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

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



Case Details

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VAERS ID: 1201949 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-03-11
Onset:2021-04-04
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 180J029 / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Coronary arterial stent insertion, Injection site erythema, Myocardial infarction, Vaccination site pain, Vaccination site swelling
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), Extravasation events (injections, infusions and implants) (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, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Cat dander
Diagnostic Lab Data: Admitted to hospital 04/04/2021. Placement of five stents same day. Discharged 04/06/2021.
CDC Split Type:

Write-up: Initially redness, slight swelling and pain at vaccine site. Duration of symptoms five days. Followed by heart attack on April 04,2021.


VAERS ID: 1201961 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-03-10
Onset:2021-03-20
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / UNK RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chest pain, Computerised tomogram thorax abnormal, Dyspnoea, Pulmonary embolism, Thrombosis
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), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 10 after I received the Janssen Covid-19 vaccine, I admitted myself to the emergency room with severe chest pain and very difficult time breathing. They ran CT scans and found multiple blood clots in both lungs, pulmonary embolism. They put me on blood thinners and transferred me to another hospital. There they monitored me for a couple days and released me with a prescription for blood thinners.


VAERS ID: 1201967 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-25
Onset:2021-04-09
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Cerebral venous sinus thrombosis, Headache, Intensive care, International normalised ratio increased, Magnetic resonance imaging head abnormal, Platelet count decreased, Prothrombin time prolonged, Scan with contrast abnormal, Superior sagittal sinus thrombosis, Transverse sinus thrombosis, Venogram abnormal, Vomiting
SMQs:, Liver-related coagulation and bleeding disturbances (narrow), Acute pancreatitis (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage laboratory terms (broad), Systemic lupus erythematosus (broad), Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Central nervous system vascular disorders, not specified as haemorrhagic or ischaemic (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: No prescriptions, OTC, dietary supplements o herbal remedies
Current Illness: None
Preexisting Conditions: None
Allergies: NKDA
Diagnostic Lab Data: (1) 4/12/21, MRI venogram sagital sinus wo contrast: "Findings suggest thrombosis of the superior sagittal sinus and transverse sinuses and straight sinus. There is no significant flow in the sigmoid sinuses and jugular vein may be related to decreased flow and/or thrombosis as well." (2) 4/12/21, MRI Brain w wo contrast: "Findings suggesting a diffuse transverse and sigmoid sinus thrombosis. Poor of flow void visualization of the jugular veins as well and is possible these could be occluded as well. No prominent hematoma is detected but on the gradient echo sequences there is prominent diminished signal in the sulci bilaterally and this can be seen in minor of subarachnoid hemorrhage. No midline shifting or mass effect is detected." (3) 4/12/21, Protime=15.4 sec (4) 4/12/21, INR=1.2 (5) 4/12/12, PLT= 64 k/uL
CDC Split Type:

Write-up: 36 y.o. female referred for the above chief complaint. She has no significant medical history and presented with a headache that became severe 3 days ago. She received the Johnson and Johnson COVID vaccine on March 25th and had a mild headache following that which she attributed to the vaccine. 3 days ago the pain became excruciating and was associated with vomiting. This prompted presentation to the ED where she was treated with Dilaudid. She was discharged home and has been using her mom''s headache cocktail with some transient relief. She presented back to the ED today with continued symptoms. MRV revealed a venous sinus thrombosis and neurology was therefore consulted. She has no history of clots personally or in the family. Her dad did have a stroke in his 50s. Patient otherwise denies any other associated speech change, vision change, extremity numbness, extremity weakness, coordination difficulty, or dizziness. Patient admitted to the neurology ICU and started on anticoagulation.


VAERS ID: 1201984 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Indiana  
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 043A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Not Known
Current Illness: Not aware of
Preexisting Conditions: Not aware
Allergies: None listed by patient on vaccine questionnaire
Diagnostic Lab Data: He was transported to hospital so I do not know. I do not know if he was admitted or what happened after that. It was just assumed that he fainted because after the first time he fainted he told me he fainted before when he was giving blood.
CDC Split Type:

Write-up: Directly after giving the vaccine the patient fainted. Patient "came to" and paramedics were called. When they got here, he fainted again and they took him to the hospital.


VAERS ID: 1201996 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-30
Onset:2021-04-01
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Angiogram pulmonary, Bed rest, Blood test abnormal, Catheter directed thrombolysis, Computerised tomogram abnormal, Computerised tomogram thorax abnormal, Dyspnoea, Echocardiogram, Intensive care, Musculoskeletal pain, Pulmonary embolism, Right ventricular enlargement, Ultrasound scan
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (narrow), 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? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prevacid 2 - 15 mg once a day, metoprolol succinate 50 mg sustained=release tablet once a day, Flonase spray as needed (50 mcg), Rosuvastatin 10 mg once a day
Current Illness: dry cough
Preexisting Conditions: Factor V Leiden heterozygous, superficial vein thrombosis, DVT ( almost 10 years ago)
Allergies: none
Diagnostic Lab Data: Chest CT with contrast on 4/4. Echocardiogram on 4/6. Ultrasound on both legs on 4/13. Various blood tests and heart strip tests done over course of 3 days.
CDC Split Type:

Write-up: Shortness of breath started 48 hours post vaccine. Ended up in the ER at hospital on 4/4 with sever shortness of breath and pain in back between shoulder blades. CT and blood work revealed massive Pulmonary Embolism in both lungs and enlarged right ventricle of heart. Pulmonary angiogram was completed, bed rest, ICU and EKOS catheter. Released from hospital on 4/6.


VAERS ID: 1202017 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-03-09
Onset:2021-03-16
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Computerised tomogram head normal, Dysphagia, Echocardiogram normal, Facial paralysis, Hypoaesthesia, Magnetic resonance imaging head normal, Scan with contrast normal, Speech disorder, Transient ischaemic attack
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, arterial (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hearing impairment (broad), Sexual dysfunction (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: LISINOPRIL/HCTZ 20/12.5MG, FAMOTIDINE 40MG
Current Illness: POSSIBLE PROSTATITIS
Preexisting Conditions: CONTROLLED HYPERTENSION
Allergies: NO KNOWN DRUG ALLEGERIES
Diagnostic Lab Data: 2 MRI''s with and w/o contrast. Ct scan with contrast and Echo scan with bubble test...as well as complete blood workup.. All test performed on 3/17/21.
CDC Split Type:

Write-up: Received vaccine on 3/9/21. Started experiencing facial numbness , difficulty with speech and swallowing on 3/16/21 around 11pm. Had facial drooping of the mouth and eye on my left side of face. Went to Hospital ER around 5:30 am on 3/17/21 as symptoms did not subside. I was later placed in stroke observation unit. I had 2 MRI''s, CT scan and Echo tests ran. i was diagnosed with TIA. All test were negative for a cause. I sent a total of about 26 hours hospitalized.


VAERS ID: 1202019 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Massachusetts  
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 043A21A / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood glucose decreased, Condition aggravated, Death, Lethargy, Somnolence
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-12
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Amiodarone PO daily, Apixaban 5mg PO BID, Budesonide 0.5mg Inhaled BID, Clopidogrel 75 mg PO daily, Klor-Con M20 MEQ ER PO daily, Lantus insulin SC injection 24 units daily, Lipitor 40 mg PO daily, Metformin 500mg PO BID, Prednisone 20mg PO
Current Illness: CHF, Atrial Fibrillation, Hypertensive Heart Disease, Ischemic Cardiomyopathy
Preexisting Conditions: Type 2 diabetes, COPD
Allergies: No known allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: This patient was under hospice care at home with Nursing Service and Hospice. He received the J&J vaccination at noon by local public health nurse on Mon 4/12/21. The patient''s wife, reported to hospice team that he had been sleepy during the day and had received a dose of Ativan earlier that morning (PRN medication at 0750). The primary hospice nurse reported wife noted he became more lethargic throughout the day after vaccination with his condition worsening at 1720; at that time his blood sugar levels were noted to be low at "47" but patient was alert enough to drink orange juice, eat ice cream. The patient continued to deteriorate so MD was consulted and he was transported to the ED where he later expired at 1930.


VAERS ID: 1202034 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: North Carolina  
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 - / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood test, Cardiac stress test, Computerised tomogram, Echocardiogram, Magnetic resonance imaging, Seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? 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: Atorvastatine, Amlodipone, Combivent, Symbicort
Current Illness:
Preexisting Conditions:
Allergies: Sulfas
Diagnostic Lab Data: CT Scan, MRI, Heart Echo, Heart Stress Test, Blood tests.
CDC Split Type:

Write-up: Two different Seizures one on March 15th and the other on April 5th


VAERS ID: 1202072 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-09
Onset:2021-04-11
   Days after vaccination:2
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: Cerebral thrombosis, Cerebrovascular accident, Dizziness, Haematemesis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), 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), Gastrointestinal haemorrhage (narrow), Vestibular disorders (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, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: diabetes
Allergies: unknown
Diagnostic Lab Data: BLOOD CLOTTING IN BRAIN
CDC Split Type:

Write-up: PATIENT WOKE UP AT 12 AM THROWING UP BLOOD AND FEELINGS OF PASSING OUT, 911 WAS CALLED AND AMBULANCE TOOK HER TO HOSPITAL, WHERE THEY DETERMINED IT WAS A STROKE AND MOVED HER TO ANOTHER HOSPITAL, WHERE CURRENTLEY BEING TREATED DETERMINED BLOOD CLOT IN BRAIN. MOST LIKELEY DUE TO VACCINE SHOT.


VAERS ID: 1202094 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Wisconsin  
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 043A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol inhaler as needed, Fluoxetine 40mg daily noon
Current Illness: none
Preexisting Conditions: asthma, COVID-19 positive 11/2/20
Allergies: cephalosporins
Diagnostic Lab Data: 4/9/21 ER evaluation at Medical Center. Vital signs were monitored and patient assessed. No labs or xrays needed. Patient was discharged on 4/9/21 0404.
CDC Split Type:

Write-up: The patient was found lying on the floor face down at 2:40am. He was responsive and able to sit up. Reported dizziness and chills. Was visibly shaking while staff were talking with him. Was sent to the ER for evaluation.


VAERS ID: 1202112 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-03-16
Onset:2021-03-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood glucose decreased, Chills, Dizziness, Fatigue, Head discomfort, Headache, Hypertension, Injection site mass, Muscle spasms, Myalgia, Sinus congestion
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Extravasation events (injections, infusions and implants) (broad), Hypertension (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (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: Losartan, Spironolacton, Pot Cl Micro Er, Mag Oxide, Trulicity and Combivent Respimat Aer
Current Illness:
Preexisting Conditions: High Blood Pressure, Diabeties, COPD
Allergies: Codene
Diagnostic Lab Data:
CDC Split Type:

Write-up: Extreme fatigue on day 2 that lasted for a few days, lump in arm at injection site still present after 4 weeks, muscle aches first night, muscle cramps in arms and legs are still present, headache started on day two and lasted a few days. Chills on day three that lasted a day. Head and sinus congestion that lasted two weeks also dizziness went to emergency room and received antibiotics. High blood pressure. Also had low blood sugar for about two days. Was hard to keep blood sugar level up.


VAERS ID: 1202118 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-16
Onset:2021-03-23
   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, Condition aggravated, Epistaxis, Sleep disorder
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: no
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: Will have one today (13th)
CDC Split Type:

Write-up: I would like to report what happened with all the facts. One week after I had vaccine, I had very serious nose bleeding in the morning. I said very serious because I felt it cannot stop by itself. I called 911 and went to ER. First time, I use 911 and ER. All previous nose bleeding is very minor and it will stop in a minute. But this time, I just felt the blood just pouring into my mouth. So I was scared and asked my wife called 911. After 2-3 hours, the bleeding stopped and I back home. To be cautious, I made an appointment with family doctor on next day (24th). But the bleeding happened again in the evening ( cannot remember exactly, but around 9pm). This time I just used the clipper for my nose and it took another 2 hours for the bleeding to stop. I had a very rough night while sitting on bed and had very little sleep. The next morning (24th), the bleeding come back after I used the restroom. The same feeling as the two bleeding before. I rushed to doctor''s office even not my appointment yet. The family doctor said he cannot do anything since he cannot observe the place of blooding and he does not have instrument needed. I was referred to a specialist. And luckily I had the same day appointment. We rushed there and after roughly several hours waiting, I was the specialist and finally he did the treatment. Since then, my nose is ok and no serious bleeding again. After I saw the side effects of JJ vaccine, I think it is better for me to report you what happened. I strongly suspect that my serious bleeding was caused by the drop of platelet which was side effect of the vaccine. I will have one blood work today. And will let you know results if you are interested. Again, I never had such serious bleeding before and that is the reason for my suspect. All the best


VAERS ID: 1202142 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-03-06
Onset:2021-04-09
   Days after vaccination:34
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 AR / SYR

Administered by: Other       Purchased by: ?
Symptoms: Blood test abnormal, Dizziness, Dyspepsia, Dyspnoea, Echocardiogram, Electrocardiogram, Flushing, Myocardial infarction, Nausea, X-ray
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Embolic and thrombotic events, arterial (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (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, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vitamin D3
Current Illness: none
Preexisting Conditions: overweight
Allergies: none
Diagnostic Lab Data: Emergency Room and Urgent Care. I had an EKG, blood work and a heart x-ray Hospital - I had multiple EKGs, cardiac angioplasty and echocardiogram
CDC Split Type:

Write-up: Shopping, climbed a single level stairway, became winded, nauseous, got bad heartburn feeling, felt flush and started getting dizzy. Took Tums, no help went to Emergency Room and was told that there was an enzyme in my blood which showed I had a heart attack


VAERS ID: 1202143 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: South Dakota  
Vaccinated:2021-03-24
Onset:2021-04-03
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / IM
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Balance disorder, Blood test, Computerised tomogram head, Diplopia, Dizziness, Echocardiogram, Feeling abnormal, Magnetic resonance imaging head, NIH stroke scale, Strabismus, Visual field defect
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Optic nerve disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Ocular motility disorders (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Brilinta, Atrovastatin, Finastride, Asprin 81mg, Omega FishOil
Current Illness: No
Preexisting Conditions: Left Anterior Descending Artery 90% blocked. Stinted 2/3/2021
Allergies: Ceclor
Diagnostic Lab Data: CT Scan, Blood Work, MRI, Stroke Scale, Bubble Test on Heart all done on 4/3/2021
CDC Split Type:

Write-up: Patient woke up on 4/3/2021 at 7:30am with the symptoms of Light Headedness, Dizziness, and not feeling like himself. He got up and continued with his normal daily routine until around 10:30 when his vision started to double and he was off balance on his feet. He was taken by ambulance to a Hospital at 11:15am upon arrival his vision trippled and his eye right started to veer outward. He was taken in for a CT scan immidiatly and then was transfered to another campus to have a MRI scan done. He was then admited to the hospital for evaluation where he stayed overnight and was released the next afternoon (4/4/21)


VAERS ID: 1202148 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-03-10
Onset:2021-03-13
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN JNJ-LOT#1805018 / 1 RA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Blood test abnormal, Chest X-ray, Dyspnoea, Electrocardiogram abnormal, Pulmonary embolism, Ultrasound Doppler
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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: Pneumonia vaccine - near inability to move arm
Other Medications: Cartia XT, Lansoprazole, Venlafaxine, Propranolol, Atorvastatin, Vitamin C, Vitamin Sambucus Black Elderberry, stool softener, Iron
Current Illness: none
Preexisting Conditions: high blood pressure, fast heart rate, high cholesterol
Allergies: penicillin, aspirin
Diagnostic Lab Data: 3/24 ECG, 3/30 ER, blood tests 3/30 4/1 , chest Xray 3/30, venous leg bilateral 3/30, echo 3/31, blood tests 4/1 ECG 4/7 Placed on Eliquis for extensive blood clots in lungs ER was Hospital
CDC Split Type:

Write-up: Began to experience shortness of breath which got worse and worse, until I couldn''t walk across a room without being totally out of breath.


VAERS ID: 1202150 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Missouri  
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 042A21A / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Influenza like illness, Injection site vesicles, Pain in extremity, Pruritus, Sluggishness
SMQs:, Anaphylactic reaction (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), 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:
Diagnostic Lab Data:
CDC Split Type:

Write-up: pt reported had vaccine on wednesday, on thursday started feeling sluggish, flu like symptoms, friday started itching and achy arm, saturday went to urgent care with blister at injection site, urgent care filled out online form and gave pt benadryl. today tuesday, pt felt better, blister went away, still little achy arm but better.


VAERS ID: 1202162 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-03-06
Onset:2021-04-08
   Days after vaccination:33
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: Unknown       Purchased by: ?
Symptoms: Computerised tomogram normal, Laboratory test normal, Seizure like phenomena, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Claritin, singular, vitamin d
Current Illness: none
Preexisting Conditions: none
Allergies: Darvocet, azithromycin
Diagnostic Lab Data: CT scan and labs
CDC Split Type:

Write-up: Syncope, seizure like activity. Negative scans and blood work in the Emergency Room on April 8. Fatigue presently


VAERS ID: 1202171 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-27
Onset:2021-04-07
   Days after vaccination:11
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: Other       Purchased by: ?
Symptoms: Angiogram cerebral normal, Angiogram pulmonary abnormal, Anxiety, Arteriogram carotid normal, Chest discomfort, Computerised tomogram neck, Computerised tomogram thorax, Dizziness, Dizziness postural, Dry mouth, Dyspnoea, Echocardiogram normal, Electrocardiogram ST segment depression, Fatigue, Fibrin D dimer increased, Gluten sensitivity, Heart rate irregular, Pulmonary embolism, Tachycardia, Ultrasound Doppler normal, Ultrasound pelvis normal
SMQs:, Anaphylactic reaction (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, venous (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Other ischaemic heart disease (broad), Vestibular disorders (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (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, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Loestrin 20ug, Biotin, Collagen, Amino Acids, CBD, Hyaluronic acid
Current Illness: Osteoarthritis
Preexisting Conditions: Osteoarthritis
Allergies: Diflucan gluten intolerance
Diagnostic Lab Data: April 7th, 2021 CTA of lungs showed pulmonary embolism in right lung April 7th, 2021 EKG tachycardia with ST depression April 8th, 2021 pelvic US- normal April 8th, 2021 Heart Echo- normal April 8th, 2021 CTA of head and neck-normal
CDC Split Type:

Write-up: 10 days after the vaccine I developed dizziness, tachycardia, dry mouth,chest pressure, shortness of breath and felt like I was going to pass out, and I had a feeling of extreme doom. I was transported to a clinic. There I had a heart rate of 140 with irregular beats. Continued feeling of doom. An EKG showed ST depression. Symptoms improved with nitroglycerin. The clinic didn''t have the technology to provide care so I was emergently transported again. At that hospital my D-dimer was positive and that lead to a CT Angiogram. This showed a pulmonary embolism. Doppler studies of both legs were negative. I was placed on Heparin for several hours and then switched to Eliquis. About 6 hours after being on Eliquis I had the exact same original symptoms and again nitro was given which helped the symptoms. I was placed back on Heparin for a longer period of time. Once I was anticoagulated I was then switch to Eliquis 10mg BID for 7 days then 5mg BID for 6-9 months. I had a CT Angiogram of the head and neck which was normal. At this time I still have dizziness with standing and intermittently with sitting, extreme fatigue, shortness of breath.


VAERS ID: 1202184 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-03-17
Onset:2021-03-22
   Days after vaccination:5
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: Chest X-ray, Chest pain, Computerised tomogram, Dyspnoea, Fatigue, Pulmonary thrombosis, Ultrasound scan
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Omeperazole, Advil, Trazadone, Potassium Chloride, Welchol, lorsartan
Current Illness: none
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data: CT Scan, chest X-ray, ultrasound
CDC Split Type:

Write-up: Blood clots in both lungs. Admitted to the hospital with severe pain in chest, trouble breathing, within 5 days of vaccination. Put on blood thinners to help get rid of the clots. Extreme fatigue before admittance to the hospital as well as ongoing extreme fatigue.


VAERS ID: 1202225 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-03-11
Onset:2021-03-13
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest X-ray, Computerised tomogram, Electrocardiogram, Headache, Hypoaesthesia, Hypoaesthesia oral, Laboratory test, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin C, Vitamin D
Current Illness: None
Preexisting Conditions: Prior history of asymptomatic PVC''s. Melanoma in 2012 requiring no treatment following excision.
Allergies: IV contrast dye and nickel
Diagnostic Lab Data: 3/13/21 - Proceeded directly to the emergency department. Completed CT of head and neck, EKG, chest x-ray and lab work. 4/8/21 - Visit to family doctor. Prescribed antiviral and Prednisone. Referral to ENT made.
CDC Split Type:

Write-up: 3/13/21-Severe left sided head pain followed by numbness of left side of face, tongue, nose, lips, left ear and left side of neck. Severe head pain lasted several seconds with the worse numbness lasting 60 minutes. My left side of face, lips, ear and head continue to be numb and tingling.


VAERS ID: 1202227 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-02
Onset:2021-04-08
   Days after vaccination:6
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: Other       Purchased by: ?
Symptoms: Diabetes mellitus, Dizziness, Fatigue, Headache, Muscular weakness, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (broad), Immune-mediated/autoimmune 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: Probiotic, magnesium-(120mg), Super Adrenal Stress Formula-(270mg) D3-5000 DHEA-(5mg) Premier DHE-(250mg)
Current Illness: nothing really
Preexisting Conditions: nothing
Allergies: Bactrim or sulfa drugs
Diagnostic Lab Data:
CDC Split Type:

Write-up: Dizziness Fatigue Headache Disorientation Pain and occasional weakness in lower legs


VAERS ID: 1202233 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Chest discomfort, Fatigue, Headache
SMQs:, Anaphylactic reaction (broad), Guillain-Barre 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: Vitamin B complex, Sildenafil 100mg PRN, percocet 5/325mg 1 tablet every 12 hours PRN pain, lisinopril/HCTZ 20mg/12.5mg one tablet daily, Flonase nasal spray 1-2 sprays each nostril daily
Current Illness: unknown
Preexisting Conditions: chronic anemia, HLD, HTN, colon polyps, rash of systemic lupus erythematosus
Allergies: amoxicillin/penicillin potassium clavulanate
Diagnostic Lab Data: 4/13/2021 patient sent to ER for evaluation for chest heaviness.
CDC Split Type:

Write-up: patient called and notified us that the was having symptoms of headache, fatigued, weakness, and chest heaviness a day after receiving the Janssen COVID immunization. Symptoms present for 4 days. Patient sent to ER for evaluation of chest heaviness on 4/13/2021 when patient called office.


VAERS ID: 1202248 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Ohio  
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 1808978 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Blood test, Cardiac monitoring, Chest X-ray, Dyspnoea, Electrocardiogram, Fatigue, Impaired work ability, Laboratory test, Pneumonia, Somnolence
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (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: Advair Discus for asthma
Current Illness: none
Preexisting Conditions: Asthma
Allergies: Penicillin
Diagnostic Lab Data: EKG 12 lead, XR Chest AP/PA and LAT, Cardia monitoring, peripheral IV, pulse oximetry, and blood lab test. All on 4/13/21.
CDC Split Type:

Write-up: Felt tired after the vaccine and continued to be more and more tired each day after the vaccine. 3 days after the vaccine I had to leave work to sleep and felt terrible (weak, shortness of breath, extreme exhaustion) on the 5th and 6th days after the vaccine with shortness of breath. On the 7th day, I went to the ER and was diagnosed with pneumonia.


VAERS ID: 1202263 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: New Mexico  
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 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Contusion, Fall, Head injury, Seizure, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Client reported she was getting over a cold - cough and runny/stuffy nose
Preexisting Conditions: None reported
Allergies: None reported
Diagnostic Lab Data:
CDC Split Type:

Write-up: About 8 minutes after vaccination client fell and hit her head, she has a large lump to right side of her head. After hitting the floor patient begin to show seizure activity for about 1-2 minutes. BP 140/20 P62. Ambulance service on site and transported to Hospital for follow up care.


VAERS ID: 1202284 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-09
Onset:2021-03-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805059 / 1 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Blindness, Chest pain, Dyspnoea, Injection site pain
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Retinal disorders (broad)

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

Write-up: -Patient reports SOB/dyspnea with some mild chest pain beginning 1 day after vaccine that persisted for 4 to 5 days. After that time, symptoms began to resolve. -3 to 4 weeks after vaccination, symptoms recurred in addition to having soreness in arm at injection site. Symptoms resolved again. -4/11/21 - patient didn''t have any significant SOB but did have temporary visual field loss in right eye which resolved. -4/12/21 - patient reported some SOB during the night while trying to sleep -4/13/21 - patient contacted the hospital for follow up on symptoms. patient advised to come to ED for workup of symptoms. awaiting results and follow through at the time of this report.


VAERS ID: 1202288 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Massachusetts  
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 042A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dizziness, Full blood count, Lipase, Liver function test, Metabolic function test, Nausea, Pyrexia, Renal pain, Retching, Somnolence, Urine analysis, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Night Before - 100mg Zoloft - 2 Zyrtec - 1 allerga - 90mg diltazem - 20mg max strength Pepcid morning of: - 1 Benadryl (25mg) orally @ 10:20 - 2 extra strength Tylenol @ 10:35 - 2 Allegra @ 9:15 - 1 Zyrtec @ 9:15 - 120mg dilazem - 1
Current Illness: Potential COVID Long Hauler-- Still receiving work ups for conditions. Believed to be a false negative covid patient in march 2020
Preexisting Conditions: POTS- Postural Orthostatic Tachycardia MCAS- Mast Cell Activation Syndrome Peanut and tree nut allergy Asthma Cronic Kidney Stones Potential past covid 19 infection
Allergies: Peanut and Tree nuts, dogs, cats, seasonal
Diagnostic Lab Data: Blood Work - CBC -Metabolic Panel - Lipase - Hepatic Function test - Urinalysis Reflex
CDC Split Type:

Write-up: I started experiencing chills, and a fever even with Tylenol . About an hour later I felt really nauseous and then started throwing up. I threw up 4 times and then continued to dry heave for another hour. My temperature hit 102. I then started experiencing extreme pain in my right kidney area. I ended up trying to take Benadryl and then threw that right up. I then ended up going to the ER and receiving Zofran, Fluids, Tylenol, Torodol and Morphine. I got discharged with "an adverse reaction to the covid-19 vaccine and unknown pain" When I was discharged I had a fever of 100 and on the drive home I was in intense pain. It subsided but I am still not feeling well, I feel very groggy and light headed in addition to the pain.


VAERS ID: 1202292 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
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 JSN 042A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal discomfort, Anxiety, Arthralgia, Burning sensation, Chest pain, Constipation, Diarrhoea, Dizziness, Gastrooesophageal reflux disease, Headache, Hyperhidrosis, Lethargy, Loss of personal independence in daily activities, Muscle spasms, Pain, Pain in extremity, Secretion discharge, Skin discolouration, Somnolence, Visual impairment
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Dystonia (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

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

Write-up: Posterior leg bilateral pain (at knees) , sweats, dizziness, sleepiness, lethargic, was unable to go to work, lobe, headache pain in center of head cramps to frontal , vision distortion, anxiety attack, body aches, pain/burning to to appendix area, right leg pain., constipation -loose burning diarrhea (4/13/21) reddish light brown in color, joint pain arm pain collar bone/shoulder, mucous, drink cool water pain to the chest-0wall noted, air bubbles coming up in throat , upper neck, back spasms


VAERS ID: 1202293 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Massachusetts  
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 - / UNK - / -

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

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

Write-up: Headache 4 days after vaccine


VAERS ID: 1202307 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: California  
Vaccinated:2021-02-08
Onset:2021-04-09
   Days after vaccination:60
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chills, Dizziness, Headache, Hypertension, Inflammation, Insomnia, Pain, Pain in extremity, Renal pain
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), 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? No
Previous Vaccinations:
Other Medications: Metoprolol 2.5 mg daily
Current Illness: None
Preexisting Conditions: NKA
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: 1ST DAY=Heachache, Dizzines, High blood pressure, Inflamation of hands. 2ND DAY= High blood pressure, headache, chills 3RD Day: Headache, kidney pain 4th Day: Headache, body ache. 5th day: Heachache, leg pain, can''t sleep.


VAERS ID: 1202318 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-03-15
Onset:2021-04-05
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 UN / SYR

Administered by: Private       Purchased by: ?
Symptoms: Fundoscopy, Headache, Magnetic resonance imaging head, Neck pain, Optic neuritis, Vertebral artery dissection, Visual impairment
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Optic nerve disorders (narrow), Demyelination (narrow), Lens disorders (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Ocular infections (broad), Arthritis (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Contraceptive implant (Nexplanon)
Current Illness: Cold 2 days prior
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Fundoscopic exam - Cherry red spot in the r eye MRI brain - b/l optic neuritis CTA head and neck: R vertebral artery dissection
CDC Split Type:

Write-up: 04/05/2021- Headaches and neck pain 04/08/2021- Bilateral vision issues with near complete blindness in R eye Unbale to enter hospitalization days. Patient is planned to be admissted for 5 days total.


VAERS ID: 1202332 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-07
Onset:2021-04-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / N/A LA / IM

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

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

Write-up: 4/07/21 12:40 PM B/P 140/78 Pulse 71, 12:56 PM B/P 144/72 Pulse 69. Chief Complaint loss of consciousness. No history of diabetes mellitus or seizure disorder, loss of consciousness with seizure like activity, not post ictal, recovered in less than 5 minute, then alert and oriented per EMT notes. EMS called and transferred to Hospital.


VAERS ID: 1202379 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-14
Onset:2021-04-13
   Days after vaccination:30
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: Blood test, Chest X-ray, Computerised tomogram head, Dysphagia, Monoplegia, Paralysis
SMQs:, Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), 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), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (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, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: no medications
Current Illness: none
Preexisting Conditions: Mild Hypertension, no prescribed medications
Allergies: No Known Allergies
Diagnostic Lab Data: CT Scan Head/brain, Chest X-ray, Blood work
CDC Split Type:

Write-up: Significant flaccid paralysis in the right arm and right leg with some difficulty swallowing


VAERS ID: 1202406 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-07
Onset:2021-04-07
   Days after vaccination:0
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: Public       Purchased by: ?
Symptoms: Altered state of consciousness, Anal incontinence, Aphasia, Decreased eye contact, Hyperhidrosis, Hypokinesia, Incoherent, Mental status changes, Pallor, Unresponsive to stimuli, Vomiting
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Dementia (broad), Parkinson-like events (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Noninfectious diarrhoea (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: Unsure
Current Illness: Anxiety
Preexisting Conditions: Anxiety
Allergies: unsure
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient resting in car.....she was not making eye contact and short with answers to questions. Patient was unresponsive, breathing and head movement with eye abnormal movement, attempted to wake patient but unable to , remained unresponsive but breathing. EMS called10:55 Patient continued to be unresponsive SPO2 98+, HR 78 patient pale and diaphoretic. 10:56 Patient was unresponsive ammonia activated and attempted X3 patient continues to be noncoherent and nonverbal. 10:57 Patient with altered mental status and began vomiting, pt aware of name and location. 11:01 B/P 105/76 vomiting continuing with continued altered mental status 11:03 Vomiting and incoherent 11:06 Ems arrived and patient was transported to the local hospital. Patient awake and state she had a bowel movement on self. Assisted patient to Cot for EMS.


VAERS ID: 1202428 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-03-07
Onset:2021-03-22
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test abnormal, Chest X-ray normal, Chest pain, Dyspnoea, Heart rate increased, Magnetic resonance imaging, Pyrexia, White blood cell count increased
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

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

Write-up: From Monday (3/22/21) to Friday, I could hardly breathe. My resting heart rate was around 110-120bpm. On Wednesday I went to the Hospital and for chest pain (when I would breathe in), shortness of breath, rapid heart rate, and a fever (on Monday). They rain many tests with chest scans and found all to be clear except I had a ?extremely elevated? white blood cell count. They said they ran blood tests and did not think I had blood clots and they did an MRI and chest x-ray and could not find anything. They sent me home to rest. The rest of the week I had trouble breathing and it slowly started getting better on Friday.


VAERS ID: 1202457 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-09
Onset:2021-04-11
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 UN / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Condition aggravated, Deep vein thrombosis, Pain in extremity
SMQs:, Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Patient was directed to Emergency Room after speaking to triage. Unknown if further testing was done.
CDC Split Type:

Write-up: Right calf pain similar to previous DVT pain she had experienced in the past. Symptoms starting 4/11/21 day 2 after receiving COVID 19 vaccine.


VAERS ID: 1202475 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-04-01
Onset:2021-04-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood test, Chest pain, Chills, Computerised tomogram, Dyspnoea, Electrocardiogram, Headache, Hyperhidrosis, Pericarditis, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Related to the pericarditis, comprehensive bloodwork, X-rays and CT scan were performed as well as EKG work.
CDC Split Type:

Write-up: The morning of 2 April, I woke up with a fever, chills, sweating and an excruciating headache. The symptoms persisted for approximately 10 hours. The following Monday, I woke up with sharp pains across my chest and shortness of breath. I was admitted to the hospital Emergency Room for about 7 hours and subsequently diagnosed with pericarditis. It is unknown if the pericarditis was associated to the vaccine but thought it was a good idea to document here.


VAERS ID: 1202509 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-10
Onset:2021-04-11
   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 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Headache, Vision blurred
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal 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:
Current Illness:
Preexisting Conditions:
Allergies: Acetaminophen, Codeine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Intermittent chest pain and shortness of breath, headache with blurred vision


VAERS ID: 1202527 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Wisconsin  
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 043A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Erythema, Pruritus
SMQs:, Anaphylactic reaction (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Client reported itchiness and redness in face during monitoring period post-vaccination. IV Benadryl was given and symptom resolved. Client was transported to ER for further evaluation.


VAERS ID: 1202528 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: New York  
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 - / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain, Blood test, Chills, Computerised tomogram, Condition aggravated, Headache, Nausea, Pain, Pyrexia, Ultrasound scan, Urine analysis, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: MAJOR ABDOMINAL PAIN, VOMITING EPISODES, NAUSEA, BODY ACHES, HEADACHES, FEVERS, CHILLS,
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: 04/05/21-04/05/21 ULTRASOUND, CAT SCAN, BLOOD SAMPLES, URINE SAMPLES.
CDC Split Type:

Write-up: MAJOR ABDOMINAL PAINS AND VOMITING EPISODES, NAUSEA, BODY ACHES, FEVERS, CHILLS, HEADACHES.


VAERS ID: 1202531 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Minnesota  
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 - / UNK - / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Dyspnoea, Dyspnoea exertional, Headache
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data: Patient directed to Emergency Room after speaking to Triage. Unknown if further testing was done.
CDC Split Type:

Write-up: Patient reports shortness of breath and chest pain 7 hours after vaccine. Patient stating he has had ongoing shortness of breath with any exertion. Chest tightness in left side with breath in. Stating breathing feels "heavier." Ongoing headaches. Symptoms starting 7 hours after vaccine. Headache intermittent. Reporting breathing intermittently feels heavier.


VAERS ID: 1202547 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Hyperhidrosis, Immediate post-injection reaction, Nausea, Pallor, Syncope, Tremor, Visual impairment
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)

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

Write-up: 33yr old patient with unknown PMH and allergies, presented to office for COVID-19 injection on 4/10. CMA administered JANSSEN COVID19 VACC (LOT # 207A21A, exp 6/23/21) IM to patient''s right deltoid at 0841. Immediately following injection, patient''s arm began to shake which continued past 5min. Patient endorsed seeing black spots, then nausea. Patient denied shortness of breath, difficulty swallowing, chest pain or other symptoms. Patient noted to be pale, diaphoretic, and fainted upon sitting down. Reporter observed patient shaking. Patient admitted to urgent care for further follow up. At 0904, BP 136/82, HR 79, 98% RA. At 0947, BP 93/61. Patient given NS 500mL bolus IV. At 1025, patient denied dizziness, weakne At 1025, patient denied dizziness, weakness, or nausea. Patient changed to sitting position with mild nausea. VS remained stable. At 1035, patient ambulating without issues. Patient discharged home in stable condition. Patient noted he had not eaten prior to injection. Urgent care provider indicated per physical exam consistent with vasovagal reaction to vaccine. POC = 142, given crackers and water x 2.


VAERS ID: 1202551 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-03-10
Onset:2021-03-16
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / N/A RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Catheterisation cardiac abnormal, Chest pain, Myocardial infarction, Pain
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lisinopril 5 mg
Current Illness: None
Preexisting Conditions: I do not have a spleen.
Allergies: None
Diagnostic Lab Data: Heart catheterization showed only 20 to 30% blockage and the doctor said that was not the cause of the heart attacks.
CDC Split Type:

Write-up: I suffered two heart attacks. First heart attack was on the 6th day after the vaccine, second heart attack was on the 9th day of vaccine. Both heart attacks woke me up from sleep. I went to the emergency room and was hospitalized each time. I suffered chest pain prior to each heart attack but have never suffered chest pain before. I am continuing to suffer from periods of chest pain at rest.


VAERS ID: 1202556 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Wisconsin  
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 043A21A / 1 RA / IM

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

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

Write-up: Within 5 minutes of vaccination client started developing hives, and reported discomfort in throat and feeling like throat was going to close. Epinephrine administered, IV Benadryl and Solumedrol administered. Client reported feeling better post-epinephrine. Client transported to ER for further evaluation.


VAERS ID: 1202570 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-04
Onset:2021-04-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / UNK RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cerebrovascular accident, Condition aggravated, Platelet count decreased, Transfusion
SMQs:, Haematopoietic thrombocytopenia (narrow), Systemic lupus erythematosus (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), 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, 15 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: stroke
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Good morning, I have the patient in the hospital. We have had to give her 2 transfusion in the last 2 weeks and 2 days. The patient also had a more pronounced stroke system. We read today that people with the systems of low platelets and stoke system need to report. I have called everyone and have had no help. I believe it has to be the health department.


VAERS ID: 1202627 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
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: Other       Purchased by: ?
Symptoms: Seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Voltaren, Tylenol, Soma
Current Illness: back pain and sciatica , neck pain
Preexisting Conditions: Cannabis dependence
Allergies: adhesives
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: Pt reports that 23 hrs after receiving the vaccine he experienced " a massive seizure" and was transported by paramedic to the Hospital. A neurologist he saw mentioned that he had seen "other seizures like this '' and they presumed he meant after COVID vaccines


VAERS ID: 1202636 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-28
Onset:2021-04-07
   Days after vaccination:10
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: Diplopia, Headache, Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Ocular motility disorders (broad), Hypoglycaemia (broad)

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

Write-up: headache, weakness in arms and legs, double vision. patient was contacted via phone for a phone appointment and directed to go immediately to the ER for further evaluation.


VAERS ID: 1202689 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: West Virginia  
Vaccinated:2021-03-20
Onset:2021-04-10
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / N/A RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cough, Thrombosis
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data: PATIENT WENT TO EMERGENCY ROOM ON SUNDAY 4/11/21
CDC Split Type:

Write-up: PATIENT REPORTS COUGHING UP BLOOD CLOTS FOR THE PAST 3 DAYS AND SENT PICTURE OF 1 THAT WAS COUGHED UP


VAERS ID: 1202699 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-03-17
Onset:2021-04-04
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Deep vein thrombosis, Ultrasound Doppler
SMQs:, Embolic and thrombotic events, venous (narrow), Thrombophlebitis (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: Symbicort, Proventil
Current Illness: None
Preexisting Conditions: Asthma
Allergies: No known
Diagnostic Lab Data: Doppler 4-6-21. ER4-13-21
CDC Split Type:

Write-up: Pain in ankle. Later diagnosed as DVT. Prescribed blood thinners


VAERS ID: 1202752 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Alaska  
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 - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test normal, Dyspnoea, Pyrexia, SARS-CoV-2 test negative, Streptococcus test positive, Urine analysis, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (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: Zertec, metformin, prenatal vitamin, and calcium supplement.
Current Illness: None
Preexisting Conditions: Endometriosis, PCOS, and asthma
Allergies: Morphine and tramadol
Diagnostic Lab Data: Covid test, strep throat test, blood tests, and urine tests all done april 13. The only test to come back positive was the strep throat test.
CDC Split Type:

Write-up: 3 hours after vaccine (12:45pm) had hives on face and had difficulty breathing. Later that night (7:00pm) ran low fever morning of next day had fever of 106.5? f (4:30am).


VAERS ID: 1202767 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-03-26
Onset:2021-03-27
   Days after vaccination:1
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: Fatigue, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)

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

Write-up: I was fatigued badly the two days following the shot. Then after about 10 days, I got cloudy vision.


VAERS ID: 1202770 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Connecticut  
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 205A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None based on consent form.
Preexisting Conditions: None based on consent form.
Allergies: None based on consent form.
Diagnostic Lab Data: Patient went to hospital for further evaluation.
CDC Split Type:

Write-up: Prior to administration of Janssen Covid-19 vaccine the patient was anxious but was completely fine once the procedure commenced and concluded. After finishing explaining the possible side effects of the vaccine and handing the patient the V-Safe handout, she got up slowly and proceeded to our designated post vaccination monitoring seating arrangement. Upon concluding the vaccination process with the patient?s partner, she alerted the pharmacist that she does not feel well. To which he asked her to further elaborate on what she is experiencing. She began to say she thinks she?s going to faint as she is attempting to drink water. As she was having a drink of water she fainted. To which he responded by running over and catching her before she hit the ground, cradling her upper torso, specifically the head and laid her down on the floor with the assistance of pharmacist and her partner. In the midst of everything he instructed another pharmacy technician to call 911 for the paramedics. As she was in the process of drinking water I saw her other hand go to the region of the neck, thinking it was also an allergic reaction and administered a dose of Epi-Pen. He administered the Epi-Pen on the upper side of her thigh, directly to the skin not through clothing. There was a very brief moment where the patient began to convulse but gradually regain consciousness. The patient became lucid and was conversing with him, apologizing for the incident. He assured her there was nothing to apologize for and to which she told me she had similar incidents from vaccinations as a child. She did not mention this prior to administration of the vaccine and through conversation we believe the incident may be caused from high anxiety of needles / vaccinations. When the paramedics arrived, they assisted the patient from the floor and gave a warning that she believed she was going to faint again, and fainted in the arms of the paramedics.


VAERS ID: 1202771 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-09
Onset:2021-04-11
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: fish oil and multi vitamin
Current Illness:
Preexisting Conditions:
Allergies: gluten allergy
Diagnostic Lab Data: went to the Hospital ER on 04-12-21 as symptoms got worse
CDC Split Type:

Write-up: Hives all over the body to include the flu like symptoms.


VAERS ID: 1202776 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Minnesota  
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 UNKNOWN / 1 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Cough, Dyspnoea, Exposure to toxic agent, Immediate post-injection reaction, Malaise, Myalgia, Nausea
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: States that he got the J&J COVID vaccine Thursday 4/8/21 States that he had immediate muscle pain right away and a cough right away Upper chest is painful and he is having trouble breathing Chest pain has started yesterday- reports the pain has gotten worse States that he exercises every day and ran this AM States that today the chest pain has gotten worse and his breathing has gotten worse as well States that he works around chemicals in a woodworking shop but doesn''t think that this is the cause of his chest pain Chest pain is located at the top of his sternum States that he feels queasy and unwell over all Advised that with current symptoms that he needs to be evaluated urgently and advised calling 911 if he did not have someone to bring him in. Patient refuses 911 but agrees to be seen in the ER. Will go to his closest ER now.


VAERS ID: 1202788 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-10
Onset:2021-04-13
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Abdominal pain upper, Abdominal tenderness, Anxiety, Blood lactic acid, Computerised tomogram abdomen, Fatigue, Haematocrit normal, Haemoglobin normal, International normalised ratio normal, Nausea, Nervousness, Nitrite urine absent, Pain in extremity, Platelet count normal, Prothrombin time shortened, Pyrexia, Red blood cell count normal, Red blood cells urine positive, Ultrasound Doppler normal, Urine leukocyte esterase positive, White blood cell count normal, White blood cells urine positive
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Chronic kidney disease (broad), Tubulointerstitial diseases (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: influenza vaccine (no additional information in chart)
Other Medications: ibuprofen (MOTRIN) 600 mg tablet olmesartan (BENICAR) 20 mg tablet pantoprazole DR (PROTONIX) 20 mg tablet amLODIPine (NORVASC) 5 mg tablet ergocalciferol 50,000 unit capsule (VITAMIN D2, DRISDOL) EPINEPHrine (AUVI-Q) 0.3 mg/0.3 mL auto-inj
Current Illness: Medication reaction to amlodipine 4/12 (swollen legs and feet) Maxillary sinusitis prescribed Augmentin, then Cephalexin Chest pain of unknown origin (possible rxn to HCTZ)
Preexisting Conditions: Cardiovascular Benign essential hypertension Hypercholesteremia Endocrinology Ovarian cyst Other Obesity, Class I, BMI 30-34.9 Vitamin D deficiency
Allergies: Dotarem [Gadoterate Meglumine]Swelling, Shortness of Breath, Other: See Comments AcyclovirIntolerance Adipex-p [Phentermine Hcl]Other: See Comments Bactrim [Sulfamethoxazole-trimethoprim]Anaphylaxis Imitrex [Sumatriptan]Swelling, Shortness of Breath Ivp Dye [Iodine]Unknown PeanutAnaphylaxis Sulfa (Sulfonamide Antibiotics)Anaphylaxis
Diagnostic Lab Data: Labs 4/13: WBC; 5.41 RBC: 5.11 Hg: 14.9 Hct: 45.9 Plt: 245 PT 10.7 INR 1 Lactate 1.7 UA: 0-5 WBC, 3-5 RBC, 25 Leukest, Negative Nitrites Imaging 4/13 Abdomen/Pelvis: 1. T-shaped IUD present within the uterus. Suspect fluid in the posterior cul-de-sac with possible subtle increased density of the fluid. Question recently ruptured hemorrhagic ovarian cyst. Further evaluation/characterization can be performed with pelvic ultrasound. 2. Nonobstructing 4 mm right lower pole calculus. 4/13: DVT bilateral scan IMPRESSION: NEGATIVE STUDY FOR ACUTE PROXIMAL DVT IN THE LEFT AND RIGHT LOWER EXTREMITIES. NEGATIVE STUDY FOR ACUTE CALF DVT IN THE LEFT AND RIGHT LOWER EXTREMITIES. NEGATIVE STUDY FOR ACUTE SUPERFICIAL THROMBOPHLEBITIS IN THE IMAGED SEGMENTS OF THE LEFT AND RIGHT LOWER EXTREMITIES.
CDC Split Type:

Write-up: 4/10 - vaccine administered 4/12 - Per patient, "I started the amlodipine and my legs and feet got so swollen and painful." changed from amlodipine to hydrochlorothiazide 4/13: Per patient, "Hi, I had my covid vaccine on 4/10/21 I had the Johnson & Johnson (Janssen) Lot# 201A21A Exp date: 6/23/21. If it could be added to my immunization list. Also I had terrible side effects including high fever which finally subsided yesterday, however my stomach feels like it is being twisted in knots. I''m having terrible cramping pains since Saturday and continues. I have been taking Motrin and Tylenol since Saturday for fever but the stomach pains are unbearable. 4/13 - Presented to ER: 37-year-old female presents emergency department for complaints of right lower leg pain and severe abdominal pain. Reported the patient had her Johnson & Johnson vaccine on Saturday a.m. several hours afterwards developed severe abdominal pain and tenderness with nausea. Denies any other specific reason for why this would have occurred. The patient states that the pain has been increasing since its onset and she is try to tough it at home taking Tylenol. Patient denies difficulty moving her bowel or bladder. Patient states in addition to this she developed right lower calf pain and tenderness and is concerned about a DVT. Patient denies any history of DVT. Patient otherwise denies any chest pain or shortness of breath. The patient relates that she has had a fever that was noted on Saturday as well and believes it was just sensitivity to the vaccine. She states she last noted the fever yesterday with T-max of 101. Review of Systems Constitutional: Positive for fatigue and fever. Respiratory: Negative for cough and shortness of breath. Gastrointestinal: Positive for abdominal pain and nausea. Negative for constipation and diarrhea. Genitourinary: Negative for difficulty urinating, flank pain and frequency. Psychiatric/Behavioral: The patient is nervous/anxious. All other systems reviewed and are negative. Physical Exam BP 132/82 | Pulse 86 | Temp (Src) 97.9 (Oral) | Resp 18 | Ht 5'' 7" (1.70m) | Wt 210 lb (95.3kg) | SpO2 100% | LMP 01/25/2021 | BMI 32.88 kg/(m^2). O2 Therapy: Room Air Physical Exam Vitals and nursing note reviewed. Constitutional: Appearance: Normal appearance. HENT: Head: Normocephalic and atraumatic. Eyes: General: No scleral icterus. Pupils: Pupils are equal, round, and reactive to light. Cardiovascular: Rate and Rhythm: Normal rate and regular rhythm. Pulses: Normal pulses. Heart sounds: Normal heart sounds. Pulmonary: Effort: Pulmonary effort is normal. Breath sounds: Normal breath sounds. Abdominal: General: There is no distension. Palpations: There is no mass. Tenderness: There is abdominal tenderness. There is no guarding or rebound. Hernia: No hernia is present. Musculoskeletal: General: Tenderness present. Right lower leg: No edema. Left lower leg: No edema. Comments: Right calf pain Skin: General: Skin is warm and dry. Capillary Refill: Capillary refill takes less than 2 seconds. Neurological: General: No focal deficit present. Mental Status: She is alert and oriented to person, place, and time. Mental status is at baseline. Psychiatric: Mood and Affect: Mood normal. Thought Content: Thought content normal.


VAERS ID: 1202790 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-07
Onset:2021-04-09
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Amnesia, Blood pressure normal, Blood test normal, Chest X-ray normal, Computerised tomogram normal, Confusional state
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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: multi vitamins; Zyrtec D - occasionally
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Blood work, x-ray of chest, CT scan or brain and chest/heart area, blood pressure was fine and all test came back normal
CDC Split Type:

Write-up: memory loss of all events that happened that day. For a 3 hour period patient could not remember what had happened that day at work, his appointments after work, that he had gotten hearing aids 2 weeks prior and that he had ever seen or worn hearing aids. He was very confused for about 3 hours. I called our doctor and he advised me to take him to the ER, it took me 45 minutes to get him there and by that time his memory was back. He has never had a problem like this before and I thought he might be having a stroke or something. there was definitely something severely wrong.


VAERS ID: 1202804 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-06
Onset:2021-04-13
   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: Private       Purchased by: ?
Symptoms: Cerebral artery embolism, Computerised tomogram, Headache
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Previous clotting disorders - factor V and MTHFR
Allergies: None
Diagnostic Lab Data: CT scan
CDC Split Type:

Write-up: My wife was sent to the ER with a headache this morning and has confirmed cerebral embolism


VAERS ID: 1202969 (history)  
Form: Version 2.0  
Age: 95.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-06
Onset:2021-04-11
   Days after vaccination:5
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: Other       Purchased by: ?
Symptoms: Death, Fall, Musculoskeletal chest pain
SMQs:, Accidents and injuries (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-11
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: death Narrative: Patient with consistent decline over the last year; March 2021- increased confusion related to dementia, falls, hospitalizations wt loss. Enrolled in home hospice on 3/26 family''s goal was to keep patient home and comfortable. Patient received J&J vaccine in the home through agency on 4/6/2021, Patient had a fall on 4/7/2021, Patient with rib pain after the fall no other injury noted. Patient passed away on home hospice on 4/11/2021.


VAERS ID: 1202974 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-03-08
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Decreased appetite, Fatigue, Headache, Hemiparesis, Libido decreased, Pruritus
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Noninfectious encephalitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Cigarette smoker (cigarettes: Half a pack a day)
Preexisting Conditions: Comments: The patient had no known allergies. The patient had no drug abuse or illicit drug usage.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210409729

Write-up: LEFT SIDED WEAKNESS; LESSENED SEXUAL DESIRE WITH SPOUSE; SEVERE ITCHING WITHOUT RASH; LOSS OF APPETITE (FOOD AND DRINK); EXTREME FATIGUE; HEADACHE; This spontaneous report received from a patient concerned a 37 year old male.The patient''s height, and weight were not reported. The patient''s concurrent conditions included no alcohol use, and smoker (cigarettes: Half a pack a day), and other pre-existing medical conditions included the patient had no known allergies.The patient had no drug abuse or illicit drug usage. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 1805022, expiry: 25-MAY-2021) dose was not reported, administered on 07-MAR-2021 on Left Arm for prophylactic vaccination.No concomitant medications were reported.The symptoms appeared on 08-MAR-2021 around 12:00 and had persisted until present. Consisted of headache, severe itching without rash, loss of appetite (food and drink), extreme fatigue, left sided weakness, and lessened sexual desire with spouse. On 2021, treatment medication included: paracetamol and ibuprofen. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from headache, severe itching without rash, loss of appetite (food and drink), extreme fatigue, left sided weakness, and lessened sexual desire with spouse. This report was serious (Other Medically Important Condition). This case, involving the same patient is linked to 20210410728.; Sender''s Comments: 20210409729-JANSSEN COVID-19 VACCINE Ad26.COV2.S- Left sided weakness. This event is considered unassessable. The event has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event.


VAERS ID: 1202980 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2021-04-06
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood glucose, Blood glucose increased, Blood pressure increased, Blood pressure measurement, Dizziness
SMQs:, Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypertension (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Diabetes
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210406; Test Name: Glucose; Result Unstructured Data: Increased; Test Date: 20210406; Test Name: Blood pressure; Result Unstructured Data: Increased
CDC Split Type: USJNJFOC20210411395

Write-up: BLOOD PRESSURE INCREASED; INCREASE GLUCOSE LEVEL; DIZZINESS; This spontaneous report received from a physician concerned an adult of unspecified sex. The patient''s height, and weight were not reported. The patient''s concurrent conditions included diabetes. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported) dose was not reported, administered on 06-APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 06-APR-2021, the subject experienced blood pressure increased. On 06-APR-2021, the subject experienced increase glucose level. On 06-APR-2021, the subject experienced dizziness. Laboratory data included: Blood pressure (NR: not provided) Increased, and Glucose (NR: not provided) Increased. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from dizziness, blood pressure increased, and increase glucose level. This report was non-serious.; Sender''s Comments: V0: Medical assessment comment not required as per standard procedure as the case was assessed as non-serious.


VAERS ID: 1202987 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Minnesota  
Vaccinated:0000-00-00
Onset:2021-04-01
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Intracranial aneurysm, Loss of consciousness, Pyrexia
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), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: In vitro fertilization
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210412164

Write-up: PASSED OUT; TERRIBLE FEVER; SMALL ANEURYSM IN BRAIN; This spontaneous report received from a patient concerned a female of unspecified age. The patient''s height, and weight were not reported. The patient''s past medical history included hormone therapy, and IVF (In-Vitro Fertilization). The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, 1 total administered on 03-APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. Concomitant medications included hormone therapy. On 03-APR-2021, the patient experienced terrible fever and headache after vaccination at night. On 04-APR-2021, the patient passed out which had never happened to her before. She was taken to the emergency room and was diagnosed with a small aneurysm in her brain. The patient was very fearful, this was new and would be getting larger/rupture sooner. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the terrible fever, passed out and small aneurysm in brain was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0- 20210412164-covid-19 vaccine ad26.cov2.s -Small aneurysm in brain, Passed out. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: MEDICAL HISTORY


VAERS ID: 1203147 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-13
Onset:2021-03-19
   Days after vaccination:6
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: Other       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Chills, Dizziness, Dyspnoea, Fatigue, Full blood count, Headache, Heart rate increased, Immune system disorder, Myalgia, Pyrexia, Tremor, Urine analysis
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Allegra, Orlissa, Slynd, Singular, Lexapro. After Vaccination I underwent Sinus Surgery and had additional medication including anesthesia.
Current Illness: Chronic Sinus Infections, Endometriosis
Preexisting Conditions: Chronic Sinus Infections, Endometriosis, Asthma
Allergies: Sulfa Drugs
Diagnostic Lab Data: Doctor - Blood work, CBC, 3/26 ER - Blood work, Chest Xray, Urine, 3/30 Doctor - Bloodwork, EKG 4/2
CDC Split Type:

Write-up: After sinus surgery, low grade fever, shakes, chills, muscle pain, headache that did not fit with recovery time from sinus surgery. Dizziness... overreactive immune response. Rapid heart rate. Headache severe, throbbing and not helped by Tylenol or Ibuprofen. Infection from the surgery resolved after antibiotics but symptoms remained. Told I might have a "virus" and my immune system was over reacting. Vitamin B12 shot. Currently taking prednisone but still short of breath and fatigued.


VAERS ID: 1203186 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Colorado  
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 203A21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Loss of consciousness, Pain in extremity, Road traffic accident
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), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

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

Write-up: I waited the advised 15min to assess any allergic reaction. I felt fine aside from a sore arm. I called my wife and drove home. Once on the freeway I felt dizzy. This came on me very fast. I thought I better get off at the next exit.. but instantly blacked out. While unconscious I struck another vehicle going approximatley 65mph, rolled my vehicle on its side, skidded, then rolled back upright. I awoke to my car spun sideways on the freeway, paramedics, and fire dept working the wreck from my window, and no recollection of what happend. It felt instantaneous to me. I ate a breakfast of granola, yoguirt. I hydrated before the shot. I even took extra Vitamin C.


VAERS ID: 1203256 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-23
Onset:2021-04-07
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Computerised tomogram head abnormal, Electrocardiogram, Generalised tonic-clonic seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Levothyroxine Wellbutrin Paxil
Current Illness: Hashimotos thyroiditis Depression Anxiety
Preexisting Conditions: See above
Allergies: Sulfas
Diagnostic Lab Data: Ctscan Ekg
CDC Split Type:

Write-up: Grand mall seizure


VAERS ID: 1203266 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-03
Onset:2021-04-04
   Days after vaccination:1
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: Asthma, Bone pain, Chest discomfort, Chest pain, Chills, Dizziness, Dyspnoea, Haemoptysis, Headache, Inflammation, Myalgia, Pyrexia, Renal function test normal, SARS-CoV-2 test negative
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Osteonecrosis (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Orsythia and no I?ve never had a blood clot or any issue taking this birth control so don?t use that as an excuse. Prozac, visteril, all taken for 15 years and low dosage. Two inhalers, steroid and emergency. Singulair and Loradatine for as
Current Illness: None
Preexisting Conditions: depression, but that hasn?t been an issue in a long time and Prozac and visteril keep it under control. Eating disorder but haven?t had any issue with it or flare up since 2016. Been healthy otherwise.
Allergies: None.
Diagnostic Lab Data: See above. All done last Tuesday and Wednesday?. Concerned this has permanently messed up my lungs. Have literally never felt this way in my life.
CDC Split Type:

Write-up: All regular side effects on day 1 + day 2. (Fever, chills, bone and muscle aches, headache). Shortness of breath started the next day on Sunday , extreme, far beyond normal asthma or any asthma attack. Went to urgent care on Tuesday- they said it was likely a side effect of j &J and tested me for COVID, kidney disease other things, all came back negtative. Apparently I wasn?t the first person they had seen with shortness of breath. Blood in cough and spit on Wednesday after 2.5 days of shortness of breath. Dizziness (extreme) throughout and chest pain, sternum hurt, chest tightness. Went to Er. They ran a lot of tests and they too said they had seen others with shortness of breath from j and j. They ruled out many things like pneumonia, a birth control blood clot, any lung diseases with X-rays and blood tests. I was given torkeril to ease the chest pain and tightness which it did. Blood stopped coming up in tissues. Doctor said likely inflammatory reaction to the vaccine in lungs, (I have a piece of paper proving that) and cartilage and sternum., which hurt extremely when he touched it. Blood was likely from burst capillaries from overcompensation from trying to breathe. Recommended I return if more blood came up, which it hasn?t. Shortness of breath has not subsided. I can?t even hold a phone app without being winded. So email back, don?t call.


VAERS ID: 1203273 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Texas  
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 1818609 / 1 LA / IM

Administered by: Other       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? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
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: patient reports no medication of any type
Current Illness: none
Preexisting Conditions: none
Allergies: unknown
Diagnostic Lab Data: unknown patient received care at another facility and is not currently a patient other than the vaccination
CDC Split Type:

Write-up: Patient reports that several hours after receiving the vaccine that he became short of breath, he was taken to the hospital via ems, Diagnosed with blood clots at hospital. Reports he is now on blood thinners. I spoke with the patient and told him I would be reporting this information and that he may be contacted.


VAERS ID: 1203289 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-11
Onset:2021-04-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Hypersensitivity, 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? 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: Fish Oil, Probiotic, LDA, tumeric, Vitamin D, Mutli, lexapro 20 mg
Current Illness: None
Preexisting Conditions: None
Allergies: Dogs.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Sever Allergic reaction. Had hives on face, head, neck, shoulders, back, chest, rib cage, arms and hands. Moved to the mouth and lips. Self administered 25mg of benedryl at 1920. Symptoms worsened. When swelling moved towards mouth at around 2010, patient went to the ED. ED administered 25mg of benadryl and 20mg of pepcid. At 2130 swelling noticeably decreased patient discharged without seeing ED physician. As of 0700 next morning all swelling had dissapated.


VAERS ID: 1203295 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Kansas  
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 203A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dyspnoea, Oropharyngeal pain, Pyrexia, Respiratory viral panel, Streptococcus test, Throat tightness, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), 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: Zertec, Adderall XR, Glucophage, albuterol
Current Illness: none
Preexisting Conditions: ADD, asthma. allergies
Allergies: Morphine, tranadol
Diagnostic Lab Data: + Group A Streptococcus,rapid screen - Resp path panel
CDC Split Type:

Write-up: Hives, SOB, throat closing 3 hours after vaccine, used inhaler with some relief, following AM had chills, fever to 104 and sore throat. + strep test in ED. She rarely uses inhaler.


VAERS ID: 1203296 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: New York  
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 / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chills, Electrocardiogram, Fatigue, Headache, Heart rate abnormal, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (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: Propranolol, Allegra, Zyrtec, Pepcid, multi vitamin
Current Illness: none
Preexisting Conditions: Anxiety
Allergies: none
Diagnostic Lab Data: Blood work, EKG, and fluids. 4/7/2021
CDC Split Type:

Write-up: In addition to the expected reaction I had heard about: Mild fever, chills, fatigue, headache and body aches, I also experienced a rapid heart rate. I went to bed around 7pm and was awoken by a rapid/ strong heart beat. I went to the ER where I was evaluated, hydrated and then released. The attributed the heart rate to the vaccine. Sometime over the course of the overnight, my heart rate returned to normal.


VAERS ID: 1203305 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-26
Onset:2021-04-07
   Days after vaccination:12
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: Dizziness, Headache, Nausea, Neck pain, Pain, Sinusitis, Vision blurred
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Arthritis (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: none
Preexisting Conditions: Chronic sinus and ear infections
Allergies: penicillin
Diagnostic Lab Data: Two visits, one teledoc one in person, treated for sinusitis - zpac on Thursday the 8th, second treated with augmentin and prednisone on Monday the 12th as symptoms have not subsided
CDC Split Type:

Write-up: headache, nausea shooting pain from back through neck up through back of my head, blurred vision, lightheaded and dizziness


VAERS ID: 1203326 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-03-05
Onset:2021-03-26
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / -

Administered by: Public       Purchased by: ?
Symptoms: Cerebrovascular accident, Computerised tomogram head abnormal, 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)

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, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Atorvastatin, Amlodipine, Metformin, Lisinopril, B-12
Current Illness:
Preexisting Conditions:
Allergies: none
Diagnostic Lab Data: CT MRI
CDC Split Type:

Write-up: Stroke


VAERS ID: 1203342 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-03
Onset:2021-04-07
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cerebrovascular accident, Fall
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), Accidents and injuries (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: duloxetine, clonazepam, carvedilol,
Current Illness: none
Preexisting Conditions: none listed by patient at time of immunization.
Allergies: no known allergies and no allergies listed by patient.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient''s daughter called phamacy today 4/13/21 to report that her father suffered a fall at his home on 4/4/21, the following day after patient received Janssen covid vaccine at pharmacy. Patient''s daughter stated on phone that she took her father to hospital after she learned that he fell on 4/7/21 to be examined. Patient''s daughter stated that he was diagnosed at hospital with having a stroke and discharged to return home on 4/8/21.


VAERS ID: 1203360 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-03-19
Onset:2021-03-21
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cerebrovascular accident
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNKNOWN
Current Illness: NO OTHER ILLNESS REPORTED AT TIME OF VACCINATION
Preexisting Conditions: NONE REPORTED
Allergies: NO KNOWN ALLERGIES REPORTED
Diagnostic Lab Data: UNKNOWN , AS PATIENT WAS HOSPITALIZED.
CDC Split Type:

Write-up: PATIENT CALLED Hospital 04-13-21 AND REPORTED HE HAD A STROKE 2 DAYS AFTER VACCINATION AND WENT TO another HOSPITAL. HE VERBALLY STATES IS HAVING PHYSICAL THERAPY FOR THIS STROKE. ENCOURGAED PATIENT TO SELF REPORT THIS EVENT. PATIETN WAS CALLING Due to THE TV NEWS NOTIFICATION OF THE J&J VACCINE PLACED ON HOLD DUE to IT CAUSING STROKES AND BLOOD CLOTS. PATIENT NOR DID HOSPITAL NOTIFY original HOSPITAL ON THIS PATIENT STROKE EVENT.


VAERS ID: 1203382 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-10
Onset:2021-04-01
   Days after vaccination:22
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: Private       Purchased by: ?
Symptoms: COVID-19 pneumonia, Deep vein thrombosis, Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 11 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Upper extremity DVT diagnosed in february 2021
Preexisting Conditions: CHF, CKD, Duodenal ulcer, HTN, Chronic anemia, Gout
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient presented on April 1st, 2021 with COVID 19 pneumonia, B/L Pulmonary emboli and bilateral lower extremity DVT''s. She was treated with heparin and warfarin for VTE. For COVID pneumonia, aptient was treated with steroids, remdecivir and actemra.


VAERS ID: 1203389 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-03-04
Onset:2021-03-21
   Days after vaccination:17
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: Facial paralysis, Facial paresis, Fatigue, Immunoglobulin therapy
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad), Immune-mediated/autoimmune 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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vitamin B12
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt reported severe fatigue over the past week, noting new onset of bilateral facial weakness 2 days ago (Sunday), progressively worsening. All symptoms started bilaterally at the same time. Diagnosed with Cranial nerve VII palsy. Received IVIG x 2 days with no improvement. At follow-up visit 2 weeks later, pt reported 80% improvement in symptoms.


VAERS ID: 1203407 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-03-30
Onset:2021-04-10
   Days after vaccination:11
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: Chills, Diarrhoea, Dizziness, Dyspnoea, Headache, Pain in extremity, Paraesthesia, Throat tightness, Tremor, Vital signs measurement
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament 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: None
Preexisting Conditions: None
Allergies: None known
Diagnostic Lab Data: Patient went to the ED on day 10 when symptoms presented. Vitals were all within normal limits and her clotting blood test came back ok according to patient. Fluids, Benadryl, and albuterol were administered. Patient had to re-dose Benadryl and albuterol everyday since. She visited her PCP yesterday and was advised to take Allegra and Pepcid daily. Patient bought Aspirin 81mg, but only took 1 dose before she was advised to not take any blood thinners at this time.
CDC Split Type:

Write-up: Patient felt fine after the vaccination, no ADR''s reported at all. On day 10, she felt a "wave go through her body" followed by immediate diarrhea and tingling/breathing constriction in her throat. Dizziness and headache reported with intermittent shaking/chills and leg pain that comes and goes. Shortness of breath with exercise after patient felt she had improved enough to run. Patient has not exercised today as she was feeling apprehensive on what is happening in her body.


VAERS ID: 1203412 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Maryland  
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 - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Chest pain, Chills, Dyspnoea, Ear pain, Fatigue, Hypersensitivity, Hypoaesthesia, Injection site pain, Migraine, Pain, Paraesthesia, Pyrexia, Tremor
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

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

Write-up: Difficulty breathing, severe chest pain, trembling, migraine, severe body aches, tingling and numbness in fingers, chills, fever, ear pain, stomach pain, sensitive senses, pain at injection site, fatigue.


VAERS ID: 1203473 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-03-22
Onset:2021-03-22
   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 / SYR

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Back pain, Burning sensation, Dehydration, Feeding disorder, Feeling cold, Headache, Heart rate increased, Hypersensitivity, Laboratory test, Nausea, Nervousness, Pain, Pollakiuria, Pruritus, Pyrexia, Rash, Tremor, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: tetanus shot several years ago (muscle aches, extreme fatigue, required steroid shot, lost 3 days work)
Other Medications: Calcium, magnesium
Current Illness: none
Preexisting Conditions: none
Allergies: pcn, prescription mouth rinse with chlorhexadine, some shampoo
Diagnostic Lab Data: tests performed at hospital - contact them for info
CDC Split Type:

Write-up: 3/22/21: Vaccine administered 4:45 pm. Burning sensation on arms and legs began about 2 hrs later. Achy and feeling cold about 2 hrs after that. Then headache, shaking, muscles quivering, fever, weakness, some itchy spots, increased urination throughout next several hours. Fitbit showed elevated heart rate for several hours. 3/23/21: Nausea and vomiting. Could not keep water down. Very weak/shaky. That night, went to ED. Treated for dehydration and allergic reaction. 3/24/21: Able to tolerate clear liquids. Still weak. 3/26/21: Woke up with rash on both legs (small bumps, not itchy). Added bread to diet. Still weak. 3/29/21: Low grade fever, strong pain in right side of lower back.


VAERS ID: 1203493 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Pennsylvania  
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 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chills, Nausea, Pain, Pain in extremity, Pyrexia, Rash, Ultrasound scan
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: CHILLS, FEVER, LEG PAIN GETTING WORSE, NAUSEA, RASH, BODY ACHES


VAERS ID: 1203501 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-03-12
Onset:2021-04-11
   Days after vaccination:30
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: School       Purchased by: ?
Symptoms: Computerised tomogram abnormal, Laboratory test, Renal embolism
SMQs:, Embolic and thrombotic events, arterial (narrow), Renovascular disorders (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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Sulfa
Diagnostic Lab Data: CT scans indicated blood clots in kidneys. Other test results still pending.
CDC Split Type:

Write-up: Blood clots in kidney. Currently hospitalized.


VAERS ID: 1203504 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: New York  
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 202A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Hyperhidrosis, Hypotension, Pallor, Pulse abnormal
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: pt reports taking an over the counter allergy medication but due to language barrier it is unclear which
Current Illness: No medical conditions reported
Preexisting Conditions: No medical conditions reported
Allergies: NKDA
Diagnostic Lab Data: None reported
CDC Split Type:

Write-up: Presented with 27 YO male, seated in a chair S/P receiving Johnson and Johnson COVID-19 vaccine. PT started to feel dizzy and started to become diaphoretic. PT does not speak English, upon translator?s arrival they advised this writer that PT was feeling dizzy, and short of breath. PT visibly diaphoretic and his skin color changing from normal to pale. PT pulse weak and thready, and PT hypotensive at 76/P. PT administered 50mg of Benadryl IM in his right deltoid, successful. PT pulse no longer palpable in the radial so PT placed in a supine position on the floor and PT legs elevated to a Trendelenburg position for his hypotension. PT administered 1mg Epinephrine 1:1,000 IM in the left deltoid, successful. Ambulance called for transport of the PT to the nearest hospital. PT blood pressure slowly starting to stabilize at 90/56. PT SPO2 reading 98% on room air with respirations 18 and regular with clear lung sounds. PT no longer having Shortness of breath or dizziness. PT no longer sweating and he is beginning to stabilize. Radial pulse palpable again and strong and regular at a rate of 76 bpm. PT blood pressure reading 110/76. Upon fire department arrival determined that the PT was stable enough to sit upright in the chair again. PT was assisted off the floor and to a seated position in a chair. PT vitals after seated position for 5-7 min, BP 120/82, pulse 86 strong and regular, RR 20 and clear equal bilateral lung sounds. PT has no other complaints at this time. PT has no allergies to medication, PT has a pollen allergy that he takes over the counter allergy medicines for. PT has no past medical history. Upon arrival of ambulance PT care relinquished to EMS with full report, PT care relinquished without incident or injury.


VAERS ID: 1203563 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: New York  
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 202A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Hyperhidrosis, Pallor, Skin discolouration, Vital signs measurement
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Presented with 28 YO male, seated in a chair S/P receiving the Johnson and Johnson COVID-19 vaccine. PT states he was feeling dizzy with shortness of breath. PT was given a bottle of water by RN for hydration. PT skin color starting to change from normal to a pale and PT started to become diaphoretic. Ambulance notified for transport to the closest facility. PT pulse 70 and strong and regular, BP 100/60 and respirations 20 strong and regular. PT denies any medical history or allergies at this time. No other interventions performed with PT due to ambulance arrival and PT care relinquished to EMS with full report, PT care relinquished without incident or injury.


VAERS ID: 1203571 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: New Jersey  
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 - / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Fatigue, Hypoaesthesia, Myalgia, Nausea, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Nexium 20mg
Current Illness: Headache and partial head numbness
Preexisting Conditions: NA
Allergies: NA
Diagnostic Lab Data:
CDC Split Type:

Write-up: 04/08 15min after injection, got breath difficulty that lasts for 1hr 04/09 Intense fatigue, muscle ache and dizziness whole day 04/10 Symptoms cease to exist 04/12 Early in the morning: Left arm and hand numbness with ache , head numbness; Noon: getting better; Evening: left leg and feet numbness, face and head numbness; Night: head numbness and nausea, left arm and hand numbness 04/13 Head numbness, left arm and hand numbness, left leg numbness


VAERS ID: 1203621 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Montana  
Vaccinated:2021-03-22
Onset:2021-04-04
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cerebellar stroke, Computerised tomogram head abnormal, Dizziness, Electrocardiogram, Gait inability, Headache, Magnetic resonance imaging head abnormal, Malaise, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Dystonia (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular 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? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: tamsulosin hcl .04 mg 1 a day lisinopril-hctz 10-12.5mg 1 a day
Current Illness:
Preexisting Conditions: high blood pressure elevated PHA numbers
Allergies: penicillin
Diagnostic Lab Data: had a cat scan had an mri had a ekg found out he had a cerebellum brain stroke.
CDC Split Type:

Write-up: dizzy,nauseaus,headache. sick on sunday the 4th called 911 on Tuesday night the 6th for transport to hospital. couldn''t walk. had a stoke.


VAERS ID: 1203625 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Texas  
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 - / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chills, Dizziness, Epistaxis, Fatigue, Nasal congestion, Nausea, Pain, Pain in extremity, Peripheral swelling, Pyrexia, Ultrasound scan, Weight increased
SMQs:, Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Armour Thyroid 90 mg, Synthroid 50 mcg, Prometrium 200 mg, claratin-d 24 hour
Current Illness: Had Covid 1 month prior- symptoms started 1/17/21 and finally tested negative 2/10/21.
Preexisting Conditions: Hypothyroid, had radio frequency ablation on the greater saphenous vein & scalerotherapy in both legs in Nov 2020
Allergies: sulfa drugs & codeine
Diagnostic Lab Data: Sono on 3/21 at Emergency Room, CT on 3/21 at Emergency Room, Sono on 4/12, labs at Dr office 4/6
CDC Split Type:

Write-up: It gave me Covid symptoms that started about 12 hours after the shot. Body aches, fever, chills, congestion, exhaustion, nausea & dizziness. That mostly resolved after 2 days. Then 1 week later on Saturday, I started having pain in my left leg where I had had RFA of the greater saphenous vein 6 months prior. Leg swelled up got a hard knot. I got dizzy & nauseated. The pain increased, & I went to the ER on 3/21. They diagnosed it as thrombophlebitis. The pain & inflammation has continued for 3 weeks now despite the use of anti-inflammatory meds & support hose. I have also had rapid weight gain of 12 lbs and edema not relieved by lasix. Two weeks after the shot I also started having severe nose bleeds.


VAERS ID: 1203629 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-04-03
Onset:2021-04-06
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Deep vein thrombosis
SMQs:, Embolic and thrombotic events, venous (narrow), Thrombophlebitis (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 a DVT four days after vaccination.


VAERS ID: 1203630 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-05
Onset:2021-04-11
   Days after vaccination:6
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: Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow)

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

Write-up: Patient developed a Pulmonary embolism


VAERS ID: 1203666 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-04-04
Onset:2021-04-05
   Days after vaccination:1
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 cerebral abnormal, Cerebrovascular disorder, Chills, Headache, Nausea, Subarachnoid haemorrhage, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), 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), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acyclovir, synthroid, b12, oxy, fish oil, voltaren, medrol dos
Current Illness: myelogram on 3/23 for spinal stimulator check, did have HA fol
Preexisting Conditions: spinal surgeries, chronic pain, depression, high cholesterol
Allergies: sulfa, macrobid
Diagnostic Lab Data: Angiogram 4/9/2021-- No definitive source of intracranial hemorrhage is identified. There are subtle caliber changes to distal branches of the cerebral vasculature
CDC Split Type:

Write-up: Patient developed a severe headache, nausea, and vomiting on 4/5 PM. She continued to have severe headache, improving to a 5 and then worsening to a 10 for several days. She had some chills develop the AM of 4/6, but no fevers, myalgias, rash, or other side effects. She went to ED on 4/9 and was transferred to our facility. Found to have subarachnoid hemorrhage. CT angio without evidence of clot. No clear etiology for bleed per neurosurgery


VAERS ID: 1203681 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-04-11
Onset:2021-04-13
   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 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure increased, Blood test normal, Heart rate increased, Hypoaesthesia, Ultrasound scan normal
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Hypertension (narrow), Dehydration (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: Symbicort, albuterol, benadryl
Current Illness: jan 1st testing positive for covid-19
Preexisting Conditions: now has chronic lung condition
Allergies: no known allergy
Diagnostic Lab Data: today went to er, had ultrasound to rule out blood clots, blood pressure monitiored and cardiac labs as well, negative for blood clots and negative for MI
CDC Split Type:

Write-up: starting having rapid heart rate, increased blood pressure, eventually resulting in a numb left arm


VAERS ID: 1203721 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Wisconsin  
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 1808978 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Anaphylactic reaction, Chest discomfort, Lip pruritus, Lip swelling, Pruritus, Rash macular
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: None known
Preexisting Conditions: None known
Allergies: None marked on her consent form she filled out.
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: I started having an annaphylaxis reaction a short time after i left. At first it was intense all over body itching that felt like it was from the inside out. By the time i got home i was getting red blotchy patches over my face, neck, and chest. I took benedryl which did nothing to subside the reaction. When my chest started feeling tight i went to the emergency room. My lips were itching and puffy. At the er i received treatment for annaphylaxis once and about a half hour to forty minutes before i was to be discharge i had a reoccurance of symptoms and was treated for it a second time and admitted to the hospital. This was from the March 31st clinic held at the fire department.


VAERS ID: 1203724 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Florida  
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 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Back pain, Chapped lips, Chest discomfort, Chills, Dyspnoea, Ear pain, Fatigue, Headache, Hyperacusis, Hypertension, Muscle spasms, Nausea, Night sweats, Ocular hyperaemia, Oral herpes, Pain, Pain in extremity, Photosensitivity reaction, Pyrexia, Tremor
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Parkinson-like events (broad), Oropharyngeal infections (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Hypertension (narrow), Cardiomyopathy (broad), Hearing impairment (narrow), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Estrodial 1mg and Tylenol
Current Illness: None
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: High fever (103.2 highest), blood shot eyes, severe headache (not making sense for 24 hours), ear aches, nausea, sensitive eyes to light/sound, body aches, chills that caused shivering and shaking of the entire body that lasted a few hours, weakness, fatigue, back ache, arm and shoulder pain, chapped lips, gas, cold sore, night sweats, day sweats, leg spasms and pain, shortness of breath and chest pressure and high blood pressure.


VAERS ID: 1203751 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Minnesota  
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 1808978 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Aphonia, Condition aggravated, Dysphonia, Dyspnoea, Hypersensitivity
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Not specified
Other Medications: Latex, Shellfish, antibiotics, other vaccines (not specified)
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient presented for Covid vaccination. She had multiple allergies with history of anaphylaxis including to other vaccines. Patient insisted her PCP wanted her to get J & J vaccine. Patient received vaccine at 12:20 AND AT 12:30 C/O of losing voice and feeling like she was reacting. EPI 0.5 given subq at 12:30. BP 138/80; HR 60 and regular. At 12:38 symptoms were getting worse with raspy voice and feeling SOB. Second dose of Epi 0.5 given subq. BP 130/84; HR 64. EMS called. Arrived at 1300 and patient was transported to hospital.


VAERS ID: 1203760 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Illinois  
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 1808609 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: vitamin D, calcium with vitamin D, potassium, magnesium, B12, advil
Current Illness:
Preexisting Conditions: COPD, arthritis, fibromyalgia, severe stomach issues, stroke and heart attack, hypothyroid, gerd,
Allergies: Zosyn, Tylenol 3, morphine IV, Neurgon, aeflax,
Diagnostic Lab Data:
CDC Split Type:

Write-up: Wednesday itching began and she start Benadryl , Thursday the itching continued, Friday her throat almost swelled shut,


VAERS ID: 1203765 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-03-31
Onset:2021-04-11
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 - / IM

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

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

Write-up: Patient received vaccine on 3/31. Developed significant headache the evening of 4/12. Called hospital telephone nurse advisor, and was directed to come to the ER for further evaluation. The patient was not admitted. No evidence/concern of thrombotic event. Patient does have a history of migraines.


VAERS ID: 1203799 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-02
Onset:2021-04-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 AR / IM

Administered by: Public       Purchased by: ?
Symptoms: Bedridden, Chills, Decreased appetite, Diarrhoea, Eyelid ptosis, Fatigue, Hypopnoea, Pulse abnormal, Resuscitation
SMQs:, Pseudomembranous colitis (broad), Acute central respiratory depression (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow), Noninfectious diarrhoea (narrow), Respiratory failure (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-07
   Days after onset: 4
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: Patient husband stated that patient had a pace-maker
Allergies: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: Patient developed chills and fatigue Saturday and Sunday (April 3rd and April 4th) . Patient developed diarrhea and lack of appetite Monday, April 5th. Patient was reported to be bedridden Wednesday, April 7th. Patients husband stated hat patients eyes were halfway closed, experiencing shallow breathing, and had a soft pulse. Husband call 911 while instructed to do chest compressions until EMTs arrived on site. First responder were reported to perform resuscitation efforts on the patient for 35 minutes until transporting the patient to the hospital.


VAERS ID: 1203855 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-04-11
Onset:2021-04-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cough, Eye swelling, Lip swelling, Oropharyngeal discomfort, Pharyngeal swelling, Wheezing
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Work up the next day with my left side swollen . My lips and eyes were very very swollen. My throat was swollen and was wheezing . Had a bad cough . Felt like something in my throat .


VAERS ID: 1203871 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: California  
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 203A21A / 1 LA / IM

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

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

Write-up: Seizure and lost of consciousness 3 minutes after vaccine was administered. No treatment was given at pharmacy, but patient was taken by paramedics.


VAERS ID: 1203874 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Florida  
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 042A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Allergy to vaccine, Chills, Headache, Hypersensitivity, Lethargy, Pain, Pyrexia, Rash, Renal pain, Tremor
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Spironolactone Estradiol Progesterone Gabapentin Saw Palmetto Collagen Vitamin D Vitamin c Zinc Iron Biotin
Current Illness: No, but had covid 2 months prior.
Preexisting Conditions: IBS Alopecia
Allergies: None
Diagnostic Lab Data: None yet. But March, I had a full panel of blood eidl done prior to starting hormone replacement therapy and my blood work showed I had a low white blood cell count.
CDC Split Type:

Write-up: 4/9/2021 10:30 am - Received vaccination 6:30 pm - Body Aches 7:30 pm - Chills and Shaking 8:00 pm - Fever from 96.9 to 98.9 9:00 pm - Fever from 98.9 to 100.1 10:00 pm - Severe Headache 11:00 pm - Fever from 100.1 to 101.50 4/10/2021 1:00 am - Fever from 101.50 to 102 2:00 am - Pains in my kidneys Throughout day, very lethargic and headache continued 8pm - Rash developed on neck and chest 4/11/2021 7:00 am - Rash moved further up my neck and pasty my shoulders 10:00 am - Called Pharmacy they recommend I go to Urgent Care or Hospital 12:00 pm - Checked in to Hospital and was treated for allergic reaction to immuzation


VAERS ID: 1203878 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: California  
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 043A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Nausea, Vital signs measurement
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NOT KNOWN
Current Illness: NOT KNOWN
Preexisting Conditions: NOT KNOWN
Allergies: NONE
Diagnostic Lab Data: none known
CDC Split Type:

Write-up: Patient received vaccine at another facility on 4/5/21. On 4/13/21 She came to our facility complaining of still having headache and nausea from her vaccination on 4/5/21. She wanted me to take her blood pressure and the machine would stop working after certain inflation. The machine was working fine because tested on another person. I tried the other arm and same thing happened so, I advised patient to go to urgent care since she said she does not have a primary care physician.


VAERS ID: 1203897 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-03-14
Onset:2021-03-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / N/A RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Headache, Injection site pain, Pain, Pain in extremity, Paraesthesia, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Keflex 750 mg capsule
Current Illness: Urinary tract infection
Preexisting Conditions: Low back pain
Allergies: No known allergies
Diagnostic Lab Data: 04/13/2021 sent to Hospital ER for further examination: recommended US Right Leg, Rule out DVT
CDC Split Type:

Write-up: Patient described right leg pain and swelling following injection, right side body pain and tingling. Headaches, and pain at the injection site.(right deltoid injection site)


VAERS ID: 1203898 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Massachusetts  
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 208A32A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Blood test, Body temperature increased, Chills, Diarrhoea, Dizziness, Fatigue, Headache, Hyperhidrosis, Malaise, Pain, Retching, Urine analysis, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: benazapril 20mg (daily) lexapro 10mg (daily)
Current Illness: none
Preexisting Conditions: high blood pressure
Allergies: none
Diagnostic Lab Data: blood work and urine sample
CDC Split Type:

Write-up: had my shot at 10:55am, waited 15 minutes in case of immediate reaction; I felt dizzy and sweated a little bit. I went home and on with my day grocery shopping and went to the beach with kids.around dinner time i started feeling very tired. I went to sleep around 7:30 and about 9:00pm i woke up feeling sick to my stomach. I vomited everything i ate all day. a little while later diarrhea started along with chills, a headache, and body aches (specifically in my lower back.) I took my temp and it was 99.98. Two hours of non stop vomiting/dry heaving i decided I should go to the ER. They gave me saline, zofran, and tylenol through an IV. Blood tests and a urine sample were given. The IV helped immensely. I was discharg


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