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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: 1208096 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-17
Onset:2021-04-06
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Bronchitis bacterial, Cystitis, Dehydration, Headache, Migraine, Pyrexia, Urinary tract infection, Viral infection
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (narrow)

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

Write-up: Acute bacterial bronchitis, acute urinary infection, bladder infection, dehydration, fever, headache, migraine, Viral syndrome


VAERS ID: 1208101 (history)  
Form: Version 2.0  
Age: 64.0  
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 205A215 / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypotension, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: n.a
Allergies: n/a
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient experienced syncope approx. 5 minutes after receiving dose. Hypotensive with approx. BP of 80/40. Was transported to hospital by emergency first responders


VAERS ID: 1208104 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Unknown  
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 - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Activated partial thromboplastin time normal, Blood magnesium normal, Full blood count normal, Metabolic function test normal, Prothrombin time normal
SMQs:

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: fluoxetine 20mg once daily
Current Illness: none
Preexisting Conditions: depression, narcolepsy
Allergies: benadryl
Diagnostic Lab Data: CBC, PT/INR, PTT, D-dimer, complete metabolic panel, magnesium level all were done on 04/14/2021
CDC Split Type:

Write-up: Patient has history of endometrial uterine ablation nearly 8 years ago. Interestingly, the day after receiving her Jansen Covid vaccine she had vaginal bleeding which lasted approximately 24 hours. She has not had any vaginal bleeding in the past 8 years since her ablation. She has also described frequent nosebleeds over the past few days since the vaccination. Work-up was done in the emergency department including CBC with platelets, D-dimer, coagulation studies, and a complete metabolic panel all which returned 100% normal. She is well-appearing and unlikely to experience any significant health issues related to the side effect but it seemed worth reporting therefore I am submitting this information.


VAERS ID: 1208112 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-03-20
Onset:2021-04-04
   Days after vaccination:15
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: Other       Purchased by: ?
Symptoms: Blood count, Cerebral infarction, Cerebrovascular accident, Computerised tomogram, Echocardiogram, Gait inability, Hypoaesthesia, Impaired work ability, Magnetic resonance imaging abnormal, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Dystonia (broad), Guillain-Barre syndrome (broad), Sexual dysfunction (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Benazapril, Hawthorn Berry, Vitamim D, Vitamin E
Current Illness: Menstrual cramps, heavy bleeding
Preexisting Conditions: anemia
Allergies: N/A
Diagnostic Lab Data: CT Scan MRI Complete blood count echocardiogram
CDC Split Type:

Write-up: Cerebral infarction 163.9. I was admitted to the hospital on April 4th, 15 days after taking the Janssen shot. My initial symptoms included tingling, numbness, and inability to walk. The doctors confirmed during MRI that I had had a stroke. I was in the hospital for four days, and released to PT/OT three times a week for the next 4 weeks to regain full use of the right side. I am also unable to work during this time.


VAERS ID: 1208130 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Kansas  
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 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diet refusal, Dizziness, Feeling abnormal, Malaise, Pain, Vision blurred, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
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:
CDC Split Type:

Write-up: Patient received the vaccine on 4-9-2021, on 4-10-21 patient felt "blah," on 4-11-21 patient got up and around and was ok, on 4-13-21 patient was not feeling real great, but was tolerable, on 4-14-21, patient was feeling worse with blurred vision, throwing up, aches, doesn''t want to eat, dizziness. Recommended that patient contact their primary care doctor for further treatment. On 4-13-21 pt went to ER and was admitted for one night, on 4-14-21 pt was dismissed from hospital, and is feeling improved.


VAERS ID: 1208142 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Vermont  
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 - / UNK - / IM

Administered by: Public       Purchased by: ?
Symptoms: Atrial fibrillation, Blood pressure increased, Blood pressure measurement, Blood test, Electrocardiogram, Heart rate, Nausea, Orthostatic hypotension, Oxygen saturation, Palpitations, Sinus rhythm
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Cardiomyopathy (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lysine Vitamin D3 Zinc
Current Illness: None
Preexisting Conditions: Arthritis Skin cancer
Allergies: Clams
Diagnostic Lab Data: Transported to Hospital . Blood work came back normal, EKG sinus rhythm and normal blood pressure before discharge.
CDC Split Type:

Write-up: Head rush and heart palpitations approximately 10 minutes after injection, and nausea. Assisted by EMTs to monitor heart rate, blood pressure , and blood oxygen level. Went into atrial fibrillation and blood pressure steadily rose. 165/99 was one reading I heard them call out.


VAERS ID: 1208149 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Texas  
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 205A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram head, Electrocardiogram, Fall, Head injury, Heart rate decreased, Hyperhidrosis, Loss of consciousness, Presyncope
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: EKG, CT of head done on 4/12/2021. He was monitored to make sure his heart rate went back up and was released a few hours later.
CDC Split Type:

Write-up: 5 minutes after receiving the injection, my husband passed out, starting sweating profusely, and was out cold for a minute. EMS were called and he was seen in ER due to low heart rate and sweating to rule out any heart conditions. He had 2 EKGs - one in the ambulance and one in the ER. He also had to have a CT for falling and bumping his head to rule out that injury. The DX was listed as a vagal response, but we are not so sure we agree given that he is 45 years old, has no priory history or anxiety about shots.


VAERS ID: 1208150 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Texas  
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 201A21A / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Body temperature increased, Feeling cold, Headache, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol 500mg
Current Illness: NA
Preexisting Conditions: NA
Allergies: NA
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Fever and chills 12 hours afterward Severe Headache since injection Fever up to 101 since injection, Tylenol and IBprofin to keep fever reduced


VAERS ID: 1208185 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-04-11
Onset:2021-04-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chest X-ray normal, Chills, Dizziness, Electrocardiogram normal, Full blood count normal, Hypotension, Pain, Pyrexia, Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (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: Digestive Enzyme, Reflux Release, Herbal Tea
Current Illness: no
Preexisting Conditions: no
Allergies: dairy, soy, onions, garlic, oil stone fruits, All Penicillins, Mycin-drugs
Diagnostic Lab Data: Chest X-ray-normal EKG-normal CBC-normal
CDC Split Type: vsafe

Write-up: During the night I felt like I had a fever, chills and body aches. And the next morning after I woke up needing to use the restroom, got up but started feeling dizzy and fainted for about 2minutes. EMT was called and once they arrived I began vomiting and my BP was super low. During the transport to the hospital I vomited again and was given antinausea meds. At the ER I was given IV fluids, chest xray, EKG and blood was drawn and I was released after a few hours of monitoring


VAERS ID: 1208205 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-03-27
Onset:2021-04-12
   Days after vaccination:16
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: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain lower, Deep vein thrombosis, Erythema, Pain in extremity, Skin warm, Swelling, Thrombophlebitis
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Advil, losartan potassium
Current Illness:
Preexisting Conditions: High blood pressure. herpes simplex
Allergies: hazelnut, penicillins, amoxicillin, sulfamethoxazole, Vitamin - B
Diagnostic Lab Data: urgent care medical examination (April 14, 2021) waiting primary cared physician exam on April 15, 2021
CDC Split Type:

Write-up: deep vein thrombosis, swelling, pain in both legs and lower abdomen. warm and red skin. red swollen veins.


VAERS ID: 1208222 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-22
Onset:2021-04-12
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / UNK LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Diverticular perforation, Intensive care, Mechanical ventilation, Surgery, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal perforation (narrow), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Respiratory failure (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Aspirin, B complex, Donepezil, escltalopram, Fish oil, Flonsae, duoneb, maalox, melatonin, metoprolol, plavix, resveratrol, rosuvastatin, multivit w/ minerals, flowmax, tylenol.
Current Illness:
Preexisting Conditions: BENIGN NEOPLASM OF COLON, ACUTE CYSTITIS WITHOUT HEMATURIA, UNSPECIFIED DEMENTIA WITHOUT BEHAVIORAL DISTURBANCE, PERSONAL HISTORY OF TRAUMATIC BRAIN INJURY, IDIOPATHIC ASEPTIC NECROSIS OF RIGHT FEMUR, CHRONIC OBSTRUCTIVE PULMONARY DISEASE, ATHEROSCLEROTIC HEART DISEASE OF NATIVE CORONARY ARTERY WITHOUT ANGINA PECTORIS, BENIGN PROSTATIC HYPERPLASIA WITH LOWER URINARY TRACT SYMPTOMS, PERIPHERAL VASCULAR DISEASE, RETENTION OF URINE, ALCOHOL DEPENDENCE, PRESENCE OF UROGENITAL IMPLANTS, ALLERGIC RHINITIS, UNSPECIFIED, OBESITY, ACUTE PYELONEPHRITIS, ALCOHOLIC POLYNEUROPATHY, SPONDYLOSIS WITHOUT MYELOPATHY OR RADICULOPATHY, CERVICAL REGION, INSOMNIA, MIXED HYPERLIPIDEMIA, DISORDER OF ARTERIES AND ARTERIOLES, ALCOHOLIC HEPATITIS WITHOUT ASCITES, IDIOPATHIC ASEPTIC NECROSIS OF LEFT FEMUR, PREDIABETES, ELEVATED PROSTATE SPECIFIC ANTIGEN [PSA]
Allergies: Simvastatin, Penicillins
Diagnostic Lab Data:
CDC Split Type:

Write-up: Per res. being taken to surgery for a perforated diverticulum. ICU, resident had made it through surgery, resident is off the vent, not really responsive at this time and will be keeping a close eye on him.


VAERS ID: 1208232 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-14
Onset:2021-04-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Neurological symptom
SMQs:

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

Write-up: 4-days post immunization, patient developed stroke symptoms while exercising at the gym. He was given immediate care by the reporter (off duty healthcare provider) and transported by ambulance to hospital and later transferred to for further treatment.


VAERS ID: 1208233 (history)  
Form: Version 2.0  
Age: 19.0  
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 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Burning sensation, Chills, Dizziness, Dyspnoea, Headache, Hyperhidrosis, Nausea, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (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), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: UTI
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: Oxygen levels, blood pressure, and everything normal
CDC Split Type:

Write-up: Cold chills, sweat, nausea, vomiting, horrible headaches, dizziness, and lightheaded, burning sensation around abdominal area, difficulty breathing.


VAERS ID: 1208245 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 002A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Disorientation, Seizure, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: Patient came in apprehensive and anxious about recieving shot, fearful of needles. After administration of the vaccine she appeared relieved afterwards and recieved a card with a note to wait for 15 minutes for any reactions. Her mother escorted her to her car, 10 minutes later, her mother came in saying "she''s having a seizure!" We had a certified nurse that was administering the shots that went out to check on her and we had a technician call 911. Patient appeared disoriented in the car and clammy to touch. We checked her blood pressure, and the nurse reported it was a little low. After paramedics arrived was being treated as a vaso-vagal response and she was transported to the nearby hospital.


VAERS ID: 1208303 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-03-24
Onset:2021-04-01
   Days after vaccination:8
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: Public       Purchased by: ?
Symptoms: Chest X-ray, Computerised tomogram, Laboratory test, Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: COPD, ADHD, anxiety
Allergies: Latex, Penicillin
Diagnostic Lab Data: Went to ER on 4/5/21 and medication prescribed, bloodwork completed, chest xray and CT scan completed
CDC Split Type:

Write-up: Pulmonary Embolism- left lung. Eliquis 5mg tablet medication once in morning and once at night


VAERS ID: 1208368 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-04-05
Onset:2021-04-12
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Differential white blood cell count, Dyspepsia, Electrocardiogram, Fibrin D dimer, Full blood count, Laboratory test, Lipase, Metabolic function test, Pain in extremity, Sleep disorder
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Norethindrone Acet-Ehyl EST 1-20 mg-mcg for birth control.
Current Illness: Seasonal allergies.
Preexisting Conditions: no
Allergies: none
Diagnostic Lab Data: CBC with differential, complete metabolic panel, lipase, D-dimer for venous thromboembolism, EKG. Lab results and EKG were unremarkable.
CDC Split Type:

Write-up: Upper abdominal pain started on 4/11/21 and on about night of 4/12/21 left calf pain woke patient up. Patient notified this PCP''s office with these symptoms on 4/13/21 at 10:28 at which time patient was referred to the hospital ER due to 6 known cases of women who had received Johnson & Johnson vaccine and developed rare type of blood clots and patient''s above symptoms to rule out deep vein thrombus. At the hospital ER provider did physical exam and ordered lab which confirmed patient had no deep vein thrombus. Patient was discharged home with diagnoses of left calf pain and dyspepsia. Patient continues to have abdominal intermittently but left calf pain has been resolved.


VAERS ID: 1208393 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-03-12
Onset:2021-04-13
   Days after vaccination:32
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, Headache, Nausea, Vomiting
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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Farxiga; Famotidine; Atorvastatin; Lantus; levothyroxine; Protonix; garlic tablets; magnesium tablets; fluticasone nasal spray; Ubrelvy; tizanidine; regular insulin; Singulair; Trulicity; Trelegy Ellipta; albuterol nebulizer solution; diclo
Current Illness: None
Preexisting Conditions: Type 2 diabetes, hyperlipidemia, insulin-dependent diabetes, GERD, seasonal allergies, migraine headaches, muscle spasms, hypertension, asthma, anxiety
Allergies: Glipizide, bee stings, mold, Januvia, chicken
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: Patient reports severe headache, nausea, vomiting and significant abdominal pain. She advised that she is proceed to the emergency department for further evaluation and care


VAERS ID: 1208394 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-03-09
Onset:2021-03-16
   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: Private       Purchased by: ?
Symptoms: Condition aggravated, Meniere's disease
SMQs:, Vestibular disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Triamterine-Hydrochorothiazide 37.5-25, Prescribed for Meniere''s Disease
Current Illness: Diagnosed with Meniere''s Disease in 1998. The last episode prior to vaccination was July, 2020
Preexisting Conditions: Meniere''s Disease, diagnosed 1998
Allergies: Environmental Allergies Metal Allergies Sensitive to Penicillin, Clindamycin
Diagnostic Lab Data:
CDC Split Type:

Write-up: One week following getting the vaccine I had a Meniere''s Episode which was by far the worst one I had ever had. Normally the episode will last several hours then I will recuperate within twenty four hours. This time symptoms reoccurred repeatedly and it took five weeks before I started feeling normal again.


VAERS ID: 1208395 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-04-08
Onset:2021-04-12
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Dyspnoea, Neck pain, Oropharyngeal pain, Pain
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Arthritis (broad)

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

Write-up: Shortness of breathe, severe neck and shoulder pain while breathing, body pains, throat pain


VAERS ID: 1208396 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-10
Onset:2021-03-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Back pain, Blood thyroid stimulating hormone normal, Chest X-ray normal, Chest pain, Dyspnoea, Electrocardiogram, Electrocardiogram normal, Fatigue, Full blood count normal, Headache, Metabolic function test normal, Nucleated red cells, Pregnancy test urine negative, Pyrexia, Sinus tachycardia, Troponin I normal
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Supraventricular tachyarrhythmias (narrow), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Estarylla Birth Control
Current Illness: None
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data: On 3/11/2021 at Hospita: ECG 12 Lead - Heart rate 153bpm POC Diagnostic Urine Pregnancy Test - negative POCT HCG Urine - negative Troponin I - negative Chest x-rays - clear Troponin I - negative Thyroid Stimulating Hormone (Reflex Free T4) - normal CBC With Differential - normal Basic Metabolic Panel - normal Complete Blood Count Component - normal Auto 6 Part Diff - normal Nucleated RBC Percent - normal Nucleated RBC Absolute - normal ECG 12 Lead - 147bmp ECG 12 Lead - 90bpm
CDC Split Type:

Write-up: I had Janssen vaccine on 3/10. I had some fatigue after, and was doing well until several hours later, when I developed severe chest pain, shortness of breath, headache, and back pain. I went to ER, fever to 102.2F. EKG w sinus tachycardia, heart rate 153bpm, treated with IV fluids, tylenol and IV ativan with significant symptomatic improvement. Labs and CXR were normal. Since then, I have not had any more symptoms.


VAERS ID: 1208425 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-03-01
Onset:2021-03-28
   Days after vaccination:27
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bell's palsy, Computerised tomogram head normal, Headache, Magnetic resonance imaging head normal
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: atorvastatin benzonatate buPROPion cefdinir cyclobenzaprine doxycycline hyclate fenofibrate nanocrystallized fluticasone propionate furosemide gabapentin glyBURIDE HYDROcodone ibuprofen Jardiance Klor-Con levothyroxine LORazepam
Current Illness: type 2 diabetic high blood pressure thyroid
Preexisting Conditions: diabetes blood pressure thyroid
Allergies: none
Diagnostic Lab Data: mri cat scan
CDC Split Type:

Write-up: extreme headache bells palsy


VAERS ID: 1208426 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Colorado  
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 205A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain, Computerised tomogram abdomen, Fatigue, Laboratory test, Lymphadenitis, Urine analysis
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vyvance
Current Illness: none
Preexisting Conditions: none
Allergies: Chicken
Diagnostic Lab Data: Abdominal Cat Scan, blood work and urine tests. All normal except for Cat Scan taking 4/13/2021 around 5:30 pm.
CDC Split Type:

Write-up: Patient received the Janssen COVID-19 Vaccine EUA April 12, 2021 and later that evening started developing severe abdominal pain that would not go away. Following day it was still there, so we took her to the Emergency Room where after an abdominal cat scan she was diagnosed with mesenteric adenitis. They gave her total to manage the pain and sent her home to let the symptoms subside hopefully after a few days. Today she is better, but very tired.


VAERS ID: 1208427 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-20
Onset:2021-03-23
   Days after vaccination:3
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: Atrial fibrillation, Cardioversion
SMQs:, Supraventricular tachyarrhythmias (narrow)

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

Write-up: Had episode of Atrial fibrillation - cardioverted - currently in normal sinus rhythm


VAERS ID: 1208446 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Missouri  
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 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Chills, Hyperhidrosis, Laboratory test, Magnetic resonance imaging, Seizure
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Retroperitoneal fibrosis (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Sumatriptan
Current Illness:
Preexisting Conditions: Asthma
Allergies: Minocycline and raw fruit
Diagnostic Lab Data: In the past, the patient had experienced a few cases of blackout migraines. To address the issue, she saw a neurologist and had blood work and an MRI, but the neurologist could not find the issue.
CDC Split Type:

Write-up: Patient was experiencing convulsions the evening/night of the vaccine administration. She also experienced shivers and had back pain. However, it was reported the patient is prone to back pain. Post convulsion, the patient was experiencing extreme sweating.


VAERS ID: 1208468 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / UN

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Balance disorder, Blood test, Cerebral venous sinus thrombosis, Computerised tomogram head abnormal, Computerised tomogram neck, Dizziness, Echocardiogram normal, Electrocardiogram normal, Fatigue, Headache, Hypertension, Hypoaesthesia, Injection site pain, Limb discomfort, Magnetic resonance imaging abnormal, Myalgia, Paraesthesia, Scan with contrast abnormal, Ultrasound Doppler, Ultrasound scan normal, Venogram abnormal
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypertension (narrow), Eosinophilic pneumonia (broad), Central nervous system vascular disorders, not specified as haemorrhagic or ischaemic (narrow), Vestibular disorders (broad), 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: SYNTHROID
Current Illness: NONE
Preexisting Conditions: MTHFR
Allergies: NONE
Diagnostic Lab Data: ECHO-NORMAL 4/12, EKG-NORMAL 4/11, ULTRASOUND OF RIGHT LEG-NORMAL 4/11, CAROTID ULTRASOUND-NORMAL 4/12, BLOOD WORK, CT W/ CONTRAST OF HEAD&NECK-ABNORMAL4/11, MRI &MRV-ABNORMAL 4/12
CDC Split Type:

Write-up: DAY 1- two hours after vaccine my right arm and right leg felt restricted, numb and had some tingling in my hand, dull headche, muscle pain and dizziness. Day 2- mild pain at injection sight, muscle pain and general tirednes, dull headache,dizzy, right arm& left arm felt restricted and numbness in right pointer finger. Right leg felt restricted and pain behind the knee. Day 3- dizzy, dull headache, faint, high blood pressure, right arm & leg and left arm felt restricted and numbness/tingling in right hand. Pain behind right knee persisted. Went to ER Sunday early afternoon. Diagnosis is a cerebral venous thrombosis in sinus cavity. Still experiencing general weakness/tired, dizzy/unbalanced.


VAERS ID: 1208478 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-04-01
Onset:2021-04-12
   Days after vaccination:11
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: Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad)

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

Write-up: History of Present Illness The patient presents with 50-year-old male with a history of hypertension and diabetes who presents via private vehicle with complaints of atraumatic left calf pain x4 hours. Symptoms started while typing on computer at work sitting in chair. Described as mild soreness to his left medial calf rating behind his knee. No frank tenderness with palpation. No fall, trauma, injury, or overuse syndrome including gym. No swelling, edema, or asymmetry. No associated motor/sensory disturbance able to wiggle and feel all digits with good pulses. No chest pain, shortness breath, palpitation, lightheadedness, or syncope. No spasms, cramps, or charley horses. Patient denies any history or DVT/ PE, hypercoaguable disorder, recent immobilization or surgery, recent long trips or travel, or active malignancy (w/ treatment in last 6 months) but does take prescribed clomiphene for androgen replacement/stimulation. Discomfort scribed as soreness, minimal intensity, 2 out of 10 without provocative or palliative factors.


VAERS ID: 1208491 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-04-02
Onset:2021-04-12
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / -

Administered by: Work       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Night sweats, Pharyngeal swelling, Pyrexia, Rash, Rash papular, Rhinorrhoea, Skin burning sensation, Somnolence, Swelling of eyelid
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Taking Collagen, zinc, vitamin c and vitamin D3, melatonin (5mg), zyrtec, and ibuprofen as needed 500Mg of Valtrex
Current Illness:
Preexisting Conditions: fibromyalgia, hsv-2, ptsd
Allergies: penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Within 4 hours I experience chills, fatigue and a headache. Within 8 hours I had a fever and slept for the next 24 hours. I broke out in buckets of night sweats. The following 2 days I was generally fatigued and had sniffles. After that I was fine, until Monday night (Day 10). I suddenly experienced a sudden onset of a painful and raised red rash at the base of my spine on my lower back. Within hours it migrated up to my head, face and then to the front of my torso. My eyes and throat closed. I took benadryl with no relief. I called Dr. on Demand and they urged me if the symptoms got worse to head to urgent care/ER. The next day (Tuesday 4.13) I went to the ER where they gave me a steroid shot, and prescribed me predisone and Prilosec to block the histimines. I am still having rash symptoms,itchiness and burning. While I have a history of seasonal allergies they''ve always been stuffy nose at the most. We had no new dietary introductions or new habits.


VAERS ID: 1208525 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Texas  
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: Private       Purchased by: ?
Symptoms: Cough, Dizziness, Pain, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Organic food supplement a.m. & p.m.
Current Illness: None
Preexisting Conditions: None
Allergies: Seasonal pollen
Diagnostic Lab Data: Have not talked with medical personal.
CDC Split Type:

Write-up: Woke a bit dizzy which lasted all day. Going to bed I coughed and searing pain flashed thru my body. After the initial pains my right hand felt like it''d been crushed by heavy object. It''s not as bad this morning but I''m using hemp creme to sooth the soreness.


VAERS ID: 1208531 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-02
Onset:2021-04-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / N/A LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Paraesthesia, Pruritus, Rash, Red blood cell abnormality, Skin burning sensation, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: HCT 25mg, Simvastatin 20mg, Vitamin D 1000mg
Current Illness: No
Preexisting Conditions: High cholesterol, HBP
Allergies: Sensitive to citric foods and shellfish
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: During observation while at the vaccination site I felt like in the middle of my forehead I was starting to have hives. But nothing could be seen. In the middle of the week it started getting red and I used hydrocortisone and it was that. On Friday 04/09 I woke up and my neck was itchy and burning, stingy, like pins or stuck in it, when I looked in the mirror there was a rash, different from hives. Some type of rash, just on the front, right below the crease of the neck and all the way across. I called the advice nurse line and I had a telehealth (video) appointment with the Urgent Care . I was prescribed some topical cream and some oral antihistamine and I just used the topical cream, not the pills. I used the cream as prescribed and I left the message to my doctor and send pics of the site and she sent me a message for an appt but since I kept using the topical cream it has been helping so I have not seen her yet.


VAERS ID: 1208544 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Injection site nodule, Injection site pain
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:
CDC Split Type:

Write-up: tender mass/nodule at injection site with worsening pain


VAERS ID: 1208556 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Pennsylvania  
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 1805022 / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Abdominal pain, Back pain, Body temperature decreased, COVID-19, Chest discomfort, Chills, Computerised tomogram, Confusional state, Cough, Decreased appetite, Diarrhoea, Dizziness, Dyspnoea, Fatigue, Headache, Hyperhidrosis, Laboratory test, Nausea, Pain, SARS-CoV-2 test positive, Urine analysis, X-ray
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft; Singulair;and Protonix
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: CT scan, xray, blood work, urine test,
CDC Split Type:

Write-up: I had leg pain beginning 3/16. I also experienced a headache, body aches, fatigue and loss of appetite. On, 3/17, I experienced confusion. On 3/31, I began to experience body chills and congestion which lasted several days. On 4/3, my symptoms increased with lower back pain and abdominal pain on my right side. I went to a clinick on 4/3 and received a positive covid test. My symptoms increased over the following weeks to include: temperature, body aches, sweating, headache, nausea, abdominal pain, fatigue, shortness of breath, coughing, dizziness and persistent diarrhea. I went to the ER for care on 4/8 and have been receiving continued care from my physician regarding possible pneumonia, shortness of breath, and chest tightness.


VAERS ID: 1208568 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-03-19
Onset:2021-04-02
   Days after vaccination:14
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, Angiogram abnormal, Cerebellar stroke, Chest X-ray normal, Computerised tomogram head normal, Dysarthria, Echocardiogram, Hemiparesis, Magnetic resonance imaging head abnormal, Thrombosis
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), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: tobacco user
Allergies: no known allergies
Diagnostic Lab Data: CXR and CT Head/Brain (04/02/2021) were unremarkable. MR Brain (04/02/2021) abnormal suggestive of left cerebellar infarcts. See next page for more. CTA head/neck (04/02/2021) were abnormal with small clot suspected in left vertebral artery in C2. TTE (04/04/2021) showed LVEF 50-55%, mild concentric LVH, trace MR/TR, no patent foramen ovale demonstrated. TEE (04/06/2021) to assess for cardioembolic source showed LVEF 60-65% and mild MR, no thrombus in LAA, no evidence of atrial septal shunting by color flow Doppler or agitated saline injection.
CDC Split Type:

Write-up: Exact date and time of COVID vaccination unknown. Patient presented to Medical Center on 04/02/21 with left sided weakness and slurred speech. He reports receiving the COVID19 Janssen vaccine 15 days prior. Details of vaccination beyond patient report are unknown. Diagnosed with acute left cerebellar stroke, status post TPA on 04/02/2021. Extensive workup in hospital negative and unremarkable, including TEE, and hypercoagulable state so far negative. Follow up with hematologist as outpatient underway to evaluate for any possible coagulation disorders.


VAERS ID: 1208571 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Wisconsin  
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 LA / SYR

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

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

Write-up: urticaria


VAERS ID: 1208577 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Indiana  
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 1805029 / 1 RA / -

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain lower, Abdominal pain upper, Blood potassium decreased, Computerised tomogram abdomen, Diarrhoea, Laboratory test abnormal
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Hypokalaemia (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: I was taking all of my blood pressure meds and my Metformin.
Current Illness: No other illnesses at the time of vaccination or up to one month prior.
Preexisting Conditions: I have High Blood Pressure and Diabetes.
Allergies: I am allergic to Penicillin.
Diagnostic Lab Data: CT Abdomen w/contrast- Normal Labs showed my Potassium was low.
CDC Split Type: vsafe

Write-up: I had stomach pain after eating that developed within an hour to a very hard pain in lower abdomen like all over vs in one place. The next morning the pain was there like a gas stomach pain with diarrhea.


VAERS ID: 1208597 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-04-11
Onset:2021-04-13
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

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

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

Write-up: Headache started Sunday night, but controlled with Tylenol. Monday the headache was intermittent. Tuesday 4/12 the headache and leg craps started in the afternoon. 4/14 She was sent home from work with nausea, headache not letting up after taking Tylenol, numb hands. I called Occupational Health and they suggested having her report to Backus ED today.


VAERS ID: 1208598 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-03-21
Onset:2021-03-22
   Days after vaccination:1
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: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Pt is currently a resident in the jail, unknown medications at time of administration
Current Illness: Pt stated he was not ill during interview for vaccination
Preexisting Conditions: Unknown
Allergies: NKA
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: 4/13 coworker received text message from mother of pt who reports that began experiencing "hives" after taking the Janssen vaccine; started on abd then spread to extremeties, back and neck Phone call to (nurse at the jail) who states she is aware of the hives and has pictures, no c/o respiratory difficulties. They have administered topical antifungal and tx for scabies thinking maybe it was related to a new blanket. Advised that due to the new reports regarding Janssen, it would be advised to have him evaluated by a physician. agreed, she will reach out to her provider for guidance. Report from mom that was taken to the ER and given a topical steroid cream only.


VAERS ID: 1208601 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: California  
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 - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram, Dizziness, Head injury, Loss of consciousness, Magnetic resonance imaging, Nausea, Seizure
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: 4/10/21 catscan, mri, emergency room. Visit
CDC Split Type:

Write-up: Dizziness, nausea, passed out, hit head, had seziure


VAERS ID: 1208609 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Virginia  
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 043A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure increased, Chest X-ray, Electrocardiogram, Fatigue, Headache, Injection site swelling, Injection site warmth, Nausea
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: fluoxetine 20mg
Current Illness:
Preexisting Conditions: anxiety/depression
Allergies: penicillin
Diagnostic Lab Data: ekg, chest x-ray
CDC Split Type:

Write-up: Patient started with swollen injection site 2 and 1/4 inch in diameter. Hurt to touch and hot to touch. Headache, bodyache, severe fatigue, and nausea. On April 13th blood pressure started to rise and was 160/106. Patient decided to go to the Emergency Department and was seen by Dr. She was prescribed ibuprofen, Zofran, acetaminophen. Dr concluded that all symptoms were from the Janssen vaccine.


VAERS ID: 1208614 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-03-10
Onset:2021-03-20
   Days after vaccination:10
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: Abdominal pain, Computerised tomogram abdomen, Gait disturbance, Hypoaesthesia, Laboratory test, Magnetic resonance imaging, Nerve compression, Tremor
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Citalopram 20mg
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Sulfa
Diagnostic Lab Data: Numerous tests including extensive blood work, MRI of spine, CT scan of abdomen, and Neurological visit. Hospital performed scans and blood work as well as the doctor.
CDC Split Type:

Write-up: Long list of symptoms that have happened 10 days after vaccine inlcluding abdominal pain, pins and needles of skin, leg numbness and hard time navigating stairs, and tremors in hands.


VAERS ID: 1208626 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Arizona  
Vaccinated:2021-03-27
Onset:2021-04-04
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Electrocardiogram, Fatigue, Gastrointestinal disorder, Headache, Inflammation, 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? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: carvadol, levothyroxine, losartin, spironolactone, acetazolamide,
Current Illness: none
Preexisting Conditions: congestive heart failure brought on by chemotherapy 5 years ago. Currently medication keeps me out of heart failure, But I have many PVCs
Allergies: none
Diagnostic Lab Data: Xrays, EKG, Labs 04/04/2021
CDC Split Type:

Write-up: 7 days following the shot I had extreme fatigue, shortness of breath, GI issues, chest pain, sharp headache and extreme leg pain. Symptoms started about 6am and got increasing worse through the day. At night when I was in bed at about 6pm my legs and chest hurt so bad I couldn''t take it, so that by 11pm I went to the ER. Because of where we live in and it was a hot day, I suggested that I was dehydrated and never thought about the shot or that it might be side effects. I was treated with IV fluids and paid meds, I have given chest Xrays and it was determined I had inflammation in my chest. Once my PVCs were under control (I had been in bi-Gemini) I was released with Zofran and Tramadol. I have felt extremely tired since. And I am unsure if I should contact a health care provider.


VAERS ID: 1208676 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-03
Onset:2021-04-03
   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: Private       Purchased by: ?
Symptoms: Asthenia, Chest pain, Chills, Computerised tomogram normal, Computerised tomogram thorax, Dizziness, Dyspnoea, Electrocardiogram normal, Headache, Hyperhidrosis, Laboratory test normal, Pain, Palpitations
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D3
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: EKG, blood work, CT scan of chest. All tests that were run came back negative.
CDC Split Type:

Write-up: Approximately eight hours after receiving the shot, I started getting a headache, body aches, and chills (April 3rd, 8 p.m.). I went to bed and had severe chills and body sweats for the entire night. The primary symptom to report is that my heart raced all night. It felt like it was beating at about 140 to 150 Hz or higher. When I woke up in the morning, it felt like my chest had been pounded on all night. The pain was in my sternum area. The headache and body aches took a little over a day to go away. The chest pain took a couple of days to die down. On April 12th, I walked my dogs in the morning and felt out of breath, which isn''t normal for me. In the afternoon, while working at my desk at home, I started getting more and more severe chest pain and then started getting dizzy and felt weak. I drove myself to the local ER and they tested me for a heart attack. All tests came back negative. They suggested going to another facility to get checked for clots or to make an appointment with a cardiologist. The next day, after talking to a doctor friend, he suggested going to the ER facility to get imaged for clots and to get fully checked out. No cardiologist appointments were available till the next week. I went to the ER facility and was there for seven hours getting tested. They came back and said all test results were negative and that my heart looked fine. They did not have any suggestions for what might be causing the pain in my chest.


VAERS ID: 1208680 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-04-08
Onset:2021-04-12
   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 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Ageusia, Amnesia, Anxiety, Aphasia, Blood pressure fluctuation, Computerised tomogram normal, Decreased appetite, Dizziness, Dysarthria, Dysphemia, Erythema, Fatigue, Feeling abnormal, Loss of consciousness, Magnetic resonance imaging normal, Mental status changes, Rash, Tremor, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: hypothyroidism
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CT scan and MRI taken at hospitalization 04/12 - negative result
CDC Split Type:

Write-up: on the day of vaccination: rash, redness of face and shoulders and neck, vomiting, extreme fatigue these symptoms continued for 48 hours then I started to feel better on 04/12 around 6pm I started feeling foggy, dizzy and felt like I was going to pass out. I called the neighbor for help. I couldn''t communicate, my body was shaking, trembling, I stuttered as I was trying to form words. I was taken to hospital by ambulance. I was unable to speak, I was shaking and my blood pressure went up and down. I was given IV fluids and Ativan for anxiety, dysarthria and altered mental state. As of 04/14 I have memory loss, loss of taste and appetite, extreme fatigue


VAERS ID: 1208686 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-06
Onset:2021-04-14
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Face injury, Fatigue, Headache, Loss of consciousness, Mental disorder, Nasal injury, Pain, Pain in extremity
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), Retroperitoneal fibrosis (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Daily multivitamin and nootropics
Current Illness: No illnesses
Preexisting Conditions: Two coronary aneurysms due to high temperature during Kawasaki syndrome (in 1992); migraine headaches; Vasovagal response that lead to me flatlining for 12 seconds (August 2017).
Allergies: None known
Diagnostic Lab Data: None yet
CDC Split Type:

Write-up: I woke up 7 days after receiving the vaccine with shooting sharp pains across my abdominal / midsection. While attempting to go to the bathroom, I must have passed out because I woke up some time later on the floor with a busted face and nose, and a severe headache. Initially the day after the shot, I had sharp shooting pains down my right leg. I have also had a headache on more days since getting the vaccine. Mental fog and tiredness is also occurring a few days after the initial shot.


VAERS ID: 1208700 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-06
Onset:2021-04-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Full blood count abnormal, Headache, Nausea, Pain in extremity, Platelet count decreased, Pyrexia, Subarachnoid haemorrhage, Surgery
SMQs:, Acute pancreatitis (broad), Haematopoietic leukopenia (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Haemorrhagic central nervous system vascular conditions (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: Reduced platelets are tested in the blood
CDC Split Type:

Write-up: Got the vaccine on Apr 6 Fever and leg pain started on Apr 7 Sever headache, nausea occurred on Apr 11, called 911 immediately and sent to emergency room of hospital The diagnosis is large volume of subarachnoid hemorrhage in the brain. Surgery conducted on April 11 and the patient is still in ICU now


VAERS ID: 1208701 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-01
Onset:2021-03-22
   Days after vaccination:21
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: Private       Purchased by: ?
Symptoms: Dyspnoea, Migraine, Pneumonia, Pulmonary pain, 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), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow)

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

Write-up: Migraines, lung infection, blood clots, pain in lungs, shortness of breath.


VAERS ID: 1208743 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-03-22
Onset:2021-04-12
   Days after vaccination:21
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: Private       Purchased by: ?
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (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: Xanax as needed at bed, 1-2 mg. Motrin, as needed
Current Illness: None
Preexisting Conditions: Fibromyalgia Diagnosis 2004
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 2 weeks from the date of injection I began to experience moderate to severe pain at the injection site. I am still experiencing this issue as of today, 4/14/21.


VAERS ID: 1208745 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-03-13
Onset:2021-03-22
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Disturbance in attention, Headache, Magnetic resonance imaging, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Noninfectious encephalopathy/delirium (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Depression (excl suicide and self injury) (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None known except seasonal allergies
Diagnostic Lab Data: At the Emergency Room on 3/24 the following tests were conducted: MRA with and without contrast was conducted and standard blood tests. None of the tests showed any irregularities.
CDC Split Type:

Write-up: I had the worst headache of my life on 3/22 but assumed it was a migraine and treated it as such. On 3/23 while playing hockey, nearly immediately after starting, the headache returned even stronger than on 3/22 and forced me to stop playing as I could not concentrate or focus. The headache lasted for several days. The following morning I went to my standard physician who immediately sent me to the ER because he was concerned about a potential aneurysm. No cause was ever determined as the tests were inconclusive but it was suspected to potentially be a pinched nerve. However, I never had any pain in my neck or elsewhere besides the headache.


VAERS ID: 1208750 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-03-10
Onset:2021-03-24
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / UNK LA / IM

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

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

Write-up: Fell two weeks after immunization. Developed blood clot after procedure. Husband concerned immunization is cause of clot and not the surgery or down-time after the procedure. Transfered to new hospital from previous hospital and had significant stroke due to clot


VAERS ID: 1208761 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: New York  
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 1808025 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Bell's palsy, Computerised tomogram, Laboratory test
SMQs:, Hearing impairment (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: Buprenorphine, colace, tylenol, mirtazapine
Current Illness: mental health illness
Preexisting Conditions: none
Allergies: nkda
Diagnostic Lab Data: Labs an CT scan in the ER
CDC Split Type:

Write-up: Bells Palsey - right side. Has had 3 episodes of left bells palsey in the past.


VAERS ID: 1208801 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Oregon  
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 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Vomiting
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: NEXPLANON, lexapro
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe abdominal pain, vomiting. Went to ER for evaluation but started to resolve before being seen. Resolved as of 4/11/21


VAERS ID: 1208872 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-03-20
Onset:2021-03-21
   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 / SYR

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Chest pain, Chills, Dyspnoea, Pain, Pulmonary embolism, Pyrexia
SMQs:, Anaphylactic reaction (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 (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: On March 20th I received the J&J covid-19 vaccine shot. Starting on March 21st I begin to experience symptom such as fever, chills and body aches. That lasted for about 2 weeks. The week of April 5th- I been to experience struggling the ability to breathe. I was having serious pain in my left side of my chest and in the lower left side in my back. It was so severe, I went to the hospital on April 8th and at the hospital the Doctors discovered I had blood clots in my lung. I was in the hospital for 2 days. Iam currently on blood thinners inhaler and and oxygen.


VAERS ID: 1208945 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-31
Onset:2021-04-07
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / N/A - / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Blood sodium decreased, Brain natriuretic peptide increased, Cardiac failure congestive, Cardio-respiratory arrest, Chest X-ray abnormal, Death, Dyspnoea, Electrocardiogram, Endotracheal intubation, Fibrin D dimer increased, Troponin increased, X-ray
SMQs:, Torsade de pointes/QT prolongation (broad), Cardiac failure (narrow), Anaphylactic reaction (narrow), Angioedema (broad), Haemorrhage laboratory terms (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Hyponatraemia/SIADH (narrow), Cardiomyopathy (broad), Chronic kidney disease (broad), Respiratory failure (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-14
   Days after onset: 7
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Aspirin, Atorvastatin, plavix, hydrochlorathiazide/lisinopril, nitroglycerin as needed, omeprazole, paroxetine
Current Illness:
Preexisting Conditions: heart attack, hypertension, dyslipidemia, depression, anxiety
Allergies: Codeine
Diagnostic Lab Data: 4/14/2021 sodium 119 Troponin 0.16 BNP 1,125 D Dimer 1039 Chest xray showed congestive heart failure
CDC Split Type:

Write-up: The patient received the vaccine on 3/31/2021. On 4/7/2021, patient developed weakness that continued until 4/14/2021. Patient also developed shortness of breath on 4/14/2021. The patient presented to the ER for weakness and shortness of breath. Patient had labwork, EKG, and an Xray. Troponin, BNP, and D-Dimer were elevated. Sodium was low. Chest xray showed congestive heart failure. Pt required intubation and then coded. Cardiac life saving procedures were started but the patient succumbed to death. Patient death pronounced per MD.


VAERS ID: 1208951 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-06
Onset:2021-04-07
   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 / SYR

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram, Dysphemia, Feeling cold, Metabolic function test, Seizure, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine 25MCG, Omerprazole 40 MG
Current Illness: Hypothyroidism and undiagnosed gastrointestinal illness
Preexisting Conditions: Hypothyroidism
Allergies: Pork
Diagnostic Lab Data: 4/7/2021 blood work for thyroid 4/13/2021 CT scan and full blood work 4/14/2021 complete blood work, blood work for various vitamin levels, and blood work to see if I have an autoimmune disease
CDC Split Type:

Write-up: I woke up at midnight, feeling really cold. Then I started to shake. I called the nurse line and started stuttering. I was instructed to go to urgent care. By then I was convulsing. I was nauseous. I was giving an IV, Tylenol, zofran, toradol, and Ativan. I got to the ER around 1 am. I was released about 4 am. I was prescribed Motrin. I continued to have headaches and nausea. I called my primary. Have a follow up visit on 2-12-20, she felt that the side effects were normal. I still had headaches and nausea went back to the same ear who treated me (Community Hospital) I had a CT scan and blood work, all is normal. I continue to have nausea and headaches. I take one Motrin 800 at night when I go to sleep.


VAERS ID: 1208960 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-02
Onset:2021-04-09
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Hyperacusis, Magnetic resonance imaging head, Migraine, Photophobia, Ultrasound scan, Varicose vein
SMQs:, Noninfectious meningitis (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad), Hearing impairment (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Sertaline (100 mg), Allergera for allergies, women multi-vitamin, B12 vitamin
Current Illness: none
Preexisting Conditions: Anxiety
Allergies: Baxtrum
Diagnostic Lab Data: On April 13, 2021, Emergency Room performed an ultra sound on left leg and found a blood clot. Hospital also performed an MRI on brain and brain vessels/sinus vessels and found no clot. On Covid-19 Vaccination Record Card, there is another number listed that may help assist: NDC 59676-580-15 Lot:1805020
CDC Split Type:

Write-up: Had Janssen shot on April 2, 2021. No issues whatsoever until April 9, 2021 when I began having a horrible blinding migraine. Sensitive to light and noise. No over counter headache medicine was helping. Same night, a painful blue line, (like varicose vein) formed in left calf. On Tuesday, April 13, 2021 went to Dr. office who agreed that these reactions are a concern and went to Hospital.


VAERS ID: 1208982 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Tennessee  
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 1805020 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Hypoaesthesia, Magnetic resonance imaging head, Paraesthesia, Tinnitus
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hearing impairment (narrow), 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: Multi vitamin, Vitamin D Vitamin C
Current Illness: None
Preexisting Conditions: NOne
Allergies: none
Diagnostic Lab Data: Reported to ER on 04/10. Blood work up and MRI of brain and neck with and without contrast. All tests came back normal. Discharged same day. Saw neurologist from Hospital who said my tests were normal. on 04/12 Saw Primary care on 4/13 . had 100.6 fever. She prescribed Prednisone an Z Pack.
CDC Split Type:

Write-up: Numbness and tingling pins and needles arms, legs hands and feet. High pitch ringing in ears


VAERS ID: 1208994 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-03-08
Onset:2021-03-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / N/A LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Computerised tomogram head, Dizziness, Full blood count, Headache, Hypoaesthesia, Paraesthesia, Pyrexia, Troponin
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Once nauseous after a flu shot (enough to miss school the next day) over 10 years ago but may have been unrelated as I was prone
Other Medications: zyrtec, fluonase, olapatadine, one a day multiivitamin
Current Illness:
Preexisting Conditions: migraines, suspected connective tissue disorder, suspected ibs
Allergies:
Diagnostic Lab Data: CBC and troponin levels taken at ER, both normal. CT scan of head found nothing. March 30th. Currently seeing a neurologist for further testing.
CDC Split Type:

Write-up: Night of vaccine: sore arm, severe headache, dizziness, low grade fever (99), chills. Recovered the following afternoon. One week after vaccine developed tingling in left leg, two weeks after vaccine developed mild numbness/loss of sensation on left side. Went to urgent care and then to ER, they suspected complex migraine as I have a history of migraine (though had never had one lasting that long). Numbness has been intermittent since but seems to have mostly gone away.


VAERS ID: 1208996 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / SYR

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

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prescriptions: Zetia, Rosuvastatin, Levothyroxin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: EKG was performed and was normal, as was my bloodwork. So far, I am feeling normal with no other side effects.
CDC Split Type:

Write-up: Approximately 4-5 after receiving the Covid Vaccination, my heart rate dropped, the top of my body was shaking and I passed out. The ambulance arrived and took me to the ER. My heart rate was at 40 . I was in the hospital for observation for 3+ hours.


VAERS ID: 1209030 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Indiana  
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 043 A21A / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Bradyphrenia, Chest X-ray, Chest pain, Chills, Dizziness, Dyspnoea, Headache, Heart rate increased, Hyperaesthesia, Hypoaesthesia, Nausea, Pain, Painful respiration, Sleep disorder, Visual impairment
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Psychosis and psychotic disorders (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad), Dehydration (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: Vyvanse Escitalopram Propranolol Birth control pill Myocycline
Current Illness: None
Preexisting Conditions: ADHD Depression Anxiety PMDD
Allergies: None
Diagnostic Lab Data: Chest X Ray 04/10/2021
CDC Split Type:

Write-up: Started out with a headache and dizziness within a few minutes of the vaccine, along with nausea. I stayed put laying down with a lollipop and water bottle along with ice packs on me for about an hour until I was well enough they thought for me to drive back to my dorm. Once I started driving the headache was back but I was driving so I couldn?t do much. Almost pulled over because I was getting over whelmed but ended up making it back to my dorm. Once I got back I changed and laid down in bed hoping to fell better. Things started getting worse from there. Throughout the rest of the day my head ache and dizziness got worse to the point where I was pretty unsteady on my feet. Chills and body aches also started and progressed rapidly despite no fever. My nausea was present in waves but eventually dissipated around 8 PM. I tried to go to bed around 11 hoping to sleep off the symptoms. I began tossing and turning. My chills were really bad and it got to the point where my skin was so sensitive that the clothes I was wearing touching and rubbing against my skin were hurting me. I was so dizzy and light headed to the point where it didn?t matter if I was laying down or sitting up, I felt the same, extremely dizzy and lightheaded as if cotton were in my brain or as if it were working too slow. It was like trying to process thoughts through molasses. Then around 1:30 I couldn?t take it anymore and thought maybe a quick shower would help me to at least feel better so I could sleep. When I got in the shower I immediately knew things were worse. My vision started going black at the edges and black spots in the middle to the point where at certain moments I couldn?t see. I was fighting to stay on my feet and conscious and it was hurting to breathe. I knew I needed to get help so I stumbled to my dorm and collapsed when I got in the doorway to my room. My vision was spotty, my chest was hurting and I could barely breathe. My hands and feet went numb as well, I was shivering, and my body temperature was a little down to about 98.1 degrees Fahrenheit. I was transported to a hospital via ambulance my vitals were normal except elevated heart rate and O2 and was admitted at 2:40 in the morning. I received a chest x ray and my heart rate was better. The dizziness was under control by then. I was discharged at 4:50 in the morning.


VAERS ID: 1209031 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-11
Onset:2021-04-13
   Days after vaccination:2
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: Pharmacy       Purchased by: ?
Symptoms: Injection site swelling, Pain in extremity, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: Site: Swelling at Injection Site-Medium, Systemic: swelling and pain in leg-Severe, Additional Details: Patient stated that they were experiencing swelling and pain when walking in leg


VAERS ID: 1209041 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Connecticut  
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 203A21A / 1 LA / IM

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

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

Write-up: Mild seizure, passed out


VAERS ID: 1209076 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-06
Onset:2021-03-13
   Days after vaccination:7
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: COVID-19, Chest X-ray, Pneumonia, SARS-CoV-2 test positive
SMQs:, Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin- Bariatric Multi Vitamin with Iron, Biotin, Fiber Pills, Probiotic, and Stool Softener daily.
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin and Sulfa Food- wild caught seafood
Diagnostic Lab Data: 3/14 Positive test for Covid 19 3/16 Chest x-ray from ER showed inflammation in the lungs and was diagnosed with pneumonia.
CDC Split Type:

Write-up: I tested positive for Covid-19 and pneumonia a week after receiving the shot.


VAERS ID: 1209102 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-04-08
Onset:2021-04-13
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Angiogram pulmonary, Anion gap, Asthenia, Blood bicarbonate decreased, Blood lactic acid, Blood pH normal, Blood potassium decreased, Chest X-ray normal, Electrocardiogram, Fatigue, Fibrin D dimer, Haemoglobin decreased, Mean cell volume normal, Monocyte count, Myalgia, Nausea, Palpitations, Platelet count normal, Pyrexia, Renal function test normal, SARS-CoV-2 test negative, Septic shock, Sinus tachycardia, Urine analysis normal, Urticaria
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Haematopoietic erythropenia (broad), Lactic acidosis (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Toxic-septic shock conditions (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Hypokalaemia (narrow), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vitamin D
Current Illness:
Preexisting Conditions: anxiety
Allergies: Quinine
Diagnostic Lab Data: EKG showed a sinus tachycardia with a rate of 137 and normal intervals. White count of 13,000 hemoglobin of 12.4, MCV of 79.3, prominent monocytes normal platelets, basic metabolic panel shows a potassium of 3.2, normal renal function with an anion gap of 18. Point-of-care lactate was three-point with a pH of 7.45 and a bicarb of 19.9. D-dimer was 233, ruling out pulmonary embolism. Urinalysis is negative for infection. She is not pregnant. MD recognize clinical syndrome of sepsis with elevated white count, tachycardia in the lactic acid 3.89. She meets criteria for sepsis with shock but without organ failure. PA and lateral chest x-ray showed no pneumonia.
CDC Split Type:

Write-up: 32-year-old otherwise healthy woman presents to the emergency department with increasing fatigue and palpitations with tachycardia. She received her Covid vaccine on March 8, had 3 days of subsequent myalgias with fevers, T-max 101.9 seemed to improve but she began having urticaria symptoms and was seen in this emergency department yesterday, 4/12 progressive recurrent urticaria symptoms unresponsive to antihistamines they were ultimately treated and improved with epinephrine. Today (4/13/21) the patient had fatigue and progressive weakness with palpitations with exertion walking up the stairs. She presented with tachycardia, her heart rate of 130, BP 140/79, she is afebrile with 100% pulse ox on room air. She has no evidence of exudative pharyngitis or oropharyngeal allergic reaction. No signs of meningitis. She has no evidence of pneumonia. No abdominal tenderness. She does have some nausea. She denies any urinary frequency urgency. No abnormal vaginal discharge. No other rashes. COVID test negative. Patient admitted for observation


VAERS ID: 1209104 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-08
Onset:2021-04-05
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / N/A LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray abnormal, Chest pain, Dyspnoea, Magnetic resonance imaging abnormal, Pulmonary embolism, Thrombosis, Ultrasound Doppler abnormal
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Infective pneumonia (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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Lung Cancer, chronic kidney disease
Preexisting Conditions: Hx of lung cancer, colon cancer and kidney disease
Allergies: Unknown
Diagnostic Lab Data: Chest Xray, MRI, Venous Doppler
CDC Split Type:

Write-up: 3 weeks post vaccination patient developed chest pain and shortness of breath. Was able to tolerate symptoms, then had radiation treatment and developed more shortness of breath. Was transported via EMS to hospital where an xray and MRI were completed and showed multiple blood clots in her lungs. Venous Doppler was also completed and blood clots were found in her legs. She was subsequently admitted to hospital.


VAERS ID: 1209107 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-07
Onset:2021-04-10
   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 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None, I?ve gone to two hospitals and one urgent care, none of them did any medical tests or blood draws.
CDC Split Type:

Write-up: Full body rash, itching and stinging. Itchy throat. I?ve had 2 shots of steroids, have been prescribed methylprednisolone, Benadryl and Pepcid. It?s keeping it lighter but not fully making it go away.


VAERS ID: 1209136 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Ohio  
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 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Computerised tomogram, Dyspnoea, Electrocardiogram, Intranasal paraesthesia, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ESCITALOPRAM, TRI-SPRINTEC
Current Illness:
Preexisting Conditions:
Allergies: CODEINE
Diagnostic Lab Data: RESULTS FAVORABLE PER PATIENT
CDC Split Type:

Write-up: TINGLING SENSATION IN BOTH ARMS UP TO SHOULDERS, TINGLING SENSATION IN NASAL SINUSES, LABORED BREATHING. HOSPITAL VISIT REQUIRED; LITER OF FLUID, 2 EKGS, BLOODWORK, CT SCAN. 5 HOURS VISIT AT HOSPITAL


VAERS ID: 1209148 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Washington  
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 1808982 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Fatigue, Feeling hot, Hyperhidrosis, Malaise, Urinary incontinence
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: needle phobias, has experienced fainting and feeling anxious and unwell from prior vaccines
Other Medications: NONE
Current Illness: NEEDLE PHOBIA, ANXIOUS
Preexisting Conditions: NONE KNOWN
Allergies: NONE
Diagnostic Lab Data: n/a
CDC Split Type: 1

Write-up: The patient had a needle phobia and was very anxious prior to the vaccine. Once the patient received the vaccine, he waited in the waiting area for 15 minutes post-vaccine. About 5 minutes after the vaccine, he notified the pharmacy staff that he wasn''t feeling well and he was feeling faint. The pharmacy staff provided him with a glass of water and was monitoring him. He said he felt like he fainted and wasn''t feeling well. He said he felt warm and sweaty. The pharmacy staff provided him with an ice pack. He then notified the pharmacy staff that he urinated in his chair while waiting post-vaccine. He wanted to be checked out and wanted us to call 911 . The patient began to feel better after about 20 minutes. The EMT arrived and checked the patient. Even though, the patient was feeling better, the EMT recommended the patient be checked further anyways. He was brought to the Triage center and was there for about 1 hour, according to the patient, and was feeling better. He said he felt slightly fatigued that day and the following day, but other than that he was feeling back to normal and no issues. He stated he has severe needle phobia and has experienced these fainting spells and anxiousness in the past. We followed up with the patient and he provided this information to us. He stated he was feeling good and back to normal. He had no further questions or concerns. We told him to follow up with us if questions or concerns came up.


VAERS ID: 1209151 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-19
Onset:2021-03-23
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805D31 / 1 UN / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram head abnormal, Haemorrhagic transformation stroke, Ischaemic stroke, Mental status changes
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Crestor 10 mg daily Fosamax 70mg once weekly
Current Illness: NA
Preexisting Conditions: Hyperlipidemia
Allergies: NA
Diagnostic Lab Data: CT Head 4/13 - L frontal subacute ischemia with hemorrhagic conversion.
CDC Split Type:

Write-up: Patient states that she developed altered mental status approximately 4 days after receiving the vaccine as witnessed by family and friends. Her mental status continued to decline over 2 week period, at which time she was brought to the hospital on April 13th. At that time, it was determined the patient had suffered an age-indeterminant ischemic stroke with hemorrhagic conversion. No neurosurgical interventions were done at this time as patients symptoms have appeared to improve after observation.


VAERS ID: 1209156 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-03-06
Onset:2021-03-10
   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: Private       Purchased by: ?
Symptoms: Chest X-ray, Chest discomfort, Computerised tomogram abnormal, Cough, Dyspnoea, Fatigue, Fibrin D dimer normal, Pain, Ultrasound Doppler normal
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Grass, birch, cats, dogs, some preservatives
Diagnostic Lab Data: Allergy test Chest X-ray - clean D-diner - abnormal Chest CT - normal - ER Doppler US for low extremities ( scheduled )
CDC Split Type:

Write-up: Severe body aches the following night after vaccination - then about a week later severe chest heaviness ( like a brick placed on chest ), hard time breathing, dry cough and severe tiredness some of the symptoms lasting over month now. PCP though might be allergy but everything started after vaccination.


VAERS ID: 1209167 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-05
Onset:2021-04-09
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN JSN042A21A / N/A LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Abdominal pain, Diarrhoea haemorrhagic, Haematochezia, Laboratory test normal, Rectal haemorrhage
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ALLOPURINOL 300 MG Q DAY , HCTZ 25 MG Q DAY , AMLODIPINE 10 MG Q DAY , BUPROPION 300 MG XL Q DAY, HYDROXYZINE 25 MG QHS ,BUSPIRONE 15 MG TID , PRAZOSIN 2MG Q HS ,CLOTRIMAZOLE SOLN BID
Current Illness: NONE
Preexisting Conditions: GOUT , HTN , PTSD, OSA, OBESITY ,SUBCLINICAL HYPERTHYROID, ,KERATOCONUS
Allergies: NONE
Diagnostic Lab Data: WENT TO LOCAL ER REPORTS LABS NORMAL
CDC Split Type:

Write-up: TWO DAY AFTER VACCINE PATIENT HAD SEVERE LOWER ABDOMINAL CRAMPS AFTER AHVING MILK SHAKE AND ON 4/9/21 HE HAD RECTAL BLEEDING X 3 FIRST TIME BLOOD MIXED WITH STOOL ,SECOND TIME BLOODY DIARRHEA .THIRD TIME BLOOD


VAERS ID: 1209183 (history)  
Form: Version 2.0  
Age: 99.0  
Sex: Female  
Location: South Carolina  
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 202A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Endoscopy, Haematemesis, Nausea, Thrombosis
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Gastrointestinal haemorrhage (narrow), Thrombophlebitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? 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 vaccinated at 2PM (4/12/21) and caregiver said that at 4AM during the night(4/13/21) patient woke up very nauseated. She immediately vomiting and it contained blood. As she vomited more, numerous clots came out which resulted in caregiver calling 911. Patient was admitted immediately to hospital where she remains today (4/14/21). Doctors have performed an endoscopy and other tests to determine the source of the blood clots and treatment options. Caregiver is available if more details are needed.


VAERS ID: 1209233 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: D.C.  
Vaccinated:2021-03-07
Onset:2021-03-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / UNK LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Blood test, Chest X-ray, Dizziness, Dyspnoea, Electrocardiogram, Fatigue, Feeling cold, Feeling jittery, Gait disturbance, Palpitations, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Blood work, EKG - 3/31/21 Blood work - 3/31/21 & 4/6/21 EKG & Chest X-ray - 4/5/21
CDC Split Type:

Write-up: Since March 7 (the day I got the J&J shot coincidentally), I have been experiencing dizziness (lightheadedness), weakness, racing heart from time to time (very badly after I did a work out on the day of the vaccination), tingling in my feet, jitters (like having too much caffeine), fatigue, and being cold (more than usual). Things have gotten progressively worse as I now cannot walk up a flight of stairs without a racing heart and heavy breathing and extreme exhaustion. (FYI, before this I was running 4-5 miles 4-5 times a week). In addition, my doctor tells me that I have no Covid-19 protection based on blood tests.


VAERS ID: 1209244 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: South Carolina  
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 1808609 / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Hyperhidrosis, Immediate post-injection reaction, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Immediately after giving the vaccine, the patient started sweating profusely and stated he had trouble breathing. He proceeded to pass out. The patient woke up within 30 seconds without the administration of an Epipen and was fairly alert. He continued to sweat and when EMS arrived he was reported to have a pulse of 54. BP was not reported


VAERS ID: 1209250 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-07
Onset:2021-03-11
   Days after vaccination:4
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: Private       Purchased by: ?
Symptoms: Blood pressure increased, Dizziness, Electrocardiogram abnormal, Feeling abnormal, Lung disorder, Lymphadenopathy, Palpitations, Platelet count increased, Productive cough, White blood cell count
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Hypertension (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Asthma, frequent UTI, carpal tunnel, cervical stenosis
Allergies: Cephalaxin, Penicillin, Cipro, Latex
Diagnostic Lab Data: ECG-abnormal Elevated platelet count elevated white blood cells
CDC Split Type:

Write-up: Initially after injection I had dizziness and slight mental fog. Four days later my lumph nodes in face and neck swelled and I had heart palpitations, abnormal ECG, and excess fluid in lungs. Went to urgent care and doctor recommended to wait it out. On 4/15/21 symptoms peaked and I began to have severe frothy phlegm, raised blood pressure, and heart palpitation. I went to the ER and was given and was prescribed antibiotics, steroid, and inhaler.


VAERS ID: 1209258 (history)  
Form: Version 2.0  
Age: 92.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-24
Onset:2021-03-26
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 105020 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Bell's palsy, Blood test, Computerised tomogram head, Dyskinesia, Ear pain, Eye movement disorder, Facial paralysis, Fatigue, Headache, Magnetic resonance imaging head, Pain, Tinnitus
SMQs:, Neuroleptic malignant syndrome (broad), Dyskinesia (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hearing impairment (narrow), Ocular motility disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Metoprolol 25 mg twice daily; Metformin 500mg twice daily, Novolog sliding scale insulin; Lantus insulin 20 units daily.
Current Illness: Diabetes Mellitus, type II Hypertension osteoarthritis high cholesterol
Preexisting Conditions: DM II HTN Osteoarthritis high cholesterol
Allergies: latex allergy
Diagnostic Lab Data: Hospitalized at Medical Center from 4/5/21 to 4/8/21. During hospitalization had CT of the brain, MRI of brain, blood tests. MD said they thought I had a stroke but no stroke showed up on brain tests, so they gave me a diagnosis of Bell''s palsy.
CDC Split Type:

Write-up: on the third day began to feel headache, body aches, and extreme fatigue. On day 9 I saw that my face was drooping and mouth was crooked, my L eye did not close, L ear pain, L buzzing in ear. I was taken to emergency room and admitted to the hospital on 4/5/21. Was diagnosed with Bell''s Palsy. Was discharged back home on 4/8/21


VAERS ID: 1209312 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN JSN 201A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Eye pain, Eye swelling, Headache, Muscle spasms
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Dystonia (broad), Glaucoma (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Cough syp Saline nasal spray Lipitor 10 ,g triamcinolone oint tylenol 325 mg Cetirizine 10 mg
Current Illness: none
Preexisting Conditions: Hyperlipidemia Allergic Rhinitis
Allergies: Tetracycline
Diagnostic Lab Data: Advised to call 911: declined opted to drive herself to Hospital
CDC Split Type:

Write-up: Severe Headache 10/10 started 1 day after injection Swelling and pain of 1 eye leg cramps


VAERS ID: 1209320 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Connecticut  
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 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Nausea, Swollen tongue, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Chest pain; Swollen tongue; Swollen epiglottis; Nausea & Vomiting


VAERS ID: 1209331 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-03-18
Onset:2021-04-13
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Computerised tomogram normal, Diarrhoea, Flank pain, 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), 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CT scan of the abdomen confirms no sign of diverticulitis or inflammatory bowel changes. Results are overall reassuring. I went and reassessed the patient. The patient was informed that this may be an early presentation of a more serious disease and that close follow up is absolutely mandatory. Patient understands this. At this point, the patient has been able to tolerate PO. Reexamination of her abdomen reveals a soft, non tender abdomen with no acute surgical processes identified. Given these reassuring findings, we will proceed with discharge home. Pt is comfortable with this plan. Prescriptions for Zofran and Norco have been written so that she can continue to treat any continual symptoms at home. Return precautions for any new, worsening or other concerning symptom were discussed at this time. Patient has verbalized understanding. They will be discharged home.
CDC Split Type:

Write-up: The patient is a 58 y.o. female who presents to the Emergency Department with abdominal pain, vomiting, and fever at 101 degrees that began two days ago. She reports additional c/o diarrhea and bilateral flank pain.


VAERS ID: 1209353 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Ohio  
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 201A21A / 1 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Abdominal pain, Blood magnesium normal, Diarrhoea, Differential white blood cell count, Faeces discoloured, Flatulence, Full blood count, Human chorionic gonadotropin negative, Lipids normal, Metabolic function test normal, Nausea, Neutrophil count decreased, Prothrombin time normal, Urine ketone body present, White blood cell count decreased
SMQs:, Acute pancreatitis (broad), Agranulocytosis (broad), Haematopoietic leukopenia (narrow), Hyperglycaemia/new onset diabetes mellitus (narrow), Systemic lupus erythematosus (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: peanuts and tree nuts
Diagnostic Lab Data: cbd + diff - wbc 2.92 L and ABS Neut 1.31 L - all other numbers in range UA dip, urine - ketone ua 15 mg comp metabolic panel - all normal HCG urine pregnancy - negative Lipid bld - within range Magnesium bld - within range Prothrombin Time - within range ALL TESTS PERFORMED IN ER 4/11/2021
CDC Split Type:

Write-up: 24 hours after getting the J&J vaccine I started experiencing severe abdominal pain, extreme gas pain, and felt nauseous and began getting diarrhea. It stared with loose stools that led to tissue type red stool that did not look like poop. Abdominal pain continued until the next day and I pooped red tissue type stools the next morning. I tried to call the VAERS toll free number and left a message. I had a virtual call with the clinic and was told they did not know of this side effect and to go to the ER.


VAERS ID: 1209359 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Puerto Rico  
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 203A21A / 1 RA / IM

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

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

Write-up: After vaccine was given at clinic, patient had a seizure episode as per nurse staff


VAERS ID: 1209372 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-01
Onset:2021-04-12
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Amylase, Arthralgia, Blood thyroid stimulating hormone, Burning sensation, C-reactive protein, Chest pain, Dyspnoea, Full blood count, Lipase, Metabolic function test, Pain in extremity, Peripheral swelling, Red blood cell sedimentation rate, Ultrasound Doppler
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Dexilant 60 mg once a day
Current Illness: Esophageal reflux
Preexisting Conditions: Lumbar spondylosis Renal calculus Anxiety
Allergies: NKA
Diagnostic Lab Data: Venous doppler done 04/13/21 - reported as negative by patient - done at outside facility. Labs done 4/14/21 include CBC, CMP, TSH, ESR, CRP, amylase, lipase
CDC Split Type:

Write-up: Lower extremity swelling, leg pain, burning in the ankle, chest pain, shortness of breath, shoulder blade pain


VAERS ID: 1209380 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-01
Onset:2021-04-08
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood urine present, Computerised tomogram normal
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D 5000 U Lantus Humalog Tresiba
Current Illness: Cyatic nerve
Preexisting Conditions: Diabetes High Cholesterol High Blood Pressue
Allergies: None
Diagnostic Lab Data: ER visit 4-13-2021; Cat scan did not reveal any abnormalities - per ER MD per patient
CDC Split Type:

Write-up: Patient states that one week later - she is experiencing heavy urinary bleeding - fresh, red blood - no pain or irritation.


VAERS ID: 1209395 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-04-06
Onset:2021-04-13
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A 21A / UNK UN / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chest pain, Computerised tomogram abnormal, Mechanical ventilation, Pulmonary oedema, X-ray abnormal
SMQs:, Cardiac failure (narrow), Acute central respiratory depression (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Respiratory failure (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: VAST PRESCRIPTIONS FOR HEART FAILURE, CHANGING AS HE JUST CAME OUT OF HOSPITAL 4 WEEKS AGO FUE TO NEEDING SURGERY FOR A PERFORATED BOWEL.
Current Illness: HEART FAILURE PERFORATED BOWEL SURGERY (4 WEEKS AGO)
Preexisting Conditions: HEART FAILURE
Allergies: N/A
Diagnostic Lab Data: X-RAY- RT LUNG CLEAR IN THE MORNING OF 4/13, EVENING OF 4/13 DISCOVERED RT LUNG FILLED WITH FLUID CT SCAN- ON THE AFTERNOON OF 4/14 FOUND SEVERAL BLOOD CLOTS PRESENT IN RIGHT LUNG
CDC Split Type:

Write-up: Developed chest pains, Rehabilitation Center moved to hospital on 4/13/2021. Took a turn for the worse in the evening of 4/13/2021. Hospital found fluid on lung x ray. He was placed on ventilator overnight preformed CT Scan the afternoon of 4/14 and discovered several bloods clots In right lung. Patient still in hospital under sedation and on ventilator. Hospital has started him on Heparin.


VAERS ID: 1209417 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-03-09
Onset:2021-03-18
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Influenza like illness, Influenza virus test negative, Pyrexia, SARS-CoV-2 test negative
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: atorvastatin - 20mg
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: I was tested for Covid and Flu. Both tests were negative.
CDC Split Type:

Write-up: Extremely severe headache that lasted 48 hours. Low grade fever and general flu like symptoms. I was tested for Covid and flu. Both tests were negative. The symptoms resolved.


VAERS ID: 1209426 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-13
Onset:2021-03-30
   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 / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram cerebral abnormal, Asthenia, Cerebellar haemorrhage, Cerebral venous sinus thrombosis, Chills, Computerised tomogram head abnormal, Dizziness, Headache, Platelet count normal, Pyrexia
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Guillain-Barre syndrome (broad), Central nervous system vascular disorders, not specified as haemorrhagic or ischaemic (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Spironolactone 25 mg QD, Probiotic QD
Current Illness:
Preexisting Conditions: Polycystic ovary syndrome, Attention deficit disorder, Gastroesphageal reflux, Migraine, Ganglion cyst
Allergies: Sulfa (Not specified)
Diagnostic Lab Data:
CDC Split Type:

Write-up: Janssen COVID-19 Vaccine EUA Patient presented to ED on 4/2/2021 with complaints of "worst headache of my life", waking her up at 2 am on 4/1/202. Describes the headache as being 10/10, sharp, and located at the back of her head. Associated fevers of 101.2F, chills, generalized weakness and dizziness. The patient states she took ibuprofen with mild improvement of her symptoms, so called her PCP and had a CT head done. The patient states she received a call from her PCP prior to arrival stating to go to the closest emergency department because her CT head showed an acute cerebellar hemorrhage. Patient admitted to Medical Center. Cerebral angio performed on 4/5/2021 which demonstrated dural sinus thrombus. Platelet count 255 on 4/2/2021 (Range 193 - 255 from April 5th through April 14th).


VAERS ID: 1209466 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: New York  
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 041A21A / N/A LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest X-ray normal, Chills, Dehydration, Dizziness, Fibrin D dimer normal, Headache, Hyperhidrosis, Laboratory test normal, Pyrexia, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Apris (birth control pill)
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 4/11 - blood work to check for D-dimer and other abnormalities, chest x-ray, blood pressure tests, -- $g all were normal, but was told to keep an eye out for any more side effects
CDC Split Type:

Write-up: 4/10 at night - lightheaded, fever, chills, sweating, headaches -- $g took Tylenol 4/11 in morning- fever, headaches, dizziness, severe dehydration, fainting/passing out -- $g taken to ER after passing out, treated with saline, other fluids, and rest


VAERS ID: 1209475 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-01
Onset:2021-04-04
   Days after vaccination:3
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: Abdominal pain, Chills, Computerised tomogram normal, Discomfort, Headache, Lethargy, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: I got a "CT Scan" on 4/5/2021 and nothing concerning was revealed.
CDC Split Type:

Write-up: First evening of the J&J vaccine (4/1/2021) I had a fever, chills, headache, and was lethargic. This lasted for 2 nights. These symptoms I anticipated. What I didn?t anticipate was my abdominal pain. I still feel as of today (4/14), pain in my abdomen. The areas of the discomfort are all over my mid-section. I was so worried that I went to ?Urgency Care? doctor on 4/5/2021 and the nurse had me go for a ?CT Scan?. I also went to my Primary care physician on 4/13/2021 and described my concern and abdominal pain but didn?t get a diagnosis.


VAERS ID: 1209478 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Massachusetts  
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 043A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Lymph node pain, Lymphadenopathy, Pain, Pyrexia, SARS-CoV-2 test negative, Streptococcus test negative
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lamexto, Hydroxidine, Vit b12, Vit D, Braylar
Current Illness: no
Preexisting Conditions: Asthma
Allergies: Benedryl, shrimp
Diagnostic Lab Data: Strep-normal COVID-19-neg
CDC Split Type: vsafe

Write-up: Later the same day after the vaccine my left lymph nodule began swelling. I had a 102.3 fever and severe body aches. My nodules continue to still hurt so I went to the ER and had a strep test which was negative but I am still experiencing these issues to date


VAERS ID: 1209498 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: New York  
Vaccinated:2021-03-24
Onset:2021-04-12
   Days after vaccination:19
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: Private       Purchased by: ?
Symptoms: Cardiac arrest, Death, SARS-CoV-2 test negative
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Cardiomyopathy (broad), Respiratory failure (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-12
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lorsatan 100mg daily Lipitor toprol XL 50mg daily nifedipine 60mg daily chlorthalidone 25mg daily
Current Illness:
Preexisting Conditions: DVT (not on anticoagulation) Brain Aneurysm CVA HTN HLD CKD
Allergies:
Diagnostic Lab Data: Covid swab on the date of expired NEGATIVE
CDC Split Type:

Write-up: Pt received the vaccine on 3/24/21. On 4/12/21 pt died of cardiac arrest


VAERS ID: 1209529 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Illinois  
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 - / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chest X-ray normal, Dizziness, Dysstasia, Electrocardiogram normal, Fatigue, Feeling abnormal, Head discomfort, Headache, Hyperhidrosis, Hypoaesthesia, Laboratory test normal, Musculoskeletal stiffness, Nausea, Paraesthesia, Skin discolouration, Syncope, Tremor, Vision blurred
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (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: Lexapro, Adderall, Astelin nasal spray
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: 15 minutes after injection: out of nowhere became extremely dizzy, nauseous, and fainted. stayed on floor, drank water, juice, crackers, tried to get up but was too weak and almost fainted again. sweating profusely and cloudy vision so lied back down. After 1+ hour felt mostly better so left . 30 minutes into my drive home felt sudden onset of nausea, left fingers tingling & numbing with save wave of extreme dizziness. Pulled onto median and called 911. My face started stiffening into a pucker like position and my muscles all through my body stiffened, but weakened with sharp tingling. I couldn''t stand so they carried me out of car and took me to Hospital. The rooms were full so I was in wheelchair waiting for room, shaking profusely, blue fingers, nauseous, dizzy and couldn''t stand on my own. I was able to go to restroom w/assistance but My muscles were stiffened for 1 hour+ and over and i felt awful. over the course of 5 hours I gained strength back and started to feel better with just mild headache and nausea. They did EKG, blood panel and chest xray which looked ok. Diagnoses as allergic reaction and told me to come back if more issues. The day after shot and every day since have had a headache at base of neck and pressure in cheek/forehead + nauseau + dizziness and extreme tired. Today is 14th and no headache today.


VAERS ID: 1209534 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-15
Onset:2021-04-02
   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: Pharmacy       Purchased by: ?
Symptoms: Deep vein thrombosis, Echocardiogram, Peripheral coldness, Peripheral swelling, Pulmonary thrombosis, Ultrasound Doppler abnormal
SMQs:, Cardiac failure (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)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: D3, Wellbutrin 150mg, Aspirin 81, 12.5 Hydrochlorothiazide, Norco 7.5-325, Trazadone,
Current Illness: No
Preexisting Conditions: Arthritis, Chronic Pain,
Allergies: No
Diagnostic Lab Data: Echocardiogram, Doppler, and test on my lungs
CDC Split Type:

Write-up: J&J vaccine 3/15 and on 4/2/2021 I thought I pulled a muscle and my leg started swelling, but my right leg only. I thought it would go down and my leg and foot started swelling up and my foot got really cold. I went to the hospital on 4/11 and they said it was a DVT and they checked my lungs and said I had small blood clots in my lungs as well. They put me on Eliquis to keep my blood thinned out.


VAERS ID: 1209538 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-03-27
Onset:2021-03-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Acoustic stimulation tests, Asthenia, Blood test, Chills, Computerised tomogram, Dizziness, Electrocardiogram, Hypersomnia, Immediate post-injection reaction, Impaired work ability, Pain, Pyrexia, Respiratory tract congestion, Urine analysis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Medical cannabis, fexofenadine, albuterol, turmeric, vitamin a, vitamin c, vitamin d, vitamin e, Women''s 1 a Day Multivitamin, & Spring Valley Women''s Probiotic.
Current Illness: None
Preexisting Conditions: Asthma
Allergies: Bees & bananas.
Diagnostic Lab Data: All tests done March 30th at Hospital: EKG Blood test Urine test CT Tests done on April 8th at Hospital ENT: Hearing Dizziness test
CDC Split Type:

Write-up: Started with some dizziness right after injection but I didn''t think much of it at the time. Within a couple hours I had body aches, chills, congestion, & dizziness became more severe. Within 3 hrs dizziness was debilitating & I had to go home from work. Next day fever, congestion, & body aches were gone. The dizziness was worse. I slept all day Sunday & Monday thinking I would be better the next day. On Tuesday I was still very dizzy my mom convinced me to go to the doctor. The nurse from the doctor''s office told me to go to immediate care, & the doctor from immediate care sent me to the ER. I''m still dizzy & unable to work.


VAERS ID: 1209544 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-03-18
Onset:2021-03-19
   Days after vaccination:1
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: Private       Purchased by: ?
Symptoms: Blood test, Computerised tomogram head, Eye pain, Facial pain, Headache, Magnetic resonance imaging head, Neck pain, Ophthalmological examination, Retinal artery occlusion, Tenderness, Visual impairment
SMQs:, Anticholinergic syndrome (broad), Embolic and thrombotic events, arterial (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (narrow), Arthritis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: The patient is a 66 y.o. female evaluated for visual impairment of the right eye and associated pain to the head and neck. Today, patient is noted to have mild tenderness to the bilateral neck posteriorly and right sided headache. However, she has a normal neurologic exam. She has no history of CVA or TIA. Ddx includes, but is not limited to: CVA, TIA, carotid or vertebral artery dissection, and carotid artery occlusion. Full ophthalmic exam was already performed at her ophthalmologist appointment so I did not focus on that portion of the exam, but will instead evaluate for causes of artery occlusion in the right eye. Will proceed with obtainment of labs, CT imaging and MRI of the brain.
CDC Split Type:

Write-up: The patient is a 66 y.o. female with past history of diabetes, GERD and HTN who presents to the Emergency Department with visual changes of the right eye and associated pain to the face and neck. Per interpretor, patient woke up feeling at baseline yesterday morning, when she had her COVID-19 vaccine. Yesterday around dinner time, she began having issues with vision in her right eye, causing her visual field in that eye to appear dark to her entire right eye. She told her husband that she thought she might have a hair or eyelash in her right eye and that she had an irritating pain radiating from her right eye to the right side of her face. Even after washing her eye with cold water, the sensation did not subside. At approximately 3-4 AM this morning, she also began to experience pain to the back of her head and neck bilaterally. This morning, the visual impairment improved from the entire visual field to now only just the inferior aspect of the right eye. However, she denies weakness to any of her extremities. Patient also denies chest pain, numbness, abdominal pain or nausea. She was seen at ophthalmology, at which Dr. diagnosed her with a right retinal branch arterial occlusion and decided to send her to SHE to be evaluated for the possibility of a CVA. She denies being on blood thinners or taking Aspirin. She denies any previous diagnosis of a CVA or TIA.


VAERS ID: 1209601 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-03-19
Onset:2021-03-25
   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: Abortion spontaneous
SMQs:, Termination of pregnancy and risk of abortion (narrow)

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

Write-up: miscarriage a week after receiving Janssen vaccine


VAERS ID: 1209606 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-07
Onset:2021-04-10
   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 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal X-ray, Decreased appetite, Diarrhoea, Feeding disorder, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Patient has a negative UA. Her XR is also negative for bowel obstruction. There is a moderate diffuse stool burden but no other acute findings. The patient states that she is feeling significantly improved and asymptomatic. I informed her of her findings. Patient feels reassured at this time. We discussed that she will need outpatient follow up with her PCP and she will plan to schedule an appointment in the next coupe of days. She also tells me that she is not compliant on her diabetic and anti hypertensive medication but that she does have it at home. I emphasized the importance of taking this medication. She understands this. Due to the stool burden found on x-ray I am giving her a stool softener to aid in this. Patient is comfortable with this plan. Return precautions for any new, worsening or other concerning symptom were discussed at this time. Patient has verbalized understanding. They will be discharged home. Impression: 1. Nausea & vomiting
CDC Split Type:

Write-up: The patient is a 70 y.o. female who presents to the Emergency Department with vomiting that began 8 days ago. She reports that she has not been able to eat for a week and has no appetite. Denies pain in the abdomen. She has been vomiting every time she eats and also has not been able to tolerate fluids. Pt reports loose stools that are almost diarrhea. Denies dysuria. Pt has a hx of DM. Also reports cramping pain in her legs that is chronic and HTN. Pt denies hx of overnight hospitalizations. Denies smoking cigarettes, using drugs, or drinking alcohol. The pt has not been checking her blood sugars at all.


VAERS ID: 1209619 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-03-11
Onset:2021-04-06
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / N/A LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood urine present, Computerised tomogram, Electrocardiogram, Haemorrhage urinary tract, Metabolic function test, Urine analysis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: 1000 mg fish oil; Loratadine - seasonal allergies; 81 mg aspirin
Current Illness: no
Preexisting Conditions: I had asthma/eczema syndrome - asthma went away as child and eczema is very infrequent and controlled
Allergies: no
Diagnostic Lab Data: Sonagram - inconclusive - ER on Wednesday CT scan ER on Wednesday ER on Wednesday they evaluated - no adverse tissue in the area but a mass in the bladder - both ER doctor and Urologist that was on call at time and came to conclusion that they couldn''t tell me if it was tumor or blood clot EKG - doctor - Primary care - Friday - normal; also took a blood panel - including TSA; and a urinalysis (all values in normal ranges for that)
CDC Split Type: vsafe

Write-up: Starting on the 8th, I saw signs of blood in urine. It started being extensive and frequent. By Wednesday at 11:30 I had extremely red bloody urine with small clots. I went to ( on Wednesday) Hospital ER - they performed a handheld exam - Flomax - to see if I could expel clotting. Late afternoon the next morning, I started expelling clots in very large quantities in very large clots. It got so bad that I had my wife take me to ER but we were in the parking lot and we called the Urologist - and he said that was what it was aiming for so that it would stretch the Urethra to pass the clots. So I didn''t go to the ER. That night my urine began clearing. It stayed clear until early morning. I had a little blood and then it went away again. Since Friday, after I saw my Primary care doctor, I haven''t had any blood in my urine. but I did see the doctor the next morning. I will see the Urologist tomorrow.


VAERS ID: 1209623 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-03-14
Onset:2021-03-14
   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: Unknown       Purchased by: ?
Symptoms: Blood glucose, Bradycardia, Differential white blood cell count, Dizziness, Electrocardiogram, Fall, Full blood count, Glomerular filtration rate, Head injury, Human chorionic gonadotropin, Metabolic function test, Paraesthesia, Presyncope, Seizure, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Peripheral neuropathy (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (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: self reported
Other Medications: Medications Inpatient No active inpatient medications Home No active home medications
Current Illness:
Preexisting Conditions: Problem List/Past Medical History Ongoing No qualifying data Historical No qualifying data
Allergies: Allergies amoxicillin Kiwi
Diagnostic Lab Data: 1. Vaso-vagal reaction, Syncope Ordered: CAR Electrocardiogram ED Discharge - Now Orders: Automated Diff Basic Metabolic Panel Random (includes Calcium) hCG Qual Beta hCG Qual Urine CBC w/ Diff, Manual if Indicated Estimated Glomerular Filtration Rate (eGFR) POC Blood Glucose by Nursing
CDC Split Type:

Write-up: History of Present Illness This is a 22-year-old female who was previously healthy with no significant past medical history presenting to the emergency department after a syncopal event. She was getting her COVID-19 shot today (Johnson Johnson). After her shot she was texting on the phone with her mom, felt slightly dizzy and the next thing she remembers was lying on the ground. Witnesses reported that she syncopized and had some convulsive like behavior afterwards. She was not postictal or incontinent however. She reportedly hit the front of her forehead on the left side. She denies any chest pain, abdominal pain, hemoptysis, recent surgeries, immobilization or recent travel. She reports that when she woke up her hands felt a little bit tingly. When the fire department arrived they found her to be bradycardic however by the time the medics arrived her heart rate had resolved. Her blood sugar was 110 on the scene. Medics noted that she was orthostatic on the scene as well. She currently is feeling well, has no complaints. States that she has gotten dizzy before in the past with COVID vaccines.


VAERS ID: 1209629 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-27
Onset:2021-03-30
   Days after vaccination:3
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: Dizziness, Fatigue, Headache
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)

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

Write-up: Headache, Dizziness and Fatigue


VAERS ID: 1209660 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-03-08
Onset:2021-03-17
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 18050 / 1 UN / IM

Administered by: Other       Purchased by: ?
Symptoms: Chest pain, Computerised tomogram thorax, Fibrin D dimer, Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Rosuvastatin
Current Illness: Knee surgery one month prior 2/15/2021
Preexisting Conditions: Hyperlipidemia
Allergies: No
Diagnostic Lab Data: CT chest/D dimer
CDC Split Type:

Write-up: Patient went to hospital with chest pain on 3/17 and was found to have a pulmonary embolus. Started on anticoagulant. Had full workup


VAERS ID: 1209674 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Oklahoma  
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 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Chest pain, Chills, Eye contusion, Eye pain, Feeling cold, Immediate post-injection reaction, Loss of consciousness, Malaise, Pain in extremity, Pain in jaw, Pallor, Pyrexia, Tremor
SMQs:, Torsade de pointes/QT prolongation (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Glaucoma (broad), Cardiomyopathy (broad), Osteonecrosis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin C, Vitamin D, Vitamin E, DHA Omega, probiotics, digestive enzymes, zinc
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Immediate loss of consciousness. I lost color in my face (pale white) I experienced chills and cold. My hands were shaking for about 4 hours following. From the fall, I developed right shoulder pain, right hip pain, jaw pain, right eye pain, right chest pain, right back pain, and a black eye. All symptoms have lasted a week.A I also had fever for about a day, along with generally feeling weak/unwell.A I


VAERS ID: 1209679 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-10
Onset:2021-03-17
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / N/A AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Alanine aminotransferase normal, Antineutrophil cytoplasmic antibody negative, Antinuclear antibody negative, Arthralgia, Aspartate aminotransferase normal, Biopsy abdominal wall normal, Biopsy muscle abnormal, Blister, Blood alkaline phosphatase normal, Blood creatinine normal, Cellulitis, Condition aggravated, Cutaneous vasculitis, Double stranded DNA antibody, Erythema, Full blood count normal, Gait disturbance, HIV antigen negative, Hepatitis viral test negative, Immunology test, International normalised ratio increased, Necrosis, Rash, Rash macular, Rash maculo-papular, Red blood cell sedimentation rate increased, Renal function test normal, Rheumatoid factor negative, SARS-CoV-2 test negative, Tenderness, Thrombosis, White blood cell count normal, X-ray abnormal
SMQs:, Rhabdomyolysis/myopathy (broad), Liver-related coagulation and bleeding disturbances (narrow), Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Haemorrhage laboratory terms (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Parkinson-like events (broad), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Vasculitis (narrow), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: warfarin 5 mg daily
Current Illness: was treated for acute recurrent sinusitis; URI: 2/24/2021 was treated with amoxicillin
Preexisting Conditions: Left proximal DVT on chronic anticoagulation, depression/anxiety, OSA, Erectile dysfunction w inflatable penile, prosthesis replaced 10/2020
Allergies: no known allergies to medications or otherwise
Diagnostic Lab Data: In the emergency department, vitals were notable for being afebrile, heart rate 111, blood pressure 162/104, normal oxygen saturation on room air. He was noted to have a maculopapular rash on bilateral lower extremities extending up the trunk to the chest. Laboratory workup showed a normal CBC, creatinine 1.29 (baseline 1), AST 34, ALT 36, alk-phos 117. INR was 2.3 on warfarin. For pain, he was given 1 tab of Norco and morphine 4 milligrams IV. He was admitted to General Medicine for further management. The patient was afebrile. He denied any chills, night sweats, change in weight, myalgias, arthralgias, or genitourinary, gastrointestinal, or pulmonary symptoms. The only medication he took was warfarin, and he denied any new or changes in supplements or medications. The patient denied history of autoimmune disease or recent infections. He was up to date on age-appropriate cancer screenings. Connective tissue and autoimmune laboratory work-up was negative, including antinuclear antibody, anti-double stranded DNA, perinuclear and cytoplasmic antineutrophil cytoplasmic antibodies, rheumatoid factor, extractable nuclear antigen panel, and compliment C3 and C4 level testing were within normal limits. Hepatitis panel and HIV antigen antibody testing were non-reactive. Hematologic, renal, and hepatic function were within normal limits. Direct immunofluorescence microscopy of a biopsied specimen from a new lesion on the abdomen was negative for specific immune deposits. Biopsy from his thigh revealed fibrinoid necrosis of vessel walls with fibrin thrombi, extravasated erythrocytes, and neutrophilic inflammatory infiltrate with leukocytoclasia. SARS COV-2 in situ hybridization was negative. The diagnosis of LCV was rendered, and initiation of high dose corticosteroids led to improvement of his cutaneous symptoms and clinical appearance of the rash. He was discharged with a home taper prednisone plan to complete 5 day course of each as follows: 100 mg, 80 mg, 60 mg, 40 mg, 20 mg, and 10 mg. The patient also presented with severe left ankle pain. The ankle lesions preceded the ankle pain, so it was suspected that the pain was likely related to cutaneous vasculitis. Ankle XR was not concerning for acute process, only soft tissue swelling. ESR and CRP were 40 and 1.7 respectively. He was afebrile, had a normal white blood cell count, and denied systemic symptoms. His physical exam was not concerning for septic arthritis. Vascular etiologies were ruled out with duplex and doppler of the left lower extremity. While inpatient, the patient''s pain was managed with scheduled Tylenol and low-dose opiates as needed. The patient was provided with a walker to take home with him. He was also provided a short course of opiate pain medication. The risks and benefits of taking the medication were discussed with the patient and start talking form was completed. Outpatient follow up with dermatology on 3/24/2021 showed continued improvement of the lesions, and no new lesions. However, left ankle pain was still prominent. Phone call on 4/14/2021 the patient reported continued difficulty with walking and oozing of the lesions.
CDC Split Type:

Write-up: Patient received his J&J vaccine for COVID-19 on 03/10/2021. On 3/17, he was at the grocery store when he felt a sting on his left lateral ankle. When he pulled up his pant leg, he saw the small little red spots that were exquisitely tender. He went immediately to his primary care physician''s office, where he was prescribed Bactrim for suspected cellulitis. The rash steadily worsened with extension up his left leg and onto his right leg and blistering of some of the lesions most markedly in his groin. Pain associated with the rash increased and remained most severe on the lateral aspect of the left ankle. He presented back to his primary care physician''s office on 3/19, where he was given methylprednisolone 80 milligrams IV, discharged with a prescription for prednisone 60 milligrams daily for the next few days. Pain worsened the morning of 3/20/21 to the point that he was unable to bear much weight on the left leg prompting his presentation to the emergency department.


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