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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: 1205940 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Maryland  
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 - / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Myocardial infarction
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow)

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

Write-up: Heart Attack


VAERS ID: 1206018 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-03-11
Onset:2021-04-09
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / UNK - / -

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

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: PNC
Diagnostic Lab Data: Contact Hospital
CDC Split Type:

Write-up: I had a blood clot in my left lung. went to ER , spent three days in the hospital was given medications (Xarelto ) required to taking medication now for a least a year.


VAERS ID: 1206024 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-03-15
Onset:2021-04-08
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / N/A RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Blood test, Cerebellar embolism, Cerebrovascular accident, Computerised tomogram, Echocardiogram, Magnetic resonance imaging, Scan with contrast
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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Synthroid Vyvanse
Current Illness: Hashimoto Disease
Preexisting Conditions: Autoimmune Disorder: Hashimoto Disease
Allergies: Food: watermelon, coconut, eggplant
Diagnostic Lab Data: CAT with contrast MRI Echocardiogram Blood Work
CDC Split Type:

Write-up: stroke caused by 2 cerebral blood clots


VAERS ID: 1206041 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Maryland  
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 201A21A / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was in attendance at the JANSSEN vaccination clinic on 4/9/21. After vaccination while he was in the observation area, PT experienced a syncopal episode and hit his head on the window sill next to where he was sitting. Staff responded and assessed PT and decided to initiate a MET call. There was concern that the patient may have experienced a seizure. Patient was taken to the Emergency Department. Patient was ultimately admitted on 4/9/21 with new onset of a. fib. He was discharged on 4/11/21. While hospitalized, the patient received IV cardizem


VAERS ID: 1206080 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood blister, Dysphagia, Erythema, Eye pruritus, Headache, Hypoaesthesia, Paraesthesia, Pharyngeal swelling, Rash, Sneezing, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

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

Write-up: 4-12-2021 Facial tingling & numbness, tightness/swelling of throat, difficulty swallowing, Given Prednisone 40 mg, 2 Benadryl and 1 Pepcit at ER visit. Prescribed Prednisone 40 mg /5 days, Benadryl & Pepcid for as long as symptoms are present. 4-13-2021 Headache, itchy eyes, sneezing, small red blood blister like areas on arms, chest, back and thighs. When Benadryl wears off throat tightness returns. Visited ER on advice from nurse hotline to check out the red blood blister like marks as she thought it was a new rash type symptom. ER recomended remaining on previously prescribed course of meds and to watch for further symptoms.


VAERS ID: 1206091 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-03-19
Onset:2021-04-03
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fibrin D dimer, Headache, Hypoaesthesia, Neck pain, Pain
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Arthritis (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: D-Dimer
CDC Split Type:

Write-up: headache, right neck pain, numbness and pain behind right ear


VAERS ID: 1206132 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-15
Onset:2021-03-26
   Days after vaccination:11
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: Private       Purchased by: ?
Symptoms: Abdominal pain lower, Blood test, Chest pain, Electrocardiogram, Erythema, Fatigue, Heart rate increased, Hypertension, Limb discomfort, Pain in extremity, Palpitations, Ultrasound abdomen, Ultrasound scan vagina
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Cardiomyopathy (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: METOPROLOL SUC TAB 25MG ER and NORTRIPTYLIN CAP 10MG
Current Illness: NONE
Preexisting Conditions: High blood pressure
Allergies: Amoxicillin
Diagnostic Lab Data: Trans abdominal & Trans vaginal ultrasound 4/1/2021 * EKG test 4/12/2021 Blood test 41/2021 * Blood works again 4/13 /2021
CDC Split Type:

Write-up: Injection site arms feeling heavy & painful for approx 45min. Fast heart beat & palpitation more than 1 hr. Redness of my face last for approx hour & half. Feeling tired for two days. On my second week, having pain in my lower left abdomen. Severely painful 1st of April check in to ER Chet pain & elevated high blood pressure Check in Urgent care


VAERS ID: 1206156 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-03-10
Onset:2021-03-19
   Days after vaccination:9
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: Other       Purchased by: ?
Symptoms: Blood test, Erythema, Pain in extremity, Peripheral swelling, Skin discolouration, Ultrasound scan
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (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: Levothyroxine, Amlodopine, Besylate, Quinapril, Pristiq, Trazadone, Stelara, Omeprazole, Fosamax, Vitamin B-12, Vitamin D3, Fish Oil, Tums, Feosol
Current Illness:
Preexisting Conditions: Crohn''s Disease, Hypertension, Osteoporosis, Depression, Thyroid disorder
Allergies: Sulfa medications, Imuran, Remicade
Diagnostic Lab Data: Extensive blood work. Ultrasound
CDC Split Type:

Write-up: Nine days after vaccination developed pain and swelling in lower right leg, ankle and foot. Red discoloration of lower leg and purple and blue discoloration on ankle/foot. Went to ER suspected blood clot. Ultrasound and blood work were done. NO blood clot was found.


VAERS ID: 1206172 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Florida  
Vaccinated:1970-02-14
Onset:2021-03-27
   Days after vaccination:18669
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Surgery, Thrombosis, Vena cava filter insertion
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Soma ,zoloft,valume,oxycotton,fierocet
Current Illness: Cancer
Preexisting Conditions: Cancer
Allergies: Benadryl
Diagnostic Lab Data: April 4th till April 12th
CDC Split Type: 1802070

Write-up: Severe blood clots,surgery sbc filter


VAERS ID: 1206173 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-09
Onset:2021-04-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 RA / SYR

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

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

Write-up: Broke out in a rash and hives all over body. Very itchy.


VAERS ID: 1206182 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-04-05
Onset:2021-04-06
   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 / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Hypoaesthesia, Migraine, Nausea
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Sexual dysfunction (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Teylnol
Current Illness: Nothinh
Preexisting Conditions: Nothing
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe headache, Numbness, and migraine, nausea for 9 days


VAERS ID: 1206192 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-03-01
Onset:2021-03-13
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Deep vein thrombosis, Ultrasound Doppler
SMQs:, Embolic and thrombotic events, venous (narrow), Thrombophlebitis (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: prior RLE unprovoked DVT
Allergies: none
Diagnostic Lab Data: confirmed with right lower leg duplex ultrasound on 3/13/2021
CDC Split Type:

Write-up: DVT in right lower leg occurring within 2 weeks of vaccination


VAERS ID: 1206203 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-03-08
Onset:2021-03-29
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Brain natriuretic peptide normal, Computerised tomogram abnormal, Condition aggravated, Dyspnoea, Pulmonary embolism, Troponin normal
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: HYPERLIPIDEMIA, OBESITY, PE (2008, 2014)
Allergies: NONE
Diagnostic Lab Data: CT SCAN: Abnormal filling defects are seen in the right upper lobe lobar pulmonary artery, right lower lobe pulmonary artery and right middle lobe there are also filling defects in the left upper lobe and left lower lobe lobar pulmonary arteries. Multiple segmental pulmonary artery filling defects are seen bilaterally as well. NORMAL TROP, NORMAL BNP
CDC Split Type:

Write-up: PATIENT SEEN FOR SOB X 2-3 WEEKS IN ED, CT SCAN SHOWED MULTIPLE PULMONARY EMBOLI. HEMODYNAMICALLY STABLE WITH NO EVIDENCE OF HEART STRAIN, D/C HOME ON XARELTO


VAERS ID: 1206205 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-07
Onset:2021-04-10
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood count, Computerised tomogram head, Computerised tomogram neck, Human chorionic gonadotropin, Hypoaesthesia, Hypoaesthesia oral, Metabolic function test, Prothrombin time, Visual impairment
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth control pills
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: CT head wo contrast, ct head neck aptt, blood count, metabolic panel, hcg, prothrombin time,
CDC Split Type:

Write-up: Experienced temporary blind spots in vision, numbness in fingers and lips followed by difficulty speaking. Had CT and bloodwork done, no significant findings and the symptoms resolved without treatment to this point.


VAERS ID: 1206217 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Indiana  
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 043A21A / 1 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Blood test, Chills, Fatigue, Headache, Myalgia, Nausea, Pyrexia, Uterine haemorrhage
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Atrovastatin 10mg Escitalopram 10mg Hydroxyine 25mg Tri Femynor
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: 4/13/21 blood work done
CDC Split Type:

Write-up: Nausea, headache, chills, fever, muscle aches, fatigue (all night of 3/31 into 4/1) As of 4/13/21 still have headache, fatigue, and uterine bleeding.


VAERS ID: 1206236 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-06
Onset:2021-04-09
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Appendicectomy, Appendicitis, Computerised tomogram, White blood cell count increased
SMQs:, Neuroleptic malignant syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: -
Current Illness: -
Preexisting Conditions: -
Allergies: -
Diagnostic Lab Data: high white blood cell count, CT scan (both on 4/9)
CDC Split Type:

Write-up: uncomplicated appendicitis, removed via surgery


VAERS ID: 1206242 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-06
Onset:2021-04-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Dyspnoea, Erythema, Migraine, Nasopharyngitis, Nodule, Pyrexia
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Hospital laughed said that?s how I should be feeling said I?m a test patient for getting it and gave me a migraine shot to ease the pain
CDC Split Type:

Write-up: Migraine from hell, lump and redness on arm, feel like I have a cold, fever, and also hard time breathing


VAERS ID: 1206254 (history)  
Form: Version 2.0  
Age: 40.0  
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 / IM

Administered by: Other       Purchased by: ?
Symptoms: Chest X-ray normal, Chest pain, Chills, Cough, Dyspnoea, Ear discomfort, Fibrin D dimer normal, Oropharyngeal pain, Pain, Pain in extremity, Platelet count normal, Pyrexia, Vascular test normal
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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: woman''s multivitamin, apple cider gummies
Current Illness: none
Preexisting Conditions: none
Allergies: shellfish, iodine
Diagnostic Lab Data: 4/13/2021 evaluation in ER. Labs relatively unremarkable. Ddimer normal. Left leg PVL negative for DVT. Chest xray normal. Normal platelets
CDC Split Type:

Write-up: day of vaccine experienced body aches, cough, congestion, sore throat, clogged ears, subjective fevers and chills which resolved after 24 hours. 4/11 began with diffuse chest pain and left calf pain. shortness of breath


VAERS ID: 1206257 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-01
Onset:2021-04-07
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / 1 AR / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Coronary artery occlusion, Dyspnoea, Pain in extremity, Peripheral arterial occlusive disease, Respiratory tract congestion, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Tendinopathies and ligament 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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: Dr has al the documents and paperwork as I am still not discharged.
CDC Split Type:

Write-up: Severe leg pain first, then trouble breather. Shortness of breath and tightness in chest. Thought it was severe congestion... delayed going to the ER. Finally went in due to vomiting trying to get breath. Had LAD 90% blocked and blockage in the right leg still in hospital receiving treatment. Will Catheter scope the right leg to very clots and severity.


VAERS ID: 1333005 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Unknown  
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 201A21 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood glucose increased, Electrocardiogram, Hyperhidrosis
SMQs:, Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant 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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: b/p 193/94 blood sugar 230, EKG conducted, PO 25mg benadryl given. EMS contacted
CDC Split Type:

Write-up: Diapharetic Narrative: see above


VAERS ID: 1206317 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-04-10
Onset:2021-04-13
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Chest pain, Diarrhoea, Electrocardiogram, Gastroenteritis, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: SINGULAIR, ZYRTEC, LEXAPRO, BENICAR, XIDUO, ALLPURINOL, ACTOS, JANUVIA, PANTOPRAZOLE
Current Illness: NONE
Preexisting Conditions: DIABETES, HIGH BLOOS PRESSURE
Allergies: ZOCOR, SIMVASTATIN
Diagnostic Lab Data: 4/13/2021 - 9:05AM MORNING AT URGENT CARE ABDOMINAL PAIN - GASTROENTERITIS; 4/13/2021 - 8:45PM FEVER, PERFORMED EKG, BLOOD PRESSURE, BLOOD GLUCOSE
CDC Split Type:

Write-up: 4/13/2021 - FEVER, ABDOMINAL PAIN, VOMITING, CHEST PAIN, DIARRHEA


VAERS ID: 1206334 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-03-12
Onset:2021-04-05
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Computerised tomogram abnormal, Computerised tomogram head, Headache, Injection site erythema, Portal vein thrombosis, Scan with contrast
SMQs:, Acute pancreatitis (broad), Embolic and thrombotic events, venous (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Morphine 15, 1 every 12 hours,, Zofran 4 mg as needed, Lyrica 100 mg 3 times a day, Allegra 1 X a day, lisinopril 10,5 mg 2 -1X a day, Enlyta 5 mg 1-2X a day, Keytruda every 3 weeks for cancer, Zometa every 6 weeks
Current Illness: Renal Cell Carcinoma
Preexisting Conditions: Renal Cell Carcinoma
Allergies: Riosemary, grass and trees pollens
Diagnostic Lab Data: 4/5/21- CT W/Contrast on Stomach 4/5/21-CT. W/Contrast for Head 4/6/21- Transportation by ambulance to Hospital Many other tests too numerous to cover here
CDC Split Type:

Write-up: Redness at site. On April 5, I had severe stomach pains and then a head ache started. They did a CT Scan and found a Portal Deep Vein Thrombosis. I had to be rushed by ambulance to a bigger hospital and was in the hospital for 2 days.


VAERS ID: 1206380 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-08
Onset:2021-04-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray, Computerised tomogram thorax, Dyspnoea, Headache, Magnetic resonance imaging, Thrombosis
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Estarylla
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: 4/13/2021: -Chest x-ray -Chest CT -MRI
CDC Split Type:

Write-up: On 4/8/2021 I developed a headache after receiving the Johnson and Johnson vaccine. I took the next few days easy, and laid in bed for the majority of the weekend. On 4/10/2021 I left my residence to get dinner and noticed I was short of breath just walking from the building to my car. The shortness of breath worsened over the next few days. On 4/13/2021 I called a clinic and told them I had been short of breath and they directed me to the ER. I arrived to the ER around 2:30 in the afternoon. They ordered a chest x-ray and ran a test to determine if I could have a blood clot. The test came back with results indicating I could have a blood clot, so they did a chest CT and an MRI. The chest CT showed a blood clot in my left pulmonary artery. They prescribed a blood thinner, told me to stop taking oral birth control, and discharged me.


VAERS ID: 1206381 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 15 / 1 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Chills, Crying, Disorientation, Dyspnoea, Hallucination, Inappropriate affect, Laboratory test, Muscle contractions involuntary, Musculoskeletal chest pain, Nausea, Pain, Pain in extremity, Pyrexia, Sensitive skin
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Acute central respiratory depression (broad), Psychosis and psychotic disorders (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Depression (excl suicide and self injury) (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? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: On April 10th my vitals were taken at the hospital. Laboratory testing was done to check if I had consumed or was under any type of drug.
CDC Split Type:

Write-up: I received the Johnson and Johson Vaccine on April 9th between 10:00 a.m.-10:20 a.m., at 10:30 p.m. that same day my legs and feet started to ache (pain level 3), by 11:00 p.m. my feet and leg (pain level rose to a 6), I drank two 500 ml pain-relieving pills. By 11:30 p.m. (pain level rose to a 9), at that time my pain traveled up to my rib cage, I felt nauseous, felt chills, felt contractions on my stomach and lower back, I felt pain and sensitivity on my skin and caught a fever. Between 12:00 a.m.-2:00 a.m. my (pain level rose to 12), I had a high fever, felt weak, disoriented, lost track of time, started to hallucinate, could not breathe normally, and experienced involuntary and uncontrollable laughter and crying. 911 was called.


VAERS ID: 1206392 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-06
Onset:2021-04-12
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042AZIA / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site pain, Ultrasound scan
SMQs:, Extravasation events (injections, infusions and implants) (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: Went to ER and had an ultrasound done on the left leg. Results came back saying it is "Thrombophlebitis, Superficial".
CDC Split Type:

Write-up: Pain on the left falf and red mark on the are where I feel pain.


VAERS ID: 1206394 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-13
Onset:2021-04-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dizziness postural, Dysstasia, Feeling hot, Headache, Heavy menstrual bleeding, Laboratory test, Loss of personal independence in daily activities, Menstruation irregular, Nausea, Vaccination complication, Vertigo, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (narrow), Fertility 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: Only daily vitamins
Current Illness: None
Preexisting Conditions: None
Allergies: Tetracycline
Diagnostic Lab Data: I got a full blood work up after I was okay enough to move after that severe dizziness. I was certain it was vaccine side-effect because there was nothing else. I specifically asked for plat
CDC Split Type:

Write-up: The night of the vaccination (3/8), my body felt very hot (not fever) like it was going to catch on fire. I took Tylenol to be safe and went to bed taking it as a sign that the vaccine was working. I thought I was mostly over the next day, but four days later on 3/12, I started bleeding only two weeks after my last period, and the it was quite different than usual - very fresh blood and lots of it. This continued for 15 days at time with very heavy flow - I bleed non-stop, and I worried that I was going to bleed to death. The worst adverse effect happened 10 days after the vaccination on 3/18. Out of blue without anything unusual, I started feeling very dizzy, nausea, and vomiting. After much vomiting, nausea stopped, but the dizziness just got so bad, I couldn''t move or even keep my eyes open (things were spinning even with my eyes closed). I couldn''t even stand up by myself. This most horrible severe vertigo lasted two and got gradually better. It took about 5 days before I felt safe enough to be alone by myself. During this time, I had a excruciating headache on my left side. It was so bad, I quickly took some painkillers which knock me out for a day. The important thing is that I don''t ever get headaches; this is the first one I had aside from one I had when going through IVF more than a decade ago.


VAERS ID: 1206413 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-01
Onset:2021-04-07
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 - / IM

Administered by: Other       Purchased by: ?
Symptoms: Deep vein thrombosis, Erythema, Feeling hot, Pain in extremity, Peripheral swelling, Ultrasound Doppler abnormal, Vascular occlusion
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: hyperlipidemia
Allergies: sulfa drugs
Diagnostic Lab Data: PVL performed which revealed extensive DVT in left lower extremity with all vessels occluded
CDC Split Type:

Write-up: left leg pain and swelling, redness, increased warmth worsening over 1 week


VAERS ID: 1206418 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-17
Onset:2021-04-10
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 - / IM

Administered by: Military       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Fibrin D dimer increased, Mental status changes
SMQs:, Anaphylactic reaction (broad), Haemorrhage laboratory terms (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Reported to facility with chest pain, AMS, shortness of breath, elevated Ddimer. Suspected PE, given antithrombolytics, transferred to higher level of care


VAERS ID: 1206521 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: California  
Vaccinated:0000-00-00
Onset:2021-04-04
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Cardiac disorder NOS; Penicillin allergy
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210417309

Write-up: DIZZINESS; This spontaneous report received from a patient concerned a 64 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included penicillin allergy, and other pre-existing medical conditions included patient had on beta blocker. The patient experienced drug allergy when treated with acetylsalicylic acid. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808978 expiry: not reported) dose was not reported, administered on 31-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 04-APR-2021, the subject experienced dizziness. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from dizziness. This report was non-serious.


VAERS ID: 1206560 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dyspnoea, Headache, Illness, Nausea, Pain in extremity, Pyrexia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), 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: N/A
Current Illness: N/A
Preexisting Conditions:
Allergies: N/A
Diagnostic Lab Data: Reason for appointment: fever, Nausea. Diagnoses: Postimmunization reaction, initial encounter. Pain, dental. Has been treated
CDC Split Type:

Write-up: Fever, headache, arms pain, sickness, leg pain and, difficulty breathing.


VAERS ID: 1206617 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Alaska  
Vaccinated:0000-00-00
Onset:2021-04-01
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood potassium, Dyspnoea, Heart rate, Heart rate increased, SARS-CoV-2 test, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Dehydration (broad), 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:
Current Illness: Allergic reaction to antibiotics; Non-smoker
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210401; Test Name: COVID-19 virus test; Result Unstructured Data: unknown; Test Date: 20210401; Test Name: Heart rate; Result Unstructured Data: 104-114; Comments: Patient heart rate ranges from 104-114 at 01:00, while sitting it was more than 70.; Test Date: 20210401; Test Name: Potassium; Result Unstructured Data: Low
CDC Split Type: USJNJFOC20210417792

Write-up: HARD TO BREATHE; INCREASE HEART RATE; WHEEZING; This spontaneous report received from a patient concerned a 43 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included allergic to sulfa antibiotics, and non-smoker. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808609, expiry: UNKNOWN) dose was not reported, administered on 31-MAR-2021 18:00 for prophylactic vaccination. No concomitant medications were reported. On 01-APR-2021, the subject experienced hard to breathe. On 01-APR-2021, the subject experienced increase heart rate. On 01-APR-2021, the subject experienced wheezing. Laboratory data included: Heart rate (NR: not provided) 104-114, Potassium (NR: not provided) Low, and SARS-CoV-2 test (NR: not provided) unknown. Treatment medications (dates unspecified) included: diphenhydramine hydrochloride. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from hard to breathe, increase heart rate, and wheezing. This report was non-serious.


VAERS ID: 1206626 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: New Jersey  
Vaccinated:0000-00-00
Onset:2021-04-08
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Injection site pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (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: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Name: Body temperature; Result Unstructured Data: 103.3 deg
CDC Split Type: USJNJFOC20210417937

Write-up: TEMPERATURE OF 103.3; PAIN AT THE INJECTION SITE; This spontaneous report received from a patient concerned a female of unspecified age. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 08-APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 08-APR-2021, the subject experienced temperature of 103.3. On 08-APR-2021, the subject experienced pain at the injection site. Laboratory data (dates unspecified) included: Body temperature (NR: not provided) 103.3 deg. Treatment medications (dates unspecified) included: paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from temperature of 103.3, and the outcome of pain at the injection site was not reported. This report was non-serious.


VAERS ID: 1206954 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-03-29
Onset:2021-03-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / UNK LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Diarrhoea, Fatigue, Gastrointestinal haemorrhage, Haemoglobin decreased, Helicobacter test, Hypotension, Melaena, Nausea, Packed red blood cell transfusion, Pain, Pallor, Peptic ulcer, Syncope, Vomiting, Weight decreased
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Haematopoietic erythropenia (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Gastrointestinal ulceration (narrow), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Myelodysplastic syndrome (broad), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Insane Labz: Psychotic Diablo - 1 capsule per day, Insane Labz: Psychotic High Stim Preworkout - 1 scoop per day
Current Illness: Denies
Preexisting Conditions: Denies
Allergies: Denies
Diagnostic Lab Data: Hgb 5.0 (01Apr2021), Hgb 11.6 (06Apr2021 and 14Apr2021)
CDC Split Type:

Write-up: Patient active-duty military on deployment at time of vaccination. Patient to return to later this week. Dr. and I remains on deployment and are best reached via e-mail or above phone number. 34 y/o active-duty male received the Jannsen COVID 19 vaccination on 29-Mar-2021. He describes expected symptoms of fatigue and body aches overnight, but reports development of melena the next morning, 30-Mar. On 31-Mar-2021, he developed nausea/vomiting and persistent diarrhea/ melena. He presented for care after an episode of syncope with extreme pallor and hypotension (BP 70s/40s). Hypotension and pallor resolved with 2L NS bolus and patient felt well and was dispositioned to quarters without further workup. On the night of 01-Apr, patient had a recurrent episode of syncope with recurrent hypotension. He was transferred to the ED and found to have a Hgb 5.0 secondary to GI bleeding due x3 peptic ulcers in different stages of healing. He received x4 units PRBCs and started on a proton-pump inhibitor. He continues omeprazole and iron supplementation. Hgb is now stable at 11.6. H. pylori pending. He will follow-up with GI physician. Of note, patient has had a voluntary weight loss of 30 pounds over the past x3 months. He has aggressive supplement use as above and reports exercising twice daily.


VAERS ID: 1206969 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-09
Onset:2021-04-14
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Burning sensation, Hypoaesthesia, Pain in extremity, Paraesthesia, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Patient denies taking any OTC medications at time of vaccination
Current Illness: None
Preexisting Conditions: DM-2, HTN
Allergies: Allergic to Keflex
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt rec''d vaccination to LUE on 4.9.21. Pt denies any trauma to LUE. Pt reports L wrist/hand pain, swelling, numbing, burning, tingling that started 4.13.2021 (Friday at around 1700 hrs). In our ED now, awaiting to be seen by our Hospitalist for possible admission to the hospital.


VAERS ID: 1206985 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-05
Onset:2021-04-10
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Discomfort, Laboratory test, Musculoskeletal stiffness
SMQs:, Anaphylactic reaction (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (broad)

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

Write-up: Systemic: Chest Tightness / Heaviness / Pain-Severe, Systemic: Stiff Neck-Severe, Additional Details: PT went to Emergency Dept 5 days post vaccination for severe Chest Pain and Stiff Neck, tests were ran, but nothing came up. ED dr said the J&J COVID vaccine was the likely culprit. Pt has since recovered, was not admitted to hospital.


VAERS ID: 1207001 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-11
Onset:2021-03-28
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805028 / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Cerebral haemorrhage, Computerised tomogram
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhagic central nervous system vascular conditions (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-29
   Days after onset: 1
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Upon request
Current Illness:
Preexisting Conditions: Diabetes Kidney disease Heart disease
Allergies: None
Diagnostic Lab Data: Ct scan
CDC Split Type:

Write-up: Intracerebral hemorrhage


VAERS ID: 1207040 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Nebraska  
Vaccinated:2021-04-06
Onset:2021-04-11
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 95838 / 1 - / SYR

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

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

Write-up: Leg aches


VAERS ID: 1207068 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-03-31
Onset:2021-04-04
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Ear swelling, Pharyngeal paraesthesia, Rash
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (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: ASA 81mg
Current Illness: Hx of sinus tachycardia, h/o CVA
Preexisting Conditions:
Allergies: PCN
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 4days post injection she developed a full body rash, ears are "swollen", and throat has a funny sensations in it. Breathing normal. Treated on 2 successive days with a predinsone injection, but then was admitted for observation the next day. Treated as an inpatient for 24 hours with Solu-Medrol every 6 hours. Recovered and was released. Patient reported that she had been previously vaccinated against COVID-19 in January, but we have no record of that (all vaccinations in Louisiana are required to be in our State Immunization Registry).


VAERS ID: 1207129 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-03-20
Onset:2021-04-09
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 18050258 / 1 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Bell's palsy, Blood test, Computerised tomogram, Magnetic resonance imaging, Urine analysis
SMQs:, Hearing impairment (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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data: CAT SCAN, MRI, BLOOD WORK, URINE SAMPLE, PHYSICAL ASSESSMENT ALL CONDUCTED ON 4/10/2021 AND 4/11/2021.
CDC Split Type:

Write-up: DEVELOPED BELLS PALSY AND WAS IN ER AND ADMITTED TO HOSPITAL ON 4/10/2021. DIAGNOSIS WAS BELLS PALSY BY A NEUROLOGIST ON STAFF


VAERS ID: 1207171 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-29
Onset:2021-03-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Blood pressure increased, Chest X-ray, Eye haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Hypertension (narrow), Retinal disorders (broad)

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

Write-up: Elevated blood pressure and rupture of eye vessel


VAERS ID: 1207189 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-19
Onset:2021-03-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / SC

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: HIV positive
Allergies: None
Diagnostic Lab Data: Seen in ER on 3/27/21. Need records.
CDC Split Type:

Write-up: Felt ill and fainted the day after the vaccine. Had persistent headaches and went to the ER on 3/27/21. Feeling better now. Reported to me, her PCP on 4/13/21.


VAERS ID: 1207193 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-03-14
Onset:2021-03-29
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Balance disorder, Computerised tomogram normal, Dizziness, Electrocardiogram normal, Otoscopy normal, Vertigo
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: penicillin
Diagnostic Lab Data: CAT scan - Normal 4/9/2021 EKG test - Normal 4/9/2021 Inner ear tests - Normal 4/12/2021
CDC Split Type:

Write-up: Dizzy, vertigo, off balance.


VAERS ID: 1207210 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-01
Onset:2021-04-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain lower, Anxiety, Back pain, Decreased appetite, Diarrhoea, Fatigue, Feeling cold, Gait disturbance, Haemorrhage, Headache, Hot flush, Migraine, Monoplegia, Muscle spasms, Nausea, Neck pain, Pain in extremity, Tinnitus
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hearing impairment (narrow), 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: Propranolol.
Current Illness: None.
Preexisting Conditions: Mitral valve prolapse.
Allergies: Penicillin, Vicodin, bees.
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Lady had vaccine, was told it was Janssen but lot # is Moderna. She got the vaccine, the night of the vaccine around 5:30 she got a raging headache (she does get reactions to most vaccines). She took Tylenol and her arm did hurt. The next day she was still really hurting, her headache was really, really bad, and it stayed until Sunday. Then on Sunday she was ok. On Monday when she went to work and her right arm went limp, and while she was walking her right leg gave way and almost fell, grabbed hold and steadied herself. The raging headache/migraine came back and she started getting nauseous, her lower back hurt, her upper neck area hurt like somebody was pounding her neck. Then she got diarrhea and really really tired on Monday and Tuesday and also had loss of appetite. Then yesterday 4/13/201 she just had the headache and a sound in her ear, went to UC and got drops for it. Her temperature was 96.5, and her normal is 98.7, and was told that she was really cold. Her PB was really high and the doctor took it again but it was not as high, attributed it to anxiety. Last night the lower abdomen pain started, feeling like she was getting her period which she has not had in over a year. She saw a little blood on her panty liner, and was thinking she was going to have a period, but the pain is excruciating in her lower abdomen. She has also taken Tylenol off and on for her symptoms, and feels like she is cramping. She is having hot/cold flashes as well, and has not had these issues from menopause.


VAERS ID: 1207220 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-20
Onset:2021-04-10
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Atrial flutter, Haemoglobin decreased, Heparin-induced thrombocytopenia, Hypotension, Hypoxia, Intensive care, Platelet count decreased, SARS-CoV-2 test negative, Vaccination complication, White blood cell count normal
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Haematopoietic erythropenia (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Supraventricular tachyarrhythmias (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad), Hypokalaemia (broad), Immune-mediated/autoimmune disorders (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 9 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: albuterol inhaler, aspirin, lipitor, biotin, symbicort, vitamin B12, folic acid, lasix, metoprolol, multivitamin, thiamine, spiriva respimat, heparin
Current Illness: unknown
Preexisting Conditions: alcohol dependence, tobacco dependence, diastolic heart failure, rheumatic mitral stenosis, emphysema, chronic hyponatremia, ADD, lymphadenopathy
Allergies: cauliflower - hives
Diagnostic Lab Data: 4/5/2021 COVID PCR negative 4/5/2021 WBC 7.7 HGB 13 PLT 134 4/10/2021 WBC 10.6 HGB 12.7 PLT 68
CDC Split Type:

Write-up: Patient has a long-standing history of cardiac issues (pulmonary hypertension and rheumatic mitral stenosis). He presented for follow-up in CT surgery clinic 4/5/2021. At that time referred to ED for new onset atrial flutter, hypoxia, and hypotension. Admitted to ICU. Platelet counts normal on admission. Patient started on heparin. 4/10/2021 platelet count dropped to low 60K and remained in this range. Differential diagnosis is heparin induced thrombocytopenia versus vaccine adverse event.


VAERS ID: 1207223 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-04-01
Onset:2021-04-06
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Alanine aminotransferase normal, Albumin globulin ratio normal, Anion gap normal, Arthralgia, Aspartate aminotransferase normal, Atrial fibrillation, Basophil count normal, Basophil percentage decreased, Blood albumin normal, Blood alkaline phosphatase increased, Blood bilirubin normal, Blood calcium normal, Blood chloride normal, Blood creatinine normal, Blood glucose normal, Blood magnesium normal, Blood osmolarity normal, Blood potassium normal, Blood sodium normal, Blood urea nitrogen/creatinine ratio, Blood urea normal, Carbon dioxide decreased, Computerised tomogram head normal, Electrocardiogram abnormal, Eosinophil count normal, Eosinophil percentage, Full blood count, Globulins increased, Glomerular filtration rate normal, Granulocyte percentage, Haematocrit normal, Haemoglobin normal, Hemiplegia, Hypoaesthesia, Immature granulocyte count, Lymphocyte count normal, Lymphocyte percentage decreased, Mean cell haemoglobin concentration normal, Mean cell haemoglobin increased, Mean cell volume normal, Mean platelet volume increased, Metabolic function test, Monocyte count increased, Monocyte percentage, Neck pain, Neutrophil count increased, Neutrophil percentage increased, Pain, Platelet count normal, Protein total increased, Red blood cell count normal, Red blood cell nucleated morphology, Red cell distribution width increased, White blood cell count increased
SMQs:, Liver related investigations, signs and symptoms (broad), Haematopoietic leukopenia (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Biliary system related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lopressor 25mg Lipitor 40mg Lisinopril 20mg
Current Illness: No other illnesses
Preexisting Conditions: CAD HLD HTN Prediabetes
Allergies: Lactose
Diagnostic Lab Data: 4/9/21: CT head/brain w/o contrast: results: No acute intracranial abnormality. 4/9/21: EKG: Atrial fibrillation with rapid ventricular response 4/9/21: labs: Magnesium 2.0 CMP: Sodium 138 135 - 145 MMOL/L Final Potassium 4.0 3.5 - 5.3 MMOL/L Final Chloride 101 95 - 107 MMOL/L Final CO2 21 21 - 31 MMOL/L Final Urea Nitrogen 16 6 - 20 MG/DL Final Creatinine 1.05 0.5 - 1.4 MG/DL Final Creatinine results have been standardized to a reference material that is traceable to IDMS method. Glucose, Bld 83 70 - 99 mg/dL Final Non fasting glucose range: 65-140 mg/dl Impaired fasting Glucose: 100-125 mg/dL Total Protein 8.5High 6.0 - 8.3 G/DL Final Albumin 4.1 3.2 - 5.5 G/DL Final Calcium 9.6 8.5 - 10.7 MG/DL Final Total Bilirubin 0.7 <1.3 MG/DL Final Alkaline Phosphatase, Serum 122High 42 - 121 IU/L Final AST 14 10 - 42 IU/L Final ALT 21 10 - 60 IU/L Final Globulin 4.4High 1.7 - 3.9 G/DL Final Albumin/Globulin 0.9 0.7 - 2.3 RATIO Final Anion Gap 16 8 - 18 mmol/L Final Osmolality Calc 286 278 - 305 MOS/KG Final Calculated Osmolality formula has been changed to the Smithline-Gardner Formula: [2(NA)+GLU/18+BUN/2.8]. Please note change in value from the previous calculated results. Bun/Creatinine 15.2 7 - 20 Final Glom Filt Rate, Estimated 74 $g60 ml/min/1.73m2 Final CBC: WBC 16.3High 4.0 - 10.5 K/uL Final RBC 5.54High 4.5 - 5.3 M/uL Final Hemoglobin 18.3High 13.0 - 16.0 g/dL Final Hematocrit 52.9High 37 - 49 % Final MCV 95.5 78 - 98 fL Final MCH 33.0 27 - 34.6 pg Final MCHC 34.6 33 - 37 g/dL Final RDW 15.0High 11.5 - 14.5 % Final Platelet Count 301 130 - 400 K/uL Final MPV 10.6 9.4 - 12.4 fL Final NRBC 0.0 0 - 0.2 % Final Absolute NRBC 0.0 0 - 0.012 K/uL Final Seg 78.7 % Final Lymph 13.3 % Final Monos 5.8 % Final Eos 1.6 % Final Baso 0.4 % Final Immature Granulocyte 0.2 % Final Absolute Neut 12.8High 1.8 - 7.7 K/uL Final Absolute Lymph 2.2 1.0 - 5.0 K/uL Final Absolute Mono 0.9High 0 - 0.8 K/uL Final Absolute Eos 0.3 0 - 0.4 K/uL Final Absolute Basophils 0.1 0 - 0.2 K/uL Final Absolute Immature Granulocyte 0.0 0.00 - 0.02 K/uL Final
CDC Split Type:

Write-up: Pt reported to Urgent Care with paralysis and numbness on his left side. Left-sided neck pain radiating into the top of the shoulder.


VAERS ID: 1207239 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-04-08
Onset:2021-04-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain, Abdominal pain upper, Back pain, Blood pressure increased, Blood test, Chest pain, Computerised tomogram, Decreased appetite, Electrocardiogram, Heart rate increased, Insomnia, Muscle spasms, Myalgia, X-ray
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lamictal, Zoloft, Gabapentin
Current Illness: None
Preexisting Conditions: Bipolar, overweight, asthma as a kid, donated a kidney in 2009 so I only have one kidney, gastric sleeve surgery in 2013.
Allergies: None
Diagnostic Lab Data: They did a CT scan, X-Ray and EKG, along with blood tests. Eventually giving me an enema, which relieved some of the pain and pressure. Still not feeling great, but pain is mostly gone.
CDC Split Type:

Write-up: Beginning two days after getting the vaccine, I completely lost my appetite and developed severe abdominal pain, my blood pressure and heart rate were elevated and my stomach continued to hurt. I also had chest and back pain, muscle aches, insomnia and cramping. Finally went to the Emergency Room on the third night.


VAERS ID: 1207254 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-20
Onset:2021-04-08
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Death, Headache
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-08
   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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Deceased complained of abdominal pain and was taking aspirin for a headache. He died within less than a day of initial complaints.


VAERS ID: 1207269 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-03-06
Onset:2021-03-22
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Angiogram, Headache, Magnetic resonance imaging neck, Neck pain, Vertebral artery thrombosis
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: hypertension; hyperlipidemia, known mild carotid plaque
Allergies:
Diagnostic Lab Data: Cervical MRI and Neck CT angiogram showed thrombus in left vertebral artery and several segments of left vertebral artery with no flow
CDC Split Type:

Write-up: Presented to A Medical Center ER with severe headache, neck pain;


VAERS ID: 1207366 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-03-23
Onset:2021-04-03
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Hypoaesthesia, Ultrasound scan
SMQs:, Peripheral neuropathy (broad), 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: 20 mg atorvastatin baby aspirin vitamin D biotin, Daily vitam
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: ultrasound to confirm no blood clots 4/5
CDC Split Type:

Write-up: numbness in right foot, pain and numbness in right leg below the knee. Immediately had ultrasound of leg to confirm no blood clots. Then saw neurologist and orthopedic doctors. They suspect common neuropothy. Started taking 30 days of 15mg Miloxacin and started PT. MRIs of back and leg to be done 4/15. Nerve function test to be done on May 20. No change after 4-5 days.


VAERS ID: 1207387 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-03-14
Onset:2021-04-02
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Arthralgia, Back pain, CSF protein increased, Cranial nerve disorder, Facial paralysis, Facial paresis, Headache, Immunology test, Magnetic resonance imaging head abnormal, Migraine, Pain, Pain in extremity, Paraesthesia, SARS-CoV-2 antibody test positive, Scan with contrast abnormal
SMQs:, Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Oral contraceptives
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: MRI Brain with and without contrast 4/7/21 - no acute intracranial abnormality MRI Brain with and without contrast 4/8/21 - abnormal bilateral 7th cranial nerve enhancement. COVID PCR - not detected 4/8/21 Lyme Antibodies - negative 4/8/21 COVID - 19 Ab IgG Qual In-house - Positive 4/8/21 Protein, CSF - 124 mg/ dL (high)
CDC Split Type:

Write-up: Severe back pain and shooting pain down both legs beginning on 4/2/21 Severe shoulder pain beginning on 4/2/21 Migraine headache beginning on 4/5/21 uncontrolled by medication Loss of facial muscle use on 4/7/21. Went to emergency room on 4/7/21 Conditions treated: facial nerve palsy likely in the setting of Johnson and Johnson COVID vaccine, elevated CSF protein, headache, unspecified, parenthesis of hand


VAERS ID: 1207403 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Catheterisation cardiac, Chest pain, Headache, Magnetic resonance imaging, Nausea, Pain in extremity, Pulmonary oedema, Pyrexia, Vomiting
SMQs:, Cardiac failure (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNKNOWN
Current Illness: UNKNOWN
Preexisting Conditions: UNKNOWN
Allergies: NONE
Diagnostic Lab Data: TROPONIN LEVEL AND HEART CATH (4/13) MRI (4/14) REST UNKNOWN
CDC Split Type:

Write-up: ON 4/7 PATIENT RECEIVED A JANSSEN COVID VACCINE AT OUR PHARMACY. THURSDAY AND FRIDAY HE HAD NORMAL REACTIONS TO A VACCINE (LOW GRADE FEVER, SORE ARM, HEADACHE). BY SATURDAY HE HAD A HIGHER FEVER AND WAS NAUSEATED. ON MONDAY HE STARTED WITH VOMITING AND SEVERE CHEST PAIN. PT WAS ADMITTED TO HOSPITAL ON TUESDAY WITH HIGH TROPONIN AND FLUID ON THE LUNGS. THEY ARE RUNNIGN MORE TESTS TODAY (WEDNESDAY). MOM CALLED ME TO REPORT.


VAERS ID: 1207440 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-06
Onset:2021-03-12
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood test, Catheterisation cardiac abnormal, Computerised tomogram, Coronary arterial stent insertion, Electrocardiogram, Myocardial infarction, Thrombectomy, Thrombosis, X-ray
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Other ischaemic heart disease (narrow)

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, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vitamin D 400mg Losartan 50mg Chlor Tabs 4mg Pantoproazole 40mg ibuprofen 600mg
Current Illness: None
Preexisting Conditions: None
Allergies: Morphine
Diagnostic Lab Data: X Rays, EKG, Cat Scan, Blood Tests at Hospital then transported to other Hospital via ambulance where they did heart cath and removed blood clot. Stating it was a massive heart attack with lower part of his hear working at 50%
CDC Split Type:

Write-up: Massive heart attack due to blood clot. Heart Cath putting in a stint with over night stay in hospital


VAERS ID: 1207454 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-12
Onset:2021-03-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 RA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Computerised tomogram, Headache, Laboratory test, Muscle spasms, Restlessness
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Akathisia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (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: Eliquis Advair Ventolin Synthroid
Current Illness: NO
Preexisting Conditions: History of blood clotting, Asthma, Thyroids
Allergies: Coumadin, Xaralto, Penicillin
Diagnostic Lab Data: Several tests including two catscans, several blood pallets were performed within 3 weeks of my Covid-19 vaccination.
CDC Split Type:

Write-up: Within 6 hours I started to feel weak, had muscle spasm, left leg cramps, headaches Went to the Emergency Room about 12 days later due to having continue to have severe headaches and my leg would not stop cramping. There was an immediate suspicion that I may have blood clotting even being on Eliquis or bleeding in my brain. A brain cat scan and other tests were performed. I was discharged from the hospital the same day. I am past a monthly the Janssen vaccine now and still have left leg cramps and headaches. My body feels weak and is restless.


VAERS ID: 1207481 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-01
Onset:2021-04-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Paraesthesia, Peripheral coldness
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Uknown
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None done at initial Urgent Care visit. Pt has f/u with Primary Care on 4/16/21
CDC Split Type:

Write-up: Pins and needles sensations to BLE and cold hands and feet


VAERS ID: 1207489 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-03-31
Onset:2021-04-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / -

Administered by: Work       Purchased by: ?
Symptoms: Chest X-ray, Cough decreased, Fatigue, Headache, Impaired work ability, Influenza like illness, Pain, Pneumonia, Pyrexia, SARS-CoV-2 test negative
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Multi vitamin vitamin c vitamin d3 omega 3 zinc magnesium B6 Testosterone
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Chest X-rays. Rapid Covid test at urgent care tested negative referred to hospital for addl pneumonia test addl non rapid Covid test at hospital came back negative but tested positive for pneumonia. Was not sick prior to vaccine and tested daily at work for temperature at work and wore mask at work and when out
CDC Split Type:

Write-up: Initial sore and very tired 03/31 then April 3 developed fever body ache Covid like symptoms fatigue body ache fever headache slight cough flu like symptoms extremely tired requiring sleep. Unable to go to work. Bed rest. April 5 went to urgent care for Covid test- negative chest xray referred to hospital for CT confirmed pneumonia My treatment is two different types of antibiotics. 1. Azithromycin for 5 day and Amoxicillin 3000mg per day for 10 days


VAERS ID: 1207496 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Axillary pain, Gait disturbance, Headache, Hypoaesthesia, Muscular weakness, Oropharyngeal pain, Pain in extremity, Painful respiration, Peripheral swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril 80 mg QD
Current Illness: HTN Atrial Fib
Preexisting Conditions: History of enclosed head injury from MVA years ago. Still sees neuro for " shots to my neck and sometimes to drain fluid"
Allergies: NkDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Husband called this am ( 04/14/2021) to ask questions about pt" side effects of vaccine" Called and spoke to pt. .Pt reports receiving J&J vaccine on 04/12/2021 at 12:30 pm. She began noticing " a severe headache" about 5:30 pm. She relays between 8:00 and 10:00 pm she begin experiencing " leg weakness that made it hard to walk" " I was suddenly walking like a 95 year old woman". This continued and on 04/13/2021 she reports that she noted " the tops of both feet became numb and my left foot was swollen" Relays legs now hurt to front and back of thighs and also at times behind knees. This am ( 04/14/2021) she reports " when I take a deep breath a pain shoots from my throat to underneath my right armpit. Advised pt to go to ED now and notify them of recent vaccine.


VAERS ID: 1207519 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-06
Onset:2021-04-08
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: School       Purchased by: ?
Symptoms: Headache, Tenderness
SMQs:

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: chlorthalidone 25mg daily fluoxetine 10mg daily
Current Illness: Denies
Preexisting Conditions: Hypertension
Allergies: NKA
Diagnostic Lab Data: Planning to go to Urgent Care this afternoon for follow up exam and treatment.
CDC Split Type:

Write-up: Headache described as what felt like the back of her head was bruised, concerns that she hit her head with no recollection of a trauma. Tender to the touch. One dose 400mg ibuprofen. Lasted intermittently for 24-48 hours. Pain score of 6-7/10.


VAERS ID: 1207524 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest X-ray, Computerised tomogram head, Concussion, Electrocardiogram, Head injury, Hypoaesthesia, Laboratory test, Loss of consciousness, Tinnitus
SMQs:, Torsade de pointes/QT prolongation (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hearing impairment (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NA
Current Illness:
Preexisting Conditions: ASTHMA
Allergies: SHELL FISH
Diagnostic Lab Data: LAB, EKG, CT SCAN OF HEAD, CHEST XRAY
CDC Split Type:

Write-up: RINGING EARS, RIGHT SIDE WENT NUMB, PASSED OUT, HIT HEAD HAS CONCUSSION


VAERS ID: 1207597 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Vermont  
Vaccinated:2021-03-19
Onset:2021-03-26
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Blood glucose normal, Disturbance in attention, Dizziness, Electrocardiogram normal, Headache
SMQs:, Anticholinergic syndrome (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: Sulfa drugs
Diagnostic Lab Data: EKG - normal Blood sugar - norma.
CDC Split Type:

Write-up: Dizziness, headache, light-headed, trouble focusing,


VAERS ID: 1207599 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-27
Onset:2021-04-05
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Bell's palsy, Dysphagia, Eyelid function disorder, Facial paralysis, Feeling of body temperature change, Headache, Hypoaesthesia, Hypoaesthesia oral, Magnetic resonance imaging, Muscle tightness, Musculoskeletal pain, Pain in jaw, Skin burning sensation, Slow speech, Tinnitus, Venogram
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dystonia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hearing impairment (narrow), Periorbital and eyelid disorders (narrow), Osteonecrosis (broad), Ocular motility disorders (narrow), 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: Qunol Extra strength; Turmeric 1000mg once daily; Lisinopril 20mg once daily; Qunol Mega CoQ10 100mg once daily
Current Illness: No illnesses leading up to time of vaccine one month prior
Preexisting Conditions: High blood pressure
Allergies: No allergies
Diagnostic Lab Data: MRI MRV
CDC Split Type:

Write-up: Pain started in buttocks; then numbness in legs, then progressed up back to mid back pain, then to neck fullness and tightness, pain on both sides of neck, jaw and chin, feeling of something popping in neck and then Bell''s Palsy of right side of face, difficulty speaking, eating, numbness of tongue; right eyelid unable to close, more pain on both sides of neck and back of head; cold and hot sensations on limbs today and no improvement of facial paralysis; hearing cricket noises in right ear at times, burning pain in patches of face.


VAERS ID: 1207602 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-10
Onset:2021-04-14
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

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

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

Write-up: Patient received vaccine. Pt felt dizzy and almost lost consciousness within 15-20 minutes. Heart rate was low. Patient appeared clammy and was conscious and alert. We believe blood sugar may have been low. EMS transported patient to ER to be checked out. Call to the patient on Sunday, was not answered.


VAERS ID: 1207608 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-10
Onset:2021-04-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / UN

Administered by: Pharmacy       Purchased by: ?
Symptoms: Discomfort, Groin pain, Nucleic acid test, Screaming, Swelling, Testicular pain
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Osteonecrosis (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Lorabid
Diagnostic Lab Data: GC and Chlamydia by Nucleic Acid amplification. US Pelvis Scrotum/Doppler
CDC Split Type:

Write-up: Prior to receiving vaccine patient was normal healthy 24 year-old male, with no underlying health conditions. Pain and Swelling in Groin area/Testicular Pain (on 4/12/2021). Started as discomfort at 9:00 a.m. and gradually worsened during the day. By midnight pain was sever, no position would give relief. Pain intensified to causing loud painful screams. Took 600 mg of Ibuprofen waited 20 minutes with no relief. Taken to local hospital ER, Emergency Department, Upon release from ER- recommended to see Urology Specialist. As of 4/14/2021 patient is still taking Ibuprofen for discomfort. Pain has lessened and is not as intense but is still present.


VAERS ID: 1207613 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Confusional state, Eye movement disorder, Fall, Foaming at mouth, Head injury, Seizure
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Ocular motility disorders (narrow), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

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

Write-up: Was sitting in chair, fell over. Hit head on cement floor. Seized for 35 seconds. Eyes rolled in to back of head and foaming at the mouth. Awakened suddenly to confusion. Escorted off floor to wheelchair. Reoriented.


VAERS ID: 1207621 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-09
Onset:2021-04-14
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / 1 UN / IM

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

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

Write-up: J&J COVID vaccine on Friday 4/9/21 Fatigue, headache, shortness of breath, chest tightness and a racing HR Symptom onset of these symptoms was yesterday Winded with any exertion Patient denies trouble breathing when she is laying down and resting Reports headaches but not bad Muscle aches Reports tightness in her chest- a dull tightness in her chest Reports some racing heart rate while she is out of bed Advised patient to be seen in the ER today for evaluation of her symptoms


VAERS ID: 1207624 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-07
Onset:2021-04-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

Administered by: Military       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Bed rest, Burning sensation, Chest X-ray, Chills, Disorientation, Dizziness, Fatigue, Feeling abnormal, Feeling cold, Hot flush, Hyperhidrosis, Immediate post-injection reaction, Influenza like illness, Injection site pain, Lacrimation increased, Pyrexia, SARS-CoV-2 test negative
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Vestibular disorders (broad), Lacrimal disorders (narrow), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (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: Flu vaccine back in the 90''s, headaches and aches and pains, flu like symptoms.
Other Medications: Synjardy, Glipizide, baby aspirin, Carvedilol, Trulicity.
Current Illness: None.
Preexisting Conditions: High blood pressure, diabetes.
Allergies: Penicillin, metformin. Bee stings.
Diagnostic Lab Data: Lab work in the ER. He had a chest x-ray and was told that it was negative.
CDC Split Type:

Write-up: Lost his vaccine card would not give him a new one. He got his vaccine, had burning sensation immediately after the needle was pulled out. About 5-10 minutes later he started sweating, and seemed to have calmed down and felt OK. He was observed for 30 minutes there and went for observation for another 30 minutes. He went to another doctors office and at about 15:00 started feeling light headed and weak. He drove back home, picked up some stuff at a grocery store, and outside the grocery store in 80 degree heat he felt the need to put on a jacket as he had the chills. he went home, went to bed feeling bad, his shoulder was still burning where he got hte vaccin.e He had a little bit of site pain, applied topical and the pain went away. He woke up the next morning feeling really bad, felt like a major flu, his head felt like it was going to explode, but no problem with sinuses, no cough, no sneezing. His eyes were watering from the pain, and chills on and off. He had to change his sheets a couple of times due to sweating. He then developed a fever of 99 degrees at about 18:00 that night, and about 19:00 he went to 102 when he checked it. After that it went to 103, and about 15 minutes after that it was 104, and then higher at 104.+. He took some vodka, honey and lemon juice and took an alcohol bath and the fever had not broken yet. He called the clinic and they told him to call 9-1- 1 and to go to the ER. He went to the ER at about 10:00, gave him fluids, did a chest x-ray and released him about midnight. He apparently disoriented and tried to walk off and didn''t remember this. They took him back to the gate and called his son. He went home, took another bath and woke up in sweat and was in bed for the entire weekend. He got up Monday morning, 4/13/21 feeling a little bit better and went to see his doctor, who does not believe he was having any side effects and that the information that is being reported is true. He is still feeling a little weak and still fatigued and on bedrest. He was taking Advil besides his regular medicines every 6 hours with 500 mg of Tylenol for the intense pain as every joint in his body ached, and the worst headache he had ever had, as well as the high fevers. His fever subsided on Saturday morning, and still had some sweats following that. Did have hot/cold flashes on Saturday and Sunday. He was given a COVID test in the ER and he was negative, but did not give him any other information regarding his lab work.


VAERS ID: 1207627 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-03-05
Onset:2021-03-11
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Cerebrovascular accident, Myocardial infarction, Pneumonia
SMQs:, Myocardial infarction (narrow), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (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, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Throat cancer.
Allergies: Morphine, Mucinex
Diagnostic Lab Data: Currently in the hospital.
CDC Split Type:

Write-up: Heart Attack, stroke, and pneumonia.


VAERS ID: 1207655 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-03-13
Onset:2021-03-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chest X-ray normal, Colonoscopy, Computerised tomogram abnormal, Dyspnoea, Fatigue, Injection site pain, Joint range of motion decreased, Limb discomfort, Loss of personal independence in daily activities, Muscular weakness, Pain, Pain in extremity, Pallor, Palpitations, Red blood cell count decreased, Thrombosis, Transfusion, Ultrasound scan abnormal, X-ray gastrointestinal tract normal
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Haematopoietic erythropenia (narrow), Peripheral neuropathy (broad), Haemorrhage laboratory terms (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad), Tendinopathies and ligament disorders (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, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lotenain 20 mg Toprol 25 mg Vitamin D 1000
Current Illness: None
Preexisting Conditions: Hyper tension managed with the above Rx
Allergies: Scallops Codeine
Diagnostic Lab Data: 4/5/2021 -4/10/2021 Daily Blood Test - showed low red blood cell count 4/5-4/6/2021 - Blood Transfusion & Iron 4/7/2021 - Upper GI - to rule out bleeding - test was remarkable and showed no bleeding 4/7/2021 Colonoscopy - rule out bleeding - test was remarkable and showed not bleeding 4/7/2021 Abnormal CAT Scan - rule out bleeding - test was negative in any abnormalities 4/8/2021 Chest X-Ray - normal 4/9/2021 - Concerns of blood clot in my arm 4/10/2021 - Ultrasound on arm indicated a blood clot 4/10/2021 - discharged
CDC Split Type:

Write-up: Day 1 & 2 after shot - left arm hurt around injection site. Day 2 I felt very tired and some body aches. By Day 5 or 6 - full body aches and my arms felt like there was pressure on them. I was feeling very tired. As more days passed; I was feeling tired, could not raise my arms, legs were weak and hurting. If I did anything (shower or carry a simple laundry basket) my arms would hurt so bad, I was out of breath and my heart was pounding so hard. By the week of March 29th - I was laying down in the middle of the day, no energy at all. Called the doctor and because of the shortness of breath & Body aches, they would only schedule a video visit for Monday, April 5th. After talking to me, they schedule to see me that day at 11:45 AM. I had weak muscle response in my arms, pale, and out of breath. They did blood work. Two hours after getting home; they called and said I needed to get to the emergency room. My red blood cell count was dangerously low, and they ordered a blood transfusion. I sent 6 days in the hospital.


VAERS ID: 1207681 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-22
Onset:2021-04-09
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood creatine, Blood electrolytes, Blood urea, Chills, Differential white blood cell count, Full blood count, Headache, Peripheral swelling, Prothrombin time, Ultrasound abdomen
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Oxybutynin, Welbutrin, Requip, Levothyroxine, Trazadone
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: Augmentin
Diagnostic Lab Data: Ultrasound on left leg, Labs: BUN, CBC, Creatinine, Prothrombin Time, Electrolytes, White blood cell differential.
CDC Split Type:

Write-up: 3/22/21- Raging headache, extreme chills. 4/9/21- Left foot swelled up like a grapefruit, was worried about blood clot when I saw them on 4/10/21.


VAERS ID: 1207698 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Dizziness, Dyspnoea, Electrocardiogram, Fatigue, Metabolic function test, Myalgia, Nausea, Troponin I, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (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)

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: Hydroclrothiazide, Lisiniprol, Doxazosin
Current Illness: None
Preexisting Conditions: Sleep Apnea
Allergies: None
Diagnostic Lab Data: BASIC METABOLIC PANEL TROPONIN I EKG-ELECTROCARDIOGRAM
CDC Split Type:

Write-up: Feeling tired, muscle aches, nausea, vomiting, difficulty breathing, dizziness, weakness, heartburn Medications given: NaCl 0.9 %, ondansetron (ZOFRAN) Rx for ZOFRAN ODT


VAERS ID: 1207701 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-03-12
Onset:2021-03-17
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Aimovig shot 1 time per month for migraines
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: No tests done. Just prescribed medication
CDC Split Type:

Write-up: After J&J vaccination developed rash over entire body on 3/17/2021 and visited an emergency room and was prescribed medication for the rash.


VAERS ID: 1207725 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-13
Onset:2021-03-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Blood pressure increased, Dizziness, Dyskinesia, Dyspnoea, Headache, Hypoaesthesia oral, Pain in extremity, Paraesthesia oral, Tachycardia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dyskinesia (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Hypertension (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (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: Eucrisa 2 % 1 application to affected area Externally twice a day Vitamin B-12 1000 MCG 15 ml Orally once a day Dicyclomine HCl 10 mg 1 capsule Orally once a day Vitamin D3 250 MCG (5000 UT) 1 capsule Orally once a day MiraLax 17gms 1 packe
Current Illness:
Preexisting Conditions: Heart, Manears, Fibromyalgia, Back and Asthma
Allergies: PCN, Any cillins, ASP, ASP compounds, Decadron, Pristiq
Diagnostic Lab Data: 3/13/2021Hospital and 4/11/2021 Medical Center
CDC Split Type:

Write-up: 3/13/2021 Taken to ER via ambulance due to tingling then numbness of the tongue, rapid heart rate, extremely elevated heart rate. Since then on going constant left leg pain, rapid heart, spike in blood pressure, headaches, dizziness, shortness of breath and intermittent uncontrolled muscle movement in hands and face.


VAERS ID: 1207726 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-09
Onset:2021-04-13
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: School       Purchased by: ?
Symptoms: Anxiety, Blindness, Blood test, Chills, Computerised tomogram head, Eye pain, Fatigue, Gait disturbance, Head discomfort, Headache, Migraine, Myalgia, Nausea, Vision blurred
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (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: Mesalamine (discontinued), humira (discontinued)
Current Illness: COVID in late October
Preexisting Conditions: Ulcerative colitis
Allergies: Amoxicillin, remicade
Diagnostic Lab Data: CT scan (april 14), blood test (april 14)
CDC Split Type:

Write-up: Had typical post vaccine symptoms right after - nausea, muscle aches, chills, fatigue. 5 days after vaccine those appeared to have dissipated. Went for a light walk in the morning. Completely lost vision in both eyes extremely blurry. Stumbled my way home running into trees, cars. Vision came back, thought it was migraine (had them before but nowhere NEAR as bad, never had vision completely blocked) Excurtating headache behind eyes and nausea, feels like pressure in head. Worst headache of my life, went to ER. Gave morphine (did not help pain at all which was horrifying) got a head CT scan which came out clear and discharged because clotting ruled out. It is now day 6 and my headache is persistent and still excruciatingly painful. I?m also extremely nauseous. I?m terrified because I know something is very wrong. ER doc said might be lingering side effect from vaccine but those effects felt very different.


VAERS ID: 1207727 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-15
Onset:2021-04-12
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Facial pain, Headache, Nausea, Neck pain, Pain
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (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: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type: 02037655

Write-up: Severe headache on right side of the head, pain irradiates to neck and right side of the face, nauseous


VAERS ID: 1207733 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-03-31
Onset:2021-03-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: 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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNKNOWN
Current Illness: UNKNOWN
Preexisting Conditions: UNKNOWN
Allergies: UNKNOWN
Diagnostic Lab Data:
CDC Split Type:

Write-up: PATIENT DEVELOPED RIGHT POPLITEAL DVT IN LEG AFTER JANSSEN/JOHNSON AND JOHNSON VACCINATION. PRESENTED TO MEDICAL GROUP 2 WEEKS AFTER VACCINATION WITH A 2 WEEK HISTORY OF LEG PAIN AND WAS DIAGNOSED AT THAT TIME. HE RECEIVED JOHNSON AND JOHNSON VACCINE AT MEDICAL CENTER.


VAERS ID: 1207734 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-03-26
Onset:2021-03-27
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Blood test, Body temperature increased, Chest X-ray, Chest pain, Computerised tomogram abnormal, Confusional state, Conversion disorder, Dysarthria, Electrocardiogram, Full blood count, Headache, Magnetic resonance imaging, Metabolic function test, Mobility decreased, Psychotic disorder, Urine analysis, Weight decreased
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Psychosis and psychotic disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hostility/aggression (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Ibuprofen, Tylenol occasional use only
Current Illness: None
Preexisting Conditions: Asthma, hypoglycemia
Allergies: Bee Stings
Diagnostic Lab Data: Bloodwork including CMP, CBC. UA (4/2/21), Chest Xray, MRI (4/10/21), CT with Contrast 4/13/21). No acute findings per patient report. 12-lead ECG revealed abnormalities.
CDC Split Type:

Write-up: Patient experienced an elevated temperature up to 104 degrees F 24hrs post vaccination along with some reported confusion. Over the next 48 hrs temperature fluctuated between 102-103 degrees. She reports confusion and difficulty with movement to lower extremities. Per her report she "felt like she had a stroke". Presented to the ER on 4/3/21 due to chest pain, no physical findings diagnosed with the exception of potential psychosis per patient report. Over the next week, patient reports experiencing seizure-like activity and pronounced difficulty with speech (stutter). Again went to ER an 4/10/21. Diagnosed with conversion disorder. on 4/13/21, seizure like activity persisted along with speech disturbances. ER referred to outpatient neurology. Additional symptoms experienced include headache and weight loss since 3/26/2021


VAERS ID: 1207761 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-03-04
Onset:2021-03-21
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: xanax, wellbutrin, vyvanse, YAZ
Current Illness:
Preexisting Conditions:
Allergies: EKG adhesive
Diagnostic Lab Data:
CDC Split Type:

Write-up: Multiple episodes of recurrent syncope on Saturday with fall. 4-6 episodes of LOC lasting minutes at a time, 2-3 minutes between episodes. Each episode of LOC followed by several seconds of confusion, then immediately back to baseline. One episode associated with urinary incontinence


VAERS ID: 1207776 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood pressure increased, Electrocardiogram, Inner ear inflammation, Magnetic resonance imaging, Nausea, Sinus tachycardia, Tachycardia, Vaccination complication, Vertigo, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Vestibular disorders (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D2, Ibuprofen, Prednisone, Progesterone
Current Illness: None reported
Preexisting Conditions: Arthritis, Vitamin D deficiency, metabolic syndrome
Allergies: Aspirin
Diagnostic Lab Data: MRI in ED four days after vaccination: no acute intracranial abnormality; ECG: sinus tachycardia.
CDC Split Type:

Write-up: Janssen COVID-19 Vaccine EUA: patient presents to emergency department (ED) reporting vertigo for four days starting soon after vaccination. At the time of vaccination patient administered multiple doses of epinephrine for suspected allergic reaction to vaccination and transported to ED for persistent nausea, vomiting, and tachycardia. Those symptoms resolved and patient was discharged to home stable. Since that event patient has experienced persistent vertigo. Vital signs within normal ranges except blood pressure 143/106 mmHg. Exam documents no focal neurologic defects. Diagnosed with vestibular inflammation, prescribed prednisone, and discharged to home stable.


VAERS ID: 1207778 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Dyspnoea, Influenza like illness, Pain in extremity, Syncope, Ultrasound scan normal
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), 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: UNKNOWN
Current Illness: UNKNOWN
Preexisting Conditions: UNKNOWN
Allergies: UNKNOWN
Diagnostic Lab Data:
CDC Split Type:

Write-up: PATIENT RECEIVED JANSSEN VACCINE ON 4/9/21. 10 HOURS POST-DOSE PATIENT REPORTS FLU LIKE SYMPTOMS AND 4 EPISODES OF SYNCOPE. SHE THEN REPORTS PAIN IN LEGS AND ABDOMEN. ULTRASOUND OF LEGS WERE NEGATIVE FOR BLOOD CLOTS. TODAY 4/14/21 SHORTNESS OF BREATH HAS NOT IMPROVED AND PAIN IN LEGS IN ABDOMEN HAS NOT IMPROVED. PATIENT IS GOING TO ER FOR EVALUATION.


VAERS ID: 1207818 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-03-06
Onset:2021-04-09
   Days after vaccination:34
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Chest pain, Dyspnoea, Fibrin D dimer normal, Flank pain, Nausea, Pulmonary embolism, Pyrexia, Ultrasound Doppler normal
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Hydrochlorothiazide, Valsartan, Atorvastatin, and Aspirin
Current Illness: None
Preexisting Conditions: Hypertension, Hyperlipidemia, and CVA
Allergies: Pencillins
Diagnostic Lab Data: 4/9/21 Chest CTA- positive for bilateral PE 4/9/21 Venous doppler study- neg for DVT 4/9/21 D-dimer 35.2
CDC Split Type:

Write-up: Flank chest pain (pain under right rib cage) and Dyspnea on exertion; woke pt up at 0300 on 4/9/21 Chest pain with deep breathing., fever, and nausea upon presentation to ED Pt denied recent travel or prolonged immobilization Patient diagnosed with bilateral pulmonary embolism per CTA


VAERS ID: 1207819 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Appendicectomy, Appendicitis perforated, Blood culture, Blood test, Chills, Computerised tomogram, Headache, Nausea, Pyrexia, Surgery
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal perforation (narrow), 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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amlodipine fenofibrate montelukast diclofenac fish oil
Current Illness: None
Preexisting Conditions: high blood pressure
Allergies: None
Diagnostic Lab Data: Blood work 4/13/21 Blood work 4/14/21 CT Scan 4/14/21 Blood culture 4/14/21
CDC Split Type:

Write-up: Symptoms of abdominal pain, nausea, fever, headache, chills began evening of vaccine and proceeded to worsen over the next five days. On April 13 I saw my doctor who ordered blood work. The pain continued to worsen and on April 14 I was admitted to the hospital with a ruptured appendix and had surgery to remove it


VAERS ID: 1207868 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-03-17
Onset:2021-03-29
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Diarrhoea, Dizziness, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: MS
Allergies: None
Diagnostic Lab Data: Hospitalized
CDC Split Type:

Write-up: Diarrhea Vomiting Dizziness Weakness


VAERS ID: 1207880 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-03-15
Onset:2021-03-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthritis, Decreased appetite, Diarrhoea, Fatigue, Feeling of body temperature change, Headache, Impaired work ability, Insomnia, Laboratory test, Neck pain, Pain, Pain in extremity, Paranasal sinus discomfort, Pharyngeal swelling, Pyrexia, Stool analysis, Tremor, Trigger finger, Urine analysis
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Arthritis (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (narrow), 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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Twice had flu shot and twice got the very bad flu. Second flu shot got a sore arm. The flu shots were years in between.
Other Medications: Took Tylenol 2 hours before vaccine - nurse told me I could do this. Bluebonnet Vit D3 drops (2000 IU) - about 4 drops daily. Bluebonnet Vit B12 and Folic Acid drops (1ml) daily. Digest Gold Enzymes - 1 Pill at meals (usually at dinner) - d
Current Illness: Digestive issues - constipation. Pain in my abdomen at various times due to intestinal issues. Sometimes acid reflux at night.
Preexisting Conditions: IBS, Chronic constipation, diary allergy, lactose intolerant, kidney stones, UTIs, cramping in feet, sinus infections in my early years, heart condition called SVT.
Allergies: Dairy allergy and lactose intolerant (severe). Also have sensitivity to eggs sometimes, especially the yolk. I can handle egg whites. Mustard I was told I have a sensitivity. Allergic (throat closing issue) with problano peppers (did not not know till I bite into one - had to go to urgent care and get benedryl) Sensitive to spices. Glutten issues - could be sensitive, not sure if I am allergic. Medicines - when I was 5 yrs old had penicillin - hives Sulfur meds - hives Advil - later in life - breathing issues Capsaicin - allergic Tylenol with codine - hallucinations Most pain meds - stomach issues, naseau, severe headaches, severe dizzyness Any over the counter meds with lactic acid Tetracycline - depression
Diagnostic Lab Data: Blood, urine, stool at Patient First weeks later. I don''t recall anything else.
CDC Split Type:

Write-up: Right after shot, did not feel anything that morning till around 5pm I started to feel feverish, headache, tired. My arm never got sore or swollen. AFter 5pm till, the feverish feeling and hot cold got worse as time went by and I started shaking uncontrollably - pretty severe. I took Tylenol early hoping to stop the achy feverish and shaking but did not seem to help. THis went to till about 1am or 2am when I could finally lay down and try to sleep. The shaking had stopped. I did take more Tylenol and drank some herbal chamole type of hot tea. I could not sleep that night. Next day I was exhausted, body aches and still had some feverish feeling. By the way, took my temperature and it was normal. Then on Wednesday, I believe is when I had a huge episode of diarrhea (came on sudden). I kept calling and talking virtually to the doctor telling him all of what was going on. The next day I the feverish feeling and body aches and being tired kept happening - adding headache getting worse. I kept taking Tylenol. Seem to help some but did not take the pain away. EAch night , I could not sleep due to the headache. I started to feel better but then on the weekend, I had that headache and tired feeling. The headache was getting stronger and it circled my whole head and both shoulder and around my neck. It scared me because I felt at times that my throat was getting smaller. I could still swallow but it was so strange. I kept putting heat packs and ice packs and taking Tyelnol. I know that on Thursday or Friday the week, the doctor told me if I wanted to to go get tested for Covid and I did. I was tested negative on both the quick test and the other test that takes longer. I had that headache, sinus tension pressure for quite a few more days. Overall it took 7 days. I had to take off most of the week from my telework job because I could not function. I also did not eat much and drank lots of water during this time. It seem to go away and then about a week later, I got this painful diarrhea out of the blue and went to see an urgent care doctor. They tested me for blood, urine, and stool and they were negative. I was also having pain on my left side. Then it seem to go away after I was on the BRAT diet for a few more days. Then the diarrhea happened again the next week or so. This week, as of yesterday, I got a very strange throbbing pain in my left hand and not sure where that came from. It can be extreme at times. I tool Tyleonol but the pain is still there. Also, during this time and before the shot, I got a trigger finger issue on my right index finger. I don''t think that has anything to do with the vaccine. Please note I have been told my doctors and I know this for a fact, my body is super sensitive to food, meds. I don''t usually get the flu shot because of that. Today I am experiencing the left hand pain and now metal tasting in my mouth. I am about 5 weeks out from the vaccine. I wish I had never taken it. I pray nothing more will happen in my body If I have left anything off it is because I did not write this down when was happening. I really thought I was going to die one night because of the pressure I was having in my head, neck and shoulders. I have a little bit of a headache now and told my PT doctor that if I needed to know, I could get a brain or some kind of scan to see if I am hainvg any issues. I am going to bring this up to my virtual call today.


VAERS ID: 1207898 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-07
Onset:2021-04-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / N/A LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Activated partial thromboplastin time shortened, Alanine aminotransferase normal, Albumin globulin ratio decreased, Angiogram cerebral abnormal, Anion gap decreased, Arteriogram carotid abnormal, Aspartate aminotransferase normal, Back pain, Basophil count normal, Basophil percentage, Blood albumin decreased, Blood alkaline phosphatase normal, Blood bilirubin normal, Blood calcium decreased, Blood chloride increased, Blood creatinine normal, Blood glucose normal, Blood osmolarity decreased, Blood potassium normal, Blood sodium normal, Blood urea decreased, Blood urea nitrogen/creatinine ratio, Carbon dioxide normal, Central nervous system lesion, Chest pain, Differential white blood cell count, Dizziness postural, Eosinophil count normal, Eosinophil percentage, Facial asymmetry, Facial paralysis, Feeling abnormal, Globulins increased, Glomerular filtration rate normal, Granulocyte percentage, Haematocrit normal, Haemoglobin normal, Head discomfort, Hypopnoea, Immature granulocyte count, International normalised ratio normal, Lymphocyte count normal, Lymphocyte percentage, Mean cell haemoglobin concentration normal, Mean cell haemoglobin normal, Mean cell volume normal, Mean platelet volume increased, Meningioma, Monocyte count normal, Monocyte percentage, Musculoskeletal chest pain, Musculoskeletal discomfort, Neutrophil count normal, Neutrophil percentage, Nucleated red cells, Ocular discomfort, Pain in extremity, Painful respiration, Paraesthesia, Platelet count normal, Protein total normal, Prothrombin time prolonged, Red blood cell count normal, Red cell distribution width normal, Sensory loss, Sinus disorder, Soft tissue inflammation, Thrombophlebitis superficial, Varicose vein, Visual impairment, White blood cell count normal
SMQs:, Rhabdomyolysis/myopathy (broad), Liver-related coagulation and bleeding disturbances (narrow), Peripheral neuropathy (narrow), Haemorrhage laboratory terms (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hyponatraemia/SIADH (broad), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hearing impairment (broad), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Tubulointerstitial diseases (broad), Respiratory failure (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: vitamin D 4000 IU daily over the counter, Zyrtec 10 mg daily as needed over the counter, Cryselle 28 norgestrel-ethinyl estradiol 0.3-30 mg-mcg per tablet once daily, lisinopril 40 mg daily.
Current Illness: None known.
Preexisting Conditions: Essential hypertension, chronic neck and back pain, chronic venous insufficiency, BMI 30.50, vitamin D deficiency, pure hypercholesterolemia,
Allergies: Lidocaine oral spray - anaphylaxis. Orange fruit/orange flavoring - hives swelling, rash. Prednisone - anaphylaxis. Hydrocodone-acetaminophen - rash. Metoprolol - rash. Sulfa antibiotics - rash. Mucinex Swelling lower extremities and throat.
Diagnostic Lab Data: CT ANGIOGRAM HEAD AND NECK IMPRESSION: 1.Negative for dural venous sinus thrombosis. Bilateral filling defects seen in the transverse sinuses are most likely arachnoid granulations. 2.Negative for DVT in the internal jugular or subclavian veins in the neck. 3.Filling defect seen within a tortuous superficial vein adjacent to the right sternoclavicular joint, consistent with a superficial venous thrombosis. The exact origin of the vein is uncertain but it appears to drain into the right subclavian vein via some engorged collaterals. Surrounding mild soft tissue inflammation and venous varices are noted. This corresponds to the site of patient''s symptoms and palpable abnormality. The right subclavian vein itself is free of clot at this time. 4.Approximately 2.2 cm diameter likely extra-axial hyperdense lesion in the anterior cranial fossa extending to the right of midline, without any adjacent vessels in the area to suspect aneurysm. This most likely reflects a planum sphenoidale meningioma. Recommend follow-up evaluation with nonemergent contrast enhanced MRI. I discussed these results with Dr. Dunaway via telephone at 4/13/2021 17:46, immediately at the time of interpretation. Report signed on 4/13/2021 5:47 PM Report created with Powerscribe360 Component WBC Value: 7.31 Flag: Ref Range: 3.87 - 9.10 Units: 10*3/uL Status: Final RBC Value: 4.69 Flag: Ref Range: 3.92 - 4.97 Units: 10*6/uL Status: Final HGB Value: 13.9 Flag: Ref Range: 12.1 - 14.8 Units: g/dL Status: Final HCT Value: 42.5 Flag: Ref Range: 37.1 - 45.1 Units: % Status: Final MCV Value: 90.6 Flag: Ref Range: 82.0 - 99.0 Units: fL Status: Final MCH Value: 29.6 Flag: Ref Range: 28.5 - 32.1 Units: pg Status: Final MCHC Value: 32.7 Flag: Ref Range: 31.4 - 34.5 Units: g/dL Status: Final Platelets Value: 288 Flag: Ref Range: 150 - 400 Units: 10*3/uL Status: Final RDW-CV Value: 13.1 Flag: Ref Range: 11.4 - 14.0 Units: % Status: Final NRBC Absolute Value: 0.00 Flag: Ref Range: 0 Units: 10*3/uL Status: Final MPV Value: 10.5 Flag: Ref Range: 8.8 - 12.2 Units: fL Status: Final Differential Type Flag: Status: Final AUTOMATED DIFFERENTIAL Neutrophil % Value: 60.2 Flag: Units: % Status: Final Neutrophils Absolute Value: 4.40 Flag: Ref Range: 1.57 - 6.01 Units: 10*3/uL Status: Final Lymphocytes % Value: 32.7 Flag: Units: % Status: Final Lymphocytes Absolute Value: 2.39 Flag: Ref Range: 0.92 - 2.93 Units: 10*3/uL Status: Final Monocyte % Value: 5.2 Flag: Units: % Status: Final Monos Absolute Value: 0.38 Flag: Ref Range: 0.26 - 0.87 Units: 10*3/uL Status: Final Eosinophils Relative % Value: 1.1 Flag: Units: % Status: Final Eosinophils Absolute Count Value: 0.08 Flag: Ref Range: 0.0 - 0.35 Units: 10*3/uL Status: Final Basophils % Value: 0.5 Flag: Units: % Status: Final Basophils Absolute Value: 0.04 Flag: Ref Range: 0.01 - 0.09 Units: 10*3/uL Status: Final Immature Granulocytes% Value: 0.3 Flag: Units: % Status: Final Immature Granulocytes Absolute Value: 0.02 Flag: Ref Range: 0.00 - 0.05 Units: 10*3/uL Status: Final Component Value Flag Ref Range Units Status Sodium 138 135 - 145 mmol/L Final Potassium 3.9 3.5 - 5.1 mmol/L Final Chloride 107 98 - 107 mmol/L Final CO2 29 21 - 32 mmol/L Final Glucose 97 65 - 100 mg/dL Final BUN 9 5 - 20 mg/dL Final Creatinine 0.69 0.55 - 1.02 mg/dL Final Calcium 8.5 8.3 - 10.3 mg/dL Final Total Protein 7.1 6.4 - 8.3 g/dL Final Albumin 3.2 Low 3.4 - 5.0 g/dL Final Bilirubin Total 0.4 0.2 - 1.0 mg/dL Final Alkaline Phosphatase 85 45 - 117 U/L Final AST 14 Low 15 - 37 U/L Final ALT 18 13 - 56 U/L Final Anion Gap 2 Low 6 - 14 mmol/L Final BUN/Creatinine Ratio 13.0 Final Osmolality Calculated 274 mosm/kg Final Globulin 3.9 g/dL Final A/G Ratio 0.8 Low 1.2 - 2.4 Final Creatinine Based eGFR $g90 $g60 mL/min/[1.73_m2] Final Status: Final result (Collected: 4/13/2021 13:55) Provider Status: Ordered Component Value Flag Ref Range Units Status PTT 25.4 22.6 - 34.1 s Final Comment: Therapeutic range for Heparin Monitoring based on serum concentrations of 0.3-0.7 units/mL. Therapeutic APTT range: 67-101 seconds Status: Final result (Collected: 4/13/2021 13:55) Provider Status: Ordered Component Value Flag Ref Range Units Status Protime 12.6 11.5 - 14.4 s Final INR 1.0 Final Comment: ---- THERAPEUTIC RANGE: Patients on standard dose for treatment of prophlaxis of thrombosis or embolism: Target INR Range: 2.0-3.0 High risk patients with mechanical heart valves: Target INR Range: 2.5-3.5
CDC Split Type:

Write-up: Left arm and left neck/face tingling, decreased sensation with subsequent Bell''s palsy like facial asymmetry on the left side, brain fog, dizziness with position changes, pressure in head when bending over behind the left eye, aching pain in left arm, fullness in the anterior lower right neck, episode of visual stars, food and drink dripping/falling out of left side of mouth, Pain in left rib cage/chest into the left back causing her to breath shallower. ER evaluation confirmed CT finding of right superficial vein thrombosis just above the sternoclavicular joint - see imaging report info.


VAERS ID: 1207907 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-04-06
Onset:2021-04-11
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Contusion, Differential white blood cell count normal, Full blood count, Gait disturbance, Headache, Impaired work ability, Malaise, Pain in extremity, Weight bearing difficulty
SMQs:, Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Accidents and injuries (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: Geodon 20mg , Geodon 60mg, hydroxyzine pamoate 50mg, Zyrtec 10mg
Current Illness: None
Preexisting Conditions: None
Allergies: No know allergies
Diagnostic Lab Data: Dr ordered CBC w/diff stat and send patient to medical center, to ER. Pt was sent via state care
CDC Split Type:

Write-up: Patient in clinic for sick call. Pt having random bruising and pain in his LE patient does have limp favoring his rt leg. Pt reports having random bruising ever since he received the Johnson and Johnson vaccine. states that he has been having headaches and pain in his feet. Pt reports head aches started about 3 days ago. Pt does report history of family members having clotting issues. Tem 97.8, B/P 105/75, P88, resp 16


VAERS ID: 1207910 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-25
Onset:2021-03-30
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / UN

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram, Dizziness, Migraine, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Meclizine 25ML; Zofran 4ML (this is the prescription my provider has prescribed for my illness due to the vaccine reaction). Vaccine Reaction Illness is (Vomit, dizziness and Migraine Headache).
Current Illness: None
Preexisting Conditions: High Blood Pressure and Diabetes
Allergies: None
Diagnostic Lab Data: yes, CAT scan was perform on 04/05/2021
CDC Split Type:

Write-up: My illness is constantly vomiting, dizziness, and migraine headache.


VAERS ID: 1207935 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-17
Onset:2021-04-09
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: HTN
Allergies: Doxycycline, Sulfa drugs
Diagnostic Lab Data: SARS-COV-2
CDC Split Type:

Write-up: Dignosed with COVID on 4/9/2021


VAERS ID: 1207953 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 5 LA / IM

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

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

Write-up: Pt received the vaccine sat in our waiting area and then passed out a couple minutes after receiving the vaccine. He came to in a minute or so. We called 911 and the paramedics came and took him to the local hospital. Per his report he had not had anything to eat that day and when he came to he felt nauseated and clammy.


VAERS ID: 1207961 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-03-05
Onset:2021-03-07
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Blood cholinesterase normal, Blood follicle stimulating hormone normal, Blood thyroid stimulating hormone normal, Burning sensation, Central nervous system lesion, Computerised tomogram normal, Diplopia, Fatigue, Headache, Hypoaesthesia, Influenza like illness, Magnetic resonance imaging head abnormal, Magnetic resonance imaging normal, Microvascular cranial nerve palsy
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Ocular motility disorders (narrow), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Shingrix, headache, weakness, flu like symptoms, incontinence
Other Medications: Azythromycin 250mg three times a week, Patanase 2 sprays in each nostril twice a day, Hizentra 18gm subq every 2 weeks. glimepiride 1mg daily, Ambien, Prenatal vitamin, Tradjenta, ZTilido patch, Zofran 4mg (not used that day), simvastatin
Current Illness: None
Preexisting Conditions: Common variable Immunodeficiency, diabetes type 2, chronic kidney disease, gastroparesis, osteoarthritis, previous stroke history, neuropathy, fibromyalgia, bipolar, cough variant asthma, chronic rhinitis, hypothyroidism
Allergies: Narcotics develops nausea vomiting, shortness of breath, and rashes.
Diagnostic Lab Data: She received the Johnson & Johnson COVID Vaccine 3/5/2021 9:30am. 3/6/2021 She reports that she was weak and exhausted and flu like symptoms. Symptoms began on 3/7/21, woke up horizontal binocular diplopia at 8:30am. Has been constant since it started. It is worst when looking to the left and best looking the right. Worse in the distance. No other associated symptoms 3/13/21: Around noon, was just sitting in the chair. She reports that she got a bad headache and then the entire left side of the body from head to toe was numb and burning in the left side face. This lasted all day, but completely resolved by night time. Had never had anything quite like that in the past. She had a headache that started soon before the numbness, that also lasted most of the day. 3/15/21: was seen in ED with reported normal MRI, CT, and EKG MRI brain with a small left pons lesion near the cranial nerve 6 nucleus She was seen by Neuro-ophthalmology Dr. (attending), Dr. (fellow) 3/17/2021 " MRI brain on 3/15/21 did not reveal a structural etiology for diplopia. Differential diagnosis includes microvascular ischemic left 6th nerve palsy versus possibly post-vaccination cranial nerve palsy (received COVID vaccine 2 days prior). Also on the differential diagnosis but less likely, includes myasthenia gravis (she did not have expected abduction saccade slowing of the left eye typical of an ischemic cranial nerve palsy). Thyroid eye disease also would be less likely. We will obtain antibody testing for myasthenia and thyroid eye disease. Today we applied a 10 prism diopter base out prism over her left glasses lens. I instructed her to remove this when appropriate, as I expect her diplopia to gradually improved." 4/7/2021 acetylcholine ab receptor negative, TSI negative, TSH receptor antibody negative, LH/FSH normal,
CDC Split Type:

Write-up: She received the Johnson & Johnson COVID Vaccine 3/5/2021 9:30am. 3/6/2021 She reports that she was weak and exhausted and flu like symptoms. Symptoms began on 3/7/21, woke up horizontal binocular diplopia at 8:30am. Has been constant since it started. It is worst when looking to the left and best looking the right. Worse in the distance. No other associated symptoms 3/13/21: Around noon, was just sitting in the chair. She reports that she got a bad headache and then the entire left side of the body from head to toe was numb and burning in the left side face. This lasted all day, but completely resolved by night time. Had never had anything quite like that in the past. She had a headache that started soon before the numbness, that also lasted most of the day. 3/15/21: was seen in ED with reported normal MRI, CT, and EKG MRI brain with a small left pons lesion near the cranial nerve 6 nucleus She was seen by Neuro-ophthalmology Dr. (attending), Dr. (fellow) 3/17/2021 " MRI brain on 3/15/21 did not reveal a structural etiology for diplopia. Differential diagnosis includes microvascular ischemic left 6th nerve palsy versus possibly post-vaccination cranial nerve palsy (received COVID vaccine 2 days prior). Also on the differential diagnosis but less likely, includes myasthenia gravis (she did not have expected abduction saccade slowing of the left eye typical of an ischemic cranial nerve palsy). Thyroid eye disease also would be less likely. We will obtain antibody testing for myasthenia and thyroid eye disease. Today we applied a 10 prism diopter base out prism over her left glasses lens. I instructed her to remove this when appropriate, as I expect her diplopia to gradually improved." 4/7/2021 acetylcholine ab receptor negative, TSI negative, TSH receptor antibody negative, LH/FSH normal,


VAERS ID: 1207971 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-03-01
Onset:2021-03-24
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Cough, Dyspnoea, Headache
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

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

Write-up: Unable to breathe, lost sense of taste, headaches, coughing


VAERS ID: 1207990 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-03-18
Onset:2021-03-23
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / UNK UN / -

Administered by: Private       Purchased by: ?
Symptoms: Deep vein thrombosis, Hiatus hernia, Joint stiffness, Joint swelling, Pain in extremity, Ultrasound Doppler abnormal, Venogram abnormal
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Mens Daily multivitamin, Vitamin D (occasionally)
Current Illness: None
Preexisting Conditions: Obesity
Allergies: Penicillin
Diagnostic Lab Data: 4/13/2021: LE Duplex US Left Lower Extremity: Acute occlusive vein thrombosis of the entire course of the femoral vein, popliteal vein, peroneal vein, soleal vein and gastrocnemius vein. Incompressible entire course of the femoral vein, popliteal vein, peroneal vein, soleal vein and gastrocnemius vein. Fully compressible entire course of the common femoral vein, deep femoral vein, posterior tibial vein, great saphenous vein and small saphenous vein. CTV 4/13/2021: 1. Deep venous thrombosis in the left femoral vein. No CT evidence of venous thrombosis within the left common femoral vein, bilateral iliac veins, or inferior vena cava. 2. No acute findings in the abdomen or pelvis. 3. Small hiatal hernia.
CDC Split Type:

Write-up: Patient developed left leg pain 5 days after the vaccine, with tightness behind the knee, and then soon developed swelling. As pain improved he did not seek attention until today, 4/14/2021 and was found to have a severe large fully extensive and occlusive femoral DVT L leg.


VAERS ID: 1207997 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-06
Onset:2021-04-11
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202AZIA / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain lower, Chest X-ray, Computerised tomogram, Diverticulitis, Laboratory test, Urine analysis
SMQs:, Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific inflammation (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin Low dose aspirin Clarion Birth control pills
Current Illness: None
Preexisting Conditions: PCOS
Allergies: None
Diagnostic Lab Data: 4/12- urine, blood, chest X-ray and CT with contrast
CDC Split Type:

Write-up: Severe abdominal pain on lower left side began 3am 4/11/21 and continued throughout the day. I sought medical treatment at 10:30am 4/12 at the ER. Through CT scan with contrast, the doctor determined it was diverticulitis and treated with antibiotics. I am still recovering, no history of diverticulitis, and unknown if this is an adverse effect.


VAERS ID: 1208041 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-15
Onset:2021-03-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angiogram, Chest pain, Computerised tomogram, Dyspnoea, Electrocardiogram, Laboratory test, Pain in extremity, X-ray
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: April 12th. EKG, CTA Scan, X-RAY April 13th full panel blood test.
CDC Split Type:

Write-up: Very strong leg pain the following day that lasted two weeks. Chest pains and trouble breathing started on Sunday April 4th and continue today.


VAERS ID: 1208046 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-03-21
Onset:2021-03-31
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 AR / IM

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain, Computerised tomogram, Full blood count, Headache, Lipase, Metabolic function test, Urine analysis
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: amlodipine, losartan, xopenex, moltelukast, duoneb, MVI, omega
Current Illness: none
Preexisting Conditions: HTN, asthma
Allergies: iodine, morphine
Diagnostic Lab Data: spiral CT, renal stone protocol CBC, CMP, lipase, Urinalysis
CDC Split Type:

Write-up: Severe r sided abdominal pain and headache. Was seen in ER, labs and spiral, renal protocol, CT negative. No evaluation for clots was done.


VAERS ID: 1208048 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-03-09
Onset:2021-03-22
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Abdominal discomfort, Blood fibrinogen abnormal, Blood pressure increased, Caesarean section, Dyspnoea, Exposure during pregnancy, Feeling abnormal, Haemorrhage in pregnancy, Headache, Joint swelling, Laboratory test, Pre-eclampsia, Premature separation of placenta
SMQs:, Liver-related coagulation and bleeding disturbances (narrow), Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Dementia (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Cardiomyopathy (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Arthritis (broad), Tendinopathies and ligament disorders (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, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prenatal Vitamin Vitamin D Supplement (50,000 IUI - 1x per week)
Current Illness: Cold month before
Preexisting Conditions:
Allergies: No
Diagnostic Lab Data: Several tests were performed on me. These can be released to the CDC per their request.
CDC Split Type:

Write-up: The week prior to delivery (3/22), I started feeling shortness of breath and a headache. I thought it was just normal pregnancy symptoms. That Friday (3/26), I noticed swelling in my ankles. I am a teacher so I asked my school nurse to check my blood pressure; it was high (for me) around 144/88. She said I should call my OB and let them know. I did, and they said to rest for the weekend and they''d see me on Tuesday for my 29 week appointment. We had a weekend trip planned. We took our son there. The next night, I didn''t feel right. My belly felt hard to me and I wasn''t feeling my daughter move as much, but soon after, I went to sleep. Our two year old son woke us up crying around midnight, and I noticed that I started bleeding when I went to the bathroom. My husband drove me straight to the emergency room. I was diagnosed with sudden and severe preeclampsia. My fibrinogen levels were 100% indicative of a placental abruption. They called the transport team in from hospital so they could transfer my daughter immediately after birth. At 5:57 am on 3/28, my daughter was born via emergency c-section. She is currently fighting everyday at the NICU in the hospital. On Friday, 4/2 I was readmitted for severe preeclampsia to hospital. My blood pressure was 190/115. I had to receive another round of magnesium sulfate. I was released from the hospital on Sunday, 4/4.


VAERS ID: 1208052 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-09
Onset:2021-04-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041AZ1A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Dysgeusia, Fatigue, Headache, Hyperhidrosis, Irritability, Jaw disorder, Laboratory test, Nausea, Neck pain, Pain, Pain in extremity, Pain of skin
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Retroperitoneal fibrosis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Arthritis (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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Had full blood panel completed at urgent care. Waiting on results
CDC Split Type:

Write-up: After Covid shot Metallic taste in my mouth Injection was on left side Extreme paid on left side of body Body aches Skin painful Scalp painful Throbbing headache Fatigue Milk production low on left side Milk difficult to let down Left foot painful at break site Jaw painful-clicking Neck and back very sore especially left sd Nausea Painful pumping Sweating at night Irritability


VAERS ID: 1208068 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Blood glucose, Blood magnesium, Feeling abnormal, Laboratory test, Muscular weakness, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Bupropion XL 300 mg.
Current Illness:
Preexisting Conditions: Depression/asthma
Allergies: None
Diagnostic Lab Data: 4/14/21- Complete blood tests, magnesium, blood sugar.
CDC Split Type:

Write-up: On Sunday an Monday after the shot I had muscle weakness. I felt fine by the end of Monday night, but then on Tuesday morning I started to feel weird brain surges and getting shaky like I was on drugs or something. I went to the ER and they said it''s vaccine related and that I just wait it out.


VAERS ID: 1208079 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-30
Onset:2021-03-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Cough, Dyspnoea, Fatigue, Headache, Night sweats, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Fever, constant headache, SOB, slight coughing, body aches, night sweats, fatigue.


VAERS ID: 1208082 (history)  
Form: Version 2.0  
Age: 92.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-03-08
Onset:2021-03-23
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Aphasia, Asthenia, Cerebrovascular accident, Computerised tomogram, Laboratory test, Magnetic resonance imaging
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-03-23
   Days after onset: 0
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: Vit D 50,000 weekly, Gabapentin 100 mg TID, Melatonin 3 mg QHS
Current Illness: AFIB, HTN, BPH, CAD,CKD, LAte Onset Alzheimer''s Disease, NIDDM,GERD, Freq UTI''s, Hypoalbuminemia, Long Term Anticoagulation (was on Apixaban for AFIB, but stopped bc bleeding, Multiple Falls, Seborrheic Dermatitis, Unsteady Gait, Vit D Deficiency
Preexisting Conditions: Pt had AFIB and was on DOAC/ELIQUIS 2.5 BID which had been stopped a few weeks before the Vaccination dt excessive bruising and bleeding .
Allergies: NKDA
Diagnostic Lab Data: Labs, Ct Scan, MRI
CDC Split Type:

Write-up: Pt had AFIB and was on ELIQUIS 2.5 mg BID. He began to bleed, a lot. We stopped DOAC, disussed possibility pt might die form blood clot without the DOAC. He had vaccine after stopping DOAC (stopped DOAC 2/24/21). On 3/8 he had the Janssen Vaccine. On 3/15 he awoke w weakness, inability to speak. Transferred to hospital where he was diagnosed w having major stroke, admitted to hospital. They decided NOT to use anticoagulant because he had too great a risk of bleeding.


VAERS ID: 1208090 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-04-01
Onset:2021-04-11
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Deep vein thrombosis, Ultrasound abdomen
SMQs:, Embolic and thrombotic events, 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: Metformin, Verpamil, Losartin, Metopolol, Vitamin C, B-12, Biotin,
Current Illness:
Preexisting Conditions: Type 2 diabetes, Cholesterol, Hypertension
Allergies: None
Diagnostic Lab Data: Ultrasound at The Hospital.
CDC Split Type:

Write-up: Left leg DVT April 11, 2021. Johnson and Johnson vaccine on March 12, 2021


VAERS ID: 1208092 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-04-09
Onset:2021-04-13
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Burning sensation, Chills, Eye swelling, Pyrexia, Rash erythematous, Skin exfoliation, Vision blurred
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Penicillin
Diagnostic Lab Data: Seen at Urgent care, treated with Benadryl but, day too and symptoms still present
CDC Split Type:

Write-up: Woke up with eyes swollen almost shut, red rash all around eyes. Blurry vision, eyes feel like they are on fire. Skin on eye lids are peeling. Fever and chills


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