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From the 10/15/2021 release of VAERS data:

Found 8,070 cases where Vaccine is COVID19 and Manufacturer is JANSSEN and Emergency Room/Doctor Visit



Case Details

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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.


VAERS ID: 1198962 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
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 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Blood pressure measurement, Loss of consciousness, Nervousness, 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: Not known
Current Illness: none listed
Preexisting Conditions: none listed
Allergies: none listed
Diagnostic Lab Data: Not sure it happened in vaccination booth and EMS took the patient in ambulance after running his blood pressure and few test
CDC Split Type:

Write-up: After i gave covid-19 Janssen shot to patient, he passed out (Syncope), out of anxiety and nervousness from the shot per patient and his wife. Incident happened around 3:40 pm. His senses soon come back. We called emergency (911) and they ran some test and took the patient to the emergency. Patient was in senses, responding and alive when he left .


VAERS ID: 1198982 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Michigan  
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 206 A21A / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Circumoral swelling, Respiratory distress
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Acute central respiratory depression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Respiratory failure (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: Unknown
Preexisting Conditions: Unknown
Allergies: None
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: A 25 y.o. male showed signs of respiratory distress and swelling around mouth about 15 minutes post vaccine. We immediately called 911 and an Epipen 0.3mg was administered. His breathing quickly began to improve. The paramedics arrived and transported him to the ER. His mother was with him throughout the process.


VAERS ID: 1198986 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-03-10
Onset:2021-03-12
   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 / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad)

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

Write-up: soreness in arm, right bottom hurts, started cycle


VAERS ID: 1199018 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Michigan  
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 / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Mouth swelling, Respiratory distress
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Acute central respiratory depression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Respiratory failure (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: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: None
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: A 25 y.o. male showed signs of respiratory distress and swelling around mouth about 15 minutes post Janssen COVID vaccine. We immediately called 911 and an Epipen 0.3mg was administered. His breathing quickly began to improve. The paramedics arrived and transported him to the ER. His mother was with him throughout the process.


VAERS ID: 1199020 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Nebraska  
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 / SYR

Administered by: Private       Purchased by: ?
Symptoms: Dysphagia, Hypoaesthesia, Lymphadenopathy
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Necon 0.5/35; Furosemide 40mg; Amiloride 2.5mg; Fexofenadine 180mg; B12 1000mcg; Potassium CL ER 20meq; Hair, Skin & Nails multivitamin; Neocell Super Collagen + Vitamin C & Biotin; LifeVantage Omega+; LifeVantage Probio; LifeVantage Protan
Current Illness: None.
Preexisting Conditions: Asthma, Hypoglycemia, Herniated disc, Bilateral Neuropathy
Allergies: Ceclor, Compazine, Vicodin, Darvocet, Latex, Morphine, Dilaudid, Tramadol, Adhesives, Tussi, Neosporin, Plaster of Paris
Diagnostic Lab Data:
CDC Split Type:

Write-up: Numbness of face; Difficulties swallowing; Swollen glands in throat


VAERS ID: 1199056 (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 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Chills, Dysphagia, Dyspnoea, Erythema, Heart rate increased, Pruritus, Rash
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

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

Write-up: Started with skin above eyebrows itching and redness on face behind mask, then chills, then at about 30 minutes post injection increased heart rate and trouble swallowing/ chest tightness Gave dose of Epi and called 911/ As waited for EMS rash showed on arms and she said hard to breath after a few minutes she started breathing easier and rash started going away and she could swallow ok EMS arrived and transported her to hospital for observation


VAERS ID: 1199136 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-03-13
Onset:2021-03-19
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / SYR

Administered by: Work       Purchased by: ?
Symptoms: Burning sensation, Hypoaesthesia, Loss of personal independence in daily activities, Mobility decreased, Muscle spasms, Paraesthesia, Walking aid user
SMQs:, Peripheral neuropathy (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (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? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: March 13 Fever 12 hours post vaccine. One week later tingling and numbness needle pin pain in finger tips which then proceeded to move up the arm. 2 weeks after same feeling in feet along with muscle spasms in buttocks and calf muscles. March 28 could not hardly move. March 29 went to hospital reported symptoms tests were run legs and arms numb pins needles and then felt like they were on fire. I was told to watch symptoms at home. That Wednesday went back to hospital ran all kind of Tests was told it was how my body is responding to vaccine and no one knows when I will be better. Discharged April 6 I need a Walker and assistance with everything still have the same symptoms. I have been given steroids muscle relaxer b12 and PT at home.


VAERS ID: 1199143 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-27
Onset:2021-04-03
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Craniectomy, Haemorrhage, Haemorrhagic stroke, Headache, Life support, Platelet count decreased, Seizure, Vomiting
SMQs:, Acute pancreatitis (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Haemorrhagic central nervous system vascular conditions (narrow), Convulsions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Acute central respiratory depression (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Generalised convulsive seizures following immunisation (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-08
   Days after onset: 5
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: unknown
Current Illness: prediabetic
Preexisting Conditions:
Allergies: none
Diagnostic Lab Data: Surgery to remove pressure on brain and brain stem 04/06/2021. Surgeon noted alarmingly low platelet count.
CDC Split Type:

Write-up: Headache and vomiting starting one week later (4/3/2021); seizure due to hemorrhagic stroke 04/ 5/2021; continued bleeds 04/06/2021, 04/07/2021; life support removed 04/08/2021.


VAERS ID: 1199225 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-23
Onset:2021-03-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chest X-ray normal, Chills, Constipation, Cough, Dyspnoea, Headache, Nausea, SARS-CoV-2 test negative, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), 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: NA
Current Illness: NA
Preexisting Conditions: NA
Allergies: morphine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient reported: Difficulty breathing; severe headaches, vomiting/nauseous for 3 weeks and counting, plus chills. Went to Urgent Care 4.1.21. Back to Urgent Care 4.9.21 - this time with symptoms above plus cough, SOB, N/V. CXR (-) COVID (-). Patient received dose J&J vaccine 3.23.21. HISTORY OF PRESENT ILLNESS: Patient is a 59 y.o. female who presents to the Urgent Care with COVID-19 (sick after receiving COVID vaccine x1week ago. Vomiting, headaches, nausea, chills) HPI: Patient presents today with complaints of nausea, vomiting, headache and chills intermittently over the past 1 week after receiving her 1st COVID 19 vaccination. She states that she got the Johnson Johnson COVID-19 vaccine. She states of then she has had an episode of vomiting daily some nausea. She has also had a headache every single day as well as some constipation. She denies any numbness or tingling, abdominal pain, diarrhea. She states that she has been taking ibuprofen, Pepto-Bismol, and Tylenol for her symptoms with minimal relief. She is drinking a lot of water as well. Medical Decision Making: No concerns for acute abdomen or neurological deficits are noted on exam today. Patient is reporting some symptomatic relief after receiving the Toradol injection today in urgent care. Educated the patient on the following: Zofran for nausea and vomiting. MiraLax and senna for any constipation symptoms. Motrin and Tylenol for pain or fever. Drink plenty of fluids. Follow up with PCP as needed. If symptoms worsen go to the emergency room such as you are not able to keep fluids down while taking the Zofran, if you develop any bloody stools, bloody vomit, or increasing abdominal pain. HISTORY OF PRESENT ILLNESS Patient is a 59 y.o. female who presents to the Urgent Care with COUGH (cough, SOB, congestion, vomiting everyday until about 1PM. headache off and on. x 2 weeks (since covid vaccine)) HPI: Patient is a 59 y.o. female who presents to the urgent care with cough, shortness of breath, congestion, nausea and vomiting and intermittent headaches over the past 2 weeks. Patient states that the symptoms started the day of her COVID vaccine. She states that she receive the Johnson&Johnson 1 time dose. She states later that day after receiving the vaccination she had a significant headache that developed. She states that since then she has had a dry nonproductive cough with intermittent shortness of breath and morning nausea and vomiting that last till about 1:00 p.m.. She states that the headaches have resolved at this time but the cough, intermittent shortness of breath and nausea and vomiting have persisted. She denies any abdominal pain, chest pain, chest pressure or chest tightness. She states that she has not been experiencing any dizziness, vision changes or lightheadedness. She was seen in the urgent care about a week ago and was prescribed Zofran to assist with the nausea. She states that she was taking it twice in the morning and has now been able to only take it once, does feel that the nausea is improving but was out of the medication today, states that she was not able to take anything today and did have an episode of nonbloody nonbilious vomiting. She states that she was having some constipation she feels that this was related to the over-the-counter pain medications that she was taking for the headaches. She states that she was advised to take MiraLax at her last urgent care visit which she has been taking, had a normal bowel movement yesterday. She states that she has had pneumonia in the past, no history of asthma or chronic obstructive pulmonary disease. With the continued symptoms came to the urgent care for evaluation. She states that there have been to other coworkers who have had exposure or have now tested positive for COVID-19. Medical Decision Making: 59-year-old well-appearing female who presents to the urgent care with cough and nausea and vomiting over the past 2 weeks. Reviewed patient''s previous urgent care notes as well as immunization record. Her vital signs are stable in the urgent care today and exam is largely benign. Given her history and current complaints did obtain a chest x-ray which appears negative, formal interpretation was pending at time of discharge. She was provided Zofran in the urgent care today which she did state helps with the nausea. Discussed with patient that I do feel that COVID-19 testing should be collected as at the time of her symptoms and given her continued symptoms she has not had full immunity from the vaccination and this could still be a COVID-19 infection. She is in agreeance and COVID testing is pending. Prescribed refill of her Zofran as well as Tessalon for cough relief and advised continued symptomatic measures and close follow-up with PCP for any persistent symptoms. She was provided a work note given her symptoms and COVID-19 testing she was provided the standard COVID-19 work letter. Patient educated on warning signs and symptoms that would prompt immediate reevaluation. They conveyed understanding and were agreeable to this plan of care. All questions addressed at this time. Pt was non toxic appearing and not in any acute distress upon discharge.


VAERS ID: 1199238 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-03-05
Onset:2021-03-29
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Deep vein thrombosis, Myalgia, Pain, Pain in extremity, Thrombosis, Ultrasound scan
SMQs:, Rhabdomyolysis/myopathy (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Approximately three weeks after receiving Johnson & Johnson vaccine, I began to get pains in legs. Calves were aching and throbbing. Didn''t think anything of it at first....just thought achy muscles and such. The day before Easter (April 3rd 2021) decided since the pain was continuing and the internet will scare you to death - I went to a local Emergency Room in advance, I had an ultrasound on my left leg and it was noted I had DVT. (blood clot in left calf) To briefly explain: I had an achilles issue back in Nov. 2020 (slight micro tear - achilles tendonitis) I thought maybe this was related to that, as I had not been to the doctor to get it checked until early March 2021. and it bothered me off and on for a few months. I thought the calf pain may have been related to that? I explained to the emergency room doctor about my achilles and thought it was an issue related to that. They decided to perform an ultrasound on my left leg. Which noted the DVT/Blood Clot. They put me on a starter pack of Xarelto and I am to follow up with my normal doctor on April 22, 2021.


VAERS ID: 1199243 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Nebraska  
Vaccinated:2021-04-02
Onset:2021-04-12
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 RA / IM

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

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

Write-up: Around 7 minutes after administration patient started to look like he was having headache. My technician asked if he was doing ok and he replied "no." I then went out and asked what symptoms he was having. He said he was having headache, dizziness, and didn''t feel well. I then stayed with him to monitor him, at which point his arms fell, I was able to lay him on the ground with an associates help without his head hitting the ground. Code white was called and store management came to the scene. Patient regained consciousness, remained on the ground for a few minutes and then said he wanted to sit up. We helped him into a chair, a few moments later, he lost consciousness again. We then laid the patient down one more time and the instore officer requested a squad. Patient was monitored until they arrived and took over.


VAERS ID: 1199258 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-03
Onset:2021-04-07
   Days after vaccination:4
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: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient developed hives over 90% of his body 4 days after receiving the vaccine. The doctor who treated him thinks it was an allergic reaction to the vaccine. He is currently being treated with steroids and reports being about 50% better at this time. He still has doses to take.


VAERS ID: 1199266 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-01
Onset:2021-04-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK LA / -

Administered by: Private       Purchased by: ?
Symptoms: Chills, Fall, Foot fracture, Syncope, X-ray limb
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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Topiramate
Current Illness: None
Preexisting Conditions: Migraine
Allergies: None
Diagnostic Lab Data: Xray done on my foot to confirm broken foot.
CDC Split Type:

Write-up: As soon as I received vaccine I left for a 2 1/2 car trip. As soon as I stood up to get out of the car I starting shivering violently. I fainted and fell onto my left foot which broke my foot. I have never fainted before.


VAERS ID: 1199306 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-04-09
Onset:2021-04-10
   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 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Blood test normal, Chest pain, Chills, Electrocardiogram normal, Headache, Hypoaesthesia, Mobility decreased, Muscle rigidity, Muscle spasms, Muscle tightness, Pain, Pain in extremity, Pyrexia, X-ray normal
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: - EKG was normal - Blood work was normal - X-ray was normal - Per emergency room doctor, symptoms were most likely related to the covid-19 Johnson & Johnson vaccine
CDC Split Type:

Write-up: These were the symptoms I was feeling: - Arm pain - Chills - Fever - Headache - Muscle Spasms - Rigidity - Facial Numbness - Chest Pain Treatment: - Went to emergency room after facial numbness and chest pain. Muscles in both arms were extremely tight and no control of my fingers as it was painful to extend them beyond a fist. Could barely walk and stand for more than 20 seconds as well. - Took tylenol and benadryl before going to hospital but had little to no effect. - Arrived at the hospital at 9:30 with severe pain throughout my body and the effects subsided by 12:30am.


VAERS ID: 1199342 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-05
Onset:2021-04-09
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Conjunctivitis, Eye pruritus, Vision blurred
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Conjunctival disorders (narrow), Ocular infections (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: Actuall, no KNOWN adverse reactions, because I do NOT get Vaxes since adu;lthood
Other Medications: Dietary supplements: Iron, Vit D3, Vit K2, Magnesium, Zinc, Curcumin, Red Marine Calcium,
Current Illness: NA
Preexisting Conditions: Anemia, HHT
Allergies: Penicillin, Tetracycline, Xarelto
Diagnostic Lab Data: I did NOT mention that I had rcvd the JJ shot 4 days prior, when I went to Urgent Care to get relief. I got the shot on the left side and my left eye was affected. Doc did a visual to rule out any abrasion. He didn''t think it was bacterial, either. I was VERY careful NOT to contaminate other eye/ I DO NOT have seasonal allergies. I am only reporting this, as one friend who did get the Viral Covid had developed pink-eye and blurry vision. So, just in case.......
CDC Split Type:

Write-up: This may NOT even be related to the JJ shot I had, but I got Conjunctivitis (Pink-Eye) 4 days after the shot. Blurred vision and severe itchiness sent me to get relief from Urgent Care


VAERS ID: 1199358 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Michigan  
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 1808978 / 1 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Feeling abnormal, Feeling hot, Flushing
SMQs:, Anaphylactic reaction (broad), Dementia (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: was sent to hospital
CDC Split Type:

Write-up: 25 minutes after injection started feeling ?Weird? She was Flushed, Hot, No Respiratory effects, BP 173/96, P 105, 98.2 ? She was sent out to hospital.


VAERS ID: 1199380 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-06
Onset:2021-04-06
   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 / SYR

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea, Electrocardiogram, Full blood count abnormal, Metabolic function test
SMQs:, Anaphylactic reaction (broad), Haematopoietic leukopenia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec
Current Illness: Tonsillitis
Preexisting Conditions: Reactive airway disorder
Allergies: Pollen, Jalape?os
Diagnostic Lab Data: Basic Metabolic Panel - 4/6/21 CBC W Auto Differential - 4/6/21 EKG 12 Lead - 4/6/21
CDC Split Type:

Write-up: Difficulty breathing


VAERS ID: 1199491 (history)  
Form: Version 2.0  
Age: 28.0  
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 042A21A / 1 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin, Sulfa, Supprex, Alcohol
Diagnostic Lab Data: I went to urgent care and they took an EKG. Everything came back normal.
CDC Split Type:

Write-up: I received the vaccine at 1:30pm on April 10, 2021. The next morning at 10am, I fainted.


VAERS ID: 1199521 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-04-09
Onset:2021-04-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK - / IM

Administered by: School       Purchased by: ?
Symptoms: Chills, Head injury, Headache, Irritability, Loss of consciousness, Nausea, Pain, 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), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), 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: Multivitamin, Loratadine 10 mg
Current Illness: None
Preexisting Conditions: None
Allergies: Codeine, Clindamycin, Seasonal allergies
Diagnostic Lab Data: Patient sent to ER for further evaluation on 4/12/2021
CDC Split Type:

Write-up: Patient passed out/syncopal episode with head injury approximately 16 hours after getting vaccine per patient. Patient states she had a headache, fever, body aches, chills approximately 7 hours the vaccine. Patient sustained a head injury/possible concussion with nausea, head pain, irritability after syncopal episode.


VAERS ID: 1199584 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: New Jersey  
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: Private       Purchased by: ?
Symptoms: Hypotension, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: syncope, fainted, very low BP


VAERS ID: 1199984 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-03-24
Onset:2021-04-11
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Computerised tomogram head, Computerised tomogram thorax, Electrocardiogram, Pain in extremity, Pneumonia, SARS-CoV-2 test, Scan with contrast, Ultrasound Doppler abnormal
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), COVID-19 (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Effexor Bentyl Trazadone Lomotil
Current Illness: No Illness
Preexisting Conditions: No long term illnesses
Allergies: No none allergies
Diagnostic Lab Data: All done on April 12, 2021: CT Chest EKG: US Duplex Doppler Venous (lower left extremity)
CDC Split Type:

Write-up: I started having pain in my left calf on Sunday 4/11/2021. I went to the doctor on the next day, Monday, April 12 at 9am. He sent me to the center where they did an Ultrasound which was positive . I was adviced to go to the Hospital for a CT scan of my lungs and brain. I went to medical center on Monday at 6pm. There I was given an Iodine CT scan. They noticed a small spot of pneumonia. They repeated the Ultrasound of my leg and took a swab for Covid-19. I was given a prescription for Xarelto and an antibiotic , Levaquin, 500mg.. I came home.


VAERS ID: 1200266 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-04-06
Onset:2021-04-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN U43A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Chills, Headache, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: Extreme chills followed by vomiting every 30 minutes and a rotating headache. Lasted for one day. Then just an upset stomach. Went to ER. They said possible stomach ulcers due to vomiting.


VAERS ID: 1200267 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-09
Onset:2021-03-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Burning sensation, Chest pain, Flushing, Palpitations
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Tramadol, meloxicam, Levythroine, amolopine
Current Illness: NONE
Preexisting Conditions: high bp
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Heart racing , Chest pain & back pain , heart pounding in chest. Entire body head to toe felt burning flush


VAERS ID: 1200280 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-03-06
Onset:2021-03-25
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: methotrexate, losartan, folic acid, prednisone
Current Illness:
Preexisting Conditions: HTN RA
Allergies: none
Diagnostic Lab Data: 3/25/2021 CT scan at ER
CDC Split Type:

Write-up: She had Pulmonary embolism


VAERS ID: 1200286 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood pressure decreased, Dizziness, Heart rate decreased, Hyperhidrosis, Laboratory test normal, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad), 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: Lisinopril 20 mg; Magnesium 250mg; Vitimin D
Current Illness: Hypertension, but normal blood pressure due to medication.
Preexisting Conditions: Hypertension, but normal blood pressure due to medication. Iritis
Allergies: None known
Diagnostic Lab Data: The ER, gave me an IV with fluids. My blood pressure dropped very low and pulse rate was down to 44. They did blood work, and it came back normal. After a few hours, they released me to go home. Today I have flew type symptoms, and my pulse is at 89 bpm. My norm is 60bpm. My blood pressure today is 140/89, which is high for me.
CDC Split Type:

Write-up: About 10 minutes after getting the shot, while waiting in the Doctor''s waiting room, I began to feel dizzy and began sweating. They moved me into an exam room, and which time I passed out. I was awoken by the doctor standing over me, rubbing my chest. I was subsequently transferred to the ER.


VAERS ID: 1200303 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-03-30
Onset:2021-04-06
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / N/A LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Contusion, Dizziness, Full blood count normal, Hypertension, Pain in extremity, Platelet count normal
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Accidents and injuries (narrow), Hypertension (narrow), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Epiduo Gel (for Acne) OTC Lactose Intolerance Medication (Chewable)
Current Illness: None
Preexisting Conditions: None
Allergies: Amoxicillin
Diagnostic Lab Data: CBC (Complete Blood Clount) on 4/6/2020 confirmed platelet count was 194. Normal enough for hospital to discharge me.
CDC Split Type:

Write-up: One week after receiving the Johnson & Johnson vaccine, several small bruises (6-8) appeared on the back of my left leg. Throughout the day, my leg developed a soreness that, after reading a 10 Feb 2021 story in the newspaper about COVID vaccine recipients developing immune thrombocytopenia caused me to seek medical treatment in the afternoon of 4/6/2020. I first visited an urgent care facility where my high blood pressure (130/98) combined with my slight lightheadedness, soreness in the leg and observes bruising were enough for the tending physician to recommend rushing to the ER for bloodwork to be performed immediately. I was admitted to the ER in the early evening with an elevated blood pressure (~150/111) and the bruising still prevalent. The tending nurse practitioner authorized a complete blood count (CBC) and discharged me an hour later when the results came back ?extremely close to normal,? noting that my platelet count of 194 was no immediate cause for concern. Since then, the bruising and soreness has subsided.


VAERS ID: 1200312 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-03-12
Onset:2021-03-27
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1082068 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Angiogram, Deep vein thrombosis, Dyspnoea, Pleuritic pain, Pulmonary embolism, Pulmonary infarction, Ultrasound Doppler abnormal
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Infective pneumonia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Atorvastatin, Metoprolol, Accupril, Allopurinol, Omega-3-fatty acids, Amlodipine, Glipizide, Stiolto, Albuterol, Stiolto, Vitamin D
Current Illness: S/p Hip replacement in January 2021
Preexisting Conditions: Type 2 diabetes, Hypertension, Hyperlipidemia, S/p hip replacement (1/21), COPD
Allergies: NKDA
Diagnostic Lab Data: Patient had CT angiogram of the chest showing a right lower lobe pulmonary embolus and infarct Patient had venous doppler which showed a chronic partially occluding DVT of the right peroneal vein
CDC Split Type:

Write-up: On March 27, 2021 the patient developed some pleuritic chest pain and shortness of breath. he went to the Emergency Department at Hospital.


VAERS ID: 1200321 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Abdominal discomfort, Blood test, Body temperature increased, Dizziness, Feeling abnormal, Headache, Malaise, Pyrexia, Tremor, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: no
Allergies: sulfa. ibuprofens
Diagnostic Lab Data: 4/10 hospital ran a bunch of test and blood work. Thought to definitely be reaction to vaccine. I most likely had natural antibodies when I took the vaccine.
CDC Split Type:

Write-up: 4/10 7:00 Pm fever started. By 9:30 pm, Fever 104.1 on Tylenol, Vomiting, Dizziness, Shaking, Stomach discomfort. I was not able to get my temperature down. I had to go to the local emergency room. I was given IV fluids with anti nausea. 4/11 Fever still 102 in the morning. Vomiting had stopped after trip to the emergency room. Still had fever (101) at bedtime. Genrally felt cruddy. Bad headache. 4/12 Low grade fever in the morning and over all malaise. 4/13 Feel better but not great


VAERS ID: 1200332 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-03-19
Onset:2021-03-26
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chest X-ray abnormal, Chest pain, Computerised tomogram normal, Dyspepsia, Electrocardiogram, Full blood count, Heart rate increased, Hypoaesthesia, Hypoaesthesia oral, Lip swelling, Pain in extremity, SARS-CoV-2 test negative, Swelling face, Troponin
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad), COVID-19 (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: Allopurinol, Cherry Supplement
Current Illness: None
Preexisting Conditions: Gout
Allergies: None
Diagnostic Lab Data: ECG - 03.27.2021 - sinus tachycardia ECG 12- LEAD - 03.28.2021 - sinus tachycardia CBC Auto Differential -03.28.2021 - Abnormal X-Ray Chest - 03.28.2021 - no acute cardiopulmonary abnormality CTA Chest -03.28.2021 - unremarkable examination Troponin - 03.28.2021 - normal VH Sars COV 2 AG - 03.28.2021 - not detected 2019 Novel Coronavirus - Nasopharyngeal - 03.28.2021 - not detected
CDC Split Type:

Write-up: About seven (7) days post vaccine injection I began to experience pain and numbness in both arms, numbness and swelling in my lips and face area and a feeling of indigestion/heartburn. I presented to urgent care and subsequently the emergency room on 03.27.2021 with those symptoms and was treated and released. The following day, the symptoms continued, specifically the pain and numbness in the bi-lateral arms and additionally began to experience pain in the chest area and increased resting heart rate (125+ bpm). Again presented to emergency room on 03.28.2021, treated and released.


VAERS ID: 1200343 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-04-05
Onset:2021-04-09
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Appendicectomy, Appendicitis, Computerised tomogram abnormal
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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 3/9 - CT Scan
CDC Split Type:

Write-up: Woke up at 3AM on Friday morning (3/9) with stomach pain. I went to an urgent care facility around 11AM and was sent for a CT scan which diagnosed appendicitis. I had my appendix removed at 11pm on Friday night. I do not know if it was related to the vaccine, but thought I should report it just in case.


VAERS ID: 1200483 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-01
Onset:2021-04-06
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram, Differential white blood cell count, Full blood count, Induration, Lymphadenopathy, Metabolic function test, Pain, Rash, Rash erythematous, Rash pruritic, Skin warm, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Ibuprofen, venlafaxine 37.5 MG 24 hr capsule metoprolol succinate 50 MG 24 hr tablet
Current Illness: none
Preexisting Conditions: Heart disease
Allergies: no
Diagnostic Lab Data: 4-6-2021 CT Scan with contrast, CBC w/ diff Comprehensive metabolic pane RESULTS : Lymphadenopathy
CDC Split Type:

Write-up: 4-6-2021 - woke up and felt a lump above my collar bone, went to the ER. 4-12-2021- woke up covered with hives/rash. Started in my armpits and got worse as the day went on. Stinging, itching, red and hot .


VAERS ID: 1200524 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-03-10
Onset:2021-03-18
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Labyrinthitis, Magnetic resonance imaging head, Vertigo
SMQs:, Anticholinergic syndrome (broad), 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 3/18-MRI of brain
CDC Split Type:

Write-up: Woke up with severe vertigo on day 7 after the vaccine. Went to Urgent Care where they did and MRI of brain and blood test. Results were normal so they diagnosed me with an inner ear infection. Will still have bouts of dizziness.


VAERS ID: 1200572 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-03-26
Onset:2021-04-02
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Angiogram, Blood test, Cerebrovascular accident, Computerised tomogram, Echocardiogram, Hepatocellular carcinoma, Magnetic resonance imaging head abnormal
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Liver malignant tumours (narrow), Non-haematological malignant tumours (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, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: mimvey 1-0.5 mg per tablet
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: CAT SCAN ANGIOGRAM BRAIN MRI - CONFIRMED STROKE OCCURRED TEE TEST - TRANSESEOPHAGEAL ECHOCARDIOGRAPHY BLOOD TESTS
CDC Split Type:

Write-up: acute CVA (CEREBROVASCULAR ACCIDENT) HCC


VAERS ID: 1200573 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-12
Onset:2021-03-15
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Brain herniation, Brain injury, Brain oedema, Death, Ear pain, Headache, Loss of consciousness, Pyrexia, Subarachnoid haemorrhage
SMQs:, Torsade de pointes/QT prolongation (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Haemorrhagic central nervous system vascular conditions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hyponatraemia/SIADH (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-16
   Days after onset: 1
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: Blood Pressure Medicine is being taken
Current Illness: N/A
Preexisting Conditions: Blood Pressure
Allergies: N/A
Diagnostic Lab Data: You Can contact hospital are request for Laboratory REsults. Am not sure on how to provide the results
CDC Split Type: 1805029

Write-up: She had a slight fever after administering vaccine. On Mar15 till 10:30PM she is doing good, working on household chores. All of a sudden she complained about a pain behind ear that creeped to her Head (Unbearable pain). With in a minute she became unconscious and we called 911, they took her to Medical Center and moved her to another Medical Center Neurosurgeon is available. As per doctors, cause of death as per Death Certificate are as follows: Cerebral Herniation Malignant Cerebral Edema Anoxic Brain Injury Aneurysmal Subarachnoid Hemorrhage


VAERS ID: 1200615 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Angiogram, Computerised tomogram head, Echocardiogram, Ischaemic stroke, Magnetic resonance imaging head abnormal
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations: influenza (respiratory issues)
Other Medications: Vitamin D, cinnamon, Mucinex-DM, Flonase, folic acid, Metformin, methimazole, Montelukast, omeprazole, miralax, Effexor-XR
Current Illness: None
Preexisting Conditions: DM II, RA, Hyperthyroidism, OSA, depression
Allergies: influenza vaccine (respiratory issues), pencillins
Diagnostic Lab Data: 4/9/21-4/12/21 - hospitalized for acute stroke - MRI brain, s/p TPA, CTA head/neck, CT head, CT perfusion, echocardiogram - then discharged to acute inpatient rehab facility for ongoing cares.
CDC Split Type:

Write-up: Johnson and Johnson Covid-19 vaccine - patient had ischemic stroke approximately 4 hours after vaccination given and was admitted to hospital.


VAERS ID: 1200707 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Unknown  
Location: New Jersey  
Vaccinated:2021-04-06
Onset:2021-04-10
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 4932042A21A / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Confusional state, Dizziness, Fall, Fatigue, Head injury, Headache, Pain, Palpitations, 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), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: NA
Current Illness: nothing
Preexisting Conditions: nothing
Allergies: no allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: I started having chest pain palpitation Tuesday night and wasnt able to sleep. Wednesday, body ache, and headache all day. Thursday headache still there but manageable. Friday no problem. Saturday, felt differently but ok... Sat around 5:50pm started to feel lightheaded, I tried to walk to my bed to lay down and fainted and hit the floor. I woke up on the floor confused and realized on what had happened. Chest tightness continues and back of the head still hurts as of today and exhaustion persists, Tuesday 4/13.


VAERS ID: 1200718 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Dehydration, Electrocardiogram normal, Eye pain, Full blood count normal, Headache, Influenza like illness, Loss of consciousness, Nasal injury, Pyrexia, Thirst
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Glaucoma (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (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: multivitamin
Current Illness: no
Preexisting Conditions: no
Allergies: Amoxicillian
Diagnostic Lab Data: EKG-normal CBC-normal
CDC Split Type: vsafe

Write-up: Later that day of the vaccine I woke up about 11pm with a fever, all joints hurting, my eyes were hurting and flu like symptoms which continued throughout the night. I was extremely thirsty which caused me to consume over 60 ounces of water overnight. Woke up about 7am and went to prepare coffee and blacked out. When I woke up I was on the floor and had a bursted nose and EMT was called. I was transported to the ER where I was administered IV fluids, EKG and CBC were done but clear and I was diagnosed as severly dehydrated. I was released about 5hrs later but the consistant feeling of constant thirst has remained even still today. I have also had a lingering headache also.


VAERS ID: 1200788 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-04-01
Onset:2021-04-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Blood pressure increased, Dyspnoea, Pain in extremity, Peripheral swelling, Swelling, Swelling face, Throat tightness
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine, Pantoprazole, Amlodipine, Allegra, Aleve
Current Illness: Allergies
Preexisting Conditions: Seasonal Allergies/asthma, high blood pressure, hypothyroid
Allergies: Penicillin, Dramamine, Strawberries
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Within 2 hours of vaccine I started experiencing shortness of breath and my throat tightened up. I tried to drive to the ER but stopped at urgent care since they were closest. They found that along wit my breathing issues my BP was also running higher than normal. I was given a steroid to get my breathing and BP under control. I was released to go home, but told that if symptoms returned that I was to go to the ER immediately. Given a 5-day prescription for Prednisone to keep future symptoms at bay. The next few days my face and neck were very swelled, but I was able to breathe. I was given the vaccination in my left arm, and my fingers have been swollen on my left hand. The fingernails on my middle, ring, and pinky fingers are also very sore to the touch.


VAERS ID: 1200821 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-03-26
Onset:2021-04-03
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bell's palsy, Physical examination
SMQs:, Hearing impairment (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Went to Tulsa ER. Dr on duty did visual test and movements and told me I have Belle Palsey
CDC Split Type:

Write-up: 5 days after shot came down with Belle Palsy


VAERS ID: 1200848 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-03-22
Onset:2021-03-29
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Blood test, Computerised tomogram, Movement disorder, Tremor, X-ray
SMQs:, Neuroleptic malignant syndrome (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (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: none
Current Illness: none
Preexisting Conditions: cerebral palsy
Allergies: none
Diagnostic Lab Data: Patient was at ER on 4/1 and 4/2/21, Blood work , xrays, cat scans show no reason for this decline in her neurological functioning
CDC Split Type:

Write-up: Patient has lost her ability to sit, crawl, roll over, hold a cup, dress herself and experiences fine tremors of her extremities


VAERS ID: 1200876 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-06
Onset:2021-04-10
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Asthma, COVID-19 pneumonia, Computerised tomogram thorax abnormal, Condition aggravated, Cough, Dyspnoea, Haemoptysis, Impaired work ability, Inspiratory capacity decreased, Pulmonary embolism, SARS-CoV-2 test positive, Thrombosis
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lisinopril, norvasc, ventolin, pumicort, azelastine nasal spray, montelukast
Current Illness:
Preexisting Conditions: Hypertension, sinuses/allergies, asthma
Allergies: Iodine, Flonase, lidocaine, dust, cockroaches, and mold
Diagnostic Lab Data: Cat scan April 10th- outcome blood clots in both lungs Covid test. April 10th- postive
CDC Split Type:

Write-up: My mother received the Jansen vaccination on April 6, 2021. 2 days post vaccination she had 2 asthma attack at work. That following Friday she was not able to attend work due to shortness of breath. Saturday morning she cold not inhale and couldn?t stop coughing. She was then attempted to be taken to urgent care, but upon arrival she was coughing up blood and was instructed to go straight to the hospital. At the hospital upon test being done she was admitted to the covid unit and diagnosed with pneumonia due to covid 19 virus, bilateral pulmonary embolism in both lungs. She is now home in quarantine taking blood thinners for the next three months and unable to work.


VAERS ID: 1200893 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-10
Onset:2021-04-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / -

Administered by: Public       Purchased by: ?
Symptoms: Rash, Swelling, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine, aspirin 325mg
Current Illness:
Preexisting Conditions: TOF
Allergies: Keflex
Diagnostic Lab Data:
CDC Split Type:

Write-up: Rash, hives, swelling


VAERS ID: 1200925 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-08
Onset:2021-04-12
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chest discomfort, Dysgeusia, Feeding disorder, Headache, Nausea, Pain, Rash
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Taste and smell disorders (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: None
Current Illness: None
Preexisting Conditions: None
Allergies: No
Diagnostic Lab Data: Client is currently at hospital
CDC Split Type:

Write-up: On Thursday evening client just had a slight headache On Friday client reported more headache, no fever, body aches and nausea On Saturday client still reported nausea and was encouraged to drink more fluids. Client was taking Tylenol for body aches On Sunday client still not able to each much but did eat a small crab cake and continued to push fluids On Monday morning client who works for us a the Health Department called to say that she woke up with a rash on her arms and legs and began taking benadryl. Later in the day when I checked on her she said itching was better, rash no worse and had taken more benadryl. She reported tasting a metallic taste in her mouth. On Tuesday morning she txtd me to say that she was having chest discomfort. I told her to go the the ER immediately which she did and is currently there now.


VAERS ID: 1200929 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-04-06
Onset:2021-04-09
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043AJ1A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Computerised tomogram, Dizziness, Dyspepsia, Ear discomfort, Electrocardiogram, Head discomfort, Myocardial necrosis marker, Nausea, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad)

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

Write-up: Chest pain/heartburn, pressure in left ear with blood rushing to head, dizziness, nausea. Went to ER on 4/10. Released after EKG and cardiac enzymes ruled out MI, CT scan no PE. Told to follow up with primary care doctor. Still experiencing chest tightness, blood rushing to left side head/tingling and now tingling left leg. Seeing doctor this afternoon.


VAERS ID: 1200952 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood pressure increased, Hypoaesthesia oral, Palpitations, Paraesthesia oral
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypertension (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: effexor 75 mg Nexium Allegra
Current Illness: none
Preexisting Conditions: Vestibular migraine Acid reflux Barrett''s esophagus
Allergies: none
Diagnostic Lab Data: pending evaluation by provider
CDC Split Type:

Write-up: within 15 mins of vaccine administration pt reported she had numbness and tingling in her lips. waited for 45 mins at vaccination site and then left. around 9 pm on 4/9/21 stated she was lying in bed and heart started pounding so she called 911. stated EMS took her BP and it was 165/? (cannot remember diastolic number) which is much higher than her "normal" BP which is "low to normal" numbers, usually running 111/80 or less. Pt stated she did not allow EMS to take her to the hospital, then later decided she would drive herself to the ER. Went to Hospital ER and waited a "long time" before deciding to leave without being seen. Pt stated she then went to Urgent Care on Saturday to have her BP checked and after an hour of waiting decided to leave. Pt reported she is going to be evaluated today.


VAERS ID: 1200956 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-04-01
Onset:2021-04-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain, Abdominal pain upper, Chills, Diarrhoea, Headache, Hyperhidrosis, Miliaria, Pain, Paraesthesia, Presyncope, Tremor, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Noninfectious diarrhoea (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: Lisinopril 10 mg, Vit D sublinguial
Current Illness: none
Preexisting Conditions:
Allergies: Penicillin, Amoxicillin, Eurythromycin
Diagnostic Lab Data: Urgent care asked for CT Scan if pain didn''t subside in two days.
CDC Split Type:

Write-up: 55 hrs after vaccination, I was doubled over with severe abdominal pain. Continuous waves of severe pain. Shortly after severe pain started, tremors/teeth chattering chills even under seven heavy blankets, lasted for hours. Headache (which had been there since 6 hrs after vaccination). Pain was so severe that I was getting ready to go to ER and then vomited. Felt a tad better only to vomit again three hours later, body in a pool of sweat but no fever. Aches, tingling hot prickly sensation running from toes to head, almost passed out. Diarreah every hour after second vomit, stomach pain started to subside then but never went away completely until 3 days after.


VAERS ID: 1200976 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-04-02
Onset:2021-04-09
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Erythema, Pain in extremity, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (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:
Preexisting Conditions:
Allergies: NKA
Diagnostic Lab Data: unknown results but patient reported they told her "no clotting issues" and "everything looked normal"
CDC Split Type:

Write-up: Bilateral redness, swelling, and pain in ankles started a week after getting the vaccine. By 8pm, patient could barely walk so went to the ER. In the ER, they did blood tests and told patient there was no clotting issues. ER prescribed the patient antibiotics and NSAIDS for inflammation. As of 04/13/21, patient still experiencing symptoms. Called PCP and ER back and they recommended an ultrasound. She is headed their now


VAERS ID: 1200992 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: D.C.  
Vaccinated:2021-03-13
Onset:2021-03-29
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / N/A LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Deep vein thrombosis, Pain in extremity, Thrombosis, Ultrasound Doppler abnormal
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Amphetamine salts, 30mg, daily Zoloft, 25mg a day Wellbutrin, 50mg/day
Current Illness:
Preexisting Conditions: I had DVT in 2009
Allergies:
Diagnostic Lab Data: 4/07/21: 1:01pm: Imaging: VL Venous doppler lower extremity right. Findings: 1) "Findings consistent with superficial veinous thrombosis of the great samphenous vein brlow the knee and lesser saphenous vein." 2) "Finding consistent with acute occlusive deep veinous thrombosis of the gastrocnemius veins."
CDC Split Type:

Write-up: I developed leg pain in my right leg 2 weeks after vaccination. A week later, I went to the hospital and they confirmed "Acute deep vein thrombosis) DVT of calf muscle vein of right lower extremity" and at least one additional superficial clot. I was prescribed blood thinners apixaban (Eliquis) and was discharged. I''d previously had a clot in the same leg in 2009.


VAERS ID: 1200997 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Maine  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute myocardial infarction, Catheterisation cardiac, Coronary arterial stent insertion, Coronary artery stenosis, Electrocardiogram abnormal, Thrombectomy
SMQs:, Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Cardiomyopathy (broad), Other ischaemic heart disease (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: VIt D3, Mega Krill fish Oil
Current Illness: N/A
Preexisting Conditions: Mild persistnet asthma
Allergies: Ilotycin
Diagnostic Lab Data: ER visit... Cardiac tests, EKG, Cardiac Cath 4/9/21
CDC Split Type:

Write-up: Appx 3 hours post-injection, developed Acute STEMI, Proximal LAD lesion, and had aspiration thrombectomy and drug eluding stent placement.


VAERS ID: 1201006 (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: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / N/A - / IM

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

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

Write-up: Client became itchy after receiving vaccine, a rash was accompanied by itching sensation. Client has a history of developing a rash after getting vaccines. Client used inhaler (albuterol). EMS administered Benadryl and observed for 30 mins. No significant improvement, transported to hospital.


VAERS ID: 1201024 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chills, Dizziness, Fatigue, Headache, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid, T3 slow release (compound thyroid medication), topiramate, buproprion, fluoxetine, allergy meds.
Current Illness: none
Preexisting Conditions: Hypothyroid
Allergies: ceclor, sulfa eyedrops, penicillin injection
Diagnostic Lab Data: Blood tests were taken at ER, but they didn''t provide any results so I assume everything was okay. Dr. on site said he felt my issues were related to the Covid vaccine.
CDC Split Type:

Write-up: Horrible headache (lasted 3 days); fever; chills; extreme body aches; nausea; dizziness; fatigue


VAERS ID: 1201025 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-06
Onset:2021-03-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Dyspnoea, Fatigue, Headache, Influenza like illness, Oropharyngeal pain, Pain, Pyrexia, SARS-CoV-2 test positive, Ultrasound scan, Vein disorder
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Benicar hct tab 20-12.5 Tylenol PM 500
Current Illness:
Preexisting Conditions: high blood pressure angiomyolipomas both kidneys
Allergies:
Diagnostic Lab Data: April 5 Covid test urgent care. Zithromax 250 mg; Benzonatate 200 mg; Fluticasone Propionate; 50 mcg April 7 Hospital Duplex sonography of right lower extremity veins with color and spectral doppler with and without compression the right soleal vein is not visualized.
CDC Split Type:

Write-up: Felt Flu like symptoms 12 hours after the injection. March 8 then had a fever and severe headache. Continued to have a sore throat and fever and headache all day. March 9 felt exhausted. April 5 tested positive for COVID 19 felt sore throat, cough, severe headache, fever, shortness of breath, exhaustion, body aches. April 6 lost taste and smell April 7 veing popped out on right calf went to hospital and got a sonogram of vein in right leg. April 8 started feeling fizzing all over skin


VAERS ID: 1201057 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-03-15
Onset:2021-03-29
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / UNK LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Dyspnoea, Thrombosis
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (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: Adderall, synthroid, singulair, trazadone, xarelto, folic acid
Current Illness: None
Preexisting Conditions: Hashimotos, blood thinners
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: 1st night very out of breath. O2 at 93 on sensor at home. Felt better next day. 3/29/21 - went to ER for blood clot in left leg.


VAERS ID: 1201089 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest X-ray, Computerised tomogram thorax, Full blood count, Haemoptysis, Headache, Metabolic function test, Pulmonary embolism
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Embolic and thrombotic events, venous (narrow), Infective pneumonia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Motrin 800 mg TID Cymbalta 60 mg QD
Current Illness: None.
Preexisting Conditions: Pernicious anemia Fibromyalgia Back pain
Allergies: Codeine- itching Wellbutrin- swollen lips and tongue Bactrim- hives
Diagnostic Lab Data: CT chest, CXR, CBCD, CMP. All completed on 4/9/2021.
CDC Split Type:

Write-up: Blood clotting and bleeding in lungs, severe headache, hemoptysis


VAERS ID: 1201098 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-03-05
Onset:2021-03-24
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram abnormal, Dyspnoea, Pneumonia, Pulmonary embolism
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Montelukast,simvastatin,tribenzor,
Current Illness: None
Preexisting Conditions: High blood pressure
Allergies: None
Diagnostic Lab Data: Cat scan revealed that lungs have multiple blood clots and pneumonia. These test were done on April 5
CDC Split Type:

Write-up: After having hard time breathing for over a week, finally went to er on April 5


VAERS ID: 1201130 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-03-10
Onset:2021-03-24
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Cardiac arrest, Death
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Cardiomyopathy (broad), Respiratory failure (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-25
   Days after onset: 1
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Aspirin, Metropolol
Current Illness: None
Preexisting Conditions: Stent placement
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Death on 03/25/2021 ruled as cardiac arrest.


VAERS ID: 1201137 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-12
Onset:2021-03-25
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Atrioventricular block complete, Blood test, Cardiac pacemaker insertion, Chest X-ray, Chest discomfort, Dyspnoea, Echocardiogram, Electrocardiogram abnormal
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Conduction defects (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypokalaemia (broad)

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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: LOSARTIN HCTZ KRILL OIL
Current Illness: NONE
Preexisting Conditions: HYPERTENSION
Allergies: ALLERGIC TO ABSORBABLE SUTURES
Diagnostic Lab Data: Blood work EKG ECHO cardiogram Chest X-ray
CDC Split Type:

Write-up: Developed shortness of breath and chest pressure on 3/25/2021. Went to the emergency facility where EKG revealed a 3rd degree heart block. Transported via EMS the same day where further cardiac workup was performed. On 3/26/2021 I underwent implantation of a dual chamber cardiac pacemaker. I was discharged home on 3/27/2021.


VAERS ID: 1201148 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-03-12
Onset:2021-03-17
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram normal, Deafness neurosensory, Deafness unilateral, Electrocardiogram normal, Full blood count normal, Magnetic resonance imaging normal, Vertigo, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hearing impairment (narrow), Vestibular disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness:
Preexisting Conditions: Asthma
Allergies: none
Diagnostic Lab Data: MRI- neg 3/17/21 CBC- neg 3/17/21 CAT Scan neg 3/17/21 EKG neg- 3/17/2021
CDC Split Type:

Write-up: 6 days after receiving vaccine, experienced sudden onset of vertigo, vomiting. ENT determined unknown nerve damage of left ear, hearing loss probably due to interruption of blood flow. No apparent injury.


VAERS ID: 1201151 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Feeling cold, Headache, Myalgia, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Eosinophilic pneumonia (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: Metformin, amlodipine, multi-vitamin
Current Illness: None
Preexisting Conditions: Diabetes, high blood pressure
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Symptoms: Extreme cold and shaking from cold. No fever. Was taken by ambulance to ER. They used heated blankets to warm me up and gave me a shot of Motrin. Symptoms began approximately 11 hours after shot was given. After returning home and sleeping, currently have a headache and muscle aches.


VAERS ID: 1201164 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-03-12
Onset:2021-03-24
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Computerised tomogram thorax, Pulmonary embolism, Thrombolysis
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vit D
Current Illness: None
Preexisting Conditions: Hypertension Hyperlipidemia
Allergies: Naproxen Esmoprazole
Diagnostic Lab Data: CT chest 3/23/2021
CDC Split Type:

Write-up: The patient had saddle pulmonary embolism on 3/24/2021 requiring hospitalization and thrombolysis. Currently the patient is on anticoagulation with Xarelto and is doing well.


VAERS ID: 1201178 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-03-19
Onset:2021-04-05
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 AR / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angiogram, Computerised tomogram, Dyspnoea, Fibrin D dimer, Pain in extremity, Pulmonary embolism, Ultrasound scan, X-ray
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Ibuprofen
Current Illness: Migraines
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Lower extremity XRAY/ULTRASOUND CT/Angiogram D-Dimer
CDC Split Type:

Write-up: Shortness of breath and leg pain times 3 days. Diagnosed with Pulmonary Embolus on April 8,2021


VAERS ID: 1201181 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-03-21
Onset:2021-03-23
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Computerised tomogram, Computerised tomogram pelvis, Computerised tomogram thorax, Fibrin D dimer, Peripheral embolism, Pulmonary embolism, Ultrasound Doppler, Ventilation/perfusion scan
SMQs:, Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, venous (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, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Omeprazole 40mg Rosuvastatin 20 mg Metropolis 25 mg Escitalopopram 10 mg
Current Illness: Shoulder Arthritis
Preexisting Conditions: GERD HIGH CHOLESTEROL ANXIETY
Allergies: Penicillin
Diagnostic Lab Data: Venous Right Lower extremity 4/2/2021 Twice CT scan of pelvis, computerized tomography, CTPA,ventilation profusion scan, blood test D-dimmer
CDC Split Type:

Write-up: Leg blood clot that traveled to my lungs leading to A Pulmonary Embolism


VAERS ID: 1201211 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Angioedema, Endotracheal intubation, Intensive care, Swelling, Swollen tongue
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Aspirin 81mg daily, atorvastatin 20mg daily, hydrochlorothiazide 25mg daily, lisinopril 20mg daily, loratadine 10mg daily, omeprazole 20mg daily, senna 8.6mg daily.
Current Illness: none known
Preexisting Conditions: chronic alcohol abuse with concern for pancreatitis, CKD stage 3, essential hypertension (controlled), cerebrovascular disease (chronic lacunar infarct)
Allergies: no known allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received Janssen COVID vaccine 4/9/21 around 9 am. Patient reported to emergency department around 10 pm that day (4/9)- says tongue began swelling since 7pm, he took a benadryl at 8pm with no improvement. Per ED physician, patient had "tremendous amount of tongue swelling, I am not even able to visualize the palate he has fullness to his left neck as well". Patient intubated in emergency room to protect airway. Patient admitted to ICU where he is still today (4/13). Per chart, the edema subsided on 4/12 and patient was extubated today (4/13). Patient received IV steroids from 4/9- 4/13 (discontinued this morning). Of note: patient does take lisinopril 20mg daily (start date July 2020). There is concern the angioedema was caused by this medication. Patient received tranexamic acid and Berinert in the emergency department to assist in treating this potential etiology.


VAERS ID: 1201212 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-03-14
Onset:2021-03-24
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blindness unilateral, Cardiovascular disorder, Computerised tomogram, Discomfort, Electroencephalogram, Feeling hot, Head discomfort, Headache, Hypoaesthesia, Magnetic resonance imaging, Paraesthesia, Transient ischaemic attack, Ultrasound skull
SMQs:, Peripheral neuropathy (broad), Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Guillain-Barre syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Retinal 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? No
Previous Vaccinations:
Other Medications: Aleve, claritan, omeprazole, magnesium/calcium/zinc, b12 injections
Current Illness: none
Preexisting Conditions: pernicious anemia, sinusitis
Allergies: Myacins, cyclines, codeine, soy, msg and all components of msg
Diagnostic Lab Data: 3/24/2021 transported by ambulance - thought it was a stroke. A CT scan and MRI were conducted at the hospital. Concluded a TIA. referred to neurologist. 3/26/2021 followed up with PCP - referred to neurologist. 4/1/2021 appointment with neurologist. Started Imetrix for headache. Scheduled brain ultrasound on 4/13 and EEG on 4/14 4/9/2021 Ophthalmologist. Pressure behind right away affecting vision. Scheduled a vision spectrum test on 4/13
CDC Split Type: vsafe

Write-up: on 3/24 I had a TIA with an intense heat pressure behind the right temple which resulted in complete numbness, heaviness, and tingling on my entire right side of the my body. I was transported by ambulance to the hospital. A CT and MRI was done, no signs of blood clots or stroke. I am still experiencing numbness and tingling in the right arm. Follow up appointments with the eye doctor indicate additional vision loss in the right eye with pressure behind the eye. I have a follow up appointment today with the neurologist for a brain scan and tomorrow for an eeg. My PCP, eye doctor, and neurologist believe it may be a blood flow issue. I have not had this type of event before.


VAERS ID: 1201225 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-04-05
Onset:2021-04-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 AR / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: I think patient has a history of cancer. She mentioned that she has had a collapsed lung in the past.
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient described having trouble breathing . She said it felt as bad as collapsed lung she had in the past.


VAERS ID: 1201232 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-03-19
Onset:2021-04-11
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Bell's palsy, Fatigue, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hearing impairment (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Atenolol/Chlorthalidone Prozac
Current Illness: None
Preexisting Conditions: HBP Acute Anxiety/Depression
Allergies: None
Diagnostic Lab Data: Diagnosis by ER doctor at hospital, on 4/12/21.
CDC Split Type:

Write-up: Had normal pain, fatigue and low grade fever after vaccination. About 3 weeks later I experienced onset of Bell?s Palsey defined as mild to moderate by the ER doctor.


VAERS ID: 1201252 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-04
Onset:2021-04-12
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Biliary colic, Headache, Hypoaesthesia, Insomnia
SMQs:, Peripheral neuropathy (broad), Gallbladder related disorders (narrow), Biliary tract disorders (narrow), Guillain-Barre syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: chlorpheniramine (CHLOR-TRIMETON) 4 mg tablet Take 4 mg by mouth. diphenhydrAMINE (BENADRYL) 12.5 mg/5 mL elixir Take 25 mg by mouth nightly at bedtime as needed for allergies. hyoscyamine (LEVSIN SL) 0.125 mg SL tablet Place 1 tablet (0.
Current Illness:
Preexisting Conditions: B12 deficiency Lumbar disc herniation Situational anxiety Irritable bowel syndrome Post-nasal drip Lumbosacral radiculopathy Chronic left-sided low back pain with left-sided sciatica Dyspepsia Closed nondisplaced fracture of phalanx of left ring finger Gastric ulcer Rash and other nonspecific skin eruption Sexual dysfunction Persistent cough Cold feeling Gall stones Elevated blood pressure reading without diagnosis of hypertension
Allergies: Sulfonamide antibiotics
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient reports she was experiencing gallbladder pain night of 4/12/21 (has a pmhx of gallstones so is familiar with this pain) and was having difficulty sleeping. Did not eat anything that would trigger an attack. This AM 4/13/21, c/o headache "at the bridge of my nose" and while on the phone started to c/o facial numbness. Denies worst headache of her life, says it would be difficult to look at screen if needed and hasn''t put her glasses on yet because it''s so bothersome. Denies hyperventilation. I advised that she present to ED.


VAERS ID: 1201289 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN JSN 042A21A / 1 - / IM

Administered by: Other       Purchased by: ?
Symptoms: Chest discomfort, Dyspnoea, 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 (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: folic aid, gabapentin, lasix, aldactone, sildenefil, ascorbic acid, etodolac, allopurinol
Current Illness: chronic stable
Preexisting Conditions:
Allergies: Penicillin
Diagnostic Lab Data: unknown ER records available through Hospital
CDC Split Type:

Write-up: About 2 hours after administration of the vaccine, veteran reported feeling throat tightness and chest tightness with difficulty breathing. He called 911 and taken to Hospital for acute treatment. He was kept in ED for several hours and discharged with epi pen and script for pepcid


VAERS ID: 1201312 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-03-11
Onset:2021-03-14
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Fatigue, Headache, Office visit
SMQs:, Guillain-Barre syndrome (broad), Arthritis (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: Cosentyx
Current Illness:
Preexisting Conditions: Psoriasis, Psoriatic arthritis, osteoarthritis, interstitial cystitis
Allergies:
Diagnostic Lab Data: ER visit and eye exam to determine healthy eyes with a Dx of ice pick headaches.
CDC Split Type:

Write-up: Within 24 hours extreme fatigue, joint pain, overall body weakness. On the date of the adverse reaction noted, ice pick headaches in left eye. Multiple times a day for one week, and sporadic thereafter.


VAERS ID: 1201317 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Alaska  
Vaccinated:2021-03-13
Onset:2021-03-24
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Ear discomfort, Tinnitus
SMQs:, Hearing impairment (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: No
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: Went to Urgent Care . Told me to take decongestant. Has been exactly 2 weeks since severe ringing started and it is worse.
CDC Split Type:

Write-up: Clogged left ear: ringing in ear/tinnitus


VAERS ID: 1201333 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Coagulopathy, Computerised tomogram normal, Computerised tomogram thorax, Condition aggravated, Deafness bilateral, Decreased appetite, Dizziness, Dyspnoea, Fatigue, Feeling abnormal, Fibrin D dimer increased, Headache, Incoherent, Migraine, Nausea, Pallor, Speech disorder, Tinnitus, Vision blurred, Visual impairment
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Haemorrhage laboratory terms (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Psychosis and psychotic disorders (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Hearing impairment (narrow), 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: Ajovy injection (3/11/21), Botox injection (3/17/21), gabapentin (2xs daily @300mg/ea), d3 (5000iu daily), flint stones multivitamin w/ iron (1 tablet daily), biotin (5000mcg daily), calcium citrate (1 tablet daily), aller-tec (1 tab daily)
Current Illness: None
Preexisting Conditions: Chronic migraines & sports induced asthma
Allergies: None
Diagnostic Lab Data: Chest ct scan (4/10/21), was at ER for test and evaluation for 5 hours (4/10/21)
CDC Split Type:

Write-up: Headache (turned into a migraine), extremely drained of energy, lack of appetite, and felt off all day (4/9/21). The next morning (4/10/21) felt the same as the day before, however, had several episodes where I would get really light headed, dizzy, and nauseous. Went to Home Depot at 2:15pm (4/10) and while there my vision blurred and started to fade, I had ringing in my ears and couldn?t hear out of the right and barely was able to hear out of the left. I got very nauseous and I couldn?t breath. I managed to sit on something and put my head between my legs that helped. Fortunately my step- dad was with me and helped me outside while I could barely see and hear and he stated I was very pale. I was having a hard time talking or being conherent. Once outside the symptoms slowly cleared over about the next 6-7 hours. At 4:45pm my mom decided to take me to the doctor but the walk in had just closed and I went to the ER. They stated I had elevated d-dime and did a chest CT scan to check for blood clots around 7:30pm (I believe not sure exact time) doctor stated they came back clear but when asked if he suspected that the episode and symptoms were due to a dissipated blood clot he would not directly answer it. I overheard him dictating his notes and he started he beloved as such. I have never experienced anything like this before. I still felt drained, headache (migraine), occasionally dizzy, and lack of appetite (4/11/21, 4/12/21) and still currently feel the same drained, migraine, lack of appetite, and occasionally dizzy.


VAERS ID: 1201355 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-03
Onset:2021-04-10
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK LA / IM

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

Write-up: Severe Throbbing headaches and back/body pain.


VAERS ID: 1201372 (history)  
Form: Version 2.0  
Age: 92.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-01
Onset:2021-04-07
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 RA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Computerised tomogram abnormal, Humerus fracture, Pain in extremity, Thrombosis
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Accidents and injuries (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: lipitor 20mg, colace 100mg, effexor xr 100mg, lasix 20mg, toprol xl 50mg, protonix 40mg, oscal 500/200 D-3, ativan 0.5mg, mucinex XR 12hr 600mg, nitrostat Sublingual, nystatin powder, milk of magnesia suspension
Current Illness: hypertension, dilation & curettage (March 2021)
Preexisting Conditions: history of transient ischemia attack, gastroesophageal reflux disease, depressive disorder, atrial fibrillation, hyperlipidemia, hypertension, type 2 diabetes,
Allergies: Lidocaine, morphine, penicillins, sulfa
Diagnostic Lab Data: CT upper extremity w/o contrast on 4/8/2021 0631: chronic appearing proximal humeral shaft fracture with fracture line readily apparent concerning for nonunion, correlate clinically, no acute osseous findings identified,
CDC Split Type:

Write-up: Resident c/o L arm pain on 4/7/2021 approx 2300. Resident transferred to ED for evaluation, CT abnormalities, transfer to higher level of care, clot manually removed on 4/8/2021, resident returned to nursing facility on 4/12/2021 without complications


VAERS ID: 1201374 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-03-16
Onset:2021-04-03
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 UN / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Angiogram pulmonary abnormal, Anticoagulant therapy, Computerised tomogram abdomen, Dyspnoea, Haemoperitoneum, Laparoscopic surgery, Mesenteric haemorrhage, Pulmonary embolism, Scan with contrast abnormal, Splenectomy, Splenic haemorrhage, Splenic rupture, Splenic thrombosis, Splenomegaly, Vena cava filter insertion
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 11 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Centrum MultiGummies for Women (1 gummy daily)
Current Illness:
Preexisting Conditions:
Allergies: No known allergies
Diagnostic Lab Data: 4/3 09:37 CTA chest and CT abdomen/pelvis - "1. Segmental and subsegmental pulmonary emboli in the lower lobes of both lungs. 2. Small volume perisplenic hemorrhage and small volume pneumoperitoneum in the pelvis or findings concerning for spontaneous splenic rupture. 3. Spleen is moderately enlarged" 4/3 23:05 CT abdomen and pelvis with IV contrast: "Small to moderate amount of hemoperitoneum, slightly increased since the earlier study. There is definitely new blood adjacent to the liver. The hemorrhage adjacent to the spleen appears similar to the earlier study. Due to the timing of the scans with relation to the contrast injection, I cannot confirm a splenic laceration, although I suspect this as the source of hemorrhage. Small amount of mesenteric blood, slightly increased" 4/7 Spleen pathology report: "? Organizing blood clot on surface, consistent with rupture ? No evidence of malignancy"
CDC Split Type:

Write-up: On 4/3/21 the patient presented with a 1 week history of slowly progressive shortness of breath and 3 day history of left upper quadrant pain. CT revealed bilateral segmental and subsegmental pulmonary emboli, moderate splenic enlargement, and small volume perisplenic hemorrhage. Continuous infusion heparin was started for the bilateral PE. On 4/4 an inferior vena cava filter was placed and patient was vaccinated with Acthib, Bexsero, and Prevnar vaccines in anticipation of splenectomy. On 4/7 a laparoscopic splenectomy was performed. The spleen was evaluated by pathology which reported "Organizing blood clot on surface, consistent with rupture. No evidence of malignancy." The patient remains inpatient while recovering from surgery. On 4/12 she was transitioned to rivaroxaban for therapeutic anticoagulation. Please note as of 4/13 the patient remains hospitalized.


VAERS ID: 1201378 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-11
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Computerised tomogram, Electrocardiogram, Ischaemic stroke, Magnetic resonance imaging, Muscular weakness, Musculoskeletal disorder, Thrombosis, Ultrasound Doppler
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vitamin D Ashwaganda Vitamin C Iron Multi-Vitamin
Current Illness: None
Preexisting Conditions: Migraines
Allergies: Amoxicillin Flexeril
Diagnostic Lab Data: 4/11/2021-4/12/2021: EKG, CT,Ultra Sound of legs and neck arteries, MRI, Blood Panel,
CDC Split Type:

Write-up: Approximately three days after vaccine, I experienced a blood clot. This caused an acute ischemic stroke in my left frontal lobe, resulting in muscle weakness and partial loss of use in my right leg.


VAERS ID: 1201402 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-06
Onset:2021-03-20
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 UN / UN

Administered by: Private       Purchased by: ?
Symptoms: Blindness, Retinal artery occlusion, Visual acuity reduced
SMQs:, Anticholinergic syndrome (broad), Embolic and thrombotic events, arterial (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (narrow)

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

Write-up: Patient received J and J vaccine . 2 weeks later had vision loss in both eyes. No light perception in the right and counting fingers in the left. Diagnosis is central retinal artery occlusion in both eyes. Work up for other causes are negative


VAERS ID: 1201443 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-07
Onset:2021-03-21
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Angiogram, Blood test, Chest X-ray, Deep vein thrombosis, Dizziness, Electrocardiogram, Pain in extremity, Peripheral swelling, Pulmonary embolism, Sensory disturbance, Ultrasound Doppler, Ultrasound scan
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: asthma
Allergies: none
Diagnostic Lab Data: Hospital ER--Chest Xray, bloodwork, EKG, CT with contrast (3/23) Hospital ER- Double doppler, bloodwork (3/26) Radiology Center- Ultrasound of leg (3/23) Primary Care--bloodwork drawn and referral to Cardiologist and Pulmonologist 4/8/21
CDC Split Type:

Write-up: 14 DAYS POST VACCINE EXPERIENCED LEFT CALF PAIN...SHARP PAIN. Applied warm compress and took tylenol. Pain persisted and increased. Visited Urgent Care center on Tuesday, 3/23 and was advised immediate ultrasound needed. Went to Radiology Facility same day and was advised I had a DVT in leg and I needed to go to ER. Went to Hospital ER on 3/23 and was treated in ER with blood thinners (IV) and advised I also had numerous PEs in chest. Released with RX for Eliquis and advised to follow up with PCP and Hemotologist asap. Friday, 3/26 leg was swelling and patient was dizzy with chest and arm sensations. Went back to ER. Double Doppler done. DVT has moved. Assumed another PE has occurred . Continue Eliquos RX. Following up with Hemotologist, Cardiologist and Pulmonologist.


VAERS ID: 1201479 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 43A21A / 1 UN / UN

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain upper, Chest pain, Chills, Diarrhoea, Differential white blood cell count normal, Electrocardiogram, Full blood count, Malaise, Nausea, Pain, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (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? 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: EKG 4-13-21 CBC with Diff 4-13-21
CDC Split Type:

Write-up: Reported not feeling well after receiving vaccine. Nausea, vomiting, diarrhea. Along with chest and epigastric pain, body aches, and chills


VAERS ID: 1201524 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-03-01
Onset:2021-03-16
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Blood test normal, Muscle spasms, Pain in extremity, Peripheral swelling, Ultrasound scan normal, Vascular pain
SMQs:, Cardiac failure (broad), Angioedema (broad), Dystonia (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Flu vaccine in Nov 2018 caused cellulitis.
Other Medications: Chlorthalidone 12.5 mg (1 each morning for osteopenia, but did not take until after vaccine that day) Potassium CL 20 MEQ ER tablets (1 x day) Propranolol 10 mg (1 each night) Amitriptyline 5 mg (1 each night) Promethazine 6.25 mg (1 each n
Current Illness: Osteopenia
Preexisting Conditions: Migraines/headaches, ankle swelling, tested posted for porphyria strain,
Allergies: Vomiting: Codeine, Demerol. Doxycycline: extreme neurological symptoms
Diagnostic Lab Data: Telenurse, teledoc, Urgent Care, and ER in same day (each elevated my case). Blood test in ER ...followed-up with Internal Med doctor soonafter, and a simple sonogram in non-moving position after IM doc. Seeing a vascular surgeon in Apr 15 ( the few prior tests were negative, but pain persists).
CDC Split Type:

Write-up: Severe vein pain around ankle/lower calf and knee pain, and some swelling. Severe cramping in both legs.


VAERS ID: 1201532 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-03-01
Onset:2021-03-20
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cerebrovascular accident, Foreign body in eye, Hypoaesthesia, Magnetic resonance imaging head abnormal
SMQs:, Peripheral neuropathy (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Corneal disorders (broad), Sexual dysfunction (broad)

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, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: No MRI metal in right eye
CDC Split Type:

Write-up: Numbness entire left side of body and face. Treatment for stroke


VAERS ID: 1201543 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-03-03
Onset:2021-03-12
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cerebral infarction, Computerised tomogram head abnormal, Computerised tomogram thorax abnormal, Death, Deep vein thrombosis, Pulmonary embolism, Renal infarct, Splenic infarction, Thrombophlebitis superficial, Ultrasound scan abnormal, Venous occlusion
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Thrombophlebitis (broad), Cardiomyopathy (broad), Renovascular disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-06
   Days after onset: 24
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Diamox Unsure of other meications
Current Illness: unknown
Preexisting Conditions: Hypertension, Type2 DM, Idopathic Intercranial Hypertension, Obesity, Chronic back pain
Allergies: Unknown
Diagnostic Lab Data: CT of Head=Subacute left MCA territory infarct, Chest CT=Acute pulmonary embolism, right kidney and splenic infarcts, Upper extremity U/S=occlusive & nonocclusive deep vein thrombosis in the bilateral upper extremities, occlusive superficial venous thrombosis within the bilateral cephalic veins
CDC Split Type:

Write-up: Death


VAERS ID: 1201555 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-03-18
Onset:2021-03-23
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Haematochezia, Kidney infection, Nausea, Pain, SARS-CoV-2 test negative, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Pseudomembranous colitis (broad), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Noninfectious diarrhoea (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? No
Previous Vaccinations:
Other Medications: Fluoxetine, Prazosin, multi-vitamin
Current Illness: Sleep apnea, chronic headache/migraines, anxiety, depression, OCD, C-PTSD, ADHD
Preexisting Conditions: Sleep apnea, chronic headache/migraines, anxiety, depression, OCD, C-PTSD, ADHD
Allergies: Mild dog allergy
Diagnostic Lab Data: March 24th - negative COVID-19 test March 28th - negative COVID-19 test
CDC Split Type:

Write-up: Diarrhea (March 23rd-present, treated with pepto-bismol and imodium) Nausea (March 23rd-present, treated with zofran and phenergan) Vomiting (March 23rd-March 31st, treated with zofran and phenergan) Kidney Infection (March 24th, treated with 7 days of Ciprofloxacin) Blood in stool (March 24th-April 9th) Body aches (March 23rd-26th, treated with acetaminophen)


VAERS ID: 1201583 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Asthenia, Blindness, Body temperature increased, Bowel movement irregularity, Confusional state, Dehydration, Dizziness, Dysphonia, Dyspnoea, Electrocardiogram, Eye movement disorder, Fall, Feeling abnormal, Headache, Loss of consciousness, Memory impairment, Oropharyngeal pain, Syncope, Urine analysis, Vision blurred
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Noninfectious diarrhoea (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: past thyroid issues, past concussions
Allergies: none
Diagnostic Lab Data: This writer was taken to immediate care and an EKG and Urine test was done. This writer was diagnosed with Syncopal Episode and dehydration. ( tests done on 4/7/2021) right after adverse reaction. This writer is still experiencing symptoms: shortness of breath, headache, sore throat, hoarse voice, dizziness, forgetful, confusion and foggy.
CDC Split Type:

Write-up: "Janssen COVID-19 Vaccine EUA" This writer was having a session with a client and her mother at the playground on 4/8/2021 and writer felt weak towards the end of session. Per mother''s report, writer''s eyes rolled back into her head and writer was about to fall backwards off the picnic table, but the mother caught writer. This writer was unconscious and then came back alert, but could not see for two minutes. This writer experieced severe abdominal pain and needed to use the restroom right after and had a bowel movement. dehydration (J & J vaccine night before at7pm) headache, difficulty breathing and blurred vision and a fever of 99.4 the next day. This writer was taken to immediate care and an EKG and Urine test was done. This writer was diagnosed with Syncopal Episode and dehydration.


VAERS ID: 1201587 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-18
Onset:2021-03-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / 1 LA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Blood test normal, Chills, Computerised tomogram normal, Dizziness, Headache, Hot flush, Nausea, Urine analysis normal
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? Yes
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: 03/27/2021 I had blood and plasma work done. All came back in normal range. 03/29/2021 I have more blood , urine, and a CT done. All came back in normal ranges.
CDC Split Type:

Write-up: I have had headaches nausea lightheadedness/dizziness body chills every now and then hot flashes. I have gone to my personal clinic. I went to urgent care there and was seen by the doctor I had a CT bloodwork and urine test I?ll run and everything came back normal. I still get random spurts of headaches nausea they did give me some medications to help treat the symptoms but I still in continue to get the symptoms.


VAERS ID: 1201646 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-06
Onset:2021-04-09
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Dizziness, Petechiae
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Had bloodwork done in the ER 4/10 that came back normal, per patient
CDC Split Type:

Write-up: Felt dizzy/lightheaded for the first few days after vaccine. 4/9 he noticed the development of petechiae. 4/10 he went to the ER about it and his labs came back normal. He said it continued to spread after his ER visit. I reviewed with him there isn''t a treatment option and it should clear on its own, but if it still continues to spread or spots get bigger, if he develops a fever, increased heart rate, or pulse changes to contact his doctor or go back to the ER and followup with us as well.


VAERS ID: 1201649 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-06
Onset:2021-04-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chills, Dehydration, Differential white blood cell count, Dizziness, Electrocardiogram, Fall, Fatigue, Full blood count, Hyperhidrosis, Loss of consciousness, Metabolic function test, Nausea, Peripheral coldness, Syncope, Troponin
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad), Dehydration (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Daily Vitamin D pill
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data: On April 7, 2021 at Medical Center: ECG; CBC with differential; CMP - Complete Metabolic Panel Troponin 1 Quantitative
CDC Split Type:

Write-up: Beginning approximately 10 PM (about 8 hours post-injection), I started to have chills (feet were freezing) and was exhausted. Went to bed, and slept most of the night, only waking once to urinate and to drink a small amount (approx 2 oz) of Coca Cola -- I was very nauseous and thought it would help settle my stomach. During the night I sweated profusely. At 8 AM, I woke again and went to urinate. At that time I felt very nauseous, dizzy, and light headed. When I walked about 2 -3 feet to my bedroom, I collapsed on the floor - unconscious. My partner called EMS, they arrived minutes later. By then I was conscious. They transported me to Medical Center Emergency Room, where I remained for several hours. They indicated that my SYNCOPE was a result of dehydration. TODAY, 4/13, news of BLOOD CLOTS has compelled me to report my adverse reaction.


VAERS ID: 1201676 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2020-04-09
Onset:2021-04-10
   Days after vaccination:366
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Fatigue, Heart rate irregular, Musculoskeletal stiffness, Myalgia, Nausea, Pyrexia, Swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Cardiac arrhythmia terms, nonspecific (narrow), 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:
Preexisting Conditions:
Allergies: NONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: SHORTNESS OF BREATH, IRREGULAR HEART BEAT, FEVER, MUSCLE ACHES, WHOLE BODY SWOLLEN, NAUSEA, FATIGUE, NECK AND BACK STIFFNESS


VAERS ID: 1201682 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-03-12
Onset:2021-03-31
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / UNK LA / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-01
   Days after onset: 1
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: PATIENT HAD DIZZINESS, WENT TO DR, THEN NEXT DAY ER AND ENDED UP DYING 4-2-2021


VAERS ID: 1201706 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-14
Onset:2021-03-19
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Computerised tomogram, Dizziness, Dyspnoea, Facial paralysis, Hypoaesthesia, Injection site pain, Injection site swelling, Magnetic resonance imaging, Pain, Pain in extremity, Swelling face, Transient ischaemic attack, Ultrasound scan, Vision blurred
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Hearing impairment (broad), Vestibular disorders (broad), Hypersensitivity (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? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Metphormine, Glipizide
Current Illness: none
Preexisting Conditions: Diabetic, Asthma
Allergies: Amoxicillin, sulfamethoxazole
Diagnostic Lab Data: 3/21/2021: 3 MRI''s, Blood work, Ultrasound on arm and cat scan. Was discharged 3/22 as a mini stroke.
CDC Split Type:

Write-up: 7:00 pm Friday started getting left arm: numbness on whole left side of body, left side of face swelling and droopy. Felt a sharp pain in left arm near basilic vein and started swelling like a ball. Felt shortness of breath and dizzy with blurry vision. Almost passed out when stood up. Was rushed to the ER. Had Sharp pains shooting through left leg.


VAERS ID: 1201724 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-03-30
Onset:2021-03-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood pressure normal, Blood test, Chest X-ray, Electrocardiogram normal, Fatigue, Tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Omeprazole, atorvastatin, allegra, topiramate, B12, D3, Fish oil Olly Stress Free supplements.
Current Illness: None
Preexisting Conditions: Depression, anxiety, GERD, high cholesterol.
Allergies: None
Diagnostic Lab Data: EKG on 3/31/2021, EKG on 4/3/2021, blood tests on 4/3/2021, chest X-ray on 4/3/2021.
CDC Split Type:

Write-up: After receiving the vaccine I was experiencing fatigue and tiredness. I went to bed that evening and experienced tachycardia for several hours. I went to the doctor the next morning as soon as possible and was given an EKG. The EKG came back normal, as did my blood pressure, but my doctor put me on a cardiac event monitor a few days later for two weeks to continue monitoring my heart. I had ongoing symptoms and went to the ER a few days later and had another EKG, blood tests, and a chest x-ray done, all of which came back clear. However, I am still wearing the heart monitor and will follow up with my doctor in a week when it is removed and the results come back to see if there is a reason for the tachycardia.


VAERS ID: 1201742 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Dysstasia, Myalgia, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Patient reported thinking he had a blood clot in both legs. Patient stated Saturday night he experienced severe leg pain in both of his legs lasting 30 minutes later. Patient stated that he felt as if he had pain in every muscle in both of his legs; patient stated that he could not stand for quite some time once pain began. Patient stated that pain caused him to wake up. Patient stated that he did not have any other problems afterwards.


VAERS ID: 1201768 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-06
Onset:2021-04-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Angina pectoris, Back pain, Chest discomfort, Condition aggravated, Discomfort, Dyspnoea, Eosinophil percentage, Fatigue, Feeling cold, Haematocrit normal, Haemoglobin normal, Hypopnoea, Immediate post-injection reaction, Lymphocyte percentage decreased, Mean cell haemoglobin concentration normal, Mean cell haemoglobin increased, Mean platelet volume increased, Monocyte percentage, Neutrophil percentage, Pain, Platelet count normal, Red blood cell count normal, Red cell distribution width normal, White blood cell count normal
SMQs:, Anaphylactic reaction (broad), Haematopoietic leukopenia (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Cardiomyopathy (broad), Other ischaemic heart disease (narrow), Hypersensitivity (narrow), Respiratory failure (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: Benadryl
Current Illness: None, other than seasonal hay fever
Preexisting Conditions: Eosinophilic esophagitis
Allergies: Sulpha based antibiotics; grasses/trees/pollens
Diagnostic Lab Data: WBC 6.66 x10''3/uL 4.00 - 10.00 x10''3/uL RBC 3.80 x10''6/uL 3.85 - 5.20 x10''6/uL Hemoglobin 13.0 gm/dL 11.5 - 16.0 gm/dL Hematocrit 39.7 % 34.7 - 46.0 % MCV 104.5 fL 80.0 - 97.0 fL MCH 34.2 pg 26.0 - 34.0 pg MCHC 32.7 gm/dL 32.0 - 36.0 gm/dL RDW 12.4 % 11.5 - 15.0 % Platelet Count 164 x10''3/uL 140 - 440 x10''3/uL MPV 11.6 fL 6.5 - 12.4 fL Auto % Neut 68.0 % 37.0 - 80.0 % Auto % Lymph 15.2 % 16.0 - 51.0 % Auto % Mono 8.0 % 0.0 - 12.0 % Auto % Eos 8.0 % 0.0 - 8.0 % Auto % Baso 0.6 % 0.0 - 3.0 % Auto % Imm Gran 0.2 % 0.0 - 1.0 % Immature granulocytes are composed of metamyelocytes, myelocytes, and promyelocytes; bands and blasts are not included. Auto % NRBC 0.0 /100 WBC 0.0 - 0.2 /100 WBC Auto ABS Neut 4.54 x10''3/uL 1.50 - 8.00 x10''3/uL Auto ABS Lymph 1.01 x10''3/uL 0.80 - 4.00 x10''3/uL Auto ABS Mono 0.53 x10''3/uL 0.00 - 1.20 x10''3/uL Auto ABS Eos 0.53 x10''3/uL 0.00 - 0.30 x10''3/uL Auto ABS Baso 0.04 x10''3/uL 0.00 - 0.30 x10''3/uL Auto ABS Imm Gran 0.01 x10''3/uL 0.00 - 0.10 x10''3/uL Auto ABS NRBC 0.00 x10''3/uL 0.00 - 0.01 x10''3/uL General Information Ordered by MD Collected on 04/06/2021 11:08 PM from Blood (Blood) Resulted on 04/06/2021 11:16 PM *********************** D-Dimer Quant HS <150 ng/mL DDU 0 - 229 ng/mL DDU A D-Dimer value of <230 ng/mL D-DU is used in conjunction with a clinical pretest probability assessment to exclude VTE in outpatients suspected of DVT and PE. Any use of the age-adjusted cutoff value is a post-analytic modification of this FDA-approved test and is considered "off-label" use of the test result. Legacy laboratory Services does not have literature to support the validity of an age-adjusted cutoff for our specific assay. General Information Ordered by MD Collected on 04/06/2021 11:53 PM (Blood) Resulted on 04/07/2021 12:05 AM Result Status: Final result *********************** Sodium 138 mmol/L 136 - 145 mmol/L Potassium 3.5 mmol/L 3.6 - 5.0 mmol/L Chloride 103 mmol/L 98 - 107 mmol/L Carbon Dioxide 28 mmol/L 22 - 28 mmol/L BUN 15 mg/dL 6 - 20 mg/dL Creatinine 0.66 mg/dL 0.60 - 1.10 mg/dL Glucose 93 mg/dL 74 - 100 mg/dL Calcium 9.4 mg/dL 8.6 - 10.3 mg/dL Total Protein 6.8 gm/dL 6.0 - 8.3 gm/dL Albumin 4.4 gm/dL 3.5 - 5.0 gm/dL SGPT/ALT 13 U/L 10 - 35 U/L SGOT/AST 15 U/L 8 - 39 U/L Alkaline Phosphatase 34 U/L 42 - 98 U/L Total Bilirubin 0.7 mg/dL 0.3 - 1.2 mg/dL General Information Ordered by MD Collected on 04/06/2021 11:08 PM from Blood (Blood) Resulted on 04/06/2021 11:35 PM Result Status: Final result *********************** VENT RATE 75 BPM BPM ATRIAL RATE 75 BPM BPM PR INTERVAL 120 ms ms QRS DURATION 82 ms ms QT INTERVAL 380 ms ms QTC 424 ms ms R AXIS 96 degrees degrees T AXIS 93 degrees degrees General Information Ordered by MD Collected on 04/06/2021 10:56 PM Resulted on 04/07/2021 12:48 AM ***************************** Troponin I <0.02 ng/mL <=0.03 ng/mL 0.03 ng/mL or less: No detectable cardiac injury 0.04 to 0.49 ng/mL: Possible Cardiac muscle injury 0.50 ng/mL or greater: Myocardial infarction Serial testing is highly recommended with a Troponin of 0.04 ng/mL or greater. General Information Ordered by MD Collected on 04/06/2021 11:08 PM from Blood (Blood) Resulted on 04/06/2021 11:35 PM Result Status: Final result ********************** EXAM: X-RAY CHEST 2 VIEWS dated 4/7/2021 12:36 AM. CLINICAL DATA: Chest pain, shortness of breath. COMPARISON EXAM: X-ray chest single view 10/13/2012. FINDINGS: OTHER: None. MEDIASTINUM: The mediastinum, hila, and pulmonary vessels are within normal limits. LUNGS: The lungs are clear. PLEURA: No pleural effusion or pneumothorax is identified. BONES: The bones are within normal limits for age. IMPRESSION: No evidence of acute cardiopulmonary disease. Verified by M.D. ***************
CDC Split Type:

Write-up: Immediately when I received the injection, I felt a cool fluid rush around my heart with a moderate discomfort/pain. I reported this to the tech who administered. He didn''t seem alarmed & advised I wait 15 mins. I still felt a "coolness" around my chest but otherwise felt "fine" so I was permitted to leave. As the day went on, I felt my chest (lungs & area around my heart) feel tighter & tighter & my breath grew more & more "shallow" like I couldn''t take deep enough breaths & I was short of breath. In the evening, it intensified. I was very fatigued (couldn''t go up our stairs or talk in complete sentences without feeling "winded"). The tightness in my chest was worse & was accompanied by periodic acute pain in my heart. I also had pain my lower back. I went to the emergency room around 10PM that night. An EKG, blood tests & chest X-ray were conducted. The ER doctor said all tests came back "normal" & they weren''t sure what my issue was. I went home & rested. I woke the next morning with the acute pains gone but the tightness still lingered. I did not feel "normal" until almost 72 hours after my vaccine.


VAERS ID: 1201790 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-03-31
Onset:2021-03-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 038A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Chest discomfort, Facial pain, Fatigue, Headache, Nausea, Neck pain, Pain, Pain in jaw
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Osteonecrosis (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Gabapentin 100mg Eliquis 5mg Tablets Levocetirizine 5mg Tablets Telmisartan 40mg Tablets Breo Ellipta 200-25mcg Oral Inh(30) Spiriva Respimat 1.25mcg In 4gm 60d Montelukast 10mg Tablets Alprazolam 0.25mg Tablets (occasional) B12 Multivitam
Current Illness: Fibromyalgia Asthma
Preexisting Conditions: Fibromyalgia Asthma
Allergies: Seasonal allergies Cats Bermuda Grass Box Eld/Maple IgE Cat Epithelium IgE Cottonwood IgE Eastern Sycamore IgE Elm IgE House Dust Mites/D.F. IgE House Dust Mites/D.P. IgE Oak IgE Rough Pigweed IgE Russian Thistle IgE Common Ragweed IgE Timothy Grass IgE Walnut Tree IgE White Ash IgE
Diagnostic Lab Data: ER Visit (4 days after) EKG D-Dimer (13 days after)
CDC Split Type:

Write-up: headache chest pressure severe headaches face pain jaw pain neck pain abdomen pain nausea fatigue all over aching


VAERS ID: 1201800 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-04-09
Onset:2021-04-13
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 0431A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Dyspnoea, Nausea, Pyrexia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient stated after the vaccine she had a fever and was nauseous but all resolved after 24 hours. She woke up today with chest pain/ tightness and stated it is painful to breathe. She was advised to go to the ER.


VAERS ID: 1201816 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cyanosis, Dizziness, Feeling hot, Pruritus, Throat irritation
SMQs:, Anaphylactic reaction (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NOT KNOWN
Current Illness: NO
Preexisting Conditions: NO
Allergies: NO
Diagnostic Lab Data: NOT KNOWN
CDC Split Type:

Write-up: PATIENT EXPERIENCED DIZZINESS, FEELING HOT, SCRATHY THROAT, FEELING ITCHIY AND LIPS TURNED BLUE WITHIN 2-3 MINUTES OF ADMINISTRATION. ADMINISTERED EPIPEN. PATIENT FELT BETTER. EMT TOOK PATIENT TO THE HOSPITAL. I CONTACTED THE PATIENT SHE IS OK AND WAS SEND HOME AFTER THE HOSPITAL.


VAERS ID: 1201827 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram, Dizziness, Dyspnoea, Electrocardiogram, Fatigue, Headache, Laboratory test, Nausea, Pain, Vision blurred, X-ray
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: Fribromialgya
Allergies: Morphine,
Diagnostic Lab Data: EKG , X Rays 04/12/21 Cat scan lab testing, 04/13/21
CDC Split Type:

Write-up: headache, body aches, fatigue, nausea, blurred vision, short of breath, dizziness


VAERS ID: 1201835 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-03-12
Onset:2021-03-19
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1 / 1 AR / SYR

Administered by: Private       Purchased by: ?
Symptoms: Cerebrovascular accident, Chills, Death, Pain, Pyrexia, Thrombosis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-22
   Days after onset: 3
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: BP, thyroid, cholesterol, headaches
Current Illness: Sleep Apnea
Preexisting Conditions: Thyroid, headaches
Allergies: None
Diagnostic Lab Data: Network will have this information. I do not at this time.
CDC Split Type:

Write-up: Low grade fever, aches & chills on 3/13/21 & 3/14/21. Felt better 3/15/21 through 3/18/21. Side effects ( fever, aches, chills ) returned on 3/19/21 & 3/20/21. Suffered stroke on 3/21/21 at 3:30 AM due to blood clots. Passed away on 3/22/21.


VAERS ID: 1201858 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-03-12
Onset:2021-03-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Lip swelling, Mouth swelling, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D, Doxepin
Current Illness: None
Preexisting Conditions: Unknown allergens - reactions to some meds causing hives.
Allergies: Aspirin, Ibuprofen
Diagnostic Lab Data: Unknown if any labs were drawn/performed.
CDC Split Type:

Write-up: Full body hives started roughly about 20-22 hours after injection. Ended up covering body within the coming days. Saw doctor virtually and prescribed prednisone and two trips into the emergency room. ER administered epinephrine shot along with Benadryl, famotidine, and Ativan as the hives become in mouth and lips and swelling was occurring.


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