National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 4/30/2021 release of VAERS data:

Found 153,440 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 23 out of 1,535

Result pages: prev   1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122   next


VAERS ID: 1221427 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-09
Onset:2021-04-13
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Headache, Hypoaesthesia
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Heart condition
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache, stomach pain, numbness, Tylenol No better


VAERS ID: 1221527 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-03
Onset:2021-04-13
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Headache, Muscle twitching
SMQs:, Dyskinesia (broad), Dystonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec Atenolol Albuterol
Current Illness: Bronchitis
Preexisting Conditions: ? Factor V Liden ? Partially deaf ? Asthma ? Trochanteric Bursitis ? Greater Trochanteric Pain Syndrome ? FAI - bilateral (Femoroacetabular Impingement, replacements needed) ? Degenerative disc disease ? Neuropathy ? Fibromyalgia ? L3, L4, L5, S1 ? Nerve damage ? Small unknown mass in right lung ? Morphea ? EAI (erythema ab igne) ? Bilateral knee replacements needed
Allergies: PCN Orudis/Celebrex Actifed/Sudafed IV contrast Ear drops Elocon
Diagnostic Lab Data: Nothing yet, have not gone in. My doctor just told me to report and go in.
CDC Split Type:

Write-up: I got the vaccine on Saturday, 4 /3/21. Not sure if this is a reaction from the vaccine or just something new I''ve developed in the last couple days. Tuesday afternoon (4/13/21), I was feeling twitching around the outside corner of my right eye/cheek area. I didn''t pay it any attention. Wednesday morning it was happening again. I started paying attention after a couple times. It feel s like someone has a string from the top of my head area that passes down the outside corner of my right eye, down my cheek, to the outside corner of my mouth; then starts tugging on the string. Also, a pain starts in the lower part of my head, behind my right ear. It''s happening more often, to where I''m getting annoyed with it. I got an automated call about the vaccine; if having any (insert list of symptoms) please contact your doctor or clinic. I contacted my doctor, she suggested I report as an adverse reaction, just in case, and to get checked out in the ER. I have not yet gone in.


VAERS ID: 1221594 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-13
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Chest X-ray, Crying, Electrocardiogram, Fall, Headache, Laboratory test, Loss of consciousness, Malaise, Muscle spasms
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), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Depression (excl suicide and self injury) (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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Went to emergency next day. They did EKG and X ray of my chest and blood work and was told I am fine but they don?t have answer why I passed out and I had made them aware that I had taken vaccines. I sis t have any other health issues . Also doctors refuses to do CT scan why I asked and send me home. I still have headaches and weakness .
CDC Split Type:

Write-up: I got Jonson and Jonson vaccine on 4/8/2021 . I was fine after that and suddenly on 4/13 /2021 I had cramping in my both leg and foot whole day. At night I woke up from deep sleep and started crying that my leg was hurting badly and felt like something was stuck in my knee couldn?t move for couple min. 5 min later I got up to take pain medicine and try to walk and I was able to walk after that so went to use bathroom ( to urinate) while I got up. After that since I had pain in my leg earlier I went to grab pain medicine than again I started crying and saying I don?t feel good than I passed out completely and was unconscious. My husband picked me up and brought me to bed and said I had black out and fell on my face on floor .


VAERS ID: 1222147 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-11
Onset:2021-04-13
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN LY01614 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain, Decreased appetite, Diarrhoea, Fatigue, Headache, Hypersomnia, Migraine, Pyrexia, Sleep disorder
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (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), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: vitamins, cetirizine, symbicort, duloxetine
Current Illness: sinus infections one month prior
Preexisting Conditions: allergies
Allergies: Sulfa drugs, grasses, horses, cats & molds
Diagnostic Lab Data:
CDC Split Type:

Write-up: Started 2 days after shot (4/13): Extreme abdominal pain with diarrhea & headache through the night starting about 7:30pm. Never had anything like that & almost went to hospital but could not leave the bathroom to go. just laid on bathroom floor while my husband put cold washcloths on my head. Day 3 after after shot: on & off Fever, fatigue & slight headache throughout the day. Day 4 after shot: fever throughout day with slight Headache until about 9 pm, then extreme migraine & fever throughout the night with no sleep. Day 5 after shot: Extreme migraine headache, fever & loss of appetite. resting in bed since yesterday. doing survey so dont know on-going.


VAERS ID: 1222350 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-02
Onset:2021-04-13
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tizanidine 4mg, Gabapentin 600mg x 3, Nortriptyline 25mg x 2, Vitamin D3 5000iu x 1, Multi vitamin x 1, atorvastatin x 1, Lisinopril 40mg x 1, Bupropion 300mg x 1, Lamotrigine 100mg x 2 and Glatiramer Acetate injections 40mg x 3 times a wee
Current Illness: M.S. & Trigeminal Neuralgia
Preexisting Conditions: M.S & Trigeminal Neuralgia
Allergies: Latex and Carbamazepine
Diagnostic Lab Data:
CDC Split Type:

Write-up: headache


VAERS ID: 1222705 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Nevada  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling
SMQs:, 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Bystolic 20mg daily, Omeprazole 20mg daily, Losartan 100mg daily, sertraline 100mg daily, hydrochlorothiazide 25mg daily
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Sore arm, redness, swelling, hot to touch, itches when touched when the patient reported the symptoms on 4/17/21


VAERS ID: 1222787 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Swelling of eyelid
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Periorbital and eyelid disorders (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin C, Nasal saline spray
Current Illness: possible allergies, hx of seasonal allergies
Preexisting Conditions: Possible diabetes, states she might be, or possibly pre-diabetic, asthma
Allergies: Septra
Diagnostic Lab Data: None
CDC Split Type:

Write-up: swelling to upper left eye lid.


VAERS ID: 1223373 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Decreased appetite, Influenza like illness, Pain in extremity
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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metoprolol, atorvastatin, glipizide ER, metformin ER, losartan, jardiance
Current Illness: No
Preexisting Conditions: Diabetes, blood clots
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Flu-like symptoms which patient expected but also severe leg pain and loss of appetite. Pt was advised to consult with physician who advised patient seek emergency help if issue persisted which it did not. Patient''s spouse reported symptom onset the morning after the vaccination


VAERS ID: 1223575 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-04-08
Onset:2021-04-13
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / IM

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

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

Write-up: Left popliteal DVT


VAERS ID: 1223685 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Vermont  
Vaccinated:2021-04-11
Onset:2021-04-13
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderal 30 mg ER Adrenal 30 mg Citalapram 30 mg
Current Illness: UTI 1 month ago
Preexisting Conditions: ADHD
Allergies: cherries
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Rash on neck, chest, under breast, abdomen, groin - treated with hydrocortisone 1% - not yet resolved


VAERS ID: 1223687 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Dyspnoea, Oxygen saturation, Vital signs measurement
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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Amlopine Atrovastatin Cetirizine Vit D3 Duloxatine Famotidine Fish Oil Gabapentin Humulin U-100 sliding scale Jublia Lantus U100 40 units at hs Levothyroxine Magnesium Oxide Miralax MVI with Minerals Myrbetriq Propranodol Systane Gel Tacrol
Current Illness:
Preexisting Conditions: Obesity HTN heart and kidney disease Chronic Kidney disease stage 3 Cervicalgia Diabetes Type 2 Low back pain GERD Hyprothyroidism Dry Eye Diastolic CHF History of COVID 19 Osteoporosis Atherosclerosis History of Liver Transplant Polyarthritis Mixed Hyperlipidemia Respiratory failure with hypoxia
Allergies: Acetaminophen Amoxicillin Hydroxyzine Morphine Oxycodone Paxil Percocet Sulfa
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Resident complained of shortness of breath and stated that it started early in the morning of the 13th of April. Pulse ox at time was 94%. No complaint of chest pain. Lung sounds were diminished. Vital signs were within normal limits. NP was notified and she advised to continue to monitor. The resident stated that the SOB subsided and no further issues were noted.


VAERS ID: 1223757 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-13
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Leukemia in remission from 2011
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Left leg pain


VAERS ID: 1223842 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Injection site pain, Muscle spasms
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: Muscle spasms in arm & forehead, LUQ pain. Ekevated temp @ Arm pain at injection site.


VAERS ID: 1224226 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-08
Onset:2021-04-13
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Allergy test, Fatigue, Headache
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Xyzal; Women''s multi-vitiamn; vitiamn E; Nasal Decongestant; excedrin
Current Illness: None
Preexisting Conditions: None
Allergies: Codine
Diagnostic Lab Data: I visited medical clinic on Friday 4/17 and was tested for allegries and miagraines.
CDC Split Type:

Write-up: The very next day after receiving the injection, I was extremely fatigued. On the following Tuesday 4/12 I woke up with a headache that persisit for 16 hours.


VAERS ID: 1225184 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-04-07
Onset:2021-04-13
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram thorax abnormal, Cyst removal, Dizziness, Dyspnoea, Knee operation, Malaise, Pulmonary embolism, Troponin normal
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Synthroid
Current Illness: Knee surgery to remove cyst on back of right knee 4-14
Preexisting Conditions: Thyroid disease
Allergies: PCNs
Diagnostic Lab Data: 4/17: Troponin 0.139 4/17: CT chest PE protocol- large volume acute multi focal bilateral lobar, segmental, and sub segmental pulmonary emboli. Right heart strain
CDC Split Type:

Write-up: On April 7th received Janssen COVID vaccine at pharmacy. On April 13 started developing shortness of breath and dizziness/light headed. Had knee surgery at hospital the 14th on right knee to remove cyst (scheduled surgery). On 15th still short of breath and felt like had cold. Worsening SOB on 16th. On 17 was SOB walking from bathroom. Talked to daughter on phone and she said to go to ER. Went to ER about 8pm and Was diagnosed with bilateral blood clots in lungs and admitted to step down on heparin drip. Getting Echo TEE on Monday 19th and bilateral leg ultrasounds today on 18th


VAERS ID: 1225700 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-04-08
Onset:2021-04-13
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK RA / -

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Dysuria, Full blood count normal, Headache, Injection site swelling, Pain, Pyrexia, SARS-CoV-2 test negative, Urine analysis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Shingrix approximately 2-3 years prior
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Previous allergic reaction to vaccine, previous allergic reaction to some antibiotics
Diagnostic Lab Data:
CDC Split Type:

Write-up: I am reporting per recommendation of the V-safe system/conversation. I am reporting as the patient. I received the Jansen vaccine through a special monitored vaccine clinic due to a past severe reaction to a Shingrix vaccine. I did not have any immediate symptoms after the Jansen vaccine. The following day I developed aches/pains and fever to 103, but this resolved within 48 hours. I then noticed itching, swelling and pain at the site of the injection and developed a mild headache, called my primary doctor on 4/13/21 and was seen on 4/14/21 at which time a CBC was done. CBC including platelets-normal. However, within the next few days a more severe headache then developed, which was severe enough to limit my activities by 4/16/21. Because of the rare problem of thrombocytopenia associated with clotting, it was advised I not take aspirin or ibuprofen. I also was having some mild abdominal pain, low grade fever (to 100.7), malaise, dysuria and arthralgias. My headache continued to be limiting my daily activities and on 4/17/21, I went to a Urgent Care. However, they were unable to check and get results back on a CBC within that day, I had a normal neurological exam, my UA had some abnormal findings but not clearly indicative of a UTI and a culture is pending. A rapid Covid test was negative. It was recommended that if I was concerned I could proceed to a local ED for further testing. I decided to continue to try conservative treatment and monitoring at home. As of today 4/18/21, the headache has mostly resolved and I no longer have a fever. I am still having some dysuria and joint pains.


VAERS ID: 1225963 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Computerised tomogram normal, Dyspnoea, Head discomfort, Laboratory test normal, Syncope, Tremor
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Clean CT Scan and blood work. Fainting from unknown causes. But with all respect to the MD I disagree. I felt doctor was in a rush and dismissive. And felt the need to report this myself so that it doesn''t happen to anyone else.
CDC Split Type:

Write-up: By midnight after my vaccine: Shortness of breath. Three days later around 6:25 am on April 15, 2020: I got out of bed, next moment I recall is of me on the floor. No memory of falling. I was shaking uncontrollably as if my body was getting many commands at the same time but I had no control over it. I could not call out for help. At one point I was biting my right hand but could not make myself stop until my shaking stopped. Bite did not penetrate skin but I had visible bite mark on my hand. I regained control suddenly and just got up slowly and shaken by the experience. Wife then drove me to the ER. Been feeling pressure on my head.


VAERS ID: 1226125 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Chest discomfort, 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? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: GNC Women''s Ultra Mega Energy & Metabolism, Kirkland CoQ10 300mg, Member''s Mark Allergy Relief Fexofenadine Hydrochloride 180 mg
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: 4/13/2021 1am shortness of breath, chest tightness, 10:30 am Dr Visit (X -ray, EKG, Blood clots lab done) 12:00pm Sent to Hospital, Again everything done(X-Ray,EKG,Blood work, CT scan) They gave me an albuterol treatment which alleviated some chest tightness. I was released around 4pm from hospital. Once home I took some Benadryl 25mg


VAERS ID: 1226131 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Maine  
Vaccinated:2021-04-10
Onset:2021-04-13
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Lip swelling, Swelling face, 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient stated that 3 days later he came down with hives and a swollen face and lip.


VAERS ID: 1226224 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-13
Onset:2021-04-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills
SMQs:

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

Write-up: complained of severe chills that were limiting ability to get out of bed


VAERS ID: 1226286 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-09
Onset:2021-04-13
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Middle ear effusion, Tinnitus
SMQs:, Hearing impairment (narrow)

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

Write-up: I feel like I have fluid in my ear. Constant fluttering noise.


VAERS ID: 1226486 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-04-11
Onset:2021-04-13
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Pain in extremity
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Occasional Ibuprofen.
Current Illness:
Preexisting Conditions: Clinical obsesity Fibromyalgia Equivocal Lyme Disease Benign Brain Cyst Temporomandibular Joint Dysfunction attributed to advanced arthritic phenomenon
Allergies: Sensitivity to mussels, but not all shellfish. (Not a true allergy.)
Diagnostic Lab Data:
CDC Split Type:

Write-up: Approximately 48 hours after first and only dose of Janssen vaccine, I experienced several accute, intense brief pains in my right foot (arch area) that lasted for only seconds. It repeated every few minutes or so, for hours. Upon sleep and a muscle relaxant, it did not re-occur. However approximately 4 days later, (today) I experienced very similar "spasms" in my left rib cage area, just below my breast. They feel like a muscle spasm, lasting only seconds, but repeat within minutes for hours.


VAERS ID: 1226739 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Chills, Decreased appetite, Fatigue, Headache, Influenza like illness, Lethargy, Nausea, Pain, Poor quality sleep, Pyrexia, Somnolence
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Starting around midnight, my joints were extremely achy. I went to bed, but tossed and turned, even though I was very tired, but so sore. I got chills and fever, but didn''t take my temperature. The next morning, took my temperature and it was 101. Ate a piece of coffee cake with some tea. Was very tired, so went back to bed. Was also a bit queasy, and not hungry for lunch, and had a mild headache. Slept most of the day, had chills and fever off and on, and joints very sore. I did eat dinner. The next day I was much better, but still had some soreness in my joints, one or two episodes of mild chills, was somewhat tired and lethargic. The next day I was more or less back to normal. I did take Tylenol at some point, but I can''t remember if it was the afternoon of the first day of fever, or not until the next afternoon. I know I did take it again the next morning. All in all, it felt like a full-blown case of the flu, but was of short duration.


VAERS ID: 1226749 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Disorientation, Disturbance in attention, Feeling abnormal
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Finasteride
Current Illness: None
Preexisting Conditions: Complicated Diverticulitis
Allergies: Phenergren
Diagnostic Lab Data:
CDC Split Type:

Write-up: The following day I get very disoriented and brain fog, severe difficulty paying attention, it?s almost a week later and I still feel off


VAERS ID: 1226968 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-07
Onset:2021-04-13
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)

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

Write-up: Every morning when I wake up, both my arms are numb from my shoulders to my tiger tips. Like they ?felt asleep?.


VAERS ID: 1227295 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-03
Onset:2021-04-13
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 808980 / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Simpesse birth control; vitamin D supplement; vitamin B12 supplement; probiotic; psyllium husk capsules.
Current Illness: None.
Preexisting Conditions: None.
Allergies: None.
Diagnostic Lab Data: An ultrasound of both legs on April 16, 2021 revealed blood clot in left leg. Bloodwork was also conducted on April 16, 2021.
CDC Split Type:

Write-up: On April 16, 2021 (Day 13 after Vaccine) I was diagnosed with acute deep vein thrombosis (DVT) of my femoral vein in my left leg by Hospital. In other words, I was diagnosed with a blood clot in my upper left leg. Pain in both my legs had started on April 13, 2021 (Day 10 after Vaccine). On April 16, I had a virtual appointment with my doctor, Dr. , who prescribed an ultrasound to rule out DVT. I went to an ultrasound appointment at Radiology at 3:30pm where a blood clot was found in my left leg. I was admitted into the emergency room at Hospital and prescribed medication and follow ups from there. These adverse symptoms developed after I submitted other adverse symptoms to VAERS on April 13, 2021 (Temporary VAERS E-Report Number: 435841).


VAERS ID: 1227302 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-04-10
Onset:2021-04-13
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Lymphadenopathy, Pain in extremity
SMQs:, 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: sulfur
Diagnostic Lab Data: none
CDC Split Type:

Write-up: 1st Adverse Event 4/13/2021, Left posterior lower leg(calve) pain, lasted 2 days, no treatment 2nd Adverse Event 4/16/2021 Left posterior knee pain, pain is still present but pain level has decreased, no treatment 3rd Adverse Event 4/16/2021 Left supraclavicular tender and enlarged lymph node for 2 days, no longer tender but lymph node is currently slightly enlarged, no treatment.


VAERS ID: 1227397 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038A21A / 1 LA / SYR
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Hysterectomy March 11, 2021
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Rash on lower back, itches .


VAERS ID: 1227435 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-13
Onset:2021-04-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020B21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Diarrhoea, Headache, Nausea, Pain, Tinnitus, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hearing impairment (narrow), Noninfectious diarrhoea (narrow)

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

Write-up: Headache, chills, body aches, nausea, vomiting, diarrhea, fatigue, worsening of tinnitus. Symptoms stated on evening of injection (4/13/21) and lasted through 4/18/21.


VAERS ID: 1227989 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-10
Onset:2021-04-13
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hot flush, Oral herpes, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal infections (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin C, B12, D. Viviscal supplement
Current Illness: none
Preexisting Conditions: high cholesterol
Allergies: penicillin, propylene glycol
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Hives on face for and occasional hot flashes for 2 days, fever blister on lip. Benadryl stopped the hives.


VAERS ID: 1228222 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-07
Onset:2021-04-13
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032M20A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Muscle twitching
SMQs:, Dyskinesia (broad), Dystonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol, symmeterel, Norvasc,amlactin, asprin, Lipitor, dulcolax, symbicort, hydroton, Flonase, Lasix, apresoline, Norco, cozaar, hyzaar, Prilosec, protonix, glycolax, pericolace.
Current Illness:
Preexisting Conditions: asthma, DM, GERD, HLD, HTN, stroke
Allergies: alendronate sodium, baclofen, ramipril, penicillins.
Diagnostic Lab Data:
CDC Split Type:

Write-up: an 87 y/o female with PMH significant for right MCA CVA s/p thrombectomy 12/27/2020 with left sided residual, left ophthalmic CVA, type 2 DM, HTN, HLD, obesity who complains of twitching. History is obtained from pt''s sister at bedside. She states over the past 3 days the pt has had twitching of her left face and arm which she says is basically constant. Unknown if there have been any recent medication changes. Pt had a telephone appointment with NES today who referred her to stroke neurology. Today pt''s sister asked her neighbor who is an RN to come take a look at her, who advised that she bring the pt to the ER.


VAERS ID: 1228266 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-11
Onset:2021-04-13
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Blister, Culture urine negative, Perineal pain, Pruritus
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lo loestrin Fe
Current Illness: N/a
Preexisting Conditions: N/a
Allergies: Suprax, Rocephin
Diagnostic Lab Data: 4/16- ER trip. Tested for herpes and other STIs., Urine Culture. Given Valtrex and Lidocaine 4/18- Negative results on tests. Area slightly improved.
CDC Split Type:

Write-up: 4/13- itching began in perineal area. 4/14- blisters appeared. Burning and itching. 4/15- more blisters, more burning and itching. 4/16- ER trip. Tested for herpes and other STIs. Given Valtrex and Lidocaine. - set f/up appointment with OB/GYN ()on Wed 4/21/21 4/17- area slightly improved. 4/18- Negative results on tests. Area slightly improved.


VAERS ID: 1228514 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-11
Onset:2021-04-13
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Adverse reaction, Body temperature increased, COVID-19, Chills, Dehydration, Fatigue, Heart rate increased, Hypertension, Oxygen saturation decreased, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Hypertension (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Statin 40mg, Clopidogrel 75mg, Aspirin 81mg, One a day mens vitamin
Current Illness: none
Preexisting Conditions: Mycardial infarction Sept 19, 2019 - 3 stents, 3 mini Strokes Sept 19, 2020,
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Monday - extreme tiredness, some chills running nose Tuesday - deep chills temp 95 deg, pulse running 30-40 pts higher, blood pressure ok, visited Dt , said it could be reaction to Janzen shot, said i need to hydrate better, drink lots of Gatorade Friday - Went to Hospital ER, Oxygen level low 90, temp 103.4, high bp - IV''d, Tested positive for Covid -19 gave me 4mg methylprednisolone - 4 days


VAERS ID: 1228691 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tri-previfem (oral birth control)
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Multiple extremely swollen lymph nodes around ear, jaw, and neck on right side of body. (Opposite of injection side) Appeared day after the shot and is still present 1 week afterwards. Swollen painful bumps on right side of the forehead and eyebrow.


VAERS ID: 1228701 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Tinnitus, Vision blurred, Visual impairment
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Hearing impairment (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: tylenol, calcium, d3, estrace, progesterone
Current Illness: none
Preexisting Conditions: none
Allergies: none known
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: ringing in ears for 2 hours with blurred /decrease in vision which still remains, frequent headaches


VAERS ID: 1228718 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-03-06
Onset:2021-04-13
   Days after vaccination:38
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Diet refusal, Fatigue, General physical health deterioration, Hypersomnia, Mobility decreased
SMQs:, Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Donepezil; memantine, meclizine, atorvastatin, fenofibrate, multivitamin, probiotic
Current Illness:
Preexisting Conditions: Dementia, Adnoid Cycstic Carcinoma
Allergies: Codeine
Diagnostic Lab Data: Hospice evaluation, regular visits from hospice personnel. 3/18: initial hospice evaluation 3/23: final hospice evaluation & admission to system 3/26: in-home care from nursing assistant & initial meeting w/hospice Nurse 3/30: in-home care from nursing assistant 4/2: in-home care from nursing assistant; follow-up w/Hospice Nurse 4/6: in-home care from nursing assistant 4/9: in-home care from nursing assistant; follow-up w/Hospice Nurse 4/13: follow-up w/Hospice Nurse 4/16: in-home care from nursing assistant 4/19: follow-up w/Hospice Nurse
CDC Split Type:

Write-up: A week following my mothers vaccination, she became increasing fatigued. On day 10 following her vaccination she went to bed and had to be helped to her room, this was unusual. She remained in bed for 19-20 hours a day for three days. I called all of her doctors, all of whom she had just been seen by, routine CT scans performed, blood work done, and visit with her neurologist. Her oncologist suggested we seek a hospice evaluation, even though her CT scans showed that her cancer had only slight growth, nothing to be concerned about. Her primary care office ordered the hospice evaluation and it was performed on Thursday, 3/18. They said ?she may just be having a bad week following her vaccination? and ?lets revisit this the following week?. her condition continued to deteriorate significantly over the next few days, so much that she began sleeping 21?23 hours a day. On the following Tuesday, 3/23, she was admitted into the hospice system. Now, four weeks later, we are in the final weeks of her life. She refuses food and water now, and her nurse says that it won?t be much longer. She went from a relatively healthily, senior woman, with underlying health issues, none of which presented her imminent demise, to dying at home within weeks of receiving her J&J vaccine. I have no idea if he demise is in anyway related to her vaccine, but thought it was important to report her symptoms.


VAERS ID: 1228820 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-09
Onset:2021-04-13
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderall, nortriptyline, Zinc,.
Current Illness:
Preexisting Conditions: History of migraines with auras, ADHD, Tourette Syndrome.
Allergies: n/a
Diagnostic Lab Data:
CDC Split Type:

Write-up: sharp pain in left temple, comes on quickly and only lasts abut a minute, happens at least once a day, some days several times a day.


VAERS ID: 1229066 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-11
Onset:2021-04-13
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Impaired work ability, Pain
SMQs:

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

Write-up: Extreme fatigue, sore everywhere. Unable to work due to symptoms.


VAERS ID: 1229504 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-15
Onset:2021-04-13
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Anticoagulant therapy, Splenic infarction
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: Patient was admitted for abdominal pain and for splenic infarct. Patient will dc on anticoagulation. Patient reports she received Johnson and Johnson COVID Vaccine. Confirmed with center on date and place of administration, Unknown lot #.


VAERS ID: 1229712 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Dyspnoea, Exposure to SARS-CoV-2, Nausea, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: zolpidem 5, fluoxetine 20, esomeprazole 40, potassium 20, candesartan 16, ezetimide 10, rosuvastatin 10,
Current Illness: n/a
Preexisting Conditions: cholesterol, blood pressure, insomnia
Allergies: n/a
Diagnostic Lab Data: Negative Covid test
CDC Split Type:

Write-up: Shortness of breath nausea weakness ***note patient tested negative to Covid but was exposed***


VAERS ID: 1229823 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Headache, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Migraine Headaches, GERD, IBS
Preexisting Conditions: Hyptertension
Allergies: Clindamycin, Ciprofloxacin
Diagnostic Lab Data: CBC - future lab
CDC Split Type:

Write-up: Headache: Began the following day after the vaccination. Has a history of migraine headaches. Restarted topiramate for treatment and will continue sumatriptan and acetaminophen for abortive therapy. Nausea and Vomiting - Continuation of Zofran for vomiting. Will use Dexilant for GERD and start famotadine for optimal therapy


VAERS ID: 1230315 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Dizziness, Headache, Insomnia
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad)

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

Write-up: headache, dizziness, no energy, insomnia since 04/13/2021


VAERS ID: 1230317 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-04-08
Onset:2021-04-13
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19 pneumonia, Chest pain, Gastrointestinal haemorrhage, Platelet count decreased, Thrombocytopenia, Troponin
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Ischaemic colitis (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: amLODIPine, 10 mg= 1 tab, PO, Daily aspirin, 81 mg= 1 tab, PO, Daily atorvastatin, 80 mg, PO, Nightly calcium acetate 667 mg oral tablet, 2001 mg= 3 tab, PO, With meals 3x/day lisinopril, 40 mg= 1 tab, PO, Daily metoprolol succinate 10
Current Illness: none
Preexisting Conditions: ESRD CAD
Allergies: No allergies
Diagnostic Lab Data: Troponin 9947 4/17/21 Platelets 66,000 4/17/21
CDC Split Type:

Write-up: Chest pain/possible MI Thrombocytopenia GI bleed COVID 19 PNA


VAERS ID: 1230515 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-10
Onset:2021-04-13
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A12A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Muscle spasms
SMQs:, Anaphylactic reaction (broad), Dystonia (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? 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 experienced shortness of breath and leg cramps, went to urgent care for a work up. per patient the tests were negative for anything remarkable .


VAERS ID: 1230747 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: New Jersey  
Vaccinated:0000-00-00
Onset:2021-04-13
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: The patient had no known drug allergies.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210424300

Write-up: SEVER LOWER BACK AND NECK MUSCULAR PAIN; This spontaneous report received from a patient concerned a 58 year old female. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included the patient had no known drug allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 207A21A, and batch number: 207A21A expiry: UNKNOWN) dose was not reported, administered on 12-APR-2021 12:15 for prophylactic vaccination. No concomitant medications were reported. On 13-APR-2021 07:30, the subject experienced sever lower back and neck muscular pain. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from sever lower back and neck muscular pain. This report was non-serious.


VAERS ID: 1230754 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: New Hampshire  
Vaccinated:0000-00-00
Onset:2021-04-13
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: COVID-19
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210424678

Write-up: FEVER; This spontaneous report received from a health care professional concerned an adult of unspecified sex. The patient''s height, and weight were not reported. The patient''s concurrent conditions included covid-19 infection. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: Unknown) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 13-APR-2021, the subject experienced fever. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of fever was not reported. This report was non-serious.


VAERS ID: 1230762 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-04-13
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Lip swelling, Paraesthesia oral
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210424874

Write-up: SWOLLEN LIPS; TINGLING LIPS; This spontaneous report received from a patient concerned a patient of unspecified age and 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: unknown) dose was not reported, administered on 12-APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 13-APR-2021, the subject experienced swollen lips. On 13-APR-2021, the subject experienced tingling lips. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the swollen lips and tingling lips was not reported. This report was non-serious.


VAERS ID: 1230834 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-09
Onset:2021-04-13
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram pulmonary, Blood culture, Chest X-ray, Computerised tomogram head, Culture urine, Discomfort, Echocardiogram, Full blood count, Hypoaesthesia, Magnetic resonance imaging head, Magnetic resonance imaging spinal, Metabolic function test, Palpitations, Paraesthesia, Ultrasound Doppler, Venogram
SMQs:, Peripheral neuropathy (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 4/13 CBC, CMP, urine culture, CTA chest 4/16 CBC, CMP, Blood cultures, CXR, CT head 4/17 CBC, CMP, CTA head, MRI brain, MRV head 4/18 CBC, CMP, LE Doppler, MRI C-spine, Echocardiogram
CDC Split Type:

Write-up: Palpitation intermittent right-sided numbness tingling heavy sensation


VAERS ID: 1230852 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-13
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test normal, Fibrin D dimer, Full blood count, Muscle spasms, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Dystonia (broad), Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: CBC, D-Dimer, Blood tests results normal
CDC Split Type:

Write-up: Tingling head, pins and needle feeling. Leg cramps


VAERS ID: 1230858 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Georgia  
Vaccinated:0000-00-00
Onset:2021-04-13
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Back pain, Body temperature, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Guillain-Barre 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210413; Test Name: Body temperature; Result Unstructured Data: 99-100 F
CDC Split Type: USJNJFOC20210425098

Write-up: LOWER BACK PAIN; WEAKNESS; FEVER 99-100; This spontaneous report received from a consumer concerned a 30 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: 042A21A expiry: UNKNOWN) dose was not reported, administered on 12-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 13-APR-2021, the subject experienced lower back pain. On 13-APR-2021, the subject experienced weakness. On 13-APR-2021, the subject experienced fever 99-100. Laboratory data included: Body temperature (NR: not provided) 99-100 F. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from fever 99-100, and weakness, and the outcome of lower back pain was not reported. This report was non-serious.


VAERS ID: 1230972 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-02-27
Onset:2021-04-13
   Days after vaccination:45
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 007B21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Pain in extremity, Thrombosis, Ultrasound joint
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LISINOPRIL; HCTZ
Current Illness: Blood pressure high
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210414; Test Name: ultrasound; Result Unstructured Data: Blood Clot in the Left leg
CDC Split Type: USMODERNATX, INC.MOD20210

Write-up: Blood Clot in the Left leg; Pain in the Left Leg; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of THROMBOSIS (Blood Clot in the Left leg) in a 74-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 007B21A and 007B21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Blood pressure high. Concomitant products included LISINOPRIL and HCTZ for Blood pressure high. On 27-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 2 dosage form. On 13-Apr-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced PAIN IN EXTREMITY (Pain in the Left Leg). On 14-Apr-2021, the patient experienced THROMBOSIS (Blood Clot in the Left leg) (seriousness criterion medically significant). At the time of the report, THROMBOSIS (Blood Clot in the Left leg) and PAIN IN EXTREMITY (Pain in the Left Leg) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 14-Apr-2021, Ultrasound joint: ultrasound (abnormal) Blood Clot in the Left leg. Patient did not have a history of Blood Clots. She was Not taking any hormones (Estrogen, Progesterone)Treatment for event included Eliquis for blood clot. The patient received both scheduled doses of mRNA-1273 prior to the events; therefore, action taken with the drug in response to the events is not applicable. Based on the current available information and temporal association between the use of the product and the onset date of the reported event a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the onset date of the reported event a causal relationship cannot be excluded.


VAERS ID: 1231401 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-13
Onset:2021-04-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

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

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

Write-up: Tingling and numbness in arm Two days later numbness and tingling in legs, intermittent still 1 week later


VAERS ID: 1231690 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2021-04-13
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Discomfort, Fatigue, Headache, Illness, 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Abstains from alcohol; Non-smoker; Comments: Patient had no known allergy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210427034

Write-up: BODY ACHES; SICKNESS; DISCOMFORT; CHILLS; MASSIVE HEADACHE; FATIGUE; FEVER; This spontaneous report received from a patient concerned a 43 year old female. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included unknown. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intravenous, batch number: Unknown) dose was not reported, administered on 12-APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 13-APR-2021, the subject experienced body aches. On 13-APR-2021, the subject experienced sickness. On 13-APR-2021, the subject experienced discomfort. On 13-APR-2021, the subject experienced chills. On 13-APR-2021, the subject experienced massive headache. On 13-APR-2021, the subject experienced fatigue. On 13-APR-2021, the subject experienced fever. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from body aches, sickness, discomfort, chills, massive headache, fatigue, and fever on 14-APR-2021. This report was non-serious.


VAERS ID: 1231701 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-04-13
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Chills, Headache, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: TOPIRAMATE
Current Illness: Migraine
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210427087

Write-up: VOMITING; WEAKNESS; CHILLS; HEADACHE; NAUSEA; This spontaneous report received from a consumer concerned a 64 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included migraine. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808609, expiry: UNKNOWN) dose was not reported, administered on 12-APR-2021 for prophylactic vaccination. Concomitant medications included topiramate for migraine. On 13-APR-2021, the subject experienced vomiting. On 13-APR-2021, the subject experienced weakness. On 13-APR-2021, the subject experienced chills. On 13-APR-2021, the subject experienced headache. On 13-APR-2021, the subject experienced nausea. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from headache, chills, vomiting, nausea, and weakness. This report was non-serious.


VAERS ID: 1231708 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-04-13
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN Q02A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210427142

Write-up: BODY ACHES; FATIGUE; FEVERISH; HEADACHE; This spontaneous report received from a patient concerned a female of unspecified age. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Q02A21A, expiry: UNKNOWN) dose was not reported, administered on 07-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 13-APR-2021, the subject experienced headache. On an unspecified date, the subject experienced body aches, fatigue, and feverish. Treatment medications (dates unspecified) included: ibuprofen. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from headache, and the outcome of fatigue, feverish and body aches was not reported. This report was non-serious.


VAERS ID: 1231760 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Illinois  
Vaccinated:0000-00-00
Onset:2021-04-13
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Headache, Injection site swelling
SMQs:, 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Alcohol use; Eczema; Ketosis; Non-smoker; Psoriasis
Preexisting Conditions: Medical History/Concurrent Conditions: Cannabis abuse
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210428213

Write-up: HEADACHE; INJECTION SITE SKIN BREAK OUT; This spontaneous report received from a patient concerned a 53 year old female. The patient''s height, and weight were not reported. The patient''s past medical history included cannabidiol abuse, and concurrent conditions included psoriasis, ketosis, eczema, non smoker, and alcohol use. The patient experienced drug allergy when treated with lidocaine. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported and batch number: 201A21A) dose was not reported, administered on 11-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 13-APR-2021, the subject experienced injection site skin break out. On an unspecified date, the subject experienced headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from injection site skin break out, and the outcome of headache was not reported. This report was non-serious.


VAERS ID: 1231776 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: California  
Vaccinated:0000-00-00
Onset:2021-04-13
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK - / -

Administered by: Other       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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Diabetes; Non-smoker
Preexisting Conditions: Comments: Patient does not abuse drug or illicit drug use.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210428550

Write-up: HEADACHE; This spontaneous report received from a patient concerned a 42 year old female. The patient''s weight was 155 pounds, and height was 62 inches. The patient''s concurrent conditions included diabetes, non-smoker, and non-alcoholic, and other pre-existing medical conditions included patient does not abuse drug or illicit drug use. The patient experienced ibuprofen allergy when treated with ibuprofen. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 201A21A, and expiry: 23-JUN-2021) dose was not reported, administered on 07-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 13-APR-2021, the subject experienced headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from headache. This report was non-serious.


VAERS ID: 1231780 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2021-04-13
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Gait disturbance, Myalgia, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210428849

Write-up: BARELY WALK; PAIN IN RIGHT LEG MORE LIKE IN CALF; MUSCLE ACHE; PAIN IN RIGHT LEG MORE LIKE IN CALF; This spontaneous report received from a patient concerned a 64 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: Unk) dose was not reported, administered on 10-APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 13-APR-2021, the subject experienced pain in right leg more like in calf. On an unspecified date, the subject experienced barely walk, pain in right leg more like in calf, and muscle ache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from pain in right leg more like in calf, and the outcome of muscle ache, barely walk and pain in right leg more like in calf was not reported. This report was non-serious.


VAERS ID: 1232000 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-13
Onset:2021-04-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037B21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient complaining of nausea/fever within a few hours after receiving vaccination. assumed normal side effects. still having nausea, fever, body aches, fatigue, after 1 week


VAERS ID: 1232036 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-04-13
Onset:2021-04-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027B21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

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

Write-up: Our health department conducted a mass vaccination event on 4/13/21 where more than 1,000 people were vaccinated. Over the course of the 8 hr event there were 1 17 yo patient who received a first dose of Moderna vaccine. We have reported this to Moderna and they recommended we fill out a VAERS for each patient. We have spoken with the parents of each patient. There were no reported adverse effects and all of them are planning on getting their second shot of Moderna Vaccine.


VAERS ID: 1232243 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-08
Onset:2021-04-13
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: birth control (junel FE), zoloft, spironolactone, inhalers
Current Illness:
Preexisting Conditions:
Allergies: augmentin
Diagnostic Lab Data:
CDC Split Type:

Write-up: itchy hands


VAERS ID: 1232475 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-08
Onset:2021-04-13
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Full blood count normal, International normalised ratio normal, Metabolic function test, Pain in extremity, Prothrombin time normal
SMQs:, 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: CBC, PT, INR, CMP-all normal
CDC Split Type:

Write-up: left lower extremity medial thigh pain


VAERS ID: 1232609 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-04-05
Onset:2021-04-13
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Blood test, Confusional state, Fatigue, Joint swelling, Pain in extremity, Peripheral swelling, Ultrasound scan abnormal
SMQs:, Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (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: None
Current Illness: None
Preexisting Conditions: None
Allergies: Shellfish
Diagnostic Lab Data: 4/18/2021, urgent care sent him to the hospital for ultrasound and blood work. Blood work was good, ultrasound revealed blood clots in superficial veins in knee and calf. He was put on blood thinners. Doctor said there?s not enough evidence to prove it?s the vaccine. But could be a coincidence.
CDC Split Type:

Write-up: Confusion, very tired, joint aches, at first. On Tuesday April 13, my husband woke up in pain to his left leg. The left leg had a painful softball sized hard lump on inside of knee and a little bigger than a golf ball hard lump on his calf. Had no treatment until April 18th


VAERS ID: 1232826 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808962 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chest discomfort, Chills, Heart rate increased, Pain, Pyrexia
SMQs:, Anaphylactic reaction (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 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Citalopram 10 mg Advair Diskus 100/50 mcg Albuterol HFA inh 8.5 gm Levocetirizine 5 mg Montelukast 10 mg
Current Illness:
Preexisting Conditions: Short of breath due to covid
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Shot administered at 2:30 pm. on April 12th. Chills started at 12:30 a.m. and lasted about 3 hours. Woke up with my whole body aching. Also had tightness in chest and rapid heartbeat and fever off and on for the next 36 hours. Fever was 100.9 at highest temperature. I took Advil to help with my symptoms. I returned to work on April 14th.


VAERS ID: 1232882 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-09
Onset:2021-04-13
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Herpes zoster
SMQs:, Opportunistic infections (broad)

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

Write-up: vaccine administered on 3/9/21. Newly diagnosed shingles on 4/13/21.


VAERS ID: 1233467 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-09
Onset:2021-04-13
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

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

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

Write-up: She had some mild symptoms 1-2 days after the vaccine that resolved. 4-5 days after the vaccine she developed a headache, describes it as constant. She has taken tylenol and advil OTC without much relief. She denies any vision changes, worse with position changes, nausea or vomiting. Today is is improved without intervention, but still present mildly.


VAERS ID: 1233528 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-09
Onset:2021-04-13
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Contusion, Muscle contractions involuntary
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Dystonia (broad), Accidents and injuries (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: VitaLiver tincture (from Rejuvica Health), Dermal repair complex
Current Illness: none
Preexisting Conditions: Hepatitis B
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: I had a deep purple bruise the size of a quarter on my right arm a few days after taking the Janssen vaccine. I did not injure myself or bump into my right arm so I was baffled about how I got the bruise. I also experienced weird sensations in the muscle of my left calf on two occasions a few days within my vaccine. They felt like muscle contractions and the muscles quivered and I thought I was getting a charlie horse, but they were not painful or unbearable. The quivering lasted about 10-30 seconds. I''ve never had any sensation like this in my calf before. All of this coincided with me hearing news about the blood clots and deaths associated with the J&J vaccine shortly after I took the jab. Initially, I brushed it off and talked myself out of any connection between the vaccine and my symptoms. I was talking with family & friends recently and they suggested I report my symptoms so that''s I why I''m reporting now 11 days after my vaccine.


VAERS ID: 1233674 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-10
Onset:2021-04-13
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Back pain, Blood urine, Chest pain, Chills, Headache, Injection site erythema, Injection site swelling, Micturition urgency, Nausea, Skin warm, Urinary tract infection
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (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: Date of Birth Date Of Birth 11/16/1993 Current Medications levonorgestrel and ethinyl estradiol (LOSEASONIQUE) 0.1-0.02 mg (84) 0.10 mg (7) oral 3MPk Instructions: Take 1 tablet by mouth daily. Authorized by DO on 2/16/2021 ibuprofen (A
Current Illness: Noted Hematology and Oncology Iron deficiency anemia 2/16/2021 Overview 2/16/2021 Heavy periods, iron deficiency anemia in women of childbearing age. Iron supplements and bowel regiment discussed. Start OCP to help regulate periods q 3 months.
Preexisting Conditions:
Allergies: Allergies as of 4/20/2021 Reviewed by CNP on 4/9/2021 Noted Reaction Type Reactions Janssen Covid-19 Vaccine (eua) [covid-19 Vac,ad26(janssen)-pf] 04/20/2021 Contraindication Percocet [oxycodone-acetaminophen] 04/02/2019 GI Upset GI upset
Diagnostic Lab Data:
CDC Split Type:

Write-up: nausea, back pain possible uti foul odor, blood in urine ongoing for 2 weeks, urine urgency, abdominal pain unsure if related to period (Period doesn''t typically last two weeks), chills, janssen vaccine small bump on arm where vaccine is, arm is warm to touch with redness around the area, headache comes ago did not have a h/a last week, chest pain


VAERS ID: 1233948 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-10
Onset:2021-04-13
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Muscle twitching
SMQs:, Dyskinesia (broad), Dystonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D3 2000 UI daily
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Small, visible muscle twitches on calves and thighs, occasionally on my back. Happens constantly while sitting or lying down, but not while walking or exercising. Never experienced this prior to vaccine. Not accompanied by pain, visible bruising or discolorations.


VAERS ID: 1234046 (history)  
Form: Version 2.0  
Age: 103.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-07
Onset:2021-04-13
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None. Used to take daily Claritin up until a bout 3 years ago.
Current Illness: None.
Preexisting Conditions: None; has been bedridden for about 3 years.
Allergies: Slight allergy to pollen.
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Received a Janssen vaccination on 4/7/21 from a home visiting nurse from the County Health Department. On approximately 4/13/21, the family noticed slight signs of an issue, with patient slumping towards the right, and showing some signs of weakness on right side of body. Family contacted the PCP, who advised to take her to the ED. Family was hesitant to do that because patient had been bedridden for past few years. She seemed to improve somewhat on 4/15/21. Then the morning of 4/16/21, the family found her on the floor of her bedroom. She appeared to have had a moderate to severe stroke. Right side of body paralyzed, cannot speak. Uncertain whether mental faculties further deteriorated. PCP ordered a hospice facility for care. Stroke likely caused by blood clot but unsure if related to JJ vaccine. She has not been evaluated in person by her health care providers.


VAERS ID: 1234231 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-07
Onset:2021-04-13
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: I take the following daily, for at least 3 months: Calcium Vitamin D Emergen-C Astaxanthin Biotin Collagen Scoop
Current Illness: None
Preexisting Conditions: Tetralogy of Fallot
Allergies: None that I am aware of
Diagnostic Lab Data:
CDC Split Type:

Write-up: 6 days after I got the vaccine, I noticed a large rash across my torso. I am unsure if the rash was developing prior to when I noticed, but the rash is on my stomach and part of my lower back. I finally visited my primary doctor today and was told the rash is a drug reaction - it is not itchy nor painful. **I am supposed to be on baby aspirin indefinitely due to my heart condition. I have not taken baby aspirin in a few years. But after there were reports of women getting blood clots after getting the JNJ vaccine, I started taking baby aspirin 6 days after I got the vaccine. The rash may have happened before or after I took my first dose of baby aspirin. I stopped taking baby aspirin the following day. Today, my doctor advised me to stop taking all Vits and Supplements. I will be taking Zyrtec and Tagamet for next 10 days, hoping the rash will go away.


VAERS ID: 1234283 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-04-01
Onset:2021-04-13
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A421A / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Women''s Multi-Vitamins
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 2005081796

Write-up: Pain in upper right leg, short sharp pain on right side of head Started April 13


VAERS ID: 1234286 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-03-20
Onset:2021-04-13
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Blood test, Pain in extremity, Thrombophlebitis superficial
SMQs:, Embolic and thrombotic events, venous (narrow), Thrombophlebitis (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: orhtotricyclen birth control
Current Illness:
Preexisting Conditions:
Allergies: nka
Diagnostic Lab Data: US Blood work
CDC Split Type:

Write-up: pt said she had isolated pain above her left elbow around 4/13/2021. the pain is now from her elbow to mid bi-cep. (she had given blood on 3/4/2021) pt saw a provider on 4/19/2021 regarding her symptoms. She was referred for a US. Results were superficial thrombosis left cephalic vein at the level of the mid upper arm extending into the forearm. She had blood work and was told to take Ibuprofen for pain and to stop taking her birth control. Pt will have a FU appt to discuss blood work results.


VAERS ID: 1235415 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Ohio  
Vaccinated:0000-00-00
Onset:2021-04-13
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Headache, Heart rate, Heart rate increased, Palpitations
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210413; Test Name: Heart rate; Result Unstructured Data: Elevated
CDC Split Type: USJNJFOC20210430903

Write-up: HEADACHE; ELEVATED HEART RATE; POUNDING HEART; This spontaneous report received from a patient concerned a 21 year old. 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 and batch number: 1808982 expiry: unknown) dose was not reported, administered on 10-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 13-APR-2021, the subject experienced elevated heart rate. On 13-APR-2021, the subject experienced heart pounding hard. Laboratory data included: Heart rate (NR: not provided) Elevated. On 15-APR-2021, the subject experienced mild headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from elevated heart rate, heart pounding hard, and mild headache. This report was non-serious.


VAERS ID: 1235526 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-04-13
Onset:2021-04-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Cardiac output increased, Confusional state, Vision blurred, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: No adverse event
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20210

Write-up: confusion/was not coherent; blurry vision; vomited; cardiac outcomes went up, from the lab results they were elevated; This spontaneous case was reported by a physician (subsequently medically confirmed) and describes the occurrence of CONFUSIONAL STATE (confusion/was not coherent), VISION BLURRED (blurry vision), VOMITING (vomited) and CARDIAC OUTPUT INCREASED (cardiac outcomes went up, from the lab results they were elevated) in a 49-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient''s past medical history included No adverse event. On 13-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 13-Apr-2021, the patient experienced CONFUSIONAL STATE (confusion/was not coherent) (seriousness criterion hospitalization), VISION BLURRED (blurry vision) (seriousness criterion hospitalization), VOMITING (vomited) (seriousness criterion hospitalization) and CARDIAC OUTPUT INCREASED (cardiac outcomes went up, from the lab results they were elevated) (seriousness criterion hospitalization). At the time of the report, CONFUSIONAL STATE (confusion/was not coherent), VISION BLURRED (blurry vision), VOMITING (vomited) and CARDIAC OUTPUT INCREASED (cardiac outcomes went up, from the lab results they were elevated) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Patient had his first dose of the Moderna COVID-19 vaccine yesterday and immediately felt the vaccine go to his chest and down to the toes; 30-40 minutes after had confusion, blurry vision; he made it to a hospital in Dallas where he vomited, he could not read at the moment, could not call 911, did not know how to send his location, how to call or text, he was not coherent. Was admitted in the ER with altered mental state, he was not responsive when she went to see him. He stayed overnight, his cardiac outcomes went up, from the lab results they were elevated. They performed CT scans, neurological checks, a holter monitor, MRI, multiple blood works and everything was clear.; Sender''s Comments: Very limited information regarding these events has been provided at this time. Further information has been requested.


VAERS ID: 1235721 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016B21A / 2 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Chills throughout night after vaccine, fever and headache for about 4 hours the day after vaccine, fatigue the day after vaccine.


VAERS ID: 1235729 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-04-13
Onset:2021-04-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032B21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: QVAR, Omega3 fish oil, multivitamin for women age 50+
Current Illness: None
Preexisting Conditions: Asthma
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Left arm was painful around the injection site, pain was peaked during night, until next day, and start to subdue after 2 days.


VAERS ID: 1236103 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Georgia  
Vaccinated:0000-00-00
Onset:2021-04-13
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER 206A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Hyperhidrosis, Myalgia, Neck pain
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Hypertension (took blood pressure medication)
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19; Comments: no known allergies.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210423914

Write-up: FATIGUE; NECKACHE; CHILLS; MUSCLE ACHES; HEADACHE; DRENCHED IN SWEAT; This spontaneous report received from a patient via a company representative concerned a 51 year old male. The patient''s height, and weight were not reported. The patient''s past medical history included covid-19 infection, and concurrent conditions included hypertension, and other pre-existing medical conditions included no known allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 206A21A, and expiry: UNKNOWN) dose was not reported, administered on 12-APR-2021 15:45 for prophylactic vaccination. No concomitant medications were reported. On 13-APR-2021, the subject experienced drenched in sweat. On 13-APR-2021, the subject experienced headache. Treatment medications included: paracetamol. On 13-APR-2021 01:00, the subject experienced chills. On 13-APR-2021 01:00, the subject experienced muscle aches. On 13-APR-2021 05:00, the subject experienced neckache. On 13-APR-2021 06:00, the subject experienced fatigue. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from drenched in sweat, chills, and muscle aches on 13-APR-2021, was recovering from neckache, and had not recovered from headache, and fatigue. This report was non-serious.


VAERS ID: 1236130 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Tennessee  
Vaccinated:0000-00-00
Onset:2021-04-13
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Dyspnoea, Headache, Injection site paraesthesia, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210413; Test Name: Body temperature; Result Unstructured Data: 100-102
CDC Split Type: USJNJFOC20210424789

Write-up: SLIGHT SHORTNESS OF BREATH; BODY ACHES; TINGLING IN INJECTED ARM; FEVER OF 100-102; HEADACHE; This spontaneous report received from a patient concerned a 29 year old female. 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: 041A21A, and expiry: UNKNOWN) dose was not reported, administered on 12-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 13-APR-2021, the subject experienced slight shortness of breath. On 13-APR-2021, the subject experienced body aches. On 13-APR-2021, the subject experienced tingling in injected arm. On 13-APR-2021, the subject experienced fever of 100-102. On 13-APR-2021, the subject experienced headache. Laboratory data included: Body temperature (NR: not provided) 100-102. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from fever of 100-102, body aches, headache, tingling in injected arm, and slight shortness of breath. This report was non-serious.; Sender''s Comments: V0: Medical Assessment comment was not required as per standard procedure as the case assessed as non-serious.


VAERS ID: 1236156 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: New Jersey  
Vaccinated:0000-00-00
Onset:2021-04-13
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ASPIRIN [ACETYLSALICYLIC ACID]; PEPCID [FAMOTIDINE]; ATORVASTATIN; MONTELUKAST; VITAMIN B12; BIOTIN
Current Illness: Abstains from alcohol; Ex-smoker (Discontinued 7 years ago.)
Preexisting Conditions: Medical History/Concurrent Conditions: Asthma; Bariatric surgery; Blood cholesterol abnormal; Diabetic; Food allergy; Heart disease, unspecified; Hives; Comments: The patient did not have any drug abuse, illicit drug use.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210425768

Write-up: DIZZINESS; NAUSEA; This spontaneous report received from a patient concerned a 61 year old female. The patient''s height, and weight were not reported. The patient''s past medical history included hives, bariatric surgery, and diabetic, and concurrent conditions included lettuce. nuts and unspecified ingredient in indian food allergy, asthma, heart disease, cholesterol problem, ex smoker, allergy of unknown food substance, and non-alcohol user, and other pre-existing medical conditions included the patient did not have any drug abuse, illicit drug use.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, and batch number: 207A21A expiry: UNKNOWN) dose was not reported, administered on 08-APR-2021 for prophylactic vaccination. Concomitant medications included montelukast for asthma, atorvastatin for high cholesterol, famotidine for stomach acid, acetylsalicylic acid, biotin, and cyanocobalamin. On 13-APR-2021, the subject experienced dizziness. On 13-APR-2021, the subject experienced nausea. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from dizziness, and nausea. This report was non-serious.


VAERS ID: 1236164 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-04-13
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Chills, 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Name: Body temperature; Result Unstructured Data: 101 F
CDC Split Type: USJNJFOC20210426816

Write-up: BODY ACHES; CHILLS; FEVER; SEVERE HEADACHE; This spontaneous report received from a patient concerned a female of unspecified age. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported) dose was not reported, administered on 12-APR-2021 for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On 13-APR-2021, the subject experienced severe headache. On an unspecified date, the subject experienced body aches, chills, and fever. Laboratory data (dates unspecified) included: Body temperature (NR: not provided) 101 F. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from fever, body aches, severe headache, and chills. This report was non-serious.


VAERS ID: 1236190 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: New Jersey  
Vaccinated:0000-00-00
Onset:2021-04-13
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Headache, Hyperventilation, Stress
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Eosinophilic 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Clot blood
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210427654

Write-up: MILD HEADACHE; HYPERVENTILATION; STRESSED OUT; This spontaneous report received from a parent concerned a female of unspecified age. The patient''s height, and weight were not reported. The patient''s past medical history included blood clots. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported) dose was not reported, administered on 29-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 13-APR-2021, the subject experienced hyperventilation. On 13-APR-2021, the subject experienced stressed out. On an unspecified date, the subject experienced mild headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the hyperventilation, stressed out and mild headache was not reported. This report was non-serious.


VAERS ID: 1236209 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Virginia  
Vaccinated:0000-00-00
Onset:2021-04-13
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A22A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Decreased appetite, Influenza like illness, Nausea
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210428079

Write-up: FLU LIKE SYMPTOMS; LOSS OF APPETITE; NAUSEA; This spontaneous report received from a consumer concerned a 48 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, and batch number: 206A22A expiry: UNKNOWN) dose was not reported, administered on 13-APR-2021 07:20 for prophylactic vaccination. No concomitant medications were reported. On 13-APR-2021 18:00, the subject experienced flu like symptoms. On 13-APR-2021 18:00, the subject experienced loss of appetite. On 13-APR-2021 18:00, the subject experienced nausea. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the flu like symptoms, loss of appetite and nausea was not reported. This report was non-serious.


VAERS ID: 1236214 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Virginia  
Vaccinated:0000-00-00
Onset:2021-04-13
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A22A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Influenza like illness, Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210428134

Write-up: SORE ARM/ CAN HARDLY MOVE IT; FLU SYMPTOMS/ NAUSEA/ NO APPETITE; This spontaneous report received from a patient concerned a 45 year old female. 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: 206A22A expiry: UNKNOWN) dose was not reported, administered on 13-APR-2021 07:20 for prophylactic vaccination. No concomitant medications were reported. On 13-APR-2021 18:00, the subject experienced flu symptoms/ nausea/ no appetite. On 14-APR-2021 08:00, the subject experienced sore arm/ can hardly move it. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from flu symptoms/ nausea/ no appetite on 14-APR-2021, and had not recovered from sore arm/ can hardly move it. This report was non-serious.


VAERS ID: 1236237 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2021-04-13
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210428432

Write-up: INJECTION SITE PAIN; This spontaneous report received from a patient concerned a female of unspecified age. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 13-APR-2021 for prophylactic vaccination .Batch number was not reported and has been requested No concomitant medications were reported. On 13-APR-2021, the subject experienced injection site pain. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of injection site pain was not reported. This report was non-serious.


VAERS ID: 1236238 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-04-13
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Feeling abnormal, Lethargy, Somnolence
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Non-smoker
Preexisting Conditions: Medical History/Concurrent Conditions: Rheumatic fever; Comments: Patient have no known drug allergies.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210428436

Write-up: FEELING BAD; LAZY; SLEEPY; This spontaneous report received from a consumer concerned a 41 year old male. The patient''s height, and weight were not reported. The patient''s past medical history included rheumatic fever, and concurrent conditions included non alcoholic, and non smoker, and other pre-existing medical conditions included patient have no known drug allergies. 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 12-APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 13-APR-2021, the subject experienced lazy. On 13-APR-2021, the subject experienced sleepy. On an unspecified date, the subject experienced feeling bad. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from lazy, and sleepy, and the outcome of feeling bad was not reported. This report was non-serious.


VAERS ID: 1236239 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: North Carolina  
Vaccinated:0000-00-00
Onset:2021-04-13
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Bedridden, Chest discomfort, Fatigue
SMQs:, Anaphylactic reaction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Breast feeding; Drug allergy; Non-smoker
Preexisting Conditions: Comments: The patient was not pregnant at the time of reporting.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210428439

Write-up: PRESSURE ON CHEST; COULD NOT GET OUT OF BED; TIREDNESS; This spontaneous report received from a patient concerned a 33 year old. The patient''s height, and weight were not reported. The patient''s concurrent conditions included breastfeeding, non smoker, and allergic to aspirin, and other pre-existing medical conditions included the patient was not pregnant at the time of reporting. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 207A21A, expiry: UNKNOWN) dose was not reported, administered on 12-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 13-APR-2021, the subject experienced could not get out of bed. On 13-APR-2021, the subject experienced tiredness. On 14-APR-2021, the subject experienced pressure on chest. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from tiredness, and the outcome of pressure on chest and could not get out of bed was not reported. This report was non-serious. This parent/child case is linked to 20210436123.


VAERS ID: 1236262 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-04-13
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Off label use, Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210428673

Write-up: ADMINISTER TO 16 YEAR OLD PATIENT; OFF LABEL USE; This spontaneous report received from a health care professional concerned a 16 year old female. The patient''s weight, height, and medical history were not reported.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 042A21A, expiry: UNKNOWN) dose was not reported, administered on 13-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 13-APR-2021, the subject experienced administer to 16 year old subject. On 13-APR-2021, the subject experienced off label use. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the administer to 16 year old patient and off label use was not reported. This report was non-serious.


VAERS ID: 1236287 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-04-13
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain upper, Diarrhoea, Frequent bowel movements
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Drug allergy; Non-smoker
Preexisting Conditions: Comments: Patient has no known medical history and patient has no history of drug abuse or illicit drug usage
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210428910

Write-up: DIARRHEA; STOMACH ACHE; INCREASED BOWEL MOVEMENT; This spontaneous report received from a patient concerned a 51 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included sulfa-based allergy, non smoker, and abstains from alcohol, and other pre-existing medical conditions included patient has no known medical history and patient has no history of drug abuse or illicit drug usage. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 205A21A, and expiry: UNKNOWN) dose was not reported, administered on 11-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 13-APR-2021, the subject experienced stomach ache. On 13-APR-2021, the subject experienced increased bowel movement. On 14-APR-2021, the subject experienced diarrhea. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from stomach ache, and the outcome of increased bowel movement and diarrhea was not reported. This report was non-serious.


VAERS ID: 1236344 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-04-13
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Fatigue, 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: The patient was not pregnant at the time of vaccination.
Allergies:
Diagnostic Lab Data: Test Date: 20210413; Test Name: Body temperature; Result Unstructured Data: 100.1 F
CDC Split Type: USJNJFOC20210429111

Write-up: FEVER; TIREDNESS; This spontaneous report received from a patient concerned a 42 year old female. 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: Unk) dose was not reported, administered on 12-APR-2021 for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers.. No concomitant medications were reported. On 13-APR-2021, the subject experienced fever. On 13-APR-2021, the subject experienced tiredness. Laboratory data included: Body temperature (NR: not provided) 100.1 F. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from fever, and tiredness. This report was non-serious.


VAERS ID: 1236387 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Alabama  
Vaccinated:0000-00-00
Onset:2021-04-13
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Adverse drug reaction
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210429824

Write-up: UNSPECIFIED SIDE EFFECTS; This spontaneous report received from a health care professional concerned a female of unspecified age. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported) dose was not reported, administered on 12-APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 13-APR-2021, the subject experienced unspecified side effects. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of unspecified side effects was not reported. This report was non-serious.


VAERS ID: 1236719 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-09
Onset:2021-04-13
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / SYR

Administered by: School       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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin 500mg
Current Illness:
Preexisting Conditions: Diabetes
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe Headaches.


VAERS ID: 1236750 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-08
Onset:2021-04-13
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / 1 UN / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Amlodipine Vitamin D3 Rosuvastatin Citalopram
Current Illness: None
Preexisting Conditions: Hypertension High Cholesterol
Allergies: Tape Neosporin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Since April 13th patient has had headache and body aches.


VAERS ID: 1236850 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-07
Onset:2021-04-13
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chills, Diarrhoea, Gaze palsy, Pain, Parosmia, Pyrexia, Taste disorder, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ocular motility disorders (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Acetaminophen after vaccination
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Day of vaccine and day after: high fever, chills, headache, body aches, vomiting, and diarrhea. April 13: food smelled rancid. April 17: certain foods smell and taste rancid. Everyday, more foods smelled/tasted rancid. 4/20/21: Symptoms improved, but several foods have a rancid aftertaste.


VAERS ID: 1236945 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-09
Onset:2021-04-13
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Fatigue
SMQs:, Retroperitoneal fibrosis (broad)

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

Write-up: I have severe back ache and fatigue . did not seek treatment. should I seek treatment??


VAERS ID: 1237091 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-04-01
Onset:2021-04-13
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Chest pain, Deep vein thrombosis, Dyspnoea, Fibrin D dimer increased, Full blood count, Haematocrit decreased, Haemoglobin decreased, Muscle spasms, Peripheral vein occlusion, Platelet count normal, Pulmonary embolism, Red blood cell count decreased, Scan with contrast abnormal, Ultrasound Doppler abnormal, White blood cell count normal
SMQs:, Anaphylactic reaction (broad), Haematopoietic erythropenia (narrow), Haemorrhage laboratory terms (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Dystonia (broad), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Lupus Chronic Kidney Disease (Lupus Nephritis) Pt had recent bilateral lower extremity edema and shortness of breath not diagnosed
Preexisting Conditions: Lupus Surgical history: hernia repair, tonsillectomy, 2013 Pleural Effusion with thoracotomy and decortication of right lung, chest tube placed
Allergies: NKA
Diagnostic Lab Data: 4/18/2021 US Venous Duplex Lower Extremity: Acute deep venous thrombosis with occlusive thrombus in the left femoral, popliteal and posterior tibial veins. 4/18/2021 CT Angio Pulmonary Embolism W and/or WO Contrast: Acute pulmonary embolism within segmental arteries of bilateral upper lobes, lower lobes and right middle lobe. 4/18/2021 D-dimer : 16,641 4/18/2021 CBC: WBC 7.0, RBC 3.95, Hgb 11.3, Hct 34.9, platelets 163
CDC Split Type:

Write-up: Patient started having leg cramping on 4/13/2021, presented to the emergency department on 4/18/2021 with increasing shortness of breath and chest pain.


VAERS ID: 1237103 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-06
Onset:2021-04-13
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

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

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

Write-up: About a week after the vaccine I noticed 1 patch of hair loss which procceded to 2 or 3. I visited my Dermatologist who injected steroids into each spot but within the next week more and more patches would fall out. A bedtime oil was prescribed for me to use and I am still experiencing the issue to date which has caused me to have to chop off all my hair yesterday. I have a 4week F/U appt with the dermatologist to see if any changes has occured


VAERS ID: 1237155 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-10
Onset:2021-04-13
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER 207A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Hypoaesthesia, Laboratory test
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: A lot of lab work was down on the day I see Dr and CT scan.
CDC Split Type:

Write-up: After the Vaccine. On the third date, April 13th 2:15pm my left side hand and leg feel numbness. On April 14th, my right side hand starts numbness. I went to see doctor on April 15th, Dr took blood works and schedule a CT scan on April 20th. On April 21st my left side hand and leg feel more numbness than before. I took a Tylenol at 9:35pm on April 21st. And When I wake up this morning which is April 22rd my right side head feel pain and I feel I can''t walk straight. Then I took another Tylenol at 9:35 am on April 22nd. My head is painful and I feel dizzy.


VAERS ID: 1237494 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-11
Onset:2021-04-13
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Vertigo
SMQs:, Vestibular disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Anastrozole, multi vitamin
Current Illness: None
Preexisting Conditions: Breast Cancer in remission since December 2020
Allergies: Sulfa drugs, penicillin
Diagnostic Lab Data: None. Was not seen by a doctor for this side effect.
CDC Split Type:

Write-up: Vertigo, severe, upon waking 2 days after vaccine injection. Resolved within a few hours.


VAERS ID: 1237590 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-10
Onset:2021-04-13
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN DOESN''T HAVE LO / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Fatigue, Headache, Hypoaesthesia, Pain, Pain in extremity, Ultrasound scan
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Allergy medication, Inhaler
Current Illness: No
Preexisting Conditions: Asthma
Allergies: Sulfa, Augmentin
Diagnostic Lab Data: Blood Work, Ultrasound (right leg)
CDC Split Type: vsafe

Write-up: The day after felt normal aches and tired. On Tuesday my calves and right leg started to hurt. I woke up on Wed felt as if right leg was numb and begin to had headache. i left work went to ER had Blood Work, Ultrasound (right leg). I went home on Sunday I don''t take my Claritin felt fine. On that Monday 4/19 I did take Claritin my right leg started back hurting. Since Tues 4/20 I haven''t taken allergy medication my right leg doesn''t feel weird.


Result pages: prev   1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122   next

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?EVENTS=ON&PAGENO=23&PERPAGE=100&ESORT=ONSET-DATE&REVERSESORT=ON&VAX=COVID19&DIED=No


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166