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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: 1196185 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: North Carolina  
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 207A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood glucose normal, Confusional state, Hyperhidrosis, Malaise, Pain in extremity, Syncope, Thinking abnormal, Tremor, Unresponsive to stimuli, Visual impairment
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), Parkinson-like events (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Blood glucose 142 PIV inserted and bolus of 500mL of 0.9% normal saline was administered
CDC Split Type:

Write-up: After administration of Janssen vaccine 0.5mL, pt reported arm was hurting and he began moving arm. CMA noticed that continued to shake arm after 5 minutes but patient was alert and oriented x 3. CMA thought the way he was shaking his arm seemed irregular so she advised pt he would be taken to an observation area for further observation. Half way to the observation area, pt reported to CMA that he was seeing spots and felt like he was going to get sick. CMA called for help. Patient experienced a syncopal event just as he made it to the chair. Several staff was helping to support patient. Legs were lifted to another chair. Patient was not responsive for a short time, very diaphoretic, breathing regular and unlabored. Patients eyes then rolled upward toward the ceiling and patient''s entire body began shaking uncontrollably while staff managed to keep patient from falling to floor from the chair. Once patient was conscious, he was able to state his name but reported he was very confused and could not think clearly. He was able to sit upright. In the meantime while patient was shaking uncontrollably, staff sought urgent care provider to come and see patient. Patient was then taken over to the urgent care side of the building to evaluate and treat patient.


VAERS ID: 1196219 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-04-07
Onset:2021-04-10
   Days after vaccination:3
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: Pharmacy       Purchased by: ?
Symptoms: Back pain, Magnetic resonance imaging
SMQs:, Retroperitoneal fibrosis (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: TRANSVERSE MYELITIS
Allergies:
Diagnostic Lab Data: 4/17/2021 MRI
CDC Split Type:

Write-up: ON 4/17/2021 PT DEVELOPED BACK PAIN SIMILAR TO WHEN HE WAS FIRST DIAGNOSED WITH TRANSVERSE MYELITIS. PT WAS SEEN AT EMERGENCY ROOM. MRI WAS ORDERED AND COMPARED TO PREVIOUS MRI WITH NO SIGNIFICANT CHANGE SHOWN. PT WAS FEELING BETTER ON 4/18/2021 WHEN I CHECKED ON HIM


VAERS ID: 1196223 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: New York  
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 205A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: SINGULAR, CETIRIZINE
Current Illness:
Preexisting Conditions: ALLERGIES
Allergies: PENICILLIN, SULFA
Diagnostic Lab Data: EMERGENCY ROOM OBSERVATION FOR 3 HOURS AND PATIENT WAS GIVEN PREDNISONE AND AN EPIPEN (FOR AT HOME USE)
CDC Split Type:

Write-up: Patient 11/18/1975 had an allergic reaction to the Janssen vaccine. She was having difficulty breathing and she said "it felt like her throat was closing up". She did not have a rash at the site of injection and she is not allergic to latex. I gave her water yet that did not help so I administered an Epipen and told her to wait another 20 minutes. She felt an improvement afterwards and I told her to call me if anything else happens. She did not call and she informed her pcp about the reaction.


VAERS ID: 1196226 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-18
Onset:2021-03-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Anti-muscle specific kinase antibody negative, Antiacetylcholine receptor antibody, Antibody test normal, Asthenia, Asthma, Blood creatine phosphokinase normal, Blood immunoglobulin G normal, Blood thyroid stimulating hormone normal, Borrelia test negative, C-reactive protein normal, Chest X-ray normal, Computerised tomogram thorax normal, Condition aggravated, Dyspnoea, Dyspnoea exertional, Echocardiogram normal, Electrocardiogram normal, Electromyogram normal, Electrophoresis protein normal, Fatigue, Fibrin D dimer normal, Full blood count normal, Immunoelectrophoresis, Magnetic resonance imaging head normal, Metabolic function test normal, Obstructive airways disorder, Prothrombin time normal, Pulmonary function test abnormal, Red blood cell sedimentation rate normal, Respiratory distress, SARS-CoV-2 test negative, Troponin normal
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: multivitamin and Mirena IUD
Current Illness: none
Preexisting Conditions: allergies. childhood asthma
Allergies: seasonal
Diagnostic Lab Data: 3/30PFT-severe obstruction, 3/30CT chest-normal, 4/1MRI brain-stable, 4/1 EMG-normal, 4/1 echo-normal, 3/31 and 3/22chest xray-normal, 3/25, 3/31, 4/1 ekg-nsr Multiple lab tests 3/31-4/2 which were stable.-immunoglobulin igg, musk antibody test, pt, d dimer, achr modulating ab, achr binding ab acetylcholine receptor, lymes, cmp, cbc, immunofixation TP electrophoresis, tsh, covid pcr, crp, sed rate, cpk, troponin
CDC Split Type: vsafe

Write-up: Fatigue , SOB (shortness of breath), Dyspnea on exertion, Generalized weakness, Respiratory distress, COVID-19 vaccine administered Asthma exacerbation Possible COVID-91 allergic reaction Nebs, inhalers, IV and oral steroids, oxygen Symptoms ongoing


VAERS ID: 1196327 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Arizona  
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 202A21A / 1 LA / IM

Administered by: Public       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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: syncopal episode times 2 following vaccine.


VAERS ID: 1196347 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / N/A LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Aphasia, Blood pressure decreased, Dizziness, Eye movement disorder, Immediate post-injection reaction, Loss of consciousness, Nausea, Pruritus
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), 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), 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), Vestibular disorders (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: Patient passed out immediately following injection of vaccine. Her eyes rolled back and she was not able to speak. The vaccinator got help immediately, and patient''s husband was in the room. She remained in a seated position with her husband holding her head up while standing behind her. Her blood pressure dropped to 78/80, heart rate was 45 bpm. She was unconscious for approximately one minute and 30 seconds. 911 was called immediately and she was transported to medical center. When I called the patient today, she did say that she was feeling better. She mostly felt nauseous and dizzy following her vaccination. She reports that her arm still feel itchy and that she has been taking Benedry


VAERS ID: 1196417 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Arizona  
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 041A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin, Epi Pen
Current Illness: None
Preexisting Conditions: Diabetic, angioedema, PCOS
Allergies: Shellfish, narcatics, lisinopril, iodine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hives to chest and arms and complaining of a "scratchy" throat. Clear lung sounds. IV established and Benadryl given IV.


VAERS ID: 1196427 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-03-09
Onset:2021-03-17
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 RA / UN

Administered by: Other       Purchased by: ?
Symptoms: Anti-ganglioside antibody, Arthralgia, Back pain, CSF cell count normal, CSF culture negative, CSF glucose increased, CSF protein increased, Chills, Computerised tomogram normal, Diarrhoea, Fatigue, HIV test negative, Hypoaesthesia, Hypoaesthesia oral, Lumbar puncture abnormal, Magnetic resonance imaging normal, Pain in extremity, Sleep disorder, Treponema test negative
SMQs:, Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prilosec
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: 26 MAR: CT Scan, MRI all normal. 27 MAR Lumbar Spinal TAP: All tests normal. Ganglioside GM1 Ab IgG <1:800 titer;
CDC Split Type:

Write-up: 9/10 MAR: Fatigue, chills. 11 MAR: Diadiarrhea. 20/21 MAR: sharp pain between shoulder blades, pain in back of upper arms, back of thighs and legs. 22-Present Mar: Numbness in face, toungue, nose, &Total Pelvis area waist down to upper thigh. 24 - present MAR: Lower back pain. Unable to sleep well due to pain. 26-Present MAR: Severe numbness in fingers, toes & Feet. 3 Days in Hospital: 20-22 MAR. hospital CSF cell count was normal. Protein 60 glucose 105. CSF culture normal. CSF VDRL negative. Serum ACE HIV Sjogren''s antibodies and Lyme antibodies were negative.


VAERS ID: 1196476 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Blood test, Chills, Dizziness, Dyspnoea, Headache, Hypersomnia, Loss of consciousness, Monoplegia, Musculoskeletal stiffness, Paraesthesia, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: -zoloft -hydroxyzine -B12 -Iron
Current Illness:
Preexisting Conditions: -ovarian cysts -anxiety disorder
Allergies: none known
Diagnostic Lab Data:
CDC Split Type:

Write-up: -4 PM: intense headache -11:30 PM chills, uncontrollable vomiting -1:00 AM dizzy, fading consciousness, full-body tingling, paralysis and stiffness of legs, difficulty breathing -2:30 AM entered ER: blood tests, Tylenol, 2 IVs -7:00 AM discharged from ER -symptoms persisted the next two days, slept most of the day


VAERS ID: 1196527 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Kentucky  
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 - / UNK LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Anxiety, Malaise, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Glutean, basil and mushrooms (anaphylatic hx)
Diagnostic Lab Data:
CDC Split Type:

Write-up: 10:02 - Vaccine given by doctor, EMT. Patient was monitored for 30 minutes after vaccine was given. After 30 minutes she stated she felt fine and left with her mother. 10:42 - Patient returned to the vaccine clinic anxious and stating that she didn''t feel well and her throat was feeling tight and getting worse. She was assessed and epinephrine was administered via epi pen by RN. Within 15-30 seconds she stated she was experiencing relief. 11:00 - Diphenhydramine 25mg was given via injection per doctor. 11:15 - Patient was transported to ambulatory, via her mother, for observation. Doctor gave a report via telephone to the facility prior to her arrival.


VAERS ID: 1196552 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Kentucky  
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 201A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Anxiety, Malaise, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Glutean, basil and mushrooms (anaphylatic hx)
Diagnostic Lab Data:
CDC Split Type:

Write-up: 10:02 - Vaccine given. Patient was monitored for 30 minutes after vaccine was given. After 30 minutes she stated she felt fine and left with her mother. 10:42 - Patient returned to the vaccine clinic anxious and stating that she didn''t feel well and her throat was feeling tight and getting worse. She was assessed and epinephrine was administered via epi pen by RN. Within 15-30 seconds she stated she was experiencing relief. 11:00 - Diphenhydramine 25mg was given via injection. 11:15 - Patient was transported to ER, via her mother, for observation. Dr. gave a report via telephone to the facility prior to her arrival.


VAERS ID: 1196582 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Iowa  
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 043A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, Pruritus, Throat tightness, Urticaria, Vomiting
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Hives, Vomiting, tightness in throat, itching, tiredness


VAERS ID: 1196601 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Chills, vomiting, nausea, lightheaded within 5 minutes of vaccine administration


VAERS ID: 1196616 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: New York  
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 202A21A / 1 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Cold sweat, Dizziness, Head injury, Hyperhidrosis, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (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:
Current Illness:
Preexisting Conditions:
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vasovagal / syncope episode with subsequent fall to the ground, striking head; taken to the Emergency Department, stated prior to syncopal episode felt lightheaded, sweaty, clammy. Patient discharged to home within 3 hours of ED admission.


VAERS ID: 1196626 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-08
Onset:2021-04-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Dyspnoea, Palpitations
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

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

Write-up: Shortness of breath Heart palpitations


VAERS ID: 1196628 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
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 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: amitriptyline 10 mg oral tablet, 10 mg= 1 tab(s), Oral, DAILY (AT BEDTIME) Dulcolax Stool Softener 100 mg oral capsule, 100 mg= 1 cap(s), Oral, DAILY, PRN ibuprofen 200 mg oral tablet, 400 mg= 2 tab(s), Oral, q8hr, PRN levothyroxine 50 mcg
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: cefaclor (Hives) morphine (Erythema at injection site, Unknown) amoxicillin (Unknown) penicillin (Unknown) ''ivory dish soap'' ?Potatoes: Anaphylaxis
Diagnostic Lab Data: None
CDC Split Type:

Write-up: started with tongue swelling and then felt like her throat was starting to close in. Placed in Wheelchair and taken up to ED. Gave her 50 po Benadryl on our way up to ED. In the ED was given the following medication Medications Administered During Visit diphenhydrAMINE, 25 mg, IV Push EPINEPHrine Soln 1 mg/mL, 0.3 mg, IM methylPREDNISolone sodium succinate, 125 mg, IV Push sodium chloride 0.9% bolus *, 500 mL, IV Piggyback Medical Decision Making 1249 Tongue back to normal. VS stable. Home. See instructions


VAERS ID: 1196670 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Pennsylvania  
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 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Electrocardiogram, Hyperhidrosis, Musculoskeletal stiffness
SMQs:, Neuroleptic malignant syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (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 FELT SWEATING AND ANXIETY IN 5 MINS , DIDN''T WAIT AFTER VACCINE DROVE HOME THEN HIS FINGERS WERE LOCKED, WENT TO HOSPITAL WAITED FOR 3 HOURS THEN EKG WAS DONE , HOSPITAL FOUND NOTHING WRONG AND WAS RELEASED. PATIENT IS DOING OK NOW


VAERS ID: 1196698 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: New York  
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 202A21A / 1 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Cold sweat, Computerised tomogram, Dizziness, Fall, Head injury, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (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:
Current Illness:
Preexisting Conditions:
Allergies: NKDA
Diagnostic Lab Data: CT head (04/11/21)
CDC Split Type:

Write-up: Vasovagal / syncope with subsequent fall to the ground, striking head; transferred to Emergency Department - stated lightheaded, dizziness, clammy prior to syncope and fall. Patient discharged to home in stable condition from facility within 3 hours.


VAERS ID: 1196712 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-12
Onset:2021-03-22
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Activated partial thromboplastin time, Blood culture, Blood grouping, Blood lactic acid, Blood magnesium, Blood phosphorus, Computerised tomogram abdomen, Computerised tomogram abnormal, Culture tissue specimen, Culture urine, Differential white blood cell count, Endoscopic retrograde cholangiopancreatography, Full blood count, Haematocrit, Haemoglobin, International normalised ratio, Lipase, Liver function test, Metabolic function test, Pain, Platelet count, Portal vein thrombosis, Prothrombin time, Rhesus antibodies, SARS-CoV-2 test, Scan with contrast, Ultrasound abdomen, Ultrasound pelvis, Ultrasound scan vagina, Urine analysis
SMQs:, Embolic and thrombotic events, venous (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Amoxicillin -Clavunate 875-125 mg Per Tablet Docusate sodium 100 Mg Capsule Hydrocodone-acetaminphen 5-325 Mg per Tablet Ibuprofen 600mg Tablet
Current Illness: Laparoscopic Cholecystectomy
Preexisting Conditions: Tyrod but under control
Allergies: NO
Diagnostic Lab Data: PROTHROMBIN TIME/INR Apr 5, 2021 Lab PROTHROMBIN TIME/INR Mar 30, 2021 Lab PROTHROMBIN TIME/INR Mar 29, 2021 Lab PLATELET COUNT Mar 29, 2021 Lab PROTHROMBIN TIME/INR Mar 26, 2021 Lab CBC Mar 25, 2021 Lab PT/INR/PTT Mar 25, 2021 Lab BASIC METABOLIC PROFILE Mar 25, 2021 Lab MAGNESIUM Mar 25, 2021 Lab PHOSPHORUS Mar 25, 2021 Lab LIVER PROFILE Mar 25, 2021 Lab CBC Mar 24, 2021 Lab LIVER PROFILE Mar 24, 2021 Lab BASIC METABOLIC PROFILE Mar 24, 2021 Lab MAGNESIUM Mar 24, 2021 Lab PHOSPHORUS Mar 24, 2021 Lab PT/INR/PTT Mar 24, 2021 Lab APTT Mar 23, 2021 Lab APTT Mar 23, 2021 Lab APTT Mar 23, 2021 Lab PROTHROMBIN TIME/INR Mar 23, 2021 Lab CBC Mar 23, 2021 Lab LIVER PROFILE Mar 23, 2021 Lab BASIC METABOLIC PROFILE Mar 23, 2021 Lab MAGNESIUM Mar 23, 2021 Lab PHOSPHORUS Mar 23, 2021 Lab HEMOGLOBIN AND HEMATOCRIT, BLOOD Mar 22, 2021 Lab PT/INR/PTT Mar 22, 2021 Imaging US PELVIS NON-OB, US TRANSVAGINAL NON-OB,DOPPLER COMPLETE Mar 22, 2021 Imaging CT abdomen pelvis with iv contrast Mar 22, 2021 Lab BASIC METABOLIC PROFILE Mar 22, 2021 Lab MAGNESIUM Mar 22, 2021 Lab PHOSPHORUS Mar 22, 2021 Lab CBC Mar 22, 2021 Lab LIVER PROFILE Mar 22, 2021 Lab SURGICAL SPECIMEN EXAM Mar 21, 2021 Imaging ERCP Mar 21, 2021 Imaging ERCP Mar 21, 2021 Lab CBC Mar 21, 2021 Lab BASIC METABOLIC PROFILE Mar 21, 2021 Lab LIVER PROFILE Mar 21, 2021 Lab MAGNESIUM Mar 21, 2021 Lab PHOSPHORUS Mar 21, 2021 Imaging US ABDOMEN LIMITED Mar 20, 2021 Lab URINALYSIS AUTO ONLY Mar 20, 2021 Lab URINE CULTURE Mar 20, 2021 Lab CULTURE, BLOOD Mar 20, 2021 Lab ABO/RH TYPE AND ANTIBODY SCREEN Mar 20, 2021 Lab CBC AND DIFFERENTIAL Mar 20, 2021 Lab BASIC METABOLIC PROFILE Mar 20, 2021 Lab PT/INR/PTT Mar 20, 2021 Lab MAGNESIUM Mar 20, 2021 Lab CULTURE, BLOOD Mar 20, 2021 Lab LACTIC ACID, PLASMA Mar 20, 2021 Lab LIPASE Mar 20, 2021 Lab LIVER PROFILE Mar 20, 2021 Lab 2019 NCORONAVIRUS, PCR Mar 20, 2021
CDC Split Type: 63715663

Write-up: Couple days after they release patient from the hospital she start with Pain, we take her to the emergency room and they made a CAT scan finding a Blood Clot on the Porta vein, she start with Blood thinners and she still on treatment because that.


VAERS ID: 1196715 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Ohio  
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 1808609 / UNK LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Allergy to vaccine
SMQs:, 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: Moderna
Other Medications: None
Current Illness:
Preexisting Conditions: none verbalized
Allergies: Several Allergies, Moderna vaccine
Diagnostic Lab Data:
CDC Split Type: MD ordered Janssen vaccin

Write-up: Pt. with history of allergic reaction to Moderna vaccine. PCP ordered administration of JnJ vaccine in presence of paramedics. Vaccination given. Per EMS, epinephrine (patient''s owns epipen) was administered @ 1059AM prior to transporting to hospital.


VAERS ID: 1196717 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / N/A LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Vasovagal syncope within 10 minutes following administration of vaccine


VAERS ID: 1196729 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 RA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: SWELLING ALL OVER BODY


VAERS ID: 1196735 (history)  
Form: Version 2.0  
Age: 43.0  
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 202A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood pressure increased, Dizziness, Nausea, Tachycardia, Tremor
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Vestibular disorders (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: c/o dizziness, nausea and shaking. BP elevated and tachycardic. Blood glucose 110. Started to resolve and then felt worse again. Transported by POV with husband driving to Er. Refused 911.


VAERS ID: 1196750 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: California  
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 - / 1 - / IM

Administered by: Other       Purchased by: ?
Symptoms: Confusional state, Loss of consciousness, Seizure, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (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), Dementia (broad), Convulsions (narrow), 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 (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: loss of consciences after injection was given, seizure, vomiting and confusion, monitoring in EMS and transferred to higher level of care via EMS services


VAERS ID: 1196754 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Gaze palsy, Hypoaesthesia, Hypoaesthesia oral, Musculoskeletal stiffness, Tremor, Vision blurred
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Ocular motility disorders (narrow), Arthritis (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: none
Preexisting Conditions: seizure disorder
Allergies: Erythromycin, Penicillin
Diagnostic Lab Data: BP log on 4/12/21: 175/94, 179/79,158/72
CDC Split Type:

Write-up: Patient experienced numbness in peripheral extremities and lips, headache, hypertension, neck stiffness, tremor, and blurred vision


VAERS ID: 1196794 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Back pain, Chills, Feeling cold, Injection site pain, Pain in extremity, Pyrexia, SARS-CoV-2 test negative, Urine analysis normal, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None.
Current Illness: None.
Preexisting Conditions: None.
Allergies: None.
Diagnostic Lab Data: On April 10, 2021 the doctor ordered a covid-19 test which came back negative. I also had a urine analysis done the same day which the results show that everything was in the normal range.
CDC Split Type:

Write-up: At around 6:30 p.m on April 9, 2021, I started to feel very cold at home. I had sever chills where I was under 5 heavy blankets unable to get warm. I also had a high fever which was 104.8 degrees Fahrenheit. I also threw up twice and had body aches in my arm where the nurse injected the vaccine, my lower back, and calves of my legs. When my temperature did not go down, I went to Emergency Room at around 12:00 a.m. April 10, 2021. I was placed in isolation. The nurse took my vitals and the doctor ordered covid test for me and a urine analysis. The covid test came back negative and my urine analysis was in the normal range. The nurse gave me Tynenol at around 1 am and ibuprofen at around 2:30 am. I was discharged at approximately 5 am on April 10, 2021 with a 98.4 degree temperature.


VAERS ID: 1196826 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: New York  
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 202A21A / 1 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Blindness, Cold sweat, Computerised tomogram head, Dizziness, Head injury, Laboratory test, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: remote history of seizure, previous history of vagal episode when donating blood, vagal episode while having labs drawn during current ED admission for vagal episode s/p COVID vaccination.
Allergies: NKDA
Diagnostic Lab Data: CT head, routine labs.
CDC Split Type:

Write-up: vasovagal episode / syncope with subsequent fall to ground, striking head. lightheaded, clammy, loss of vision prior to episode. Brought to Emergency Department, discharged to home in stable condition within 5 hours.


VAERS ID: 1196869 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Arizona  
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 1805020 / 1 UN / IM

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Chills, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Hypoglycaemia (broad)

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

Write-up: Post-vaccination, patient began trembling and stated she had the chills (shivering). She took 2 tablets of her own personal oral Benadryl. Blood pressure and heart rate per checked; BP 168/90 HR 123. When checked 15 minutes later, BP was the same and HR was 118. Patient stated she was anxious and did not take her fluoxetine that morning. EMS was called and patient was transported.


VAERS ID: 1196901 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Disorientation, Dizziness, Dysarthria, Fall, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Vestibular disorders (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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: propranolol vitamin D calcium
Current Illness: none known
Preexisting Conditions: cerebral palsy which affected mental not physical
Allergies: bees
Diagnostic Lab Data: blood work 4/9/21 chest xray 4/9/21
CDC Split Type:

Write-up: around 3 AM patient got dizzy and passed out. When I talked to patient at 6:30 AM, he stated to me that he was dizzy and fell during the night, his voice was very slurred and I could hardly understand him, he was also very disoriented. Took him to hospital ER around 7 AM


VAERS ID: 1196992 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Massachusetts  
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 043A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chest discomfort, Headache
SMQs:, Anaphylactic reaction (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: Multiple allergies
Allergies: milk, silicone, augmentin, caffeine, corticosteroid, reglan
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Patient received vaccine and escorted to monitoring area . Developed chest tightness and headache several minutes after administration. she reported multiple allergies, took own Claritin. VS stable, airway patent, no erythema or edema. speaking clearly. 911 called, she declined transport. Watched for 30 minutes and went to ER by private car


VAERS ID: 1197014 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chest discomfort, Pruritus, Rash, Swelling face
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Became itchy on extremities. Developed rash but chest and throat. Started to have swelling to forehead and eyes. Denies SOA but states chest feels heavy. PT sent tp ED via Ambulance.


VAERS ID: 1197028 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Massachusetts  
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 043A21A / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Immediate post-injection reaction, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)

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

Write-up: Patient fainted immediately after receiving the vaccine


VAERS ID: 1197031 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-05
Onset:2021-04-06
   Days after vaccination:1
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: Body temperature increased, Cough, Dyspnoea, Headache, Influenza virus test negative, SARS-CoV-2 test negative, Tremor, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (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), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Thyroid medication
Current Illness:
Preexisting Conditions:
Allergies: Ceclor , hydroclorprep
Diagnostic Lab Data: 3 PCR test(4/6 & 2 on 4/9) & 1 rapid (4/9) ? all negative Flu also on 4/9 and negative
CDC Split Type:

Write-up: 103.5+ temp, uncontrollable shakes, headaches, vomiting for 7 days, cough, difficulty catching breath


VAERS ID: 1197039 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-04-08
Onset:2021-04-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain upper, Diarrhoea, Gastric dilatation, Palpitations, Vital signs measurement
SMQs:, Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific dysfunction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow)

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

Write-up: Diarrhea, noticeably distended stomach, with severe stomach pain for about 2 days. treated with smooth muscle relaxer. Currently recovering.


VAERS ID: 1197040 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Illinois  
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 201A21A / 1 UN / IM

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

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

Write-up: Patient began to feel dizzy around 10 minutes of waiting after the vaccine administration. Patient then began to vomit but could not get all of the vomit out of her throat. She then passed out. Patient was lethargic and difficult to arouse. Patient''s blood pressure was 122/80. Medics were called and arrived on scene and took patient to the ER.


VAERS ID: 1197046 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: South Carolina  
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 206A21A / 1 LA / IM

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

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

Write-up: Patient representative called pharmacy 4/12/21 stating husband, fainted while at dinner about 5 hours after receiving vaccination on 4/11/21. 911 was called and patient was cleared by EMS at home.


VAERS ID: 1197047 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Virginia  
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 1808980 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain upper, Diarrhoea, Dizziness, Electrocardiogram, Headache, Heart rate increased, Influenza like illness, Loss of consciousness, Nausea, Pyrexia
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: none
Preexisting Conditions: Alpha Gal Allergy
Allergies: Alpha Gal Allergy Erythomycin Iodine Contrast Dye Morphine
Diagnostic Lab Data: EKG 4-11-2021
CDC Split Type:

Write-up: Sever dizziness approximately 10min after dosing of the vaccine. Several hours later severe flulike symptoms. At around 2am April 11 I went to use the bathroom and blacked out. My wife found me on the floor and was able to rouse me. Went to the ER with severe stomach pain, nausea, diarrhea, severe headache, fever, high pulse of 120-140bpm. Pulse dropped to 108bpm by the time i got to te hospital. Hospital administered Zofran for my gastro issues and ran an EKG. We waited 3+ hours and never saw a doctor and was never even taken back in the ER. We left due to staff and patients in the waiting room not wearing respirators or masks or even basic sanitary precautions or separation of patients with Covid symptoms from other patients.


VAERS ID: 1197092 (history)  
Form: Version 2.0  
Age: 41.0  
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 202A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Anxiety, Blood glucose, Dizziness, Feeling jittery, Hypotension, Pallor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None reported by patient
Current Illness: None
Preexisting Conditions: Self reported anxiety, near syncope and syncope with medical procedures, especially needles.
Allergies: No known allergies reported
Diagnostic Lab Data: Finger stick glucose Rhythm strip, NSR
CDC Split Type:

Write-up: Patient with self-reported history of anxiety, syncope and near syncope with medical procedures/needles. Complained of feeling anxious, light-headed, jittery after vaccination. Became pale, placed in a supine position, provided oral fluids, including fluids with sugar, VS stable, hypotensive to 77/57, pulse ox 99%, blood glucose 185, NSR on monitor reported by EMT on site. Husband called, patient declined EMS transport, was able to ambulate with supervision to husband''s car, husband transport to local ER in private vehicle. Follow up with patient <24 hrs post vaccination: patient reported feeling better. Admitted she was anxious about receiving vaccination since appointment was made one week ago.


VAERS ID: 1197093 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-03-09
Onset:2021-03-11
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Palpitations, Rash
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine , Colchicine, Amitriptyline, Quinapril, Metropolol Succinate. Multivitamin Vitamin C Vitamin d3 Magnesium COQ10
Current Illness:
Preexisting Conditions: Post Lyme Arthritis , Behcets Syndrome , Mitral Valve Leak, Cardiac Arrythmia,
Allergies: Penicillin,Sulfa ,Tegretol
Diagnostic Lab Data:
CDC Split Type:

Write-up: Diarrhea, palpitations, rash on feet and legs


VAERS ID: 1197127 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dyspnoea, Presyncope, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

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

Write-up: Shortness of breath, tightening of throat, near syncope. PT had a Hx asthma and allergic reactions to antibiotics. 0.3 mg EPI via autoinjector left medical thigh. 8 doses of albuterol MDI PT improved after treatment. Evaluated, treated by EMS. Transported to ED for further evaluation and treatment.


VAERS ID: 1197133 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A-21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Cardiac function test, Chills, Dyspnoea, Electrocardiogram, Electrocardiogram ambulatory, Fatigue, Feeling abnormal, Fibrin D dimer, Full blood count, Metabolic function test, Pain, Palpitations, Pyrexia, Tremor
SMQs:, Anaphylactic reaction (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), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (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: Multi-vitamin
Current Illness: none
Preexisting Conditions: none
Allergies: NKA
Diagnostic Lab Data: EKG, Holter monitor, CBC, Chem Profile, Cardiac Profile, D-dimer, bag of fluids given and 1 bag of Magnesium sulfate given all done during ER visit 4/9/2021 @ 2200. Will be following up with cardiologist later this week.
CDC Split Type:

Write-up: At 1500 started having chills, running a fever and was very shaky. Took Tylenol and rested. Around 2100 woke up feeling even worse and felt like heart was racing with frequent pauses (3-5 PVC''s/minute). Following ER visit continued to feel tired, achy, and occasional SOB.


VAERS ID: 1197135 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-12
Onset:2021-04-12
   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: Unknown       Purchased by: ?
Symptoms: Dyspnoea, Heart rate increased, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Dehydration (broad)

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

Write-up: SOB, WHEEZING, ELEVATED HR, EPI X1. Evaluated by EMS- Transported to Emergency room/department or urgent care.


VAERS ID: 1197155 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-09
Onset:2021-04-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: none
Preexisting Conditions: obesity
Allergies: benadryl, nyquil, sulfa (alcohol), goat cheese, bees, watermelon, lobster, amoxicillan, some antihistemines
Diagnostic Lab Data: bloodwork IV Steroids
CDC Split Type:

Write-up: 7:00am hives right arm 11:00am hives spread on left arm 12:30pm hives spread to neck and face under chin and cheeks 1:00pm went to ER


VAERS ID: 1197167 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Feeling hot, Flushing, Nausea, Paraesthesia, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Moderna COVID vaccine on 12/24/2021 (already a VAERS report)
Other Medications:
Current Illness:
Preexisting Conditions: Diabetes, GERD
Allergies: Allergic reaction to Moderna COVID vaccine
Diagnostic Lab Data: No labs or tests done in ER
CDC Split Type:

Write-up: Patient became very warm, with tingling and nausea. Pt vomited approximately 30 minutes after vaccine and face and neck became flushed. Taken to ER for continued monitoring and treatment


VAERS ID: 1197219 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Illinois  
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 - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Blood creatine phosphokinase, Blood lactic acid, Chest discomfort, Chills, Differential white blood cell count, Drug screen, Dyspnoea, Dystonia, Electrocardiogram, Full blood count, Headache, Human chorionic gonadotropin, Hyperhidrosis, Hypoaesthesia, Metabolic function test, Muscle contractions involuntary, Myalgia, Nervous system disorder, Paraesthesia, Pyrexia, Seizure, Speech disorder, Tremor, Troponin, Urinary incontinence, Visual impairment
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (narrow), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Dystonia (narrow), Parkinson-like events (broad), Drug abuse and dependence (broad), Acute central respiratory depression (broad), Psychosis and psychotic disorders (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Generalised convulsive seizures following immunisation (narrow), 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? 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: CBC W/DIFF AUTOMATED CHRONIC GONADOTROPIN HCG QL CK (CPK) COMPREHENSIVE METABOLIC PANEL DRUG SCREEN RAPID LACTIC ACID TROPONIN, QUANT ECG 12 LEAD
CDC Split Type:

Write-up: 11pm: Fever, chills and muscle aches 3am: Chills and muscle aches worsen 6am: Weak and short of breath 7:30am: Body begins to tingle, cant really feel hands or feet, trouble breathing, shaking, eyesight worsens, chest tightens, headache 7:43am: Call husband for help, begin sweating a lot 8am: Call 911, begin convulsing, trouble talking, cant see well, trouble breathing, urinate on myself Continue to have convulsions. Taken by ambulance to hospital. Continue to have involuntary contractions, tightening of chest, trouble breathing, bad eyesight, headache. etc. Diagnosed with Dystonic Reaction and Neurologic Problem because of a vaccine complication


VAERS ID: 1197228 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Connecticut  
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 1808982 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dyskinesia, Gaze palsy, Hyperhidrosis, Immediate post-injection reaction, Loss of consciousness, Pallor, 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), Dyskinesia (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)

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

Write-up: 30 year old femail received Janssen vaccine Lot# 1808982 exp: 6/23/21 at approximately 3pm in the left deltoid. Immediately after being vaccinated, pt. requested to remain seated. The nurse noted that the pt. was getting pale so she suggested the pt. take off the surgical mask to get some air. Before pt. had a chance to take off the mask she lost consciousness. Together with another nurse patient was lowered onto the floor. Pt. regained consciousness for 30-45 seconds and then began to have seizure like activity. Her eyes rolled back and her body became stiff and began a jerking motion. 911 was called. This seizure like activity lasted 4-6 seconds at which time pt. regained consciousness and immediately sat up. Pt was pale and diaphoretic. BP 98/64, HR 78, Pulse Ox 99%. Pt vomited multiple times. Ice was applied to the posterior neck and a cold compress to the forehead . EMS arrived and took vitals: BP 78/40. Pt. was aware of person, place and situation. Pt. was taken to Hospital accompanied by her husband. Pt was called by me Friday and she was home. All tests showed no sign of having a seizure.


VAERS ID: 1197247 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Illinois  
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 / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Laboratory test normal, Loss of consciousness, Unresponsive to stimuli
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: Unknown
Current Illness: None
Preexisting Conditions: none
Allergies: None
Diagnostic Lab Data: No abdnormal tests found 4/3
CDC Split Type:

Write-up: Patient passed out and unresponsive and brought to hospital $g 24 hours after vaccine given


VAERS ID: 1197388 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Oregon  
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 041A21A / 1 AR / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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 was nervous about the vaccination. About 5 minutes after vaccination patient got up from waiting area to ask for water and fainted, fell and hit her head. EMS was immediately called, arrived shortly and transported patient.


VAERS ID: 1197486 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Anaphylactic reaction, Feeling abnormal, Suspected COVID-19
SMQs:, Anaphylactic reaction (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Dementia (broad), Hypersensitivity (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210409239

Write-up: ANAPHYLAXIS; COVID LIKE SYMPTOMS; FLAT OUT; This spontaneous report received from a patient via a company representative concerned a 54 year old of unspecified sex. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. It was reported that the health care professional (HCP) did the stress full immunity after three four weeks with vaccine. They caught anaphylaxis quickly. The patient was expecting to have a reaction as the patient was vaccine sensitive. It took about 8 minutes post jab. The HCP was on it very quickly, but it was severe. The patient clarified that it was full anaphylaxis. On an unspecified date the patient was flat out. The patient might have been exposed to emergency room (ER). The patient was having COVID like symptoms so would get a test on Monday. The patient was still recovering. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from anaphylaxis, flat out, and COVID like symptoms. This report was serious (Hospitalization Caused / Prolonged, and Other Medically Important Condition).; Sender''s Comments: 20210409239-JANSSEN COVID-19 VACCINE Ad26.COV2.S- Anaphylaxis. This event is considered related. The event has a compatible/suggestive temporal relationship, is unlabeled, and is scientifically plausible. There are no other factors more likely to be associated with the event than the drug.


VAERS ID: 1197488 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Virginia  
Vaccinated:0000-00-00
Onset:2021-03-09
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Chest discomfort, Chills, Dyspnoea, Muscular weakness, Musculoskeletal stiffness, Pain in extremity, Pyrexia, Sensory disturbance
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Non-smoker
Preexisting Conditions: Comments: The patient had no known drug allergies and no any drug abuse or illicit drug use
Allergies:
Diagnostic Lab Data: Test Date: 20210309; Test Name: Body temperature; Result Unstructured Data: 101.1 F, High
CDC Split Type: USJNJFOC20210409397

Write-up: Pain of lower extremities; SHORTNESS OF BREATH; WEAKNESS OF THE UPPER ARMS; WEAKNESS OF LEGS; Chills; Fever; VIBRATION SENSE ON BOTH LEGS; Chest tightness; STIFFNESS/TIGHTNESS OF LEGS; This spontaneous report received from a consumer concerned a 62 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included non alcohol user, and non smoker, and other pre-existing medical conditions included the patient had no known drug allergies and no any drug abuse or illicit drug use. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805029 expiry: UNKNOWN) dose was not reported, administered on 09-MAR-2021 14:30 for prophylactic vaccination. No concomitant medications were reported. On 09-MAR-2021, the subject experienced vibration sense on both legs. On 09-MAR-2021, the subject experienced chest tightness. On 09-MAR-2021, the subject experienced stiffness/tightness of legs. On 09-MAR-2021, the subject experienced chills. On 09-MAR-2021, the subject experienced fever. Laboratory data included: Body temperature (NR: not provided) 101.1 F. On 16-MAR-2021, the subject experienced weakness of legs. On 23-MAR-2021, the subject experienced weakness of the upper arms. On 04-APR-2021, the subject experienced shortness of breath. On an unspecified date, the subject experienced pain of lower extremities. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from chest tightness, chills, and fever on 10-MAR-2021, and had not recovered from vibration sense on both legs, shortness of breath, weakness of legs, weakness of the upper arms, stiffness/tightness of legs, and pain of lower extremities. This report was non-serious.; Sender''s Comments: V0: Medical Assessment Comment not required as per standard procedure as case assessed as Non serious.


VAERS ID: 1197515 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Platelet count, Platelet count decreased
SMQs:, Haematopoietic thrombocytopenia (narrow), Systemic lupus erythematosus (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? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Autoimmune deficiency syndrome
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Name: Platelet count; Result Unstructured Data: worse; Test Name: Platelet count; Result Unstructured Data: Low/Poor numbers
CDC Split Type: USJNJFOC20210411605

Write-up: PLATELETS DECREASED; This spontaneous report received from a consumer concerned of unspecified age. The patient''s height, and weight were not reported. The patient''s concurrent conditions included autoimmune deficiency. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose,1 total, start therapy date were not reported for prophylactic vaccination. No concomitant medications were reported. The batch number was not reported. Per procedure, no follow-up will be requested for this case. Laboratory test was recommended by her doctor due to her autoimmune deficiency. On an unspecified date, the patient did quarterly blood test for platelet count which showed poor platelets numbers (platelets decreased), however retest was performed for possible test error and poor numbers. Retest showed the worse results and doctor requested patient to proceed to an emergency room. Patient was hospitalized (date unspecified) for a week with hourly blood test to daily test. Patient was discharged from hospital at the end of week with weekly test checks. Laboratory data (dates unspecified) included: Platelet count as Low/Poor numbers and platelet count second test showed worse result. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from platelets decreased. This report was serious (Hospitalization Caused / Prolonged).; Sender''s Comments: V0: 20210411605-covid-19 vaccine ad26.cov2.s-platelets decreased. This event is considered not related. The event has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event than the drug. Specifically: MEDICAL HISTORY


VAERS ID: 1197517 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Unknown  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-04-06
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure measurement, Heart rate, Hypertension, Oxygen saturation, Palpitations, Somnolence, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypertension (narrow), Cardiomyopathy (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? Yes, ? days
   Extended hospital stay? 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: Did go down eventually; Test Date: 20210406; Test Name: Pulse rate; Result Unstructured Data: Normal; Test Date: 20210406; Test Name: Blood pressure; Result Unstructured Data: 230/116 mmHg; Test Date: 20210406; Test Name: Oxygen saturation; Result Unstructured Data: Normal
CDC Split Type: USJNJFOC20210411645

Write-up: ELEVATED BLOOD PRESSURE; HEART PALPITATIONS; SHAKINESS; DROWSINESS; This spontaneous report received from a health care professional concerned a 29 years old of unspecified sex. The patient''s weight, height, and medical history were not reported. The patient received COVID-19 VACCINE AD26.COV2.S (suspension for injection, route of admin not reported, batch number: 042A21A, expiry: UNKNOWN) dose was not reported, 1 total administered on 06-APR-2021 on left arm for prophylactic vaccination. No concomitant medications were reported. On 06-APR-2021, five minutes after vaccination the patient experienced elevated blood pressure, heart palpitations, shakiness and drowsiness. On 06-APR-2021, Laboratory data included: Blood pressure (NR: not provided) 230/116 mmHg, Oxygen saturation (NR: not provided) Normal, and Pulse rate (NR: not provided) Normal. Blood pressure did go down eventually. Patient was rushed to the hospital/Emergency room on 06-APR-2021. The action taken with COVID-19 VACCINE AD26.COV2.S was not applicable. The patient was recovering from elevated blood pressure and heart palpitations, and the outcome of shakiness and drowsiness was not reported. This report was serious (Hospitalization Caused / Prolonged).; Sender''s Comments: COVID-19 VACCINE AD26.COV2.S -elevated blood pressure, heart palpitations, shakiness and drowsiness. These events are considered unassessable. The events have a compatible/suggestive temporal relationship, are unlabeled, and have unknown scientific plausibility. There is no information on any other factors potentially associated with the events.


VAERS ID: 1197523 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:0000-00-00
Onset:2021-04-03
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blister, Body temperature, Facial pain, Pyrexia
SMQs:, Severe cutaneous adverse reactions (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Glaucoma (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: PENICILLIN [BENZYLPENICILLIN]
Current Illness: Penicillin allergy
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210403; Test Name: Body temperature; Result Unstructured Data: 38 C, 38 CELSIUS
CDC Split Type: USJNJFOC20210411692

Write-up: LEFT SIDE FACE PAIN; BLISTERS ON THE FACE; FEVER; This spontaneous report received from a consumer concerned a 28-year-old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included penicillin allergy. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 042A21A, expiry: UNKNOWN) dose was not reported, administered on 03-APR-2021 in left deltoid for prophylactic vaccination. Concomitant medications included benzylpenicillin. On 03-APR-2021, the subject experienced fever. Laboratory data included: Body temperature (NR: not provided) 38 C. On 05-APR-2021, the subject experienced left side face pain. On 05-APR-2021, the subject experienced blisters on the face. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from fever on 04-APR-2021, and had not recovered from left side face pain, and blisters on the face. This report was non-serious.


VAERS ID: 1197536 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: California  
Vaccinated:0000-00-00
Onset:2021-04-04
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Burning sensation, Electric shock sensation, Headache, Injection site erythema, Injection site pain, Injection site reaction, Lethargy, Malaise, Pain, Pain in extremity, Pyrexia, Skin induration
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: TYLENOL
Current Illness: Hyperlipidemia; Penicillin allergy
Preexisting Conditions: Medical History/Concurrent Conditions: Drug allergy; Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210412007

Write-up: HARDNESS AT INJECTION SITE; SKIN INDURATION; INJECTION SITE REDNESS; LETHARGIC; ACHING; LOW FEVER; HEADACHE; LEFT ARM PIT SORES / BURNING PAIN TO LEFT ARM; SHOCK FEELING; DOESN''T FEEL GOOD TO GO; BURNING SENSATION; PAIN IN ARM; This spontaneous report received from a patient concerned a 59 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included hyperlipidemia, allergic to penicillin, and codeine allergy. The patient was previously treated with codeine. 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 04-APR-2021 for prophylactic vaccination in left arm. The batch number was not reported and has been requested. Concomitant medications included paracetamol for aches, and fever. On 04-APR-2021, the subject experienced burning sensation. On 04-APR-2021, the subject experienced pain in arm. On 05-APR-2021, the subject experienced lethargic. On 05-APR-2021, the subject experienced aching. On 05-APR-2021, the subject experienced shock feeling. On 05-APR-2021, the subject experienced doesn''t feel good to go. On 05-APR-2021, the subject experienced low fever. On 05-APR-2021, the subject experienced headache. On 05-APR-2021, the subject experienced left arm pit sores / burning pain to left arm. On 06-APR-2021, the subject experienced hardness at injection site. On 06-APR-2021, the subject experienced skin induration. On 06-APR-2021, the subject experienced injection site redness. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from headache, aching, and low fever, and had not recovered from left arm pit sores / burning pain to left arm, lethargic, hardness at injection site, shock feeling, doesn''t feel good to go, burning sensation, pain in arm, injection site redness, and skin induration. This report was non-serious. This case, from the same reporter is linked to 20210412133.


VAERS ID: 1197575 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Michigan  
Vaccinated:0000-00-00
Onset:2021-04-04
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Illness, Palpitations, Vomiting
SMQs:, Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210413562

Write-up: HEART BEATING OUT OF HER CHEST/RACING; SICK; THROWING UP; This spontaneous report received from a patient concerned a female of unspecified age. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 04-APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 04-APR-2021, the subject experienced throwing up. On 04-APR-2021, the subject experienced sick. On an unspecified date, the subject experienced heart beating out of her chest/racing. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from throwing up, heart beating out of her chest/racing, and sick. This report was non-serious.


VAERS ID: 1197624 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure fluctuation, Hyperhidrosis, Nausea, Pallor, Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (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: Fluoxetine and Xanax
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: pt sent to ED
CDC Split Type:

Write-up: Approx 6 mins after vaccination pt fainted. She recovered on her own within a minute and was very diaphoretic and pale, but was alert and oriented x 3. Pt then stated she was feeling very nauseous and proceeded to vomit. 911 was called and B/P 87/58, HR 91 and O2 99. EMS arrived B/P was fluctuating and pt was brought to ED for evaluation


VAERS ID: 1197636 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Texas  
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 042A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: gabapentin, levetiratam
Current Illness:
Preexisting Conditions: seizures
Allergies: sulfa, morphine, robaxin, plavix, baclofen, vitalopran, cymbalta, latex
Diagnostic Lab Data: iv
CDC Split Type:

Write-up: light headed, couldn''t breathe, hospital trip


VAERS ID: 1197665 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-03-04
Onset:2021-03-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Angiogram, Cerebral haemorrhage, Computerised tomogram, Craniotomy, Hemiplegia, Magnetic resonance imaging, Subdural haematoma
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Accidents and injuries (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 15 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: Just Diabetes managed by diet and exercise
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data: MRA, MRI, CTScan, Angiogram
CDC Split Type:

Write-up: Subdural Hematoma- Brain bleed paralyzed on my entire right side and Craniotomy


VAERS ID: 1197686 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-10
Onset:2021-04-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature increased, Chills, Ear swelling, Fatigue, Headache, Pain, Pyrexia, SARS-CoV-2 test, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: exercise induced asthma
Allergies: Seasonal allergies
Diagnostic Lab Data: None, visit to urgent care walk-in clinic, COVID - 19 test done as precaution, however patient felt fine with no symptoms prior to and during time of vaccination.
CDC Split Type:

Write-up: 6 hrs after injection developed fever, chills, headache, body aches, fatigue, sent home from work went to bed, temperature 101 degrees F. Symptoms continued through Sunday, fever down between 99-100 degrees F, chills and body aches mild, still fatigue. By Monday morning around 2am hives developed, spread across body, face, lips and ears very swollen, went to walk-in clinic by 9am Monday morning. Patient prescribed prednisone and benadryl for relief of symptoms most likely due to vaccination.


VAERS ID: 1197700 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Virginia  
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 202A21A / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Ear pain, Fatigue, Feeling abnormal, Feeling hot, Hyperhidrosis, Injection site swelling, Insomnia, Mobility decreased, Movement disorder, Nausea, Pain, Pyrexia, Skin burning sensation, Tinnitus, Tremor
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hearing impairment (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: Thalassemia minor beta, Parsonage Turner Syndrome
Allergies: Gluten Free, no iron, no malarials.
Diagnostic Lab Data: No tests were done at the urgent care, I requested an IV of fluids because I know I was dehydrated but they did not want to do anything. No lab work was done, even though I mentioned that I had thalassemia.
CDC Split Type:

Write-up: Everything was fine at time of shot which was at 11:45. I had no effects, I left clinic around 12: 30 that afternoon, and went to do a job. I headed home around 4 pm and started to feel warm, but thought it was the sun. Around 5:15 I got the chills, very bad. So bad my jaws were shaking. I tried to use a heating blanket to get warm, but was very miserable. About an hour later I started running a fever that kept going up. My ears started to hurt and the ringing was really bad. By 8:30 my fever had spiked to 102 and I was so nauseous I had a hard time moving around, I almost used the bathroom on myself twice. Started burning up but still unable to move, I went outside to cool down and had a family member take me to the urgent care. They said my arm was swollen from the injection site and that everything was normal and that it was a good thing I was having these experiences because it means the vaccine was working. Gave me nausea medicine and aspirin and sent me home. I was unable to sleep from all the pain in my body and just laid here in pain starting to get really hot. Woke up around 4 soaking wet where I broke the fever and then continued to have a mild fever all day Sunday, April 11, with mild sweats on and off when my body would get too hot. Today just been trying to move around but very tired and exhausted. Had hard time sitting up to do some work at the table, so been laying down most of the day.


VAERS ID: 1197711 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure decreased, Dizziness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received J&J COVID Vaccine 4/12/21 around 12:05 pm. Patient waited in waiting area and complained to her husband about feeling dizzy and might faint. Pharmacists went to aid the patient and lay her down gently, monitored her blood pressure which was high at the time, once patient sat up her BP decreased, it fluctuated the whole time, EMT was called and once they arrived and monitored her, they said the cause of her fainting was due to her blood pressure. Patient was alert and responsive the whole time. Patient was unsure if she took her BP medicine this morning.


VAERS ID: 1197740 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 6964823 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anaphylactic reaction, Dysphagia, Dyspnoea, Eye movement disorder, Loss of consciousness, Pharyngeal swelling, Swelling face
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Ocular motility disorders (narrow), 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? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Tb test
Other Medications: Claritin D Levothyroxine Metformin
Current Illness: None
Preexisting Conditions: Allergies
Allergies: Penicillin Ceclor Zpack Tb test Steroids Heparin
Diagnostic Lab Data: Epinephrine and Benadryl
CDC Split Type:

Write-up: Anaphylactic reaction Swelling in face and throat Passing out feeling Rapid eyelid movement Trouble breathing, trouble swallowing


VAERS ID: 1197762 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-08
Onset:2021-04-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Haemoglobin, Metabolic function test, Muscle spasms
SMQs:, Dystonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Phentermine
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: CT Dye, Sulfur drugs, Azithromycin, Flaggel, Macrobid
Diagnostic Lab Data: Basic Metabolic panel Hemoglobin Results: blood pressure 109/62 Weight 194lbs Height 5''3" Temperature 97.8 F Pulse 93 Oxygen Saturation 98% Respiration 20
CDC Split Type:

Write-up: Extreme muscle spasms of both lower legs


VAERS ID: 1197804 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Illinois  
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 / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Aphasia, Computerised tomogram, Dysphagia, Dyspnoea, Facial pain, Neck pain, Oropharyngeal discomfort, Oropharyngeal pain, Pharyngeal swelling, Scan with contrast
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Glaucoma (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: asthma
Allergies: meds-avalox,levaquin Bees, seasonal allergies,mold
Diagnostic Lab Data: CT scan with contrast
CDC Split Type:

Write-up: extreme pain on left side of face, throat, and neck. swelling in throat that caused fair amount of difficulty in breathing, talking and swallowing received epipen at urgent care on 04/09/2021 as the doctor felt I was having an allergic reaction to the covid vaccine and was told to go to the emergency room. was given IV of benedryl and pepcid. had a CT with contrast do to feeling of having something lodged in my throat. sent home with perscriptions for steroids and pepcid. still having symptoms though they are less severe


VAERS ID: 1197926 (history)  
Form: Version 2.0  
Age: 71.0  
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 1808982 / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Facial paralysis, Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (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: amitriptyline 25mg, apap 325 q 4 h, ASA 81mg, ferrous sulfate 325mg, folic acid 1mg, methotrexate 10mg once weekly, sumatriptan 100mg, turmeric
Current Illness: none known
Preexisting Conditions: pre-diabetes
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: right arm numbness, right facial drooping, weakness


VAERS ID: 1197965 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: HUSBAND CALLED 911. SHE WAS TAKEN TO MEDICAL CENTER TO BE CHECKED OUT. SHE SAID SHE FELT FINE AFTER BEING RELEASED. SHE SAID MEDICAL PERSONNEL THOUGHT IT WAS RELATED TO THE VACCINATION. SHE CALLED AND REPORTED TO ME 4/10/21. SHE STATED THAT SHE STILL FELT OK.
CDC Split Type:

Write-up: PASSED OUT, WENT RIGID TEMPORARILY


VAERS ID: 1197978 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Diarrhoea, Ear haemorrhage, Headache, Hypoaesthesia, Muscular weakness, Oropharyngeal pain, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Reports that she had headache, sore throat, diarrhea for 4-5 days, bleeding of left ear and numbness, tingling and weakness of upper extremities. This started within 24 hours of vaccine


VAERS ID: 1198009 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Colorado  
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 205A21A / 1 RA / -

Administered by: Public       Purchased by: ?
Symptoms: Contusion, Dyspnoea, Pruritus, Throat tightness, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Baclofen Lunesta Allegra Progesterone Synthroid Liothronnine Topomax Pepsi?s Lexapro D3 Dexilant Crestor
Current Illness: Strep
Preexisting Conditions: Asthma
Allergies: Sulfa Carbatrol Webutrin Cytomel Pork
Diagnostic Lab Data: Paramedics at the shot site put in an IV administered 50mg of benedryl. Helped some, but I started getting worse with my breathing, it was decided that I needed to go to the hospital and receive further treatment. In the ambulance I received decadran, a nebulizer breathing treatment, then dropped off at the hospital where I received Pepsi?s and was watched for an hour then released. On day 2(4/11/21) symptoms were worsening, severe itching, and vascular bruising, which I was concerned it was blood clotting. Went back to the ER(sky ridge hospital lone tree colorado) had another IV of benedryl, steroids, Pepcid, and determined that the bruising was not blood clots but some type of reaction to the vaccine. Given prescriptions for prednisone, Pepcid, epi pen, benedryl, to keep the regimen going for 5 days. Day 3 - all symptoms still very prevalent, I am seriously considering going back to the emergency room. Breathing is difficult, using a nebulizer and inhaler every 4 hours, benedryl (50mg) every 4 hour to try to manage the hives, itching.
CDC Split Type:

Write-up: Tightness in throat, breathing problems, used my albuteral inhaler 2x, coughing, very itchy all within 10 minutes of the shot. I was taken back to a separate room and seen by paramedics.


VAERS ID: 1198067 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Oregon  
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 1808978 / 1 LA / IM

Administered by: Private       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:
Current Illness:
Preexisting Conditions:
Allergies: Peanuts
Diagnostic Lab Data:
CDC Split Type:

Write-up: syncope, HR 44, O2 90% RA. gave 50 mg IM Benadryl, 1 dose Epi-Pen, JR. B/P after meds- 143/72 and 122/68, HR improved to 76


VAERS ID: 1198138 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

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

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

Write-up: Janssen COVID-19 Vaccine EUA: During the post-observation period, vaccine recipient developed pruritus, fine raised rash on face, itchy throat, swollen under left eye. She was treated with diphenhydramine by EMS. She was monitored for additional 45 minutes. Then she continued to have itchy throat and felt that throat was swelling. She was transported to the emergency department.


VAERS ID: 1198184 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: recent surgery (unknown reason/type of surgery or date of surgery) reported by patient''s brother
Preexisting Conditions: asthma (treated with albuterol when needed, but not recently)
Allergies: allergy to penicillin
Diagnostic Lab Data: None at this facility (unsure if any tests were done at the emergency department where patient was transferred)
CDC Split Type:

Write-up: After being screened to enter the healthcare facility and completing the intake screening for COVID vaccine, patient received the Janssen COVID vaccine at approximately 11:00am. Several minutes later while sitting in the observation area, patient stated that he felt like throwing up and that he had a headache. He said he just started feeling tired. He denied any shortness of breath, swelling in his mouth or throat, or rashes. He stated he had not eaten breakfast in the morning. When his vital signs were checked, his blood pressure was 149/94 and heart rate was 90. He was alert and oriented. He was transported to the facility urgent care for further assessment and observation. In urgent care, he appeared to become more lethargic, although his vital signs remained stable. 911 was called. While waiting for the ambulance, staff spoke to the patient''s brother (who had been waiting outside for patient). Patient''s brother stated that patient had a fever and stomachache the night before, and that patient had a recent surgery and had not completed his post-op antibiotic course. Patient''s brother stated that he came to clinic anyways for the vaccine appointment because he wanted to get the COVID vaccine so that he could return to work (as required by his employer). Patient was transported to Hospital. Per nurse report, he was released from the emergency room after a brief observation period.


VAERS ID: 1198192 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-03-05
Onset:2021-04-01
   Days after vaccination:27
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / 1 RA / SYR

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

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

Write-up: shingles


VAERS ID: 1198226 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 RA / IM

Administered by: School       Purchased by: ?
Symptoms: Cold sweat, Dyspnoea, Hyperhidrosis, Pallor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Patient received her vaccine and was being observed in the observation area upon becoming diaphoretic, pale, clammy and not looking well. RN approached asked if she was having difficulty breathing and pt reported yes. initially unable to obtain pulse or 02 reading. BP 58/38 and Epi injection was administered to the right outer thigh. Patient color and vitals started to improve and breathing was better. patient also was placed on cot in supine position initially. Last set of vitals prior to EMS arriving was BP 84/72, p-71, 02-99% and respirations are 22.


VAERS ID: 1198229 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-05
Onset:2021-04-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Back pain, Chest pain, Chills, Cough, Dyspnoea, Injection site pain, Malaise, Myalgia, Pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Sulfa
Diagnostic Lab Data: Focused exam revealed: BP 104/64 | Pulse 73 | Temp 98.6 ?F (37 ?C) | Resp 16 | SpO2 98% WNWD, no distress. Heart sounds normal. Lungs CTAB. Right upper back nontender to palpation, but hurts w movement. No LE edema. CXR, EKG normal Troponin negative D-dimer negative
CDC Split Type:

Write-up: Patient reports shortness of breath, fevers, chills, diffuse myalgias along with right-sided back and chest pain since receiving the COVID vaccine. Symptoms began a few hours after receiving the vaccine. She reports localized pain to the injection site but denies redness or swelling. She reports she had fevers for 2 to 3 days, highest being of 101. She presented to the ED on 4/10/21 because of worsening shortness of breath with mild cough and pain in her back. This is exertional along with pleuritic. She reports she has overall improved from the myalgias but is generally not feeling well and continues to have dyspnea.


VAERS ID: 1198247 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Ohio  
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 RA / SYR

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

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

Write-up: Fever of 102.9. Nauseous. Pain, dizzy. Went to ER. Given tordal shot and nausea meds


VAERS ID: 1198259 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Axillary pain, Blood pressure decreased, Dizziness, Electrocardiogram normal, Laboratory test abnormal, Mobility decreased, Nausea, Pain, Pain in extremity, Pyrexia, Visual impairment, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine .75 mcg Lexapro 10mg Vit C 1,000 mg Vit D3 2,000 IU Fish Oil 1,200 Tumeric 500 mg Milkthistle 250mg Collagen 1,500 mg CO Q10 100 mg Zinc 50mg
Current Illness: None
Preexisting Conditions: None
Allergies: Iodine if injected in my bloodstream
Diagnostic Lab Data: EKG - Normal Bloodwork run at hospital - All Normal
CDC Split Type:

Write-up: Became Lightheaded within 5 min of injection, progressed to severe dizziness, black spots in my eyes, could hardly lift my arms, progressed further to nausea, was given zofran on tongue by EMS, progressed to severe vomiting. EMS took blood pressure it was 93/50 hear rate was very low. Called ambulance and advised I go to hospital immediately. Blood pressured jumped to 150 then dropped again. Once in ambulance they put IV in and gave Zofran through IV, I don''t know if they put anything else in there. Blood pressure stabilized around 110 which is normal for me, I normally have low blood pressure and heart rate. Nausea and dizziness dissipated by the time I got to hospital. They put EKG on also while I was in ambulance and said I was having PVC''s advised dr to do another EKG once I got to hospital. Felt better by about 5:00 PM. Overnight I had slight fever and body aches, took Advil and symptoms subsided. Slight soreness in arm and armpit, but not major. Have been feeling fine now other than being traumatized by the whole event.


VAERS ID: 1198292 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Hyperhidrosis, Tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Vestibular disorders (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: history of dizziness after vaccination
Other Medications: cochicine, xarelato
Current Illness: gout
Preexisting Conditions: no known chronic condition besides gout
Allergies: no known drug allergies, food, and other products
Diagnostic Lab Data: no known any medical and lab results
CDC Split Type:

Write-up: After 10 minutes of vaccination, patient was sweating and dizzy. Ambulance team arrived check the vital signs which were stable. Patient was alert and conscious at the movement. He indicated that he wanted water. The ambulance team allowed him to drink about 1 sip (10-15 ml) of water. Then he had tachycardia. Then ambulance took him to the hospital. His wife was with him.


VAERS ID: 1198352 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / N/A LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: per MOM she has a history of fainting with vaccines.
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient fainted upon receiving the Janssen COVID-19 vaccine. They were in a chair in the waiting area and did not fall or injure themselves. We gave her no food or drink, took her blood pressure and stayed with her. She then fainted again at which point we called for a paramedic. They evaluated her and took her blood pressure again and her blood sugar. She then recovered and walked out of the store unassisted. She did not go to the ER but chose to go to an urgent care center I believe.


VAERS ID: 1198370 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Florida  
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 1808609 / 1 LA / IM

Administered by: School       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Lethargy, Pain, Pyrexia, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Chills started 7 hours after the injection around 8:00pm, followed by uncontrollable shaking. Headache started at 1:00am, followed by fever of 100.8. A few hours later, fever climbed to 102. Experiencing body aches, lethargy and exhaustion.


VAERS ID: 1198371 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 - / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: multi-vitamin and vitamin d supplement
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CT scan - 4/11/21 Bloodwork - 4/11/21 EKG - 4/11/21 All tests came back normal.
CDC Split Type:

Write-up: vasovagal syncope - Fainted 16 hours after receiving vaccination. Felt lightheaded when woke up. Received care from EMTs and was admitted into ER.


VAERS ID: 1198401 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Foreign body in throat, Nausea, Throat irritation, Vomiting
SMQs:, Acute pancreatitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: Patient presented with nausea and vomiting. Also, c/o itchy throat, like something was stuck in her throat


VAERS ID: 1198404 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Texas  
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 203A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE REPORTED
Current Illness: NONE REPORTED
Preexisting Conditions: NONE REPORTED
Allergies: NONE REPORTED
Diagnostic Lab Data: RECOMMENDED PATIENT TO SEEK MEDICAL ATTENTION SINCE AFTER 2 DAYS OF BENADRYL SYMPTOMS HAVE NOT SUBSIDED.
CDC Split Type:

Write-up: PATIENT STATED THAT ABOUT 1 HOUR POST VACCINATION SHE STARTED WITH A RASH AND HIVES LOCATED ON THE SIDE WHERE THE VACCINE WAS ADMINISTERED. THE HIVES PERSISTED TO SPREAD AND WELPS OCCURED OVER THE WEEKEND THROUGH BODY.


VAERS ID: 1198412 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Washington  
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 202A21A / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Electrocardiogram, Fall, Immediate post-injection reaction, Loss of consciousness, Musculoskeletal stiffness, Tooth injury, Tremor
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), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), 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: Unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: No known allergies
Diagnostic Lab Data: EMS called and pt transported to Hospital for further evaluation. ED chart notes indicate dental injury to two front teeth and dental appt made for that afternoon. Pt also had ECG completed due to syncope which showed normal sinus rhythm. Pt with history of similar syncopal episodes.
CDC Split Type:

Write-up: Pt received vaccine. Immediately upon standing, pt lost consciousness and fell face first to the ground. Pt noted to have arms down to side and was stiff and shaking lying on his abdomen. Pt turned to supine position and mask removed. Pt noted to have obvious damage to two front teeth and blood to mouth and lip. Possible laceration to lip.


VAERS ID: 1198433 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Washington  
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 202A21A / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Electrocardiogram normal, Lip injury, Loss of consciousness, Tooth fracture, Tremor
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), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: no known allergies
Diagnostic Lab Data: EMS called and pt transported to hospital. ED notes indicate ECG was completed due to syncope and showed normal sinus rhythm. Pt scheduled for dental appt later that afternoon and noted to have fracture to two front teeth.
CDC Split Type:

Write-up: Pt received injection and immediately upon standing, pt lost consciousness and fell face first to the ground. Pt noted to have hands to side and was shaking. Pt turned to supine position and mask removed. Pt noted to have moderate amount of blood to mouth and lips. Visible damage to two front teeth observed as well as possible laceration to lip.


VAERS ID: 1198495 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-03
Onset:2021-04-03
   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: Unknown       Purchased by: ?
Symptoms: Blindness, Chills, Computerised tomogram, Fall, Head injury, Pyrexia, Vertigo
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Accidents and injuries (narrow), Glaucoma (broad), Optic nerve disorders (broad), Retinal disorders (broad), Vestibular disorders (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: Cymbalta 70 mg for generalized anxiety disorder, Keflex for bacterial infection
Current Illness: Miscarriage 2 weeks prior and was not over on the day of the vaccine. Pill taken to complete miscarriage did not finish the job. Suction was done the day after vaccine to empty the uterus from pregnancy tissue.
Preexisting Conditions: Generalize Anxiety Disorder
Allergies: None
Diagnostic Lab Data: CT scan of my head because I hit my head during the fall on April 11, 2021
CDC Split Type:

Write-up: Fever of 101.8F, shivers, and sever vertigo. Vertigo resulted in me falling down multiple times and hitting my head on the stairs. I could not see where I was going and what was in front of me.


VAERS ID: 1198509 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood potassium decreased, Chest X-ray normal, Chest pain, Full blood count normal, Pharyngeal swelling, Swollen tongue, Tachycardia
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (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: None
Current Illness: None
Preexisting Conditions: None
Allergies: Bee stings
Diagnostic Lab Data: CDC done and chest xray - all normal except for low potassium.
CDC Split Type: 00324

Write-up: C/O tongue and throat swelling, chest pain 15 minutes after injection; tachy, BP 132/84; Hx of anaphylactic reaction to bee stings. Carries own epi. Epi and Benadryl given at 30 minutes after injection. 911 called when pt. reported no change in s/s. Was seen in ER and tx with solumedrol.


VAERS ID: 1198510 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Pennsylvania  
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 202A21A / 1 LA / IM

Administered by: Public       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: Denise ingestion of illegal drugs on day of incident
Current Illness:
Preexisting Conditions:
Allergies: Denies allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: According to vaccinating nurse, a few minutes after vaccination patient experienced a short (less than one minute) generalized seizure. She was able to lower him to the ground and patient did not hit his head or suffer fall. Two EMTs were on site and attended to patient. 911 was called and patient evaluated by medics. Blood sugar and vital signs within normal limits. Patient'' s father also came to the scene. Patient and father refused transport to the local hospital. Father stated they will go directly to the local emergency room for evaluation.


VAERS ID: 1198522 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Anaphylactic reaction, Asthenia, Asthma, Cough, Dyspnoea, Headache, Oropharyngeal pain, Pharyngeal swelling, Tremor
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (narrow), Neuroleptic malignant syndrome (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), 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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Amour Thyroid 2 tablets (60 mg), Liothyrion ( thryroid), 10 mg northodoine, singular 10 mg, Advair 2 puffs am, Abuteral inhaler 2 puffs when experiencing asthma symptoms.
Current Illness: I was not Sick prior to having vaccine.
Preexisting Conditions: Being Treated for following chronic illness: Hashimotos Autoimmune disease, Hypoglycemic, Endometriosis, asthma and allergies.
Allergies: Lactose intolerance Erythromycin, Amoxicillin, generic Azthromycin, Dilutted First ever vaccine had allergic reaction
Diagnostic Lab Data:
CDC Split Type:

Write-up: 10 minutes after shot administered in left arm upper bicep. Anaphylactic Reaction: sore throat went to very sore strep throat feeling, throat felt like closing, difficult breathing 15 minutes: coughing asthma began. Blood sugar felt it was dropping ( 20 min prior had breakfast sandwich before shot). Right arm hand tremors began, week in legs even when sitting sever headache. Asked staff get a Benadryl- call 911. Took 25 mg tab benedryl 5 min prior to EMT arrived. Same time another woman started difficulty breathing and staff at facility asked if Emt could look at her too. Emt called another ambulance to scene as strap into gurney. Way to ER gave me liquid steroid. ER given epi, nebulizer breathing treatment Abuterol help breathing, pepicid too. Discharge after 3:30 pm. 40 mg prednisone ( 2 tabs a day for 4 days) and instructed Benedryl 4-6 hours. Use epi pen if throat and sever sore throat comes back- return to er.


VAERS ID: 1198575 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-12
Onset:2021-04-12
   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: Pharmacy       Purchased by: ?
Symptoms: Hypertension
SMQs:, Neuroleptic malignant syndrome (broad), Hypertension (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: blood pressure medication
Current Illness: heart problems
Preexisting Conditions: heart problems
Allergies: egg allergy
Diagnostic Lab Data:
CDC Split Type:

Write-up: high blood pressure over 200/80


VAERS ID: 1198626 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-03-16
Onset:2021-03-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal discomfort, Chills, Diarrhoea, Laboratory test normal, Muscle spasms, On and off phenomenon, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Dystonia (broad), Parkinson-like events (narrow), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Omega 3 b complex
Current Illness:
Preexisting Conditions: Autoimmune illness
Allergies: Gluten sensitivity Certain perfumes & chemicals Different antibiotics
Diagnostic Lab Data: Lab work - normal
CDC Split Type: vsafe

Write-up: Same night of the vaccine I had fevers & chills. They were gone after 12 hrs. On 3/18/2021 I stated having stomach problems. I had diarrhea & cramping this was going on & off. Around one week later I went to urgent care because of how much I was cramping. I followed up with my regular doctor & he did some la work. It kept going on & off but it started getting better & today on 4/12/2021 is the first day I started feeling like myself.


VAERS ID: 1198771 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: South Dakota  
Vaccinated:2021-04-09
Onset:2021-04-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray normal, Computerised tomogram head normal, Dysarthria, Hypoaesthesia, Laboratory test normal, Magnetic resonance imaging head normal, Muscle spasms, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: unknown
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Patient presented to clinic on 4/12/21, was transferred to the ER and admitted on the same day. There was concern for possibility of stroke, pt had head CT, chest x-ray and MRI of head which were all negative. Labwork unremarkable. Pt admitted for observation.
CDC Split Type:

Write-up: Pt reported to clinic with slurred speech, generalized numbness and tingling, cramps to bilateral hands


VAERS ID: 1198784 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dysstasia, Electrocardiogram normal, Fatigue, Laboratory test normal, Nausea, Vertigo, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NA
Current Illness: NA
Preexisting Conditions: NA
Allergies: NA
Diagnostic Lab Data: 04/11 /2021 Blood work and EKG
CDC Split Type:

Write-up: Early Morning dizziness, Room Spinning very fast, Nauseous. Could not stand without holding onto something. Cleared up except being dizzy. Evening 4:00 pm got very dizzy and a lot of vomiting and room would not stop spinning could not stand at all. Vomiting for at least 2 hours off and on. DATE 04/11/2021 Date 04/12/2021 Dizzy spells throughout the day and fatigue.


VAERS ID: 1198786 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-09
   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 RA / IM

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

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

Write-up: Seizures started Friday. Patient sent to hospital. Patient back at rehab


VAERS ID: 1198853 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Ohio  
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 1808982 / UNK LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Balance disorder, Blood test normal, Dizziness, Electrocardiogram normal, Fatigue, Feeling abnormal, Full blood count normal, Headache, Heart rate irregular, Hypotension, Injection site pain, Loss of consciousness, Myalgia, Nausea, Pain in extremity, Road traffic accident, SARS-CoV-2 test negative, Sinus node dysfunction
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (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), Disorders of sinus node function (narrow), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Cardiac arrhythmia terms, nonspecific (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: At the hospital on the day of the reaction (4/10/21), my CBC, CHEM7, and EKG results came back normal. My Covid test came back negative.
CDC Split Type:

Write-up: Within a few minutes of receiving the vaccination I lost consciousness. It was a drive-through vaccination clinic by the Health department. My vehicle rolled into a cement and metal bar/side of the building''s exit at a slow speed. The EMS at the scene stated that my heartbeat was irregular, varying between bradycardia and tachycardia. When they checked my blood pressure inside the ambulance they stated it was very low. About 15-20 minutes later I tried to sit up and was still unstable and unable to keep myself upright without assistance. I was then taken by ambulance to the nearest hospital''s emergency department. Nothing notable or unusual was found when I was checked out there. Within a couple hours I felt well enough to go home. Once home I had a headache, fatigue, mild dizziness, and nausea with physical activity. The following day I had a headache, muscle aches, pain at the injection site, and nausea with extended physical activity. Today I have pain in the arm where I received the vaccine and a mild headache.


VAERS ID: 1198855 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: similar even as previously prescribed
Other Medications: OCP
Current Illness: none
Preexisting Conditions: none
Allergies: sulfa, keflex
Diagnostic Lab Data: Vital taken - see above
CDC Split Type:

Write-up: Patient states at 10 min mark post vaccination (around 17:15 PM) that she developed sweats/clammy, some lightheadedness while waiting her 15 minutes in the lobby post vaccination injection. There was no rash, throat swelling, dysphagia, drooling, angioedema, rashes, etc in clinic. Vitals were taken in clinic which were WNL (O2 -98%, RR-16, temp- 98.6, BP - 100/60 (this is Normal for her), and HR -74). Patient states this has happened to her previously receiving injections and has had vagal responses. A cold pack was given to patient to place on head and Patient was monitored for an additional 20 minutes in exam room/clinic without complication. No epi/Benadryl was given/needed and I felt patient was stable/safe for discharge home. No signs of anaphylaxis. However, strict ED precautions given to patient. Patient was in right mind state and capable of making proper decision making.


VAERS ID: 1198863 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: South Carolina  
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 202A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: PATIENT STATES SHE WAS TOLD 8 YEARS AGO SHE HAD AN AUTO IMMUNE DISORDER BUT DID NOT RECALL WHAT KIND. AND DOES NOT TAKE MEDICATION TO IT
Allergies: NONE
Diagnostic Lab Data: PATIENT VITALS WERE CHECKED AND WERE STABLE. SHE WAS TRANSPORTED TO HOSPITAL TO HAVE HEART MONITORED BECAUSE WE GAVE A DOSE OF EPI-PEN. PATIENT WAS CALLED LATER AND WE WERE TOLD SHE FELT FINE.
CDC Split Type:

Write-up: PATIENT WAS HOT AND DIZZY AND FAINTED. AFTER 10 MINUTES OF GETTING THE JANSSEN COVID VACCINE. WE ADMINISTERED AN EPI-PEN DOSE AND CALLED 911. SHE REGAINED CONSIOUS APPROXIMATELY 30 SECONDS LATER. WE APPLIED COOL CLOTHS TO NECK .. PATIENT STATED SHE HAD NOT EATEN ANY BREAKFAST AND A LIGHT SUPPER. WE CALLED 911 AND THEY CAME AS WELL.


VAERS ID: 1198867 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

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

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

Write-up: Fainting, sweating, light-headed


VAERS ID: 1198909 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Connecticut  
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 1808982 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Muscle spasms, Pallor
SMQs:, Dystonia (broad), Hypotonic-hyporesponsive episode (broad)

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

Write-up: Client vaccinated at 6:30pm on 4/10/2021 During 15 mins observation. Someone yelled stating that client fell. Upon arrival, RN noted that client face was very dusky and pale. She was assisted by other providers to lie down on her back and legs elevated. BP 132/79 P 86, O2 86%, RN noted carpal spasm started on right arm and then to left arm. 911 called, Fire Department arrived O2 applied. BP 128/81 P105, O2 95% Client went to Hospital via ambulance.


VAERS ID: 1198911 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Loss of consciousness, 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), 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: A few minutes after vaccination patient turned pale and eyes started closing. Patient seems to have fainted. Patient was then in and out of consciousness over the next 5 minutes. Patient was given water and was able to drink. 911 was called immediately, and a cop escorted her out of the pharmacy area and to an ambulance outside


VAERS ID: 1198948 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Oregon  
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 042A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chest discomfort, Electrocardiogram abnormal, Flushing, Hypertension
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hypertension (narrow), Cardiomyopathy (broad), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Albuterol; methotrexate; "allergy shots"; allergy medicine; etc.
Current Illness: Asthma, Psoriatic Arthritis, etc.
Preexisting Conditions: Asthma, Psoriatic Arthritis, etc. We do not have the list of her health care reconciliation
Allergies: Yes. We know she was allergic to eggs. We are unsure everything she is allergic to.
Diagnostic Lab Data: EKG - sinus tach
CDC Split Type:

Write-up: Patient showed up to clinic with Dr''s note saying she has allergies but that she should get the COVID 19 Vaccine. Prior to administration, patient appeared anxious and states "I shouldn''t have had mayo...I''m allergic to eggs." appx 5 min later, patient appears flushed and c/o chest tightness. Was moved into room to lay down and Dr was brought in along with a total of 3 RNs, 1 EMT-1, etc. MD prescribed 50mg Benadryl IM and patient was sent to hospital via local ambulance. During event, patients BP was elevated, HR 120s, SPO2 96% on 1L O2. Patient was able to speak in full sentences and lung sounds were clear bilaterally.


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