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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: 1214423 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-03-20
Onset:2021-03-31
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Laboratory test, Mobility decreased, Muscle spasms, Thrombosis, Ultrasound scan abnormal
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Dystonia (broad), Parkinson-like events (broad), Thrombophlebitis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NOTHING
Current Illness: NONE, EXCELLENT HEALTH
Preexisting Conditions: NONE
Allergies: NKA
Diagnostic Lab Data: ultrasound and blood work 4/14/21
CDC Split Type:

Write-up: Charlie horse began 10 days after vaccine, leg felt full with cramping not allowing motion, went to ER diagnosed with blood clot in left calf


VAERS ID: 1214451 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-07
Onset:2021-03-24
   Days after vaccination:17
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: Joint swelling, Peripheral swelling, Rash
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: feet swelling, legs, ankle swelling, rash all over legs


VAERS ID: 1214499 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-03-05
Onset:2021-03-01
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / N/A RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril, water pill, multivitamin, turmeric, Sea Moss, garlic pill
Current Illness: No
Preexisting Conditions: HBP, High cholesterol, prediabetic
Allergies: None
Diagnostic Lab Data: None
CDC Split Type: vsafe

Write-up: Some weeks after vaccination I started feeling shortness of breath. When I walked from the parking lot to my work desk it was hard and when I arrived at work my co-workers could hear me grasping for air, I felt winded, and it never happened before. Also, another episode when the elevator broke down I could not go the flight of stairs without having to stop and catching my breath. Since the weather is better I decided to start walking in the park for exercise but I realized I did not have the strength nor the capacity to breathe. I amafraid at night because sometimes when I lay down I can''t breathe.


VAERS ID: 1214533 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-03-10
Onset:2021-04-06
   Days after vaccination:27
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN RS AD26 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Blood creatine phosphokinase, Diarrhoea, Dizziness, Fatigue, Full blood count, Headache, Lipase, Metabolic function test, Occult blood, Oedema peripheral, Pyrexia, Red blood cell count, SARS-CoV-2 test, Troponin, Urine analysis
SMQs:, Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Noninfectious diarrhoea (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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Flu vaccine 2012 - rash
Other Medications: Albuterol 90mgc Inh - 2 puffs q 6 hrs PRN wheeze; Arthritis Pain relief 650mg - 1 tab PO TID PRN pain; Vitamin C 250mg - 1 tab PO Qd; Tessalon pearls 100mg caps- 1 cap PO QD PRN cough; Vitamin D3 1000units - 1 tab PO QD; Colace 100mf caps-
Current Illness: N/A
Preexisting Conditions: Asthma; Vitamin D Deficiency; Migraines; Idiopathic Uticaria; Spinal Stenosis; Macular degeneration; Sleep d/o; Esophageal RIng; GERD; Dysphagia; CKD Stg. 3; Panic D/O; MDD; Low back pain; Poor manual Dexterity; Benzodiazepine Dependence; Narcotic dependence;
Allergies: Lipitor - unknown; FLu Vaccine 2012 - rash; Nitrofurantoin - unknown; PCN - unknown; Sucralfate - dizziness; Citalopram - rash; ALendonic Acid - GI upset; Levofloxacin - GI Upset; Macrolide ABX- unknown; Risedronate - GI Upset
Diagnostic Lab Data: Urinalysis; CPK;CMP; Occult blood-stool; Troponin; Lipase; CBC w/ diff - 4/15/21 LFTs; CBC; BMP; RBC; Urinalysis; Covid test 4/7/21
CDC Split Type:

Write-up: Pt reports fever; BLE edema; H/A - on & off with dizziness; Abdominal cramping; looses stools w/ offensive odor; fatigue started on 4/6/21


VAERS ID: 1214552 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-07
Onset:2021-04-15
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Electrocardiogram normal, Fatigue, Metabolic function test, Tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Vestibular disorders (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None, patient healthy at the time of vaccination and up to one month prior
Preexisting Conditions: None
Allergies: Aspirin, reaction: hives
Diagnostic Lab Data: 4/15/21 08:48 AM: EKG showed sinus rhythm, with ventricular and atrial rates of 100 beats per minute, QTc (Bezet) of 448. 4/15/21 09:48 AM: repeat EKG showed normal sinus rhythm with sinus arrhythmia, ventericular and atrial rate of 87 beats per minute. QTc (Bezet) of 428. 4/15/21 10:23 Basic Metabolic Panel (BMP) showed no abnormalities
CDC Split Type:

Write-up: Patient developed dizziness and lightheaded 15 minutes after the vaccine. Then felt fatigued the next day. Patient is an avid runner who runs three to four times week. Today (4/15/21), patient developed tachycardia in the high 180s ten minutes into her run. She then stopped running and started walking on flat surface for 30 minutes in hopes to slow down her heart rate. However, after 30 minutes of walking her heart rate remained in the 185 to 205 beats per minutes. The tachycardia lasted for one hour since she stopped running. She then came to the ED for check ups.


VAERS ID: 1214573 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-08
Onset:2021-04-14
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Bone pain, Tenderness, X-ray normal
SMQs:, Osteonecrosis (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Flexeril, Zyrtec, escitalopram, trazodone, MiraLAX as needed, Flonase
Current Illness: None
Preexisting Conditions: past medical history of gastroesophageal reflux disorder, diverticulitis, depression, seasonal allergy, insomnia
Allergies: No known drug allergies
Diagnostic Lab Data: X ray right shin showed no fracture or malalignment no destructive osseous processes or aggressive periosteal reaction. No radiopaque foreign body or soft tissue gas.
CDC Split Type:

Write-up: Patient was seen in ER On 4/14/2021 with a complaint of right anterior hip pain. Patient denied any injury she received Johnson & Johnson vaccine on 4/8/2021 and has been worried about the side effects. Patient endorses a sharp pain which is worse with palpation right over the tibial bone. Right anterior shin x-ray showed no fracture or malalignment no destructive osseous processes or aggressive periosteal reaction. No radiopaque foreign body or soft tissue gas. Patient was discharged home to follow-up with her primary care. On today''s visit patient states that she continues to have her right shin pain overall it is getting better she has tried ibuprofen/Aleve, however still worried about Johnson & Johnson vaccine side effects. Denies recent fall or injury. No swelling on exam Duplex ordered


VAERS ID: 1214577 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-08
Onset:2021-04-14
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Thrombophlebitis superficial, Ultrasound Doppler
SMQs:, Embolic and thrombotic events, venous (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: norethindrone, alprazolam, ubrogepant, citalopram
Current Illness:
Preexisting Conditions: Hx of DVT/PE not currently on anticoagulation
Allergies: penicillin
Diagnostic Lab Data: identified by duplex ultrasound
CDC Split Type:

Write-up: RLE thrombosis of greater saphenous vein


VAERS ID: 1214606 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Delaware  
Vaccinated:2021-03-27
Onset:2021-03-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Computerised tomogram, Concussion, Contusion, Dizziness, Epistaxis, Fall, Fatigue, Headache, Heavy menstrual bleeding, Lymph node pain, Muscle spasms, Pain, Pyrexia, Swelling, Thrombosis
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Dystonia (broad), Thrombophlebitis (broad), Accidents and injuries (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: lispriol for high blood pressure 10 mg
Current Illness: Feb 28 a D&C surgery and scope perform as out patient procedure other wise good health
Preexisting Conditions: blood pressure but treated
Allergies: none
Diagnostic Lab Data: A cat scan was performed on Sat April 10 at the emergency room steriods were given to control swelling in head and neck area
CDC Split Type:

Write-up: 4 hrs after onset of severe headache and body pain in lymph nodes under arm pit breast, on top of kidneys and in stomach fatigue low fever. After 4 days of that I got a really super heavy period with cramping and blood clots in my menustral flow. It was a horrible period, while the one after the surgery in Feb was very light. Dizzy and fatique 10 days after shot on the April 8 I took a fall from a chair outside, and from Thrusday to the Saturday 10th I ended up in the Emergency room with a concussion and head symptoms including dizziness and nose bleeds. This was from a simple fall, and i suspect the covid shot might have caused complications after the fall with additional swelling and brusing.


VAERS ID: 1214612 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-03-31
Onset:2021-04-03
   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: Private       Purchased by: ?
Symptoms: Chest X-ray normal, Computerised tomogram head, Epistaxis, Full blood count, Haemoptysis, Headache, Metabolic function test
SMQs:, Haemorrhage terms (excl laboratory terms) (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? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: nkda
Diagnostic Lab Data: cbc, cmp, ct head with iv contrast, cxr, all normal, no thrombopenia no evidence of cavernous sinus thrombosis
CDC Split Type:

Write-up: VACCINATED MARCH 31ST, headache appeared on Saturday April 3rd, associated to minor nose bleeds and blood tinged sputum.


VAERS ID: 1214638 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-13
Onset:2021-03-16
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / N/A RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Mobility decreased, Sleep disorder, X-ray
SMQs:, Parkinson-like events (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: My right shoulder joint on the side of the shot started to hurt within a week of getting of the shot. It was very painful, and I had problems moving my arm and carrying my tools. I went to Urgent care and I have been referred to an Orthopedic specialist. I have lost the range of motion in that arm and I can?t lay down on my side. I have never had any problems since I injured that shoulder 20 years ago as a kid. I take an Aleve or Tylenol if I need to but it does not really help with the pain.


VAERS ID: 1214653 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-04-07
Onset:2021-04-07
   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: Abdominal pain, Diarrhoea, Fibrin D dimer, Headache, Injection site pain, Pain in extremity, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Went to test blood. D-dimer level .36 mcg/ml FEU. Got sent home without any medications. Pain still in legs.
CDC Split Type:

Write-up: 6 hours after I got the vaccine I had High fever 102.5 for about 3 days, vomiting and diarrhea as well for 4 days. That went away the. developed Headache and leg pain and abdominal pain for about 4 days. Injection site still hurts


VAERS ID: 1214663 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Michigan  
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 203A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Not reported
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: No known allergies or previous reactions to previous vaccinations reported
Diagnostic Lab Data: Unknown to the pharmacy - patient transported to the emergency room
CDC Split Type:

Write-up: Patient came into the pharmacy with her mother to receive the JANSSEN COVID-19 vaccine. Per technician that witnessed the event the patient passed out while next to her mother while walking over to the chair to wait 15 minutes after immunization. The mother started yelling and the patient ended up in the chair, did not fall onto the floor. At this time the senior technician called 911. The patient regained consciousness, was breathing but appeared pale in complexion. The patient verbalized that her heart was racing. EMS arrived, patient was put on oxygen and transported to the hospital.


VAERS ID: 1214697 (history)  
Form: Version 2.0  
Age: 82.0  
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 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Atelectasis, Chest X-ray abnormal, Computerised tomogram thorax abnormal, Dizziness, Pleural effusion, Pneumonia, Pulmonary embolism
SMQs:, Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, venous (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular 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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tylenol #3 One tab Q6H prn, Atorvastatin 40 mg QD, (Continued)
Current Illness:
Preexisting Conditions: Heart Transplant 1998, Anemia, Arthritis, CHF, ESRD on Hemodialysis, hyperlipidemia, hypertension
Allergies: Phenobarbital, Quinine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Janssen COVID-19 Vaccine EUA Patient received J&J COVID Vaccine on 3/15/2021 per vaccine card. Patient had an ED Visit on 3/17/2021 for a chief complaint of lightheadedness and was diagnosed with Pneumonia with Chest X-ray showing small bilateral pleural effusions with underlying atelectasis or consolidation. On 4/12/2021, Patient presented to ED as instructed by outside physician for finding of blood clot on CT the morning of 4/12/2021 (Pulmonary emboli at the left upper lobe). The patient had CT scheduled during an office appointment on 4/5/2021. Patient admitted for treatment of pulmonary embolism.


VAERS ID: 1214703 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Florida  
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 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Central nervous system lesion, Headache, Magnetic resonance imaging head abnormal, Malaise, Musculoskeletal stiffness, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Fever after 24 HRS, sick and in bed all day. From Tuesday to date - leg stiffness and some headaches. Admitted to Hospital for testing, found lesion on brain.


VAERS ID: 1214714 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-09
Onset:2021-04-10
   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 / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram, Electrocardiogram, Headache, Injection site rash, Injection site reaction, Laboratory test, Rash erythematous, Scan with contrast
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Celexa 30 mg
Current Illness: None
Preexisting Conditions: None
Allergies: No e
Diagnostic Lab Data: Ekg Cat scan with contrast - head Blood tests All on April 14, 2021
CDC Split Type:

Write-up: Severe headache continuing for 7 days and rash red 2 in circle near vaccine site started on day 5.


VAERS ID: 1214724 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-08
Onset:2021-04-13
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute myocardial infarction, Acute respiratory failure, Bilevel positive airway pressure, Blood bicarbonate normal, Blood pH decreased, Cardiac failure congestive, Cardiac monitoring, Chest X-ray abnormal, Chest discomfort, Condition aggravated, Dyspnoea, Echocardiogram abnormal, Electrocardiogram QT prolonged, Fluid overload, Hyperglycaemia, Hyperlipidaemia, Hypertensive emergency, Intensive care, Left ventricular failure, Lymphocytosis, PCO2 increased, Polycythaemia, Polyuria, Respiratory failure
SMQs:, Torsade de pointes/QT prolongation (narrow), Cardiac failure (narrow), Anaphylactic reaction (broad), Dyslipidaemia (narrow), Lactic acidosis (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Myocardial infarction (narrow), Conduction defects (narrow), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (narrow), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Embolic and thrombotic events, arterial (narrow), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Cardiomyopathy (broad), Lipodystrophy (broad), Chronic kidney disease (broad), Hypersensitivity (broad), Tubulointerstitial diseases (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Home Medications (9) Active amLODIPine 10 mg oral tablet 10 mg = 1 tab(s), PO, Daily aspirin 81 mg oral tablet 81 mg = 1 tab(s), PO, Daily atorvastatin 40 mg oral tablet 40 mg = 1 tab(s), PO, Daily furosemide 40 mg oral tablet 40 mg = 1 tab
Current Illness:
Preexisting Conditions: PAST MEDICAL HISTORY: Coronary artery disease, status post MI, PTCA in 2002, PCI in 2013 and again in 2014, heart failure with a left ventricular ejection fraction of 45% to 50% on the last cardiology note in 2019. hypertension, diabetes mellitus type 2, hyperlipidemia, right lung mass incidentally found noted on in 2019.
Allergies: ALLERGIES: PENICILLIN.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Emergency Department Note (Verified) Visit Date: 04/13/2021 CHIEF COMPLAINT: Shortness of breath. HISTORY OF PRESENT ILLNESS: The patient is a 65-year-old male with a history of hypertension and congestive heart failure, presents with shortness of breath that started on Friday and worsened significantly this morning. He does have some chest discomfort with this. No fevers, chills, or other complaints. Discharge Diagnoses 1. Hypertensive emergency, 04/13/2021 2. Chest discomfort, 04/14/2021 3. Heart failure, systolic, 04/13/2021 Assessment and Plan 65M w/ HTN and HFrEF p/w hypoxic respiratory failure i/s/o a hypertensive emergency. BP and respiratory status much improved, admitted to CCU for acute BP management and medication titration. #HTN Emergency Likely precipitated by lack of medication non-adherence since 04/11, when he ran out of his medications. SBP approx 220 at time of presentation, good response to enalapril and nitro gtt. Decreased work of breathing with Bi-pap. MAP 130-140 on presentation, will attempt to lower by 20-25% in first 2-6hrs w/ MAP goal of approx 100, while aiming towards normotensive in next 24-48 hrs while transitioning from IV to PO meds. -TTE ordered -cont incremental BP mgmt: -goal MAP < 110 -prn hydralazine -gradual goal towards normotensive over next 24-48hrs thereafter -cardiac monitor -will ensure that patient has anti-hypertensives prior to DC -q4hr neuro checks #Acute Hypoxic and Hypercapnic respiratory failure Decreased work of breathing with Bi-pap. Likely related to HTN emergency as above in addition to moderate-severe volume overload as seen on CXR. VBG in am of 4/13 showed pH 7.17, pCO2 64, pO2 58, bicarb 24. -cont Bi-pap, will wean as tolerable -repeat VBG this am for resp acidosis #HFrEF w/ acute exacerbation Last echo 04/14/2017, LVEF 38%, cxr on admission shows moderate-severe volume overload. -TTE ordered on 4/13 -may consider additional diuresis, given furosemide in ED on presentation, mindful of BP -goal net negative 1-2L/24hrs as pressures permit -daily standing weights -fluid and sodium restriction when off Bi-Pap #NSTEMI Likely type II given HTN emergency, did have chest pain on presentation which was relieved with BP control. -trend trops until flat, next at 08:00 #type II DM Hgb A1c 7.5% on 4/13, mild hyperglycemia on presentation -SSI #polycythemia Could be indicative of undiagnosed OSA vs manifestation of heart failure. Additionally, hemoconcentration from CHF i/s/o HTN emergency is another possibility. -TTE as above -ctm w/ am labs #lymphocytosis Afebrile, no urinary symptoms. Hypoxic on presentation, likely related to edema i/s/o HTN emergency as above. No suspicion for infectious etiology at this time, no white count. -ctm w/ am labs #HLD -cont statin #QTC prolongation 561 on 4/13/2021 -avoid QTc prolonging medications


VAERS ID: 1214733 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Indiana  
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 1808978 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blindness unilateral, Cerebrovascular accident, Eye pain
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), Glaucoma (broad), Optic nerve disorders (broad), Retinal disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: none
Preexisting Conditions: hypothyroidism
Allergies: None
Diagnostic Lab Data: Do not have access to them
CDC Split Type:

Write-up: Patient reports that she had pain behind her eye. Went to hospital and was diagnosed with having a stroke. Patient states she lost sight in her left eye and is still blind in her left eye. Optometrist states patient will not regain her vision in her left eye.


VAERS ID: 1214765 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-03-17
Onset:2021-03-18
   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 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bell's palsy, Computerised tomogram, Eye pain, Fatigue, Feeling cold, Gastrointestinal pain, Laboratory test, Magnetic resonance imaging, Malaise, Neck pain, Sleep disorder
SMQs:, Acute pancreatitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Hearing impairment (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: High blood pressure (controlled), Free diabetic (controlled)
Allergies: Levoflaxin, I have severe allergies to food, vegetables and nuts
Diagnostic Lab Data: MRI, CT scan, lab work
CDC Split Type: vsafe

Write-up: My symptoms started 03-18-2021 at 11am where I developed chills, was very sleepy that I slept 15 hours straight. I felt very fatigued and my eyes hurt so much and I could not keep them open. On 04-06-2021 I still was not feeling well. I started to have problems with my right side of my face, eyes and mouth which gradually got worse so I went to the hospital. At the hospital they checked me for stroke, performed lab work, did MRI and CT scans and the the doctors came back and said it was Bell''s palsy. I again went to the hospital 04-11-2021 but this time due to GI issues with pain. On 04-14-2021 through 04-15-2021, I started to experience neck pain behind my right ear. At the hospital they had prescribed my prednisone 50mg, so I took half for my pain. I still have trouble sleeping and have lots of pain.


VAERS ID: 1214770 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Nebraska  
Vaccinated:2021-04-02
Onset:2021-04-07
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 5 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: emgality other unknown meds
Current Illness: CHF and Cardiac Issues migraines
Preexisting Conditions: see above
Allergies: iodine, prinivil, cheery
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: Pt got dizzy and feel had to go to ED


VAERS ID: 1214791 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Iowa  
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 043A21A / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray, Computerised tomogram, Dizziness, Dyspnoea, Headache, Heart rate increased, Laboratory test, Myalgia, Nausea, Pain, Palpitations, Pyrexia, Vision blurred
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Nortriptyline
Current Illness:
Preexisting Conditions: Asthma, Hashimotos
Allergies: Penicillin, lanolin
Diagnostic Lab Data: CT Scan of head and chest, chest x-ray, blood work. all of these were 4/14/21
CDC Split Type:

Write-up: Headache, nausea, dizziness/lightheadedness, blurred vision, muscle and body aches, fever 102.4, increased heart rate and palpitations, shortness of breath.


VAERS ID: 1214799 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-03-05
Onset:2021-03-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / 1 LA / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain upper, Computerised tomogram, Diarrhoea, Endoscopy, Magnetic resonance imaging, Pancreatitis acute, Ultrasound scan, Vomiting
SMQs:, Acute pancreatitis (narrow), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Armour Thyroid 60 MG Daily Vitamin Selenium 200 MG Vitamin D3 125mcg Fiber supplement
Current Illness: None
Preexisting Conditions: Thyroid
Allergies: None
Diagnostic Lab Data: Altrasound Cat scan MRI Endoscopy
CDC Split Type:

Write-up: I had the Janssen vaccine at 2pm. on Friday afternoon. By 8:00 I was doubled over with stomach pain. All weekend had pain, diarrhea and vomiting horribly. By Monday March 8th I doubled over in stomach pain so bad I had to call an ambulance. Was admitted to hospital on Monday with Accute Pancreatitus. Was in the hospital until Friday March 12th. I am a TOTALLY HEALTHY person that is NEVER sick, very healthy, and I workout daily. I have no gallbladder, I NEVER drink ANYTHING, there was NO reason I should have been there except for the vaccine reaction. After having a Cat scan, MRI, Altrasound , and an Endoscopy, the my specialist concluded it was the vacinne.


VAERS ID: 1214809 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-03-10
Onset:2021-04-09
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / UNK LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Angiogram cerebral normal, Arteriogram carotid normal, Blood creatinine increased, Computerised tomogram head normal, Haemoglobin decreased, Hypoaesthesia, Magnetic resonance imaging head normal, Plasmapheresis, Platelet count decreased, Transient ischaemic attack
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Haematopoietic erythropenia (broad), Haematopoietic thrombocytopenia (narrow), Peripheral neuropathy (broad), Haemorrhage laboratory terms (broad), Systemic lupus erythematosus (broad), Ischaemic central nervous system vascular conditions (narrow), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, arterial (narrow), Guillain-Barre syndrome (broad), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: rivaroxaban, lisinopril, aspirin, diclofenac sodium gel
Current Illness: sickle cell trait, peripheral arterial disease, hypertension
Preexisting Conditions: sickle cell trait, peripheral arterial disease, hypertension
Allergies: No known allergies
Diagnostic Lab Data: 4/9: platelets = 13 (per notes); Hemoglobin 6.6 4/10: platelets = 29K, hemoglobin 9.1, SCr 1.14 4/12: platelets 12K, hemoglobin 8.8, SCr 1.35 4/13: platelets 19K, hemoglobin 7.9, SCr 1.02 4/14: platelets 21K, hemoglobin 7.7, SCr 1.12 4/15: platelets 43K, hemoglobin 7.9, SCr 1.05
CDC Split Type:

Write-up: Patient was admitted on 4/9 to hospital with left facial, upper and lower extremity numbness that last 5 min and resolved. In ED had similar symptoms. CT head, MRI brain, MRA head and neck unremarkable. Hgb 6.6 and Plt 13. Transferred to Medical Center on 4/10 for more care. Diagnosed with TIA and possible TTP (ADAMTS13 pending, meets other criteria). Started on high dose methylprednisolone 1000 mg IV x 3 doses on 4/11, plasmapheresis on 4/11, and weekly rituximab on 4/11. Status/outcomes pending


VAERS ID: 1214840 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-06
Onset:2021-04-10
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute kidney injury, Hypokalaemia, Occult blood positive, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Haemorrhage laboratory terms (narrow), Arrhythmia related investigations, signs and symptoms (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), Gastrointestinal haemorrhage (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (narrow)

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

Write-up: N17.9 - AKI (acute kidney injury) R19.5 - Occult blood positive stool E87.6 - Hypokalemia R55 - Syncope


VAERS ID: 1214844 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: New York  
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 1808980 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Decreased appetite, Dehydration, Fatigue, Full blood count, Headache, Injection site bruising, Lethargy, Urine analysis, Vertigo, Vision blurred
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (narrow), Hypoglycaemia (broad), Dehydration (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Effexor Topomax Torazadone
Current Illness:
Preexisting Conditions: Mild COPD Fibromyalgia
Allergies: N/A
Diagnostic Lab Data: 2 - different virtual urgent care visit with Health Care nothing both virtual 1 in person urgent care visit with Health Care they didn?t do any test except vital 1 Emergency Room visit did CBC, urine, and vital- gave me IV fluids sent me home
CDC Split Type:

Write-up: Dehydration Vertigo Headache Weakness Extreme tiredness Loss of appetite Blurry vision Bruise at injection site 2-weeks now Lethargic Stomach pain


VAERS ID: 1214868 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-03-24
Onset:2021-04-07
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 UN / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: CSF protein increased, Central venous catheterisation, Coma scale abnormal, Computerised tomogram head, Endotracheal intubation, Lumbar puncture abnormal, Magnetic resonance imaging head, Muscular weakness, Paresis, Plasmapheresis, Respiratory distress
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), 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), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lisinopril 5mg and TOPROL-XL 50mg
Current Illness: None reported
Preexisting Conditions: Back Pain, Hypertension
Allergies: No known Allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: 4/10/2021 - Arrived in ED with weakness reported in R arm and Bilateral legs, Admitted into facility. 4/11/2021 - Neurology consulted expressed concern for AIDP, various neurological tests performed (MRI Brain, CT head and Lumbar Puncture). CVC placed for plasma exchange treatment 1/5 4/12/2021 - CT no acute abnormality, L.P. high protein. 4/13/2021 - Continued ascending Paresis. Monitored closely for Respiratory distress plasma exchange treatment 2/5 4/14/2021 - Plasmapheresis 3/5 performed. decreasing GCS intubated.


VAERS ID: 1214878 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Minnesota  
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 205A21A / N/A LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: NKDA
Diagnostic Lab Data: Patient states he was taken by ambulance to emergency department where he was treated, observed and later released that same afternoon.
CDC Split Type:

Write-up: Patient received Janssen COVID19 vaccine at 9:30am. Upon receiving vaccine he sat down on chair to wait for 15 minutes post-vaccination. Just minutes after sitting down patient lost consciousness, fell from chair, and hit his head on a nearby countertop in room. He fell on his side on floor, EMS were called, and ice pack was placed on his head while awaiting EMS arrival.


VAERS ID: 1214907 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-15
Onset:2021-03-26
   Days after vaccination:11
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 decreased, Deep vein thrombosis, Haemoglobin normal, Platelet count normal, Ultrasound Doppler abnormal, White blood cell count normal
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (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: acetaminophen 500 mg oral tablet,2 tabs Oral TID PRN pain |not to exceed 3000 mg/day |Not taking Lipitor 40 mg oral tablet,1 tabs Oral QDAY,Instr:Hold while taking antibiotics |Hold while taking antibiotics |Not taking diclofenac 1% topical
Current Illness: None known
Preexisting Conditions: Chronic back pain Depression Diastasis recti Elbow pain right , old injury Esophagitis grade III H/o L radial head avulsion Fx, non-displaced. Non-operative per Ortho. Helicobacter pylori infection Hiatal hernia HTN - Hypertension OA knee Overweight Rib cage pain hx of fracture ( remote ) Ventral hernia
Allergies: Amlodipine
Diagnostic Lab Data: WBC 6.99, Hg 15.5, Plt 219 Cr 0.7 RLE Duplex US: 1. Acute deep vein thrombosis note in right soleal venous sinus 2. The rest of the visualized veins of the right lower extremity appear patent. However part of the right peroneal right posterior tibial veins could not be visualized and hence cannot rule out DVT in this vein.
CDC Split Type:

Write-up: Patient developed right lower extremity DVT (unprovoked) diagnosed on 3/26/21.


VAERS ID: 1214940 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Washington  
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 042A21A / UNK - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Blood test
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Osteo Bi Flex, Advil
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Blood drawn, no results yet.
CDC Split Type:

Write-up: Severe stomack pain. 2 days. Went to the Urgent Care and was sent to the ER for exrays. Nothing found, No explaination. Following up on 4/15.


VAERS ID: 1214942 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-03-15
Onset:2021-03-15
   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 RA / IM

Administered by: School       Purchased by: ?
Symptoms: Headache, Magnetic resonance imaging head normal
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: Symbicort 8-4.5 mg/actuation inhaler 2 puffs twice daily; multivitamin and vitamin D3
Current Illness: None
Preexisting Conditions: Moderate persistent asthma
Allergies: None
Diagnostic Lab Data: MRV 4/15/21 Impression: No evidence of venous sinus thrombosis. MRI 4/15/21 Impression: No evidence of acute intracranial hemorrhage, mass lesion, or acute infarct. A few punctate nonspecific foci of T2 hyperintensity involving the supratentorial white matter. Considerations include mild chronic small vessel ischemic disease, sequelae of hypertension or diabetes, demyelinating process such as multiple sclerosis, infectious processes as Lyme disease, migraine, granulomatous disease, vasculitis.
CDC Split Type:

Write-up: Ongoing throbbing headache since 20 minutes after vaccine was administered. No previous history of headaches like this. Went to ER and ruled out clot via MRI/MRV and was given cocktail injection with Benadryl, Gadoteridol, Ketorolac, with improvement of headache for 5 hours.


VAERS ID: 1214980 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Oklahoma  
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 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Altered visual depth perception, Arthralgia, Aura, Blood test normal, Cardiac imaging procedure abnormal, Chest X-ray normal, Chest pain, Computerised tomogram abnormal, Dizziness, Dysgeusia, Electrocardiogram normal, Feeling abnormal, Heart rate irregular, Myocardial necrosis marker normal, Nausea, Pain in extremity, Paraesthesia, Parosmia, Pericarditis, Retching, Scan with contrast abnormal, Tremor
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Vestibular disorders (broad), Generalised convulsive seizures following immunisation (broad), Chronic kidney disease (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations: Tetanus hives, vomiting age 32
Other Medications: Synthroid, Xanax, Aspirin, Atenolol, Amlodipine, Omeprazole,
Current Illness: ear infection diagnosed and treated almost 4 weeks before Simvastatin, Diazepam, Cephalexin, Tetracycline. Latex. Contrast Dye (esp. iodine ones), vaccines. Cleaners, insect sprays Paint fumes, Shellfish.
Preexisting Conditions: paralyzed vocal cord, hypothyroidism, hypertension
Allergies: Penicillins, Erythromycin, Oxycodone Acetaminophen, Niacin, Gabapentine, Simvastatin, Fluticasone Propionate
Diagnostic Lab Data: 4/12-13/21 EKGs, chest X-rays and blood tests normal, cardiac enzyme tests showed no heart attack. 4/13/21 Heart CT showed inflammation of the pericardium. The Cardiologist said it m was caused by the Covid 19 immunization. I was placed on colchicine for 2 weeks. I was given follow-up appointments with my primary care physician and the cardiologist. These are results my husband and I were told during my hospital stay but I do not yet have the documentation in hand.
CDC Split Type:

Write-up: Strange odor a few minutes after injection, followed by bitter taste, then nausea and spaciness. Dizzyness, with vision looking 2D and flat by 15 minutes. Told Pharmacist, of spaciness who said stay as long as I wanted. Left at 30 minute point, still spacy and nauseous. Spaciness ended by an hour with nausea off and on. Chest pain - began around 7pm, continued to expand in area of chest, sharp stabbing pain later, pain from just above left elbow to hand and tingling of fingers, pain lower left leg and tingling of left foot. Irregular heart rate at different times. Checked into emergency room at 11:00. IV inserted, placed on continual heart and oxygen monitors, EKGs, chest X-rays (2), blood tests (3). Admitted to hospital sometime during the night. Given IV medications to counteract IV contrast allergy. These medications caused full body shakes, eyesight auras and extreme nausea with gagging. Heart CT taken with IV contrast. Discharged around 3:00 PM.


VAERS ID: 1214990 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-04-06
Onset:2021-04-11
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / N/A LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Blood test, Pain in extremity, Sensitive skin, Ultrasound scan normal
SMQs:, 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: Oxybutynin - 5 mg; Levothyroxine - 75 mcg; PQ2 (for heart); and CoQ10 (for heart); Biotin; Spectravite Multi-Vitamin; Vit B Complex; Calcium with Magnesium; Vitamin combination for eyes - AREDS 2; chelated zinc; Vit D3; Vit C; Hemp oil; Vi
Current Illness: for three or four months I had irritable bowel syndrome- they discovered the cause was microscopic inflammation. I had been treated it before the vaccine; Steroid - Dudesfriode (spelled) - took it for three weeks but finished it a couple of days before I had the shot (on Friday, the 2nd).
Preexisting Conditions: no - Breast Cancer - 9 years ago
Allergies: Ragweed; adhesive on band-aids
Diagnostic Lab Data: Ultrasound - I saw the Dr on 13th and I had the Ultrasound that day - at hospital. That came out fine ER visit 4/14/2021 - Magnesium drip
CDC Split Type: vsafe

Write-up: 5 pm on Sunday, I started getting pains on my lower leg. Not like an ache. All up and down the inside of the leg (the pain was). There was a pressure point where I found a point where if I pressed it, it was really painful. My skin - the inner leg towards the back - it was really really sensitive. If you touched it lightly it felt painful - not a searing pain. If I massaged it, it would go away but in a few minutes it would come back. I took an aspirin in case of a clot. At this time, I was thinking of deep vein thrombosis. Gradually, it went away. It lasted quite awhile - it lasted between 2 or three hours like this. Even now, the skin isn''t sensitive, but I can still press that one point and it hurts. (That pressure point.) I went to the Doctor on the 13th, he sent me to an Ultrasound there wasn''t a clot in the leg. That came out fine. When I had the IBS for four months (with a lot of diarrhea). I just found out yesterday that my magnesium was low and they gave me a drip for that. My potassium was a little low also. I had the magnesium drip last night - it was an Hospital ER visit - but it was for bloodwork that had been done yesterday to check me after IBS symptoms.


VAERS ID: 1215013 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-03-18
Onset:2021-03-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain, Computerised tomogram, Diabetes mellitus, Fatigue, Full blood count, Headache, Immediate post-injection reaction, Impaired work ability, Urine analysis, Vomiting
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Aczone, trention, multivitamin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: CT scan, CBC, monitors, Blood pressure, pulse ox, urine screen. Physical exam.
CDC Split Type:

Write-up: Immediate headache behind left ear in lymph node, fatigue and worsening headaches within 5 hours. Missed one week of work due to fatigue. Following week vomiting and diarrhea in addition to the fatigue. Abdominal pain. ER visit to rehydrate and evaluate.


VAERS ID: 1215014 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-09
Onset:2021-04-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Asthenia, Dizziness, Dyspepsia, Gait disturbance, Headache, Laboratory test, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific dysfunction (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), 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: Lisinopril 10MG once daily Carvedilol 12.5 MG twice daily Atorvastatin 40 MG once at night Pantoprazole 40 MG once daily
Current Illness: None
Preexisting Conditions: Tachycardia Asthma Scoliosis High Blood Pressure GURD
Allergies: Penicillin Shell Fish Contrast Dye Benedryl Bees
Diagnostic Lab Data: Blood work ordered by Primary April 14, 2021 and done on April 15, 2021. Awaiting results
CDC Split Type:

Write-up: Monday started having swelling behind my neck between my two shoulders and then a headache began. Went to Healthcare expressed by the doctor did not think it was blood clot, but probably related to the vaccine. Gave me a steroid and muscle relaxer sent me home to call provider next day. Had Televisit with primary?s Wednesday April 14, 2021, by then news had broke about the new type of blood clot CVST and the low platelet count, I explained still had headache and swelling, sour stomach over night(have had this before) and felt weak for a brief few minutes on right side but quickly went away, also was walking for a brief few minutes like I was drunk, again went away after a few minutes. Discussed with primary my anxiety could be contributing to some of the extra feelings I was having, agreed to do bloodwork to check platelet levels. She did not think it was blood clots discussed with me about what I needed to look for and to go to ER immediately if I experienced any of them. Blood work did today, Thursday April 15, 2021. still headache and some swelling in back of neck between shoulders, dizzy off and on. All pain moderate to mild. Awaiting blood work for next step.


VAERS ID: 1215016 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-03-13
Onset:2021-03-22
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 RA / IM

Administered by: School       Purchased by: ?
Symptoms: Anticoagulant therapy, Erythema, Pain in extremity, Peripheral swelling, SARS-CoV-2 antibody test negative, Skin warm, Tenderness, Thrombophlebitis superficial, Ultrasound Doppler abnormal
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Current Medications (F) Heart Verapamil (300 mg) once daily Flecainide (100 mg) twice daily Niacin (500 mg) once daily Essential Tremor Primidone (100 mg) 3 times daily Cholesterol Atorvastatin (20 mg) once daily Prostate Tadalafil (5
Current Illness: Sinusitis and Asthma
Preexisting Conditions: Atrial tachycardia plus rare AFib Eosinophilic Asthma Chronic rhinosinusitis Sleep Apnea Essential Tremor Arthritis Chronic Urticaria
Allergies: Cartia Hydroxezine Gabapentin Raw Shellfish
Diagnostic Lab Data: US LEFT DUPLEX LOWER EXTREMITY VEINS Also had COVID antibody test that showed the following results: Component Your value Standard Range INDEX (S/C) 0.0 S/C <1.4 S/C<1.4 S/C INTERP, SARS-COV-2 IGG Negative Negative
CDC Split Type:

Write-up: I received the Janssen vaccine on March 13. By the next weekend, I had what I thought was a spider bite on the inside of my left thigh. That "bite" got worse--bigger, hot to the touch, and then red. On the weekend of the 27-28 of March, it was red, raised and very painful even when not touched. I called my family doctor on Monday morning, the 29th of March, and I was sent to the Emergency Room, where I was diagnosed with a 7cm thrombosis in my left greater saphenous vein, which is treated the same as a DVT. I was treated first with Lovenox injections, then Eliquis 10 mg 2x daily, now 5 mg 2x daily. The blood clot is still painful to the touch.


VAERS ID: 1215019 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-04-02
Onset:2021-04-13
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Pain, Peripheral swelling, Thrombosis
SMQs:, Cardiac failure (broad), Angioedema (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient right leg became very swollen from knee down and was very painful to walk. Patient went to Urgent Care and was told that he would need to have ultrasound done to see what was going on. Patient went to Imaging and was told that he had several blood clots through out his right leg. They advised him to go to emergency room evaluation. Patient went to Medical Center and it was confirmed that patient had blood clots and was put on Xarelto for treatment.


VAERS ID: 1215031 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-07
Onset:2021-03-11
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 180518 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain, Computerised tomogram, Contusion, Dyspnoea, Headache, Magnetic resonance imaging, Migraine, Pain in extremity, Pyrexia, Vaginal haemorrhage, Visual impairment
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Flu vaccine
Other Medications: Albuterol, Trazadone, Eliquis, Nexium, Latuda, Cymbalta
Current Illness: No, only a nerve steroid injection into lower back
Preexisting Conditions: Insomnia, Anemia, Stroke, Post CVA, Neuropathy, Anxiety, Asthma, Depression, Acid Reflux, DVT - legs, lungs and brain, Fibromyalgia, CAD,
Allergies: Dixoclycoline, Prednisone pill pack, Rocephin, Zyprexa, Remeron, Cogentin, Beans, Amitriptyline, Lyrica, Codeine
Diagnostic Lab Data: MRI and Ct done in March
CDC Split Type:

Write-up: About 4 days after I started having abdomen pain, it was like having contractions, then bleeding and spotting, and it was a different type of color instead of a period color, more burgundy. it lasted 26 days, when I''d eat it would start again, I started having headaches, and had vision problems, then SOB started and I used the inhaler to help. I also had a low grade fever of 99.8 - 100 that lasted up until about 5 days ago. I started having bruising and leg pain, the bruising would be if someone helped me get up, I have little bruising dots over my body. I went to the ER 3/16/2021 because the stomach and headache pains, they did a MRI and Ct and said it was acute stomach pain and migraines and told me to see a OBGYN for the bleeding and gave me meds for stomach pains. Bentel for stomach and Floraset for headaches but it never worked. I had a nerve block on my head for the migraines but it didn''t work. The GYN gave me something to stop the bleeding and she''s wants to do a D&C. I''m waiting to see my PCP on the 19th. I still have the purple dots and headaches, I still get the contractions and the stomach issues have settled some.


VAERS ID: 1215073 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-03-10
Onset:2021-04-10
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1082072 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anticoagulant therapy, Blood test, Computerised tomogram, Dyspnoea, Incision site pain, Mobility decreased, Pneumonia, Pulmonary thrombosis, Thrombectomy, X-ray
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Parkinson-like events (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? 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: Buspirone, losartan, propranolol, hyoscyamine, B12, tumeric, cetirizine, AZO cranberry, ashwagundha, cbd oil, vitamin d3
Current Illness: high heart rate
Preexisting Conditions: low back pain
Allergies: Shell fish
Diagnostic Lab Data: Medical Test = blood drawn, x rays and CT Scan
CDC Split Type:

Write-up: On 4/10/21 to Urgent Care. Found blood clots in my lungs and Pneumonia, Clots removed at Hospital on 4/11/21. Hospitalized until 4/13/21. Treatment - blood thinners (enoxaparin, heprin and steroids), azithromycin, Advair disk, albuterol, Spiriva, Symbicort Outcome: Still trouble breathing, slow moving and sore from the incesion.


VAERS ID: 1215079 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: California  
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 - / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Dizziness, Dysstasia, Electrocardiogram normal, Head injury, Hypersomnia, Hypertension, Hypotension, Injection site pain, Nausea, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Cardiomyopathy (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: 4/13/2021 EKG / Blood work - all normal or within range
CDC Split Type:

Write-up: 4/11/2021 3:00am Dizzy when got up from bed 8:01am - dizzy and nauseous had to crawl, fainted - hit head, injection site very sor Slept rest of day low blood pressure - 102/67 4/12/2021 - High blood pressure, dizzy and nauseous 4/13/2021 High blood pressure - went to ER - 177/111 - ER doctor was not aware that J&J was being paused and told me results had nothing to do with vaccine. 4/15 - Followup phone call with different Dr to review symptons encouraged me to submit symptons


VAERS ID: 1215088 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Iowa  
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 1805018 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Colonoscopy, Endoscopy, Gastric ulcer, Impaired work ability, Laboratory test, Migraine, Vomiting, Weight decreased
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Gastrointestinal ulceration (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: sumatriptan 50mg at onset of headache, advil 400mg as needed, eyepromise
Current Illness:
Preexisting Conditions: Migraines, factor 5 leiden
Allergies: No known allergies
Diagnostic Lab Data: Patient has had multiple blood draws for lab work, an endoscopy, colonoscopy and is awaiting approval for an MRI, MRA and MRV.
CDC Split Type:

Write-up: Developed a severe migraine about 7 days after receiving shot. Migraine has persisted despite multiple treatment attempts. Patient has thrown up and lost 10 pounds due to the severity of migraine and has only been able to work about 3 days since she received her vaccine. Patient medicated with advil so much that she ended up with a stomach ulcer. Provider has tried toradol, nurtec, dicyclomine and patient is currently on emgality 120mg, zofran 8mg and omeprazole 40mg.


VAERS ID: 1215094 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Minnesota  
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 205A21A / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Condition aggravated, Electrocardiogram, Fall, Head injury, Hypotension, Loss of consciousness, Seizure, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (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, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: NKDA
Diagnostic Lab Data: Patient states she received an EKG while at the ED, then released later that afternoon post-observation.
CDC Split Type:

Write-up: Patient received Janssen COVID19 vaccine at 10:15am. Upon receiving vaccine she sat down on chair to wait for 15 minutes post-vaccination. Just minutes after sitting down patient lost consciousness, fell from chair, hit her head on the floor, seize for a short moment, only to momentarily regain consciousness, and faint for a second time. EMS were called and patient was transported to Emergency Department for testing and observation. Patient believes she fainted the first time due to not having eaten much by that point in the day and due to anxiety about receiving the vaccine, and she was told she fainted a second time due to hypotension. She states she has a history of previously fainting during other medical procedures, though no similar previous reactions she can recall after vaccines.


VAERS ID: 1215096 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-03-23
Onset:2021-04-05
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Blood magnesium, Computerised tomogram, Electrocardiogram, Epiploic appendagitis, Full blood count, Hepatic enzyme, Impaired work ability, Lipase, Metabolic function test, Pain, Troponin, Urine analysis
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin; Glipizide; Lantus; Simvastatin; Losartan; Metoprolol; 81mg aspirin; Omeprazole; Multi Vitamin; Vitamin D; Fish Oil; CoQ-10
Current Illness: None
Preexisting Conditions: Diabetes; high blood pressure; high cholesterol; fatty liver; A-fib
Allergies: Lisinopril; Latex;
Diagnostic Lab Data: Blood work (basic metabolic panel; cbc auto differential; hepatic function panel; lipase; magnesium; troponin); Urinalysis w/reflex to microscopic & culture; CT abdomen pelvis with contrast; ECG 12 lead
CDC Split Type:

Write-up: During the week of 3/29/21 (the week following my vaccine), I began to experience periodic lower abdominal pain (lower right and lower center) during movement (walking or going from sitting to standing. On Monday, 4/5/21 (13 days after my vaccine), I began experiencing severe abdominal pain upon getting out of bed at 7am. The pain was worse with movement of any kind (walking, turning, going from sitting to standing). I was convinced something was seriously wrong, and called my Dr''s office . While waiting for the NP to call me, I decided that I should go to the hospital. My husband drove me, and even the car ride there was painful (bumps and turns). The pain upon standing was as if my bladder was going to fall out. The pain when walking was a stabbing type of pain in my lower right abdomen and a stretching sensation in my center/lower abdomen. The E.R. Dr diagnosed me with epiplogic appendagitis, and instructed me to rest, hydrate, and take tylenol. I followed the Drs advice. I took 4/5&6 off from work, spending most of that time in a reclining position in my livingroom and I drank plenty of water. I felt noticeable improvements daily. I saw my PCP for a follow-up visit on 4/8 for an abdominal exam, at which time I was experiencing pain primarily in bed (in a stretched out position) and periodically with movement (walking and going from sitting to standing or turning). I had my second follow-up today with my PCP (4/15). I continue to improve daily.


VAERS ID: 1215097 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Male  
Location: North Carolina  
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 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Chills, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: UNKNOWN. WIFE TOOK PATIENT TO HOSPITAL AND HE "RECEIVED A SHOT".
CDC Split Type:

Write-up: WIFE DESCRIBED FEVER, CHILLS, AND UPSET STOMACH


VAERS ID: 1215099 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-03
Onset:2021-04-12
   Days after vaccination:9
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: Pharmacy       Purchased by: ?
Symptoms: Joint swelling
SMQs:, Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: left knee swelling


VAERS ID: 1215107 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-03-31
Onset:2021-04-05
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Coagulopathy, Pain in extremity, Pyrexia, Swelling, X-ray abnormal
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), 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? No
Previous Vaccinations:
Other Medications: Tamsulosin Atorvastatin Metformin Telmisartan Ciprofloxacin-hospital discharge Eliquis-hospital discharge
Current Illness: Hyperlipidemia Hypertension Diabetes Benign Prostatic Hyperplasia (enlarged prostate)
Preexisting Conditions: Hyperlipidemia Hypertension Diabetes Benign Prostatic Hyperplasia (enlarged prostate)
Allergies: NKA
Diagnostic Lab Data: Xrays performed on or around 4/15/2019
CDC Split Type:

Write-up: Patient presented to the hospital with left leg pain and swelling in the groin region as well as fever. Xrays were performed and blood clotting was diagnosed. Symptoms started around 4/5/2019, but he did not seek immediate treatment until the condition worsened. This is a new diagnosis. Upon discharge he was prescribed both Ciprofloxacin and Eliquis


VAERS ID: 1215124 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Nebraska  
Vaccinated:2021-03-01
Onset:2021-03-01
   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: Private       Purchased by: ?
Symptoms: Ataxia, Demyelinating polyneuropathy, Electromyogram abnormal, Facial paresis, Headache, Lumbar puncture abnormal, Magnetic resonance imaging head abnormal, Miller Fisher syndrome, Myalgia, Scan with contrast abnormal
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Demyelination (narrow), Eosinophilic pneumonia (broad), Ocular motility disorders (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? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tysabri cholecalciferol
Current Illness: None
Preexisting Conditions: Relapsing Remitting Multiple Sclerosis
Allergies: Lisinopril
Diagnostic Lab Data: MRI''s Brain 3/28 , Cervical 3/28 , Thoracic 3/30 and Lumbar spine 3/30: all with and without contrast EMG/NCS 4/2 LP 3/29
CDC Split Type:

Write-up: 11 days after vaccination patient had the onset of generalized myalgias, headaches. This was followed by the onset of unilateral facial weakness 17 days after vaccination. On examination, he had ataxia and facial weakness. He had MRI''s, LP and EMG/NCS which confirmed demyelinating polyradiculoneuropathy, presumably Miller Fisher variant of Guillain Barre Syndrome.


VAERS ID: 1215133 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: California  
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 1805029 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Balance disorder, Dizziness, Nausea, Paraesthesia, Paraesthesia oral
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NO
Preexisting Conditions: CARDIAC ARRYTHMIA, DIABETES, COPD. HYPERTENTION, BLOOD CLOTTS, MYOCARDIAL INFARCTION, ATRIAL FIB
Allergies: CODEINE, IODINE, ADHESIVES
Diagnostic Lab Data: SENT AMBULANCE TO HER HOUSE
CDC Split Type:

Write-up: DIZZINESS, NAUSEA, TINGLING/ NUMBNESS OF LIPS AND MOUTH AND BODY, FELT UNSTEADY ON HER FEET


VAERS ID: 1215155 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-03
Onset:2021-04-07
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Atrial fibrillation, Hypotension
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Supraventricular tachyarrhythmias (narrow), 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? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: AFib, low BP, Patient hospitalized for 3 days


VAERS ID: 1215321 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-02
Onset:2021-04-02
   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 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Chills, Fatigue, Head discomfort, Headache, Injection site pain, Mouth swelling, On and off phenomenon, Pain in extremity, Pyrexia, SARS-CoV-2 test negative, Urticaria, Vision blurred
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (narrow), Oropharyngeal allergic conditions (narrow), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxcin 50mg
Current Illness: None
Preexisting Conditions: Hypothyroidism
Allergies: Berries, amoxicilin
Diagnostic Lab Data: Seen urgent care dr. Covid test taken. Results were negative.
CDC Split Type:

Write-up: 04/02/2021 @ 7:30pm - chills lasting all night 04/02/2021 @ 9:45pm - fever of 104.3. Fever bounced between 103.1 and 104.3. 04/03/2021 @ 8am - extreme fatigue with my head feeling like it is being pumped and blurry vision with each pump. Lasted 2 days. Fatigue lasted 6 days. Would go away if i layed down. It wouls start back up when i sat up. Sore arm at injection site for 1 wk. Left leg pain most of the day. 04/04/2021 @ 7am - woke up with hives covering the inside of my mouth. Weakness and head pulsing all day but no vision issues. 04/05/2021 @ 7am - woke up with swollen mouth(gums and lips) Went to urgent care. Swelling was on and off all day including the hives 04/06/2021 @ 1:15pm - headache back of my head.


VAERS ID: 1215336 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Illinois  
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 043A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Blood culture, Blood glucose, Body temperature increased, Chills, Dyspnoea, Feeding disorder, Full blood count, Headache, Heart rate increased, Myalgia, Nausea, Pain, Photophobia, SARS-CoV-2 test negative, Sleep disorder, Urine analysis, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Corneal disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: synthroid, prescription Vitamin D2
Current Illness: None
Preexisting Conditions: Celiac Disease, hypothyroidism
Allergies: gluten
Diagnostic Lab Data: Tests - Blood cultures, CBCs, multiple glucose, and urine analysis checks. April 8-10, 2021
CDC Split Type:

Write-up: 5 hours post injection - violent chills, shortness of breath, elevated heart rate (100+), temperature went from 98.1 to 101.3 in less than 30 mins, weakness, severe full body muscle pain. Unable to sleep, rest or eat. Day 2 - intense, severe full body muscle pain, temperature 101.7 even with tylenol taken ever 4-6 hours, severe headache and light sensitivity, nausea, unable to eat and unable to sleep. Day 3 - ongoing headache and light sensitivity. Vomited stomach acid. Day 3 around 5pm went to Immediate Care - covid test negative; was referred to Emergency Room and eventually admitted to inpatient floor. ER tests showed - 2 bags of fluid given. Admitted as inpatient, 1 additional bag fluid.


VAERS ID: 1215369 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-03-15
Onset:2021-04-07
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / UNK RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Activated partial thromboplastin time, Angiogram, Brain natriuretic peptide, Deep vein thrombosis, Full blood count, International normalised ratio, Metabolic function test, Prothrombin time, Pulmonary embolism, Ultrasound Doppler
SMQs:, Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Losartan/HCTZ, Norvasc, Metoprolol, Magnesium, Vitamin D, Vitamin B12, Potassium, Protonix, Carafate, Macrobid, Zofran, aspirin, zyrtec
Current Illness: Polycythemia vera, bladder cancer, hypertension, GERD
Preexisting Conditions: Polycythemia vera, bladder cancer, hypertension, GERD
Allergies: Levaquin, Lisinopril, Sulfa, Lortab, Loracet
Diagnostic Lab Data: CT angio, Lower extremity doppler, ultrasound, PTT, PT/INR, CBC, BMP, BNP
CDC Split Type:

Write-up: DVT right lower extremity and pulmonary embolism: was hospitalized for 2days with a Heparin Drip and discharged home with Eliquis 10mg twice a day. Home meds discontinued: all BP meds, Ibuprofen, Tylenol, and Torodol. Follow up appointments with Dr. oncologist. Also had to cancel upcoming ventral hernia repair after having to wait 3 years due to complications with bowel obstructions and had to lose weight before surgery due to high risk. Now will have to wait longer until cleared medically, primary physician instructed me that it would be 6months or more before being cleared.


VAERS ID: 1215391 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Maryland  
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 - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Blood test, Chills, Computerised tomogram abdomen, Haemangioma of liver, Headache, Pain in extremity, Pyrexia
SMQs:, Liver neoplasms, benign (incl cysts and polyps) (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: no
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: CT Abd, and Blood work (04/14/2021)
CDC Split Type:

Write-up: Experienced chill, headache, abdominal pain, leg pain, fever for 3-4 days, in 5 th day headache reduces but abdominal pain persist. On day 7, abdominal pain was severe, feeling like fever, contacted PCP and as per PCP''s recommendation went to ER. ER report shows several liver Hemangioma, released from ER, pain is is still there, taking pain medicine. Will check with PCP. Had CAT scan before but never reported lever Hemangioma.


VAERS ID: 1215421 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-01
Onset:2021-04-02
   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: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Exposure during pregnancy, Headache
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)

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

Write-up: abdominal pain since vaccine, found to be pregnant. headache 1 week after vaccine. normal exam. no change in vision. no personal or family history of clots. better with reglan


VAERS ID: 1215492 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-06
Onset:2021-04-10
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chest discomfort, Chest pain, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Severe chest pain started a and led to externally heavy chest feeling, currently in hospital. Evening of vaccine very weak and muscle aches. Within days extreme chest pain, weakness, heavy ness in chest.constant pain and breathing problems


VAERS ID: 1215502 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-03-26
Onset:2021-04-02
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 AR / IM

Administered by: Work       Purchased by: ?
Symptoms: Ageusia, Bell's palsy, Computerised tomogram, Facial paralysis, Hypoaesthesia oral
SMQs:, Taste and smell disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: EMGALITY, LYRICA, PROPRANOLOL
Current Illness:
Preexisting Conditions: MIGRAINE HEADACHE, BACK PAIN
Allergies:
Diagnostic Lab Data: CT SCAN 4/3/2021
CDC Split Type:

Write-up: 7 DAYS AFTER VACCINATION PATIENT FELT NUMBNESS AND LOSS OF TASTE IN HER TONGUE. THE FOLLOWING MORNING SHE WOKE AND ONE SIDE OF THE FACE WAS DROOPING. PATIENT RECEIVED CARE AT AN URGENT CARE FACILITY. A CT SCAN WAS PERFORMED TO RULE OUT BLOOD CLOT. PATIENT WAS DIAGNOSED WITH BELL''S PALSY


VAERS ID: 1215510 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-03
Onset:2021-04-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram, Gait inability, Magnetic resonance imaging, Thrombosis, Transient ischaemic attack, Ultrasound scan
SMQs:, Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Dystonia (broad), Thrombophlebitis (broad), Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Hydrocortisone 20mg 1.5 per day Levoxine for thyroid 100 micrograms1 per day
Current Illness: None
Preexisting Conditions: None
Allergies: Na
Diagnostic Lab Data: CT SCAN ULTRA SCAN AND MRI
CDC Split Type:

Write-up: Woke up Sunday the day after and couldn''t walk. Waited to see if it would wear off the next day was admitted into emergency with a minor stroke caused by a blood clot


VAERS ID: 1215511 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Wisconsin  
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 043A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, Hypersomnia, Migraine, Nausea, Sinusitis
SMQs:, Acute pancreatitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (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: Lithium
Current Illness: None
Preexisting Conditions: EDS type 3, bpd, fragile x
Allergies: Fentynol, remeron, bactrum Dark chocolate
Diagnostic Lab Data:
CDC Split Type:

Write-up: Been sleeping for almost 5 days, nauseous, muscle weakness and exhaustion, rapid onset sinus infection, migraine I can''t get rid of, hot and cold Migraine startig 4/14 as of 6 pm 4/15 not gone.


VAERS ID: 1215527 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-03-05
Onset:2021-04-04
   Days after vaccination:30
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: Dizziness, Feeling abnormal, Memory impairment, Pain in extremity, Physiotherapy, Vertigo
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (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: Fosamax 70mg weekly Omeprazole 20mg daily at bedtime Inderal LA 80 mg daily Levothyroxine 75 mcg daily clotrimazole-betamethasone twice daily Calcium Citrate 600mg twice daily Vitamin D3, cholecaliferol, 1000 units daily
Current Illness: none
Preexisting Conditions: hypothyroidism, vitamin D deficiency, solar lentigo, essential tremor
Allergies: none
Diagnostic Lab Data: ER visit 4-4-21, physical therapy 4-4-21, 4-7-21 vestibular treatment, 4-9-21 vestibular treatment, 4-10-21 urgent care-treated for sinus infection, cerumen impaction irrigation, oral steroid and antibiotic therapy for sinus congestion and Meclizine for dizziness, 4-12-21 vestibular treatment, 4-15-21 vestibular treatment, 4-15-21 doctor visit for vertigo non -resolving and inability to work due to debilitating dizziness and memory issues.
CDC Split Type:

Write-up: Dizziness, Vertigo, Leg pain, memory issues (patient reports as "brain fog")


VAERS ID: 1215821 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-08
Onset:2021-03-11
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 180206 / 1 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Computerised tomogram, Fatigue, Flatulence, Headache, Oropharyngeal pain, Pain in extremity, Tonsillitis
SMQs:, Agranulocytosis (broad), Oropharyngeal infections (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Acyclovir, Aspirin, CO-Q 10, L-Carnitine, Testosterone Supplement, Zinc, Vitamin C, Vitamin D with Calcium
Current Illness: Fatigue, shortness of breath
Preexisting Conditions: Mollaret syndrome, Asthma, Mitochondrial Myopathy , sleep apnea
Allergies:
Diagnostic Lab Data: Cat Scan
CDC Split Type:

Write-up: Tonsillitis, fatigue, sore tongue, gas, foot pain, pain on left side of head.


VAERS ID: 1215849 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-03-24
Onset:2021-03-25
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 18050185121 / N/A LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Blood test, Computerised tomogram, Diarrhoea, Fatigue, Nausea, Pyrexia, Swelling face
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Midodrine, Flovent, Levoxyl, Proair inhaler, Epi pen prn, Zinc, garlic, probiotics, turmeric, ginger, B complex, Vitamin c, Magnesium, omega 3, Vitamin D, MCT oil, Cacao powder
Current Illness:
Preexisting Conditions: Asthma, Hypothyroid, TBI/post concussion syndrome, Autonomic dysfunction, Neurocardiogenic pre syncope, Chronic Fatigue, Sleep Apnea, Migraines
Allergies: sulfa, Erythromycin, Ibuprofen, Aspirin, NSAIDS-Asthma Flare up Betadine, Chloraprep, latex, Avocados, banana, most fruit except citrus, peanuts/nuts, sea food.
Diagnostic Lab Data: Blood Tests CT scan GI tests
CDC Split Type: vsafe

Write-up: I had some issues with facial swelling and fatigue described in VAERS report # 1178881 The day after vaccination I also had nausea and a low grade fever. I had vague abdominal pain which intensified in the last week. I am four weeks out from vaccination and I get acute gastric pain after I eat with diarrhea. The pain is from my midline to upper right quadrant pain that radiates out. It is a constant pain at a 3-4 intensity level which intensifies to a 9-10 for a few hours after I eat. I have been trying to treat with heat. I try not to eat too often but it is difficult. I have had to visit the ER and the doctor because of the acute GI pain. There was imaging and IV fluids and labs in the ER yesterday. The CT scan did not indicate anything but I have scheduled an endoscopy to check up higher in my GI tract.


VAERS ID: 1215850 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: New Jersey  
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 042A21A / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Oxycodone 10 mg.
Current Illness: None
Preexisting Conditions: Neuropathy, reflex sympathetic dystrophy
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Broke out in hives over my entire body, was prescribed steroids, and antibitics


VAERS ID: 1215867 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-04-09
Onset:2021-04-10
   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: Private       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: DECISION MAKING: Adverse side effects of Covid-19 Vaccination his presentation is common for adverse effects for vaccination. He does not report any anaphylaxis or thromoemobolitic type reactions. We discussed that him adding in 600 to 800 mg of ibuprofen medication every 6 to 8 hrs to alternate with his Excedrin (caffiene, Tylenol, and ASA) medication every 4 to 6 hrs with food to avoid GI upset. I advised him to incorporate other comfort measures such as a heating pad, rest, fluids such as ginger ale, rest for the next 24 hours and that his symptoms are likely to resolve. If however they worsen he understands that he should be seen in person immediately. I encouraged him to register his symptoms with the CDC so he will have ongoing monitoring of his adverse side effects. He indicated he would do so. 1. Adverse effect of vaccine, initial encounter
CDC Split Type:

Write-up: Pt. is a 44 y.o. male evaluated with a web video visit for evaluation of side effects after undergoing the Janssen Covid-19 vaccine yesterday. He describes having systemic side effects of fever as high as 100.8F, chills, fatigue, body aches, and headache. He underwent the vaccine yesterday at approximately 1045. He relates that he took Excedrin migraine a few hours ago but is not having relief. He would like to know if it okay for him to take any other medications to treat his side effects. He denies any cutaneous, thrombohemolytic, or analphylaxis side effects.


VAERS ID: 1215909 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-03-21
Onset:2021-03-23
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Back pain, Blood test, Chest X-ray, Chills, Computerised tomogram normal, Dyspnoea, Fibrin D dimer increased, Headache, Myalgia, Nausea, Pyrexia, X-ray normal
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), 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? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 3/31/2021 - Doctor appointment at clinic. I described my pain and a chest x-ray and blood test for blood clots was prescribed (D-Dimer). X-ray and D-Dimer were completed on site at NOR DIAG. 3/31/2021 - X-ray looked good, but D-Dimer was positive. 3/31/2021 - I was urged to go to the emergency department. I checked in on 3/31/2021 late at night and was discharged after midnight on 4/1/2021. A CT scan was ordered to test for a pulmonary embolism. No pulmonary emboli noted and no acute pulmonary disease noted.
CDC Split Type:

Write-up: 9 hours after receiving the vaccine, around 5:00 PM on 3/21/2021, I experienced a fever, nausea, headache, soreness in muscles/joints, and chills. The next morning, these symptoms had all gone away. A couple of days after the vaccination, I believe on 3/23/2021, I began experiencing unexplained back pain and shortness of breath. This pain was severe at time and I still have a dull pain in my back as of today, 4/15/2021.


VAERS ID: 1215922 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Florida  
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 043A21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bell's palsy, Computerised tomogram, Headache, Hypoaesthesia, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hearing impairment (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: Celexa, Gabapentin, Trulicity
Current Illness: None
Preexisting Conditions: Diabetes
Allergies: Morphine, Norco
Diagnostic Lab Data: CT Scan - 4/14/2021
CDC Split Type:

Write-up: Around 8:00 pm on Tuesday April 13, 2021 I started to get a really bad headache that was like sharp stabbing pains that would come and go. The next morning I woke up with sharp stabbing pains in the left side of my head and numbness/tingling in the left side of my face. As the day went on I started to feel worse so I went to the emergency room. The doctor there checked me out and stated that I had Bell''s Palsy and prescribed me three different medications. I am currently on these medicines trying to get better.


VAERS ID: 1215951 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-05
Onset:2021-04-13
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardioversion, Catheterisation cardiac abnormal, Computerised tomogram head normal, Coronary arterial stent insertion, Coronary artery occlusion, Electrocardiogram abnormal, Myocardial infarction, Resuscitation
SMQs:, Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, arterial (narrow), Cardiomyopathy (broad), Other ischaemic heart disease (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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Testosterone IM q week Multivitamin Magnesium
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: CT of head normal Cardiac Cath, EKGs showing infarct lab work, will list with dates as comes in
CDC Split Type:

Write-up: Patient suffered massive heart attack with 100% blockage of Left Main Coronary requiring CPR, shocking, Cardiac Cath and stent placement.


VAERS ID: 1215985 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-03-16
Onset:2021-03-17
   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: School       Purchased by: ?
Symptoms: Atrial fibrillation, Balance disorder, Chest X-ray, Coordination abnormal, Echocardiogram, Electrocardiogram, Heart rate irregular, Laboratory test, Stress echocardiogram
SMQs:, Anticholinergic syndrome (broad), Supraventricular tachyarrhythmias (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiac arrhythmia terms, nonspecific (narrow), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Medical tests: EKG''s, Echocardiograms, Stress echocardiograms, scope of nose cavity, blood work, chest x rays.
CDC Split Type:

Write-up: Adverse effect: Experienced Atrial fibrillation. (chronic) Treatment: Emergency room visit and was given a cardioversion to bring heart back into normal sinus rhythm. Outcome: Still experiencing episodes of irregular heartbeat and seeking treatment from doctors and hospitals. Adverse effect: Balance and coordination problems (chronic) Treatment: Neurologist appointment Outcome: Taking medication for basilar migraine Adverse effect: Restless legs Treatment: None Outcome: None


VAERS ID: 1216015 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-13
   Days after vaccination:5
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: Abdominal pain, Chest pain
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)

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

Write-up: patient stated that she had symptoms of chest pain starting the night of 04/13/21. and following morning she felt abdominal pain as well. (patient reported her adverse effects when she called in to request for the duplicate card for vaccination proof and per patient she was going for ER and needed her vaccination proof copy as she was not able to find her vaccination card that was provided at the time of vaccination.)


VAERS ID: 1216039 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-13
Onset:2021-03-25
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Confusional state, Dizziness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: 12 days after COVID vaccine, patient had episode of syncope, preceded by dizziness and confusion.


VAERS ID: 1216071 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-03-17
Onset:2021-03-26
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Impaired work ability, Loss of personal independence in daily activities, Magnetic resonance imaging, Nausea, Tremor, Vertigo, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular 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? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: docusate, acetaminophen, fiber supplement tablets (OTC), ibuprofen
Current Illness: no other recent illnesses
Preexisting Conditions: COPD - controlled, no medications colon resection from polyp 2017 4inches of small intestine removed from bowel obstruction 2020
Allergies: aspirin allergy/intolerance - caused ulcer
Diagnostic Lab Data: MRI 3/26/21 per patient (others unknown at this time to the vaccine administering pharmacy)
CDC Split Type:

Write-up: Patient received the Janssen vaccine on 3/17/21 at 4:42 pm. Beginning at 2:30 am on 3/18/21 the patient began to experience dizziness, vertigo, shaking, tremors, nausea, and vomiting. The shaking and tremors occurs all over but is most significant in the hands and arms leaving the patient unable to do simple daily tasks or return to work. These symptoms began 3/17 and have persisted every day since in varying severity. Sometimes the tremors last for more than 20 minutes straight. The patient was seen in the emergency department on 3/26/21 but the hospital notes are unavailable to the pharmacy at this time. Per patient, he had an MRI and no other tests and was given a prescription for ondansetron for nausea and discharged. The patient believes he was not adequately assessed and is still suffering from symptoms. He has a follow up with a primary physician 5/28/21 which is the soonest he was able to be referred.


VAERS ID: 1216083 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-03-21
Onset:2021-04-08
   Days after vaccination:18
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 test, Computerised tomogram head, Dizziness, Dyspnoea, Electrocardiogram, Headache, Pain in extremity, Syncope, Ultrasound Doppler
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Symbicort, Albuterol, Advil
Current Illness: Asthma, blurry vision, low back pain
Preexisting Conditions: Asthma, Chronic Low Back Pain, Vit D Deficiency, Hyperlipidemia
Allergies: Advair intolerance
Diagnostic Lab Data: She went to the hospital but I don''t have notes, we''ve faxed the hospital to obtain records. Per patient EKG, bloodwork and CT of head were done but doesn''t know results. She came to see PCP in office 4/15/21, we ordered ultrasound to r/o DVT
CDC Split Type:

Write-up: About a week ago: frontal and occipital head pain, lightheadedness, syncope for seconds, right calf pain, shortness of breath


VAERS ID: 1216134 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-03-19
Onset:2021-04-04
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 AR / SYR

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

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

Write-up: Cardiac arrest...death


VAERS ID: 1216146 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-04-09
Onset:2021-04-10
   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 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Alanine aminotransferase normal, Albumin globulin ratio, Anion gap, Aspartate aminotransferase normal, Basophil count normal, Basophil percentage, Blood albumin normal, Blood alkaline phosphatase normal, Blood bilirubin normal, Blood calcium decreased, Blood chloride normal, Blood creatinine normal, Blood glucose normal, Blood osmolarity, Blood potassium normal, Blood sodium normal, Blood urea nitrogen/creatinine ratio, Blood urea normal, Carbon dioxide normal, Cerebral venous sinus thrombosis, Chills, Dyspnoea, Eosinophil count normal, Eosinophil percentage, Globulin, Glomerular filtration rate, Haematocrit normal, Haemoglobin normal, Headache, Hyperhidrosis, Lymphocyte count increased, Lymphocyte percentage increased, Mean cell haemoglobin concentration normal, Mean cell haemoglobin normal, Mean cell volume normal, Mean platelet volume normal, Monocyte count increased, Monocyte percentage, Neutrophil count normal, Neutrophil percentage decreased, Pain, Platelet count normal, Protein total normal, Red blood cell count normal, Red cell distribution width normal, Scan with contrast abnormal, Troponin T normal, Venogram abnormal, Vision blurred, White blood cell count normal
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Agranulocytosis (broad), Haematopoietic leukopenia (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Central nervous system vascular disorders, not specified as haemorrhagic or ischaemic (narrow), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Levothyroxine 75 mcg PO QD Metformin 2000 mg PO QD Multivitamin 1 tab PO QD
Current Illness:
Preexisting Conditions: PCOS Type 2 diabetes
Allergies: Propoxyphene - unknown
Diagnostic Lab Data: EXAM: MRA VENO HEAD W/WO C INDICATION: Other- Note in Reason For Exam FreeText. Worsening headache and blurred vision status post recent Johnson and Johnson vaccine menstruation COMPARISON: None. TECHNIQUE: MR venogram of the head performed without and with 10 cc gadolinium based IV contrast. FINDINGS: There is asymmetric decreased enhancement of the right cavernous sinus as compared to the left (for example sequence 701, image 99). Dural venous sinuses otherwise appear patent. Cortical veins are patent. IMPRESSION: Findings are suspicious for cavernous sinus thrombosis on the right. 4/14/2021 Sodium 140 mmol/L Normal Potassium 4.4 mmol/L Normal Chloride 104 mmol/L Normal CO2 24 mmol/L Normal Anion Gap 12 mmol/L Normal Glucose 90 mg/dL Normal BUN 11 mg/dL Normal Creatinine 0.69 mg/dL Normal Bun/Crea 16 Ratio Normal eGFR 99 mL/min/1.73 m2 NA eGFR 119 mL/min/1.73 m2 NA Calc Osmo 278 Normal ALT 22 International Units/L Normal AST 26 International Units/L Normal Alkaline phosphatase 61 Units/L Normal Bilirubin Total 0.2 mg/dL Normal Total Protein 6.5 gm/dL Normal Albumin 3.7 gm/dL Normal Globulin 2.8 gm/dL Normal Alb/Glob 1.3 NA Calcium 8.6 mg/dL LOW Troponin T w/Courtesy Call <0.01 ng/mL Normal WBC 9.58 thous/uL Normal RBC 5.37 mill/uL Normal Hgb 15.4 gm/dL Normal Hct 45.8 % Normal MCV 85.3 fl Normal MCH 28.7 pg Normal MCHC 33.6 gm/dL Normal Platelet 289 thous/uL Normal MPV 10.7 fl Normal RDW-CV 13.4 % Normal Neut % 46.3 % NA Lymph % 42.7 % NA Mono % 8.2 % NA Eos % 2.1 % NA Baso % 0.5 % NA Neut # 4.43 thous/uL Normal Lymph # 4.09 thous/uL HI Mono # 0.79 thous/uL HI Eos # 0.20 thous/uL Normal Baso # 0.05 thous/uL Normal IG % 0.2 % NA IG Abs 0.02 thous/uL Normal
CDC Split Type:

Write-up: Janssen COVID-19 Vaccine EUA Patient received Janssen vaccine 4/9/2021. Patient presented to ED 4/14/2021. Patient is a very pleasant 32-year-old female, with past medical history significant for taking bromocriptine for prolactin issues as well as metformin for type 2 diabetes, presents to the emergency department for evaluation of continued headache over the last 1 week. Patient also reports chills, sweats, body aches ever since receiving the Johnson and Johnson coronavirus vaccination 1 week ago. The headache started after receiving the vaccination and has been continuing ever since. It does not fluctuate in intensity. It is caused her blurred vision and difficulty focusing. No tinnitus or hearing loss. No slurred speech, vomiting, numbness or weakness or tingling to the extremities or any facial droop. No history of strokes or aneurysms. She is not on blood thinning medication at all. No upper nor lower extremity swelling or redness. No abdominal pain, nausea, vomiting or diarrhea. She reports the continued subtle shortness of breath and body aches since the vaccination as well. No rapid heart rate, long flights, long car rides, surgeries nor oral contraceptive use. Patient started on heparin drip. Neurologist recommended transferring patient to higher level of care. emergency department physician is willing to accept the patient at their facility. Patient transferred to the facility.


VAERS ID: 1216215 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-03-05
Onset:2021-03-05
   Days after vaccination:0
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: Asthenia, Blood magnesium, Blood thyroid stimulating hormone, Brain natriuretic peptide, Cardiac stress test, Chills, Differential white blood cell count, Dyspnoea, Echocardiogram, Electrocardiogram, Electrocardiogram ambulatory, Fatigue, Full blood count, Laboratory test, Metabolic function test, Muscle spasms, Retching, Troponin, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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: Flecainide Acetate, Atorvastatin
Current Illness: none
Preexisting Conditions: Afib
Allergies: none
Diagnostic Lab Data: March 8 Basic Metabolic Panel Complete Blood Count with Differential x2 EKG x2 Brain Natriuretic Peptide TSH Magnesium Hepatic Function Panel troponin 1 March 10 Holter Monitor 24 hrs EKG March 25 Echocardiogram Adult Complete NM Nuclear Stress Test Nuclear Stress Test Lab
CDC Split Type:

Write-up: severe chills all night went away around 6 am. Vomit with dry heaves at 1:15 am last round at 5:30 am. Very severe at times. Shortness of breath started in the afternoon or the 6th of March, lasted for 14 days. Cramps in my legs periodically still get them not as often now. Still don''t have the same energy I had before the shot. I still tire easily.


VAERS ID: 1216258 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-03-06
Onset:2021-03-18
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Dyspnoea, Pain
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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: Adipex Balcom Metformin
Current Illness: None
Preexisting Conditions: None
Allergies: Shell food Morphine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Difficulty breathing, stomach pain, body pain.


VAERS ID: 1216337 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-03-06
Onset:2021-03-27
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Atrial septal defect, Blood cholesterol increased, Cardiac monitoring, Cerebrovascular accident, Echocardiogram
SMQs:, Dyslipidaemia (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Congenital, familial and genetic disorders (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Lipodystrophy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: celexa, metoprolol succinate er, losartan potassium
Current Illness: none
Preexisting Conditions: high blood pressure, smoker, alcoholism (sober 2.5 years)
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: I had a stroke three weeks after the vaccine. I didn''t think they were related, but I figured I should report it based on the recent news. TEE determined PFO. Heart monitor was placed to check for arrhythmia. High cholesterol was noted and medication for that was given. I was also given blood thinners and aspirin.


VAERS ID: 1216396 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-09
Onset:2021-03-22
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bronchitis, Computerised tomogram, Dyspnoea, Electrocardiogram, X-ray
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: LEVOTHYROXINE/METFORMIN
Current Illness:
Preexisting Conditions: ASTHMA/DIABETES/CANCER
Allergies:
Diagnostic Lab Data: EKG/XRAY/CT SCAN. NOW HAVE A $3000 ER BILL DUE TO THIS. I CAN PROVIDE TEST RESULTS ON REQUEST. HOSPITAL DIAGNOSED IT AS BRONCHITIS. THIS WAS DIAGNOSED BEFORE THE PUBLIC WAS ADVISED TO REPORT ANY EFFECTS TO PHYSICIANS.
CDC Split Type:

Write-up: SHORTNESS OF BREATH. HAD VIRTUAL CALL WITH DR. SYMPTOMS DID NOT GO AWAY. WENT TO ER ON MONDAY APRIL 5 DUE TO STILL NOT BEING ABLE TO BREATH AND HAVING SHORTNESS OF BREATH.


VAERS ID: 1216446 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-03-26
Onset:2021-03-26
   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 / -

Administered by: Unknown       Purchased by: ?
Symptoms: Allodynia, Burning sensation, Chills, Headache, Pain
SMQs:, Peripheral neuropathy (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: migraine
Allergies: Lidocaine - pruritis
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Four hours after vaccine administration, the patient began experiencing body aches, headache, and chills typical of post-vaccine immune response. however, three hours later (7 hours after administration), she began having a burning sensation in her thoracic back, upper chest, shoulders, and upper arms with accompanying allodynia, the patient reports was up to 10/10 intensity. She went to an emergency room and was given acetaminophen, prednisone, diphenhydramine, and famotidine. Her symptoms did not significantly improve and was discharged. The burning sensation and allodynia did resolve overnight and have not reoccurred, but these symptoms are the adverse event I am reporting.


VAERS ID: 1216458 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-14
Onset:2021-03-23
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / UNK RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Dyspnoea, Impaired work ability, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Camber 0.5 MG
Current Illness: NO
Preexisting Conditions: NO
Allergies: NO
Diagnostic Lab Data: Collected on 3/23/2021; Results on 3/23/2021; Authorized by MD.
CDC Split Type:

Write-up: I go to work but I can breathe. I said to my manager I can''t work. I need to come back home. I drove my car very difficult. After I come home, I can''t breathe so my husband called 911. I was fainting. I check everything. I have a problem, I can''t breathe when I read or phone. Now I am better than old. I don''t know what happened. I think it is the problem when I take the vaccine.


VAERS ID: 1216516 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: California  
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 - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Headache, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (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: Nexplanon implant
Current Illness: None
Preexisting Conditions: None
Allergies: NKDA
Diagnostic Lab Data: Blood work at hospital 4/14/21
CDC Split Type:

Write-up: Intermittent headaches, muscle aches


VAERS ID: 1216520 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-03-13
Onset:2021-04-08
   Days after vaccination:26
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: Arteriogram coronary normal, Blood pressure decreased, Cardiac pacemaker insertion, Chest pain, Heart rate decreased
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Dehydration (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? No
Previous Vaccinations:
Other Medications: multiple
Current Illness: recent bladder infection
Preexisting Conditions: n/a
Allergies: penicillin
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Started having chest pain. Went to the ER. Was parked in the ER hallway all night, around 3 or 4 am, her heart rate slowed to nothing and blood pressure dropped to zero. She was admitted to a room. Angiogram showed no blockages, doctor said it was an electrical problem from old age. Installed a pacemaker.


VAERS ID: 1216533 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-03
Onset:2021-04-04
   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: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Atrial fibrillation, Cardiac murmur, Chest X-ray, Decreased appetite, Dyspnoea, Electrocardiogram, Fatigue, Headache, Heart rate irregular, Laboratory test, Nausea, Pain, Pericardial effusion
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Systemic lupus erythematosus (broad), Supraventricular tachyarrhythmias (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (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: Align, Gas x, miralax
Current Illness: Asthma
Preexisting Conditions: Asthma
Allergies: penicillins, vicodin
Diagnostic Lab Data: EKG , chest X-ray, blood tests found liquid in heart on April 12, 2021 at the hospital confirming Atrial Fib. On April 13, 2021, PCP diagnosed heart murmur.
CDC Split Type:

Write-up: Patient started experiencing headache, nausea, body aches, exhaustion, unclear thinking, strange behaviors per patient''s son on April 4, 2021. These symptoms didn''t get any better the day after. Patient lost appetite, and no energy and started shortness of breath started April 5, 2021. On April 6, breathing problems got worse, and too tired to work. Patient woke up with nausea, headache, no energy, shortness of breath and on going problems until April 12 when patient came to the ER due to irregular heart beat and Atrial fibrillation, and patient can''t function.


VAERS ID: 1215755 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Indiana  
Vaccinated:0000-00-00
Onset:2021-03-25
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210408678

Write-up: ANGIOEDEMA; This spontaneous report received from a pharmacist concerned an 81 year old female patient. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of administration was not reported, batch number: unknown) dose was not reported, administered on 25-MAR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 25-MAR-2021 (1 hour after vaccination), the patient developed angioedema and was hospitalized. She did not experience respiratory distress. The patient was discharged on 31-MAR-2021. The number of days of hospitalization was 6. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from angioedema on 31-MAR-2021. This report was serious (Hospitalization Caused / Prolonged).; Sender''s Comments: V0: 20210408678-covid-19 vaccine ad26.cov2.s - Angioedema. This event is considered related. The event has a compatible/suggestive temporal relationship, is unlabeled, and is scientifically plausible. There is no information on any other factors potentially associated with the event.


VAERS ID: 1215757 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Appendicitis
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210408818

Write-up: APPENDICITIS; This spontaneous report received from a patient via a company representative concerned a female of unspecified age. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of administration not reported, batch number: unknown) dose was not reported, administered on 2021 for prophylactic vaccination. Batch number was not reported. Per procedure, no follow up will be requested for this case. No concomitant medications were reported. On an unspecified date in 2021 (3 weeks after the vaccination), the patient developed appendicitis and ended up in the emergency room (ER) (hospitalization date unspecified) and underwent a surgery. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from appendicitis. This report was serious (Hospitalization Caused / Prolonged).; Sender''s Comments: V0:-20210408818- Covid-19 vaccine ad26.cov2.s-appendicitis. This event is considered unassessable. The event has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event.


VAERS ID: 1215758 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: New Jersey  
Vaccinated:0000-00-00
Onset:2021-04-03
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Loss of consciousness, Myalgia
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (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), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Cancer (NOS); Radiation therapy
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210408864

Write-up: BLACKED OUT MOMENTARILY; CHILLS; MUSCLE SORENESS; This spontaneous report received from a patient concerned a female of unspecified age. The patient''s height, and weight were not reported. The patient''s concurrent conditions included radiation treatment for an unspecified cancer. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 03-APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 03-APR-2021, at 7 pm the patient experienced chills, muscle soreness. On 04-APR-2021, around 08:00 AM the patient was blacked out momentarily and visited an emergency room for the same. Treatment medications (dates unspecified) included: paracetamol used for chills, muscle soreness. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from blacked out, and the outcome of chills and muscle soreness was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0: 20210408864-covid-19 vaccine ad26.cov2.s -black out. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).


VAERS ID: 1215762 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: North Carolina  
Vaccinated:0000-00-00
Onset:2021-03-19
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Chest pain, Chills, Electrocardiogram, Feeling abnormal, Headache, Hypoacusis, Loss of consciousness, Nausea, Swelling, Tinnitus, Tremor
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hearing impairment (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Arthritis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Back arthritis; Type II diabetes mellitus
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 202103; Test Name: Electrocardiogram; Result Unstructured Data: unknown; Comments: EKG performed for chest pains.
CDC Split Type: USJNJFOC20210409641

Write-up: CHILLS; SHOULDER PAIN; HEADACHE; NAUSEATED; PASSED OUT; HEARING LOSS GETTING WORSE; CHEST PAINS; SWELLED UP; RINGING IN LEFT EAR; TREMBLING; BRAIN FOG; This spontaneous report received from a patient concerned a 74 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included type 2 diabetes and arthritis in the lower back. The patient was not pregnant. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of administration not reported, batch number: 1805018, and expiry: unknown) dose was not reported, administered on left arm on 19-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 19-MAR-2021, 30 minutes post-vaccination, the patient passed out and was rushed to the hospital and later she recovered. On the same day, the patient also experienced chest pains, chills, brain fog, trembling, nausea, shoulder pain that was shooting up and down between shoulder and elbow, ringing in left ear, developed swelling; headache and hearing loss in left ear that got worse. Electrocardiogram (EKG) was performed for chest pains (result unknown). At the hospital, she was given treatment that included Benadryl (diphenhydramine hydrochloride), many different shots (unspecified) and ''intravenous'' (IV). The patient was at the hospital for about 8 hours. The patient was sent to a hearing specialist for her hearing loss. On 21-MAR-2021, the patient recovered from the events chest pains, chills, ?swelled up'', nausea and trembling. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from chest pains, chills, swelled up, nauseated, trembling and passed out, and had not recovered from brain fog, shoulder pain, headache, left ear hearing loss, and ringing in left ear. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0: 20210409641- covid-19 vaccine ad26.cov2.s - passed out. This event is considered unassessable. The event has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event.


VAERS ID: 1215767 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2021-04-05
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood glucose, Blood pressure measurement, Diarrhoea, Heart rate, Oxygen saturation, Seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Pseudomembranous colitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Generalised convulsive seizures following immunisation (narrow), Noninfectious diarrhoea (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: Fear of needles
Preexisting Conditions: Comments: Patient is afraid of needles
Allergies:
Diagnostic Lab Data: Test Date: 20210405; Test Name: Heart rate; Result Unstructured Data: 112 (tachycardia); Test Date: 20210405; Test Name: Glucose; Result Unstructured Data: 90; Test Date: 20210405; Test Name: Oxygen saturation; Result Unstructured Data: 98; Test Date: 20210405; Test Name: Blood pressure; Result Unstructured Data: 135/83
CDC Split Type: USJNJFOC20210410630

Write-up: SEIZURE; DIARRHEA; This spontaneous report received from a patient concerned a 37 years old male. The patient''s height, and weight were not reported. The patient''s concurrent condition included fear of needle. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered 1 total on 05-APR-2021 for prophylactic vaccination. Batch number was not reported and has been requested. No concomitant medications were reported. On 05-APR-2021, after receiving vaccination, the patient experienced seizure (fainting, tremor, tachycardia and bladder incontinence) and diarrhea. Upon examination of his vitals, heart rate was 112, showing tachycardia, blood pressure (BP) was 135/83, oxygen saturation was at 98 and glucose was 90. The patient was taken to the emergency room where he was released after evaluation. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from diarrhea on 05-APR-2021, recovered with sequelae from seizure on 05-APR-2021. This report was serious (Other Medically Important Condition). This case, from the same reporter is linked to 20210411486, 20210411395 and 20210410874.; Sender''s Comments: V0: 20210410630 -COVID-19 VACCINE AD26.COV2.S- seizure. This event is considered unassessable. The event has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the events.


VAERS ID: 1215769 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Louisiana  
Vaccinated:0000-00-00
Onset:2021-03-01
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain upper, Blood glucose, Blood glucose increased
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (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? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Non-smoker; Seasonal allergy
Preexisting Conditions: Comments: The patient has no history of drug abuse or illicit drug use.
Allergies:
Diagnostic Lab Data: Test Date: 20210315; Test Name: Blood glucose; Result Unstructured Data: 400 (units unspecified)
CDC Split Type: USJNJFOC20210410812

Write-up: ELEVATED BLOOD SUGAR OF 400; STOMACH CRAMPS; This spontaneous report received from a patient concerned a female of unspecified age. The patient''s height, and weight were not reported. The patient''s concurrent conditions included seasonal allergies, non-alcohol user, and non-smoker. The patient has no history of drug abuse or illicit drug use. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805018, expiry: UNKNOWN) dose was not reported, 1 total, administered on right deltoid muscle on 10-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. In MAR-2021, the patient had elevated blood sugar of 400. On 15-MAR-2021, the patient visited urgent care where her capillary blood glucose was 400 (units unspecified). In 2021, the patient experienced stomach cramps. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from stomach cramps, and had not recovered from elevated blood sugar of 400. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0: 20210410812-covid-19 vaccine ad26.cov2.s -elevated blood sugar of 400. This event is considered unassessable. The event has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event.


VAERS ID: 1215770 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Delaware  
Vaccinated:0000-00-00
Onset:2021-04-03
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Hypoaesthesia, Migraine, Pain, Pyrexia, Syncope, Tremor, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Non-smoker; Penicillin allergy
Preexisting Conditions: Comments: The patient was not pregnant at the time of vaccination. The patient had no history of drug abuse/illicit drug use. Gravida 1 Para 1.
Allergies:
Diagnostic Lab Data: Test Date: 20210403; Test Name: Body temperature; Result Unstructured Data: 105 F
CDC Split Type: USJNJFOC20210411086

Write-up: SYNCOPE; MIGRAINE; WHOLE BODY TREMORS; VOMITING; NUMBNESS IN HAND AND FEET; WHOLE BODY ACHES; 105.0 F TEMPERATURE; This spontaneous report received from a patient concerned a 26 year old female. The patient''s weight was 120 pounds, and height was 60 inches. Obstetrics history included gravida 1 para 1 (gave birth to a daughter 8 weeks ago). Concurrent conditions included penicillin allergy, non-alcohol user and non-smoker. The patient was not pregnant at the time of vaccination and had no history of drug abuse/illicit drug use. The patient experienced drug allergy when treated with amoxicillin. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 043A21A, and expiry: 21-JUN-2021) dose was not reported, administered on left arm on 03-APR-2021 for prophylactic vaccination. The product was stored properly from receipt to administration. No concomitant medications were reported. On 03-APR-2021, the patient experienced migraine, whole body tremors, vomiting, had a temperature of 105.0 F (required emergency room visit/urgent care), numbness in hand and feet, and whole body aches. On the same day, she recovered from whole body tremors. On 04-APR-2021, the patient experienced syncope. On the same day, she recovered from syncope, vomiting, and numbness in hand and feet. On 05-APR-2021, she recovered from whole body aches and ''temperature 105.0 F''. The patient was breastfeeding her child at the time of report. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from syncope, vomiting, numbness in hand and feet, 105.0 F temperature, whole body aches and whole body tremors, and was recovering from migraine. This report was serious (Other Medically Important Condition). This parent/child case is linked to 20210412341.; Sender''s Comments: V0:20210411086-covid-19 vaccine ad26.cov2.s-Syncope. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).


VAERS ID: 1215787 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Unknown  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-04-06
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Back pain, Blood pressure measurement, Chills, Diarrhoea, Dyspnoea, Headache, Hypotension, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Noninfectious diarrhoea (narrow), 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:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210406; Test Name: Blood pressure; Result Unstructured Data: Low
CDC Split Type: USJNJFOC20210414531

Write-up: PASSED OUT; LOW BLOOD PRESSURE; DIFFICULTY BREATHING; DIARRHEA; BACK PAIN; CHILLS; HEADACHE; This spontaneous report received from a patient concerned a 38 year old of unspecified sex. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 042A21A) dose was not reported, frequency once total, administered on 06-APR-2021 on left deltoid for prophylactic vaccination. No concomitant medications were reported. On 06-APR-2021, Laboratory data included: Blood pressure (NR: not provided) low. The patient experienced side effects of chills, back pain, felt passed out, low blood pressure, headaches and diarrhea. The patient had difficulty breathing and went to emergency room stable at the time of reporting. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from passed out, low blood pressure, difficulty breathing, diarrhea, and chills on 06-APR-2021, and had not recovered from back pain, and headache. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0: 20210414531-JANSSEN COVID-19 VACCINE Ad26.COV2.S- Passed out. This event is considered unassessable. The event has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event.


VAERS ID: 1216589 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-07
Onset:2021-04-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Military       Purchased by: ?
Symptoms: Chest pain, Migraine
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: EKG
CDC Split Type:

Write-up: Chest pain, Migraines


VAERS ID: 1216619 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-03-17
Onset:2021-03-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Asthenia, Blood test, Chest X-ray, Chills, Computerised tomogram, Decreased appetite, Depressed level of consciousness, Dizziness, Dysmenorrhoea, Dyspnoea, Dyspnoea exertional, Dysstasia, Fatigue, Feeling cold, Gait inability, Haemoglobin decreased, Head discomfort, Headache, Heart rate increased, Heavy menstrual bleeding, Hypersomnia, Injection site pain, Joint swelling, Mobility decreased, Muscular weakness, Pain, Pallor, Pelvic pain, SARS-CoV-2 test, Somnolence, Thrombosis, Transfusion, Visual impairment
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Haematopoietic erythropenia (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Dystonia (broad), Parkinson-like events (broad), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Dehydration (broad), COVID-19 (broad), Sexual dysfunction (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: None
Current Illness: None
Preexisting Conditions: Hypothyroidism
Allergies: None
Diagnostic Lab Data: 04/06/2021 blood pressure, temperature, blood tests, covid test, and CT scan. I was given 2 units of blood because my hemoglobin was at a 4.8 04/07/2021 chest xray and 2 more units of blood because my hemoglobin only went up to a 6.4
CDC Split Type:

Write-up: On 03/18/2021 at 03:30AM I had a lot of arm pain from my shoulder to my elbow in my left arm. This lasted until 03/31/2021. On 03/18/2021 I woke up with a headache that would not go away. Next, at about 03:15PM I was not able to walk for about 10 minutes. Then, at about 05:00PM I started menstruating. At 07:00PM I had severe pain in my pelvic area for an hour and a half. At approximately 08:30PM I passed a softball sized blood clot vaginally. I bled heavily through the night. On 03/19/2021 I still had a headache and no energy at all. I continued to bleed heavily all day as well. 03/20/2021 was the exact same as the days prior. 03/21/2021 I was still bleeding heavily throughout the day with no energy. I still had the headache as well. I started feeling dizzy while walking on this day. 03/22/2021 I went to work like normal. I was cold all day. I was still bleeding, headache and dizziness. It was hard to stand for 30 minutes. While climbing the stairs I got very light headed and dizzy. I could not go up the stairs at a normal pace. 03/23/2021 I had the same symptoms all day but I was getting short of breath walking short distances. I still had very little energy and a headache. I also lost all color in my face and hands. I was still cold all day. I noticed some slight swelling in my ankles. 03/24/2021 The symptoms were getting more intense. I was still cold. I finally took some aspirin for the headache because it was very severe. The medication didn''t help with it. This routine went on for the next week and the symptoms intensified with each day. Throughout this time I was still passing clots that ranged in size from golf/ping pong ball to baseballs. They were very painful when they passed. The days from 03/25/2021 to 04/01/2021 were all the same as far as how I felt. On 04/02/2021 I woke up with the same symptoms but now I could not stay awake for anything. I slept on and off all day. I only ate one meal a day because I was so tired and I had no appetite. The headache was getting worse as the days went on. The bleeding was still happening. It was not as heavy as the weeks before, but enough to be painful still. I also started having abdominal pain. On 04/03/2021 I was seeing stars when I moved too quickly. My heart rate was elevated with shortness of breath along with the rest of the previous symptoms. My headache however was very intense. 04/04/2021 I still couldn''t stay awake on top of all the other symptoms. The dizziness and stars were more frequent. I couldn''t move my head without seeing stars. 04/05/2021 I couldn''t get warm and I still felt the same way. I called and made a doctor?s appointment for Wednesday the 7th. I had all the same symptoms still and they were getting worse. I had to move in slow motion so I could try to function. 04/06/2021 I woke up drained of all my energy and color. I couldn''t shower because of the pain in my body. I couldn''t stand because I felt like I was going to fall down. I could barely stand up straight let alone walk very far. I was shaking from being so cold. I had all the same symptoms from the days prior. I was in severe pain. I couldn''t sit because of the pain in my abdomen I couldn''t stand because of the weakness in my legs. I could barely see anything because of the stars I was seeing. At this point I had no color and I was barely conscious. That is when my family took me to the emergency room.


VAERS ID: 1216653 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-06
Onset:2021-04-09
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Blood test, Chest pain, Chills, Dyspnoea, Electrocardiogram, Headache
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Kidney stone
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: No blood clot. Blood work, lungs and heart (EKG result) looked okay. Test revealed I have a kidneystone in my left kidney.
CDC Split Type:

Write-up: Chills and joint pain in the evenings from day 3 through day 7. Mild to moderate Headaches from day 3 through day 9. Shortness of breath, twice between day 5 and 7. Chest pain on the evening of day 6, lasted 3 to 4 minutes.


VAERS ID: 1216662 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bradyphrenia, Diarrhoea, Dizziness, Feeling cold, Hyperhidrosis, Hypertrophy of tongue papillae, Injection site pain, Migraine, Pyrexia, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Psychosis and psychotic disorders (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: PATIENT DID NOT WANT TO DISCLOSE THIS INFORMATION
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: UNKNOWN
CDC Split Type:

Write-up: APPROXIMATELY 3 HOURS AFTER VACCINATION THE PATIENT EXPERIENCED A SLIGHT FEVER, CHILLS, SWEATS, AND AN EXTREME MIGRAINE HEADACHE. SHE TOOK TYLENOL FOR HER SYMPTOMS. OVER THE NEXT 2 DAYS THESE SYMPTOMS IMPROVED BUT SHE DEVELOPED A RASH WITH BUMPS ON HER TONGUE, DIZZINESS, AND SLOW COGNITION WHICH LASTED ABOUT 2 DAYS. SHE WAS FINE FOR 24-48 HOURS WHEN ALL THE PREVIOUSLY MENTIONED SYMPTOMS RETURNED BUT EVEN MORE PRONOUNCED AND SHE HAD EXPLOSIVE DIARRHEA WITH INCREASED PAIN AT THE INJECTION SITE. AT SOME POINT DURING ALL THIS SHE VISITED HER MAIN PHARMACY AND AS SHE WAS TELLING THE PHARMACIST ABOUT HER SYMPTOMS SHE FAINTED AND WOKE TO EMS AND WAS TRANSPORTED TO THE HOSPITAL. THE ER DID NOT FIND ANY REASON FOR HER FAINTING. SHE WAS HYDRATED AND THINKS IT WAS ANXIETY BROUGHT ON BY HER EXPERIENCE. SHE CALLED ME TODAY 4/15/21 TO TELL ME ABOUT HER SYMPTOMS AND EXPERIENCE. SHE STATED THAT SHE HAD A NEW SYMPTOM OF A SHARP PAIN IN HER BACK SO I STRONGLY SUGGESTED SHE GO BACK TO ER TO CONTINUE TESTING IN CASE THE PAIN WAS SOMEHOW RELATED TO THE VACCINE INCIDENT. SHE SAID SHE WOULD GO TO URGENT CARE IF SHE FELT THE PAIN WAS BAD ENOUGH.


VAERS ID: 1216678 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-03-11
Onset:2021-03-30
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Aphasia, Blood test, Cardiac monitoring, Computerised tomogram abnormal, Computerised tomogram head, Computerised tomogram spine, Disturbance in attention, Dizziness, Heart rate decreased, Magnetic resonance imaging heart, Magnetic resonance imaging normal
SMQs:, Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None (or multivatamine once a week)
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: This info should be provided by hospital. It was not only just test regular blood tubes during hospital, but also tested 16 blood tubes right before discharging to hospital.
CDC Split Type:

Write-up: 3/30/21, Tue. Got up and felt dizzy. Went to bed a few times to have a sleep. 3/31/21, Wed. Got up and felt better. Went to work but felt no idea of work related material. 4/1/21, Thu. Got up and felt good, but could not speak too much because of some loss of words. Called for PTO for Thu and Fri. 4/2/21, Fri. Mindset went back but still could not speak too much. 4/2/21, Fri night. After bible study at night, almost all bro & sis said that was symptom of stroke, and suggested us to see emergency doctor. On 11pm, we were at emergency room. 4/3/21, Sat. I was admitted 1-2 am into impatience room. CT diagnosed a big gray area in between speech are and spine. 4/3/21, Sat afternoon. MRI and MRA had been tested. Cardiologist said he could not rule out the last option, which was due to slow heart beat 50-60. But I have slow heart beat since I remembered things from 4-5 year-old. He suggested wearing a heart monitoring device for a 4 weeks after discharged. 4/4/21, Sun noon. Doctor admitted to discharge. They could not find cause, and would like to follow up within 1 to 2 weeks after discharging. 4/13/21, Tue night, I started wiring body monitoring device.


VAERS ID: 1216708 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-15
Onset:2021-04-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

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

Write-up: Headache


VAERS ID: 1216724 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Georgia  
Vaccinated:0000-00-00
Onset:2021-04-07
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Bradycardia, Hyperhidrosis, Hypotension, Pallor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210417122

Write-up: BRADYCARDIA; DIAPHORETIC; PALE; HYPOTENSIVE; This spontaneous report received from a health care professional concerned multiple patients. The patient''s weight, height, and medical history were not reported. Patients received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805031, expiry: UNKNOWN) dose was not reported, administered 1 total on 07-APR-2021 for prophylactic vaccination. No concomitant medications were reported. Health care professional reported that, on 07-APR-2021, after vaccination, while being observed the patients were diaphoretic, pale, hypotensive and bradycardia. EMS (Emergency medical service) was called and patients were evaluated. Patients decided against transport and were discharged home. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the diaphoretic, pale, hypotensive and bradycardia was not reported. This report was serious (Other Medically Important Condition). This case, from the same reporter is linked to 20210418457, 20210417209, 20210417256, 20210417456, 20210417469, 20210417550 and 20210417620; Sender''s Comments: V0: 20210417122-covid-19 vaccine ad26.cov2.s -Bradycardia. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).


VAERS ID: 1216737 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Mississippi  
Vaccinated:0000-00-00
Onset:2021-04-02
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Blood pressure measurement, Fatigue, Fear, Feeling abnormal, Headache, Hunger, Pain in extremity
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Dementia (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: ATIVAN
Current Illness: Abstains from alcohol; Bipolar disorder (could get wild, had been to 2 mental hospitals); Cigarette smoker; Stress
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Name: Blood pressure; Result Unstructured Data: unknown
CDC Split Type: USJNJFOC20210417763

Write-up: HUNGRY; VERY ANXIOUS; FEELING UNSAFE TO WALK BY HERSELF; FEELING TRAPPED; BAD HEADACHE; FEELING TIRED; SORE ARM; This spontaneous report received from a patient concerned a 42 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included bipolar, no alcohol use, cigarette smoker and too stressed to take care of herself. The patient experienced drug abuse when treated with metamfetamine, and drug allergy when treated with lisinopril. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808978, and expiry: UNKNOWN) dose was not reported, administered on 02-APR-2021 for prophylactic vaccination. Concomitant medications included lorazepam for bipolar disorder. On 02-APR-2021, the subject experienced sore arm. On 08-APR-2021, the subject experienced very anxious. On 08-APR-2021, the subject experienced feeling unsafe to walk by herself. On 08-APR-2021, the subject experienced feeling trapped. On 08-APR-2021, the subject experienced bad headache. On 08-APR-2021, the subject experienced feeling tired. On an unspecified date, the subject experienced hungry. Laboratory data (dates unspecified) included: Blood pressure (NR: not provided) unknown. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from very anxious, and feeling unsafe to walk by herself on 09-APR-2021, and feeling trapped, and sore arm on APR-2021, and was recovering from feeling tired, bad headache, and hungry. This report was non-serious.


VAERS ID: 1216853 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-04-07
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Dehydration, Heart rate increased, Pain, Pyrexia
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Name: Body temperature; Result Unstructured Data: 101
CDC Split Type: USJNJFOC20210420552

Write-up: DEHYDRATED PER ER; FAST HEART RATE; ACHES; FEVER; This spontaneous report received from a patient concerned a 63 year old male. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 206A21A, and expiry:23/JUN/2021) dose was not reported, administered on 06-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 07-APR-2021 02:00, the subject experienced aches. On 07-APR-2021 02:00, the subject experienced fever. On 07-APR-2021 04:00, the subject experienced fast heart rate. On an unspecified date, the subject experienced dehydration. Laboratory data (dates unspecified) included: Body temperature (NR: not provided) 101 (units unspecified). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from fast heart rate on 07-APR-2021, was recovering from fever, and aches, and the outcome of dehydration was not reported. This report was non-serious.


VAERS ID: 1216870 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Application site rash, Rash, Skin induration, Tenderness
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210420635

Write-up: SORE TO TOUCH; HARD AND KNOTTED; OVAL SHAPED; UNCONFIRMED FACE RASH; This spontaneous report received from a consumer concerned a male of unspecified age. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 09-APR-2021 for prophylactic vaccination. The Batch number was not reported and has been requested. No concomitant medications were reported. No concomitant medications were reported. On 09-APR-2021, the subject experienced sore to touch. On 09-APR-2021, the subject experienced hard and knotted. On 09-APR-2021, the subject experienced oval shaped. On 09-APR-2021, the subject experienced unconfirmed face rash. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from sore to touch, hard and knotted, and oval shaped, and the outcome of unconfirmed face rash was not reported. This report was non-serious.


VAERS ID: 1217069 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Minnesota  
Vaccinated:0000-00-00
Onset:2021-04-03
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Atrial fibrillation, Body mass index, Cardiac ventricular thrombosis, Deep vein thrombosis, Echocardiogram, Heart rate, Investigation, Oxygen saturation, Pulmonary embolism, Respiratory rate, SARS-CoV-2 test negative
SMQs:, Supraventricular tachyarrhythmias (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: LOSARTAN; HCTZ; AMLODIPINE
Current Illness: Blood pressure high; Gout attack (2 gout attacks in the past 8 months. Last attack two weeks back, it was in left foot.); Persistent cough
Preexisting Conditions: Comments: Obese, body mass index (BMI) 40 No history of clots or atrial fibrillation. He has a strong family history of thrombosis: his father had 2 deep vein thrombosis (DVT and mother had a pulmonary embolism (PE)
Allergies:
Diagnostic Lab Data: Test Date: 20210331; Test Name: COVID-19 virus test negative; Result Unstructured Data: Negative; Test Date: 20210402; Test Name: COVID-19 rapid POC test negative; Result Unstructured Data: Negative; Test Date: 20210403; Test Name: Pulse rate; Result Unstructured Data: fast and irregular; Test Date: 20210403; Test Name: Investigation; Result Unstructured Data: a saddle pulmonary embolus and a deep venous thrombosis on the left.; Test Date: 20210403; Test Name: Respiratory rate; Result Unstructured Data: 22; Test Date: 20210403; Test Name: Echocardiogram; Result Unstructured Data: number of clots in right ventricle, which were "bouncing all around"; Test Date: 20210403; Test Name: Oxygen saturation; Result Unstructured Data: 70s; Test Name: Body mass index; Result Unstructured Data: 40
CDC Split Type: USJNJFOC20210422070

Write-up: DVT (LEFT CALF); PULMONARY EMBOLISM (BOTH LUNGS); ATRIAL FIBRILLATION; BLOOD CLOT IN RIGHT VENTRICLE; This spontaneous report was received from a consumer (patient''s wife) and concerned a 68 year old male. The patient''s weight was 250 pounds and was obese (body mass index 40) and sedentary. His height was not provided. The patient''s concurrent conditions included high blood pressure, and 2 gout attacks in the last 8 months. The last gout attack was 2 weeks ago in the left foot. There was no history of clots or atrial fibrillation. He had a strong family history of thrombosis: his father had 2 episodes of deep vein thrombosis and his mother had a pulmonary embolism. No testing to identify any familial clotting issues have been performed. The patient developed a cough starting 29-MAR-2021 and, prior to vaccination, took a COVID-19 test on 31-MAR-2021 which was negative. On 02-APR-2021 a rapid COVID-19 test also came back negative. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 043A21A, and expiry: UNKNOWN) on 02-APR-2021 at approximately 19:00 in the left arm for prophylactic vaccination. Concomitant medications included amlodipine, hydrochlorothiazide, and losartan for high blood pressure. On 03-APR-2021, the patient''s cough persisted but had not worsened and he developed pain in the ribs on the right. His wife checked his pulse, which seemed fast and irregular. His respiratory rate was 22 breaths per minute and his oxygen saturation with a home pulse oximeter was in the 70s. He was not in distress at the time. The patient called his physician and the doctor suggested to go to Emergency room. The patient went to Emergency room at approximately 10:00. An echocardiogram revealed a number of clots in the right ventricle which were "bouncing all around". He was also found to be in atrial fibrillation which the doctors said was secondary to the ventricular clots. Unspecified tests revealed a saddle pulmonary embolus and a deep vein thrombosis on the left. He was diagnosed with deep vein thrombosis (left calf), pulmonary embolism (both lungs), blood clots in right ventricle and atrial fibrillation. Platelet count was not known by the reporter; it is unknown if D-dimer and fibrinogen levels were performed. He underwent emergency surgery at 19:00, during which most of the ventricular clots and the pulmonary embolism were removed. He was placed on heparin after the surgery. He spent 5 days in the Intensive Care Unit (ICU) and 2 additional days in the hospital. The patient was discharged from the hospital after 1 week and had recovered from the events of deep vein thrombosis (left calf), pulmonary embolism (both lungs), atrial fibrillation, and blood clots in right ventricle. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The reporter did not believe that the covid-19 vaccine ad26.cov2.s had caused deep vein thrombosis (left calf), pulmonary embolism (both lungs), atrial fibrillation, and blood clot in right ventricle This report was serious (Hospitalization Caused / Prolonged, and Other Medically Important Condition).; Sender''s Comments: V0: a 68-year-old male experienced left deep vein thrombosis, saddle pulmonary embolism, right ventricular thrombosis, and atrial fibrillation, approximately 15 hours after receiving the Janssen COVID-19 vaccine for prevention of COVID-19 infection. The patient has a history of hypertension, is obese (BMI 40) and has a strong family history of blood clots. He tested negative for COVID 2 days before and the day of vaccine administration. He developed a cough 4 days prior to vaccination. The morning after vaccination, he developed right rib pain; his heart rate was rapid and irregular, and oxygen saturation with home pulse oximeter was in the 70s. Upon arrival in the emergency room, he was found to have clots in the right cardiac ventricle, a saddle pulmonary embolus, left deep vein thrombosis and new-onset atrial fibrillation. He underwent surgery for removal of the ventricular clots and pulmonary embolism. No laboratory details were provided. Given the symptoms which pre-dated vaccine administration, the short latency between the vaccine administration and the event, and multiple risk factors for embolism and thrombosis (family history, obesity, sedentary nature), the events are assessed as inconsistent with the causal association to immunization, per the WHO causality classification for adverse events following immunization. Therefore, company causality is considered not related to the Janssen COVID-19 vaccine.


VAERS ID: 1217214 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-04-10
Onset:2021-04-14
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Women?s multivitamin DIM supplement
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Lab work April 15,2021
CDC Split Type:

Write-up: Hives and welts not controlled with Benadryl Cream or oral tabs. Went to ER as spread was significant and had IV solumedrol. Hives led up. Within an hour of discharge they started coming back and were not controlled with Benadryl still. Hives were apprearing in new locations and spreading rapidly again. Went back to ER for further treatment.


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