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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: 1211952 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-09
Onset:2021-04-17
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Blood test, Computerised tomogram, Electrocardiogram, Fibrin D dimer, Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: HIT (heparin induced thrombocytopenia) High blood pressure Esophogectomy from EC
Allergies:
Diagnostic Lab Data: EKG - 11/14 CT''s with contrast - 11/14 D-Dimer - 11/14 bloodwork- 11/13
CDC Split Type:

Write-up: pulmonary embolisms


VAERS ID: 1212002 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / N/A RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Decreased appetite, Fatigue, Hypersomnia, Injection site erythema, Pain, Pain in extremity, Platelet count normal, Restless legs syndrome, Seizure like phenomena, Vomiting
SMQs:, Acute pancreatitis (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations: flu vaccine
Other Medications: Yaz- birht control vitamin B12 vitamin D salt pills multivitamins one a day
Current Illness: POTS, MCAS, EDS, chronic fatigue, dysautonomia
Preexisting Conditions: POTS, MCAS, EDS, chronic fatigue, dysautonomia
Allergies: penicillin amoxicillin fentanyl Sudafed dilaudid
Diagnostic Lab Data: please contact the physician or hospital for details. We were not provided a list of blood work. We did ask about platelets and were told the level was "normal"
CDC Split Type:

Write-up: my daughter, 30 year old, on disability with POTS, MCAS, EDS, dysautonomia, received the JJ COVID vaccine at 1:30 PM on 4/9/2021.. She started vomiting 20 minutes after the vaccine was administered and the pharmacist said it was because she was anxious and has not eaten much. We went home, she was very tired and slept most of the afternoon. At 6 PM she started vomiting again. It continued till 10:30 PM when she could not drink anything. We went to the hospital where she exhibited what looked like a seizure in the waiting room and was admitted to the hospital for observation. Discharged 4/10/2021 evening. 4/11/2021 exhibited restless leg syndrome, could not sit, lay down, whole body aches. 4/12/2021 extremely sore arm, could not move it without pain. Area of injection looks read but not hot and no swelling.


VAERS ID: 1212087 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-03-09
Onset:2021-04-01
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Injection site pain, Lethargy, Myalgia, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

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

Write-up: Site: Pain at Injection Site-Mild, Systemic: Body Aches Generalized-Medium, Systemic: Right leg pain-Medium, Systemic: Joint Pain-Mild, Additional Details: Patient states she is suffering from right leg muscle pain that started on 04/01/2021. She saw on the news about the Johnson & Johnson vaccine being paused so she is wondering if her pain is a result of her vaccine .She has an appointment to see her doctor tomorrow on 04/15/2021.


VAERS ID: 1212116 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Ageusia, Angiogram, Body temperature increased, Chest X-ray, Chest pain, Dysgeusia, Electrocardiogram, Full blood count, Metabolic function test, Nausea, Pyrexia, Sleep disorder, Troponin, Urticaria
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CXR, CT angio, basic metabolic panel, cbc, troponin, ekg all done on 4/13
CDC Split Type:

Write-up: Due to history of vaccine reaction of hives to flu vaccine, took 25 mg benadryl 1.5 hours prior to receiving covid vaccine. approximately 1 hours after vaccination, experienced sharp, constant retrosternal chest pain that is was non-radiating. on 4/11 experienced fever, and developed hives to right arm that injection was given as well as nausea without vomiting or diarrhea. Fever continued x 4 days with maximum temperature of 102.9 on 4/12. Chest pain continues as of 4/15. On 4/14 at approximately 2am was awoken with worsening chest pain and at that time also noticed development of a metallic taste in mouth, and since that time have been unable to taste anything but metal regardless of what is eaten or drank. Still with chest pain and metallic taste, hives resolved 4/12 evening and fever resolved on 4/14 late evening.


VAERS ID: 1212121 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Malaise, Menstrual disorder, Nausea, Pain, Seizure
SMQs:, Acute pancreatitis (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

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

Write-up: Systemic: Body Aches Generalized-Medium, Systemic: Nausea-Medium, Systemic: Seizure-Medium, Additional Details: patient was taken to er after having a seizure. patient has been feeling sick ever since injection and has missed her period. The physicians at the Emergency room said they could not find anything wrong with her. But mother is convinced something is not right. she is seeking a second opinion from different hospital


VAERS ID: 1212142 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-03-09
Onset:2021-03-15
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Peripheral swelling, Ultrasound scan
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Humulin R U-500, Hydrochlorothiazide 12.5 mg, Metformin 500 ml, Verapamil 240 mg, Rosuvastatin calcium 5mg, Montelukast sodium 10mg, Lisinopril 40mg, Meloxicam15 mg
Current Illness:
Preexisting Conditions: Diabetes, COPD
Allergies: Viagra
Diagnostic Lab Data: Ultrasound 4/8/2021
CDC Split Type:

Write-up: Started with swelling of Rt. lower leg with pain, pain went to Rt. and Lt. side of upper leg, had appointment with Fam. Doctor was sent to get Ultra sound of Rt. upper leg was then advised to go straight to emergency room, started on cores of blood thinners after a blood clot was found.


VAERS ID: 1212147 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-09
Onset:2021-04-14
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Deep vein thrombosis, Dyspnoea, Pain in extremity, Platelet count normal
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (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: Insulin glargine
Current Illness: N/A
Preexisting Conditions: Diabetes
Allergies: No known drug allergies
Diagnostic Lab Data: None at the time of presentation. Noting platelet counts normal at the time.
CDC Split Type:

Write-up: Patient presented with leg pain and shortness of breath to the emergency department. Was subsequently found to have a DVT


VAERS ID: 1212154 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-03-09
Onset:2021-03-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Back pain, COVID-19, Chest X-ray, Chills, Computerised tomogram, Cough, Dyspnoea, Fatigue, Headache, Nausea, Oropharyngeal pain, Pain, Pain in extremity, SARS-CoV-2 test positive, Tremor
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Infective pneumonia (broad), 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: none
Current Illness: none
Preexisting Conditions: partially clotted varicose vein in upper right thigh
Allergies: amoxicillan, penicillan
Diagnostic Lab Data: 3/19/21 - chest x-ray, CT scan at hospital
CDC Split Type:

Write-up: Within 4 hours of receiving the vaccine on 3/9/21 I felt exhaustion, body aches, chills and headache. About 30 hours later I started to experience extreme leg pain/tremors, severe nausea and an unrelenting headache, lower back pain and continued chills. 6 days after receiving the vaccine (3/15/21) I tested positive for Covid-19 and the symptoms worsened. 8 days after receiving the vaccine I developed a cough and sore throat and trouble breathing. 10 days after receiving the vaccine I went to the emergency room (3/19/21) and received a chest x-ray and diagnosed with covid pneumonia and given antibiotics to treat along with a CT scan. Symptoms started to subside about 2 weeks after receiving the vaccine, although to this day I am still troubled with a lingering headache and constant fatigue. Throughout the duration I relied on Tylenol and Motrin. At the hospital I was prescribed indomethacin and ondansetron for pain and nausea.


VAERS ID: 1212156 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / N/A RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dysphagia, Tongue erythema, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)

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

Write-up: pt. having difficulty - swallowing, redness noted on tongue; no swelling; exp. wheezing noted 50 mg benadryl IM right thigh at 1450- Epi given at 1500 after pt. noted to have exp & insp wheezing. Ambulance called & transported to hospital


VAERS ID: 1212280 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-03-20
Onset:2021-04-09
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chest pain
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Routine daily meds- Aspirin, Avastatin, Nitro patch, Naproxin, "pain killers"-unsure name
Current Illness:
Preexisting Conditions: History of heart disease with a heart attack in 2014 with stent She has had 5 other stents since then. Last being on 12/01/2020. History of 3 back surgeries.
Allergies: Oxycodone
Diagnostic Lab Data:
CDC Split Type:

Write-up: Complaints of chest pain. She went to ER. She was sent home and said no heart attack. She then had another episode of chest pain on 04/11/21 and went to ER and was sent home and told to see cardiologist.


VAERS ID: 1212310 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: amoxicillan
Diagnostic Lab Data: We went to hospital when his fever started to rise. They took blood and did triage, but we never saw a Dr....his fever broke on it''s own at 4:30am
CDC Split Type:

Write-up: High fever 104.6 at 1:30am


VAERS ID: 1212317 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-06
Onset:2021-04-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chills, Nasal congestion, Pain, Paranasal sinus discomfort, Pyrexia, SARS-CoV-2 test positive
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), 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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Positive test on 4/10/2021
CDC Split Type:

Write-up: I had fever, body ache, chills , congestion and sinus pressure for over a week. I tested positive for COVID after and negative before my shot


VAERS ID: 1212347 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-10
Onset:2021-04-13
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN J&J / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Hot flush, Nausea, Pyrexia, Tremor, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (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? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Thyroid medication 112mg
Current Illness: none
Preexisting Conditions: underactive Thyroid
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: first day: horrible headache, vomit, shakes,fever. NOW: fatigued, hot flashes, chills, nauseous


VAERS ID: 1212413 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-06
Onset:2021-04-14
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Balance disorder, Blood test, Computerised tomogram, Dizziness, Electrocardiogram, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), 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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Wellbutrin
Current Illness: None
Preexisting Conditions: None
Allergies: Ambien, keflex, flagella, compezinr
Diagnostic Lab Data: Ct scan Blood work Ekg
CDC Split Type:

Write-up: Lightheaded, blurry vision off balance


VAERS ID: 1212417 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-11
Onset:2021-04-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Diarrhoea, Dizziness, Fatigue, Headache, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Headache in back of head started day after the shot. Was intermittent, but now 4/15 has developed into worst headache of life. Since day after vaccine had fever, diarrhea, fatigue, nausea, dizziness 4/13 had N/V. Stomach pain today around belly button.


VAERS ID: 1212453 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chest discomfort, Chills, Erythema, Fatigue, Hypoaesthesia, Injection site swelling, Nausea, Paraesthesia, Vomiting
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

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

Write-up: 24 hours post (4/11) n/v, chills, fatigue; 4/14 numbness/tingling R arm (opposite); chest tightness. local site small swollen, red area;


VAERS ID: 1212458 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-03-06
Onset:2021-03-20
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Aphasia, Cerebral thrombosis, Craniocerebral injury, Mobility decreased, Skull fracture, Thrombosis
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Parkinson-like events (broad), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Hypertension, hypothyroidism, hyperlipidemia
Preexisting Conditions: Hypertension, hypothyroidism, hyperlipidemia
Allergies: NKA
Diagnostic Lab Data: Treated at Medical Center 3/20/21
CDC Split Type:

Write-up: 2 weeks 8 days after vaccine, patient suffered which sent pt to emergency room. Husband states she had a "blood clot" to brain with skull fracture and traumatic brain injury. Transferred to Medical Center, then to long term facility. Has not recovered to date. Husband states unable to speak or move.


VAERS ID: 1212460 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-11
Onset:2021-04-13
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Laboratory test, Pain in extremity, Paraesthesia, Platelet count normal, Ultrasound Doppler normal
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Ultrasound - 4/14/21 (no DVT) Blood work - 4/13/21 and 4/14/21 (Platelets and blood normal)
CDC Split Type:

Write-up: Tingling and pain in both legs beginning 48 hours after shot. Still happening 4 days after shot


VAERS ID: 1212461 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-03-12
Onset:2021-04-14
   Days after vaccination:33
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Chest pain, Computerised tomogram thorax, Pain in extremity, Platelet count normal, Pulmonary embolism, Ultrasound Doppler, Ultrasound Doppler normal
SMQs:, Embolic and thrombotic events, venous (narrow), 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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Calcium carbonate 500 mg po qHS, Kariva 1 tab po qHS, escitalopram 10 mg po daily, fexofenadine 180 mg po daily, and pantoprazole 40 mg po daily.
Current Illness: none
Preexisting Conditions: Hyperlipidemia, anxiety, and PCOS
Allergies: Codeine (hives, shortness of breath)
Diagnostic Lab Data:
CDC Split Type:

Write-up: On 4/15/2021 patient presented with chest pain and left lower extremity pain, which started about 2 days prior to admission. CTA showed large volume multifocal bilateral pulmonary emboli throughout numerous right lower lobe, right middle lobe, right upper lobe, left upper lobe, and left lower lobe segmental branches. Left lower extremity venous ultrasound showed no evidence of deep or superficial vein thrombosis; the right lower extremity was not scanned. Patient denies personal or family history of VTE. She states that she does not smoke and has no history of smoking. Patient was treated with apixaban 10 mg po BID x7 d followed by 5 mg po BID. Platelets were 295 on admission.


VAERS ID: 1212470 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-01
Onset:2021-04-14
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Pleuritic pain, Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow), 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, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: sertraline
Current Illness: no
Preexisting Conditions: none
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: 29yom with no significant medical history was diagnosed by CT with acute pulmonary embolism involving the branch vessel in the right lower lobe 14 days after receiving Johnson & Johnson vaccine. Symptoms of right pleuritic pain began 4 days prior to the diagnosis. Initiated therapy on oral anticoagulants.


VAERS ID: 1212565 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-04-09
Onset:2021-04-14
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Coeliac artery stenosis, Computerised tomogram abdomen abnormal, Computerised tomogram pelvis abnormal, Splenic artery thrombosis, Splenic infarction
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), 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, 1 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: Developed acute severe abdominal pain and found to have splenic infarct, splenic artery thrombosis, celiac artery stenosis on morning of 4/14/2021 on CT abd/pelvis with IV contrast and presented to ED for symptoms. Started on apixaban.


VAERS ID: 1212596 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-03-31
Onset:2021-04-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood lactic acid normal, Confusional state, Discomfort, Endotracheal intubation, Feeling abnormal, Intensive care, N-terminal prohormone brain natriuretic peptide increased, Sepsis, Troponin T increased, Unresponsive to stimuli
SMQs:, Cardiac failure (broad), Angioedema (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Respiratory failure (broad), Hypoglycaemia (broad), Sepsis (narrow), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Spironolactone Duloxetine Insulin Lactulose Nadolol Rifaximin SITagliptin Bumetanide Omeprazole Cyanocobalamin cholecalciferol
Current Illness: None
Preexisting Conditions: Cirrhosis Diabetes, Type 2
Allergies: Aspirin, Beta Blockers, Statins
Diagnostic Lab Data: SEPSIS LACTATE WITH REFLEX result 4.5 PRO B-TYPE NATRIURETIC PEPTIDE result 1984 Troponin T high-sensitivity result 93
CDC Split Type:

Write-up: Patient woke up at 3am not feeling good and confused. Became increasingly confused and uncomfortable. Not very responsive to caregivers. Called an ambulance at 7:30am. ER ran tests that showed Sepsis with n o underlying infection. Patient had to be intubated. Admitted to ICU in hospital. Spent 3 days there and 4 days in regular room at hospital. Then transferred to a rehabilitation clinic where she is currently.


VAERS ID: 1212613 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-03-24
Onset:2021-04-03
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lasix, Propanolol, Protonix, Prednisone, Potassium, Crestor, Amitiza, Humalog, Rituxan,Vitamin D3, Hydroclorathiazide, Benicar
Current Illness: left eye dysfunction
Preexisting Conditions: R A, diabetes, crohns, hypertension, kidney disease
Allergies: Sulfa, Amoxicillin, opana, IVP dye
Diagnostic Lab Data: Hospitalization,Stroke
CDC Split Type:

Write-up: stroke


VAERS ID: 1212647 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anxiety, Blood test abnormal, Dizziness, Fatigue, Pain in extremity, Platelet count decreased, Pyrexia, Rash, Rash erythematous, Throat tightness, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Haematopoietic thrombocytopenia (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), 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? No
Previous Vaccinations:
Other Medications: Levothyroxine
Current Illness: no
Preexisting Conditions: none
Allergies: benzonatate
Diagnostic Lab Data: Blood work
CDC Split Type:

Write-up: pt says she had an achy left arm w/ fatigue. Next day she had a low-grade fever and hives on her stomach. She started taking Benadryl per Teladoc. She started getting very dizzy and her hives were moving towards her shoulders and her throat was closing up. 911 was called. She was told her anxiety was very high. She was transported to Hospital ER. She was put on fluids and steroids, (methylprednisolone 125mg, famotidine 20mg, sodium chloride 100ml) They did blood work which showed low platelets. Her rash was bright red and spreading down her arms and her stomach while she was being monitored. She was discharged w/ DX; Acute allergic reaction and given an EPI pen and oral steroids. She has a FU w/PCP on 5/3/2021 to check blood platelets and will go from there.


VAERS ID: 1212666 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-03-31
Onset:2021-04-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Computerised tomogram, Haematology test, Laboratory test, Palpitations, Pregnancy test, Pyrexia, Seizure, Urine analysis
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data: CT SCAN LABORATORY TEST HEMATOLOGY CHEMISTRY LAB TEST URINE TEST PREGNANCY TEST
CDC Split Type:

Write-up: SYMPTOMS PRESENTED: SEIZURES, PALPITATIONS, FEVER, PULSE IN 125-130 FOR SEVERAL HOURS EVEN WHEN I WAS RESTING, BLOOD PRESSURE 86/66


VAERS ID: 1212673 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-06
Onset:2021-04-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Contusion, Pain in extremity, Platelet count normal, Thrombosis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Accidents and injuries (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Metoprolo, Duloxetine, Bupropion, Armodafinil, Gabapentin, D3
Current Illness: No illnesses
Preexisting Conditions: Arrythmia, AICD Implant, Willis-ekbom disease
Allergies: No Allergies
Diagnostic Lab Data: 04/14/16, Blood test, platelet was within range, clotting was within range. Imaging shows partial blockage.
CDC Split Type:

Write-up: Blood Clot and bruising on lower backside of leg, I noticed leg Pain (just uncomfortable) in the right leg at the location of clot. A time frame in relationship to the time of shot is unkown. Estimated within 24 hours. Bruising appeared morning of 04/14/21, PCP recommended in person visit. I went to urgent care, they had me drive to emergency Room at local hospital. Evaluation, blood testing and imaging concluded a blood clot in the lower right leg. Blod thinners was prescribed Eliquia 5 mg, discharged same day. It may be possible the hospital had submitted this form on my behalf.


VAERS ID: 1212692 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-03-30
Onset:2021-03-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Swelling face
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: zyrtec, benadryl
Current Illness:
Preexisting Conditions:
Allergies: IV contrast, motrin, penicillins, premarin, prevacid, sulfa drugs, pineapple, shell fish
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient had onset on facial swelling while driving home s/p Johnson and Johnson vaccine after waiting in office for over an hour. No lip or tongue swelling or shortness of breath. Had zyrtec with her and took 10mg. Did not use epi-pen. Drove herself to ER, was given 50mg benadryl with improvement and was monitored. Continued on 50mg benadryl at night and 10mg zyrtec daily and doing better.


VAERS ID: 1212693 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-12
Onset:2021-04-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood pressure increased, Computerised tomogram, Full blood count, Headache, Metabolic function test, Nausea, Tachycardia, Troponin, Urine analysis, X-ray
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: cbc, urinalyses, cardiac troponin, metabolic panel, CT scan, x ray
CDC Split Type:

Write-up: Tachycardia, elevated BP, nausea, headache


VAERS ID: 1212752 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-26
Onset:2021-03-27
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 RL / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Computerised tomogram normal, Decreased appetite, Laboratory test normal, Nausea, Tachycardia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Dehydration (broad)

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

Write-up: presents originally for loss of appetite and nausea vomiting times eight X 1 day after getting her Johnson & Johnson vaccine. Since she came into the emergency room last night her vomiting has subsided,4L of LR given, pain has been controlled, however she remain tachycardic after negative infectious work up, negative CT scan


VAERS ID: 1212814 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-09
Onset:2021-04-14
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / 1 UN / IM

Administered by: Other       Purchased by: ?
Symptoms: Aphasia, Carotid artery stenosis, Cerebral infarction, Dysarthria, Ear discomfort, Eye pain, Hypoaesthesia, Intensive care, Jaw disorder, Magnetic resonance imaging head abnormal, Muscular weakness, Tongue discomfort
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Ischaemic central nervous system vascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Glaucoma (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: complex migraines, menorrhagia and heart murmur since childhood smoked for 25y, quit in Jan 2021
Allergies: codeine
Diagnostic Lab Data: Patient underwent MRI and MRA of the brain which showed multifocal small acute infarcts along the right frontal and right parietal lobes, as well as punctate acute infarcts in the right occipital lobe. No evidence of intracranial bleeding. Also noted a filling defect in the right carotid bifurcation causing severe stenosis of the right ECA origin and moderate stenosis of the right ICA origin
CDC Split Type:

Write-up: Patient states that she had acute onset of left arm weakness, numbness, difficulty speaking and slurred speech that started at 22:50. Patient was seen as a code stroke, was FANG?D +. Patient underwent MRI and MRA of the brain which showed multifocal small acute infarcts along the right frontal and right parietal lobes, as well as punctate acute infarcts in the right occipital lobe. No evidence of intracranial bleeding. Also noted a filling defect in the right carotid bifurcation causing severe stenosis of the right ECA origin and moderate stenosis of the right ICA origin. Patient was not given TPA, and was started on heparin drip and admitted to the ICU. Patient did receive the Johnson & Johnson Covid?19 vaccine on 4/9. Patient also complained of right ear and right jaw discomfort, pain behind L eye and L aura, as well as burning discomfort of the back of her tongue for the past two days Started on heparin drip initially and then converted over to argatroban drip based on CDC guidance. No IVIG given as platelets are $g 500


VAERS ID: 1212826 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-03-05
Onset:2021-03-28
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Aphasia, Chest pain, Electrocardiogram normal, International normalised ratio normal, Movement disorder, Platelet count normal, Troponin normal, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Dementia (broad), Akathisia (broad), Dyskinesia (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 (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 19 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: aspirin EC 81 mg QD, rosuvastatin 20 mg QD, multivitamin, lisinopril 10 mg QD, escitalopram 10 mg QD, vitamin D 1000 QD, vitamin B-12 100 mcg QD, vitamin E 100 units QD
Current Illness:
Preexisting Conditions: hypertension, hyperlipidemia, depression
Allergies: PCN, sulfa (yeast infection to both)
Diagnostic Lab Data: 3/28/2021 EKG showed normal sinus rhythm. 3/28/2021 troponin <0.012 3/28/2021 INR 0.93 3/28/2021 platelet count 265 K/ul
CDC Split Type:

Write-up: 3/28/2021 at 6:00 a.m. patient reported chest pain to a family member. He arrived at her home at 6:15 and found her slumped to the right in her chair, unresponsive. Patient was taken to our facility via EMS. On arrival, patient could open her eyes but could not talk or move her extremities. She was treated with alteplase 100 mg and flown to a trauma center. She was released on 4/2 and is currently receiving rehabilitation services in our facility; she is expected to return home in 4-5 days.


VAERS ID: 1212835 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-04-09
Onset:2021-04-11
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Kidney infection, Laboratory test abnormal, Pain, Pain in extremity, Swelling, Urine analysis abnormal
SMQs:, Anaphylactic reaction (broad), Angioedema (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: HYDROCODONE, MELOXICAM, VIT D, PANTOPRAZOLE
Current Illness: POSSIBLE KIDNEY STONES/ KIDNEY INFECTION
Preexisting Conditions: HYPOTHYROIDISM, OSTEOARTHRITIS
Allergies: NUTS, SEASPONAL ALLERGIES, GREENS
Diagnostic Lab Data: PT SAID THEY DID BLOOD WORK AND URINE TEST AND THATS WHEN THEY DISCOVERED POSSIBLE KIDNEY INFECTION
CDC Split Type:

Write-up: PATIENT EXPERIENCED PAIN/SWELLING AT STARTING ON SUNDAY APRIL,11 2 DAYS AFTER INJECTION, MORE PAIN THAN WITH OTHER VACCINES. MONDAY MORE PAIN HAD DEVELOPED AND EXTENDED DOWN THE REST OF HER ARM. I SPOKE WITH PT ON APRIL 10, TALKED ABOUT POSSIBLE REMEDIES BUT EXPRESSED THAT SHE MIGHT WANT TO CONSIDER GOING TO THE DR JUST IN CASE THERE WAS INFECTION AND TO RULE OUT ANYTHING ELSE. PATIENT WENT TO ER AFTER PHONE CALL, THEY GAVE HER A ROCEPHIN AND STEROID SHOT, A PRESCRIPTION OF KEFLEX AND INSTRUCTIONS TO FOLLOW UP IF NOT BETTER AFTER 72 HOURS


VAERS ID: 1212844 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: New Hampshire  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chest discomfort, Fatigue, Myalgia, Pain, Pruritus, Pyrexia, Rash
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Sinus infection 6 weeks prior to vaccination, treated with Augmentin x 10 days (course completed weeks prior to vaccination)
Preexisting Conditions: IgA deficiency (complete) and IgG deficiency (severe)
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fatigue, Fevers, Painful Itchy Rash, Muscle aches and pains, Chest "stitch"


VAERS ID: 1212875 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Delaware  
Vaccinated:2021-03-13
Onset:2021-03-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram head, Headache
SMQs:

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: ASA 81 mg Zyrtec 10 mg PO QD
Current Illness: Sinus Congestion History of COVID
Preexisting Conditions: Factor V Leiden
Allergies: None known
Diagnostic Lab Data: CT of head 4/10/2021 CT angio of head 4/10/2021 xray of chest 4/10/2021
CDC Split Type:

Write-up: Daily Headache since vaccination


VAERS ID: 1212932 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Back pain, Blood test normal, Chest X-ray normal, Chest pain, Dyspnoea, Fatigue, Headache, Mobility decreased
SMQs:, Anaphylactic reaction (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (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: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: I had a chest X-ray that came out normal and had bloodwork done that came out normal. They said the headache and fatigue are normal but its been a week now and they cant explain the chest pain.
CDC Split Type:

Write-up: the next morning (4/9/21) i had a very bad headache and my lower bad hurt so bad i could barely move, extremely tired. slept most of the day. this continued until Monday. Monday my back was better and headache was better but very tired. Starting Monday night and continuing currently my chest has a sharp pain and i lose my breathe very quickly doing any kind of strenuous activity. Headache and fatigue have continued since then also.


VAERS ID: 1212936 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-06
Onset:2021-04-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest X-ray abnormal, Chest pain, Computerised tomogram thorax abnormal, Dizziness, Dyspnoea, Electrocardiogram normal, Fibrin D dimer increased, Injection site pain, Lung opacity, Pain, Painful respiration, Paraesthesia, Pulmonary embolism, Ultrasound Doppler normal
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Haemorrhage laboratory terms (broad), Interstitial lung disease (narrow), Anticholinergic syndrome (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Infective pneumonia (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? No
Previous Vaccinations:
Other Medications: Allopurinol, Finasteride
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: EKG - normal Chest X-ray - showed ground glass appearance D-Dimer - elevated results which indicated potential thrombus CT Scan - showed many pulmonary emboli, in both lungs, top/bottom Leg Ultrasound - no trace / evidence of DVT or clotting
CDC Split Type:

Write-up: Got COVID (Janssen) vaccine shot on April 6th at noon. Felt fine Tuesday and went to bed as normal. Woke up April 7th at 7AM with sharp pains in my left shoulder (same side as shot) and slight shortness of breath, and slight chest pain in the left quadrant of my torso (same side as shot). Proceeded to take Advil and seemed to help a bit. Minor aches/pains and shortness of breath throughout the day until about 8PM. At this time shoulder chest pain became more severe, and breathing became very strained, short, and painful. Pain and breathing kept getting worse and at midnight on Wednesday night thought I was having a heart attack due to extreme chest pain, couldn''t breath, lightheaded, dizzy, tingly extremities. My wife drove me to ER at 12:30 AM Thursday.


VAERS ID: 1212994 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-17
Onset:2021-04-08
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bell's palsy, Facial paresis, Neurological examination, Pain in jaw
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad), Osteonecrosis (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro; Wellbutrin; Armor Thyroid; Seroquel
Current Illness: no
Preexisting Conditions: hypo thyroid
Allergies: Latex
Diagnostic Lab Data: Neurological exam
CDC Split Type: vsafe

Write-up: I got Bells Palsy - it was on the left side of my face - I went to the ER that Friday (9th). They gave me prednisone. It''s getting better. I still experience little pain in the jaw area on my left side; a little weakness still on the left side of my cheeks. I am still taking the prednisone.


VAERS ID: 1213004 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Peripheral swelling, Ultrasound Doppler normal
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ALBUTEROL 90MCG (CFC-F) 200D ORAL INHL INHALE 2 PUFFS BY MOUTH EVERY 6 HOURS AS NEEDED FOR BREATHING ASPIRIN 81MG CHEW TAB CHEW one tab daily DICLOFENAC NA 1% TOP GEL APPLY 1 MODERATE AMOUNT TO THE SKIN FOUR TIMES
Current Illness: None
Preexisting Conditions: Carpal tunnel syndrome Edema of lower extremity History of repair of rupture of quadriceps tendon Diabetes mellitus Benign essential hypertension Lumbar radiculopathy Overactive bladder Gastroesophageal reflux disease Hyperlipidemia Vitamin D deficiency Neck Pain Pain In Leg Benign prostatic hypertrophy without outflow obstruction Shoulder Joint replacement Status
Allergies: METFOMRIN CAUSES INDIGESTION
Diagnostic Lab Data: Doppler of left lower extremity was negative for Deep Vein Thrombosis
CDC Split Type:

Write-up: Patient called reporting right lower extremity swelling that started in his right ankle about 45 minutes after his vaccination. The swelling gradually went up to his calf.


VAERS ID: 1213016 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-19
Onset:2021-03-28
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 0260364-14488 / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Gait inability, Pain in extremity
SMQs:, Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (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: Losartan Janumet Norvasc Lipitor Hydrodiuril Xalatan opthal. sol. Timolol opthal. sol.
Current Illness: Neck pain
Preexisting Conditions: Diabetes HTN Hyperlipidemia Glaucoma
Allergies: No known allergies
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 10 days after receiving Janssen COVID-19 vaccine I suddenly developed severe pain to my right leg. Pain was so severe I could not walk, I dragged myself into the medicine pantry and believing it could possibly be a thrombosis, I instantly took 2 baby aspirins. Although I wanted to call for help, I was too far from my phone therefore I began to massage the area and remained in place until the pain subsided enough to regain movement.


VAERS ID: 1213020 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-08
Onset:2021-03-17
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenopia, Bell's palsy, Dry eye, Dysarthria, Dyspnoea, Eyelid disorder, Feeding disorder, Feeling abnormal, Headache, Lacrimation increased, Neck pain, Oropharyngeal pain, Peripheral swelling, Sleep disorder, Speech disorder, Throat irritation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Psychosis and psychotic disorders (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Corneal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hearing impairment (broad), Conjunctival disorders (narrow), Lacrimal disorders (narrow), Periorbital and eyelid disorders (narrow), Arthritis (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Simvastatin, Losartan, Metformin, Amlodipine. 4 TOTAL, everyday.
Current Illness: none
Preexisting Conditions: High blood pressure. Obesity. Borderline diabetic (A1C = 7)
Allergies: Erythromycin.
Diagnostic Lab Data: * MAR 21st = Emergency Room. Diagnosed w/ BELLS PALSY. * APR 1st = first available date to be seen by my Primary Care Physician (PCP). She examined me for BELLS PALSY. Doctor referred me to a NEUROLOGIST. * MAY 3rd = first available date to be seen by Specialist Doctor. Still waiting for appointment date.
CDC Split Type:

Write-up: * MAR 8th = Vaccine shot * MAR 15th = alleged "sore throat" * MAR 19th = watery eyes; dry eyes; tired eyes. Onset of right eye not blinking/closing. * MAR 21st = Emergency Room. Diagnosed w/ BELLS PALSY. [Ruled out stroke] The following week after my vaccination (approximately MAR 15th), I experienced a strange feeling at the back of my throat. It can best described as a "sore throat". I noticed it upon waking up. I could feel it at the back of my throat when swallowing; the act of swallowing would enable me to "feel" the sensation at the back of my throat. This was unusual and not normal for me. I thought I was coming down with a cold virus. I had not been sick for over a year and thought it was a strange feeling. I was concerned. With the recent schools, restaurants, and gyms opening up with less restrictions, I learned from coworkers that there was an increase of illnesses because our immune systems are not as strong and germs are easily transferable during the usual interactions. Therefore, I expected my sore throat to be the start of a harmless cold virus. Then, later in the week (MAR 19th), I noticed my eyes were abnormally dripping tears. It is my experience that I get this effect in the office setting or during winter when my eyes are "dry". However, I was neither in the workplace (office), nor was it winter. I was not sure why my eyes had excessive tears coming out. Finally, on SUN (MAR 21st), an obvious physical symptom finally became apparent to me and my family members. My speech was impaired. I could not chew properly. I could not drink from a cup. I struggled during breakfast. I was not sure if I was having a STROKE. I recited the alphabet to hear for a slurred speech. I looked in the mirror, and my smile was not perfect. I got dressed and went to the Emergency Room. The doctors performed physical PUSH-PULL tests, eye tests, etc. DIAGNOSIS = Bells Palsy. OTHER SYMPTOMS = + shortness of breath. + leg swelling. + headaches. + excruciating pain in the neck, especially during sleep (laying down).


VAERS ID: 1213025 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-07
Onset:2021-04-14
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chest X-ray, Ear pain, Electrocardiogram, Head discomfort, Headache, Muscular weakness, Urine analysis
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (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: Tramadol, Methylene Blue, Ketotifen oral capsule
Current Illness: no active illness at time of vaccine
Preexisting Conditions: Lyme disease, possible MS, neuropathy, chronic pain syndrome, chronic fatigue syndrome, chronic headaches/migraines
Allergies: Sulfa drugs, Codeine, Prednisone, Latex
Diagnostic Lab Data: Neuro exam, 2vw chest radiograph, Urinalysis, EKG (all done at urgent care 4/14/21)
CDC Split Type:

Write-up: Atypical Headache 8 days post J&J vaccine. Woke up with headache at 7:30am and the headache got progressively worse throughout the day. Headache symptoms included head pressure, ear pain, and generalized full body weakness. Went to urgent care at 6:00pm. Due to ongoing health issues it was hard for the doctor to tell if it was a reaction to the vaccine or not at the time of exam. The doctor discharged me and recommend I go to ER if symptoms progress/get worse.


VAERS ID: 1213036 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-24
Onset:2021-04-10
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Back pain, Blood glucose increased, Computerised tomogram abnormal, Electrocardiogram normal, Haematuria, Haemoglobin decreased, Haemoptysis, Hypertension, Pain, Pain in extremity, Peripheral swelling, SARS-CoV-2 test negative, Ultrasound Doppler, Urine analysis abnormal, Urine electrolytes normal
SMQs:, Cardiac failure (broad), Angioedema (broad), Haematopoietic erythropenia (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Tubulointerstitial diseases (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: aspirin, azelastine nasal spray, escitalopram, ibuprofen, levETIRAcetam, MVI, nitroGLYCERIN, pantoprazole
Current Illness: 3/9/21: CV LEFT HEART CATHETERIZATION, CORONARY ANGIOGRAM
Preexisting Conditions: ascending aortic aneurysm (Aug 2020); DVT; pseudoseizures; GERD; thrombocytopenia; tobacco, marijuana and cocaine use; mitral and tricuspid regurgitation; MRSA; bipolar; ADHD; aortic stenosis; CAD; heart valve disorder; dysrhythmia; asthma; seizures; brain cyst; hiatal hernia; pulmonary nodules; epilepsy; migraine; anxiety/depression; schizoaffective disorder;
Allergies: aztreonam, bee venom, carbapenems, ceclor, cephalosporins, depakote, penicillins, pineapple
Diagnostic Lab Data:
CDC Split Type:

Write-up: Received vaccine 3.24.21. Had been incarcerated / in prison system until 4.7.21. Complex past medical history. 4.10.21: Went to ED on 4.10.21 - for hematuria. CHIEF COMPLAINT: BLOOD IN URINE (patient reports hematuria an hour prior to arrival along with spitting up a large clot (hemoptysis). denies rectal bleeding at this time. denies being on a blood thinner. c/o back pain starting a few hours ago. HX aortic aneurysm and scheduled to get surgery in a few weeks. )Urinalysis returned showing moderate amount of blood was 73 RBCs. Patient did not have frank hematuria on specimen. Patient''s laboratory work otherwise remains unremarkable. Electrolytes within normal limits. Patient has a stable hemoglobin of 13.8. CT scan showed evidence of acute aortic dissection. There were scattered faint ground-glass opacities along the right upper lobe as well as left upper lobe. COVID-19 testing was added on after results. At this time I do not have a great explanation for the patient''s hematuria. I did instructed to follow up with Urology for further evaluation of this. He is hemodynamically stable I do not believe further testing is warranted at this time. Return precautions were discussed including urinary retention, large volume bleeding or any other concerning symptoms. He voiced understanding of this and was discharged stable condition. He was provided a work note as he is on probation and it is for her of his hospitalization at this time. 4.13.21: Went to ED on 4.13.21: CHIEF COMPLAINT: LEG PAIN (pt c.o. right leg swelling/pain that started 3 days ago; had johnson&johnson vaccine on 3/24 and is concerned for blood clots; supposed to have surgery at the end of the month; recently seen for blood in urine; c.o. generalized body aches)42-year-old male presents with right calf pain and reported swelling. On presentation patient is well-appearing and nontoxic, afebrile, hypertensive 134/113 with otherwise normal vital signs. On exam, the patient has no swelling in the bilateral lower extremities, he does have very mild tenderness to palpation in the right posterior proximal calf just below the knee. Remainder of physical examination is otherwise unremarkable. Given history of blood clot and reported right calf pain, right lower extremity duplex venous ultrasound ordered to evaluate for DVT. EKG was obtained on arrival, and showed normal sinus rhythm with no evidence of ST segment elevated for depression, no dysrhythmia, no comparison when compared with prior EKG from July 2019. Right lower extremity ultrasound showed no evidence of DVT. I shared results of the workup with the patient and told him that there is no indication for further workup or treatment at this time. I recommended Tylenol or Motrin as needed for right leg pain. I recommended compression stockings as needed for right leg swelling. I encouraged him to follow up with all specialists physicians as previously scheduled and with his primary care physician as needed. Office visit 4.14.21: Subjective: a 42 yr.. male evaluated with a video visit on 4/14/2021 Currently he complains of headache, hot/cold flashes (no fever), nasal congestion, and Bilat ear pain. R leg is swollen. The symptoms have been present for 2 day(s). Was incarcerated - has been out for about week. He denies a history of chills and fevers He has tried acetaminophen, Flonase for his symptoms. Sick Contacts: none known History is provided by patient There is history of asthma or recurrent respiratory infections. Went to the ER yesterday and 4/10 Had his J&J vaccine: 3/24 COVID19: negative 4/10


VAERS ID: 1213048 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-03-09
Onset:2021-03-18
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / UNK LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood pressure increased, Computerised tomogram thorax abnormal, Deep vein thrombosis, Full blood count abnormal, Headache, Joint swelling, Platelet count decreased, Pruritus, Rash, Ultrasound Doppler abnormal
SMQs:, Anaphylactic reaction (broad), Haematopoietic leukopenia (broad), Haematopoietic thrombocytopenia (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Bupropion, HCTz, Ibuprofen, Levothyroxine, Losartan
Current Illness:
Preexisting Conditions: hypothyroid, obesity
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: initial symptoms- rash, itching, elevated BP, headache, ankle swelling ultrasound on 4/6/2021 - bilateral DVT CBC low platelets - 16 thousand CT chest - moderate burden PE Pt. was hospitalized


VAERS ID: 1213052 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Bell's palsy, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Hearing impairment (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Pt had fever, extreme weakness, N & V, Bell''s Palsy. PT was seen by provider and sent to the ER.


VAERS ID: 1213069 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-02
Onset:2021-04-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Chills, Fatigue, Pain, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: RX U-500: Units75/20/35 Victoza: Units 1.8 Tegretol 400XRMG 2x daily Amlodipine 10 MG, 1x daily Sertaline 50MG , 1x daily Lossartan 100MG, 1x daily Carvedilol 25MG, 2x daily Spironolactone 50MG 1x daily Hydrochlorothiazide 25MG, 1x daily O
Current Illness: no illness to report
Preexisting Conditions: Diabetic, seizure disorder, high blood pressure, overweight.
Allergies: Allergic to kiwi fruit
Diagnostic Lab Data: XRays at Urgent Care on 4/3/2021.
CDC Split Type:

Write-up: 4/2/2021 3PM, Exhaustion and Chills 4/3/2021 8AM, Swollen left foot, painful to walk on 10/10 level of pain. Low back pain left side. 4/4/2021 - 4/15/2021: Exhaustion continues on and off


VAERS ID: 1213078 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Acute kidney injury, Bacterial test positive, Blood creatine normal, Blood culture, Blood lactic acid, Blood sodium decreased, Blood urea normal, C-reactive protein increased, Chills, Culture urine, Diarrhoea, Dysuria, Headache, Hyponatraemia, Leukocytosis, Nausea, Nitrite urine present, Procalcitonin increased, Pyrexia, Red blood cell sedimentation rate increased, Red blood cells urine positive, Urine abnormality, Urine analysis abnormal, Vomiting, White blood cell count increased, White blood cells urine positive
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hyponatraemia/SIADH (narrow), Chronic kidney disease (broad), Noninfectious diarrhoea (narrow), Tumour lysis syndrome (broad), Proteinuria (broad), Tubulointerstitial diseases (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Infective pneumonia (broad), Dehydration (broad), Sepsis (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: DM, thyroid disease
Allergies: CLINDAMYCIN; HYDROCODONE-ACETAMINOPHEN; ROFECOXIB
Diagnostic Lab Data: In the emergency room febrile 107.5? blood pressure 103/56, HR 135, RR 20, 100% on RA. His labs notable for leukocytosis 18.4, BUN/Cr 13/1.2, hyponatremia 132 , elevated infection markers CRP 260, ESR 49 and Procal 9.6. Lactic acid 1.8. UA cloudy with +ve nitrate. Urine microscopy RBC$g36, WBC$g100 and many bacteria. Blood and urine cultures obtained. In ED received Vancomycin and ceftriaxone and 1 L of RL
CDC Split Type:

Write-up: Pt received the J&J vaccine on Monday 4/12 around 10 am. Reports onset of diarrhea mon night, frequent episodes. Then Tuesday 4/13 developed dysuria, fever/chills, headache, nausea, vomiting. Presented to ED 4/14 and admitted to hospital medicine with acute kidney injury.


VAERS ID: 1213084 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Computerised tomogram, Fatigue, Full blood count, Headache, Muscle spasms, Nausea, Pain, Pyrexia, Seizure
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Dystonia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: About 5pm after the vaccine I developed a cramp in my left leg, felt really tired and the fever began. About 10pm the symptoms got worse so I took nyquil because I was feeling horrible. My fever elevted to 101 causing me to have a seizure. EMT transported me to the ER about 12midnight and I was given meds for nausea, pain and monitored and about 3:30am I was released. The next day I was really tired, fatigued and had a really bad headache but by that Wed all symptoms had subsided.


VAERS ID: 1213097 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-03
Onset:2021-04-02
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Sexual dysfunction (broad)

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

Write-up: significant HA, head numbness


VAERS ID: 1213101 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-03-31
Onset:2021-04-13
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Deep vein thrombosis, Nausea, Pain in extremity, Peripheral swelling, Sciatica, Ultrasound scan
SMQs:, Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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: On 4/13/2021 at 11:00 AM pt. began experiencing left leg pain with swelling noted around left knee and extended above knee. By 11:00 PM pt. felt faint and nauseated and left leg was swollen and discolored. Rescue squad was called and took pt. to Hosp where she was told it was sciaticia. After showing the medical professionals her leg and insisting upon an ultrasound of her leg she was told the "machine" was not available and she would be called the next day to be scheduled. Per pt''s daughter, she was never called and daughter called hospital to have U/S scheduled. Pt. went back to hospital on 4/14 at 3:15 PM for U/S and she was diagnosed with multi DVT''s in left leg which at that time had swelling all the way down to her foot. Pt. was put on Coumadin.


VAERS ID: 1213131 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-11
Onset:2021-03-29
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / UNK RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Autopsy, Death, Fall, Hip fracture, Spinal fracture, Thrombosis
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Accidents and injuries (narrow), Osteoporosis/osteopenia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-29
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Diabetic Medications (Pills)
Current Illness: broke 3 back bones and hip chip due to fall 3/22/2021 a store parking lot
Preexisting Conditions: Diabetic
Allergies: none
Diagnostic Lab Data: AUTOPSY PERFORMED AND CONFIRMED
CDC Split Type:

Write-up: PATIENT DIED FROM BLOOD CLOT 3/29/2021 - AUTOPSY PERFORMED AND CONFIRMED


VAERS ID: 1213133 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-09
Onset:2021-03-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Diarrhoea, Dizziness, Dyspnoea, Fatigue, Female sex hormone level, Headache, Hot flush, Hyperhidrosis, Injection site pain, Myalgia, Night sweats, Pain in extremity, Pyrexia, Tachycardia, Ultrasound scan, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec
Current Illness: None
Preexisting Conditions: None
Allergies: Codeine
Diagnostic Lab Data: Full hormone panel and ultrasound of left leg.
CDC Split Type:

Write-up: At 8 hours post vaccination the following symptoms occurred: muscle pain and weakness, 104 fever, pain at injection site, shortness of breath, dizziness, vomiting, diarrhea, tacchycardia, fatigue headache, and profuse sweating. These symptoms continued for 4 days. Three days after vaccination pain in left calf started. Still continues to present day. Hot flashes started with fever have continued, and continue to present day. Hot flashes and night sweats cause to wake at night. Hot flashes continue 12 or more times each day.


VAERS ID: 1213142 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808892 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Gaze palsy, Pain
SMQs:, Ocular motility disorders (narrow)

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

Write-up: Patient reported a headache to me in the temple and body aches. I advised her to get with her Dr. She saw a provider at the urgent care and was evaluated and provided medication.


VAERS ID: 1213157 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-03-26
Onset:2021-03-27
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Exposure during pregnancy, Influenza virus test, Pyrexia, SARS-CoV-2 test
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: One A Day prenatal
Current Illness: None
Preexisting Conditions: None
Allergies: Azithromycin, Doxycycline
Diagnostic Lab Data: Rapid Flu and Covid-19 test March 28th
CDC Split Type:

Write-up: Severe fever (101.7) and abdominal pain began around 12am on March 27th, and persisted throughout the day and into March 28th. Symptoms were unresponsive to Acetaminophen 1000mg. Needed to consistently take 1000mgs every 4 hours to bring fever down to 100.7. I was 18 weeks pregnant at the time of vaccination, due on Aug 28th 2021, and 10 oz


VAERS ID: 1213171 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-22
Onset:2021-03-26
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye disorder, Injection, Magnetic resonance imaging, Tremor, Vision blurred
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Glaucoma (broad), Lens disorders (broad), Corneal disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Answered: Yes to "Do you have a weakened immune system caused by something such as HIV infection or cancer or do you take immunosuppressive drugs or therapies?"
Preexisting Conditions: Unknown
Allergies: Non listed on consent
Diagnostic Lab Data: MRI without contrast , possibly on 3/26/21 (pt could not remember dates). Scheduled for an MRI with contrast. Received "injections" in her left eye 4/15/21.
CDC Split Type:

Write-up: 4/15/21 Pt called stating that she has had some of the symptoms that everyone is talking about with the vaccine. She stated that Friday after her shot on Monday she had severe tremors, so bad it shook the car, and she went to the ER. They ordered an MRI without contrast and she is scheduled for an MRI with contrast soon. She cannot remember the date, but she began having blurry vision in her left eye. She went to her eye doctor and he stated she had an "eye stroke". She had injections in her eye today. I asked her to please call her primary physician as well and she agreed. I told her I was going to report her symptoms.


VAERS ID: 1213179 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-12
Onset:2021-03-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Computerised tomogram normal, Headache, Pain, Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

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

Write-up: Patient had COVID-19 J&J vaccine 10 days ago at external facility Patient states that after vaccine she developed aches and headache The headache and upper body pain has not gone away The headache is dull and throbbing and is consistent Patient has not yet taken anything for pain relief No other associated or neurological symptoms Two nights ago patient awoke to palpitations Since then patient gets sharp shooting pain across the chest 1-2 times an hour Symptoms can occur at rest


VAERS ID: 1213180 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Laboratory test, Loss of consciousness, Pneumothorax traumatic, Rib fracture
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), Osteoporosis/osteopenia (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Patient visit to ED, no chart notes acquired by myself.
CDC Split Type:

Write-up: Possible vasovagal syncope. She "blacked out" in bathroom and fell. Broke ribs and had pneumothorax due to the fall. Had a couple other episodes of "blacking out" in the next 48 hours. Went to E.D. for injury. Work up was done, she mentioned she had just had the vaccine a few days prior and no VAERS was submitted by ED, they dismissed it. According to patient workup was done to detect embolism or hemorrhage and none was found.


VAERS ID: 1213198 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Headache, Urethral 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: cranberry pill Reclipsen
Current Illness:
Preexisting Conditions: As per patient - adolescent epilepsy
Allergies: Amoxicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache, vomiting, back pain, urethral discomfort


VAERS ID: 1213215 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-03-04
Onset:2021-04-12
   Days after vaccination:39
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Blood iron decreased, Computerised tomogram abdomen abnormal, Computerised tomogram thorax abnormal, Deep vein thrombosis, Endoscopy upper gastrointestinal tract normal, Haemoglobin decreased, Laboratory test, Mineral supplementation, Pain in extremity, Transfusion, Ultrasound scan abnormal
SMQs:, Haematopoietic erythropenia (broad), Haemorrhage laboratory terms (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Thrombophlebitis (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: OTC Omeprazole
Current Illness: None
Preexisting Conditions: GERD and Hiatal Hernia
Allergies: NKA
Diagnostic Lab Data: As listed above but also had blood work in a follow up appointment with Doctor on 04/13/21 (results not known at this time) and have scheduled another ultrasound on 05/17/21 for DVT check. Awaiting approval for capsule endoscopy.
CDC Split Type:

Write-up: On 3/12/21 developed pain in left calf area. Pain continued to progress and became extremely painful by April 2, 2021. April 3rd went to urgent care for assessment. Sent from urgent care to Lab for ultrasound of left calf which came back positive for DVT. Sent to ER and started on IV heparin. Also received CT Scan of Chest and Abdomen which showed PE in right lower lobe of lung. Admitted to Vascular unit. Doctor ordered an upper Endoscopy to check for bleeding due to low HGB and FE. The Scope was negative for bleeding. Lab work was ordered on 04/06/21 and due to very low HGB and FE patient was given an FE (iron) infusion the evening of 4/06/21 and again the morning of 04/07/21. The patient also received a unit of blood the morning of 04/07/21 prior to being discharged from the hospital. Patient was started on Eliquis 5mg 2x a day, Ferrus Sulfate 325mg 1x a day and Omeprazole 20mg 1x a day as discharge medications.


VAERS ID: 1213231 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-04-07
Onset:2021-04-11
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Ageusia, Asthenia, Chest X-ray, Chest discomfort, Computerised tomogram thorax, Influenza like illness, Laboratory test, Paranasal sinus discomfort, Peripheral swelling, Tremor, Ultrasound Doppler
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (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: None
Current Illness: None
Preexisting Conditions: High cholesterol
Allergies: None
Diagnostic Lab Data: 4/13/2021 ER visit. Doppler done on both legs targeting right upper leg, CT of chest with contrast die and chest x-ray and labs drawn.
CDC Split Type:

Write-up: Feeling flu symptoms w/o fever, felt weak, heavy chest, swelling of right upper inner leg, some loss of taste, head pressure in sinus area and forehead, and shakiness. Rest and slept on Monday. Went to ER on Tuesday. Was diagnosed with vaccine reaction. Went home and slept again. Return to work on Wednesday. Symptoms are getting better except for the right upper inner leg which is still the same.


VAERS ID: 1213235 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-03-06
Onset:2021-03-23
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram cerebral normal, Arteriogram carotid normal, Computerised tomogram head normal, Retinal artery occlusion, Retinal function test abnormal, Vision blurred, Visual field defect, Vitreous detachment
SMQs:, Anticholinergic syndrome (broad), Embolic and thrombotic events, arterial (narrow), Noninfectious encephalitis (broad), Accidents and injuries (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (narrow), Hypoglycaemia (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: Simvastatin, acyclovir prn, amlodipine, omeprazole, oxybutynin
Current Illness:
Preexisting Conditions: HTN, HLD, COPD, HSV (oral), GERD, bladder spasm
Allergies: Codeine
Diagnostic Lab Data: Retinal exam - 3/26/21 CVA workup with normal CT Head and CTA Head and Neck - 3/24/21
CDC Split Type:

Write-up: Visual field defect and hazy vision. Retinal exam revealed superotemporal branch of retinal artery occlusion in R eye along with posterior vitreous detachment.


VAERS ID: 1213244 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-04-01
Onset:2021-04-08
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: C-reactive protein normal, Haematocrit increased, Haemoglobin increased, Joint effusion, Platelet count normal, Polyarthritis, Red blood cell sedimentation rate normal, White blood cell count normal
SMQs:, Systemic lupus erythematosus (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (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: citalopram
Current Illness:
Preexisting Conditions: none
Allergies: sulfa drugs
Diagnostic Lab Data: 4/12: WBC 5.5, Hgb 16.3, Hct 48.3, Plt 258, CRP normal, ESR normal.
CDC Split Type:

Write-up: Polyarthritis with joint effusions and no inflammatory changes, primarily ankles/knees, also wrists/elbows/fingers Treated with NSAIDs and Medrol Dosepak


VAERS ID: 1213260 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-07
Onset:2021-04-14
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Blood bilirubin, Blood fibrinogen increased, C-reactive protein increased, Differential white blood cell count normal, Fibrin D dimer increased, HIV test negative, Haemoglobin decreased, Hepatitis B surface antigen negative, Hepatitis B test negative, Hepatitis C virus test, International normalised ratio increased, Metabolic function test, Palpable purpura, Platelet count normal, SARS-CoV-2 test negative, White blood cell count normal
SMQs:, Liver-related coagulation and bleeding disturbances (narrow), Haematopoietic erythropenia (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Vasculitis (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow), COVID-19 (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: warfarin
Current Illness: no
Preexisting Conditions: History of Aortic valve replacement
Allergies: gabapentin ibuprofen
Diagnostic Lab Data: PendingBilirubin 3.2. Rest of CMP is normal.White blood cell count 5.5 thousand, hemoglobin 12.5, platelets 186,000, Normal manual differential, fibrinogen 581, INR therapeutic at 2.1, d-dimer 0.72. Blood type O+.SARS COV2 PCR negative HCV Ab and HBV SAg negative,HIV negative. C-reactive protein 83.
CDC Split Type:

Write-up: Patient presented to ED on 4/14/2021 with 24 h of progressive painful/pruritic palpable purpura of distal upper and lower extremities. No evidence of additional organ involvement.


VAERS ID: 1213303 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-03-09
Onset:2021-03-26
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram, Electrocardiogram ambulatory, Hemiplegia, Hypertension, Impaired work ability, Laboratory test, Loss of personal independence in daily activities, Magnetic resonance imaging, Transient ischaemic attack
SMQs:, Neuroleptic malignant syndrome (broad), Ischaemic 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), Hypertension (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (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: Flecanide and losartan
Current Illness: No
Preexisting Conditions: High blood pressure and arrythmia
Allergies: No
Diagnostic Lab Data: CT Scan, MRI, blood work, holter monitor,
CDC Split Type:

Write-up: I called a message that patient had experienced a stroke recently and had also rececived the Jansson vaccine. I called patient, who had reported that it happened on 4/2. She had woke up and couldn''t put her robe on. Her left arm was not working right. She also noted that she had drooled. She kept thinking that she was find and got ready and went to work. During work she was typing and found that her left hand was not working still, but still went throughout her day and typed with her right hand. Later that evening when she got home, her husband took her to the ER. There, she reports that her blood pressure was through the roof. She had a CT scan and MRI and labs done and was diagnosed with a TIA. She was started on Plavix, baby aspirin, and was started on a statin drug (couldn''t remember the name as that information was at home and she was at work at time of call). She is on a heart monitor for 4 weeks and has follow ups with her outside PCP and cardiologist. Today she states that she is feeling back to normal and has regained function on her left side. She reports that she had a headache at time that had lasted for a while. She also reports that she feels like she was having issues weeks before because her brain felt foggy and just was not thinking right.


VAERS ID: 1213313 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-03-12
Onset:2021-03-31
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test normal, Epistaxis
SMQs:, Haemorrhage terms (excl 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: Multivitamin, KCL 99 mg once a day OTC, 81 mg ASA
Current Illness:
Preexisting Conditions: Hypertension
Allergies: Flagyl
Diagnostic Lab Data: See ER information but they did check my blood but it?s unknown to me the results except they said it looked normal.
CDC Split Type:

Write-up: 19 days after receiving vaccine I had a nose bleed that I couldn?t stop and neither could ER until they packed my nose after four hours of continued bleeding. I never had a nosebleed before and have had one weekly since then.


VAERS ID: 1213314 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-03-15
Onset:2021-03-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Amnesia, Asthenia, Dizziness, Electrocardiogram, Headache, Hypoaesthesia, Mobility decreased, Nausea
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Cymbalta Calcium Estrogen hormone replacement patch
Current Illness: None
Preexisting Conditions: Kidney stones otherwise none
Allergies: None
Diagnostic Lab Data: EKG- Full lab panel.
CDC Split Type:

Write-up: Dizziness, Nausea, lost feeling in legs, unable to use muscle in left leg for about 4 hours, weakness, headache, brief loss of memory.


VAERS ID: 1213323 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-08
Onset:2021-03-29
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Arteriogram carotid abnormal, Carotid angioplasty, Carotid artery occlusion, Carotid artery stenosis, Cerebrovascular accident, Condition aggravated, Thrombectomy
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 17 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: only eye drops for glaucoma
Current Illness:
Preexisting Conditions: glaucoma h/o remote right frontal CVA h/o NSTEMI 2015 senile dementia
Allergies: NKDA
Diagnostic Lab Data: see above
CDC Split Type:

Write-up: Presented with CVA. CTA showed large segment occlusion of L ICA, S/P thrombectomy and carotid angioplasty by IR. Residual L internal carotid 70% stenosis post procedure


VAERS ID: 1213353 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Rash, Swelling face
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: NA
Current Illness: NA
Preexisting Conditions: NA
Allergies: NA
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: patient developed swelling in her face and rash all over her body


VAERS ID: 1213373 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram head, Vision blurred, Visual acuity tests normal
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Calcium, Magnesium, and Vitamin D.
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: CT Brain- Negative Visual Acuity-normal Labs: WNL
CDC Split Type:

Write-up: Blurry vision onset approximately 4 hours after vaccine administration


VAERS ID: 1213382 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-03-18
Onset:2021-03-24
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test normal, Computerised tomogram normal, Headache, Hypoaesthesia, Magnetic resonance imaging normal
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Hives, at age 47, vaccine on 9/23/20, Influenza Quad w/ preservatives.
Other Medications: Vitamin D
Current Illness:
Preexisting Conditions: Autoimmune disease that was identified about a year ago
Allergies: NKDA
Diagnostic Lab Data: MRI on 3/24/21: No finding, Blood work on 3/24/21: No finding other than positive biomarker for autoimmune related disease, CT on 4/12/21: No finding
CDC Split Type:

Write-up: Left-sided severe headache and 3 occasion of left-sided facial numbness starting around 3/24/21 10:30 pm. Facial numbness is currently resolved. The severity of headache has improved.


VAERS ID: 1213385 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-03-18
Onset:2021-03-24
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Autoimmune disorder, Computerised tomogram, Headache, Hypoaesthesia, Laboratory test abnormal, Magnetic resonance imaging
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Immune-mediated/autoimmune disorders (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: Hives, at age 47, vaccine on 9/23/20, Influenza Quad w/ preservatives.
Other Medications: Vitamin D
Current Illness:
Preexisting Conditions: Autoimmune disease that was identified about a year ago
Allergies: NKDA
Diagnostic Lab Data: MRI on 3/24/21: No finding, Blood work on 3/24/21: No finding other than positive biomarker for autoimmune related disease, CT on 4/12/21: No finding
CDC Split Type:

Write-up: Left-sided severe headache and 3 occasion of left-sided facial numbness starting around 3/24/21 10:30 pm. Facial numbness is currently resolved. The severity of headache has improved.


VAERS ID: 1213406 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-05
Onset:2021-04-07
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram, Facial pain, Hypoaesthesia, Pain of skin, X-ray
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Glaucoma (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:
Other Medications: CARVEDILOL, RAMIPRIL
Current Illness: N/A
Preexisting Conditions: HEART CONDITION..HE WAS ON COREG AND RAMIPRIL ACCORDING TO HIS LETTER
Allergies: NO KNOWN
Diagnostic Lab Data: heart X ray CAT scan
CDC Split Type:

Write-up: 4/5/21 vaccinated 4/7/21 numbed face.,right side from nose to ear and from upper lip to top of scalp. painful face and scalp like a severe burn.


VAERS ID: 1213407 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Eye pain, Pain, Pyrexia, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Glaucoma (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: AROUND 11PM STARTED GETING THE CHILLS, LEGS SHAKING AND HAD FEVER OF 104. AT 1:30AM, EYES HURT TO THE TOUCH. MOM ENDED TAKING TO ER AROUND 3AM. THEY GAVE HER TYLENOL AND IBUPROFEN. SHE GOT HOME AT 6AM AND SLEPT AND TOOK TYLENOL AND IBUPROFEN ON AND OFF. FEVER FLUCTUATED FROM 101 TO 104 AND BACK, TYLENOL TOOK FEVER DOWN TO 99.7. BUT UPTO TODAY, SHE STILL HAS BODY ACHES.


VAERS ID: 1213411 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Anticoagulant therapy, Chest X-ray, Deep vein thrombosis, Dyspnoea, Electrocardiogram, Fatigue, Full blood count, Gait inability, Metabolic function test, Muscle spasms, Pain in extremity, Peripheral swelling, Tenderness, Ultrasound Doppler abnormal
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Dystonia (broad), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Losartan 50 mg once a day Melaleuca bone and joint supplements for women over 50 years old
Current Illness:
Preexisting Conditions: Psoriatic arthritis
Allergies: Allergies to sulfas
Diagnostic Lab Data: At the ER, a freestanding facility, my mother underwent the following tests: X-Ray of the chest Electrocardiogram Ultrasound of the legs Basic metabolic panel (Blood work) CBC panel (blood work) After interpreting the results, doctor diagnosed my mother with Deep Vein Thrombosis in the right leg (DVT). They put her on blood thinners and transfer her to ER to be under blood thinners and monitoring for 2 more days.
CDC Split Type:

Write-up: The day after having been vaccinated with Johnson & Johnson/Janssen COVID19 vaccine (04/11/2021), my mother started to feel intense pain, swelling, tenderness and cramping in her legs, especially her right leg, to the point that she couldn''t walk. By the fourth day after the vaccine her right leg was completely swollen, twice as big as its normal size, the pain was unbearable and she experienced fatigue and shortness of breath. I took her to the ER on 04/14/2021


VAERS ID: 1213429 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-03-08
Onset:2021-03-22
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood chloride normal, Blood glucose increased, Blood potassium normal, Blood sodium normal, Carbon dioxide normal, Deep vein thrombosis, Haematocrit normal, Haemoglobin normal, Mean cell haemoglobin normal, Muscle strain, Pain in extremity, Red blood cell count normal, Red cell distribution width normal, Tendonitis, Thrombophlebitis superficial, White blood cell count normal
SMQs:, Hyperglycaemia/new onset diabetes mellitus (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Accidents and injuries (narrow), Tendinopathies and ligament 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: None
Current Illness: None
Preexisting Conditions: None
Allergies: Amoxicillin, Latex
Diagnostic Lab Data: LAB RESULTS: This is an incomplete list of lab results from this encounter. Refer to Results Review for all results. Heme WBC: 7.6 K/mcL RBC: 4.97 x10^6/mcL Hemoglobin: 15 g/dL Hematocrit: 43.5 % MCV: 87.5 fL MCH: 30.2 pg MCHC: 34.5 g/dL RDW SD: 38.6 fL RDW: 12.1 % Chemistries Sodium Level: 140 mmol/L Potassium Level: 4.3 mmol/L Chloride Level: 106 mmol/L CO2: 28 mmol/L Anion Gap (Na Cl CO2): 6 mmol/L Glucose Level: 101 mg/dL High
CDC Split Type:

Write-up: DIAGNOSIS: 1. Superficial thrombophlebitis MEDICAL DECISION MAKING/DIFFERENTIAL DX: Differential diagnosis includes DVT, superficial thrombophlebitis, muscle strain, tendinitis. The patient presented to the emergency department with atraumatic left leg pain. An ultrasound reveals a fairly large blood clot in the greater saphenous vein. Although this is a superficial clot, given its extent, I think it warrants anticoagulation. Per the trial, the patient would benefit from 45 days of 10 mg Xarelto treatment. The patient was given good precautions regarding bleeding risk while on a blood thinner. He will schedule follow-up appoint with his primary care doctor. He will also use Tylenol and warm packs to help with the discomfort from the superficial thrombophlebitis. He was discharged in satisfactory condition.


VAERS ID: 1213435 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-03-31
Onset:2021-04-11
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Aphasia, Asthenia, Balance disorder, Chest discomfort, Computerised tomogram normal, Deafness, Diarrhoea, Feeling abnormal, Headache, Hypertension, Hypoaesthesia, Loss of personal independence in daily activities, Pain in extremity, Ultrasound scan
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hearing impairment (narrow), Vestibular disorders (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Wellbutrin, Lithium, Pro-Air
Current Illness: None
Preexisting Conditions: None
Allergies: Ceclore
Diagnostic Lab Data: Cat Scan, 4/13/21 Ultrasound of right leg 4/14/21 Both results came back normal. Neurologist cannot see me until June.
CDC Split Type:

Write-up: Noticed headache bottom left back of head before bed. Woke up at 2:30am with right leg fully asleep. Attempted to wake leg up, lost equilibrium, stumbled, lost hearing, couldn''t put words together to tell wife what was going on and ended up on the floor to regain composure. Had difficulty putting on clothes to go to hospital. Went to ER, had severe diarrhea there, they did blood work and EKG, sent me home saying maybe I feinted. Had high blood pressure at ER, 150/86. Felt weak and ''off'' sense the event, felt tightness in chest and odd limb pain past 72 hours. Woke up at 3:30am on 4/15 with left arm asleep, went back to bed fine. Never had these symptoms before.


VAERS ID: 1213440 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-09
Onset:2021-04-11
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Balance disorder, Blood test abnormal, Burning sensation, Chills, Computerised tomogram thorax normal, Dizziness, Feeling abnormal, Fibrin D dimer increased, Headache, International normalised ratio normal, Magnetic resonance imaging normal, Metabolic function test, Muscle spasms, Nausea, Pain, Paraesthesia, Prothrombin time, Ultrasound Doppler normal
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Haemorrhage laboratory terms (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: 20 mg Nexium, Symbicort (inhaler), Dymista (nasal spray), 10 mg Singulaire, birth control Mibelas, 450 mg Ashwaghanda
Current Illness: None.
Preexisting Conditions: Asthma, allergies, GERD, irregular heartbeat.
Allergies: Cefzil, biaxin, amoxicillin, demerol
Diagnostic Lab Data: Doctor ordered D dimer and PT tests as well as complete metabolic and other tests not related to blood clots. 4/13/21 D dimer results were 1,650 ng/mL FEU, PT INR result < 0.9. The on-call doctor instructed me to go to the hospital and get tested for blood clots. 4/13/21 Ultrasound of legs came back clear. 4/12/21 CT of chest showed no clots. 4/14/21 MRI showed no clots. Still no explanation of why my bloodwork showed potential clotting as I do not have any bruises, cuts or trauma.
CDC Split Type:

Write-up: Friday evening I had what I thought was normal reaction: chills, aches, headache, nausea. Saturday it was mostly aches. Sunday was dizziness, aches, nausea and cramping in left leg. Monday was nausea, aches, tingling in hands and feet, headache, brain fog. Tuesday I woke up with major imbalance and needed to use walls to walk without falling over. Dizziness subsided after some time to only rapid movements. I had a warm burning sensation in left leg with tingling hands and feet. Moderate headache. Reports came out of stopping the Janssen vaccine so I contacted my doctor with my symptoms and they ordered blood tests for clots.


VAERS ID: 1213466 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-11
Onset:2021-04-15
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pain in extremity, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (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: multivitamin, vitamin D, Iron
Current Illness: No
Preexisting Conditions: Lymphoma
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: pain in lower leg, slight swelling


VAERS ID: 1213469 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: 4/15 ER work up. Cardiac work up normal. C T chest normal
CDC Split Type:

Write-up: SOB, CP, Fever, Nausea, Body aches. Seen in ER for cardiac work up. Labs normal and CT chest normal


VAERS ID: 1213473 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-26
Onset:2021-04-12
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Deep vein thrombosis
SMQs:, Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: right lower extremity femoral dvt


VAERS ID: 1213490 (history)  
Form: Version 2.0  
Age: 91.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-04-10
Onset:2021-04-13
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Unevaluable event
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalized secondary to PE 4 days post vaccination.


VAERS ID: 1213493 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: New York  
Vaccinated:2021-03-28
Onset:2021-03-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / UN
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / UN

Administered by: Other       Purchased by: ?
Symptoms: Anticoagulant therapy, Blood pressure increased, COVID-19, Cerebral venous thrombosis, Chest pain, Computerised tomogram head abnormal, Dysphonia, Erythema of eyelid, Intensive care, Magnetic resonance imaging head abnormal, Malaise, SARS-CoV-2 test positive, Swelling of eyelid, Venogram abnormal
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, venous (narrow), Parkinson-like events (broad), Thrombophlebitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypertension (narrow), Cardiomyopathy (broad), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: None
Allergies: No
Diagnostic Lab Data: See hospital records. CT, MRI, MRV show dural venous filling defect.
CDC Split Type:

Write-up: Had COVID on 2/7/21- Feverish feeling x 1 day, fine after. Tested negative 2/17/21. One half hour after receiving the vaccine, onset of hoarseness. Severe hoarseness persists until today. Eyelids pink, swollen slightly, persisted 2 weeks. Did not feel well. 4/15/21 -Hospital Emergency Room. Chest pain. Elevated blood pressure. COVID test positive. Disharged with azithromycin, zinc sulfate 220mg, ProAir. High blood pressure, new onset. On 4/6/21 BP 160/120 both arms. 4/7/21 Hospital ER. MRI, CT brain showed Dural Venous Thrombosis. To ICU for anti coagulation, until 4/14/21. MRV done. Now on floors, started coumadin. 9 days hospitalization so far. CT done again 4/15/


VAERS ID: 1213504 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-03-24
Onset:2021-03-27
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Thrombosis, Ultrasound scan
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Xanax, Norvasc, Buspar, Tums, Vitamin D3, Coenzyme Q 10, Culturelle, Vitamin B12, Lexapro, Latanoprost, Lisinopril, Magnesium, Zyprexa, Creston, Zinc
Current Illness: None
Preexisting Conditions: High Blood Pressure, diverticulitis, cutaneous t cell lymphoma, glaucoma, depressive disorder, osteoporosis
Allergies: Bactrim, Augmentin, Erythromycin, Macrodantin, Sulfa, Triaminic, Troleandomycin, Valium
Diagnostic Lab Data: Ultrasound
CDC Split Type:

Write-up: Deep Vein Blood Clot


VAERS ID: 1213944 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Heart rate decreased, Hypotension, Loss of consciousness, Pallor
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad), Dehydration (broad), 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: Unknown
Current Illness: None
Preexisting Conditions: None
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was looking pale a minute after the shot, I asked how he was doing, he responded by saying he felt very dizzy. I asked him to take slow deep breaths, gave him some water. About after 1 more minute he passed out (very unresponsive but still breathing, pupils very dilated) pulse was slow but still palpable. Tried ammonium smelling salts, that did not bring patient around. Called 911. Tried patting patient and talking to patient to bring them back to consciousness. After about a minute or two patient was able to respond to me. He knew his name and date of birth and where he was. Asked him to wait for ambulance to check vitals. Patient said he still felt very dizzy. Kept his head down and eyes closed. Once EMS arrived they checked his vitals, determined BP was low (they did not tell me a number). They monitored patient''s vitals for 10-15 minutes. BP did not "bounce back" per EMS so they took him to the hospital for IV drip possibly.


VAERS ID: 1213970 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-03-17
Onset:2021-03-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, Feeling jittery, Magnetic resonance imaging, Neck pain, Oedema
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pneumococcal 23 vaccine
Other Medications:
Current Illness: None
Preexisting Conditions: Asthma, CAD, fibromyalgia, HTN, hyperlipidemia, depression and anxiety
Allergies: pneumococcal vaccination- large local reaction, advised not to get again.
Diagnostic Lab Data: MRI of neck 3/30/21. It did show DDD in neck, spinal stenosis, some edema
CDC Split Type:

Write-up: Initial reaction was noted on 8:00 PM 3/17. Jitteriness and fatigue on 3/17. Around 9:00 felt neck pain and it was hard to move her neck. The neck pain was severe 10/10. Still has problems with the neck. Her neck pain has improved but the pain is worse than it was before she had the vaccine.


VAERS ID: 1213979 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-15
Onset:2021-04-12
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 - / IM

Administered by: Work       Purchased by: ?
Symptoms: Thrombosis, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), 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), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: END STAGE RENAL DISEASE AND HYPERTENSION
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: HOSPITALIZED FOR BLOOD CLOTS, UNRESPONSIVE AND TAKEN TO HOSPITAL


VAERS ID: 1213981 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Immediate post-injection reaction, Injection site pain, Nerve injury, Pain in extremity, Paraesthesia, Physical examination
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: After scheduling an appt with my Dr, the office advised me to go to the ER. I went the day she advised me on 4/13. There the ER DR believes some how my ulnar nerve in my left arm was effected by the vaccine, which is causing the pain in my elbow, down the arm to my palm and two fingers. I now have a follow with my DR on 4/23.
CDC Split Type:

Write-up: Immediately after receiving the vaccine I felt burning at the site and shoulder that went away after a few minutes. My left arm was tingling , this lasted the rest of the night. The next day i experienced numbness/tingling and dull aching pain in my elbow, down my arm to my palm and two fingers (middle and ring). This has been intermittent for a week now, really effecting me while i drive and work as a travel nurse.


VAERS ID: 1214054 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-31
Onset:2021-03-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / N/A RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Atrial fibrillation, Blood test, Chest pain, Chills, Computerised tomogram, Condition aggravated, Diarrhoea, Echocardiogram, Electrocardiogram, Headache, Hyperhidrosis, Pain, Pyrexia, Rash, Retching, Scan with contrast
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Supraventricular tachyarrhythmias (narrow), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: LISINOPRIL 5 MG DAILY, METOPROLOL TARTATE 50MG TWICE A DAY, CRESTOR 20 MG DAILY, ASA 81 MG DAILY
Current Illness: NONE
Preexisting Conditions: HEART ATTACK 2007, A-FIB, CARDIAC STENT, HIGH CHOLESTEROL
Allergies: CODIENE- SEVERE NAUSEA/VOMITING
Diagnostic Lab Data: EKG, ECHOCARDIOGRAM, BLOOD WORK AND CT SCAN WITH CONTRAST
CDC Split Type:

Write-up: 3/31/2021: 6-7 HOURS S/P VACCINATION: HEADACHE, FEVER, COLD CHILLS, SWEATING, AND DRY HEAVES 3/31/2021-4/1/2021: UP AND DOWN ALL NIGHT, DIARRHEA, BODY ACHES, STOMACH ACHE, HEADACHE, DRY HEAVES 4/1/2021-4/4/2021: ABOVE SYMPTOMS CONTINUED . 4/4/2021: STARTED HAVING CHEST PAIN AND WENT TO MEDICAL CENTER - ER . WAS ADMITTED TO HOSPITAL FOR TREATMENT OF A-FIB. 4/8/2021: DEVELOPED A RASH ON BACK.


VAERS ID: 1214065 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-08
Onset:2021-04-12
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Laboratory test, Muscle spasms, Musculoskeletal pain, Pain in extremity, Peripheral swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Angioedema (broad), Dystonia (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness:
Preexisting Conditions:
Allergies: unknown
Diagnostic Lab Data: labs drawn but no diagnostic imaging was ordered to rule out blood clot .
CDC Split Type:

Write-up: Patient presented to the ED and complained of bilateral posterior thigh and buttock pain. Reports the prior evening had cramping and a lump in left calf.


VAERS ID: 1214076 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Nausea, Pain, Rash, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: HEADACHE, NAUSEA, VOMITING, BODY ACHES, RASH


VAERS ID: 1214101 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-08
Onset:2021-04-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dyspnoea, Pain in extremity, Pneumonia
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow)

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

Write-up: Patient received vaccination without noted reaction. On 04/10/2021 patient was transported to hospital via ambulance c/o shortness of breath. Patient was diagnosed with pneumonia. Patient refused admission and returned home with prescriptions for inhalers, steroids, and antibiotics. Patient claims on 02 at home prior to event. Patient also c/o left leg pain (unspecified) but has not sought medical care. Patient treated at Hospital. Patient was advised to follow with her PCP for leg pain.


VAERS ID: 1214103 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-03-15
Onset:2021-03-24
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 805022 / 1 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Biopsy skin, Blood test, Culture negative, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Triamcinolone acetonide cream USP 0.1% Hydrocortisone anti itch cream 1% Prednisone 20MG
Current Illness: No
Preexisting Conditions: No
Allergies: N/A
Diagnostic Lab Data: I had culture''s done on my face and biopsy done on both arms. The culture''s came back negative and no results yet on biopsy. I also had blood work done.
CDC Split Type:

Write-up: I got a rash on my face , head, arms, chest and top part of back. I went to the er and dermatologist and received topical and oral medicine to use and take. The rash appeared about a week and a half after the shot and I still have it.


VAERS ID: 1214117 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-04-12
Onset:2021-04-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Guillain-Barre syndrome, Laboratory test, Pain in extremity
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow), Tendinopathies and ligament disorders (broad), Immune-mediated/autoimmune 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: Yellow Fever Vaccine/2014
Other Medications: Vitamin D, K, Vitamin B complex Multivitamin Fish Oil
Current Illness: None
Preexisting Conditions: None
Allergies: Yellow Fever Vaccine
Diagnostic Lab Data: He received IV Toradol to help out with his extremity pain. Labs were checked to rule out electrolyte disturbance, thrombocytopenia. The patient''s neurologic examination does not demonstrate classic signs of Guillain-Barre, there is no evidence of muscle weakness or paralysis and his deep tendon reflexes are normal. Acute pain has been described in acute Guillain-Barre, and so I gave the patient return precautions regarding progressive symptoms. At this point, there are not enough objective criteria to diagnose him with GBS, symptoms do not suggest the need for hospitalization for observation. Even so, it is clear the severe extremity pain is a result of the vaccine.
CDC Split Type:

Write-up: Patient developed mild case of Guillain Barre Syndrome 34 hours after injection of the Johnson and Johnson vaccine. Patient has severe extremity pains. The patient has a personal history of being diagnosed with Guillain-Barre after a yellow fever vaccination.


VAERS ID: 1214234 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-03-04
Onset:2021-03-14
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / 1 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: LISINOPRIL 10MG CARVEDILOL 6.25MG SIMVASTATIN 20MG ASA 81MG
Current Illness:
Preexisting Conditions: TRIPLE BYPASS 2012 (HEART DISEASE)
Allergies: NO KNOWN DRUG ALLERGIES
Diagnostic Lab Data:
CDC Split Type:

Write-up: PATIENT CALLED AND STATED THAT HE HAD A HEART ATTACK ON 3/14/21. (TEN DAYS AFTER THE VACCINATION) HE STATES THAT HE CALLED THE DEPARTMENT OF HEALTH AND WAS TOLD TO CONTACT THE LOCATION WHERE HE RECEIVED THE VACCINATION.


VAERS ID: 1214246 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-04-06
Onset:2021-04-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Computerised tomogram thorax, Contusion, Induration, Mobility decreased, Muscle spasms, Pain in extremity, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Dystonia (broad), Parkinson-like events (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: estrogen replacement therapy
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: CT scan of the chest on 4/8/21
CDC Split Type:

Write-up: Pt called LPHA to report she was seen in the ER on 4/8/21 for a potential blood clot in her left leg. Pt reported she awoke from sleep late 4/7/21 early 4/8/21 with severe pain in her left leg. She reported it hurt so bad she was "screaming". She stated it felt like a "charley horse" and her husband noted a knot in her leg. She went to the ER on 4/8/21 due to the inability to put pressure on her leg and/or walk on her leg. She reports having a CT scan of her chest at the ER and no clots were noted. She stated they did not image her leg at that time and scheduled an ultrasound/doppler for around 4/27. She was prescribed some oral blood thinner, but could not recall the name. She stated she stopped the blood thinner on 4/12/21 after the new reports regarding the J & J vaccine and not using blood thinners to treat. Today she states her leg is purple, black and blue and is swelling more when she is up on it at work. RN instructed pt to call her primary provider regarding stopping the blood thinner and to see if re-evaluation of her leg is needed. Pt also instructed to seek emergency treatment for increased swelling or pain to her leg, headache, abdominal pain, shortness of breath or any other concerns. Pt plans to speak with or see her primary provider today.


VAERS ID: 1214248 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-03-10
Onset:2021-04-14
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / 1 UN / IM

Administered by: Public       Purchased by: ?
Symptoms: Deep vein thrombosis, Thrombophlebitis superficial, Ultrasound scan abnormal
SMQs:, Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Thrombophlebitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: omeprazole 20 mg once daily multivitamin daily albuterol inhaler 2 puffs q6 hrs prn shortness of breath
Current Illness:
Preexisting Conditions: obesity sleep apnea asthma
Allergies: iodine shellfish hydrocodone
Diagnostic Lab Data: Venous ultrasound with right peroneal deep venous thrombosis and right lesser saphenous superficial venous thrombosis. diagnosed in visit to ER. discharged from ER on antocoagulant
CDC Split Type:

Write-up: Patient presented with new onset dvt 5 wks post covid 19 vaccination. 36 yr old female with solitary risk factor of previous history of DVT. Of note, pt had dvt in 2002 which occurred while on birth control (and pt became pregnant).


VAERS ID: 1214249 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-04-05
Onset:2021-04-06
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Electrocardiogram normal, Rash
SMQs:, Anaphylactic reaction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Nitrofurantoin
Current Illness: UTI - taking Nitrofurantoin
Preexisting Conditions: None noted
Allergies: NKDA
Diagnostic Lab Data: EKG - HR 90, normal sinus rythym
CDC Split Type:

Write-up: Patient presented to ER with diffuse rash over body and minimal shortness of breath. Patient received Janssen Covid vaccine the day prior. Patient also on last day of antibiotic regimen (nitrofurantoin) for urinary tract infection.


VAERS ID: 1214279 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-03-01
Onset:2021-04-15
   Days after vaccination:45
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Headache, Influenza like illness, Neck pain
SMQs:, 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient''s daughter called on her behalf to translate from Spanish. She reported that her mother was having "flu-like" symptoms approximately 3 weeks after receiving the J&J vaccine. She also mentioned that she was having a headache in the back of her head and neck which are known to be possible indication of a cerebral venous sinus thrombosis which has been rarely associated with the J&J vaccine. I advised the daughter to take the mother to the emergency department for further evaluation and she agreed that she would take her right away.


VAERS ID: 1214336 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-04-06
Onset:2021-04-08
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Pain in extremity, Peripheral swelling, Thrombophlebitis superficial, Ultrasound scan abnormal
SMQs:, Cardiac failure (broad), Angioedema (broad), Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), 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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Methotrexate, humira, baclofen, folic acid
Current Illness: none
Preexisting Conditions: rheumatoid arthritis, EtOH abuse, anxiety/depression
Allergies: none
Diagnostic Lab Data: Ultrasound 4/9/2021
CDC Split Type:

Write-up: Patient had LLE swelling and pain, went to see PV provider the next day who recommended pt go to ER. Pt was diagnosed with nonocclusive SVT in the L short saphenous vein via ultrasound. Good prognosis, no CP or SOB.


VAERS ID: 1214345 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / N/A RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dysarthria, Loss of consciousness, Somnolence
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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

Write-up: Nurse administered vaccine, within 1-2 mins the patient became drowsy, drooping head forward, closing eyes, and slurring speech. Patient lost consciousness and slumped into chair, EMS on site, administered IV fluids and transported to hospital.


VAERS ID: 1214402 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-11
Onset:2021-04-15
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Chills, Decreased appetite, Fatigue, Malaise, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad)

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

Write-up: fatigue, weakness, malaise, n/v, joint pain, chills, diarrhea, anorexia. Treated with ondansetron and NS 1L.


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