to resolve and the eruptions will likely fade slowly and possibly peel.


VAERS ID: 1185192 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / N/A LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Generalised tonic-clonic seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

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

Write-up: Tonic/Clonic seizure, 2 in a row. Hx of seizures.


VAERS ID: 1185198 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Hypoaesthesia oral, Mouth swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (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: side of mouth swelling, side of mouth numb. Evaluated by EMS- Transported to Emergency room/department or urgent care.


VAERS ID: 1185213 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 OT / IM

Administered by: Unknown       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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: lightheaded/dizzy, generalized weakness. Evaluated by EMS-Transported to Emergency room/department or urgent care.


VAERS ID: 1185242 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Dyspnoea, Flushing
SMQs:, Anaphylactic reaction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Asthma, diabetes
Allergies: Codeine, Penicillin, Serum, and vaccines allergy
Diagnostic Lab Data:
CDC Split Type:

Write-up: Difficulty breathing, anxiety, flushed skin.


VAERS ID: 1185249 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-07
Onset:2021-04-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysphagia, Eye pain, Facial pain, Feeling abnormal, Hypoaesthesia, Muscle twitching, Ocular discomfort, Paralysis, Pharyngeal hypoaesthesia, Reduced facial expression, Swelling face, Taste disorder, Vision blurred
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Dementia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitafusion women?s multivitamin Allopurinol - 300mg Culturelle
Current Illness: None
Preexisting Conditions: Gout
Allergies: Penicillin
Diagnostic Lab Data: Physical exam in emergency room 04/07/2021 Cat scan scheduled 04/09/2021
CDC Split Type:

Write-up: Taste of medicine in mouth/throat - 1:30pm Swelling and numbing of right side of face begins - 2:30pm Benadryl taken - 2:53pm Numbing spread to both sides of throat, difficulty swallowing - 3:15pm 24/7 Nurse Hotline at Medical Center called - 3:16pm Nurse hotline advised to call 911 immediately Paramedics arrive - 3:23pm Bell?s palsy symptoms begin - 3:25pm Transported via ambulance to Emergency Room - 3:26pm Bell?s palsy worsens, facial contractions continue Prednisone given in emergency room Prescription of Methylprednisolone Tablets, USP is prescribed for 6 days, 21 pills, 4mg each Continue use of 25mg of Benadryl as needed Follow up with neurologist recommended and scheduled for 04/09/2021 Day 2, 04/08/2021 - slept off and on, felt terrible, facial twitching, forehead pain from twitching, right eye uncomfortable. Day 3, current day, waiting to see neurologist, right eye pain increasing and blurriness of vision in that eye.


VAERS ID: 1185263 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Eye movement disorder, Fall, Immediate post-injection reaction, Syncope, Tonic clonic movements
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Accidents and injuries (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)

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

Write-up: Patient given COVID J&J vaccine and within a minute complained of being dizzy/faint. While seated, patient fainted, eyes rolled, arms and hands clonic/tonic activity which caused him to fall from chair. Doctor was able to hold on to upper back of patient as both fell to the floor. Patient hit head on carpet with not traumatic injury. 911 was called and by time of paramedic arrival the patient was alert and oriented. Patient was assited to wheelchair and taken to ED for evaluation.


VAERS ID: 1185264 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Dysphonia, Feeling abnormal, Pallor, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 9:40 BP 73/56, HR 50, O2 95% 10:05 BP 70/systolic HR 47
CDC Split Type:

Write-up: 9:45 c/o dizziness, "foggy" brain 9:48 throat tightness, pale lips 9:50 epi injection 9:52 Benadryl 50mg IM 9:58 throat sill tight, speech slightly hoarse 10:05 A + O x3, Throat tightness, speech clear EMS transported to ER


VAERS ID: 1185281 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Throat tightness, Tremor
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalopathy/delirium (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

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

Write-up: After vaccine patient felt like her throat was tightening up - very shaky. states she is allergic to morphine and felt like this was a similar reaction. Says this reaction is not as fast but she feels it. We were with patient for approximately 30 minutes and she presented as stable. Patient was ultimately transported to a local hospital by EMS


VAERS ID: 1185312 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Swollen tongue
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: The feeling of anxiety and swelling of tongue


VAERS ID: 1185326 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-25
Onset:2021-03-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN RX#137414-1401 / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Blood test, Chills, Electrocardiogram, Feeling hot, Headache, Hypoaesthesia, Impaired driving ability, Loss of consciousness, Nausea, Pain, Pyrexia, Respiratory rate increased, Seizure, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro 20 mg daily
Current Illness: None
Preexisting Conditions: None
Allergies: Levaquin
Diagnostic Lab Data: Bloodwork, EKG, followed up with primary and have been referred to a neurologist for follow-up testing.
CDC Split Type:

Write-up: 2:00pm - headache and body aces started 5:30pm- headache, body aches, low grade fever and chills 5:45pm- was driving with my children and felt a wave of heat, followed by extreme nausea, was able to pull over my vehicle and then fainted. After passing out, I started to seize. Rapid breathing, lost feeling of my arms and legs. Ambulance was called. I was transported to the hospital.


VAERS ID: 1185380 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Presyncope, Seizure, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

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

Write-up: Patient had an episode of vasovagal syncope about 2 minutes after vaccine administration followed by about 10 seconds of seizure.


VAERS ID: 1185450 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Fall, Seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

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

Write-up: Patient with previous hx of seizure disorder started convulsing within 10 minutes of vaccination, fell to the ground and convulsed for approximately 7 minutes. Convulsions reduced significantly and patient was coherent without post-ictal state. EMS was called and she was taken to nearby hospital for further evaluation. Patient had reportedly taken ativan and depakote this morning prior to arrival.


VAERS ID: 1185528 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LL / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood pressure measurement, Heart rate, Nausea, Oxygen saturation, Paraesthesia, Throat tightness
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Paxil, Gabapentin, Aldactone
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 10:17 BP 100/39 HR 42 O2 95% 10:20 BP 102/63 HR 77 O2 98% 10:27 BP 114/60 EMS arrived
CDC Split Type:

Write-up: Started feeling tingling to face and closing to throat some nausea, zero dizziness, zero SOB except feeling throat is still closing 10:18 Benadryl given IM 10:20 epinephrine


VAERS ID: 1185893 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-04-01
Onset:2021-04-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Aphasia, Cardiac failure congestive, Dyspnoea, Gingival pain, Mouth swelling, Toothache
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Angioedema (narrow), Dementia (broad), Oropharyngeal allergic conditions (narrow), Gingival disorders (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Allopurinol, Atorvastatin, Famotidine, Furosemide, Gabapentin, Lisinopril, Potassium, Warfarin, Aspirin 81 mg
Current Illness: Cold symptoms 2 weeks prior to vaccination
Preexisting Conditions: COPD, A-fib, hypertension, gout, acid reflux, high cholesterol
Allergies: Sulfa allergy
Diagnostic Lab Data: I do not have access to medical tests and laboratory results. He was seen in the ER Medical Center on 4/2/21 and 4/3/21 by a medical staff.
CDC Split Type:

Write-up: Vaccine was given on 4/1/21. Symptoms started 4/2/21 in the afternoon. Symptoms were described as teeth/gums hurting. At 12:30 am on 4/3/21 his mouth was very swollen and he couldn''t talk. Also he had trouble breathing. He went to the ER and was given IV solu-medrol. Patient was sent home 30-40 minutes later with the instructions to take Benadryl PO. In the morning they purchased some benadryl and gave it PO every 4-6 hours all day Saturday, 4/3/21. On Sunday, 4/4/21 at about 5:30 am his gums and lips were swollen again. He made another trip to the ER and was given solu-medrol IV again and PO methylprednisolone for 5 days. At this visit, they also gave lasix IV due to extra fluid around his heart. He was told by the ER provider that he developed congestive heart failure due to the vaccine. Patient followed up with his primary care provider on 4/8/21 and was told that his symptoms of congestive heart failure had resolved. Patient also reported his symptoms of swollen gums and mouth had resolved at this time.


VAERS ID: 1185908 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Limb discomfort, Paraesthesia, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Hydrocodone PRN. None today, last dose was yesterday at 8:00 PM
Current Illness: None
Preexisting Conditions: None
Allergies: None known
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient complained of left arm heaviness at 12:44pm. BP was 158/98 Pulse was 101 and O2 saturation was 99. No other complaints at that time. After observation period patient went to the bathroom around 1:00pm and vomited in the restroom. She returned to post vac area where BP was checked (208/124) Pulse (107), O2 saturation (98), and respirations were at 28. No blurred vision, shortness of breath, or dizziness. Due to elevated BP we elected to call EMS for further evaluation. While waiting for EMS BP was taken again at 1:30 pm and it was 170/92 and pulse and apical HR were at 96, respirations at 24, O2 Sat at 97% and pt. reported arm was less heavy but she felt a tingling sensation from her arm to her wrist. EMS arrived at 1:35 and BP was 220/120 and temp was at 97 degrees.


VAERS ID: 1185915 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Heart rate decreased, Hyperhidrosis, Hypotension, Pallor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: Patient had syncopal episode witnessed by nursing staff Patient appeared pale and diaphoretic Patient seen by medical team and provided with water Patient had history of syncopal episodes and hypotension Patient sent to The hospital via ambulance for low blood pressure and low heart rate


VAERS ID: 1185928 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Seizure, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? 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: Fainting / Unresponsive-Severe, Systemic: Seizure-Severe


VAERS ID: 1185934 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK - / -

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

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

Write-up: 15 minutes after receiving the vaccine patient started to feel itchy in her throat but did not have tightening in the throat, hives or shortness of breath. Patient was taken to the emergency department where IV benadryl and solu-medrol were given.


VAERS ID: 1185984 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Lip swelling, Pruritus
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: history not avail
Current Illness: n/a
Preexisting Conditions: N/A
Allergies: marked no allergies to medications on vaccine form
Diagnostic Lab Data:
CDC Split Type:

Write-up: patient came into pharmacy obtaining Rx''s for medrol dose pack and benadryl. She mentioned yesterday (4/08) around the afternoon her arms started to itch so she used hydrocortisone cream. By 4:30 in the morning (4/09) she woke up with her lips swelling.


VAERS ID: 1186023 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Computerised tomogram, Consciousness fluctuating, Dyskinesia, Dyspnoea, Eye movement disorder, Hot flush, Hyperhidrosis, Hypoaesthesia oral, Seizure
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Dyskinesia (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Ocular motility disorders (narrow), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Men?s one a day Glucosamine
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Ambulance attended to and transported to hospital. Blood test, chest X-ray, CT so far done at hospital.
CDC Split Type:

Write-up: Five minutes after shot started losing consciousness, sweating, hot flashes, trouble breathing, numbness on tongue, seizure ( several minutes) came in and out of consciousness during it, eyes rolled back in head. Arms flailing.


VAERS ID: 1186040 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Blood pressure increased, Headache
SMQs:, Neuroleptic malignant syndrome (broad), Hypertension (narrow), Hypoglycaemia (broad)

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

Write-up: Increased anxiety, headache, blood pressure of 220/150.


VAERS ID: 1186055 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: School       Purchased by: ?
Symptoms: Hypersensitivity, Pharyngeal swelling, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: full body allergic reaction, hives, swelling of throat


VAERS ID: 1186060 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Electrocardiogram, Nausea, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Spironolactone 100mg daily
Current Illness: None known
Preexisting Conditions: Autoimmune thyroiditis 12/22/2019; Vasovagal near syncope 04/23/2018; Concussion with no loss of consciousness 04/23/2018; Heterozygous MTHFR mutation C677T (CMS-HCC) 12/01/2016; Encounter for IUD insertion 10/12/2014; Paragard placed 10/4/19
Allergies: None known
Diagnostic Lab Data: EKG was obtained and found normal sinus rhythm without any acute changes.
CDC Split Type:

Write-up: Received vaccine and ambulated over to the observation area where she started feeling dizziness and nausea and then felt faint prior to fainting. Treated with ondansetron and IV fluids. Was discharged once symptom free and able to tolerate fluids without vomitting.


VAERS ID: 1186073 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / N/A LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray, Chest discomfort, Cough, Dizziness, Dysphagia, Dyspnoea, Electrocardiogram, Paraesthesia oral, Pharyngeal paraesthesia
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Bioactive woman''s one daily multivitamin high potency (once a day)
Current Illness: Ear infection (was on Bactrim x 10 days, finished 3/26)
Preexisting Conditions: TIA x 2 (last one 2012), obesity, OSA, endometriosis, chronic interstitial cystitis, SLE, fibromyalgia
Allergies: Ibuprofen, aspirin, Alka-Seltzer, butorphanol, latex, meperidine, oxycodone-acetaminophen - causes anaphylaxis (sometimes face swelling, itching)
Diagnostic Lab Data: 4/8 - chest x-ray, 12 lead ECG
CDC Split Type:

Write-up: 12:30 - Received J&J vaccine 13:00 - Started to experience lip/gum tingling and chest tightness. Given Benadryl 50 mg PO x 1 in vaccine clinic. Symptoms progressed to throat tingling, coughing, difficulty swallowing, lightheadedness, some SOB. 13:15 - Transported to ED. Received IM Epi x 1; improved within a few minutes. Also received methylprednisolone, famotidine, IVF. 19:00 - Monitored in ED. Discharged home with Epi pen, prednisone, famotidine, Benadryl.


VAERS ID: 1186092 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Hypotension, Muscle rigidity, Muscle spasms, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (broad), Parkinson-like events (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: EMS dispatched to the Vaccine Clinic for the syncopal. Found male supine in vehicle ico event paramedic. Stated male received a Johnson and Johnson vaccine. Stated he drove his car to the medical monitoring location. Stated he had a syncopal episode with muscle rigidity. IV established. Fluids administered. Vitals noted to be hypotensive. Patient-stretcher-ambulance. Patient stated he felt dizzy. Muscle rigidity present. Patient stated he feels his whole body cramping. Stated he remember events that occurred. Denies chest pain. Denies SOB. Denies ABD pain. Denies N/V. Stated he felt healthy prior to the vaccine. No incident during transport. Muscle rigidity resolved PTA at the ER. Patient received 900cc NS. Transfer of care to ER nurse w/ report.


VAERS ID: 1186145 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anaphylactic reaction, Dizziness, Dizziness postural, Joint lock, Nausea, Nervousness, Pallor, Skin discolouration, Skin warm, Tremor
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Hypoglycemia and occasional tachycardia
Allergies: None
Diagnostic Lab Data: Pt. reported to me that the ER gave him fluids and monitored him. He said they believed it was a severe vasovagal response. He has not yet followed up with a new doctor.
CDC Split Type:

Write-up: Pt. received the vaccine at approximately 2:44pm. Before I could hand him his card, his hands began trembling and he looked pale. I asked how he was feeling. He reported feeling shaky, dizzy, and very hot. I asked him if he was having any difficulty breathing, had tightness in his throat/airways, or even felt a tingle. He said no. Noting the time, I asked if he had eaten lunch. I asked if he has ever felt this way before. He said he had when he gets a "hypoglycemic attack." While not diabetic nor on any medications, he said he will occasionally get very low blood sugar. He said he had not eaten since early that morning. Another employee brought some juice I requested. I again asked him about symptoms related to anaphylaxis, to which was not an indication of an anaphylactic reaction. I gave him the juice to sip. I asked him again about symptoms. Because he was still dizzy, I took his blood pressure/heart rate. His BP was 160/119 and heart rate 96bpm. His color became more gray over the next several minutes. He was still too dizzy to stand, felt hot, shaky, and now nauseous. He handed over the juice and was given a receptacle if he vomited. We suspected a vasovagal response, but was still symptomatic after 10 minutes. Meanwhile, the other pharmacist tried to call his doctor''s office. We learned his doctor had moved away and he had not yet come in nor selected a new provider. We asked him if he felt he needed to be seen by a doctor. He said he did and agreed to us calling an ambulance. The ambulance arrived around 3:10. The EMTs took his BP. It had come down, but he could not stand up without his knees buckling. The EMTs got him on the stretcher and took him to the hospital.


VAERS ID: 1186175 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Blood pressure measurement, Dizziness, Dyspnoea, Hyperhidrosis, Nausea, Skin discolouration, Skin warm, Vital signs measurement, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: U/A found EMS with 56 yo F seated in stationary vehicle, CAO x 4, c/o N/V and dizziness approx 10 mins after receiving her Covid vaccine (Johnson & Johnson). Paramedic advised that pt had initial BP of 90 mmHG systolic, 12 lead showed sinus rhythm w/o ectopy, and that he attempted ODT zofran w/o success due to pt''s vomiting, all prior to EMS arrival. Pt. denied CP, abd pain, diarrhea, fever, cough, HA, syncope, neck or back pain. Pt. stated she felt SOB immediately after vomiting. All assessments/interventions as noted in rest of ePCR. GCS= 15, skin pink, warm, diaphoretic. No obvious signs of trauma. Pt. assisted from vehicle to stretcher, secured w/ straps. VS taken, WNL. Abd. soft, non-tender to palpation. Cardiac monitor showed sinus rhythm, rate of 60 bpm. Pt. actively vomited x 3 while IV access attempted and established. Pt. given 4 mg zofran IV w/ improvement in N/V. Pt requested transport for further evaluation. During transport, pt''s VS remained WNL, and pt stated she was feeling better, that dizziness and nausea had stopped. Noted occasional unifocal PVC on 4 lead as well as increase of HR to 124 bpm for approx. 3 seconds during transport, then returning to baseline of sinus rhythm or sinus brady. Pt. stated she normally had a low HR and BP, and had felt palpitations in the past, but no episodes of palpitations today, including during transport. Pt. transported COLD traffic to where pt care, 12 lead, and report were transferred to RN in triage w/o incident.


VAERS ID: 1186205 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / -

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

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

Write-up: Pt was CAO x 4 upon EMS arrival. EMS 3 stated pt experienced a syncopal episode after getting her COVID vaccine. Pt had a brief LOC and was initially hypotensive. IV was initiated by EMS 3 and NS was started. VS were WNL upon EMS arrival. Pt skin was still pale and clammy during assessment. Pt stated this has happened in the past with shots and blood draws, however, she has never fully lost consciousness. Pt was still c/o dizziness. Pt requested transport to REX ER. Pt was on the cardiac monitor upon EMS 14 arrival and a sinus rhythm was noted. 12 lead revealed a sinus rhythm with no STEMI criteria met. Pt was able to stand and pivot onto the stretcher without incident. Pt secured via straps and loaded into the unit. Once in the unit, VS reassessed. NS was reduced to a KVO rate due to improvement in BP. Pt had received approx 200mL of NS at the time. Pt denied any chest pain, SOB, N/V, or abd pain. Pt only complaint was dizziness. Pt was initially very anxious and was coached through breathing techniques which improved her anxiety. EMS left en route to REX ER. Pt was monitored during transport with improvement in her condition. Pt skin color and condition improved and her VS remained WNL. Pt denied any complaints during transport other than dizziness which she reported was improving. EMS arrived at REX ER. Pt was taken into the ER triage area and was able to stand and pivot onto a wheel chair. NS DC''d, pt received approx 300mL total. Report given to the triage RN and care transferred to same.


VAERS ID: 1186242 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Cough, Flushing, Oropharyngeal discomfort, Pruritus, Skin warm
SMQs:, Anaphylactic reaction (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient is GCS 15, A&Ox4, with skin that is flushed, warm, and dry and a strong radial pulse. Patient is coughing. Patient states she received her vaccine about 30 minutes ago. She states 20 minutes after the vaccine was administered she began to feel itchy and as if something was stuck in her throat. Patient denies any allergies or respiratory history. The Vaccine Clinic standby units have already administered 50mg Benadryl PO prior to arrival. Lung sounds are clear in all fields. No stridor noted to auscultation. No redness or angioedema noted to patient''s airway. Patient''s skin is flushed on the chest. No urticaria noted. Patient denies and GI symptoms. An 18G IV is established in the RAC. 125mg Solumedrol administered IV. Patient requests transport to Rex ER. Transport is initiated non emergent to Rex ED. Enroute 0.3mg IM epi is administered. Patient reports her itchiness is gone after Epi administration but is still coughing and states she still feels like something is in her throat. Upon arrival to the ED care is transferred to the RN at triage.


VAERS ID: 1186325 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Heart rate increased, Pallor
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hypotonic-hyporesponsive episode (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Client states fluid on lungs
Preexisting Conditions: Client quadriplegic, uses wheelchair
Allergies: No known allergies
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Vaccinator called EMT, client looked pale. Reevaluated by EMT, BP 157/111 @ 3:03 pm with elevated heart rate. Client alert and talking. Client stated was seen at home earlier today for BP concerns. Transported to ER by EMS


VAERS ID: 1186344 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-04-07
Onset:2021-04-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Gait disturbance, Pain in extremity
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

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

Write-up: Patient went to ER later that day after receiving the Jansson Vaccine at AFC Bessemer. She was watched for 15 minutes and had no contraindications to the vaccine. At the ER, she c/o severe left leg pain and difficulty walking due to pain. The ER called to report this and spoke to a medical assistant at who then gave the message to me.


VAERS ID: 1186349 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

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

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

Write-up: within a minute of patient leaving the consulation room after receiving the vaccine - patient sat down and passed out. When I looked over, I saw patient experiences minor convulsions. She was still in her chair. Episode lasted not even 10 seconds. Patient awoke and said she blacked out. She was coherent and responsive. We called 911. Patient said she has no history of seizures or low blood sugar. She said she tends to faint when giving blood or during vaccines due to the needle. Paramedic checked patient out and cleared the patient. No ambulance was taken. Will call patient tomorrow to follow up.


VAERS ID: 1186427 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-03-20
Onset:2021-03-27
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Vertigo
SMQs:, Vestibular disorders (narrow)

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: Escitalopram
Current Illness: None
Preexisting Conditions: None
Allergies: Peanut, celery, penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Acute onset of vertigo approximately 1 week post vaccination. Have never experienced vertigo prior. Symptoms worsened throughout day and I sought emergency care approximately 6 hours post first onset of symptoms. No diagnosis provided but physician suspected peripheral vestibular problem. Treated with meclizine for vertigo and migraine medication and discharged. Symptoms persisted for 1.5 weeks. Vertigo has mostly resolved


VAERS ID: 1186468 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anxiety, Asthenia, Cervical spinal stenosis, Condition aggravated, Conversion disorder, Dizziness, Dysphagia, Fatigue, Gait inability, Magnetic resonance imaging, Malaise, Muscular weakness, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dystonia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNKNOWN
Current Illness: UNKNOWN
Preexisting Conditions: ANXIETY, EPISODES OF ARM/LEG WEAKNESS
Allergies: INSECT VENOM, POISON IVY, SULFA
Diagnostic Lab Data: MRI
CDC Split Type:

Write-up: 48yr old female with history of anxiety, previous episodes of arm and leg weakness currently undergoing work-up for intermittent neurologic symptoms x 2yrs (on , allergies (insect venom: hives, shortness of breath; poison ivy: hives, shortness of breath; sulfa: hives) presented for COVID-19 J&J vaccine on 4/8/21. RN administered JANSSEN COVID19 VACC (LOT # 207A21A, exp 6/23/21) IM in patient''s left deltoid at 1410. Approximately 5 minutes after receiving vaccine, patient complained of dizziness which later manifested as increased fatigue, malaise, weakness of the extremities with eventual report of tingling in the face. Patient unable to ambulate. Patient transported to exam room via wheelchair and transferred


VAERS ID: 1186513 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Angioedema, Full blood count normal, Metabolic function test, Urine analysis normal
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: hypertension, bronchitis, gerd
Allergies: ACE inhibitors
Diagnostic Lab Data: In the ER, a CBC, CMP, and urinalysis were run with results within normal limits.
CDC Split Type:

Write-up: angioedema


VAERS ID: 1186533 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Swollen tongue
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Na
Current Illness: NA
Preexisting Conditions: NA
Allergies: NA
Diagnostic Lab Data: Vitals, blood pressure, spo2
CDC Split Type:

Write-up: Tongue swelling, transported via ambulance to hospital


VAERS ID: 1186558 (history)  
Form: Version 2.0  
Age: 94.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Condition aggravated, Deep vein thrombosis, Pain in extremity
SMQs:, Embolic and thrombotic events, venous (narrow), Thrombophlebitis (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Eloquis, dose unknown to writer
Current Illness: unknown
Preexisting Conditions: History of DVT
Allergies: No known allergies
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: Patient was transported to the hospital with c/o pain in her leg(s) and diagnosed with a DVT.


VAERS ID: 1186573 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-04-06
Onset:2021-04-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / N/A LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Lip swelling, Mouth swelling, Pharyngeal swelling, Pruritus, 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:
Current Illness:
Preexisting Conditions:
Allergies: No known allergic reactions
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic itching and hives; swelling of lips, inside of the mouth and throat. Seen at ED. Treated with IV fluids and steriods. Released to home after several hours. Physician believes it was from the vaccination and ruled out any other cause(s) for the reaction.


VAERS ID: 1186683 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chills, Computerised tomogram head normal, Dizziness, Fall, Head injury, Laboratory test normal, Loss of consciousness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Acetaminophen, amlodipine 5mg daily, cetirizine 10mg daily, Vitamin D 2000 iu daily, montelukast 10mg daily, hydrochlorothiazide 10mg daily
Current Illness: none
Preexisting Conditions: HTN, vitamin D deficiency, past positive COVID-19 10/15/20
Allergies: none
Diagnostic Lab Data: Patient was sent to the ER for evaluation. CT of head was performed and results were normal. EKG and blood work were unremarkable. Was instructed to avoid prolonged standing and exertion today and use tylenol and ice for pain.
CDC Split Type:

Write-up: Patient fainted when standing for count. Fell to the floor, lost consciousness, and hit his head against the wall. Reported overnight he experienced chills and lightheadedness


VAERS ID: 1186709 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-03-21
Onset:2021-03-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / N/A RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain upper, Chills, Fatigue, Haematochezia, Headache, Lymphadenopathy, Rash
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: no
Current Illness: no
Preexisting Conditions: obese
Allergies: Amoxicillin; hydrocodone; peanuts
Diagnostic Lab Data: Bloodwork and stool sample at first ER on 23rd - they sent me home with a stool softener and OTC Tylenol.
CDC Split Type: vsafe

Write-up: Headache that evening and that lasted for about two days. Around 11 PM that same night of vaccine - I had chills but no fever. The second and third day I was super fatigued. Everything was okay after that but a week and a half later I was receiving severe stomach pain and a little blood in my stool. That is what brought me to the ER on 23rd when I had the blood in my stool . I had a rash on the back of my thighs and I had swollen lymph nodes on each side of my neck that started after that. I went to ER again last weekend and that ER was at another location - no tests were done there. They told me to take OTC Tylenol. I still have the swollen lymph nodes and the rash is getting better not completely gone.


VAERS ID: 1186720 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-19
Onset:2021-03-25
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram head, Computerised tomogram neck, Dizziness, Magnetic resonance imaging head, Magnetic resonance imaging neck, Scan with contrast, Vertigo
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: doxycycline,lisinopril 40mg.,amlodipine 10mg,pravastatin 40 mg.,symbicort 160/4.5.,spireva.vitamin e 400 iu.,vitamin c 1000mg., vitamin b complex.,zinc 30mg.,magnesium oxide 300mg.
Current Illness: COPD.,Cellulitius.
Preexisting Conditions: COPD
Allergies: none
Diagnostic Lab Data: Ct scan,Ct scan with contrast,MRI. All of head and neck.
CDC Split Type:

Write-up: Sever vertigo,was admitted to hospital on March 25,2021,still am dizzy undergoing PT now.$/9-?


VAERS ID: 1186735 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth Control meds ProAir inhaler as needed Singulair 10mg at HS Symbicort inhaler
Current Illness: none known
Preexisting Conditions: asthma
Allergies: Cherries grass nuts oranges red 40 dye seafood
Diagnostic Lab Data: None ordered.
CDC Split Type:

Write-up: Patient received vaccine at 14:22, waited the 30 minute observation period. Patient returned to clinic at 15:35 with reports of chest pain and c/o throat closing. She did not use her epi pen, but had it during the observation period after her injection. Nurse met patient in waiting room and escorted directly to ED. Patient was seen by ED physician and was given albuterol, solumedrol and benadryl. Was discharged home in good and improved condition at 17:33.


VAERS ID: 1186759 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-04-06
Onset:2021-04-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Headache, Immediate post-injection reaction, Nausea, Pain, Pyrexia, Syncope, Vision blurred
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: 1. Vasovagal syncope almost immediately after vaccination, little to no warning of oncoming syncope 2. Extremely fast acting fever (temperature went from 98.6 to 100.5 in roughly 30 minutes) followed by nausea, pounding headache, and body aches/chills. Remedied by alternating very high doses of ibuprofen (800mg) and acetaminophen (1000mg or 1g) every two to three hours. This did not ever bring down the fever below 100 degrees. 3. Blurred vision around 29 hours after vaccine - advised to go to ER by triage nurse. ER doctor determined not to worry about, likely due to headache but not 100% sure.


VAERS ID: 1186784 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fall, Malaise
SMQs:, Accidents and injuries (narrow)

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

Write-up: patient complained about " not feeling well", 5 minutes after vaccination. pharmacist and technician assisted in caring for patient. patient then closed their eyes and slumped to the side. 1 minute later, patient became aware and answered questions correctly about who and where she was. ems were called and appeared shortly thereafter. patient was transported out of pharmacy via stretcher by ems.


VAERS ID: 1186837 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21Q / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Abdominal distension, Urticaria
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: swelling hives


VAERS ID: 1186854 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

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

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

Write-up: Patient passed out during waiting period after vaccination.


VAERS ID: 1186860 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Pharyngeal swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: 13:00 HR 107 O2 90% 13:04 BP 150/90 13:08 HR 105 O2 96% 13:10 BP 125/70
CDC Split Type:

Write-up: C/o throat swelling "feels thick" husband says "looks swollen" states cannot swallow 13:04 epi IM given 13:06 Symptoms resolved 13:15 report to EMS


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