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

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



Case Details

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VAERS ID: 1191683 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Hyperventilation, Tearfulness, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown.
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Not on file
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: S/P injection pt was tearful, hyperventilating, VSS. At one point pt vomited. No LOC. Presumed anxiety attack AED ED notes.


VAERS ID: 1191714 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-03-23
Onset:2021-03-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Blood test, Chest pain, Computerised tomogram, Dysgeusia, Dyspnoea, Haematoma, Immediate post-injection reaction, Insomnia, Palpitations, Paraesthesia, Peripheral coldness, Peripheral swelling, Skin discolouration, X-ray
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Taste and smell disorders (narrow), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), 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: None
Current Illness: None
Preexisting Conditions: None
Allergies: Tramidol/Ultram, Narco, bee stings
Diagnostic Lab Data: X-rau on lungs, blood panel, x-ray on finger, CT scan on lungs.
CDC Split Type:

Write-up: Immediately after injection, my heart raced, I got a metallic taste in my mouth, and my fingers got cold and tingly. The next day, I developed chest pain, racing heart, shortness of breath, and insomnia. I continue to have chest pain. On 04/08/2021, without injury or anything that I did, my right middle finger swelled and turned purple and it''s still purple. The ER doctor said it was a hematoma.


VAERS ID: 1191729 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-04-03
Onset:2021-04-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test normal, Body temperature increased, Computerised tomogram normal, Dizziness, Fatigue, Feeling abnormal, Head injury, Hyperhidrosis, Pyrexia, Syncope, Vision blurred
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Accidents and injuries (narrow), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: D-AMPHETAMINE ER 30MG SALT COMBO CP
Current Illness: NA
Preexisting Conditions: NA
Allergies: NA
Diagnostic Lab Data: 04/04/2021 - CT Scan, bloodwork - came back just fine according to ER Doctor.
CDC Split Type:

Write-up: At around 7PM the day of the J&J vaccine, I began to feel very fatigued and could tell that I was going to come down with a fever. I went to bed early that day around 10PM. Woke up around 1:30AM on the 4th. Felt terrible and took my temperature. It read 101.5. Got up to use restroom and when washing hands, everything started to go blurry, I thought i had just become lightheaded and that it would pass so i stood there leaning against the bathroom door.I ended up fainting and hitting my head on the cabinets. I was completely soaked in sweat. An hour later we drove to the ER to make sure everything as okay. IV was started, some test performed, and fever was gone by 5AM. Felt completely fine after going home and resting for a few hours.


VAERS ID: 1191746 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

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

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

Write-up: patient called and said she was throwing up non stop that she had to go to the hospital


VAERS ID: 1191949 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808990 / UNK UN / IM

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, 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), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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

Write-up: Pt feeling weak in observation area while sitting down after vaccine administration. Pt slowly lowered to ground by clinical staff,911 called lost consciousness for less than 2 mins aprox., pt afterwards aaox3, ambulance arrived, transported to ER


VAERS ID: 1191964 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808990 / UNK - / IM

Administered by: Other       Purchased by: ?
Symptoms: Chest pain, Dizziness, Immediate post-injection reaction, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt reported feeling dizzy, blurry vision, chest pain directly after vaccine administration, while sitting in chair, 911 called, , ambulance arrived, pt refused ER transfer. Pt reported feeling better and went home with husband.


VAERS ID: 1191971 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-04-04
Onset:2021-04-07
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling abnormal, Myalgia, Pain, Pain in extremity, Respiration abnormal, Tenderness
SMQs:, Rhabdomyolysis/myopathy (broad), Dementia (broad), Acute central respiratory depression (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: PATIENT RECEIVED VACCINE ON 4/4/21. ON 4/7/21, WAS AWAKENED DURING SLEEP WITH SHARP, STABBING PAIN IN LEFT LEG CALF MUSCLE. PAIN LASTED FOR 30-40 SECONDS. FOR THE NEXT 2 DAYS, PAIN IN THIS AREA REMAINED SORE, IRRITATED, AND TENDER. RATED PAIN 1-2/10 IF NOT TOUCHING THE AREA, BUT UP TO A 3/10 WITH TOUCHING THE AREA. IN ADDITION, FELT BREATHING HAS BEEN HEAVIER AND LITTLE WORSE THAN HIS NORMAL BASELINE (BASELINE DUE TO HISTORY OF ANEMIA/LOW IRON), AS WELL AS FEELING BRAIN FOGGY SINCE RECEIVING THE SHOT.


VAERS ID: 1192004 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / IM

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

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

Write-up: syncope w / prodrome during post-vaccine obs period, while sitting in chair


VAERS ID: 1192005 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-04-02
Onset:2021-04-09
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Blood test, Dizziness, Electrocardiogram, Magnetic resonance imaging head, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: rosuvastatin 20 MG tablet metFORMIN 750 MG 24 hr tablet lisinopril 5 MG tablet metoprolol succinate 50 MG 24 hr tablet aspirin 81 MG EC tablet
Current Illness: None
Preexisting Conditions: High blood pressure
Allergies: None
Diagnostic Lab Data: Blood work, EKG, brain MRI.
CDC Split Type:

Write-up: Waves of Nausea and Lightheadedness for 2 hours. Went to ER around 12:30PM on 4/9/21.


VAERS ID: 1192011 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-05
Onset:2021-04-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Bronchial disorder, Chest discomfort, Dyspnoea, Inflammation
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

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

Write-up: Started to have shortness of breath and tight chest. We brought her to the ER, they said it was inflamed bronchial tubes. They gave her an inhaler and prenazone to help with inflammation.


VAERS ID: 1192026 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

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

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

Write-up: Client received vaccine and became dizzy and was "seeing stars". Sat for about 20 seconds right after being vaccinated and then passed out for 10 seconds. BP was unreadable, pulse 72, O2 saturation 98%. Was transported to hospital


VAERS ID: 1192038 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-06
Onset:2021-04-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 UN / UN

Administered by: Pharmacy       Purchased by: ?
Symptoms: Atrial fibrillation, Condition aggravated, Electrocardiogram
SMQs:, Supraventricular tachyarrhythmias (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: blood pressure medicine Xarelto Sotalol
Current Illness: N/A
Preexisting Conditions: - Atrial flutter - hypertension
Allergies: N/A
Diagnostic Lab Data: A lot of EKGs since checking into the hospital.
CDC Split Type:

Write-up: I got the shot on Tuesday morning, and then by Wednesday morning I had a bad afib event, and still have afib and am at Hospital. I haven''t had an event like this in 2 years. The cardiologist here thinks it''s related to the vaccine.


VAERS ID: 1192048 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / N/A RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Erythema, Exophthalmos, Loss of consciousness, Malaise, Mobility decreased, Staring, Unresponsive to stimuli
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), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hyperthyroidism (narrow), Vestibular disorders (broad), Ocular infections (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Prior to receiving her COVID-19 vaccine, the patient was already having symptoms from anxiety/nervousness about the vaccine. Patient was given her injection and within 1-2 minutes, she began feeling dizzy and lightheaded. The vaccine administrator came to me (pharmacist on duty) to notify me that she was not feeling well. I went to go check on her and she stated that she felt as though she was going to faint. I advised her to stay seated, asked if she would like an ice pack and water, and stepped out to get those for her while remaining vigilant (because I wanted to be in the same room as her for observation/safety). I brought her the ice pack, she held it on her chest and head and said it felt nice. After about a minute I stepped out again to ask a technician to get a water for her. When I came back, the patient was still seated but had a blank stare and her mouth was slightly open. I repeated her name out loud and nudged her shoulder several times, however the patient was unresponsive completely. I immediately looked for the red emergency kit in the consultation room but did not see one (I later found out that there was an EpiPen on the table in the room, but I did not see it at the time due to the urgency of the situation). I rushed back into the pharmacy, told the technicians to call 911, and took an EpiPen off the shelf in the pharmacy. I ran back into the room and the patient''s face was very red, her eyes were bulging slightly, and it looked like she was trying to reach her hand up or move it, but was unable to. I injected her with the EpiPen immediately, and within roughly 5 seconds she came back to consciousness and looked at me and said "I''m sorry". EMS arrived extremely fast and was there a few minutes after using the EpiPen. She was then taken by ambulance to the hospital. Patient had a friend, with her at the store who was scheduled to receive the vaccine as well, but after the incident she decided otherwise. Later that evening I gave patient''s friend a phone call to check and see how patient was doing, and to also let her know that patient''s vaccination card was at the pharmacy if she wanted to pick it up. That evening around 6:30-7pm, patient''s husband came to the pharmacy to get her card, he updated us that she was being discharged from the hospital and that she was okay.


VAERS ID: 1192107 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (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: None known
Current Illness: None Known
Preexisting Conditions: None known
Allergies: NKDA
Diagnostic Lab Data: Sent to ED
CDC Split Type:

Write-up: Patient began to feel as though throat was closing, brought to ED.


VAERS ID: 1192135 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-29
Onset:2021-03-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Blood potassium decreased, Diarrhoea, Dyspnoea, Lactic acidosis, Tremor, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Lactic acidosis (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Pseudomembranous colitis (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), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad), Hypokalaemia (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: Prozac 20mg Magnesium 400mg B2 100mg Vitamin D
Current Illness: None
Preexisting Conditions: Excercise induced asthma... Albuterol as needed.. haven?t needed in over 6 months.
Allergies: Tree nuts Mango Kiwi
Diagnostic Lab Data: Low potassium and high lactic acid..
CDC Split Type:

Write-up: Severe vomiting, diarrhea, stomach pain. Trouble breathing... shaking like a seizure.


VAERS ID: 1192152 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-08
Onset:2021-04-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Fatigue, Headache, Myalgia, Rash
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Beconase AQ Beclomethsone Diprop 42 mg Nasal Spray 1 spray twice dailyq Fexofenadine 180mg tab, as needed Vitamin B-12 1000mcg, cyanocobalamin Vitamin D-3 50mcg as cholecalciferol
Current Illness: None
Preexisting Conditions: None
Allergies: Pecans, walnuts, almonds Sometimes Avacado and coconut
Diagnostic Lab Data:
CDC Split Type:

Write-up: Rash, headache, dizziness, fatigue, muscle aches


VAERS ID: 1192197 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Migraine, Pain, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: 104 fever, vomiting, migraines, body aches


VAERS ID: 1192209 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Dizziness, Fall, Fear of injection, Head injury, Headache, Injection site pain, 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), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (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: Parent stated not taking any medications.
Current Illness: No other illnesses known.
Preexisting Conditions: Asthma
Allergies: No Known Medication Allergies
Diagnostic Lab Data: Unknown if any tests were provided in ER.
CDC Split Type:

Write-up: Patient was administered Janssen COVID vaccine. Patient was fine immediately post administration in the IMZ room but witness stated he fell sideways (within a few minutes of receiving the vaccine) out of post-administration observation chair (which is in front of the pharmacy). Technician called code white and patient was immediately met with management and the pharmacy team. Patient was laying on his stomach on the floor, supporting himself upward with both hands/forearms. Patient had blood dripping from forehead and nose. Gauze was applied to laceration on forehead to help with bleeding and once patient was able to roll over on his back, an ice pack was applied to his forehead/nose area. Patient said he felt "pain" after the injection and then he felt light-headed. He remembered blacking out for a few seconds. Patient stated he felt "ok", then later stated he felt better but just had a bad headache. Patient stated he felt "it starting to hurt" and that it triggered his anxiety. Dad was in the store and arrived a few minutes later; dad said son/patient has a "fear of needles" and "he hasn''t had anything to eat today in quite awhile". EMS arrived to examine patient and asked him if he needed to go to the ER; dad felt going to the ER was for the best since they had a 3 hour car ride home. Paramedics then transported patient to the ER and said he would likely need a stitch for the cut above his eyebrow.


VAERS ID: 1192223 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-04-01
Onset:2021-04-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anger, Blood test, Chills, Hallucination, Headache, Hyperhidrosis, Influenza, Insomnia, Lumbar puncture, Magnetic resonance imaging head, Psychotic disorder, Pyrexia, Tachyphrenia
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hostility/aggression (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zoloft
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Medical tests were done at Hospital that included bloodwork, lumber puncture, MRI on the brain, Psych Evaluation.
CDC Split Type:

Write-up: Within 12 hours of getting the shot I developed severe flu symptoms with a fever of 102+, chills, severe headache, sweating, hallucinating, I recovered from that about 35 hours later but then about 2 days later I started having a lot of unusual anger, sleeplessness, racing thoughts, and ended up having a psychotic break. I was sent to the ER where they ran multiple tests on me to determine a cause. No alcohol, no drugs, no bipolar, no infection. It was determined that the vaccine was the cause of this really awful event.


VAERS ID: 1192302 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Fatigue, Flushing, Headache, Hyperhidrosis, Nausea, Vital signs measurement
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (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:
Allergies: Diphenhydramine, Methimazole
Diagnostic Lab Data:
CDC Split Type:

Write-up: Flushing, Sweating, Dizziness, and Fatigue. BP 141/88 HR82 RR 19. After monitoring in observation area, despite stable VS, patient continued to report dizziness, nausea, and headache, EMS called and patient taken to ED.


VAERS ID: 1192309 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-05
Onset:2021-04-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chest X-ray, Chest discomfort, Dizziness, Electrocardiogram, Feeling cold, Oropharyngeal discomfort, Presyncope, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: EKG, chest X-ray 4/5 I do not have results.
CDC Split Type:

Write-up: Cold flash, lightheaded, heavy chest and throat while driving home from receiving vaccine. Pulled over and called 911 because I thought I was going to pass out and couldn?t breath normally. I was by myself. Lasted about 3-5 minutes. I started to feel better while on the phone with 911 dispatcher. I was able to walk to the ambulance. Still felt a little woozy, but could breath fine. My chest got a little heavy while in back of ambulance, but not as severe. Was transported to ER. Discharged same day Diagnosis- vaccine reaction; syncope near-vasovagal reaction


VAERS ID: 1192355 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Alaska  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling hot, Loss of consciousness, Pallor, Thirst
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), 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: Unkown
Current Illness: none
Preexisting Conditions: not aware of any
Allergies: None reported
Diagnostic Lab Data: Don''t know
CDC Split Type:

Write-up: 2-3 Minutes after receiving the vaccine, the patient was seated in the waiting area for his 15 minute wait time. We heard a crash and the yell of his wife and 3 children. Found the patient laying on his back on the ground. Patient was breathing, but non responsive to tapping and shouting. 911 was called. Patient regained consciousness after about 15-30 seconds. He complained of being hot, thirsty, having to go to the bathroom and feeling out of it. He appeared pale. We did record a BP of 95/57. He remained conscious until EMT''s arrived. He was attended to and taken to the ER by emergency personal.


VAERS ID: 1192591 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / UN

Administered by: Pharmacy       Purchased by: ?
Symptoms: Differential white blood cell count, Dizziness, Electrocardiogram, Full blood count, Metabolic function test, 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril, lorazepam, claratin
Current Illness: N/a
Preexisting Conditions: Htn
Allergies: N/a
Diagnostic Lab Data: EKG, CBC, basic metabolic panel, white blood cell differential
CDC Split Type:

Write-up: Nausea, dizziness, syncope


VAERS ID: 1192676 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-04-08
Onset:2021-04-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood test normal, Depressed level of consciousness, Electrocardiogram normal, Hypotension, Presyncope, Syncope, Unresponsive to stimuli
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), 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 (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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: The medical professionals at the vaccination site told me that I needed to go to the ER immediately and arranged for me to go get tested to make sure this wasn''t a cardiac event or something else. The emergency room did a cardiac trace and blood tests, all of which showed I was fine, and concluded that I had a vasovagal reaction to the covid shot. I was released after an hour or two later, the same day, April 8 2021.
CDC Split Type:

Write-up: Approximately five minutes after the shot, I experienced vasovagal syncope. I was, reportedly, non-responsive for about three minutes. When aroused, my heart was reportedly beating about 40 beats per minute, my blood pressure was low, and it took me quite a while to regain my senses.


VAERS ID: 1192845 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain, Dizziness, Dyspnoea, Immediate post-injection reaction, Nausea, Oral pruritus, Rash, Swelling face, Swollen tongue
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Child, flu shot, don''t remember much about it
Other Medications: Synthroid, cytomel, Wellbutrin, Zoloft, Allegra, flonase, azelastine HCI
Current Illness: None
Preexisting Conditions: Depression, hoshimotos thyroid, obesity, sleep apnea
Allergies: Latex, natural rubber, amoxicillin, corn, wheat, sesame
Diagnostic Lab Data:
CDC Split Type:

Write-up: Immediately -Dizziness, soon after-mouth itching, Hour later- severe nausea, abdominal pain ,rash,three hours later- facial swelling, tongue swelling, epipen dose 1, trouble breathing on way to hospital and extreme dizziness. Epi dose 2. Arrive at hospital given IV and meds


VAERS ID: 1192879 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202121A / UNK LA / IM
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 2021201A / UNK AR / IM

Administered by: School       Purchased by: ?
Symptoms: Seizure, Vomiting
SMQs:, Acute pancreatitis (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: unknown
Current Illness: None
Preexisting Conditions: None
Allergies: none
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: Approximately 5 minutes after vaccine patient was in 15 minute lot, car in park. Observer Called on emergency radio for RN with bag. RN noted patient was actively Seizing. the patient''s wife was in the vehicle and confirmed the seizure. The patient was conscious within 2 minutes, vomited x 1 and stated he was stating to feel better. EMS was activated as son as the seizure was noted and took approximately 10 minutes to arrive. The patient was conciuos and walked to the ambulance and was transported to hospital


VAERS ID: 1192883 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-05
Onset:2021-04-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / ID

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Blood magnesium, Cold sweat, Dizziness, Dyspnoea, Fatigue, Glomerular filtration rate normal, Headache, Liver function test normal, Metabolic function test, Nausea, Night sweats, Palpitations, Pyrexia, Retching, Syncope, Troponin
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), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (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), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ministrin birth control pills
Current Illness: none
Preexisting Conditions: none
Allergies: Novocain
Diagnostic Lab Data: All performed on April 10th: Results all normal AUTOMATED DIFF BASIC METABOLIC PANEL D-DIMER GLOMERULAR FILTRATION RATE-ESTIMATED HEME PROFILE + ELECT DIFF HEPATIC FUNCTION PANEL MAGNESIUM NT PROBNP TROPONIN T
CDC Split Type:

Write-up: On Mon, April 5, had the vaccine, fainted at site 5 minutes after getting the vaccine. 9pm Apr 5, had fatigue, fever, slight headache, night sweats, clammy skin feeling. This continued until Wed Apr 7th Wed Apr 7 and Thursday Apr 8th were fine Friday, Apr 9th developed all of the above issues plus dizziness, nausea, upset stomach and dry heaving. This continued into Sat Apr 10th with added shortness of breath and heart palpatations. Went to the emergency room Sat Apr 10th Sunday, Apr 11th, severe nausea and stomach problems continuing along with continued night sweats.


VAERS ID: 1192913 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-06
Onset:2021-04-10
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Thrombophlebitis superficial, Ultrasound Doppler
SMQs:, Embolic and thrombotic events, venous (narrow)

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

Write-up: Left greater saphenous vein superficial thrombophlebitis


VAERS ID: 1192928 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anaphylactic reaction, Chest discomfort, Dizziness, Injection site pain
SMQs:, Anaphylactic reaction (narrow), Anticholinergic syndrome (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Extravasation events (injections, infusions and implants) (broad), Vestibular disorders (broad), 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: Site: Pain at Injection Site-Mild, Systemic: Allergic: Anaphylaxis-Mild, Systemic: Chest Tightness / Heaviness / Pain-Mild, Systemic: Dizziness / Lightheadness-Mild


VAERS ID: 1192974 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Asthenia, Dizziness, Hyperventilation, Nausea, Syncope, Tremor, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (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: Systemic: Abdominal Pain-Mild, Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Mild, Systemic: Hyperventilation-Mild, Systemic: Nausea-Severe, Systemic: Shakiness-Mild, Systemic: Vomiting-Medium, Systemic: Weakness-Mild, Additional Details: The first side effects of nausea and vomiting were reporting a few minutes after vaccination.The patient then reported some dizziness/lightheadness.Upon checking back,they changed their original report of dizziness/lightheadness to also include possible fainting.Blood pressure measurement was attempted 3 times with 2 different cuffs,but an error was displayed.It was sucessfully tested on a collaegue.EMS noted BP 120/81.Patient was coherent and conscious,albeit nervous,while conversing.


VAERS ID: 1193000 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, Blood test, C-reactive protein increased, COVID-19, Chest X-ray, Fatigue, Headache, Heart rate increased, Hypotension, Lipase, Nausea, Pneumonia, Pyrexia, Sepsis
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Dehydration (broad), Hypokalaemia (broad), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D, Vitamin C
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Blood proteins, sepsis, pneumonia/chest x-ray, lipase, CRP, COVID-19
CDC Split Type:

Write-up: High heart rate, low blood pressure, high fever, nausea, fatigue, weakness, headache


VAERS ID: 1193023 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / N/A - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dyspnoea, Malaise, Obstructive airways disorder, Pharyngeal hypoaesthesia, Pharyngeal swelling, Respiratory rate increased, Tremor, Vital signs measurement
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: PATIENT FELT UNWELL AT 1230, BP 124/82, HR 73, RR28 1237 GAVE 25MG BENADRYL IM 1245 PATIENT STARTED TO SHAKE, INCREASED RESPIRATORY RATE, STARTED TO HAVE AIRWAY CLOSURE 1245 EPI PEN GIVEN IN LEFT LEG IN RESPONSE TO SOB, REPORTED NUMBNESS AND SWELLING IN THROAT, INCREASED RESPIRATORY RATE. 1246 PATIENT ABLE TO BREATHE BETTER AFTER EPI 1247 PATIENT TRANSPORTED TO ED FOR OBSERVATION 1257 EMS TRANSPORT TO ED


VAERS ID: 1193121 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-09
Onset:2021-03-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / IM

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

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

Write-up: You came to the ER today because of a passing out episode after you got your first covid vaccine. Your exam was reassuring. Your labs and EKG are unremarkable. The cardiologist recommends continuing outpatient testing. Please call your doctors today to set up follow-up appointments. Please return to the ER if your symptoms change or worsen.,


VAERS ID: 1193129 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-04-01
Onset:2021-04-08
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Chest pain, Cold sweat, Full blood count, Hypoaesthesia, Lipase increased, Metabolic function test, Pallor, Palpitations, Syncope, Tachycardia, Troponin
SMQs:, Torsade de pointes/QT prolongation (broad), Liver related investigations, signs and symptoms (narrow), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad), Sexual dysfunction (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Troponin, CMP, CBC (4/8/21), (4/9/21)
CDC Split Type:

Write-up: Fainting, pale hands, numbness on left arm, chest pain, clammy, hospitalization, elevated ALT, elevated AST, elevated Lipase, tachycardia, palpitations.


VAERS ID: 1193142 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cognitive disorder, Dizziness, Fall, Feeling hot, Hyperhidrosis, Muscle rigidity, Seizure like phenomena, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: Seizure-like episode. Patient was seated when his body went rigid and he lost postural control and started to slide sideways. His body was shaking slightly and his eyes were open but there was no cognitive awareness. This lasted no more than 90 seconds and then patient came to abruptly and reoriented himself on the chair before I had the opportunity to get him to the floor. Patient then stated that he was lightheaded, warm and sweaty. EMT had been called and upon assessment of the patient transported him to the ER.


VAERS ID: 1193172 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Burning sensation, Hyperhidrosis, Pain, Pruritus, Pyrexia, Swelling face, Swollen tongue, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), 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: Synthroid
Current Illness: None
Preexisting Conditions: Thyroid disease
Allergies: Nickel, ultram and morphine.
Diagnostic Lab Data: Blood test on 4/10/21 at 2:30 am at hospital. I was giving liquid steroid to help stop my allergic reaction to the Janssen vaccine and Pepcid.
CDC Split Type:

Write-up: Body aches & fever started 10 hours after jassen vaccine. Hives on arm of injection mostly a few on my other arm and on my legs and face swelling itchy burning ears started 21 hours after vaccine. My tounge swelled 45 hours after jassen vaccine causing a trip to the hospital. They have me liquid steroid to drink calming my allergic reaction my hives are still visual as of today 4/11/21. I am still having alot of sweating spells too.


VAERS ID: 1193243 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Chills, Computerised tomogram, Dyspnoea, Headache, Retching
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (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: Rosuvastatin 5MG,cholecalif 25MCG, fishoil 1000MG.
Current Illness:
Preexisting Conditions: Moderate to severe tinnitus
Allergies: None
Diagnostic Lab Data: Ct scan and blood tests 4/10/2021. All normal
CDC Split Type:

Write-up: Chills after 6hrs, headache after 12hrs, severe headache after 15hrs, dry heaves and shortness of breath after 18 hrs.


VAERS ID: 1193291 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-07
Onset:2021-04-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Pain, Pruritus, 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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Hives all over body including abdomen, back, neck, face, eyes, scalp. Symptoms started 4/9, 2 days after vaccination. Took benadryl for itchiness. Symptoms was severe on Saturday 4/10. Benadryl could not control hives. Went to urgent care because hives were so severe and causing body ache.


VAERS ID: 1193514 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Blood pressure increased, Chills, Heart rate increased, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hypertension (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinpril Vitamin D supplement Birth control
Current Illness: None
Preexisting Conditions: High blood pressure
Allergies: Allergies to cipro and macrobid. Allergies to bee stings.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Chills Body aches Joint pain Fever of 105.9 F Elevated heart rate Elevated blood pressure


VAERS ID: 1193520 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-17
Onset:2021-03-31
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 10805031 / UNK LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Abnormal behaviour, Blood test normal, Computerised tomogram normal, Delusion, Hallucination, Insomnia, Poor quality sleep, Psychotic behaviour, Screaming, Speech disorder, Urine analysis abnormal
SMQs:, Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hostility/aggression (broad), Depression (excl suicide and self injury) (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: No Prescription drugs Takes alavert on occasion for allergies Tums
Current Illness: None
Preexisting Conditions: Patient is cognitively disabled, but functions fairly well with day to day activities and routines. She has not experienced any incidents or conditions that she displayed beginning on March 31st 2021.
Allergies: None
Diagnostic Lab Data: Given a Urine Test and Blood Test on Sunday, April 4th. Urine test for UTI was inconclusive and blood test was normal Given a Urine Test and Blood Test on Monday, April 5th, as well as a CT scan. Urine test for UTI continued to be inconclusive, blood test was normal and CT was scan was normal. Patient was placed on anti-psychotic medication while in the psychiatric ward. After about three days of non-sleep, she finally began to sleep. She is doing well under the medication but is very sedated.
CDC Split Type:

Write-up: My daughter, although has cognitive issues, has not ever displayed any adverse behavior. We first noticed some unusual behavior on March 31st 2021. Three days later, on April 3rd, her behavior became more noticeable and unusual for her. She was saying things that didn''t make any sense and wasn''t sleeping well or not at all. On Sunday April 4th, her behavior intensified into delusions and hallucinations. She was talking to people not there and making bizarre statements. She was taken to emergency hospital late Sunday night and given a blood and urine test and sent home. By Monday morning, she had not slept the entire night and was shouting out, trying to leave the house and her hallucinations and delusions had intensified. We took her to Emergency room, where she was diagnosed with psychotic behavior and was admitted to the psychiatric ward. She is expected to be released today, April 11th, 2021.


VAERS ID: 1193523 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

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

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

Write-up: High fever Headache Body aches


VAERS ID: 1193529 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure increased, Cough, Retching, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypertension (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: Unknown
Current Illness: Unknown
Preexisting Conditions: Hypertension; Asthma
Allergies: Unknown
Diagnostic Lab Data: Patient transported by ambulance to hospital.
CDC Split Type:

Write-up: 43 y/o female reports "throat closing up" 10-12 minutes after receiving Janssen vaccine at 12:43pm. Patient with intractable, non-productive cough and dry heaving. Elevated blood pressure however oxygen saturation and pulse remained within normal limits throughout assessment period; 12:53-1:23pm. Medical doctors with verbal order for Epi Pen administration. 1:23pm Epi-Pen administered. Paramedics were already on site and took over patient care at 1:24pm. Patient transferred by ambulance to hospital for emergency care at 1;33pm.


VAERS ID: 1193571 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-06
Onset:2021-04-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Body temperature increased, Chills, Genital discomfort, Genital pain, Herpes virus test, Vulval disorder
SMQs:, Neuroleptic malignant syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (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: Hives following Gardasil vaccine.
Other Medications: Apri (birth control)
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Penicillin, Azithromycin, Gardasil
Diagnostic Lab Data: Herpes swap conducted. Awaiting results.
CDC Split Type:

Write-up: Approximately 6 hours following vaccination, patient experienced chills and a high temperature of 99.0F which passed after 36 hours. Approximately 12 hours following vaccination, patient experienced discomfort in external genitalia area upon wiping with toilet paper. Approximately 60 hours following vaccination, patient noticed three yellow-colored lesions on labia with extreme pain. Patient reports no recent sexual risk activity.


VAERS ID: 1193626 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-29
Onset:2021-04-01
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Diarrhoea, Muscle spasms
SMQs:, Pseudomembranous colitis (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (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: Women''s daily vitamins
Current Illness: UTI
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe Diarrhea and leg cramps occurred 3 days after vaccine


VAERS ID: 1193629 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Eye movement disorder, Feeling hot, Hypopnoea, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (narrow), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (broad), Ocular motility disorders (narrow), 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Almost immediately after COVID 19 vaccine administration, patient began experiencing warmth ,dizziness and faint, variable breathing shallow, deep etc. Cool compress applied to patient. Patient began to slump, tremors, and appeared to be passing out, eyes began to roll back. EPIPEN was administered and 911 was called. The 911 medics arrived and patient was transported to emergency room .


VAERS ID: 1193742 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Maine  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

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

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

Write-up: A few minutes after administration of the vaccine, the patient became light headed followed by loss of consciousness for several seconds.


VAERS ID: 1193757 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: New York  
Vaccinated:2021-03-07
Onset:2021-03-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Back pain, Deep vein thrombosis, Fatigue, Muscle spasms, Pain in extremity, Peripheral swelling, Weight bearing difficulty
SMQs:, Cardiac failure (broad), Angioedema (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, venous (narrow), Dystonia (broad), Thrombophlebitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Phenytoin, Clonazepam, Vitamin D3, Jardiance, Pantrapazole, Vitamin C, B12, Folic Acid,
Current Illness: None
Preexisting Conditions: No chronic or long standing health conditions prior to being vaccinated with the Johnson & Johnson Vaccine.
Allergies: Allergic to Botox, Sumatriptan, Halcion, Imatrex, and Metformin
Diagnostic Lab Data: I ended up going to the emergency room through the local VA Hospital where I was diagnosed with a substantial DVT, Deep Vein Thrombosis in my right leg, I was advised that the DVT is substantial and that I needed to follow up with the Anticoagulation Clinic once I was discharged. I was started on Lovonox injections @ 100ML twice a day and I was started on Warfarin 5 mg. daily. I am currently receiving treatment for the DVT from the Anticoagulation Clinic with labs twice a week and a Clinic as needed at least once a month I was advised. I was advised by the Anticoagulation Clinic to enroll through the VAERS System in regards to my adverse reaction to the J&J Vaccine and the Deep Vein Thrombosis (DVT),
CDC Split Type:

Write-up: Shortly after receiving the vaccination I started to experience chronic exhaustion, leg cramping and pain in my lower back right side, upper right thigh, behind my right knee and down into my right calf. I figured that the pain would go away but the pain increased and my leg started swelling and the pain increased making it very difficult for me to put my leg down on the ground and put pressure on my right leg.


VAERS ID: 1193804 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature increased, Chills, Facial paralysis, Feeling abnormal, Movement disorder, Nausea, Pain, Paralysis, Speech disorder
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Dementia (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hearing impairment (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: Cymbalta , 10 mg thc
Current Illness: No
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data: Hospital report . Young staff on hand dismissed it as thc . There is no way that this caused this scary reaction . I still have a wobbly leg .
CDC Split Type:

Write-up: 8 hours later , I had 101 fever , shivers , nausea and full on body aches . Since feeling so bad , next day I had a thc gummy to help with pain . That night , I could not move my legs ... a paralysis feeling went from feet to face . Half of my fave was crooked and I could barely talk .


VAERS ID: 1193820 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 experienced vasovagal syncope 5 minutes after receiving her vaccine. She woke up immediately after smelling alcohol and elevating her feet above chest level. 911 was called and was present within minutes and patient was taken to ER where she was monitored for 3 hours. She reported she had stable blood pressure, HR, and blood sugar. She was discharged after 3 hours of observation and is feeling well the next day.


VAERS ID: 1194039 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: D.C.  
Vaccinated:0000-00-00
Onset:2021-03-01
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Ageusia, Anosmia, Blood potassium, Blood potassium decreased, Chest pain, Cough, Dizziness, Eructation, Fatigue, Migraine, Musculoskeletal stiffness, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Arthritis (broad), Hypokalaemia (narrow), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: The patient had no known medical issues or known low potassium prior to receiving vaccine.
Allergies:
Diagnostic Lab Data: Test Date: 202103; Test Name: Potassium; Result Unstructured Data: low
CDC Split Type: USJNJFOC20210407790

Write-up: LOSS OF SMELL; LOSS OF TASTE; NECK STIFFNESS; VOMITING; LIGHTHEADEDNESS; LOW POTASSIUM; BACK STIFFNESS; MIGRAINE WITH LIGHT SENSITIVITY; INTERMITTENT COUGHING; BURPING; CHEST PAIN; FATIGUE; This spontaneous report received from a patient concerned a female of unspecified age. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included the patient had no known medical issues or known low potassium prior to receiving vaccine. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805022, expiry: UNKNOWN) dose was not reported, administered on left deltoid muscle on 06-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On MAR-2021, the subject experienced loss of smell. On MAR-2021, the subject experienced loss of taste. On MAR-2021, the subject experienced neck stiffness. On MAR-2021, the subject experienced vomiting. On MAR-2021, the subject experienced lightheadedness. On MAR-2021, the subject experienced low potassium. On MAR-2021, the subject experienced back stiffness. On MAR-2021, the subject experienced migraine with light sensitivity. On MAR-2021, the subject experienced intermittent coughing. On MAR-2021, the subject experienced burping. On MAR-2021, the subject experienced chest pain. On MAR-2021, the subject experienced fatigue. Laboratory data included: Potassium (NR: not provided) low. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from loss of smell, and loss of taste on 2021, and the outcome of neck stiffness, intermittent coughing, vomiting, lightheadedness, fatigue, burping, low potassium, back stiffness, chest pain and migraine with light sensitivity was not reported. This report was non-serious.; Sender''s Comments: V0: Medical Assessment comment not required as per standard procedure as the case assessed as non-serious.


VAERS ID: 1194104 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2021-04-05
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure measurement, Headache, Heart rate, Hypertension, Oxygen saturation, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Hypertension (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: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 202104; Test Name: Blood pressure; Result Unstructured Data: 148/80 mmHg; Test Date: 202104; Test Name: Pulse oximetry; Result Unstructured Data: 99(not reported); Test Date: 202104; Test Name: Heart rate; Result Unstructured Data: 62 BPM (beats per minute); Test Date: 20210405; Test Name: Blood pressure; Result Unstructured Data: 153/90 mmHg
CDC Split Type: USJNJFOC20210410874

Write-up: HYPERTENSIVE WITH BLOOD PRESSURE OF 153/90; HIVES IN THE UPPER EXTREMITY AND CHEST; HEADACHE; This spontaneous report received from a physician concerned a 51 year old male. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 05-APR-2021 18:30 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On APR-2021, Laboratory data included: Blood pressure (NR: not provided) 148/80 mmHg, Heart rate (NR: not provided) 62 BPM (beats per minute), and Pulse oximetry (NR: not provided) 99 (not reported). On 05-APR-2021, Laboratory data included: Blood pressure (NR: not provided) 153/90 mmHg. On 05-APR-2021 21:30, the subject experienced hypertensive with blood pressure of 153/90. On 05-APR-2021 21:30, the subject experienced hives in the upper extremity and chest. On 05-APR-2021 21:30, the subject experienced headache. Treatment medications (dates unspecified) included: famotidine, diphenhydramine hydrochloride, and ibuprofen. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from hypertensive with blood pressure of 153/90, hives in the upper extremity and chest, and headache on 06-APR-2021. This report was non-serious.; Sender''s Comments: V0: Medical assessment comment not required as per the standard operating procedure as the case is assessed as non-serious.


VAERS ID: 1194168 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

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

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

Write-up: Systemic: Confusion-Severe, Systemic: Fainting / Unresponsive-Severe, Systemic: Weakness-Severe, Additional Details: THis event happened approximately 30 sec after receiving the Janssen COVID-19 Vaccine. Patient was brought to the ER by firemen due to in and out consciousness. Patient was with boyfriend who caught her as she was falling. Patient did not hit her head. She did state that she has passed out in the pass once after receiving a vaccine, but not regularly. She states she does not have a fear of needles when asked by fireman.


VAERS ID: 1194277 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

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

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

Write-up: High fever


VAERS ID: 1194306 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Dizziness, Heart rate increased, Pyrexia, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril 10 mg-hydrochlorothiazide 12.5 mg ( 2 tablets a day)
Current Illness: None
Preexisting Conditions: High Blood Pressure
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: - Rapid Heart Beat along with Chills and Fever starting around 4/8/21 6:00 pm. -At 9:45 pm, Fever was 102.1. Took Tylenol ( 500 mg x2). - At 10:30 pm, Pulse rate was 145 bpm and fever was 101.9. - On 4/9/21 4:30 am, after urinating felt dizzy and fainted. Called 911 and went to the Emergency Room. Was treated there for syncope.


VAERS ID: 1194317 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / N/A LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: syncope, EMS called and patron transported by Fire Dept to unknown facility


VAERS ID: 1194341 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / N/A RA / IM

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

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

Write-up: syncope


VAERS ID: 1194349 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-02
Onset:2021-04-05
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Contusion, Dizziness, Loss of consciousness, Pruritus, Rash, Syncope, Tooth loss
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), 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), 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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: Antibiotics
Diagnostic Lab Data:
CDC Split Type:

Write-up: I am a very healthy person but I had a rough time with a Covid shot. Severe rash and itching over the entire body 2 days after getting the vaccine. Took Benadryl for two days. The itching was getting worth. Went to see a doctor who prescribed IC Prednisone 10 mg tablet. On the 3rd of taking the IC Prednisone, I felt dizzy and fainted, lose consciousness. Ended up in ER. Multiple bruises, lost 4 front teeth.


VAERS ID: 1194352 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / N/A LA / IM

Administered by: School       Purchased by: ?
Symptoms: Eye movement disorder, Seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none known
Preexisting Conditions: hx of seizures
Allergies: Patient states she had allergic reaction to anticonvulsants - states her reaction is seizures
Diagnostic Lab Data:
CDC Split Type:

Write-up: described pre-seizure aura and described as having eyes rolling back in head


VAERS ID: 1194369 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chest pain, Dizziness, Dyspnoea, Electrocardiogram, Feeling cold, Feeling hot, Headache, Laboratory test, Malaise, Oropharyngeal discomfort, Pain, Tremor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Asthma medications, birth control, daily vitamin
Current Illness: NA
Preexisting Conditions: Asthma
Allergies: Augmentin
Diagnostic Lab Data: EKG and standard lab tests performed on 04/10/2021
CDC Split Type:

Write-up: Began with spasming of throat, difficulty breathing, violent body shakes, hot followed by cold temperature, headache, light headedness, aches, and chest pain. Lasted about 3 hours while in ER until some relief. ER stated some feelings could come back later in the evening. Headache, aches, and chest pain came back later in the evening with an overall sick feeling.


VAERS ID: 1194407 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

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

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

Write-up: Patient fainted twice, EMS called


VAERS ID: 1194435 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Computerised tomogram, Dyspnoea, Fatigue, Gastrointestinal pain, Loss of consciousness, Mental status changes, Pyrexia, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Acute central respiratory depression (broad), Pulmonary hypertension (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 (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Chills difficulty breathing loss of consciousness altered mental status fainting fever fatigue gastrointestinal pain


VAERS ID: 1194443 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Fall, Fatigue, Gait inability, Malaise, Muscle contractions involuntary, Myalgia, Pain, Presyncope, Pyrexia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Sertraline 100mg daily
Current Illness: N/A
Preexisting Conditions: Minor scoliosis, anxiety
Allergies: Soframycin, chloromycetin
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: At roughly 4pm the day of vaccine I started to feel generally sore in my muscles. At around 7pm I started to become light headed, had a headache, and bad muscle pain. My fever at this point measured 102f. These negative effects increased over the next few hours until I fell on the floor and couldn''t get up without help from my wife. I felt like I was going to pass out every five seconds, threw up twice, my muscles kept contracting and relaxing and were intensely painful. Around 12:30am Saturday morning we went to the emergency department. I needed a wheelchair to get around. The wait at emergency was too long, and by 3am we went back home. I was feeling slightly better, but still not great, and my fever had reduced. I rested on Saturday with less severe but still considerable symptoms, and took paracetamol. Now on Sunday I feel sick and a little sore and very tired, but mostly better.


VAERS ID: 1194456 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Confusional state, Cyanosis, Disorientation, Loss of consciousness, Malaise, Pallor, Tremor
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), Parkinson-like events (broad), Acute central respiratory depression (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), 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: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data:
CDC Split Type:

Write-up: After the immunization was administered to the patient, she was asked to have a seat in the waiting area for observation. A few minutes after she sat, she told her husband who was seated with her she didn''t feel well (he did not inform us). The technician observing her noticed she passed out and reported to the pharmacist (myself). I designated a team member to call 911 and ran out to the patient. She was extremely pale and her lips were blue. With the assistance of her husband I laid her on the floor, had him elevate her feet and checked for pulse and breathing. I couldn''t immediately find her pulse but within 30 seconds she began to come to. She appeared to tremor a few times as she came to and her color began to return. She was extremely confused and did not know where she was upon awakening. EMS arrived on the scene approximately 10-15 minutes after the event. They did standard patient evaluation which was unremarkable and proceeded to bring her to the local ED, According to the patient, the ED visit yielded nothing and they said "she couldn''t be more healthy". One note, that was revealed in conversation with the patient while waiting for EMS to arrive is that the patient had very little to eat or drink prior to being administered the vaccine.


VAERS ID: 1194552 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-05
Onset:2021-04-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Rash, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Penicillin
Diagnostic Lab Data: Unknown. Patient did go to hospital, but did not disclose medical tests and laboratory results to pharmacist.
CDC Split Type:

Write-up: That evening patient developed rash on legs. Progressed over the course of several days to include severe rash (red/purple bumps) on legs, red spot at injection site, itchy all over. Rash spread to include trunk by 4/11/21. Patient was using hydrocortisone cream and benadryl over the counter. Advised patient to see medical doctor. Patient went to hospital and was discharged on Prednisone.


VAERS ID: 1194560 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hyperhidrosis, Loss of consciousness, Pallor, 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: patient had a seizure and lost consciousness; pt regained consciousness after a couple minutes; pale and perspiring, paramedics came and provided care from there


VAERS ID: 1194573 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Injection site pain, Pain, Swelling, Tenderness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: norethindrone 0.35 mg tablet, multi vitamin, vitamin c, vitamin d
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient had covid19 vaccine yesterday in her left arm. Today, she noted some swelling at the base of her neck on the left and it is quite tender to touch. The upper arm is only mildly tender. The vaccine was Johnson and Johnson. She has no breathing difficulties and no trouble swallowing. No fever, chills or myalgia. No chest pain. Acute onset. Stable. She has no evidence of airway compromise or difficulty swallowing. This does not appear to be lymphadenopathy. I want her to monitor closely. Apply ice to area as directed on after visit summary. Acetaminophen for pain. If enlarges with any evidence of airway compromise at all, she must go directly to Emergency Department or call 911. I encouraged her to report this on VAERS site for adverse vaccine reaction. As of 4/11 1:41pm pain at collarbone is same, but swelling is down a bit. Injection site is now very tender/ painful to touch.


VAERS ID: 1194579 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-04-07
Onset:2021-04-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Foaming at mouth, Loss of consciousness, Malaise, Pallor, Syncope, 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), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

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

Write-up: Patient received the vaccine and was asked to wait in the observation area afterwards. He approached the counter a few minutes later to report he wasn''t feeling well. As he was speaking with the technician he became very pale, reported lightheadedness and fainted with loss of consciousness. The technician reported that he witnessed convulsive type tonic movements concentrated in the neck and upper-arms more than the abdomen or legs. He also reported foaming at the mouth and following each event which repeated 3 times in less then 15 minutes, he woke with confusion and no memory of where he was. EMS arrived after 15 minutes and transported the patient to the ED for evaluation. Upon follow up with the patient the next day, he reported that the ED found nothing on his medical exam and he had worked a 10 hour shift prior to receiving the vaccine and had had nothing to eat or drink.


VAERS ID: 1194632 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Flushing, Hyperhidrosis
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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 immediately became flushed and red and was sweating profusely. Lied on the ground. Declined to get Epipen from pharmacist. Was not feeling well for up to 25 minutes after and then left with EMTs to the hospital.


VAERS ID: 1194633 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Diarrhoea, Dizziness, Fatigue, Headache, Hypoaesthesia, Oropharyngeal pain, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Gabapentin, tylenol, malexocam, zyrtec, bupropion, topiramate, losartan, escitalopram, hydroxychloriquine, singular, vitamin d.
Current Illness: Sinus infection
Preexisting Conditions: Lupus, EDS, depression, anxiety
Allergies: Cosine, strawberry, amlodipine
Diagnostic Lab Data: Went to er on 4/11/2021.
CDC Split Type:

Write-up: Headaches, fever, fatigue, lightheaded, hands keep going numb, diarrhea, sore throat.


VAERS ID: 1194771 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood glucose abnormal, Malaise, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Patient had blood sugar readings in the excess of 400 mg/dL and was feeling ill, she fainted and was transported to the hospital.


VAERS ID: 1194807 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Hyperhidrosis, Loss of consciousness, Muscle rigidity, Muscle twitching, Pallor, 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), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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

Write-up: Pale, diaphoretic rigid, twitching, unconscious, syncope episode, EMS was called and patient was transported


VAERS ID: 1194818 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Headache, Hypoaesthesia, Pain, Pain in extremity, Paraesthesia, Pyrexia, Ultrasound scan
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: birth control pill
Current Illness: no
Preexisting Conditions: no
Allergies: gluten and lactose sensitive
Diagnostic Lab Data: 4/11 got an ultra sound to test for blood clot and they ruled that it wasn?t a blood clot. no specific diagnosis of what the pain/tingly sensation is
CDC Split Type:

Write-up: between 5 and 6 in the evening i started feeling a sharp throbbing pain in my right quad and then gradually my entire leg got tingly/numb feeling. in addition my symptoms of fever, headache, and body aches set in at this time too


VAERS ID: 1194829 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-04-05
Onset:2021-04-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Balance disorder, Chest discomfort, Chills, Headache, Hypoaesthesia, Pain, Peripheral coldness, Pyrexia, Skin warm, Visual field defect, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Optic nerve disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

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

Write-up: Janssen COVID-19 Vaccine, arms and legs were fully numb and cold, chest and back were hot, fever, headache, could not look to the edge of my vision, could not hold down food or water, intense pain in the lower back, bad balance, chills, aches,.


VAERS ID: 1194857 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray, Computerised tomogram, Dizziness, Laboratory test, 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: Tylenol
Current Illness: Previous diarrhea within last week
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Ct scan, chest X-ray, blood work
CDC Split Type:

Write-up: Fainting, nausea, lightheaded


VAERS ID: 1194859 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 04ZAZ1A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysphagia, Nausea, Peripheral swelling, Pruritus
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), 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: Zoloft Allegra
Current Illness: None
Preexisting Conditions: Migraines Factor II Prothrombin Clotting Disorder Anticardiolipin
Allergies: Betadine Bees Ants Wasps Yellowjackets
Diagnostic Lab Data: None
CDC Split Type:

Write-up: First I began to notice generalized itching a few hours post vaccine, similar to allergic reactions I have had to insects. Then I began to notice mild finger swelling. Then swallowing became difficult, then I began to become nauseated.


VAERS ID: 1194920 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Nebraska  
Vaccinated:2021-04-01
Onset:2021-04-10
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Loss of consciousness, Musculoskeletal stiffness, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Arthritis (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: Do not know
Current Illness: None
Preexisting Conditions: None
Allergies: None provided
Diagnostic Lab Data: not sure
CDC Split Type:

Write-up: Patient passed out after sitting about 5 minutes after the vaccine. He went stiff and out for less than 30 to 45 seconds. He came to and was alert and talking. EMTs arrived and he passed out again and started vomiting. They did take him in the ambulance.


VAERS ID: 1194952 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Blood pressure measurement, Cold sweat, Dizziness, Heart rate, Hyperhidrosis, Nausea, Pallor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Patient reported feeling a little dizzy and nauseated after being vaccinated with girlfriend Patient soon after had syncopal episode Patient appeared clammy and pale and diaphoretic Patient seen by medical team Blood pressure 91/45 and heart rate 61 Patient provided water and repeat BP was 109/61 Patient refused medical transport and signed ama form but will have girlfriend drive him to hospital


VAERS ID: 1194968 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-06
Onset:2021-04-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Chills, Fatigue, Feeling of body temperature change, Injection site pain, Malaise, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)

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

Write-up: COVID VACCINE BY JANSSEN LOT# 1808982 EXP JUNE 23/2021 IN ADDITION TO REGULAR SIDE EFFECTS - PAIN AT INJECTION SITE, FEELING UNWELL, HOT AND COLD CHILDS, TIRED, NAUSEA - THE PTNT ALSO HAS CHEST PAIN AND VOMITING. PHARMACIST ADVISED PTNT TO GO TO ER - PTNT WAS RELEASED UNCER FATHER CARE. ADVERSE EFFECTS AND SYMTPONS IMPROVED AND WERE GONE BY DAY 5.


VAERS ID: 1194975 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Heart rate increased, Hypertension, Pulmonary embolism, Thrombosis, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Parkinson-like events (broad), Thrombophlebitis (broad), Noninfectious encephalopathy/delirium (broad), Hypertension (narrow), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: Severe shaking. Admitted to ED for 180/90 blood pressure and rapid heartbeat ($g120). Screened for potential pulmonary embolism and blood clots


VAERS ID: 1195004 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Heart rate increased, Palpitations, Pyrexia, Sinus tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? 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: Heart palpitations that turned into sinus tachycardia lasting for around 6 hours until intervention. Heart rate peaked around 180. Rapid heart rate was likely a response to a high fever of 103 degrees F.


VAERS ID: 1195038 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-04
Onset:2021-04-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Balance disorder, Cerebrovascular accident, Dysarthria, Gait disturbance, Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Vestibular disorders (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Pt has cardiomyopathy and congestive heart failure.
Current Illness: none
Preexisting Conditions: cardiomyopathy and congestive heart failure
Allergies: sulfa drugs
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: PT had no reactions post administration. About 36 hours after administration, the patient had a CVA. Pt experienced numbness in his left arm and shortly after proceed to have slurred speech and loss of balance and gait. Patient take to Emergency Room where he received the diagnosis. the patient was hospitalized. After several days, patient was discharge and was recovering.


VAERS ID: 1195069 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-06
Onset:2021-04-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / -

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure increased, Dizziness, Dyspnoea, Headache, Heart rate increased, Hot flush, Myalgia, Peripheral swelling, Swelling face
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Flu vaccine, 24 yrs old. Shortness of breath. Swelling of injection site, swelling of face and hands
Other Medications: None
Current Illness: None
Preexisting Conditions: L4,L5 disc bulges; hip bursitis
Allergies: Flu vaccine, sudafedrine
Diagnostic Lab Data:
CDC Split Type:

Write-up: face and hand swelling, shortness of breath, increased heart rate to 120 BPM, dizziness and nearly fainted. Lasted 3-4 minutes. Was observed, blood pressure taken and was slightly elevated. Symptoms dissipated and was released to go home. Later had lasting headache and muscle pins for approx 18 hrs along with hot flashes. On 4/11/21 I then experienced the same episode lasting over an hour.


VAERS ID: 1195080 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A12A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood glucose, Blood magnesium, Blood pressure measurement, Computerised tomogram head, Electrocardiogram, Fall, Full blood count, Glomerular filtration rate, Head injury, Metabolic function test, Syncope, Urine analysis
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Thyroid
Allergies:
Diagnostic Lab Data: DPC POC GLUCOSE WHOLE BLOOD ECG 12-LEAD ORTHOSTATIC BLOOD PRESSURE BMP CBC EGFR (MDRD) Magnesium Level Pregnancy, Urine, Point of Care CT Head Without IV Contrast
CDC Split Type:

Write-up: Fainted and got hurt on the forehead with the fall , Went for urgent care next day and was advised to go to emergency for further examination. Feeling better now


VAERS ID: 1195126 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cold sweat, Dizziness, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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: none listed
Preexisting Conditions: Thrombocytopenia
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was vaccinated at clinic at approx 4pm and showed no signs and symptons during required 15 minute observation period. She return to work but began feeling lightheadness, cold sweats. and shortness of breath at 530pm. EMS was contacted at work place and patient was transported to hospital.


VAERS ID: 1195133 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Vermont  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Cold sweat, Disorientation, Electrocardiogram, Feeling abnormal, Feeling hot, Laboratory test, Palpitations
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Erithromycin
Diagnostic Lab Data: pulse, blood pressure, ecg, blood draws (don''t know what labs done).
CDC Split Type:

Write-up: I had shot and sat to be observed at 8:30 am. After about three minutes I felt a wave of adrenaline type feeling wash over me and my heart raced and I felt really out of it/fearful. I sat for a minute hoping it would pass, and it didn''t so I asked for help. EMT gave me pulse check and blood pressure, both were very very high (don''t know what) and irregular so they brought ECG. The ECG was also irregular. I felt disoriented and had waves of heat/blood racing/pulse racing. I was taken by ambulance to Hospital. Within 2.5 hours I was feeling better, not recovered but not as acute. They did another ECG, still irregular and did some blood draws which seemed to satisfy the Dr. that nothing was acute. Once I had returned to a more normal level they released me. Tonight at home I still have a bit of a racy clammy feeling but have felt more stable thus far. It was an awful, scary feeling and it come on in just two or three minutes after shot.


VAERS ID: 1195157 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Body temperature increased, Chills, Confusional state, Dizziness, Ear discomfort, Electrocardiogram normal, Fall, Fatigue, Feeling abnormal, Feeling hot, Gait disturbance, Hypoaesthesia, Insomnia, Loss of consciousness, Lymphadenopathy, Nausea, Pain, Pain in extremity, Paraesthesia, Poor quality sleep, Skin laceration, Somnolence, Syncope, Vision blurred
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Sertraline, 100 mg, daily
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 2021-04-09 EKG - normal Concussion check - negative
CDC Split Type:

Write-up: Major symptoms, roughly 20 hours after vaccination, 10-15 minutes after waking, while walking and standing: - Extreme pain in right hip joint. Pain is sharp, stabbing, burning. Pain radiates down leg, and right foot numb and tingly - Overheating - Lightheadedness, blurred vision, confusion - Fainting or loss of consciousness, falling to ground Timeline of events: 2021-04-08 13:00 Injected with Johnson & Johnson 13:00 - 13:15 Very slight nausea 13:15 - 22:00 Very slight nausea and fatigue 22:30 Lymph nodes in neck feel swollen, ears feel slightly clogged (typical early cold symptoms) 23:30 Insomnia and chills 2021-04-09 00:00 - 07:30 Insomnia, poor sleep, and cycles of chills and overheating while trying to sleep or sleeping. Stronger nausea than before 07:30 Wake up, knees feel slightly weak when walking 07:35 - 07:40 While walking inside a market. Right hip joint begins to hurt with sharp, stabbing, hot pain. The pain radiates down right thigh. Right foot begins to feel numb and tingle. This pain increased over 5 minutes, to excruciating levels, with right leg feeling numb, and sharp stabbing tingles in right foot. Difficult to walk normally 07:40 - 07:45 Pain becomes overbearing, and market counter used for support. Begin to feel light headed. Begin to feel hot, and begin to overheat within ~2 minutes. Walk outside market (outside temperature 32 - 40F) to cool down. Lean on car hood for support, and become increasingly lightheaded. Vision becomes blurry. Stumble and fall onto face. Regain consciousness after unknown time, groggy and with blurred vision, lightheaded feeling. Attempt to stand and fall again onto face. Regain consciousness after unknown time. No longer feeling extremely hot. After roughly 1 minute, regain clear vision and lucidity. Pain in hip and leg completely subsided 07:45 - 09:00 Driven to hospital. Treated by hospital staff for laceration in forehead requiring 7 sutures. EKG reports normal. Concussion check negative. 09:00 - 00:00 Occasional nausea, fatigue, weakness (same as weak cold) 2021-04-10 11:00 While walking and standing in line. Right hip joint begins to hurt, with pain radiating down right thigh. Right foot begins to feel numb and tingle. Begin to feel warm. Hip Pain remains at manageable level, and walking normally is easy. Hip pain is roughly 1/3 of pain of 2021-04-09. 2021-04-11 07:30 - 11:00 Occasional slight pain in right hip and left hip joints. Hip pain is sharp and burning, and roughly 1/10 of pain from 2021-04-09.


VAERS ID: 1195295 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-03-08
Onset:2021-03-13
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN NA / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Blindness unilateral, Computerised tomogram, Injection site pain, Magnetic resonance imaging, Muscle tightness, Neck pain, Optic ischaemic neuropathy, Pain in extremity, Pain in jaw, Rash, Scan with contrast, Vision blurred, X-ray
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Dystonia (broad), Extravasation events (injections, infusions and implants) (broad), Glaucoma (broad), Optic nerve disorders (narrow), Lens disorders (broad), Retinal disorders (broad), Osteonecrosis (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Truvada
Current Illness: None
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data: On March 17th you were treated by the physical therapist for arm pain. Next day saw doctor who booked physical therapy and chiropractor. Saw eye doctor on March 26th and received initial diagnosis of NAION and told to go to ER if symptoms develop worse. Saw doctor for eye pain on March 29th at the ER. Entered the emergency room on Monday March 29th and was treated with a CT scan and x ray and an MRI with dye, to test for blockages for arteries because of concern of stroke as a result of pain in neck and neck. No blockages diagnosed but pain was coming from the NAION and possible reaction to COVID shot.
CDC Split Type:

Write-up: Extreme left arm and shoulder neck pain and tightness within a week of shot and has persisted for over a month. Treated with Methocarbamol and Diclofenac Sodium. Within two and a half weeks of the shot, on March 23rd, sudden loss of peripheral vision in right eye. Doctor diagnosed as NAION, non-arthritic anterior ischemic optic neuropathy. Vision loss in one eye is blurred from varying angles and grayed out and is considered permanent. Eye problem caused pain down neck and jaw. Also, a rash developed over chest with symptoms similar to shingles.


VAERS ID: 1195310 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-04-09
Onset:2021-04-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Blood pressure decreased, Chest X-ray, Dizziness, Electrocardiogram, Full blood count, Metabolic function test, Pregnancy test, Syncope, Troponin
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Vestibular disorders (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: None
Current Illness: None
Preexisting Conditions: None
Allergies: Nonr
Diagnostic Lab Data: 4/10/21: Basic metabolic panel, complete blood count with auto differential, POCT pregnancy, urine, Troponin 1, ECG 12 lead, XR chest 2vw
CDC Split Type:

Write-up: Dizziness, severe drop in blood pressure & weakness leading to Syncope.


VAERS ID: 1195464 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abortion spontaneous, Blood urine present, Exposure during pregnancy, Labour pain, Premature separation of placenta, Surgery, Uterine contractions during pregnancy, Vaginal dilation procedure, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Termination of pregnancy and risk of abortion (narrow), Normal pregnancy conditions and outcomes (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Gestational Diabetes due to pregnancy and UTI
Preexisting Conditions: No
Allergies: None
Diagnostic Lab Data: All tests and laboratory results will be made available at Hospital. Placenta tests also performed at the same location. Reports maybe sent to Dr. at clinic
CDC Split Type:

Write-up: Patient was about 15 weeks pregnant and this was her first pregnancy. Her anticipated due date was Oct 1st 2021. On April 9th 2021 during a scheduled doctor visit at 3pm both baby and mother were in good health. On the same evening after the appointment she went for vaccination at Pharmacy and received the J&J vaccine. After receiving the vaccine in about 15 mins she felt like urinating and noticed blood in the urine and felt vaginal dilation. Within the next 15 to 20 mins she started experiencing mild labor pains and contractions. In the next 30 mins she started bleeding and was immediately taken to the ER. In the ER it was confirmed that she was having a miscarriage and the fetus was delivered. She also had to undergo emergency surgery to remove any remaining placenta in the uterus.


VAERS ID: 1195476 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Confusional state, Dizziness, Pyrexia, Seizure
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (narrow), Retroperitoneal fibrosis (broad), Dementia (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Seizures (never had before), high fever 102+, dizziness, severe back pain, convulsions and confusion


VAERS ID: 1195480 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-25
Onset:2021-03-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / IM

Administered by: School       Purchased by: ?
Symptoms: Abnormal behaviour, Behaviour disorder, Dizziness, Dizziness postural, Hyperhidrosis, Hypoacusis, Hypoaesthesia, Injection site pain, Laboratory test, Malaise, Panic attack, Paraesthesia, Vision blurred
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Hostility/aggression (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hearing impairment (narrow), Vestibular disorders (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Nothing was done to me because supposedly i left voluntarily that?s how out of it i was and disoriented i was that I didn?t even know i had left the hospital until the following day. I saw my primary physician and April 1 2021 he ordered labs after i mentioned what had happened to me still waiting on results.
CDC Split Type:

Write-up: Was administered covid vaccine J&J on left arm felt a burning sensation just after it which i knew it normal you just got a vaccine. Walked to the observatory area where we are supposed to wait 15min until you are released to go. Well less than 10 min in the observation area that?s when i started to feel un well my body started sweating excessively and thats when i felt numbness on my right side of my head with a tingling sensation couldn?t hear with my right ear and i freaked out when i started to get blurred vision thats when i knew something was wrong i got up to ask for water once i got up i felt like i was going to faint and felt really dizzy. Once i got to the lady that was there in the observation area she was shocked at how i looked she told me to go sit down and brought me water as she called the ambulance. Once i was sitting down and was brought water i drank like more than half of the water and the numbness was going down from my right side of my head but still had blurred vision and just felt disoriented and not my self. The ambulance took me to the ER once i got there i felt a little better but still disoriented and dizzy. So disoriented that i left the hospital with me actually realizing i had to stay there to get checked because they kept saying i was fine.


VAERS ID: 1195568 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-02
Onset:2021-04-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Blood thyroid stimulating hormone increased, Dizziness, Fatigue, Hypothyroidism, Insomnia, Laboratory test, Muscular weakness, Pain, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Hypothyroidism (narrow), Hyperthyroidism (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Ozempic, Metformin, Sertraline, Levocetirizine, Lisinopril, Pantroprazole, Atorvastatin, Fenofibrate
Current Illness: None
Preexisting Conditions: Type 2 Diabetes Non-Alcoholic Steatohepatitis Asthma
Allergies: None
Diagnostic Lab Data: Hypothyroidism (abnormally high TSH scores), via blood test 4/7/21 High white blood cell count, via blood test 4/7/21
CDC Split Type:

Write-up: Extreme fatigue, muscle weakness, faintness, insomnia, total body aches


VAERS ID: 1195594 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-19
Onset:2021-04-09
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Bell's palsy, Computerised tomogram, Laboratory test, Magnetic resonance imaging
SMQs:, Hearing impairment (broad)

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

Write-up: Bell''s Palsy


VAERS ID: 1195742 (history)  
Form: Version 2.0  
Age: 8.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

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

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

Write-up: Patient was administered a Janssen COVID vaccine lot # 043A21A at approximately 10:33 on 4/10/2021. Patient expressed no history of difficulty with shots or vaccinations. Patient gave no indication he was not feeling well or any indication he was experiencing difficulties. Shortly after administration of the vaccine, approximately 3 minutes and while handing Patient his paperwork, he became unresponsive. Patient was lowered to the floor where he exhibited what could be described as minor convulsions that were very short lived. His feet were elevated and he regained consciousness after approximately 2-3 minutes. His vitals were taken and recorded. Patient reported that he has no remarkable medical.


VAERS ID: 1195818 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-04-07
Onset:2021-04-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blindness transient, Confusional state, Dizziness, Flushing, Headache, Hyperhidrosis, Hypotension, Metamorphopsia, Pain, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Embolic and thrombotic events, arterial (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Retinal disorders (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (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: Body Aches Generalized-Severe, Systemic: Confusion-Severe, Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Severe, Systemic: Flushed / Sweating-Severe, Systemic: Headache-Severe, Systemic: Hypotension-Severe, Systemic: Visual Changes/Disturbances-Severe, Additional Details: patient experienced temporary blindness, sweating ,syncope- which is ultimately why we call the ambulance


VAERS ID: 1195955 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Blood test, Culture, Fatigue, Freezing phenomenon, Headache, Pain, Pyrexia, Urine analysis, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Levi thyroxine and Zyrtec
Current Illness: None
Preexisting Conditions: No thyroid, calcium disorder
Allergies: Vancomycin, seasonal allergies, latex
Diagnostic Lab Data: Went to ER got Bloodwork, cultures, urinalysis, fluids zofran snd toradol
CDC Split Type:

Write-up: Got the shot at 12pm by 2pm felt weak, achy, started to get a fever of 99.9, extremely tired. Took Tylenol by 1:30-? was throwing up and fever continued to spike to 102.4 and vomiting started. Pounding headache. Could not get fever to break and freezing.


VAERS ID: 1196032 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Conversion disorder, Muscular weakness, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (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:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt after denying any issues with injections appeared to faint in chair. At no time did pt fall forward or to the side. Pt alternating between following commands to open eyes with not responding Pulse 80 to 100 and reg rhythm throughout, strong in quality. When transferring pt to stretcher legs gave out but when chest thumb thrust applied pt pushed hand away and stood up to allow turn to stretcher. Placed in O2 via nasal cannula at 2lpm. Placed cold pac at base of neck and patient pushed it away also when applying rails pt pushed away from rails but unaable to grasps my fingers for strength check Pupils equal and reacting to light in less than two minutes pt began to follow commands and open eyes. Pt insistent upon driving self home " in a few hours." Pt quite upset son agrees with Dr and myself needs ED eval.Pt alternated with being unable to move lower extremities to moving feet on command. Per son this is not unusual for pt to do this. 911 called pt to TOH alert and responding Oriented times three. Son with pt. ED Dx: vasovagal episode with recurrent conversion disorder Patient refused admission, discharged home from ED


VAERS ID: 1196094 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-03-31
Onset:2021-03-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Hypoaesthesia, Malaise, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: AR2137

Write-up: Johnson-Johnson COVID-19 Vaccine EUA-- on 3/31/21 client presented at clinic 0750 for vaccine, completed paperwork and COVID vaccine administered by guardsman and given time she may leave. She stayed longer due to questions and her sister getting vaccine also. I had to call PCP for sister to get vaccine due to medical issues. I could not get through to PCP informed her I would call her. I called to tell them they would need to call her sister''s PCP At about 0846 she stated she was not feeling well. Stated she thinks her right side may be numb-tingling and right side of face. Informed her to go to ER if she thought she was having an allergic reaction or call 911. She stated she was in ER parking lot now. Stated her PCP wanted her to have this vaccine and she is allergic to Epinephrine, informed her to tell ER what she just told me and that she had received the COVID vaccine. At 3:00 PM client called and asked if predisone she got in ER would elevate her BP. She stated ER papers say paresthesia of skin, TIA vs allergic reaction to vaccine, work up TIA symptoms and sent home to follow up with PCP.


VAERS ID: 1196106 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dyskinesia, Flat affect, Foaming at mouth, Hyperhidrosis, Pallor
SMQs:, Neuroleptic malignant syndrome (broad), Dementia (broad), Convulsions (broad), Dyskinesia (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Psychosis and psychotic disorders (broad), Noninfectious encephalopathy/delirium (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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

Write-up: Approximately 2.5 minutes post vaccination- patient became diaphoretic, pale, and exhibited a flat affect. Upon opening his car door to further assess, client began to jerk and froth at the mouth. Event lasted <30 seconds. Epi pen administered at 5:20 pm and ambulance called. B/P 88/42, P-120, R-20, SaO2- 96%. Patient evaluated by ambulance personnel, but refused transfer. His girlfriend stated that she would take him via private car to hospital. Patient strongly encouraged to go via ambulance- repeatedly refused.


VAERS ID: 1196156 (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: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21 A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest X-ray, Chest pain, Electrocardiogram, Head discomfort, Laboratory test, Musculoskeletal chest pain, Pain, Tenderness
SMQs:, 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: Trazidone
Current Illness:
Preexisting Conditions:
Allergies: Darvocet, Percocet and sulfa
Diagnostic Lab Data: Chest X-rays, EKG and blood tests. 4/9/2021
CDC Split Type:

Write-up: Started with feeling a brick on my chest. Them my ribs hurt. Every breath hurt and I couldn?t take a deep breath. The pain spread all across my ribs and up my chest. It hurt to the touch.


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