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From the 9/10/2021 release of VAERS data:

Found 7,242 cases where Vaccine is COVID19 and Manufacturer is JANSSEN and Emergency Room/Doctor Visit



Case Details

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VAERS ID: 1224229 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain upper, Dizziness, Fatigue, Headache, Muscle spasms, Neck pain, Pain
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Nothing
Current Illness: Nothing
Preexisting Conditions: Brain cyst benign
Allergies: Nothing
Diagnostic Lab Data: Adverse reaction to vaccine
CDC Split Type: Unknown

Write-up: Headache since second day after injection, along with muscle spasms, body soreness, dizziness, fatigue, stomach ache, and neck pain.


VAERS ID: 1224238 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-04-09
Onset:2021-04-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042G21A / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Fibrin D dimer, Pain in extremity, Thrombosis, Ultrasound scan abnormal
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Thrombophlebitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: D-dimer negative Acute left posterior tibial vein clot on Ultrasound
CDC Split Type:

Write-up: Left leg pain Mild Chest pain (resolved)


VAERS ID: 1224243 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: North Dakota  
Vaccinated:2021-04-07
Onset:2021-04-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 180890 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angiogram, Chills, Computerised tomogram head, Facial pain, Fatigue, Full blood count, Headache, Malaise, Metabolic function test, Neck pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Glaucoma (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Nothing
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin, morphine, jalape?o
Diagnostic Lab Data: 04/17/21 head/neck CT, CBC, chem14
CDC Split Type:

Write-up: Headache, chills, fever, body headache, rigors, fatigue, malaise, through the vaccination night. Since vacation has continuous fatigue and headache. 4/12/21 right side neck/face pain and headache on right side.-worsening 4/16/21-went to walk in clinic. 4/17/21 headache/neck pain extreme went to ED. Continues to have neck/face and headache.


VAERS ID: 1224256 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-06
Onset:2021-04-08
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 - / SYR

Administered by: Public       Purchased by: ?
Symptoms: Computerised tomogram, Discomfort, Dizziness, Feeling abnormal, Headache, Pregnancy test, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec, Flonase
Current Illness:
Preexisting Conditions:
Allergies: No
Diagnostic Lab Data: Pregnancy Test, CT Scan 4/12
CDC Split Type:

Write-up: Persistent headache for days, lightheadedness, blurred vision, heavy, almost vertigo-like. Fog


VAERS ID: 1225176 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-06
Onset:2021-04-12
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Blood test, Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow), Pulmonary hypertension (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Albuterol, ibuprofen, Percocet, losartan, metoprolol, pantoprazole
Current Illness: None
Preexisting Conditions: Heterozygous mutation for factor V Leiden, essential hypertension, hyperlipidemia, chronic back pain, narcotic dependence, morbid obesity, diffuse lipomas, GERD
Allergies: Cephalexin, erythromycin, Toradol
Diagnostic Lab Data: Bloodwork and CTA Chest
CDC Split Type:

Write-up: Pulmonary embolism


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: 1225415 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Enuresis, Foaming at mouth, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Convulsions (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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

Write-up: When the patient enbered the observation area within a few minutes she fell to the ground and appeared unresponsive. When I arrived I noticed foaming around her mouth and she urinated on herself. No clonal movements noted. Pulse could not be felt so CPR was initiated. She woke up in about 30 seconds. Paramedics called and arrived within 5 minutes. Patient was awake and oriented. When asked she indicated that she had a history of a seizure many years ago. Paramedics transported her to a Medical Center.


VAERS ID: 1225451 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-09
Onset:2021-04-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Haematocrit normal, Haemoglobin normal, Platelet count normal, Vaginal haemorrhage
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: vaginal bleeding
Preexisting Conditions: diverticulitis
Allergies: oxycodone
Diagnostic Lab Data: Collected/resulted 4/16/21 Hemoglobin 12.2, Hematocrit 36, Platelets 263
CDC Split Type:

Write-up: abdominal pain associated with MORE vaginal bleeding 1day after vaccine (pt already had vaginal bleeding preceding vaccine)


VAERS ID: 1225587 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-03-19
Onset:2021-04-17
   Days after vaccination:29
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: Activated partial thromboplastin time, Brain natriuretic peptide, Chest X-ray, Computerised tomogram abdomen, Computerised tomogram thorax, Electrocardiogram, Full blood count, International normalised ratio, Metabolic function test, Prothrombin time, Pulmonary embolism, Troponin I, Ultrasound scan
SMQs:, Embolic and thrombotic events, venous (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: on 4/18: CBC, CMP, troponin I, BNP, EKG, PT/INR, PTT, CXR, CT abd/pelvis, CT Pulm Angio, bedside echo, HITA, SRS
CDC Split Type:

Write-up: Pt found to have bilateral subsegmental pulmonary emboli. No right heart strain. Otherwise determined to be low-risk PE but will require anticoagulation.


VAERS ID: 1225589 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-04-07
Onset:2021-04-14
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Alanine aminotransferase increased, Arthralgia, Aspartate aminotransferase increased, Blood creatine phosphokinase increased, Blood creatinine normal, Blood urine present, C-reactive protein normal, Gait disturbance, Haemoglobin normal, Liver function test normal, Metabolic function test, Myalgia, Pain, Pain in extremity, Paraesthesia, Platelet count normal, Pregnancy test urine negative, Protein urine present, Red blood cells urine negative, Renal function test normal, Rhabdomyolysis, Urine analysis abnormal, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (narrow), Acute renal failure (broad), Liver related investigations, signs and symptoms (narrow), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Arthritis (broad), Proteinuria (narrow), Tubulointerstitial diseases (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: D+C due to retained products of conception on 4/2 after voluntary interruption of pregnancy via medication on 3/22
Preexisting Conditions: Mitral valve prolapse, asymptomatic
Allergies: NKDA
Diagnostic Lab Data: 4/16: CK 127768. WBC 12.66, Hgb 14.6, platelets 278. BMP, CRP wnl. Cr:0.6. Urine pregnancy negative. UA with large blood, 100 protein 4/17: CK 76,406. AST 1772, ALT 513. Cr: 0.6 4/18: CK 46034. AST: 1220 ALT:454
CDC Split Type:

Write-up: Vaccine received 4/7/2020. On Wednesday 4/14/2020, pt went to the gym and did high intensity interval training involving body weight exercises, specifically an exercise called "v-ups". Exercise was not more strenuous than usual, and pt was well hydrated. Pt reports that she exercises often and this was not a new exercise. Soon after workout, pt began having muscular pain in the hip, radiating into her inner thighs bilaterally with associated tingling. On 4/15, pain worsened and pt had difficulty ambulating. Denies any edema, erythema in her legs or unilateral leg swelling. Presented to the ED on 4/16 and found to have elevated CK of 127,768 with UA significant for large blood and protein, without RBC, indicative of rhabdomyolysis. Pt did not have any known risk factors that may precipitate rhabdomyolysis. On admission, fluids were initiated with downtrending CK, LFTs, and renal function remained stable. er D&C was done at on 4/2 and she reports there were no complications during or after the procedure. Her BHCG was elevated at the time and she tried an oral abortion pill but still had some fetal remnants so went for a D&C. She had the J&J vaccine shortly after on 4/7 and she reports no complications around and shortly after getting the vaccine. Denies vaginal bleeding or odor. Denies fevers, chills, abd pain, diarrhea, constipation, dysuria, chest pain, palpitations, shortness of breath, nausea/vomiting.


VAERS ID: 1225607 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-08
Onset:2021-04-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Metamorphopsia
SMQs:, Retinal disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Propranolol, baclofen, lexapro, zomig
Current Illness: None
Preexisting Conditions: Migraines, anemia, depression, gerd
Allergies: Biaxin, codeine, Prilosec, nexium
Diagnostic Lab Data:
CDC Split Type:

Write-up: Day2, vision obstruction with what looked like waves of water, and again on day 10, same symptoms. Essential vision loss since the waves were taking over the whole pupil


VAERS ID: 1225669 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-03-06
Onset:2021-03-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood 25-hydroxycholecalciferol, Brain natriuretic peptide, C-reactive protein, Chest discomfort, Cough, Differential white blood cell count, Dyspnoea, Eye pain, Fibrin D dimer, Full blood count, Headache, Lipase, Liver function test, Malaise, Metabolic function test, Nausea, Pain in extremity, SARS-CoV-2 test negative, Troponin I, Vitamin B12
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: none
Allergies: Penicillin, keflex, gluten, possibly ibuprofen.
Diagnostic Lab Data: Blood work taken twice on 4/13 and 4/14 2021 basic metabolic panel Troponin 1 CBC with also auto differential D-Dimer Lipase Hepatic function B-type Natriuretic High Sensitivity CRP Vitamin B12 Vitamin D25 Hydroxy
CDC Split Type:

Write-up: Started morning after with terrible headache, pain in the eyes, nausea and sore arm. Few days later felt tightness in the chest, shortness of breath and a cough started. Feeling unwell. Continued and went to urgent care. Covid 19 test negative. continued to feel the worse and went back again to urgent care. Same symptoms with nausea and headache on and off. another covid test negative and chest xray. looked ok. Continued with the same symptoms and went to Primary Care Cough worse and pain in chest. Blood work done. Looked ok. Woke up with terrible headache at 3am. Went to the ER. IV ,Blood work ,ct scan, ekg. No real answersBP elevated. Still struggling but cough improving.


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: 1225727 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-10
Onset:2021-04-02
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Blood test abnormal, Cerebrovascular accident, Echocardiogram, Electrocardiogram ambulatory, Hypoaesthesia, Hypoaesthesia oral, Magnetic resonance imaging abnormal
SMQs:, Peripheral neuropathy (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Sexual dysfunction (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: VITAMIN D, LISINOPRIL, SPIRONOLACTONE, CARVEDILOL
Current Illness: NONE
Preexisting Conditions: high blood pressure
Allergies: RAGLAN
Diagnostic Lab Data: APRIL 2ND NUMBNESS IN TONGUE, FOLLOWED BY NUMBNESS IN LIP AND PART OF CHEEK, FOLLOWED BY NUMBNESS IN RIGHT HAND. TRIP TO EMERGENCY ROOM . A BLOOD TEST AND MRI WAS GIVEN AND A STROKE WAS CONFIRMED. I WAS ADMITTED TO THE HOSPITAL FOR OBSERVATION IN EARLY MORNING OF APRIL 3RD. ECHO CARDIOGRAM WAS ADMINISTERED ON APRIL 3. I WAS DISMISSED FROM THE HOSPITAL ON APRIL 3. ON APRIL 5 I PICKED UP A HEART MONITOR TO WEAR FOR ONE MONTH. I HAVE A SCHEDULED APPOINTMENT WITH MY PRIMARY CARE DOCTOR ON FRIDAY, APRIL 16.
CDC Split Type:

Write-up: APRIL 2ND NUMBNESS IN TONGUE, FOLLOWED BY NUMBNESS IN LIP AND PART OF CHEEK, FOLLOWED BY NUMBNESS IN RIGHT HAND. TRIP TO EMERGENCY ROOM . A BLOOD TEST AND MRI WAS GIVEN AND A STROKE WAS CONFIRMED. I WAS ADMITTED TO THE HOSPITAL FOR OBSERVATION IN EARLY MORNING OF APRIL 3RD. ECHO CARDIOGRAM WAS ADMINISTERED ON APRIL 3. I WAS DISMISSED FROM THE HOSPITAL ON APRIL 3. ON APRIL 5 I PICKED UP A HEART MONITOR TO WEAR FOR ONE MONTH. I HAVE A SCHEDULED APPOINTMENT WITH MY PRIMARY CARE DOCTOR ON FRIDAY, APRIL 16.


VAERS ID: 1225765 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-09
Onset:2021-04-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Abdominal distension, Alanine aminotransferase normal, Albumin globulin ratio, Anion gap normal, Aspartate aminotransferase decreased, Back pain, Blood albumin decreased, Blood alkaline phosphatase increased, Blood bilirubin normal, Blood calcium normal, Blood chloride normal, Blood creatinine normal, Blood glucose normal, Blood potassium normal, Blood sodium normal, Blood thyroid stimulating hormone, Blood urea normal, Brain natriuretic peptide increased, Carbon dioxide normal, Chills, Cough, Diarrhoea, Dyspnoea, Fibrin D dimer, Globulin, Haematocrit normal, Haemoglobin normal, Influenza A virus test negative, Influenza B virus test, Lymphocyte count, Lymphocyte percentage, Malaise, Mean cell haemoglobin concentration normal, Mean cell haemoglobin normal, Mean cell volume normal, Monocyte count increased, Monocyte percentage, Nasal congestion, Neutrophil count increased, Platelet count normal, Protein total, Pyrexia, Red blood cell count normal, Red cell distribution width normal, Rhinorrhoea, SARS-CoV-2 test negative, Tachycardia, Thyroxine free, Vomiting, White blood cell count increased
SMQs:, Cardiac failure (broad), Liver related investigations, signs and symptoms (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Biliary system related investigations, signs and symptoms (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Dehydration (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: erythromycin, azithromycin, sulfa abx
Diagnostic Lab Data: Recent Results (from the past 24 hour(s)) P POCT PCR INFLUENZA A & B AND COVID 19 Collection Time: 04/17/21 12:00 AM Result Value Ref Range Influenza A PCR POCT Not Detected Influenza B PCR POCT Not Detected COVID 19 PCR POCT Not Detected O TSH REFLEX FT4 Collection Time: 04/17/21 10:33 AM Result Value Ref Range TSH 0.2 (L) 0.4 - 4.7 uIU/mL O COMPREHENSIVE METABOLIC PANEL Collection Time: 04/17/21 10:33 AM Result Value Ref Range Na 136 135 - 145 mmol/L K 4.5 3.6 - 5.3 mmol/L Cl 101 98 - 109 mmol/L CO2 26 21 - 28 mmol/L Anion gap w/o K 9 7 - 15 BUN 10 8 - 24 mg/dL Creatinine 0.81 0.6 - 1.2 mg/dL GFR non African Amer 82 $g59 mL/min GFR African American 99 $g59 mL/min Glucose 91 65 - 120 mg/dL SGOT/AST 23 5 - 40 IU/L Alk Phos 271 (H) 28 - 126 IU/L SGPT/ALT 39 6 - 60 IU/L Bilirubin total 0.5 0.2 - 1.4 mg/dL Protein 7.1 6.2 - 8.0 g/dL Albumin 2.9 (L) 3.2 - 5.0 g/dL Globulin (calc) 4.2 2.0 - 4.5 g/dL A:G Ratio 0.7 (L) $g1.0 Calcium 9.2 8.5 - 10.5 mg/dL O D DIMER QUANTITATIVE Collection Time: 04/17/21 10:33 AM Result Value Ref Range D Dimer quantitative 1.67 (H) 0.0 - 0.5 ug/mL FEU O CBC WITH DIFF Collection Time: 04/17/21 10:33 AM Result Value Ref Range WBC 13.02 (H) 4.00 - 11.00 K/uL RBC 4.80 4.00 - 5.50 mil/uL Hgb 14.5 12.2 - 16.2 g/dL Hct 44.2 37 - 47 % MCV 92.1 80 - 98 fL MCH 30.2 27 - 33 pg MCHC 32.8 32 - 36 g/dL RDW 13.1 11 - 15 % RDW SD 43.0 35.1 - 46.3 fL Plt 328 140 - 425 K/uL Segs 74.0 % Lymphs 13.0 % Monos 13.0 % Abs neuts 9.64 (H) 1.80 - 7.80 K/uL Abs lymphs 1.69 0.80 - 3.30 K/uL Abs monos 1.69 (H) 0.10 - 1.00 K/uL Differential type Manual Plt estimate Adequate RBC morphology Reviewed RBC morphology O FREE T4 Collection Time: 04/17/21 10:33 AM Result Value Ref Range Free T4 1.15 0.70 - 1.48 ng/dL O BNP (B NATRIURETIC PEPTIDE) Collection Time: 04/17/21 1:37 PM Result Value Ref Range BNP 100 (H) <100 pg/mL O Xr Chest 2 View - Pa, Lat Result Date: 4/17/2021 EXAM: CHEST RADIOGRAPHY EXAM DATE: 4/17/2021 10:40 AM. CLINICAL HISTORY: COUGH, SOB. COMPARISON: None. TECHNIQUE: 2 views. FINDINGS: Lungs/Pleura: Left basilar scarring versus atelectasis. No effusion. No pneumothorax. Mediastinum: Heart and mediastinal contours are unremarkable. Other: None. IMPRESSION: 1. Left basilar scarring versus atelectasis. RADIA Patients are advised to discuss imaging findings and recommendations with the ordering provider. O Ct Angio Chest Result Date: 4/17/2021 EXAM: CT ANGIOGRAM CHEST EXAM DATE: 4/17/2021 12:17 PM. CLINICAL HISTORY: PE SUSPECTED, LOW/INTERMEDIATE PROB, POSITIVE D-DIMER. COMPARISON: None. TECHNIQUE: Routine helical imaging was performed through the chest in the pulmonary arterial phase. IV Contrast: 100CC ISOVUE 370. Reconstructions: Coronal 3-D MIP reconstructions. Sagittal and coronal. In accordance with CT protocol optimization, one or more of the following dose reduction techniques were utilized for this exam: automated exposure control, adjustment of mA and/or KV based on patient size, or use of iterative reconstructive technique. FINDINGS: Pulmonary Arteries: Diagnostic quality: Adequate through the segmental arteries. No evidence for acute or chronic pulmonary emboli. RV/LV is within normal limits. There is no interventricular septal bowing. There is no reflux of contrast material in the IVC. Lungs/Pleura: Trace pleural effusions with bibasilar atelectasis. No suspicious nodules. No interstitial thickening. No pneumothorax Mediastinum: Mild cardiomegaly. Noted thorax. Thoracic Aorta: Unremarkable. Upper Abdomen: Unremarkable. Other: None. IMPRESSION: 1. No pulmonary emboli. 2. Trace pleural effusions. 3. Mild cardiomegaly. Patients are advised to discuss imaging findings and recommendations with the ordering provider.
CDC Split Type:

Write-up: The patient presents to Urgent Care today with complaint of fever and dry cough x7 days. She had the J&J covid vaccine on 4/9 and began not feeling well on Saturday. She developed a fever and chills and tachycardic. She said every day since then her fever has been going up and down. She started to vomit on Sunday, last time she vomited was Monday night. She was having diarrhea as well. She denies rhinorrhea or congestion. She denies throat pain. She went to the ED on Tuesday and she was given fluids. She said she felt a lot better on Tuesday when she left the ED. She said now she feels bloated. She does have an appetite but because she feels full she isn''t eating a lot but states she drinks 1 gallon of water a day, her water bottle is with her. She is having some sob. She denies chest pain. She has bilateral lower back pain when she is sleeping. She took anti nausea meds which did help. She has been taking ibuprofen.


VAERS ID: 1225799 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-03
Onset:2021-04-11
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Computerised tomogram, Thrombosis, Ultrasound scan vagina, Urine analysis, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: TYLENOL IBUPROFEN
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data: 4/12/2021 3A PRESENTED TO ER DEPT...VAGINAL EXAM CONFIRMS BLEEDING BUT COULD NOT DETERMINE IT''S SOURCE. ALSO UNDERWENT VAGINAL ULTRASOUND AND PELVIC CT SCAN W/ CONTRAST. NEITHER EXAM COULD GIVE REASON FOR THE BLEEDING. LABS WERE ALSO TAKEN, BUT UNDISCOVERABLE. I WAS LATER RELEASED AND ASK TO FOLLOW UP WITH PRIMARY CARE / GYN. 4/16/2021 SAW MY PRIMARY. SHE DID URINALYSIS AND RECTAL EXAM , BOTH NORMAL. NO EVIDENCE OF BLADDER OR RECTAL BLEED. I ADVISED PCP OF THE RECENT DATA OF THE J &J VACCINATION...WHICH WAS DISCOVERED AFTER MY ER VISIT.
CDC Split Type:

Write-up: 4/11/2021 830PM I NOTICED MOISTURE IN MY UNDERWEAR. WENT INTO BATHROOM , PANTIES BLOODIED, BRIGHT RED AND A QUARTER SIZED CLOT WAS INTHE TOILET. I SUFFERED NO PAIN. HOWEVER I HAD A TOTAL HYSTERECTOMY IN 1997, AND SHOULD NOT HAVE ANY BLEEDING WHATSO EVER. TOOK A SHOWER, ADVISED MY HUSBAND OF THE INCIDENT. WENT TO BED , 230AM 4/12/2021 SAME THING HAPPENS, ONLY NOW I AM WIPING BRIGHT RED BLOOD AND I FELT A LARGER SIZED CLOT LEAVE MY BODY. I WENT TO THE ER IMMEDIATELY.


VAERS ID: 1225881 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-03-26
Onset:2021-03-31
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Balance disorder, Blood test, Chest X-ray, Computerised tomogram head, Dizziness, Electrocardiogram, Feeling hot, Headache, Hemiparesis, Hyperhidrosis, Loss of consciousness, Magnetic resonance imaging head, Muscular weakness, Transient ischaemic attack, Vision blurred
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Thyroid tablets, olmesartan and chlorthalidone
Current Illness: n/a
Preexisting Conditions: Hypothyroid, high blood pressure
Allergies: penicllian
Diagnostic Lab Data: Blood work, Chest xray done on 4/1/21. Have slight weakness on left arm/shoulder and was referred to Physical therapy. Was still experiencing headache/blurred vision in left eye up to 4/13/21. Was admitted to hopsital on 4/13/21 and underwent head CT, blood work, ekg, MRA of brain, head and neck. No signs of any permenant damage and was told I experienced TIA. Hospital noted weakness on left side.
CDC Split Type:

Write-up: 6 days after receiving vaccine, I experienced an episode where I got extremely hot, sweaty in neck and chest area, dizzy, loss of balance, blurred vision and blacked out for a few seconds. The episode lastly apprx. 4-5 mins. I laid down and fell asleep for about 20 mins afterward and woke up to moderate headache and slight burry vision still on left side. I saw my primary dr the next morning on 4/1/21 and reported issue.


VAERS ID: 1225900 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-03-21
Onset:2021-04-18
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Activated partial thromboplastin time shortened, Alanine aminotransferase normal, Anion gap, Aspartate aminotransferase normal, Blood albumin normal, Blood alkaline phosphatase normal, Blood bicarbonate normal, Blood bilirubin normal, Blood calcium normal, Blood chloride normal, Blood fibrinogen increased, Blood glucose increased, Blood potassium normal, Blood sodium normal, Blood urea decreased, Creatinine renal clearance increased, Fibrin D dimer, Glomerular filtration rate normal, Haematocrit normal, Haemoglobin normal, International normalised ratio normal, Lipase normal, Mean cell haemoglobin concentration normal, Mean cell haemoglobin increased, Mean cell volume increased, Platelet count decreased, Protein total normal, Pulmonary embolism, Red blood cell count decreased, Red cell distribution width normal, Thrombocytopenia, Troponin I normal, White blood cell count normal
SMQs:, Haematopoietic erythropenia (narrow), Haematopoietic thrombocytopenia (narrow), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Systemic lupus erythematosus (broad), Embolic and thrombotic events, venous (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: None
Preexisting Conditions: none
Allergies: NKDA
Diagnostic Lab Data: Na:138 mmol/L K: 4.6 mmol/L Cl: 100 mmol/L Bicarb: 28 mmol/L BUN: 8 mg/dL Cr: 0.9 mg/dL eGFR: 101 * Cr. Clearance: 155 mL/min * Glucose: 179 mg/dL H Ca: 9.5 mg/dL T. Protein: 7.2 gm/dL Albumin: 4.6 gm/dL Bili: 1.0 mg/dL Alk Phos: 57 U/L AST: 16 U/L ALT: 28 U/L AGAP: 10 mmol/L Lipase: 5.0 U/L L Troponin I: <0.01 ng/mL WBC: 7.6 x10^3/mm3 RBC: 4.69 x10^6/mm3 Hgb: 15.6 gm/dL Hct: 44.7 % MCV: 95.3 fl MCH: 33.3 pg MCHC: 34.9 gm/dL RDW: 11.4 % L Plt: 129 x10^3/mm3 L d-Dimer: 2.53 mcg/mL (FEU) * H Fibrinogen: $g700 mg/dL * H INR: 1.0 * PTT: 31.3 sec All labs performed on 4/18/21
CDC Split Type:

Write-up: Patient with large pulmonary embolism. Associated thrombocytopenia. No provoking factor identified.


VAERS ID: 1225951 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Activated partial thromboplastin time, Acute myocardial infarction, Blood test, COVID-19, Catheterisation cardiac, Chest discomfort, Echocardiogram, Electrocardiogram, Influenza A virus test, Influenza B virus test, International normalised ratio, Nausea, Stent placement, Troponin
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Eliquis, Toprol-XL, quinapril
Current Illness:
Preexisting Conditions: atrial fibrillation, hypertension
Allergies: none
Diagnostic Lab Data: April 9, 2021: Covid-19, Influenza A, B (not detected); ECG 12-Lead; Troponin; Protime-INR; APTT; POC ACT-RALS; plus additional blood tests April 10, 2021: Echocardiogram
CDC Split Type:

Write-up: I received the Johnson and Johnson/Janssen Covid-19 vaccine at the vaccination pod on Thursday, April 8th, 2021 (04-08-2021) at around 12:45 pm. The next morning, Friday, April 9th, 2021 (04-09-2021), I woke up around 9:30 am and felt fine at first. But after taking a drink of water, I felt nauseous. I also had a pressure sensation in the center of my chest below my collarbone. After contacting my doctor''s office, my family called 911 at around 11:40 am to have the emergency squad take me to the hospital to be evaluated for a heart attack. At the hospital, I was diagnosed with an acute ST elevation myocardial infarction. I was taken to the catheterization lab for a heart catheterization and a stent was placed in my left anterior descending artery (LAD). I was admitted to the hospital on Friday, April 9th, 2021 (04-09-2021) and discharged from the hospital on Saturday, April 10th, 2021 (04-10-2021).


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: 1226025 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-10
Onset:2021-04-17
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: School       Purchased by: ?
Symptoms: Burning sensation, Pain in extremity
SMQs:, Peripheral neuropathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol, ibuprofen, levonorgestrel, and levothyroxine
Current Illness:
Preexisting Conditions: hypothyroidism, and history of DVT in same leg with leg pain
Allergies: latex, gabapentin, azithromycin, and hydromorphone
Diagnostic Lab Data: Patient referred to Emergency Department for ultrasound to rule out thrombosis.
CDC Split Type:

Write-up: Patient is reporting right-sided leg pain and burning sensation.


VAERS ID: 1226055 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041AZ1A / UNK LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Contusion, Dizziness, Dyspnoea, Fatigue, Headache, Myalgia, Nausea
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid, cytomel, , lorazepam, Low dose naltrexone, vit d, turmeric, b12
Current Illness: None
Preexisting Conditions: Hashimotos
Allergies: Latex
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Headache, bruising, shortness of breath, nausea, dizzy, extreme fatigue, muscle aches, joint pain going on 11 days


VAERS ID: 1226069 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-06
Onset:2021-04-16
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A5064 / 1 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Oedema, Peripheral swelling, Skin warm, Thrombophlebitis, Ultrasound scan
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Venlafaxine Magnesium Xanax Ambien Claritin Desogestrel-ethinyl estradiol
Current Illness: None
Preexisting Conditions: Generalized anxiety disorder Obesity Hyperthyroidism Fibroids
Allergies: Shellfish
Diagnostic Lab Data: Ultrasound -4/18/21
CDC Split Type:

Write-up: Left leg swelling, redness, warm to the touch, diagnosis of edema and thrombophlebitis


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: 1226128 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-09
Onset:2021-04-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Contusion, Fatigue, Headache, Nausea, Pain in extremity, Pruritus
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: MIGRAINE, ANXIETY
Allergies: AMOXICILLIN, CIPRO, FLUOXETINE
Diagnostic Lab Data: ADVISED ER FOR FURTHER EVALUATION
CDC Split Type:

Write-up: HEADACHE, EXCESSIVE FATIGUE, NAUSEA,LEG ITCHING, LEG BRUISING, LEG PAIN


VAERS ID: 1226147 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-04-09
Onset:2021-04-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Ataxia, Blood test normal, Chills, Computerised tomogram head normal, Computerised tomogram normal, Computerised tomogram spine, Confusional state, Dizziness, Dysarthria, Electrocardiogram normal, Electroencephalogram normal, Full blood count normal, Hyperhidrosis, Immunology test, LDL/HDL ratio, Lipids normal, Magnetic resonance imaging normal, Metabolic function test normal, Palpitations, Pyrexia, SARS-CoV-2 test negative, Syncope, Treponema test negative, Urine analysis normal, Vitamin B12 normal, X-ray normal
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Medication: Ceclor - hives
Diagnostic Lab Data: CBC - 4/10,12,13 - All normal EKG - 4/10,12,13 - All normal CT Head/Cervical Spine 4/10 - Clear X-Ray - 4/10 - Normal Basic Metabolic Panel - 4/12 - Clear Urinalysis - 4/12 - Normal COVID-19 PCR - 4/12 - Negative Lyme Disease - Negative MRI - 4/12 - Normal EEG - 4/12 - normal Vitamin B12 - 4/12 - normal RPR- 4/12 - negative Lipid Panel - HDL and LDL low, ratio normal
CDC Split Type:

Write-up: Extreme chills and high fever starting approximately 12 hours following vaccination. 14 hours after vaccination had high fever, profuse sweating, leading to heart palpitations and two syncope episodes resulting in hospitalization. CT scan and xrays, ekg and blood tests, all normal, sent home on fluids. 76 hours after vaccination presented axatia, slurred speech, confusion, dizziness, resulting in rehospitalization. MRI, EEG, EKG, blood, and urine tests all completed and normal. Sent home on steroid.


VAERS ID: 1226207 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-08
Onset:2021-04-11
   Days after vaccination:3
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: Chest pain, Chills, Dyspnoea, Malaise, Tremor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypoglycaemia (broad)

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

Write-up: My wife and I were driving home and while I was driving I started experiencing a pain in my chest and started experiencing a shortness of breath. We pulled of the freeway and I walked around for a few minutes trying to catch my breath but I was unable to. My wife started to drive and I as I sat in the passenger seat I started getting the chills and all the muscles in my body were shaking. When we got to town I told my wife we needed to go to the ER because I was not feeling well. That is where they did some tests and hooked me up to an IV.


VAERS ID: 1226225 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-09
Onset:2021-04-16
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Does not follow with doctor - history of bladder cancer, undiagnosed uncontrolled diabetes
Preexisting Conditions:
Allergies: No known allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Stroke confirmed with CT/CTA


VAERS ID: 1226231 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-03-17
Onset:2021-03-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Aggression, Agitation, Angiogram cerebral normal, Aphasia, Aura, Computerised tomogram head normal, Confabulation, Confusional state, Contusion, Delirium, Disorganised speech, Dysarthria, Encephalitis, Fatigue, Feeling abnormal, Headache, Hypotension, Intensive care, Magnetic resonance imaging head normal, Mental impairment, Mental status changes, Metabolic encephalopathy, Nausea, Vaccination complication
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (narrow), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (narrow), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Generalised convulsive seizures following immunisation (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Advair, Prevacid, Effexor,Valtrex, Budenoside, Ondansetron, Calcium, Vitamin D3
Current Illness: Spontaneous CSF Leak Syndrome, EDS, Allergies
Preexisting Conditions: EDS, Spontaneous CSF Leak Syndrome , Allergies
Allergies: Codeine, Sulfas, Percocet. Zyrtec, Opioids, Singular
Diagnostic Lab Data: CT: no acute intracranial hemorrage or injury. CTA: no significant narrowing, occlusion, or aneurysmal change. Brain MRI: no acute findings.
CDC Split Type:

Write-up: At 23 hours post Johnson and Johnson vaccination, I began to have a 10/10 headache (which was the worst headache of my life), nausea and severe aura. I then became extremely confused and was taken to the emergency department by my husband. The following was reported to me the next day when I awoke in the ICU at Hospital: within an hour of arriving at the ED, I exhibited a progressive hyperactive delirium, agitation, slurred speech (word salad), combativeness, confabulation, word finding difficulties and an inability to follow commands. The neurologist in the ED said that she was seeing this adverse vaccination side effect in other patients at the 24-hour period. I received Haldol, Zyprexa, and Ativan to control the delirium and received a head CT angiogram in the ED, which was normal. I was transferred by ambulance to the main hospital due to acute metabolic encephalopathy/altered mental status. I was admitted to the neurological unit whereby I became critically hypotensive (60s over 30s) and was transferred to the ICU due to persistent hypotension unresponsive to IV normal saline. I was then transferred and admitted to the ICU and was given continued IV fluid resuscitation and Levophed vasopressor. I was eventually weaned from vasopressors and was discharged back home in three days exhausted, bruised, fatigued and with continuous clouded mentation. I have been told by all of the doctors that this was a vaccination side-effect, which caused cerebritis. I was subsequently treated as an outpatient at Hospital for intractable aura with IV Valporic Acid, Magnesium, and Lasix infusion on April 1, 2021.


VAERS ID: 1226242 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-02
Onset:2021-04-10
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angiogram cerebral abnormal, Angiogram pulmonary abnormal, Cerebrovascular accident, Chest X-ray abnormal, Computerised tomogram head, Computerised tomogram thorax, Dyspnoea, Echocardiogram, Fatigue, Headache, Magnetic resonance imaging head, Scan with contrast abnormal, Thrombosis, Ultrasound Doppler, Ultrasound Doppler normal, Visual impairment
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypoglycaemia (broad), Infective pneumonia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: bronchiectasis
Allergies: Sulfa drugs
Diagnostic Lab Data: 4/15 - X-ray chest 4/15 - Battery of blood tests 4/16 - CTA Head W WO Contrast 4/16 - CTA Chest For PE Protocol 4/16 - US Carotid Doppler 4/16 - US Doppler Venous Leg Bilat 4/16 - MRA Venous Head W Contrast 4/16 - MRI Brain W WO Contrast 4/16 - Battery of blood tests 4/17 - 2D ECHO Complete Per Protocol 4/17 - Battery of blood tests 4/18 - Battery of blood tests
CDC Split Type:

Write-up: Eight days after receiving the vaccine, my wife developed shortness of breath, headache, fatigue, and unusual vision problems. She was taken to the emergency room on 4/15 where she underwent a battery of tests (see details below). She was admitted to the hospital (where she currently is) and was diagnosed with blood clots in the lungs and two strokes in the area of the brain that affects vision. She then underwent ultrasound tests of her legs and carotid artery, which were negative for signs of blood clots. Although my wife''s symptoms are different than the symptoms of others that led to the vaccine pause, her doctors strongly encouraged us to report it to the VAERS. My wife had no underlying or pre existing conditions that would lead to blood clots in her lungs, and stroke. After extensive testing there is no evidence that the blood clots in her lungs as well as the clot/clots that went to her brain initiated in her legs. They believe that some sort of "event" would have had to happen to cause these blood clots, and the only unusual thing in the time frame of this condition is the vaccine. As I mentioned earlier, my wife is still hospitalized.


VAERS ID: 1226294 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-03-23
Onset:2021-03-30
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Bedridden, Blood test, Condition aggravated, Diaphragm muscle weakness, Dyspnoea, Echocardiogram, Electrocardiogram, Fatigue, Headache, Hypersomnia, Immediate post-injection reaction, Intensive care, Myasthenia gravis crisis
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Depression (excl suicide and self injury) (broad), Hypersensitivity (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 9 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Amlodipine/Olmesartan/Metoprolol/HCTZ/Synthroid/Nexium/Pravastatin/Xanax/Aspirin/Biotin/Vitamin B Complex/Vitamin C/Vitamin D3/Vitamin E/Iron/Folic Acid/Probiotics
Current Illness: None
Preexisting Conditions: Myasthenia Gravis/ Hypothyroid/CAD/GERD/High BO/High Cholesterol/Anxiety
Allergies: Codeine/Anesthesia Type Unknown but not Amide Type/Iodine Dye/Ct Scan Dye/ Myelogram Dye
Diagnostic Lab Data: No vaccine related tests were done. Just for Myasthenic Crisis, bloodwork, EKG, Echocardiogram. NIF breathing scores 26 when admitted. Went up to 40, dropped to 28, up through 30?s, down to 28, up to 40 then discharged. Was told my insurance was not covering hospital stay. NIF scores at home 25 to 30. Have been bedridden with short of breath at home. Sleeping most of time. No strength.
CDC Split Type:

Write-up: Myasthenic Crisis. Hospitalized. Immediately after shot got headache/still have it. Extreme tiredness day after shot which continued throughput. Got Short of Breath around day 9. Was sent to ER by ambulance from Urgent Care. Was close to being intubated.Was in SICU 7 days, then 2 days regular hospital room. Am still very tired and weak and short of breath with weak diaphragm and will ho back to ER if no improvement.


VAERS ID: 1226308 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-11
Onset:2021-04-14
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / UNK LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Appendicectomy, Appendicitis, Computerised tomogram abdomen abnormal, Surgery, White blood cell count increased
SMQs:, Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Women?s one a day multivitamin, fish oil, daily probiotic, vitamin C, vitamin D, vitamin B, Microgestin birth control
Current Illness: None
Preexisting Conditions: Chronic low back pain, degenerative disc disease, spinal stenosis, herniated discs
Allergies: None
Diagnostic Lab Data: Er visit 4/15/21 with bloodwork showing elevated white blood cell count as well as CT scan confirming appendicitis
CDC Split Type:

Write-up: Appendicitis beginning 4/14/21, leading to surgery (appendectomy) 4/15/21


VAERS ID: 1226415 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-05
Onset:2021-04-17
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Inflammation, Pain in extremity, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Insulin, Pristiq, Adderall, Vitamin D, Vitamin B12, Reishi, Glutathione, Magnesium, Ginseng
Current Illness:
Preexisting Conditions: Type 1 Diabetes; Celiac Disease
Allergies: Celiac Disease
Diagnostic Lab Data:
CDC Split Type:

Write-up: Painful swelling and inflammation of hands and arms


VAERS ID: 1226442 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Alaska  
Vaccinated:2021-03-30
Onset:2021-04-04
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Abdominal pain upper, Arthralgia, Back pain, Chest pain, Computerised tomogram abnormal, Hepatic enzyme increased, Laboratory test, Musculoskeletal chest pain, Pain in extremity, Pelvic pain
SMQs:, Liver related investigations, signs and symptoms (narrow), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Aspirin
Diagnostic Lab Data: CT scan showed inflamed small intestines and liver on April 5, 2021. Blood draw showed slightly high liver enzymes on April 15, 2021.
CDC Split Type:

Write-up: April 4 - abdominal pain and some back pain. April 14, left leg pain, chest pain, light pressure on chest, left hip pain. April 16 left leg and foot pain. April 17, pain under rib cage and pelvic, stomach pain. April 18, left forearm and leg pain, left side back pain, slight stomach pain.


VAERS ID: 1226718 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Guam  
Vaccinated:2021-04-02
Onset:2021-04-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Anal incontinence, Aphasia, Confusional state, Loss of consciousness, Seizure, Tremor, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Convulsions (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Noninfectious diarrhoea (broad), Hypoglycaemia (broad)

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

Write-up: Approximately 10 minutes after injection, I passed out. Witness said that I was unconscious for approximately 1 minute. My body shook, and it appeared that I had a seizure. Immediately upon waking I started vomiting and having uncontrollable bowel movements for about an hour. I felt confused for about 30 minutes and was unable to speak for a few moments upon waking. When I arrived at the hospital I was still vomiting and having uncontrollable bowel movements. I was given fluids and zofran and sent home without further testing.


VAERS ID: 1226909 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Indiana  
Vaccinated:0000-00-00
Onset:2021-03-07
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068JJ / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure measurement, Blood test, Condition aggravated, Feeling jittery, Heart rate, Hypoaesthesia, Nervousness, Paraesthesia, Tremor, Vital functions abnormal, pH body fluid abnormal
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: SINGULAIR; ZYRTEC [CETIRIZINE HYDROCHLORIDE]; ZITHROMAX; BUPROPION
Current Illness: Anxiety; Depression; Seasonal allergy; Smoker (1/2 ppd); Social alcohol drinker (3-4 drinks once a month)
Preexisting Conditions: Comments: Patient takes allergy shots for her seasonal allergies. No drug abuse or illicit drug usage
Allergies:
Diagnostic Lab Data: Test Date: 20210307; Test Name: Blood pressure; Result Unstructured Data: 170/110 mmHg; Comments: after the vaccine; Test Date: 20210307; Test Name: Pulse rate; Result Unstructured Data: 80-90 bpm; Comments: at the time of leaving the clinic; Test Date: 20210307; Test Name: Heart rate; Result Unstructured Data: 106 bpm; Comments: after the vaccine; Test Date: 20210308; Test Name: Blood pressure; Result Unstructured Data: 154/92 mmHg; Comments: at the ER before treatment; Test Date: 20210308; Test Name: Heart rate; Result Unstructured Data: 129 bpm; Comments: at the ER before treatment; Test Date: 20210308; Test Name: Blood pressure; Result Unstructured Data: 114/75 mmHg; Comments: at the ER after treatment; Test Date: 20210308; Test Name: Heart rate; Result Unstructured Data: 80 bpm; Comments: at the ER after treatment; Test Date: 20210308; Test Name: Blood test; Result Unstructured Data: Acidic pH level; Comments: At the ER; Test Date: 20210308; Test Name: Blood pressure; Result Unstructured Data: 136/97 mmHg; Test Date: 20210308; Test Name: Blood pressure; Result Unstructured Data: 114/75 mmHg; Test Date: 20210308; Test Name: Heart rate; Result Unstructured Data: 110 bpm
CDC Split Type: USJNJFOC20210315655

Write-up: FLARE UP; NERVOUS; ACIDIC PH; TINGLING; NUMBNESS; SHAKING; JITTERY; ABNORMAL VITALS; 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 depression, anxiety, seasonal allergies, social drinker, and smoker, and other pre-existing medical conditions included patient takes allergy shots for her seasonal allergies. no drug abuse or illicit drug usage.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 1802068JJ and expiry: UNKNOWN) .5 ml, administered on 07-MAR-2021 to Right Arm for prophylactic vaccination. Concomitant medications included bupropion for anxiety, and depression, azithromycin for seasonal allergies, cetirizine hydrochloride for seasonal allergies, and montelukast sodium for seasonal allergies. On 07-MAR-2021, the subject experienced tingling. On 07-MAR-2021, the subject experienced numbness. On 07-MAR-2021, the subject experienced shaking. On 07-MAR-2021, the subject experienced jittery. On 07-MAR-2021, the subject experienced abnormal vitals. Laboratory data included: Blood pressure (NR: not provided) 170/110 mmHg, Heart rate (NR: not provided) 106 bpm, and Pulse rate (NR: not provided) 80-90 bpm. On 08-MAR-2021, the subject experienced flare up. On 08-MAR-2021, the subject experienced nervous. On 08-MAR-2021, the subject experienced acidic ph. Laboratory data included: Blood pressure (NR: not provided) 136/97 mmHg, 154/92 mmHg, 114/75 mmHg, 114/75 mmHg, Heart rate (NR: not provided) 80 bpm, 110 bpm, 129 bpm, and (NR: not provided) Acidic pH level. Treatment medications (dates unspecified) included: lorazepam. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from abnormal vitals on 08-MAR-2021, was recovering from numbness, jittery, flare up, and nervous, had not recovered from tingling, and shaking, and the outcome of acidic ph was not reported. This report was non-serious.


VAERS ID: 1226912 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Colorado  
Vaccinated:0000-00-00
Onset:2021-03-07
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain upper, Back pain, Moaning, Vomiting
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210315693

Write-up: VOMITING; STOMACH PAIN; BACK PAIN; MOANING; This spontaneous report received from a consumer concerned a male of unspecified age. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: Unknown, and batch number: UNKNOWN expiry: UNKNOWN) .5 ml, administered on 06-MAR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 07-MAR-2021, the subject experienced vomiting. On 07-MAR-2021, the subject experienced stomach pain. On 07-MAR-2021, the subject experienced back pain. On 07-MAR-2021, the subject experienced moaning. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from vomiting, stomach pain, and back pain, and the outcome of moaning was not reported. This report was non-serious.


VAERS ID: 1226916 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-03-08
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chest discomfort, Chills, Headache, Pain
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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210315733

Write-up: CHEST TIGHTNESS; HEADACHE; CHILLS; BODY ACHES; This spontaneous report received from 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, intramuscular, batch number: Unknown) dose was not reported, administered on 08-MAR-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 08-MAR-2021, the patient experienced chest tightness, headache, chills and body aches. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from headache, chills, chest tightness, and body aches. This report was non-serious.; Sender''s Comments: V0: Medical Assessment comment not required as per standard procedure as the case assessed as non-serious.


VAERS ID: 1226934 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-04-06
Onset:2021-04-17
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Appendicectomy, Appendicitis, Computerised tomogram
SMQs:

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Citalopram
Current Illness:
Preexisting Conditions:
Allergies: Sulfa
Diagnostic Lab Data: All done on 4/17- lots of tests and CT scan
CDC Split Type:

Write-up: Appendicitis and emergency appendectomy.


VAERS ID: 1226980 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Cardiac monitoring, Chills, Decreased appetite, Fatigue, Headache, Muscle spasms, Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Shingles vaccine on feb 24th, 2021. Similar reaction but not as severe and no emergency room visit.
Other Medications: Prozac 40mg once a day, Vitamin D 500units once a day, multivitamin once a day
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data: 4/9/21 taken to emergency room and placed on heart monitor, IV placed and IVF''s infused along with a IV dose of magnesium. IV toradol given, IV zofran given and IV Ativan given.
CDC Split Type:

Write-up: At 10:30 PM on the day of the vaccine I became achy throughout my body, chills, headache and severe nausea. By midnight my body was going in to full body cramping and nausea was unbearable along with the headache. Taken to emergency room at midnight. all symptoms persisted through Sunday April 11th along with a fever up to 101.2 on the 10th. By the 12th of April I was able to get up and move around and start to eat. Today is the 18th and I continue to have bouts of nausea, poor appetite, intermittent body aches and tiredness.


VAERS ID: 1227127 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Georgia  
Vaccinated:0000-00-00
Onset:2021-04-07
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood glucose, Blood pressure measurement, Computerised tomogram, Generalised tonic-clonic seizure, Hypotension
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 202104; Test Name: Blood glucose; Result Unstructured Data: 97; Test Date: 202104; Test Name: CT scan; Result Unstructured Data: Negative; Test Date: 20210407; Test Name: Blood pressure; Result Unstructured Data: 94/72
CDC Split Type: USJNJFOC20210417620

Write-up: TONIC- CLONIC SEIZURES; LOW BLOOD PRESSURE; This spontaneous report received from a health care professional 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: 1805031 and expiry: UNKNOWN) dose was not reported, 1 total administered on 07-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 07-APR-2021, the patient experienced tonic- clonic seizures for 3 minutes and the patient''s blood pressure was low 94/72 and then the Emergency medical services (EMS) was called and the patient was transported for evaluation the same day. The patient visited emergency room or department/urgent care facility for treatment of the events. On APR-2021, Laboratory data included: Blood glucose (NR: not provided) 97, CT scan (NR: not provided) Negative (units unspecified) and Blood pressure (NR: not provided) 94/72. On 08-APR-2021, patient was discharged from emergency room/urgent care facility and followed up with neurology. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the tonic- clonic seizures and low blood pressure was not reported. This report was serious (Other Medically Important Condition). This case, from the same reporter is linked to 20210417256, 20210417209, 20210417456 and 20210417122.; Sender''s Comments: V0:20210417620-Covid-19 vaccine ad26.cov2.s-Tonic-clonic seizures. This event is considered unassessable. The event has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event.


VAERS ID: 1227128 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-04-11
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Cardiomegaly, Computerised tomogram, Heart rate, Oxygen saturation, Pulmonary thrombosis, Thrombosis, Ultrasound scan
SMQs:, Cardiac failure (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Cardiomyopathy (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Non-smoker
Preexisting Conditions: Medical History/Concurrent Conditions: Hip fracture; Hip replacement
Allergies:
Diagnostic Lab Data: Test Date: 20210411; Test Name: CT scan; Result Unstructured Data: 3 clots in lung; Test Date: 20210411; Test Name: Ultrasound scan; Result Unstructured Data: 2 clots in her legs; Test Date: 20210415; Test Name: Oxygen saturation; Result Unstructured Data: 90s; Test Name: Oxygen saturation; Result Unstructured Data: 80; Test Name: Pulse rate; Result Unstructured Data: 139
CDC Split Type: USJNJFOC20210424514

Write-up: THREE BLOOD CLOTS IN THE LUNG; TWO BLOOD CLOTS IN THE LEG; HEART ENLARGEMENT OF LOWER CHAMBERS; This spontaneous report received from a consumer concerned an 86 year old female patient. Initial information received on 13-APR-2021 and processed with additional information received on 15-APR-2021. The patient''s weight was 161 pounds, and height was 67 inches. The patient''s past medical history included hip fracture in 2015, and uncomplicated hip replacement surgery in 2015. Patient''s concurrent conditions included non-smoker and no alcohol use. No recent travel or trauma was reported. No varicose veins or known cancer was reported. Patient saw her doctor for annual checkups and cancer screening. She is an active person who lives alone, still drives, and performs activities of daily living independently. The patient received vaccination with covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805029) dose was not reported, administered on 08-MAR-2021 for prophylactic vaccination. Vaccination site was not reported. No concomitant medications were reported as it was reported that the patient denied HRT and chronic medications. Approximately 1 week later, on or about 15-MAR-2021, she began to feel fatigue, tiredness, and shortness of breath which she thought might be due to the start of a heavy pollen season. On 11-APR-2021, the patient''s fatigue, shortness of breath, and tiredness did not improve, so her son took her to the Emergency Room (ER), where CT scan found 3 clots in her lungs and duplex scan found 2 clots in her legs (patient''s son was not certain if bilateral or unilateral). Patient''s oxygen saturation was in 80s. On 11-APR-2021, a test also revealed that the lower chambers of her heart were enlarged. On 12-APR-2021, patient underwent EKOS procedure to treat lung clots. Tissue Plasminogen Activator (TPA) had been put into the lungs via EKOS procedure ''with ultrasound inserted into blood clot in the lung''. Patient initially was treated with heparin but was stopped. Patient was treated with unspecified anticoagulant as patient''s son did not know. Pulse rate was 139. On 12-APR-2021, patient was admitted to Intensive Care Unit (ICU) (no beds were available on 11-APR-2021). He had no information regarding lab results. On 15-APR-2021, patient was transferred out of ICU to a room on regular floor. Patient was still very tired. Oxygen saturation was in 90s. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from three blood clots in the lung, two blood clots in the leg, and heart enlargement of lower chambers. This report was serious (Hospitalization Caused / Prolonged, and Life Threatening).; Sender''s Comments: V0: This 86 year-old active, independent female was hospitalized for 3 blood clots in her lungs and 2 blood clots in her legs 5 weeks after receiving Janssen Covid-19 vaccination. Medical history includes hip surgery after a hip fracture with uncomplicated course 6 years prior; she is a nonsmoker, does not have varicose veins, no known cancer, no history of recent trauma or travel and takes no chronic medications. Approximately 1 week after vaccination, the patient began to feel fatigue and shortness of breath. She initially thought her symptoms were due to the start of heavy pollen season. When symptoms did not improve 4 weeks later, she went to the emergency room where CT scan found 3 clots in her lungs and duplex scan found 2 clots in her legs. Oxygen saturation was in the 80s at that time. The following day she underwent EKOS procedure to treat the lung clots and was initially treated with heparin. The anticoagulant was subsequently changed after a public health announcement. She was admitted to the ICU and transferred to a regular room 3 days later. She was told the lower chambers of her heart were enlarged. She still feels very tired but her O2 saturation has improved to the 90''s. No laboratory results were available to the reporter. Based on the limited information, the event is inconsistent with the causal association to immunization, per the WHO causality classification for adverse events following immunization.


VAERS ID: 1227208 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-02
Onset:2021-04-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / UNK - / IM

Administered by: Work       Purchased by: ?
Symptoms: Blood culture, Blood gases, Blood lactic acid, Brain stem syndrome, C-reactive protein, Chills, Computerised tomogram neck, Dizziness, Double stranded DNA antibody, Dysphagia, Fatigue, Full blood count, Headache, Hypoglossal nerve paralysis, Joint stiffness, Magnetic resonance imaging head, Metabolic function test, Myalgia, Nausea, Neck pain, Pyrexia, Red blood cell sedimentation rate, Spinal X-ray
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations: Flu
Other Medications: Lisinopril/Hctz Tabs 20/25mg, Montelukast 10mg, Duloxetine Hcl Caps 60mg, Tizanidine 4mg, B-3 200mg, and ZyrTEC 20MG.
Current Illness: Essential Hypertension, Neuropathy in both feet, and Allergic Rhinitis
Preexisting Conditions: Essential Hypertension, Neuropathy in both feet, and Allergic Rhinitis
Allergies: Sulfa, Tetracycline & related, Prednisone & related steroids, Ecklonia Kurome, and fish allergy
Diagnostic Lab Data: Comprehensive metabolic, complete blood cell count, XR Neck Soft Tissue, MRI Brain w/out Contrast, CT Neck Soft Tissue w/out Contrast, Blood Gas Venous W/lactate, Blood Culture, XR Esophagus, DS DNA Antibody, C-reactive Protein, Sedimentation Rate (ESR)
CDC Split Type:

Write-up: Hospitalized on 4/12/2021 [10-days after vaccination] for Hypoglossal Nerve Palsey, Neck pain on right side, and other dysphagia. Due to brain stem electrical event on 4/12/2021. Symptom onset 4-hours after vaccination on 4/2/2021 w/chills, headache, lightheadedness. Fever w/in 24-hours of 101.6 for 4-days. Accompanied by nausea, chills, persistent headache, extreme fatigue, joint stiffness, and achy muscles.


VAERS ID: 1227297 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Nebraska  
Vaccinated:2021-03-09
Onset:2021-03-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 RA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Abdominal pain, Alanine aminotransferase increased, Aspartate aminotransferase increased, Autoimmune hepatitis, Bile duct stent insertion, Biliary obstruction, Biopsy liver, Blood albumin decreased, Blood alkaline phosphatase increased, Blood bilirubin increased, Blood test abnormal, Cholangitis sclerosing, Cholecystectomy, Cholecystitis, Chromaturia, Colitis ulcerative, Colonoscopy abnormal, Computerised tomogram abnormal, Decreased appetite, Endoscopic retrograde cholangiopancreatography, Faeces discoloured, Fatigue, Feeling abnormal, Gastrointestinal disorder, Gastrointestinal inflammation, Globulins increased, Haematocrit decreased, Haemoglobin decreased, Headache, Heart rate increased, Hepatitis, Hypertension, Insomnia, Jaundice, Malaise, Pain, Platelet count increased, Pyrexia, Red blood cell count decreased, Red cell distribution width increased, Ultrasound scan abnormal, Weight decreased, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Liver related investigations, signs and symptoms (narrow), Cholestasis and jaundice of hepatic origin (narrow), Hepatitis, non-infectious (narrow), Acute pancreatitis (narrow), Haematopoietic erythropenia (narrow), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Pseudomembranous colitis (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal ulceration (narrow), Infectious biliary disorders (narrow), Biliary system related investigations, signs and symptoms (narrow), Gallbladder related disorders (narrow), Biliary tract disorders (narrow), Gastrointestinal nonspecific inflammation (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Hypertension (narrow), Noninfectious diarrhoea (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Dehydration (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: LEVOTHYROXINE
Current Illness: NONE
Preexisting Conditions: GRAVES DISEASE
Allergies: NONE
Diagnostic Lab Data: APRIL 4 BILIRUBIN 10.5 APRIL 15 BILIRUBIN 16.7 APRIL 6 ALBUMIN 1.8 APRIL 4 ALKALINE PHOSPHATASE 695 APRIL 12 ALT (SGPT) 1,358 APRIL 8 AST (SGOT) 828 APRIL 12 GLOBULIN 5.0 APRIL 7 HEMATOCRIT 33.0 APRIL 7 HEMOGLOBIN 10.8 APRIL 4 PLATELET COUNT 480 APRIL 7 RBC 3.62 APRIL 8 RDW 17.9 APRIL 4 WBC 13.58
CDC Split Type:

Write-up: MARCH 9: BODY ACHES AND HEADACHE, SLEEPLESSNESS. CONTINUED OFF AND ON OVER FOLLOWING DAYS. MARCH 18: BLOOD PRESSURE AND PULSE WERE TOO HIGH TO DONATE PLASMA MARCH 21: DIDN''T FEEL NORMAL, GASTROINTESTINAL ISSUES, FATIGUE, SLEEPLESSNESS, ABDOMINAL PAIN, RAPID WEIGHT LOSS, LOSS OF APPETITE MARCH 26: URINE STARTED DARKENING TO ORANGE COLOR DESPITE STAYING HYDRATED, FEVER, MALAISE. APRIL 1: WENT TO DONATE PLASMA AT BIOTEST PLASMA CENTER AND NOTICED BLOOD PLASMA WAS AN ODD COLOR. APRIL 4: EMERGENCY ROOM PRESENTED WITH ABDOMINAL PAIN, JAUNDICE, WHITE/LIGHT COLORED STOOL. BLOODWORK, ULTRASOUNDS, CT''S WERE DONE AND SHOWED INFLAMMATION IN LIVER/GALLBLADDER/GI TRACT. HIGH BILIRUBIN. APRIL 5: COLONOSCOPY PERFORMED. DIAGNOSIS: ULCERATIVE COLITIS. ERCP PERFORMED WITH LIVER BIOPSIES. DIAGNOSIS: COMMON BILE DUCT BLOCKAGE WITH CHOLECYSTITIS AND HEPATITIS. STENT WAS PLACED. POSSIBLE PRIMARY SCLEROSING CHOLANGITIS- DEPENDING ON BIOPSY RESULTS. APRIL 6: CHOLECYSTECTOMY, MORE LIVER BIOPSIES TAKEN. APRIL 7: LIVER BIOPSY RESULTS/DIAGNOSES: OVERLAP SYNDROME OF AUTOIMMUNE HEPATITIS & PRIMARY SCLEROSING CHOLANGITIS. PLACED ON PREDNISONE. AWAITING APPROVAL FOR REMICADE INFUSIONS WITH POSSIBLE NEED FOR LIVER TRANSPLANT IN THE FUTURE AS PSC PROGRESSES. AS OF APRIL 18: JAUNDICE STILL PRESENT, BILIRUBIN NOT DECREASING. BEING REFERRED TO MEDICAL CENTER FOR FURTHER OBSERVATION AND TREATMENT.


VAERS ID: 1227303 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-12
Onset:2021-04-16
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Deafness unilateral, Neck pain, Pyrexia, Tinnitus
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hearing impairment (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: N/a
Current Illness: None
Preexisting Conditions: None
Allergies: Intolerant to gluten and dairy
Diagnostic Lab Data: Urgent care visit on 4/16 and 4/17 with visual and physical inspection of ear and vitals taken. Vitals were normal.
CDC Split Type:

Write-up: Received dose on Monday 4/12 at 7:15am. Low grade fever, neck ache and chills developed that evening and went away by next morning. On 4/16, woke up with almost no ability to hear out of my left ear and there was a very loud ringing sound in my ear. Happened off and on throughout the day but by evening, I only heard a ringing noise. I went to the urgent care and they said my ear had no sign of ear infection or allergies. Next morning, I couldn?t hear almost anything out of my ear with a very loud ringing noise. Was consistent through 4:30pm that day. Went back to the urgent care and a different nurse practicing confirmed my ear looked completely normal. I?ve never experienced deafness or ringing in my ear before. Since this morning (4/18) I have had a low ringing sound in my left ear, but no more deafness.


VAERS ID: 1227346 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-08
Onset:2021-04-11
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood magnesium normal, Blood thyroid stimulating hormone normal, Blood urea, Bradycardia, Decreased appetite, Differential white blood cell count normal, Dizziness, Electrocardiogram normal, Fatigue, Fibrin D dimer normal, Full blood count normal, Haematocrit increased, Heart rate increased, Influenza like illness, Metabolic function test normal, Muscular weakness, Neurological examination normal
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol - PRN Tirosint - .25mcg
Current Illness: n/a
Preexisting Conditions: subclinical hypothyroidism
Allergies: Dairy - allergy Gluten - sensitivity
Diagnostic Lab Data: I (patient) has been monitoring O2, and blood pressure for any abnormalities alongside bradycardia, both have been normal Went to urgentcare center 4/16/21 for ECG and evaluation given steady decline of rhr and bradycardia with no other explanation except vaccine, wanted ECG as symptoms not resolving Friday, 4/16/21 (DAY 8) the following testing was conducted: ECG = normal readout D-Dimer = normal results CBC with Auto Differential = normal except for HCT very slightly out of range (ref range max = 46%) at 47.2% Basic Metabolic Panel = all normal except BUN is slightly out of range at .6 (ref range .5-1.0) TSH = normal within range @ 2.130 Magnesium = normal Neuro exam = normal
CDC Split Type:

Write-up: BRADYCARDIA Typical flu like reaction to vaccine day after injection [Fri, 4/9 - Day 1 post vax (aka PV)] with modest HR increase (as expected) (Background: typical resting heart rate (rhr) taking into account variables (i.e. hormonal variations, hydration status, altitude changes etc) = 63 rhr - I am NOT an elite athlete, but am fit and active) Beginning Saturday, 4/10 - DAY 2 PV heart rate began steadily decreasing by two average heart beats / minute for three days, which has never happened before. Monday 4/12, DAY 4 PV, rhr dropped to 57, which is the lowest is has been ever. Between 4/12 - 4/15, DAYS 4-7 rhr = 57/58 Friday, 4/16 DAY 8 rhr = 56 Saturday, 4/17 DAY 9 rhr = 56 Sunday, 4/18 DAY 10 rhr = 55 symptoms = increased fatigue, some weakness in hands, lightheadedness, decreased appetite


VAERS ID: 1227348 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-08
Onset:2021-04-16
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Dyspnoea, Headache, Nausea, Pain, Urticaria
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Nausea, shortness of breath, body aches, headache, hives started on day 6


VAERS ID: 1227376 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-03-15
Onset:2021-03-25
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Acute respiratory failure, Anaemia, Blood test, Catheter directed thrombolysis, Chest X-ray abnormal, Deep vein thrombosis, Dyspnoea, Echocardiogram abnormal, Electrocardiogram abnormal, Headache, Hyponatraemia, Intensive care, Metabolic acidosis, Myocardial strain, Nausea, Pulmonary embolism, Pulmonary function test abnormal, Ultrasound Doppler abnormal, Urine analysis, Vision blurred
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Haematopoietic erythropenia (broad), Lactic acidosis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hyponatraemia/SIADH (narrow), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Chronic kidney disease (broad), Hypersensitivity (broad), Tumour lysis syndrome (broad), Respiratory failure (narrow), Hypoglycaemia (broad), Infective pneumonia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: April 4th-7th: Chest x-ray, EKG, CT, Echocardiogram, Ultrasound on legs, blood tests, urine test March 30: EKG, Chest x-ray, blood tests, urine test March 31: Pulmonary function test
CDC Split Type:

Write-up: Shortness of breath, nausea, headache, incident of blurred vision in one eye. Had visit with PCP on March 26th with follow-up testing on March 30th and 31st. Condition worsened and went to emergency room on April 4th and was admitted to ICU. EKOS procedure performed on April 5th. Discharge diagnosis on April 7th: 1) Acute bilateral PE (Pulmonary Embolisms/Blood Clots) with significant right heart strain status EKOS cath directed thrombolytics on April 5th. 2) Extensive bilateral deep vein thrombosis. 3) Significant right heart strain confirmed on the echo 4) Mild anemia 5) Metabolic acidosis with mild hyponatremia 6) Hypercoagulable workup, most results pending at discharge 7) Acute hypoxic respiratory failure


VAERS ID: 1227385 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Military       Purchased by: ?
Symptoms: Acute respiratory distress syndrome, Dyspnoea, Endotracheal intubation, Respiratory distress
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Interstitial lung disease (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: tylenol,albuterol inhaler,guiafenesin,lorazepam,morphine,oxycodone, synthroid, folic acid,lidocaine patch,omeprazole, sennakot
Current Illness: new diagnosis of metastatic lung ca on 3/14/2021. had 1st round of chemotherapy/immunotherapy on 4/5/2021
Preexisting Conditions: ptsd,thyroidectomy, left bka, copd
Allergies: nka
Diagnostic Lab Data:
CDC Split Type:

Write-up: increased respiratory difficulty beginning at 2pm on 4/7/2021. unable to improve or control respiratory distress overnite despite a change in meds and aggressive treatment at home. sent to emergency room at 0700 on 4/8/2021 at 0700 with acute respiratory distress and intubated. discharged to inpatient hospice on 4/12/2021, did have a prior intubation on 3/20/2021.


VAERS ID: 1227426 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: New York  
Vaccinated:2021-03-15
Onset:2021-04-16
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Shingles/Herpes Zoster (left chest, single dermatome)


VAERS ID: 1227819 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: New Jersey  
Vaccinated:0000-00-00
Onset:2021-03-01
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Activated partial thromboplastin time, Blood pressure measurement, Body mass index, Fatigue, Fibrin D dimer, Heart rate, International normalised ratio, Oxygen saturation, Prothrombin time, Swelling, Thrombosis, Ultrasound scan
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: BACLOFEN; LEXAPRO; ACTONEL
Current Illness: Edema of lower extremities (pre-existing for years); Non-smoker; Progressive multiple sclerosis
Preexisting Conditions: Comments: The patient had no known drug allergies. The patient was not a pregnant at the time of reporting. The patient had no family history of thrombosis, no prior DVT.
Allergies:
Diagnostic Lab Data: Test Date: 20210406; Test Name: Fibrin D dimer; Result Unstructured Data: Blood clot identified on left thigh; Test Date: 20210406; Test Name: Heart rate; Result Unstructured Data: 88 beats min; Test Date: 20210406; Test Name: APTT; Result Unstructured Data: 34.8 sec; Test Date: 20210406; Test Name: Ultrasound scan; Result Unstructured Data: Blood clot identified on left thigh; Test Date: 20210406; Test Name: Blood pressure; Result Unstructured Data: 124/70 mmHg; Test Date: 20210406; Test Name: Oxygen saturation; Result Unstructured Data: 99 %; Test Date: 20210406; Test Name: Prothrombin time; Result Unstructured Data: 13.4 sec; Test Date: 20210406; Test Name: INR; Result Unstructured Data: 1.2; Test Name: Body mass index; Result Unstructured Data: 19.5 kg/m2; Test Name: Body mass index; Result Unstructured Data: 19.5 kg/m2
CDC Split Type: USJNJFOC20210423970

Write-up: BLOOD CLOT IN LEFT THIGH; SWELLING; FATIGUE; This spontaneous report received from a consumer concerned a 55 year old female. Initial information received on 13-APR-2021, processed along with information received via telephone communication on 15-APR-2021 The patient''s weight was 100 pounds, and height was 152.4 centimeters. The patient''s concurrent conditions included progressive multiple sclerosis, swelling of the left leg and foot, and non smoker, and other pre-existing medical conditions included the patient had no known drug allergies. the patient was not a pregnant at the time of reporting. The patient had no family history of thrombosis, no prior deep vein thrombosis (DVT). 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, 1 total, administered on 22-MAR-2021 for prophylactic vaccination. Concomitant medications included baclofen, escitalopram oxalate, and risedronate sodium (received 2 doses and stopped after the event). The patient''s husband reported that in MAR-2021, the patient had symptoms of fatigue. On 23-MAR-2021, the patient had swelling and fatigue. Her fatigue was resolved on 24-MAR-2021 and swelling was resolving. On 05-APR-2021, the patient developed left thigh swelling. On 06-APR-2021, the patient''s swelling was not going down and she visited her primary care physician. The physician could not determine the cause of swelling (left thigh very noticeable clot swollen around where clot was located) and the physician suspected clot and performed an AD dimer (fibrin degradation) test to look for potential blood clotting. The patient also had a venous duplex ultrasound that showed left leg clot. At 19:00 on the same day, the patient''s physician advised to visit emergency room and determined there was a clot on left thigh and she was prescribed Eliquis Starter Pack (apixaban) for 3 months treatment and recommended another scan in several months. On 06-APR-2021, the patient''s vitals were reported as blood pressure 124/70 mmHg, heart rate 88 bpm and oxygen saturation of 99%. Laboratory data included prothrombin time (PT) 13.4 sec , International normalized ratio (INR) 1.2 and activated partial thromboplastin time (APTT) 34.8 sec. (Normal range not reported for all) d-dimer and platelet count results were not available and Covid-19 test was not performed. Body max index was 19.5 kg/m2. On an unspecified date the patient was feeling better but had not recovered from the event. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from fatigue on 24-MAR-2021, had not recovered from blood clot in left thigh, and recovering from swelling. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0: This case concerns a 55-year- old female subject, immobile due to progressive multiple sclerosis who developed a left thigh swelling 12 days after Janssen COVID-19 vaccine was administered intramuscularly for the prevention of symptomatic SARS-CoV-2 virus infection. The patient''s concurrent conditions included body max index of 19.5 kg/m2, progressive multiple sclerosis and swelling of the left leg and foot. She is a non-smoker, no known drug allergies, no family history of thrombosis, or prior deep vein thrombosis (DVT). Symptoms started with swelling of the left thigh and fatigue. The fatigue resolved the next day. The patient''s swelling in the left thigh was not going down and she visited her primary care physician who checked her D-dimer dimer (level not known to patient) and scheduled a venous duplex ultrasound that showed a clot in the left thigh. Her vital signs were blood pressure of 124/70 mmHg, heart rate 88 bpm and oxygen saturation of 99%. and she was prescribed Eliquis Starter Pack (apixaban) for 3 months treatment and recommended another scan in several months. Laboratory data included PT 13.4 sec, INR 1.2 and APTT 34.8 sec. D-dimer and platelet count results were not available and Covid-19 test was not performed. The patient is feeling better but had not recovered from blood clot in the left thigh, and is recovering from the swelling. Given underlying progressive multiple sclerosis with immobility and preexisting swelling of the left leg and foot on the same lower extremity, the clotting of the left thigh is considered not related to Janssen COVID-19 vaccine. Additional information has been requested.


VAERS ID: 1227829 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-05
Onset:2021-04-12
   Days after vaccination:7
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: Military       Purchased by: ?
Symptoms: Asthenia, Computerised tomogram, Electrocardiogram, Fatigue, Headache, Hyperhidrosis, Laboratory test, Loss of consciousness, Muscle spasms, Nausea
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: OTC Advil, OTC Mucinex, vitamin B3
Current Illness: none
Preexisting Conditions: none
Allergies: eurythomiacin
Diagnostic Lab Data: 12 Apr 2021, blood pressure, blood work, temperature, EKG, and CAT scan.
CDC Split Type:

Write-up: I received the Janssen COVAX on Monday morning, 5 Apr 2021. A week later, on Monday evening, 12 Apr 2021, I experienced extremely painful leg cramps and broke out in a sweat. I felt extremely nauseous, and weak, this was followed by a sever pain in my head that was so extreme that I passed out. After coming to, the pain in my head finally began to subside, along with the leg cramps. My husband indicated that I was unconscious for just under a minute. For the next two days, I had bouts of nausea, headaches, sweats, and was extremely tired. On Wednesday, 14 Apr, after learning of the issues related to the Janssen vaccine, and the symptoms described being what I experienced, I contacted the advice (cont''d)..Additional information for Item 18: Line and was told to go to Emergency Room at the hospital, which I did. I do not feel that they addressed my concerns or the symptoms that I was experiencing, and at no time did they try to determine if it was due to the vaccine. The discharge papers did not even address the "event" and the "symptoms" that I described. They did not take any information down related to the vaccine, lot number, etc., that I had received. They seemed to go through a set routine: blood pressure, blood work, temperature, EKG, and CAT scan. 21. (continued)...Visited Emergency Room, however, was requested by ER to go to Primary Care as follow-up, however, as a Employee we cannot be seen by Primary Care on THIS site. Instead , we have to go on the local clinic to receive care. The issue is that this was a vaccine that I was scheduled by my leadership to receive, with no choice in choosing which vaccine I could receive, and without follow-up care for adverse reactions. The hospital did not indicate to me that I should report this incident, however, I am concerned as a result of the "event" that I experienced, that it should be reported. Furthermore,we should have a choice as to which vaccine we want to receive, just as everyone does. Your form does not allow for input addresses Also, your form does not allow for a phone number. I am out of the country.


VAERS ID: 1227834 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-09
Onset:2021-04-14
   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 / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure increased, Chest pain, Computerised tomogram thorax normal, Echocardiogram normal, Fibrin D dimer decreased, Magnetic resonance imaging normal, Myocardial necrosis marker increased, Myocarditis, Scan with contrast normal, Ventilation/perfusion scan
SMQs:, Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypertension (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune 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, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Guafacine 1mg 2x day bystolic 10 mg 1x day Rousavastin 10mg 1x day
Current Illness: Autism, hypentsion
Preexisting Conditions: Austism
Allergies: Iodine contrast dye
Diagnostic Lab Data: Cardiac enzymes blood work ...as high as 17.67 ..discharged from hospital at 7.35.. ..extremely elevated Cat scan with contract...normal no blockage no damage to heart muscle D dimer test low.. .nuclear scan of lungs..no clots found Leg dabbler..no clots found Echocardiogram .. no periocarditis No trigger evidence except that Johnson and Johnson vaccine was received 5 days earlier
CDC Split Type:

Write-up: Chest pain, Elevated blood pressure, elevated cardiac enzymes, Acute myocarditis


VAERS ID: 1227918 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Washington  
Vaccinated:0000-00-00
Onset:2021-03-13
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Alanine aminotransferase, Aspartate aminotransferase, COVID-19, Deep vein thrombosis, Haematocrit, Haemoglobin, Platelet count, Red blood cell count, Ultrasound scan, White blood cell count
SMQs:, Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Body mass index (26.6 kg/m2); Clotting disorder (unspecified, family medical history on mother''s side, mother does not have clotting disorder); Non-smoker
Preexisting Conditions: Comments: Past medical history was insignificant with no prior history of blood clots. Patient reportedly active and does not use birth control.
Allergies:
Diagnostic Lab Data: Test Date: 202012; Test Name: COVID-19; Result Unstructured Data: negative; Comments: 3 months ago; Test Date: 202103; Test Name: Red blood cell count; Result Unstructured Data: 5.19; Test Date: 202103; Test Name: Platelet count; Result Unstructured Data: 316,000; Test Date: 202103; Test Name: White blood cell count; Result Unstructured Data: 9.1; Test Date: 202103; Test Name: Aspartate aminotransferase; Result Unstructured Data: 15; Test Date: 202103; Test Name: Hemoglobin; Result Unstructured Data: 14.6; Test Date: 202103; Test Name: Hematocrit; Result Unstructured Data: 41.9; Test Date: 202103; Test Name: Alanine aminotransferase; Result Unstructured Data: 15; Test Date: 20210320; Test Name: Diagnostic ultrasound; Result Unstructured Data: blood clot confirmed
CDC Split Type: USJNJFOC20210426156

Write-up: DEEP VEIN THROMBOSIS OF LEFT PERONEAL VEIN; This spontaneous self-report was received from a patient, female 24 years of age. Initial information received from the patient on 13-APR-2021 was processed with additional information received from on 14-APR-2021 and from the patient via telephone follow up on 16-APR-2021. The patient''s weight was 180 pounds, height 69 inches and BMI 26.6 kg/m2. Past medical history was insignificant with no prior history of blood clots, does not smoke, and does not use birth control. The patient was reportedly active and working as a teacher. Family medical history included clotting disorder (unspecified) on mother''s side; mother does not have clotting disorder. In DEC-2020, COVID-19 test was negative. The patient received COVID-19 VACCINE AD26.COV2.S (suspension for injection, route of administration and dose not reported, batch number: 1805018, expiry: unknown) administered on 13-MAR-2021 in left deltoid for prophylactic vaccination. No concomitant medications were taken. On 13-MAR-2021, the patient experienced deep vein thrombosis of left peroneal vein (also reported as 2 blood clots). The pain started the day after vaccination on 14-MAR-2021, and she thought it was muscle soreness. On 20-MAR-2021, her physician sent an order for ultrasound, and on 21-MAR-2021, the blood clot was confirmed (also reported as 2 blood clots), report not provided. Laboratory tests included Platelet count (NR: not provided) 316,000 (units not provided), White blood cell count (NR: not provided) 9.1 (units not provided), Red blood cell count (NR: not provided) 5.19 (units not provided), Hemoglobin (NR: not provided) 14.6 (units not provided), Hematocrit (NR: not provided) 41.9 (units not provided), Alanine aminotransferase (NR: not provided) 15 (units not provided) and Aspartate aminotransferase (NR: not provided) 15 (units not provided). Antiplatelet PF4 antibodies was not performed. The patient was prescribed XARELTO (rivaroxaban) for 6 months. At the time of the report, the patient was still in pain described as throbbing with some improvement with treatment and no redness. The patient agreed to send medical records. The patient considered the blood clots to be caused by the vaccine. The action taken with COVID-19 VACCINE AD26.COV2.S was not applicable. The patient had not recovered from deep vein thrombosis of left peroneal vein. The suspected product quality complaint number 90000176260 was evaluated and voided; based on the PQC evaluation/investigation performed, it was confirmed that no product quality complaint was identified within the report. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0: The case concerns a 24-year-old overweight female patient (BMI 26.6 kg/m2) who developed deep vein thrombosis of left peroneal vein 7 days after Janssen COVID-19 vaccine was administered intramuscularly for the prevention of symptomatic SARS-CoV-2 virus infection. The subject does not report any significant medical history or prior history of blood clots. She is a teacher, does not smoke and is active. Her family history is significant for clotting disorder in maternal family, but her mother does not have it. She does not take any medication or birth control. Last COVID-19 test 3 months prior was negative. The pain in the left leg started on the day of vaccination and was thought to be a muscle soreness. A week later her medical doctor ordered a diagnostic ultrasound, and the blood clot was confirmed (report not provided). Platelet count was 316, 000, WBC 9.1, RBC 5.19, HGB 14.6, HCT 41.9, ALT 15, AST 15 (D-dimer, platelet PF4 antibodies not available). The patient was prescribed rivaroxaban for deep vein thrombosis for 6 months. Leg redness had resolved, she is still in pain, but has some improvement with the prescribed treatment. Given short temporal relationship (with first symptoms on the day of vaccination), subject''s risk factors of being overweight and a family history of blood clotting disorder, the event of deep vein thrombosis of left peroneal vein is considered to have an indeterminate causal association to immunization, per the WHO causality classification for adverse events following immunization (Level 3 of diagnostic certainty, per the Brighton Collaboration case definition). The company causality is considered not related to Janssen COVID-19 vaccine.


VAERS ID: 1227921 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Tennessee  
Vaccinated:0000-00-00
Onset:2021-03-01
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: Deep vein thrombosis, Dyspnoea, Headache, Pyrexia, Tremor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, venous (narrow), Parkinson-like events (broad), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ESTROGEN
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210427131

Write-up: DVT; HEADACHE; UNCONTROLLED SHAKING; TROUBLE BREATHING; FEVER; This spontaneous report received from a company representative concerned a 29-year-old female. The company representative heard the information on the local news. The patient''s height, and weight were not reported. The patient was taking estrogen-based birth control pills. 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 19-MAR-2021 for prophylactic vaccination. Concomitant medications included estradiol for birth control. On an unspecified date in MAR-2021, one-week post-vaccination, patient developed uncontrolled shaking, had trouble breathing and fever. She went to the emergency room for her symptoms and was sent home (no time frame was reported). One week later, she developed swollen legs and couldn''t walk, and she was diagnosed with a deep vein thrombosis (DVT). On an unspecified date she was hospitalized and admitted in the intensive care unit (ICU). Patient was out of the ICU on 11-APR-2021 (Sunday). Patient was still under treatment. It was also reported that patient had headache that persisted for 2 weeks. The report was from the local news and follow-up was not possible. The action taken with COVID-19 vaccine ad26.cov2.s was not applicable. The outcome of the uncontrolled shaking, trouble breathing, fever, headache and DVT was not reported. This report was serious (Hospitalization Caused / Prolonged, and Other Medically Important Condition).; Sender''s Comments: V0: This is a spontaneous report of a 29-year-old female who developed a deep vein thrombosis two weeks after receipt of the Janssen COVID-19 vaccine. She also reported uncontrolled shaking, trouble breathing, and fever one week after vaccine administration, and a headache which had persisted for two weeks. No medical history was reported; she was taking estrogen-based birth control pills. Estrogen-based birth control pills place the patient at risk for thrombosis, but there are insufficient other details to make a meaningful medical assessment regarding the events in the case.


VAERS ID: 1227925 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Kansas  
Vaccinated:0000-00-00
Onset:0000-00-00
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: Platelet count, Pulmonary embolism, Thrombocytopenia
SMQs:, Haematopoietic thrombocytopenia (narrow), Systemic lupus erythematosus (broad), Embolic and thrombotic events, venous (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: General physical health deterioration
Preexisting Conditions: Medical History/Concurrent Conditions: Cancer (Unspecified type)
Allergies:
Diagnostic Lab Data: Test Name: Platelet count; Result Unstructured Data: Thrombocytopenia (count unspecified)
CDC Split Type: USJNJFOC20210427876

Write-up: SUSPECTED PULMONARY EMBOLISM; THROMBOCYTOPENIA; This spontaneous report received from a health care professional from a state immunization program concerned a 60 year old male. The patient''s height, and weight were not reported. The patient''s past medical history included cancer, and concurrent conditions included overall poor health. The patient received COVID-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown), date of administration was not reported, for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On an unspecified date, approximately 24 hours post-vaccination, the patient was taken to the hospital after being found unresponsive. It was suspected that the patient had experienced a pulmonary embolism, resulting in his death. Laboratory results revealed thrombocytopenia. Reportedly, no heparin was used in his treatment. On an unspecified date, the subject died from suspected pulmonary embolism, and had not recovered from thrombocytopenia. An autopsy had not been performed at the time of the report, as it was pending family''s approval. The action taken with COVID-19 vaccine ad26.cov2.s was not applicable. This report was serious (Death, and Other Medically Important Condition).; Sender''s Comments: V0: This is a spontaneous report of a 60-year-old male patient, who died of a suspected pulmonary embolism approximately 24 hours after receipt of the Janssen COVID-19 vaccine. The patient had an unspecified cancer and was described as in overall poor health. He was brought to a hospital, where it was suspected that he had died due to a pulmonary embolism. He was also found to be thrombocytopenic. The patient''s cancer could provide a plausible alternative explanation for the event, although there are insufficient details to make a meaningful medical assessment at this time.; Reported Cause(s) of Death: SUSPECTED PULMONARY EMBOLISM


VAERS ID: 1227928 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-03-17
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Deep vein thrombosis, Oedema peripheral, Thrombosis
SMQs:, Cardiac failure (broad), Angioedema (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Smoker
Preexisting Conditions: Comments: The patient had no known allergies. The patient did not have any drug abuse/illicit drug use.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210429398

Write-up: POTENTIAL DEEP VEIN THROMBOSIS; SMALL BLOOD CLOT; ANKLE CALF BOTH SWOLLEN; This spontaneous self-report was received from a patient and concerned a 64 year old female. The patient''s height and weight were not reported. The patient''s concurrent conditions included no known allergies and smoker. Other relevant history included no alcohol intake, nor any drug abuse/illicit drug use. The patient received COVID-19 VACCINE AD26.COV2.S (suspension for injection, route of administration and dose not reported, batch number: 1805029, and expiry: unknown) administered on 14-MAR-2021 on the left arm for prophylactic vaccination. No concomitant medications were reported. On 17-MAR-2021, the patient had "ankle calf both swollen" indicating potential deep vein thrombosis. She went to hospital emergency room, and "HCP confirmed small clot". The action taken with COVID-19 VACCINE AD26.COV2.S was not applicable. The patient was recovering from "ankle calf both swollen" and had not recovered from potential deep vein thrombosis and small blood clot. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0: This is a spontaneous report of a 64 year old female who developed a swollen calf and ankle swelling indicating a potential deep vein thrombosis 3 days after receipt of Janssen COVID 19 vaccine. Patient was seen in the emergency room by HCP, who confirmed a small clot. No other medical history was reported but patient was noted to be a smoker, reported as 2x a year. Age increases the risk of deep vein thrombosis, but the there is insufficient other details to make a meaningful medical assessment.


VAERS ID: 1227932 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: New Jersey  
Vaccinated:0000-00-00
Onset:2021-03-01
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Deep vein thrombosis, Pain, Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Non-smoker
Preexisting Conditions: Medical History/Concurrent Conditions: Cancer; Comments: The patient was not pregnant at the time of reporting. The patient had no known allergies and drug abuse/illicit drug usage.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210430202

Write-up: BILATERAL DEEP VEIN THROMBOSIS TO LOWER EXTREMITIES; PULMONARY EMBOLISM IN BOTH LUNGS; BODY ACHE; CHILLS; This spontaneous report received from a consumer concerned a 54 year old female. The patient''s weight was 190 pounds, and height was 66 inches. The patient''s past medical history included cancer, and concurrent conditions included no alcohol use, and non-smoker, and other pre-existing medical conditions included the patient was not pregnant at the time of reporting. The patient had no known allergies and drug abuse/illicit drug usage. The patient received JANSSEN COVID-19 VACCINE (covid-19 vaccine ad26.cov2.s) (suspension for injection, route of admin intramuscular, batch number: 1805031, and expiry:not reported) dose was not reported, 1 total, administered in left arm on 05-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 03-MAR-2021, the patient experienced chills. On 06-MAR-2021, the patient experienced body ache. Since 09-APR-2021, patient started experiencing leg pain and was admitted to a hospital on 10-APR-2021. The patient was diagnosed with 2 deep vein thrombosis (DVTs) to the lower extremities with pulmonary embolism. The patient was on therapeutic Lovonox (enoxaparin sodium) and was prescribed Lovonox injection twice a day for 6 months. The patient had visited emergency room and hospitalized for 5 days. The patient was discharged from hospital on 13-APR-2021. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from body ache, and chills on 10-MAR-2021, and was recovering from bilateral deep vein thrombosis to lower extremities, and pulmonary embolism in both lungs. This report was serious (Hospitalization Caused / Prolonged).; Sender''s Comments: V0: This 54-year-old obese female with BMI of 30.7 was hospitalized due to bilateral deep vein thrombosis (DVT) to lower extremities and pulmonary embolism (PE) in both lungs 35 days after receiving JANSSEN COVID-19 VACCINE (covid-19 vaccine ad26.cov2.s) in left arm for prophylactic vaccination. The patient''s past medical history included cancer. The subject had chills 2 days prior to the vaccination and body ache 1 day post vaccination. The symptoms resolved 5 days post vaccination. She started experiencing bilateral leg pain 33 days post vaccination and chest pain 34 days post vaccination. The patient visited emergency room and was hospitalized. She was diagnosed with bilateral DVTs to the lower extremities and PE in both lungs. Details of the hospitalization were not reported. She was discharged after 5 days of hospitalization with prescription of enoxaparin injection twice a day for 6 months. The patient was recovering from bilateral DVT to lower extremities and PE in both lungs. Based on the available information, with risk factors of obesity and cancer, DVT and PE are assessed as indeterminate with causal association to immunization, per WHO causality classification for adverse events following immunization. Company causality is considered not related to JANSSEN COVID-19 VACCINE. Additional information has been requested for further assessment.


VAERS ID: 1227934 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Illinois  
Vaccinated:0000-00-00
Onset:2021-04-14
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: 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:
Current Illness:
Preexisting Conditions: Comments: Patient medical history is unknown.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210430394

Write-up: FEMORAL DEEP VEIN THROMBOSIS; This spontaneous report received from a physician concerned a 30-40 year old male. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions were unknown. 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 25-MAR-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 14-APR-2021, approximately 20 days after the patient received vaccination, he experienced femoral deep vein thrombosis. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from femoral deep vein thrombosis. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0: A 30-40 year-old man experienced femoral deep vein thrombosis approximately 20 days after vaccination. No past medical history or concomitant medications were reported. There were no details provided, including diagnostic workup. There is insufficient information to make a meaningful medical assessment.


VAERS ID: 1228115 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Virginia  
Vaccinated:0000-00-00
Onset:2021-03-09
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: Contusion, Injection site pain, Rotator cuff syndrome, Ultrasound scan
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Tendinopathies and ligament disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210310; Test Name: Sonogram; Result Unstructured Data: NEGATIVE
CDC Split Type: USJNJFOC20210320980

Write-up: TORN ROTATOR CUFF; VERY PAINFUL NEAR INJECTION SITE; BLACK AND BLUE AREA TO THE TIP OF THE SHOULDER; 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, intramuscular, batch number: Unknown, and batch number: 1805022 expiry: UNKNOWN) .5 ml, administered on 08-MAR-2021 to Left Arm for prophylactic vaccination. No concomitant medications were reported. On 09-MAR-2021, the subject experienced black and blue area to the tip of the shoulder. On 09-MAR-2021, the subject experienced very painful near injection site. On 10-MAR-2021, Laboratory data included: Sonogram (NR: not provided) NEGATIVE (units unspecified). On an unspecified date, the subject experienced torn rotator cuff. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from very painful near injection site, and black and blue area to the tip of the shoulder, and the outcome of torn rotator cuff was not reported. This report was non-serious.


VAERS ID: 1228189 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Puerto Rico  
Vaccinated:2021-03-31
Onset:2021-04-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Laboratory test, Peripheral venous disease, Ultrasound Doppler, Ultrasound scan
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Syntroid Atenolol
Current Illness: No
Preexisting Conditions: Cancer
Allergies: Penicillin
Diagnostic Lab Data: Labs, doppler, sonogram Where medical condition is evidenced
CDC Split Type:

Write-up: This vaccine altered me, nor did I know, that I had a venous insufficiency condition. It attacked the affected areas.


VAERS ID: 1228193 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / N/A LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Chest X-ray, Chest discomfort, Chest pain, Dizziness, Dyspnoea, Full blood count, Hot flush, Metabolic function test, Pharyngeal swelling, Rash, Troponin
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Ritalin, Magnesium, Vitamin C, Mirena, Tramadol, Medical Marijuana
Current Illness: NO
Preexisting Conditions: Mitchell''s Disease, Chronic generalized pain
Allergies: Acetaminophen, Oxycodone, Desoxycortisone, Ibuprofen, PRegablin
Diagnostic Lab Data: pt had CMP, CBC, troponin levels, chest xray on 4/12/21 per ER reports. Not able to get more information at this time.
CDC Split Type:

Write-up: per patients mother: pt had complained of dizzyness right after leaving clininc. Mother was driving, she said that about 5 minutes later pt started getting hot flashes and had developed a rash across chest, decided to drive to hospital on the way there she progressively got worse she started to complaine of chest tightness/pain. once at ER she double over from severe stomach pain-said it felt like she had to go to the bathroom. Mom said that things quickly worsened. She started to have throat swelling. Epinepherine was administered and IV benedryl, pt stayed in ER and was observed for several hours. Mom reports they were sent home around 4pm and around 7320pm that night pt started feeling tightness in her chest and difficulty breathing mom gave epinephirine and called 911. EMT''s transported her back to ER. She was stablized and sent home. pt continued to have these episodes of Chest tightening and difficulty breathing resulting in several more visits to the ER and one over night stay. Last visit to the Hopsital was on 4/15/21


VAERS ID: 1228200 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Guam  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Blood test normal, Dizziness, Full blood count normal, Headache, Metabolic function test, Nausea, Urine analysis normal
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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None reported
Current Illness: None reported
Preexisting Conditions: none reported
Allergies: NKDA
Diagnostic Lab Data: Normal blood work (CBC, BMP, UA).
CDC Split Type:

Write-up: This patient presented with my ER on 16APR21 with headache, lightheadedness, nausea, every day since vaccination which was on the 9th of April. This may be a duplicate, but I was advised to place the report regardless as the symptoms are persisting. The patients symptoms nearly resolved after Tylenol and IV fluids.


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: 1228274 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-31
Onset:2021-04-08
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood glucose normal, Blood pressure increased, Chest X-ray normal, Computerised tomogram head normal, Computerised tomogram neck, Confusional state, Dysarthria, Facial paralysis, International normalised ratio, Leukocytosis, Metabolic function test normal, Prothrombin time, White blood cell count increased
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypertension (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hearing impairment (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: 86-year-old spanish speaking female brought into the ED with concerns of slurred speech and confusion that was noted at 3 PM on 4/8. Patient''s last known well was at 10 AM on 4/8. GCS on arrival 15. NIH SS 2 recorded at 18: 12 (for mild right-sided facial droop and mild dysarthria). In the EMS blood glucose was 122, no meds were given. Patient is not on any anticoagulation. Patient''s blood pressure was elevated at 233/78. Patient denying any headaches, nausea, vomiting. Per the family no focal neurologic deficits noted except for dysarthria which was improved during the ED visit. Neurology contacted in the ED for stroke code. Patient outside of TPA window. CT head was negative. CT head negative for acute intracranial infarction. Chest x-ray negative for any acute cardiopulmonary findings. Patient was started on nicardipine drip in the ED with the blood pressure reduced to 145/70, then turned off. CBC showed mild leukocytosis (14.8) likely reactive. CMP unremarkable. PT/INR was also obtained. After discussion with neurology given the CT head and CTA head and neck, CTP negative are reassuring for low concern of stroke. ASA 325 once was given. However neurology does recommend an admission for further evaluation with an MRI for notably rule out stroke. After discussion with family and the physicians the patient refused admission. Upon reexamination no further worsening of her initial symptoms, blood pressure controlled. Patient was discharged in a stable condition. She was discharged AMA. Patient was thoroughly explained the risks and benefits of leaving AMA. Patient said she understood and was advised to come back if the symptoms worsen. Patient was discharged with aspirin, Plavix and atorvastatin. Recommended to follow-up with the PCP tomorrow soon as possible. Also advised to return to the ED if any of the symptoms return.


VAERS ID: 1228285 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-04-02
Onset:2021-04-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Blood test normal, Chest pain, Computerised tomogram normal, Electrocardiogram normal, Fatigue, Headache, Heart rate increased, Malaise, Myalgia, Oesophagitis, Pain, Pain in extremity, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific inflammation (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Flonase, Xyzal, Vitamin D-3 & MK-7, Womens Multivitamin
Current Illness: None
Preexisting Conditions: None
Allergies: Codine , Hydrocodone
Diagnostic Lab Data: April 13th EKG- Normal April 13th Blood Work-Normal April 13th CT with contrast-Normal
CDC Split Type:

Write-up: I was given the vaccine at 11:10am and by 5:30pm I was beginning to feel tired and unwell. At 6:45 I had a fever, body aches, pain in my arm, headache, and chest pain. These symptoms continued for three days and my fever reached 102.7. After three days the fever and body aches subsided but the fatigue and chest pain continued. The chest pain has continued with increased heart rate during small bursts of activity. I called the clinic that administered my shot on April 9th and was told chest pain was normal up to 10 days and if it continued to be a problem to go to the ER. After 11 days of chest pain I went to the ER on April 13th and they did an EKG, CT with contrast, and blood work. They concluded I was fine. I was told it could be esophagitis so to take 2 15mg Prevacid a day which I have done with no relief. I was also informed it could be muscle related so I have iced, taken anti-inflammatory medication, and have not exerted myself. It is now April 19th and I am still experiencing chest pain and racing heart rate with minimal exertion.


VAERS ID: 1228439 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-03-08
Onset:2021-03-12
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Computerised tomogram head, Fatigue, Headache, Oropharyngeal pain
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (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: Testosterone injections, Clonazepam,
Current Illness: none
Preexisting Conditions: Weight loss, low testosterone
Allergies: Penicillin, NSAID Medications
Diagnostic Lab Data: CAT Scan of brain, 3/31/2021
CDC Split Type:

Write-up: Extreme headaches , sore throat, overall feeling of tiredness


VAERS ID: 1228476 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-03-30
Onset:2021-04-16
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A 6/21/21 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram, Head discomfort, Headache, Pain, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Buproprion; levathyroxine, co q 10, potassium, vitamin e,
Current Illness: None
Preexisting Conditions: Thyroid and depression (both have been managed well for several years)
Allergies: Levaquin, penicillin
Diagnostic Lab Data: April 18th Catscan without contrast.
CDC Split Type:

Write-up: Severe sudden headache Friday evening, continues today... its been over 50 hours of nonstop pain. Took advil, tylenol, tylenol cold, day quil, night quil, benadryl, nothing is working totaled the headache away. The drs office gave me an injection of toradol. It took the edge off for about 30 minutes. Did not kill the pain. My temples feel very tight and veins are protruding from my temples


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: 1228553 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-05
Onset:2021-04-18
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Fibrin D dimer increased, Mental status changes, Pain, Platelet count decreased, Portal vein thrombosis, Retching, Thrombocytopenia, Venous occlusion, Venous thrombosis limb
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage laboratory terms (broad), Systemic lupus erythematosus (broad), Dementia (broad), Embolic and thrombotic events, venous (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: CITALOPRAM, METOPROLOL TARTRATE
Current Illness:
Preexisting Conditions: HYPERTENSION
Allergies: PENICILLIN
Diagnostic Lab Data: Platelets: 4/15 12:31 92 4/16 07:00 36 4/16 15:00 32 4/17 08:52 23 4/18 07:48 19 4/19 05:20 28
CDC Split Type:

Write-up: The patient presented to the emergency department with altered mental status, dry heaving, and body aches. She was found to have a partially occluding thrombus of the right cephalic vein consistent with venous thrombosis, as well as findings of thrombosis in the anterior segment branch of the right portal vein. She had a d-dimer of 25.77 increased to 35.2, and was thrombocytopenic with a platelet count of 92, which dropped to 36 the following morning. Platelets to present were: 92-36-32-23-19-28. The patient received the Johnson & Johnson COVID-19 vaccination two weeks prior to presentation.


VAERS ID: 1228668 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-17
Onset:2021-04-01
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test abnormal, Embolic stroke, Headache, Scan brain, Thrombosis, Urinary incontinence, Vomiting
SMQs:, Acute pancreatitis (broad), Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations: Janssen
Other Medications: No
Current Illness: No
Preexisting Conditions: No
Allergies: Yodo
Diagnostic Lab Data: Hospital did everything even scans of my head and nothing. The only thing they told me was blood clots and also loww Blood count. !! Never ever in my life had that!
CDC Split Type:

Write-up: My symptoms i had sever headache! Once April 1st Hit! Thats Was the day I Had a Heart stroke at store, i don?t remember anything and once i woke up i was at the hospital, and they told me that i had a heart stroke because i had lots of blood clots in my body. And they told me i vomit and peed myself durong the whole situation i went in store


VAERS ID: 1228680 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-03-14
Onset:2021-04-15
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Skin discolouration
SMQs:, Hypotonic-hyporesponsive episode (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: Purple spots on left leg


VAERS ID: 1228716 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-09
Onset:2021-04-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / UNK - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Burning sensation
SMQs:, Peripheral neuropathy (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: THE DAY AFTER VACCINATION, PATIENT HAD BURING SENSATION AND PAIN IN BILATERAL LOWER EXTREMITIES. REFERRED TO ER. ULTASOUND SHOWED NO EVIDENCE OF CLOTS


VAERS ID: 1228773 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-03-25
Onset:2021-03-27
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Erythema, Pain in extremity, Peripheral swelling, Ultrasound scan
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ASA 81MG DAILY (NOT TAKING AT TIME OF INCIDENT), 4000 UNITS CHOLECALFIEROL DAILY, 500MCG CYANOCOBALAMIN DAILY
Current Illness: N/A
Preexisting Conditions: AFIB, HTN, HX OF PE, GLAUCOMA
Allergies: PORK, BEEF, LAMB
Diagnostic Lab Data: u/s 4/8/2021 - awaiting records
CDC Split Type:

Write-up: Patient received the 1 dose J&J vaccine on 3/25/2021. Patient reports on 3/27/2021 swelling and pain and redness in LLE. Of note, patient has a hx of PE (1995) and afib, and is not on a blood thinner per cardiologist. Patient presented to ED on 4/8/2021 and u/s r/u DVT. Patient contacted physician''s office on 4/19/2021 with continuation of symptoms. Unsure if this is truly an ADE as patient reports the pain/swelling/redness occurred during a walk.


VAERS ID: 1228845 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-08
Onset:2021-04-18
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chest X-ray, Computerised tomogram, Dyspnoea, Electrocardiogram, Pulmonary pain, Urine analysis
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol, Synthroid, Cymbalta, Caltrate calcium, B6, B12, Probiotic, Apple Cider vinegar gummies, zinc, elderberry, Glucosamine/Chondroitin
Current Illness: none
Preexisting Conditions: Mild Copd. Arthritis
Allergies: Penicillian
Diagnostic Lab Data: ekg, chest xray, CT scan, bloodwork and urine tests
CDC Split Type:

Write-up: pain in lower left lung under breast. hurt to breathe, prescribed steroids and pain patch. was told no sign of clot, possible pleurisy.


VAERS ID: 1228852 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-18
Onset:2021-03-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Asthenia, Injection site pain, Mobility decreased, Neck pain, Neuropathy peripheral, Pain, Pain in extremity
SMQs:, Peripheral neuropathy (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Severe R shoulder/arm pain since injection. Upon receiveing the injection I experienced severe pain in my R shoulder joint, but the nurse told me that was normal. Over the following hours/days/weeks the pain began to radiate up my neck, down my arm and into my scapula and lat areas. My range of motion (ROM) had become severely limited and I began to experience neuropathies in my right arm and hand. I tried all OTC pain relievers which had absolutely no effect. On April 6th, I was in so much pain that I went to an urgent care clinic. They provided me with prednisone, soma and celebrex (upon completion of steroid). In addition, I started myself on gabapentin which was provided in the past. I have one more day of celebrex remaining. While my symptoms are not nearly as bad as they were, they have not resolved. I continue to have pain in/around my R shoulder, neuropathy in my R arm and limited ROM/weakness cross-body and above 90 degrees.


VAERS ID: 1228855 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-05
Onset:2021-03-19
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: ADAMTS13 activity normal, Angiogram pulmonary abnormal, Anticoagulant therapy, Antiphospholipid antibodies negative, Blood fibrinogen decreased, Computerised tomogram abdomen, Computerised tomogram head normal, Echocardiogram, Flow cytometry, Full blood count, Haemoglobin decreased, Headache, Immunoglobulin therapy, International normalised ratio increased, Laboratory test normal, Lymphocyte percentage increased, Magnetic resonance imaging head normal, Mean cell volume normal, Neutrophil percentage decreased, Packed red blood cell transfusion, Platelet count decreased, Platelet transfusion, Post procedural haemorrhage, Prothrombin time prolonged, Pulmonary artery dilatation, Pulmonary embolism, Pulmonary hypertension, Pulmonary infarction, Right ventricular dilatation, Scan with contrast normal, Thrombectomy, White blood cell count normal
SMQs:, Cardiac failure (broad), Liver-related coagulation and bleeding disturbances (narrow), Agranulocytosis (broad), Haematopoietic erythropenia (broad), Haematopoietic leukopenia (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Systemic lupus erythematosus (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Pulmonary hypertension (narrow), Cardiomyopathy (broad), Myelodysplastic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: 28 y/o female with h/o obesity (120kg), anxiety and depression, received the J&J vaccine on 3/5/2021 (Lot 1805020). Home meds included only citalopram and an OCP which she had stopped on 3/10. On 3/15 she developed a predominantly R sided headache 9/10 pain, described as the worst of her life that didn''t remit with over the counter analgesics and eventually became global in distribution, lasting 4 days. She was seen for this in urgent care on 3/19, given a shot of Toradol and then transferred to the emergency department where CBC showed platelets of 33, WBC 9.1 53% PMNs, 43% lymphs, Hgb 14.1, MCV 87, PT 15.7 INR 1.2. Chemistries were all normal. CT brain was unremarkable.


VAERS ID: 1228872 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: New York  
Vaccinated:2021-03-18
Onset:2021-03-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure normal, Chills, Computerised tomogram normal, Dizziness, Electrocardiogram normal, Feeling abnormal, Head injury, Heart rate normal, Impaired work ability, Influenza like illness, Sleep disorder, Syncope, Tremor, Vomiting projectile
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Parkinson-like events (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No prescriptions. No dietary supplements. No herbal remedies.
Current Illness: None
Preexisting Conditions: None
Allergies: Allergic to certain nuts, including macadamia, pistachio, and cashews.
Diagnostic Lab Data: My EKG, cat scan, blood pressure, heart rate, and pulse were all normal and consistent with my prior EKGs and naturally low blood sugar and pulse.
CDC Split Type:

Write-up: I received the J&J vaccine at 10:00am on March 18, 2021 at the Community Center. By about 5:00pm, I started to feel minor flu-like symptoms, but as the night progressed it got significantly worse. Around 8-9pm, I was bedridden with the worst chills/shaking I''ve ever experienced in my life. Around 9:30-10:00pm, I was filling water at my sink and projectile vomitted multiple times into the sink and could not make it to the bathroom. Subsequently, I ate a bagel and drank lots of water, knowing my vomitting could make me dehydrated. Throughout the night, I was awake and shaking, and drank and filled my water bottle repeatedly. At 8:00am, I was filling my water, and without my knowledge of awareness, fainted on my kitchen floor, dropping the Brita filter and likely hitting my head. My roommate heard the commotion and saw me passed out in our kitchen. He tried to wake me up and I phased in, but then subsequently phased out again 20-30 seconds later as I was trying to stand and likely hit my head again. My roommate eventually got me over to our couch and called EMTs. Upon their arrival, EMTs checked my pulse, which was fine, and saw an open laceration on the back of my head, so they took me to Hospital to access the Trauma Center. On the way, I threw up repeatedly and was very lightheaded. Upon my arrival at Hospital, I was checked for any neck bone breaks, given an IV, a CT scan, an EKG, and staples were placed in the back of my head to heal the laceration. After my release, I was bedridden for 2-3 days and required a daily nap during work (1-2) hours for the next 1 1/2 to 2 weeks. For a while, everything was fine, but recently during the first two weeks of April, it has become apparent that my head is foggy and reacts to changes in the weather, which leads me to believe that I likely banged my head pretty good when I fainted those two times.


VAERS ID: 1228882 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: per patient: see last box (additional items) Prescriptions taken at time of vaccine as per patient: 1) pantoprazole 40mg 2) fluoxetine 10mg 3) atorvastatin 20mg 4) aspirin 81mg 5) mometasone nasal spray 6) fluoxetine 10mg 7) mvi 8) calcium
Current Illness: endoscopy 3/31/21 which she reported"fungus growing in throat"
Preexisting Conditions: chronic cough, acid reflux
Allergies: Scallops
Diagnostic Lab Data: need to obtain from patient.
CDC Split Type:

Write-up: This is a spouse. Medical Center do not have this patient''s medical record and is reporting the reaction on her behalf based on available information. Patient reported she was having brunch 4/11/21 am and started feeling very dizzy (was dining outside) and her son informed her that she was very pale. Her stomach started to rumble and threw up. Son called the ambulance due to "low pulse" and "loss of consciousness". She was treated at ER with iv fluids and anti-nausea medicine and was discharged that day (4/11/21) around 1pm with diagnosis of "Vagal Response". She recalled being in the ambulance around 4/11@11:10am.


VAERS ID: 1228894 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-03-16
Onset:2021-04-18
   Days after vaccination:33
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Haematoma, Pain in extremity, Pain of skin, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Dicyclomine, MVI (prn-Hydroxyzine, Ibuprofen, Acetaminophen)
Current Illness:
Preexisting Conditions: IBS, anxiety, Laparoscopic sleeve gastrectomy 05/31/2019 fistula repair of gastric sleeve anastomosis
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Pt is a 24 year old male with hx of IBS and anxiety with reported swelling and pain to the left shin that just popped up prior to presenting to ER. Complained of pain on Lt shin that started while he was standing at the sink. Started stinging, looked down at shin, he stated it started swelling and stinging. Does not remember any injury, but is unsure. DX - Hematoma to the left lower extremity. BP 155/72 Temp-98.0 HR 77 R- 18


VAERS ID: 1228897 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-03-11
Onset:2021-03-16
   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 / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Clopidogrel 75 mg., Doxepin 25 mg., Furosemide 40 mg., Gabapentin 300mg., lisinopril 20/12.5mg., morphine 30mg. Oxycodone 30mg., Pantoprazole 40mg., Pravastatin 40 mg., Ranolazine 1000mg., Tizanidine 4mg., Toprol XL25mg.
Current Illness:
Preexisting Conditions: High blood pressure
Allergies: Flexeril
Diagnostic Lab Data:
CDC Split Type:

Write-up: None stated.


VAERS ID: 1228898 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-12
Onset:2021-04-22
   Days after vaccination:10
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: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Asthenia, Blood test abnormal, Dehydration, Diarrhoea, Dyspnoea, Gait inability, Lymphocyte count increased, Red blood cell count increased
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Fentanyl patch, Tylenol #3, Lisinopril, Seroquel, Amitripylline, Furosemide, Humalog Mix 75/25, Cyclobenzaprine, Pravastatin,
Current Illness: None
Preexisting Conditions: Diabetes, blood pressure, cholesterol, chronic pain
Allergies: NKA
Diagnostic Lab Data: Patient states that bloodwork revealed high T-cell and RBC counts.
CDC Split Type:

Write-up: On 4/14/2021 patient woke up with stomach cramps and diarrhea. states he could not walk, and had no energy from dehydration. patient states he had SOB. Patient has emergency alert system, so he pressed the button and an ambulance took him to the ER.


VAERS ID: 1228935 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-05
Onset:2021-04-19
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Angiogram cerebral abnormal, Aphasia, Asthenia, Carotid artery occlusion, Computerised tomogram head abnormal, Facial paralysis, Haematocrit normal, Haemoglobin normal, Hemiparesis, Infarction, Platelet count normal, White blood cell count increased
SMQs:, Neuroleptic malignant syndrome (broad), Myocardial infarction (broad), Ischaemic central nervous system vascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Hearing impairment (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vyvanse 50 mg daly
Current Illness: None
Preexisting Conditions: Asthma
Allergies: Aspirin (Nausea/Vomitting)
Diagnostic Lab Data: WBC 12.4, Hgb 14.3, HCT 43, Plt 271
CDC Split Type:

Write-up: Presented to emergency department for evaluation of weakness and aphasia. The patient has her eyes open on arrival. She does follow commands with mild weakness to the right upper and lower extremities. Mild right facial droop is noted on physical exam. The patient does not speak otherwise. Initial CT concerning for ischemic stroke. CTA with perfusion was then obtained that shows evidence of a small area of core infarct with a large area of penumbra. Carotid occlusion from the bifurcation LP is noted on the left side with collateral circulation coming from the Act. Patient transfered from this emergency department to tertiary care center for possible thrombectomy.


VAERS ID: 1228936 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-03-18
Onset:2021-04-15
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 180525 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory failure, Anticoagulant therapy, Chest pain, Coagulation test, Computerised tomogram abdomen, Computerised tomogram thorax, Deep vein thrombosis, Dyspnoea, Echocardiogram, Full blood count, Metabolic function test, Pulmonary embolism, Pulmonary infarction, Ultrasound Doppler
SMQs:, Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Respiratory failure (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Aspirin, losartan?hydrochlorothiazide, mesalamine, multivitamin, niacin, pravastatin, vitamin E
Current Illness: None
Preexisting Conditions: Hypertension, ulcerative colitis well-controlled
Allergies: No known allergies
Diagnostic Lab Data: CT angiogram of chest/abdomen/pelvis 4/17/2021 Bilateral lower extremity venous Doppler ultrasound 4/17/2021 Echocardiogram 4/18/2021 Daily CBC, metabolic panel, coagulation panel 4/17?4/20/2021
CDC Split Type:

Write-up: Patient developed chest pain and shortness of breath 4/15 Presented to hospital emergency department 4/17 found to have a pulmonary embolism without heart strain, however with pulmonary infarction of left lower lobe with associated right lower extremity DVT Patient admitted to the hospital, initiated on therapeutic anticoagulation with Lovenox, started on oxygen therapy for acute hypoxic respiratory failure Discharged home 4/20 on therapeutic anticoagulation with Xarelto and home oxygen as needed


VAERS ID: 1228937 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-12
Onset:2021-04-15
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Herpes zoster, Laboratory test, Pain in extremity, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: acetaminophen, amlodipine, aspirin, atorvastatin, famotidine, HCTZ, losartan, doclofenac
Current Illness:
Preexisting Conditions: HTN, CAD, hyperlipidemia
Allergies:
Diagnostic Lab Data: Labs, and Valtrex therapy initiated
CDC Split Type:

Write-up: Patient recived Janssen COVID vaccine at alternate site, came to ED with complaints of pain and rash starting in same arm and spreading. Diagnosed with Shingles


VAERS ID: 1229014 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-04-01
Onset:2021-04-18
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Brain scan abnormal, Magnetic resonance imaging head abnormal, Scan, Transient ischaemic attack
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Malignancy related therapeutic and diagnostic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Metformin/ blood pressure medications
Current Illness: Diabetic
Preexisting Conditions: Diabetic/ high blood pressure
Allergies: None
Diagnostic Lab Data: Scan and mri
CDC Split Type:

Write-up: 6 days after vaccination, patient had mini stroke and hospitalized


VAERS ID: 1229025 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / UNK UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Dyspnoea, Full blood count normal, Headache, Hyperaesthesia, Muscle spasms, Myalgia, Neutrophil count decreased, Pain in extremity, Platelet count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Agranulocytosis (broad), Haematopoietic leukopenia (narrow), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: CBC: Platelet count 434 (140-400 normal), absolute neutrophils 0 (normal 15-500) otherwise normal
CDC Split Type:

Write-up: Posterior headache, shooting leg pain, short of air, myalgias, muscle spasms, sensativity to touch, decreased energy


VAERS ID: 1229029 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-08
Onset:2021-04-17
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram head, Full blood count, International normalised ratio, Metabolic function test, Pain in extremity, Prothrombin time, Rash, Ultrasound Doppler
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Xanax, Xopenex, Simvastatin
Current Illness:
Preexisting Conditions: Anxiety/Depression, Asthma, Hyperlipidemia
Allergies: Avelox, PCN
Diagnostic Lab Data: CT Brain & Venous Doppler of LE both done 4/17/21 CBC, CMP, & PT/INR all done on 4/16/21
CDC Split Type:

Write-up: Leg pain/rash, hand pain/rash Pt treated with Morphine in ER Seen in dr office today & treated with Prednisone for continued symptoms


VAERS ID: 1229055 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-10
Onset:2021-03-29
   Days after vaccination:19
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: Adverse reaction, Exposure during pregnancy, Foetal heart rate abnormal, Pregnancy test positive, Rash, Ultrasound scan vagina, Ultrasound uterus, Vaginal haemorrhage
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Foetal disorders (narrow), Normal pregnancy conditions and outcomes (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: I found out about my pregnancy the day I got the vaccine (which was after I got the vaccine). After that I proceeded to get a pregnancy test confirmation (march 26) and it came back positive from the doctors office. On March 28 I began to have bleeding and I passed a blood clot the size of a baseball. I called the nurse line that next day and they told me they could not give me any medical advice because I had not been seen by a doctor for this pregnancy. During that week I began to experience a rash that began in the middle of my chest and proceeded to spread All over my stomach and back. It is now April 19 in the rash has continue to spread all over my limbs. On April 5 I went to the pregnancy clinic and was also getting a ultrasound and they were unable to locate the embryo in the uterus. On April 15 I got an ultrasound transvaginal and they were unable to locate an embryo or in a heartbeat. I then went to the hospital the next day on April 16 the hospital that I received my vaccine at and they did not give me any care and told me that my rash was a possible contact to something I may have come in contact recently. I try to express to the doctor that I?ve been experiencing issues since I received the vaccine and he did not connect any of the dots to my experiences. As of today April 19 I have come across several Different websites that state that red spot is a part of the symptoms an adverse reaction to the vaccine or should be of concern.


VAERS ID: 1229057 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-02
Onset:2021-04-17
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, COVID-19 pneumonia, Chest discomfort, Cough, Dyspnoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: None on file
Preexisting Conditions: None on file
Allergies: No known allergies
Diagnostic Lab Data: 4/17/2021 - Positive for SARS-CoV-2 via PCR NP swab
CDC Split Type:

Write-up: Pt received her 1st and only needed dose of the Janssen COVID-19 vaccine on 4/2/2021. After the 2 weeks needed to be considered fully vaccinated, She presented to the ED with cough, SOB, and chest discomfort on 4/17 and was diagnosed with COVID pneumonia. She was treated but not admitted.


VAERS ID: 1229080 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-03-08
Onset:2021-03-19
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 AR / IM

Administered by: Public       Purchased by: ?
Symptoms: Activated partial thromboplastin time shortened, Angiogram cerebral normal, Angiogram pulmonary normal, Anion gap, Antibody test, Antiphospholipid antibodies, Antithrombin III decreased, Arteriogram carotid normal, Basophil count decreased, Basophil count normal, Beta 2 microglobulin normal, Bilirubin urine, Blood calcium decreased, Blood chloride increased, Blood cholesterol normal, Blood creatinine normal, Blood culture, Blood glucose increased, Blood potassium normal, Blood sodium normal, Blood triglycerides, Blood urea decreased, Blood urea nitrogen/creatinine ratio, Carbon dioxide decreased, Cardiac telemetry normal, Cardiolipin antibody, Cardiolipin antibody negative, Computerised tomogram head normal, Computerised tomogram kidney abnormal, Computerised tomogram neck, Computerised tomogram thorax normal, Creatinine renal clearance normal, Echocardiogram normal, Eosinophil count decreased, Factor V Leiden mutation, Flank pain, Glomerular filtration rate normal, Glucose urine absent, Haematocrit decreased, Haemoglobin decreased, High density lipoprotein normal, International normalised ratio normal, Low density lipoprotein normal, Lymphocyte count decreased, Mean cell haemoglobin concentration normal, Mean cell haemoglobin normal, Mean cell volume normal, Monocyte count, Monocyte count normal, Neutrophil count, Neutrophil count normal, Nitrite urine absent, Non-high-density lipoprotein cholesterol, Platelet count decreased, Protein C, Protein S decreased, Protein urine absent, Prothrombin time normal, Prothrombin time prolonged, Red blood cell count decreased, Red blood cells urine negative, Red cell distribution width normal, Renal infarct, Russell's viper venom time abnormal, Specific gravity urine normal, Urinary sediment present, Urine ketone body absent, Urine leukocyte esterase, Urobilinogen urine decreased, White blood cell count normal, White blood cells urine negative, pH urine normal
SMQs:, Rhabdomyolysis/myopathy (broad), Liver related investigations, signs and symptoms (broad), Liver-related coagulation and bleeding disturbances (narrow), Haematopoietic erythropenia (narrow), Haematopoietic leukopenia (narrow), Haematopoietic thrombocytopenia (narrow), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Systemic lupus erythematosus (broad), Retroperitoneal fibrosis (broad), Congenital, familial and genetic disorders (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Biliary system related investigations, signs and symptoms (broad), Renovascular disorders (narrow), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Tubulointerstitial diseases (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vitamin B-12 500 mcg tablet ibuprofen 200 mg capsule take 3 capsule by oral route every 8 hours as needed cyclobenzaprine 5 mg tablet take 1 tablet by oral route every day at bedtime Calcium 500 + D 500 mg (1,250 mg)-200 unit tablet
Current Illness: Ovarian Cyst
Preexisting Conditions: Urinary Calculi
Allergies: NKA
Diagnostic Lab Data: ANTITHROMBIN III ACTIVITY 75 FACTOR 5 LEIDEN R506Q MUTATION Negative PROTEIN C ACTIVITY 109 DRVVT SCREEN 1.08 INR 1.1 LUPUS ANTICOAGULANT TECH INTER See Result PROTHROMBIN TIME, PT 12.0 PTT(LAC) SCREEN 23 PROTEIN S ACTIVITY 59 BETA 2 MICROGLOBULIN 1.40 CARDIOLIPIN AB IGA <9.4 EPITHELIAL CELL 21-30 RBC-URINE 3-5 URINE APP-CHARACTER Clear URINE BILIRUBIN Negative URINE BLOOD Small URINE COLOR Yellow URINE GLUCOSE Negative URINE KETONES Negative URINE LEUKOCYTES Negative URINE NITRITE Negative URINE PH 6.0 URINE PROTEIN Negative URINE SPECIFIC GRAVITY 1.025 URINE WBC 1 UROBILINOGEN Negative Elements 3/19/21 EPITHELIAL CELL 21-30 RBC-URINE 3-5 URINE APP-CHARACTER Clear URINE BILIRUBIN Negative URINE BLOOD Small URINE COLOR Yellow URINE GLUCOSE Negative URINE KETONES Negative URINE LEUKOCYTES Negative URINE NITRITE Negative URINE PH 6.0 URINE PROTEIN Negative URINE SPECIFIC GRAVITY 1.025 URINE WBC 1 UROBILINOGEN ABSOLUTE BASOPHILS 0.0 ABSOLUTE EOSINOPHIL CNT 0.0 ABSOLUTE LYMPHOCYTE COUNT 0.7 ABSOLUTE MONOCYTES 0.5 ABSOLUTE NEUTROPHIL COUNT 5.6 BASOPHIL 0.5 EOSINOPHIL 0.0 HEMATOCRIT 34.0 HEMOGLOBIN 11.6 LYMPHOCYTE 10.4 MEAN CELL HEMOGLOBIN 29.7 MEAN CELL HGB CONC. 34.2 MEAN CELL VOLUME 86.7 MONOCYTE 7.3 NEUTROPHIL 81.8 PLATELETS 143 RBC DISTRIBUTION WIDTH 12.5 RED BLOOD CELL 3.93 PT 14.8 PT(INR) 1.2 WHITE CELL CNT 6.8 ANION GAP 4 BLOOD UREA NITROGEN 6.0 BUN/CREATININE RATIO 10 CALCIUM 7.6 CHLORIDE 112 ESTIMATED CREATININE CLEARANCE 93.5 GFR ESTIMATED More Than 60 GLUCOSE 116 POTASSIUM 3.7 SERUM CREATININE 0.60 SODIUM 138 TOTAL CARBON DIOXIDE 22 PTT THROMBOPLASTIN TIME 25 HDL CHOLESTEROL 58 LDL CHOLESTEROL DIRECT 103 LIPID CUTPOINTS Recommendations NON HDL CHOLESTEROL 107 TOTAL CHOLESTEROL 165 TRIGLYCERIDES CRP INFLAMMATION Less Than 4.0
CDC Split Type:

Write-up: Patient is a 41 yo woman with no PMH who presented to an outside urgent care with left flank pain found to have a wedgelike defect in the posterior left lower renal pole suggestive of a renal infarct. She underwent CTA which did not show any embolism, thrombus, dissection. The radiologist did note mild beading of the bilateral renal arteries, however the radiologist at Valley View reviewed the images as well and was not as convinced. Left renal infarct: Given suggestion of mild feeding of the bilateral renal arteries, patient underwent CTA of the chest, head and neck which did not show any other signs of fibromuscular dysplasia. Echocardiogram did not have any thrombus or decrease in function. Patient did not have any arrhythmias on telemetry. Blood cultures were ordered and pending on discharge, but patient did not have any of endocarditis A hypercoagulable work-up including factor V Leiden, protein C, protein S, Antithrombin, lupus anticoagulant, beta-2 microglobulin, anticardiolipin antibodies were all sent and are pending at the time of discharge Discussed the case with hematology at hospital: Most experts treat with 3 months of anticoagulation other evidence is not entirely clear and aspirin 81 mg may be a reasonable choice. In light of the patient''s lack of insurance, decision was made to treat with 1 month of apixaban followed by 81 mg of aspirin daily indefinitely Discharged with a short course of oxycodone 5 mg #15


VAERS ID: 1229147 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-02
Onset:2021-04-05
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dysgeusia, Neurological examination, Vertigo
SMQs:, Taste and smell disorders (narrow), Vestibular disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Omeprazole
Current Illness:
Preexisting Conditions: Vertigo Acid Reflux
Allergies:
Diagnostic Lab Data: Neurological exam to rule out brain issues on 4/13/2021 at Urgent Care.
CDC Split Type:

Write-up: Vertigo that started a few days after the shot has gotten progressively worse over the last two weeks and is ongoing. Metallic taste in mouth for the first two days immediately after the shot.


VAERS ID: 1229158 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / N/A RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fall, Head injury, Skin laceration, Syncope, Traumatic haemorrhage
SMQs:, Torsade de pointes/QT prolongation (broad), Haemorrhage terms (excl laboratory terms) (narrow), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: a number of minutes after receiving the vaccine, patient fainted while seated, fell backwards in his chair, and hit his head on the floor. as a result of the fall, the back of his head was cut. he remained on the floor and gauze was held against the cut to slow/stop the bleeding until the ambulance service arrived. Patient was taken to the hospital for treatment of the cut. Patient is currently in good health.


VAERS ID: 1229186 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-04-05
Onset:2021-04-12
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043AZ1A / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Blood test normal, Chest X-ray normal, Computerised tomogram head, Computerised tomogram neck, Computerised tomogram normal, Confusional state, Electric shock sensation, Electrocardiogram normal, Magnetic resonance imaging head, Musculoskeletal stiffness, Neck pain, Pain in extremity, Pain of skin
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid, Dyazide, Depakote
Current Illness: NONE
Preexisting Conditions: History of thyroid cancer
Allergies: Zarontin, Demerol, Erythromycin, Levaquin
Diagnostic Lab Data: April 5 ER CTA Brain and Neck and CT C spine neg except for arthritis. Bloodwork including serial cardiac enzymes negative Negative chest X-ray and EKG Still trying to get insurance company to approve MRV and MRI brain
CDC Split Type:

Write-up: I had an electrical jolt run from the back of my neck into the scalp and down the left side of my neck into my left arm with pain pressure and soreness in these area and in the base of my head with some confusion and stiffness in the left side of my face followed by the right side. This lasted for six days afterward


VAERS ID: 1229228 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-03
Onset:2021-04-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 - / IM

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Muscular weakness, X-ray limb
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Arthritis (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: Famotidine 40 mg. D3, B12, Zinc, Glucosimine Chondrontin, Testosterone
Current Illness: NONE
Preexisting Conditions: esophageal reflux
Allergies: NKA
Diagnostic Lab Data: 4/14/2021 @19:08:14 XR Knee complete bi-lateral
CDC Split Type:

Write-up: After receiving the vaccine I returned to work and then went home, ate dinner, showered and bed. The following morning (Easter Sunday) I woke up at approximately 07:00 AM and when I got out of bed my legs (bi-laterally knee pain) were so weak that I almost fell down, I had to hold on to various furniture and walls to get to the bathroom. This weakness and joint pain has been constant and continuous and is still ongoing as of this writing. On 4/8/2021 I called my private physician, and explained what was happening and he prescribed me METHYLPREDNISOLONE 4 MG DOSEPK (medrol). I took the medication as prescribed and had no relief. On 4/14/2021 I went to ER and had X-rays taken of both knees and was sent home with a suggestion to follow-up with my private physician (on vacation until 4/26/2021) whom I have a telemedicine call scheduled with for that same day 4/26/2021. I have scheduled an appointment with an Orthopedic Specialist now on 4/20/2021 @ 3:20 PM for an evaluation.


VAERS ID: 1229229 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-03-15
Onset:2021-04-09
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN JAN1805029 / UNK LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Cerebrovascular accident, Computerised tomogram head abnormal, Electrocardiogram, Magnetic resonance imaging head abnormal, Scan with contrast abnormal, Visual field defect, Visual impairment
SMQs:, Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Noninfectious encephalitis (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Eliquis, Sotalol, Vit B 12, Catalyst 7, Microactive Coq10, Xen
Current Illness: None
Preexisting Conditions: Hypertension, Afib
Allergies: Morphine, Poison Ivy
Diagnostic Lab Data: CT with and without contrast; MRI with and without contrast; EKG. Dates of tests 04/09/21-04/11/21.
CDC Split Type:

Write-up: Patient awoke 04/09/2021 with visual disturbance and limited field of vision. Went to eye center and was evaluated. MD at eye center sent him to ER and told patient that it appeared he was having a stroke. Admitted to medical center 04/09/2021. Patient reports he was diagnosed with a stroke affecting the occipital region that affects his vision. Patient was discharged from the hospital 04/11/2021.


VAERS ID: 1229254 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-06
Onset:2021-04-06
   Days after vaccination:0
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: 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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: In conjunction with temporary VAERs # 414873 submitted on 7Apr21. My fever lasted nine days and required a trip to the ER. Was 104.3 on 9Apr21 and was 102.9 14Apr21. My normal temperature is 97.4. Took mostly Acetaminophen and some Ibuprofen. Was well hydrated.


VAERS ID: 1229312 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-03-08
Onset:2021-04-17
   Days after vaccination:40
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Alanine aminotransferase normal, Albumin globulin ratio normal, Aspartate aminotransferase normal, Basophil count decreased, Blood albumin normal, Blood alkaline phosphatase normal, Blood bilirubin normal, Blood calcium normal, Blood chloride normal, Blood creatine phosphokinase MB normal, Blood creatinine normal, Blood glucose increased, Blood magnesium normal, Blood potassium normal, Blood sodium normal, Blood thyroid stimulating hormone normal, Blood urea normal, Carbon dioxide normal, Chest X-ray normal, Differential white blood cell count normal, Eosinophil count normal, Erythroblast count normal, Fibrin D dimer normal, Full blood count, Glomerular filtration rate decreased, Haematocrit normal, Haemoglobin normal, Immature granulocyte count increased, Lymphocyte count, Lymphocyte count normal, Mean cell haemoglobin concentration normal, Mean cell haemoglobin increased, Mean cell volume normal, Mean platelet volume normal, Metabolic function test abnormal, Monocyte count, Monocyte count increased, Neutrophil count, Neutrophil count normal, Platelet count normal, Protein total normal, Red blood cell count normal, Red cell distribution width normal, Tachycardia, Troponin I normal
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Haematopoietic leukopenia (narrow), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Current Outpatient Medications: ? atorvaSTATin (LIPITOR) 10 MG tablet, Take 10 mg by mouth daily, Disp: , Rfl: ? cholecalciferol (VITAMIN D) 25 MCG (1000 UT) tablet, Take 1,000 Units by mouth daily, Disp: , Rfl: ? metFORMIN (GLUCOPHAG
Current Illness:
Preexisting Conditions:
Allergies: nka
Diagnostic Lab Data: CKMB [247900288] Collected: 04/17/21 0923 Order Status: Completed Specimen: Blood Updated: 04/17/21 1003 Creatine Kinase-MB 0.8 0.0 - 3.6 NG/ML Troponin Series [247900289] Collected: 04/17/21 0923 Order Status: Completed Specimen: Blood Updated: 04/17/21 1003 Troponin I 0.00 0.00 - 0.06 ng/mL Comment: 0.1 to 0.5 ng/mL shows an increased risk of AMI. 0.6 to 1.5 or greater is suggestive of AMI. Comprehensive metabolic panel [247900293] (Abnormal) Collected: 04/17/21 0923 Order Status: Completed Specimen: Blood Updated: 04/17/21 1003 Glucose 147High 65 - 100 MG/DL Blood Urea Nitrogen 18 7 - 18 MG/DL Creatinine 1.2 0.7 - 1.3 MG/DL Sodium 139 136 - 145 MMOL/L Potassium 4.7 3.5 - 5.1 MMOL/L Chloride 104 98 - 107 MMOL/L Co2 28 21 - 32 MMOL/L Calcium 9.2 8.5 - 10.1 MG/DL Protein Total 7.5 6.4 - 8.2 G/DL Albumin 4.0 3.4 - 5.0 G/DL A/G Ratio 1.1 0.8 - 2.0 Alkaline Phosphatase 96 46 - 116 U/L Alt (SGPT) 50 16 - 63 U/L AST(SGOT) 25 15 - 37 U/L Bilirubin, Total 0.7 0.2 - 1.0 MG/DL GFR Comment IF PATIENT IS AFRICAN AMERICAN, MULTIPLY RESULT BY 1.16 Est GFR 67Low $g90 ML/MIN/1.73sq.m Magnesium [247900294] Collected: 04/17/21 0923 Order Status: Completed Specimen: Blood Updated: 04/17/21 1003 Magnesium 2.2 1.8 - 2.4 MG/DL TSH Third Generation [247900299] Collected: 04/17/21 1000 Order Status: Completed Specimen: Blood Updated: 04/17/21 1003 TSH 2.57 0.30 - 3.04 uIU/mL D-dimer, quantitative [247900291] Collected: 04/17/21 0923 Order Status: Completed Specimen: Blood Updated: 04/17/21 1001 D-Dimer <100 0 - 400 NG/ML FEU XR Chest Portable [247900296] Collected: 04/17/21 0935 Order Status: Completed Updated: 04/17/21 1000 Narrative: EXAMINATION: PORTABLE CHEST SINGLE VIEW, 4/17/2021 at 0926 hours CLINICAL INFORMATION: Tachycardia COMPARISON: None FINDINGS: The cardiomediastinal silhouette is upper limits of normal in size. There is no significant consolidation or effusion. Osseous structures are without acute abnormality. IMPRESSION: Negative. CBC w Auto Diff [247900292] Collected: 04/17/21 0923 Order Status: Completed Specimen: Blood Updated: 04/17/21 0938 White Blood Cell Count 7.7 4.8 - 9.6 THOUS/uL Red Blood Cell Count 4.98 4.33 - 5.59 MIL/uL Hemoglobin 15.8 13.1 - 16.8 GM/DL Hematocrit 46.0 38.8 - 49.0 % Mean Corpuscular Volume 92.4 82.7 - 94.4 FL Mean Corpuscular Hemoglobin 31.7 27.7 - 32.6 PG Mean Corpuscular Hemoglobin Conc 34.3 32.4 - 35.7 G/DL Rdwcv 12.7 11.6 - 13.9 % Rdwsd 42.7 36.0 - 46.1 FL Platelet Count 202 154 - 364 THOUS/uL Mean Platelet Volume 9.1 8.7 - 11.7 FL Nucleated Red Blood Cells 0.0 0.0 /100 WBC''S Abs NRBC 0.0 0.0 THOUS/uL Differential Type AUTO Neutrophils 60.7 34.0 - 67.9 % Lymphs 27.6 19.1 - 41.2 % Monocytes 9.6 6.1 - 12.3 % Eos 1.3 0.9 - 7.6 % Basos 0.5 0.2 - 1.5 % Neutrophils Absolute Count 4.7 2.7 - 5.8 THOUS/uL Lymphocytes Absolute Count 2.1 1.1 - 3.3 THOUS/uL Monocytes Absolute Count 0.7 0.4 - 0.9 THOUS/uL Eosinophils Absolute Count 0.1 0.1 - 0.6 THOUS/uL Basophils Absolute Count 0.0 0.0 - 0.1 THOUS/uL Imm Gran 0.3 0.2 - 0.9 % Abs Imm Gran 0.02 0.0 - 0.1 THOUS/uL
CDC Split Type:

Write-up: 4/17/21 ER HPI: 56 y.o. male who presents with asymptomatic tachycardia. The patient purchased a home blood pressure monitoring device approximately 2 weeks ago and at that time he noted that the machine recorded his pulse at 150-160 beats per minute. The patient has repeatedly taking his blood pressure at home with this device and every time and has recorded his pulse in the same range. He denies fevers chills chest pain palpitations syncope lightheadedness peripheral edema or dyspnea. He presents today for evaluation of this as the machine again indicated that his pulse was 100 50-160 beats per minute


VAERS ID: 1229328 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-08
Onset:2021-04-16
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test normal, Computerised tomogram normal, Cyanosis, Disturbance in attention, Dyspnoea, Exophthalmos, Fall, Joint dislocation, Loss of bladder sensation, Loss of consciousness, Seizure
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hyperthyroidism (narrow), Depression (excl suicide and self injury) (broad), Ocular infections (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: CT scan came back normal as did all of my bloodwork.
CDC Split Type:

Write-up: Was at the grocery store and was having a hard time focusing. All of the colors were running together. I then fell backwards, and began having a seizure. Bystander said my eyes got huge and mouth and tongue turned blue as I couldn?t breathe. I had a seizure for about 5-8 minutes and was totally blacked out. During the seizure I lost control of my bladder and dislocated my jaw.


VAERS ID: 1229337 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-03-13
Onset:2021-04-06
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 180503 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram, Computerised tomogram head abnormal, Headache, Pain, Subdural haematoma
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Accidents and injuries (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Allopurinol 300 mg QD, Atorvastatin 20 mg QD, Cyanocobalamin 1000 mcg Daily, Digoxin 62.5 mcg QD, Ferrous Glucoante 324 mg QD, Fluticasone 2 sprays each nare QD, Furosemide 40 mg QD, Norco 5/325 Q6H prn, Probiotic daily, Losartan 25 mg QD,
Current Illness:
Preexisting Conditions: Anemia in chronic kideny disease stage 3, BPH, CHF, Chronic pain, CAD, Atrial Fibrillation, GERD, Hypertension, Hyperlipidemia, hyperuricemia, Pacemaker, Nephrolithiasis, Nonischemic cardiomyopathy, Schwannoma, Sick sinus syndrome, H/.O stroke/TIA.
Allergies: Cephalexin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Janssen COVID-19 Vaccine EUA Patient received vaccine on 3/13/2021. Patient presented to physician office complaining of headache for over 3 weeks. Headache is worse when bending forward, and keeps patient awake and/or awakens him. Described as a constant pounding headache in the frontal and bitemporal area radiating towards his occiput. No nausea, emesis, vision changes, or personality changes. CT of Head demonstrates an acute left frontal subdural hematoma measuring 5 mm in maximum thickness. Patient''s warfarin held, keppra started, vitamin K and PCC administered. Patient stabilized clinically and on CT and was discharged on 4/9/2021


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