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From the 5/7/2021 release of VAERS data:

Found 188,897 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 26 out of 1,889

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VAERS ID: 1233730 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-03-23
Onset:2021-04-18
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bell's palsy, Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hearing impairment (broad)

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

Write-up: I had numbness in the left side of my face on April 18, 2021 and was treated for Bells Palsy today April 20, 2021. That puts me almost 4 weeks from when I received the vaccine so I don?t know if this could be any side effect but felt the need to report this.


VAERS ID: 1234553 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-12
Onset:2021-04-18
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Body temperature increased, Chest pain, Cough, Fatigue, Headache, Impaired work ability, Lower respiratory tract infection, Pain, Rhinorrhoea, Sneezing, Sputum discoloured, Tinnitus
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hearing impairment (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Simvastatin, Adderall
Current Illness: None
Preexisting Conditions: Arthritis
Allergies: Gabapentin taken orally only.
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: No reaction until the 6th day, Sunday. Expected reactions on Day 6: temperature 100.4, tiredness behind eyes, slightly achy body. Massive headache by Monday and ringing in ears. Took Naproxin and Mucinex Monday morning before going to work. At the end of the day I took Naproxin and Mucinex in order to sleep. By Tuesday I had chest congestion which has gotten only worse along with needle-like pain in the chest upon coughing. I spit up yellow phlegm, tiredness behind eyes returned, sneezing, choking on phlegm, and constant runny nose and ringing in ears. This has made working difficult, but not impossible. Please ignore if these are normal reactions. I''m just not sure.


VAERS ID: 1234565 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-09
Onset:2021-04-18
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal discomfort, Diarrhoea
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

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

Write-up: diarrhea, stomach issues


VAERS ID: 1235428 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-10
Onset:2021-04-18
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: trazadone 50mg, metronidazole 500 mg, ciprofloxacin 500 mg, methoprolol 50mg, dicyclomine 10mg, clindamycin 300mg, levofloxacin 500mg, omeprazole DR 40mg
Current Illness: possible inflamed pancreas
Preexisting Conditions: Crohns and glaucoma
Allergies: PCN, Lactose
Diagnostic Lab Data: none
CDC Split Type:

Write-up: itching (constantly) and swollen lymphoid on my neck and collarbone area (left side)


VAERS ID: 1235590 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-17
Onset:2021-04-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 2 - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Diarrhoea, Discomfort, Fatigue, Feeling of body temperature change, Mobility decreased, Nausea, Pain in extremity, Pyrexia, Sleep disorder, Tremor
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: At 2am, 12 hours after shot woke up with severe chills and couldn?t get out of bed. Took Advil a and Tylenol to sleep. Woke up next morning and took Tylenol at 8am so I could try to have a normal day. Held off on medicine but started to feel exhausted and got hot / shaking chills again at 3pm and could not get warm . Took a nap to try to avoid medication but then took Advil/Tylenol again at 5pm because my fever reached 103 and I was too uncomfortable. Fever broke an hour later and I was able to sleep all night. Felt 90% better in morning and pretty normal by 48 hours after shot though continued to have fatigue and some periodic nausea into following day and one instance of diarrhea. Also arm was sore.


VAERS ID: 1235647 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-17
Onset:2021-04-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / SYR

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

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

Write-up: Pain and swelling in cheeks and around eyes where dermal fillers were previously injected.


VAERS ID: 1235719 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-12
Onset:2021-04-18
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0153 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test abnormal, Deep vein thrombosis, Fibrin D dimer increased, Musculoskeletal discomfort, Peripheral swelling, Thrombosis, Ultrasound scan
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Angioedema (broad), Haemorrhage laboratory terms (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 4/20 blood test D-dimer high 1.31 4/20 ultrasound. DVT
CDC Split Type:

Write-up: left arm swelling started from 4/18, extended from upper arm to lower arm in the afternoon. went to Urgent care on 4/19 morning, the NP reviewed my blood report and referred me to do ultrasound and also ask me to go to ER if the swell extend. as the swell extend, i went to ER in the afternoon. blood test shows high D-dimer and then ultrasound finds blood clot in the vessel near left neck. diagonised to be Deep Vein Thrombosis. no family history of such problem. in the hospital, they gave me a shot of blood thinner and also prescript oral blood thinner to be take at home.


VAERS ID: 1235855 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-04-17
Onset:2021-04-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Injection site induration, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Iron, vitamin c, d3, claritin, and multivitamin.
Current Illness: None
Preexisting Conditions: Obesity
Allergies: Doxycycline
Diagnostic Lab Data: Na
CDC Split Type:

Write-up: Skin swollen, hard, painful to the touch in a 2 in radius around the injection site.


VAERS ID: 1235857 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-17
Onset:2021-04-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 042B21A / 2 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Injection site pruritus, Lethargy, Pain
SMQs:, Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)

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

Write-up: Lethargy, achy, chills, all subsiding after 24 hours. Itching at injection site 2 days after 2nd dose injection. No symptoms with first dose.


VAERS ID: 1236955 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-31
Onset:2021-04-18
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Computerised tomogram head normal, Condition aggravated, Dysphonia, Facial paresis, Headache, Immunoglobulin therapy, Lumbar puncture normal, Magnetic resonance imaging normal, Neck pain, Paraesthesia, Paraesthesia oral, Scan with contrast, Vision blurred, Visual impairment
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Arthritis (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Normal MRI w/wo contrast = unremarkable; lumbar puncture = unremarkable
CDC Split Type:

Write-up: This is a comprehensive neurological evaluation for a very pleasant right handed 32 year old gentleman who denies any past medical history who presents to the hospital with several day progressive visual changes and facial weakness. Patient reports he noted on Saturday that he had somewhat of a headache, he does get headaches from time to time in particular while looking at screens the television, he did have some associated blurring of his vision as well. This was not the worst headache of his life. He had no other associated symptoms. He went to bed on Saturday, he awoke on Sunday and went out to eat and noted that he couldn''t form his mouth around the utensil, his face and lips and mouth felt weak. He still did have an intermittent headache and perhaps some neck pain as well at this point. His vision was still blurry. He denies any recent trauma, no car accident no whiplash no falls. He did go to an outside facility where a CT brain was performed and was normal he was told. He has noted yesterday that he could not close his eyes unless he did it manually, also he notes the way his voice sounds is different to him. He has not appreciated any weakness of his arms or legs. He is able to lift up his head off the bed without trouble. He does not think he has a hard time swallowing or breathing per se however he does describe that he is more "aware" of his breathing. He describes paresthesias of his face and around his mouth. No recent URI or diarrheal/GI illness, he did receive the Johnson & Johnson COVID -19 vaccine March 31st. Seen and evaluated in the ED with ed staff. He does report he recently ran a virtual type marathon over the course of 16 days. Clinical context and exam most consistent with that of GBS type variant (?Miller Fisher). Treated with IVIG. Symptoms improved after 1 dose. 4 more doses pending.


VAERS ID: 1237062 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-04-12
Onset:2021-04-18
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / UNK RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Full blood count, Headache, Metabolic function test, Pruritus, Rash erythematous, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: losartan 50mg, chlorthalidone 25mg, metformin ER m750mg, aspirin 81mg, multivitim, osteobiflex, ibuprofen 200mg
Current Illness: none
Preexisting Conditions: hyhpertension, obesity, arthritis, back pain
Allergies: none
Diagnostic Lab Data: CBC, CMP
CDC Split Type:

Write-up: uriticaria all over body, hands, palms, arms, torso, back, abdomen, itching, Small reddened diffuse bumps , mild R sided headache


VAERS ID: 1237292 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-04
Onset:2021-04-18
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Contusion, Gingival pain
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Gingival disorders (narrow), Accidents and injuries (narrow)

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

Write-up: Went to the dentist on 4/17/21 for routine cleaning. My gums became sore the next day. Today is 4/21, 4 days later and my gums are still sore. Normal gum soreness for me after a cleaning goes away by the next day when I wake up. On Sunday 4/18, I was working on the car and bruised my arm/wrist in a couple of places. That evening the locations bruised up really good and was tender. Today the areas are still tender and have dark bruising patterns. I generally do not bruise like this, and frankly was surprised bruises even appeared. Yes, I did bang my arm on the car a couple of times, but no where hard enough to receive this kind of bruising. I do not think this is an issue for me -- more of "just dealing with the inconvenience," but am curious if this is some sort of side effect from the vaccine. I could not find any information online related to "easily bruises" at all.


VAERS ID: 1237716 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-04-10
Onset:2021-04-18
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Back pain, Computerised tomogram, Dizziness, Dysarthria, Energy increased, Facial paralysis, Fatigue, Feeling abnormal, Full blood count, Headache, Hemiparesis, Magnetic resonance imaging, Nausea, Neck pain, Pain in extremity, Urine analysis
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), 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), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Hearing impairment (broad), Vestibular disorders (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: Amoxicillin, Zoloft
Current Illness: None
Preexisting Conditions: Lyme disease
Allergies: Sulfa-antibiotics
Diagnostic Lab Data: CT Scan with contrast CBC Urinalysis MRI all tests run on 4/18 with no s/s of stroke.
CDC Split Type:

Write-up: 4/10 - sore arm, no other symptoms 4/11 - headache 8/10, brain fog, nausea, dizziness, 7/10 neck and back pain, 8/10 exhaustion 4/12-4/17 - low grade headache 3-4/10 4/19 - 8/10 headache, 8/10 exhaustion, extreme weakness on right-side, rapid onset of stroke-like symptoms (Est 815am) to right side (face droop with impaired slurred slow speech, right arm, right leg immobility) facial symptoms resolved quickly (less than 1 minute), complete speech impairment lasting 2-3 minutes, partial speech impairment sustaining through to mid-day, complete right side weakness lasting 3-5 minutes before total resolve and intermittent R-side weakness after transport to hospital. Arrived at Emergency department about 930/10am, most symptoms subsided by time of admission - slowed speech persisted to mid-day. Discharged at 4pm to home. 4/19 - 6/10 exhaustion through most of the day 4/20-4-21 unusually high level of energy 4/21 - back pain and low grade headache return 3/10 4/22 - back pain more intense 4/10, intermittent headache 3/10 - report to CDC 4/26 - scheduled follow up appointment with Neurology


VAERS ID: 1238558 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-12
Onset:2021-04-18
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pharyngeal paraesthesia, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Albuterol Inhaler Advair Singular Ambien Xanax Atorvastatin Dexilant Nystatin Powder Nystatin Cream Prenatal Vitamin Melatonin Vitamin B12 Energy
Current Illness: Gastritis
Preexisting Conditions:
Allergies: Allergic to seafood
Diagnostic Lab Data:
CDC Split Type:

Write-up: On Sunday she began to experience a feeling of tightness and tingling in her throat. This continued for three days before she returned to the pharmacy to report the reaction. Because of the throat involvement it was recommended to the patient to follow up with her doctor as soon as possible and report to the ER if she at any point has difficulty breathing. She reports that it is worse at night. She said that the reaction feels similar to her seafood allergy but she only reports tightness and tingling not difficulty breathing.


VAERS ID: 1238765 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2021-03-31
Onset:2021-04-18
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)

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

Write-up: Patient reported having abdominal pain and shortness of breathe for two days. Patient was assessed over the phone by P.A. and it was recommended for patient to call 911 or go to the nearest emergency room to be assessed further. Patient refused to go to ER on 4/20/21 patient verbalized that he would go on 4/21/2021.


VAERS ID: 1238826 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-04-09
Onset:2021-04-18
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Nasal congestion, Nasopharyngitis, Oropharyngeal pain, Pain, Rhinorrhoea
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)

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

Write-up: Sore throat for 2 days followed by runny nose, congestion, mild aches, possible low fever, basically cold symptoms


VAERS ID: 1238918 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-10
Onset:2021-04-18
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Contusion, Erythema, Platelet count, Pruritus, Ultrasound scan
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Advil, b6, b12
Current Illness: None
Preexisting Conditions: None
Allergies: NA
Diagnostic Lab Data: Ultrasound of both legs along with platelet blood test. Ultrasound showed no clotting.
CDC Split Type:

Write-up: Patient developed unexplained bilateral bruising behind both knees eight days following vaccination. Does not have a history of bruising so visibly nor a history of blood clots. Bruises started off very red, slightly itchy and scattered. Over the next few days, the bruises darkened purple and merged closer together. Bruising was much more severe on the left leg than the right. Bruising has become less apparent over time.


VAERS ID: 1238962 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-10
Onset:2021-04-18
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anticoagulant therapy, Computerised tomogram thorax abnormal, Pulmonary embolism, Scan with contrast abnormal
SMQs:, Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: PT GIVEN HEPARIN. RELEASE WITH ELIQUIS 4/20/2021
CDC Split Type:

Write-up: PATIENT HOSPITALIZED ON 4/18. ON 4/19- CT SCAN WITH CONTRAST- SMALL PULMONARY EMBOLISM RT LOWER LOBE


VAERS ID: 1240193 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-18
Onset:2021-04-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pain, Injection site warmth, Mouth ulceration, Pain
SMQs:, Severe cutaneous adverse reactions (broad), Systemic lupus erythematosus (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: General Soreness, mouth ulcer, warmth and soreness to touch at injection site.


VAERS ID: 1240211 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-04-14
Onset:2021-04-18
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Suicidal ideation
SMQs:, Suicide/self-injury (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Wellbutrin, Levothyroxine, Birth control, Singular, D3, Biotin
Current Illness: none
Preexisting Conditions: none
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Suicidal ideation both after both shots. Never experienced suicidal ideation prior. Lasted on and off for 1-2 days


VAERS ID: 1240495 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-18
Onset:2021-04-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8734 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: ANXIETY
Allergies: NONE
Diagnostic Lab Data: 116/110 (HR 69) FOR FIRST READING. EMT TOOK OTHER READINGS BUT REMAINED SIMILAR FOR NEXT 20 MINS
CDC Split Type:

Write-up: PT MENTIONED SHE WAS NERVOUS ABOUT GETTING THE SHOT. AFTER SHE RECEIVED THE SHOT, SHE WENT INTO THE WAITING ROOM AND A FEW MINS LATER, FELT LIKE SHE WAS GOING TO PASS OUT. WE HAD HER LAY ON THE FLOOR AND ELEVATED HER FEET. SHE PROCEEDED TO PASS OUT. WE ADMINISTERED THE SMELLING SALTS, SHE WAS SLIGHTLY AWAKE BUT OUT OF IT AND SAID SHE DIDN''T SMELL ANYTHING. WE LIFTED HER MASK AND DID ANOTHER SMELLING SALT AND SHE "WOKE UP" BUT STILL REMAINDED ON THE FLOOR. SHE FELT WEIRD, EYES REMAINDED CLOSED AND SHE WAS SLIGHTLY CRYING AN SCARED. WE ASKED HER PARTNER IF THIS HAS EVERY HAPPENED BEFORE AND HE SAID SHE HAS ONLY PASSED OUT B/C OF PAIN NOT ANXIETY. WE TOOK HER PRESSURE/HEART RATE EVERY 5 MIN FOR 15 MIN. IT WAS ELEVATED 165/110 (HR 69) AND STAYED AROUND THAT EACH READING. WE ASKED HER IF SHE WANTED US TO CALL EMT AFTER THE FIRST 5-10 MIN AND SHE WASN''T SURE. 15-20 MIN LATER WE CALLED EMT AND THEY CAME TO ASSIST. THEY TOOK HER VITALS AND THEN EVENTUALLY HELPED HER SIT UP AND EVENTUALLY SHE WALKED OUT ON HER OWN.


VAERS ID: 1240892 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-15
Onset:2021-04-18
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Feeling hot, Pain in extremity, Pruritus, Rash papular
SMQs:, Anaphylactic reaction (broad), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Chronic regional pain syndrome
Allergies: Bee stings
Diagnostic Lab Data:
CDC Split Type:

Write-up: ?Covid arm? large raised bump, warm to touch, itchy and painfuk


VAERS ID: 1241232 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-04-18
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Dyspnoea, Headache
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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210436343

Write-up: SHORTNESS OF BREATH; HEADACHE; This spontaneous report received from a patient concerned a 54 year old male. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported and batch number: 043A21A expiry: UNKNOWN) dose was not reported, administered on 05-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 18-APR-2021, the subject experienced shortness of breath. On 18-APR-2021, the subject experienced headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from shortness of breath, and headache. This report was non-serious.


VAERS ID: 1241314 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-17
Onset:2021-04-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Fatigue, Malaise, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Microgestrin fe
Current Illness: Na
Preexisting Conditions: Endometriosis.
Allergies: Seasonal allergies. Reaction to haloperidol.
Diagnostic Lab Data:
CDC Split Type:

Write-up: I had a fever, joint pain in my knees, elbows and wrists. I was also very fatigued and generally didn''t feel good.


VAERS ID: 1241342 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-18
Onset:2021-04-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA ? / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Mobility decreased, Pain, Pain in extremity
SMQs:, Parkinson-like events (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: severe arm pain for 5 days throbbing and piercing pain in the area from shoulder down to elbow unable to lift arm without pain for 5 days now moderna covid-19 vaccine EUA


VAERS ID: 1241661 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-18
Onset:2021-04-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Paraesthesia, Shoulder injury related to vaccine administration
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Arthritis (broad)

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

Write-up: Error: Shoulder Joint Injury (prolonged pain, tingling, etc.)


VAERS ID: 1241957 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-10
Onset:2021-04-18
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Airborne Multi Vitamin Vitamin D, Vitamin K, Vitamin B12, selenium
Current Illness: none
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Doctor''s Examination to confirm cause of pain 4/22/21
CDC Split Type:

Write-up: Thrombosed Hemorrhoid (blood clot). Rapid onset of initial pain. Still experiencing pain.


VAERS ID: 1242141 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-06
Onset:2021-04-18
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 0432A1A / 1 LA / IM

Administered by: School       Purchased by: ?
Symptoms: Arthralgia, Back pain, Gastrointestinal pain, Renal pain
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Atorvastatin, Lisiniprol and CERC as medications Vitamins B-12, C, D-3, CO Q 10, K, Multivitamin, Pectasol_-C , Glucosomine-Chrondritin, probiotic
Current Illness: None
Preexisting Conditions: None
Allergies: penicillin
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Acute gastro intestinal cramps for 12-18 hours Joint pain in kidney, bank and left hip joints Both reactions were acute on the first day experienced then on more modest basis 2 days later


VAERS ID: 1244518 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-12
Onset:2021-04-18
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / SYR

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

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

Write-up: Patient began experiencing acute hives across their entire body beginning 5 to 6 days after receiving the J&J janssen covid-19 vaccine. Hives will appear on bith arms & hands, both arms & feet, torso, and face. the Patient has been treating with topical over the counter cortizone cream, and taking recommended (2 tablets every 6 hours as needed) doses of over the counter allergy medicine. (Benadryl Allergy, Dipenhydramine HCI 25mg)


VAERS ID: 1244816 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-10
Onset:2021-04-18
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Acute sinusitis, Blood lactate dehydrogenase increased, Brain oedema, Cerebral haemorrhage, Chills, Computerised tomogram head abnormal, Computerised tomogram thorax abnormal, Critical illness, Discomfort, Drug screen negative, Endotracheal intubation, Fall, Fibrin D dimer increased, Gait disturbance, Heparin-induced thrombocytopenia test, Limb discomfort, Mental status changes, Platelet count decreased, Pulmonary embolism, Pyrexia, Reticulocyte count normal, Seizure, Superior sagittal sinus thrombosis, Venogram abnormal
SMQs:, Angioedema (broad), Haematopoietic thrombocytopenia (narrow), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Haemorrhagic central nervous system vascular conditions (narrow), Dementia (broad), Convulsions (narrow), Embolic and thrombotic events, venous (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hyponatraemia/SIADH (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Central nervous system vascular disorders, not specified as haemorrhagic or ischaemic (narrow), Generalised convulsive seizures following immunisation (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: progesterone 200 mg, letrozole, labetalol, pregnyl
Current Illness: None
Preexisting Conditions: history of sinusitis, hypothyroidism, asthma, chronic benign HTN, cervical polyps
Allergies: NKDA
Diagnostic Lab Data: CAT scan CT veinogram of the head - R frontal lobe hemorrhage, mild edema, extensive thrombus in superior sagital sinus; CT chest - massive bilateral PE with possible lung infarct, may also have renal ischemia; reticulocyte 2.2, LDH 337, D dimer $g21.6, platelets 36k. sent for HIT testing (pending), urine drug screen negative
CDC Split Type:

Write-up: Patient complained of fever and chills on 4/18. Patient continued to have symptoms, suspected to be acute frontal sinusitis. On 4/21, patient complained of bilateral leg heaviness, felt weighed down, difficult to walk, no weakness, swelling, or redness. Patient elevated legs and felt better on 4/22. Patient later presented to the ED with acute mental status changes. Patient fell at home and had a seizure according to family. Patient is currently intubated and critically ill.


VAERS ID: 1245118 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-04-18
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Hypersomnia
SMQs:, Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210436394

Write-up: SLEEPY MOST OF THE DAY; FATIGUE; This spontaneous report received from a patient concerned a female of unspecified age. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 18-APR-2021, the subject experienced sleepy most of the day. On 18-APR-2021, the subject experienced fatigue. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the fatigue and sleepy most of the day was not reported. This report was non-serious.


VAERS ID: 1245245 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-10
Onset:2021-04-18
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site erythema, Injection site pruritus, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

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

Write-up: Redness, swelling, and itching at dose sight developed one week after injection. Treated with antihistamines and anti itch cream.


VAERS ID: 1245324 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-04-14
Onset:2021-04-18
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Body temperature increased, Rash, Rash morbilliform
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Started developing morbiliform exanthem that spread to the whole body, sparing palms and soles of feet 4 days after Vaccination, Worsened into day 8 in spite of Prednisone 20mg Daily 2 doses. Also developed Temp up to 102 day 7-8.


VAERS ID: 1245325 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-07
Onset:2021-04-18
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Fatigue, Feeling abnormal, Headache, Hot flush, Insomnia, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Estrogen, Progesterone, Lipitor 20 mg, Benadryl, Trazadone 50 mg, etc.
Current Illness:
Preexisting Conditions:
Allergies: only slight allergy if consume large quantity of sea food
Diagnostic Lab Data: I have a TIME-SENSITIVE Suggestion for JNJ, FDA, CDC on JNJ vaccine warning label. If indeed those 6 women are all on birth control pills which are composed of synthetic estrogen and progesterone, then the warning label should also warn people who take these hormone supplements, instead of just an age range.
CDC Split Type:

Write-up: I got the JNJ vaccine on Wed 4/7/21 (a wk before FDA paused that covid vaccine). Initial response was Extreme Fatigue, but starting 11:45 pm on 4/18/21, I suffered headache, chest pain, short of breath. I could not sleep at all till 4/19/21 PM after asking my kids to pray for me. In case it''s just heartburn, I took TUMS at 8:15 pm on 4/19/21 . Headache, short of breath comes and goes, but the chest pain persists, and I develop a hot flash. I never took birth control pills, but my OB/GYN prescribed daily Estrogen (to prevent osteoporosis) and every 3 month, Progesterone for 10 days (to prevent breast cancer). Estrogen & Progesterone happen to be the birth control pills'' composition. On 4/17/21, I finished my 10 days Progesterone regime. I discontinued the Estrogen supplement on 4/19/21 or 4/20/21, now (4/23/21 1:20 am) no more chest pain, but still feel fatigue, feverish with a hazy/foggy head (not really a headache). I have a suggestion for JNJ, FDA, CDC on JNJ vaccine warning label. If indeed those 6 women are all on birth control pills which are composed of synthetic estrogen and progesterone, then the warning label should also warn people who take these hormone supplements, instead of just an age range.


VAERS ID: 1245469 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-17
Onset:2021-04-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037B21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Cellulitis, Vaccination site pain, Vaccination site swelling, Vaccination site warmth
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: No adverse event (Relevant medical history not reported)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20210

Write-up: cellulitis site infection; Injection site warm to touch; Injection site is sore; Injection site is swollen; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of CELLULITIS (cellulitis site infection) in a 55-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037B21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included No adverse event (Relevant medical history not reported). On 17-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 18-Apr-2021, the patient experienced VACCINATION SITE WARMTH (Injection site warm to touch), VACCINATION SITE PAIN (Injection site is sore) and VACCINATION SITE SWELLING (Injection site is swollen). On an unknown date, the patient experienced CELLULITIS (cellulitis site infection) (seriousness criterion medically significant). At the time of the report, CELLULITIS (cellulitis site infection), VACCINATION SITE WARMTH (Injection site warm to touch), VACCINATION SITE PAIN (Injection site is sore) and VACCINATION SITE SWELLING (Injection site is swollen) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medications were not provided by the reporter. Patient was evaluated by a nurse and an antibiotic was prescribed for treatment of the suspected cellulitis. Based on current available information and the temporal association between product use and the start date of the events a causal relationship cannot be excluded.; Sender''s Comments: Based on current available information and the temporal association between product use and the start date of the events a causal relationship cannot be excluded.


VAERS ID: 1245499 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-03-28
Onset:2021-04-18
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6198 / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Blister, Herpes zoster, Rash, Viral test
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prednisone and tacrolimus
Current Illness:
Preexisting Conditions: Lupus SLE Lichen planus Sjögren''s syndrome
Allergies: Penicillin Sulfur Codiene Morphine Echinacea
Diagnostic Lab Data: A swab test was taken of the area on 04.22.21. At a Dermatologist office. Awaiting results.
CDC Split Type:

Write-up: I had Shingles three years ago and was diagnosed with Shingles again on 04.22.21. It effects my left leg and thigh. Rash/blisters started on 04.18.21. It is possible the Covid Pfizer vaccine reactivated the virus.


VAERS ID: 1247351 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-09
Onset:2021-04-18
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Back pain, Dyspnoea, Headache, Peripheral swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: atorvastatin 20 mg 1 daily
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Symptoms are headache, backache, shortness of breath, leg swelling. Symptoms have lasted 6 days.


VAERS ID: 1247838 (history)  
Form: Version 2.0  
Age: 89.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-09
Onset:2021-04-18
   Days after vaccination:40
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain, Anticoagulant therapy, Nausea, Oesophagogastroduodenoscopy normal, Platelet count normal, 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? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Severe AS s/pt TAVR (6/2020), HTN, HLD, CAD s/p PTCA/DES to occlusion s/p SMA and celiac artery stent (10/2020)
Allergies:
Diagnostic Lab Data: No PF4 collected, platelets within normal limits
CDC Split Type:

Write-up: 89 yo female received J&J COVID-19 vaccination on 3/9/21. Patient with history of SMA thrombosis presenting with 1 month history of abdominal pain, nausea, and vomiting, found to have SMA stent thrombosis. Stopped antiplatelet therapy several months prior to admission without consulting vascular team. Admitted and stable on heparin drip. GI was consulted, as her symptoms are not a classic presentation of mesenteric ischemia. On 4/21 she underwent EGD. EGD was read as normal stomach and duodenum, Schatzki ring (widely patent) and regular Z-line. After this patient was able to resume PO intake in increasing volumes without nausea, vomiting or abdominal pain. Pt discharged on 4/23 with prescription for apixaban.


VAERS ID: 1248053 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-04-09
Onset:2021-04-18
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Ascorbic acid 500 mg , desvenlafaxine 100 mg, Dexilant 60 mg, Diazepam 5 mg PRN, Entresto 24-26 mg BID, metoprolol tartrate 50 mg BID, naproxen 550 mg PRN, spironolactone 25 mg, Vitamin D3 50 mcg, Vitamin E 100 units, pantoprazole 40 mg
Current Illness: Received vaccination on 4/9/21, started experiencing a headache on 4/14/21, presented to ER on 4/17/21 late evening, diagnosed with pulmonary embolism on 4/18/21
Preexisting Conditions: non-ischemic cardiomyopathy /p defibrillator placement, PVCs s/p ablation
Allergies: Sulfamethoxazole, Sulfanilimide
Diagnostic Lab Data: CTA - significant for pulmonary embolism
CDC Split Type:

Write-up: Patient received J&J vaccine on April 9th. She stated to experience a left sided headache on 4/14/21. She was hospitalized late on 4/17/21 and was diagnosed with a pulmonary embolism on 4/18/21.


VAERS ID: 1248145 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-08
Onset:2021-04-18
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Migraine, Musculoskeletal stiffness, Paraesthesia, Visual impairment
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Arthritis (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin B12
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Migraine, stiff neck, vision problems, tingling in hand. Still on going


VAERS ID: 1249624 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-03-30
Onset:2021-04-18
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Dysphonia, Helicobacter infection, Oropharyngeal discomfort, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (Reported having Coronavirus in December.)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20210

Write-up: after the vaccine, she had a bacteria in her stomach; Dysphonic; Woke up feeling bad of the throat; Fever; This spontaneous case was reported by a consumer and describes the occurrence of HELICOBACTER INFECTION (after the vaccine, she had a bacteria in her stomach) in a 49-year-old female patient who received mRNA-1273 for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included COVID-19 (Reported having Coronavirus in December.) in December 2020. On 30-Mar-2021, the patient received first dose of mRNA-1273 (Intramuscular) 1 dosage form. On 18-Apr-2021, the patient experienced DYSPHONIA (Dysphonic), OROPHARYNGEAL DISCOMFORT (Woke up feeling bad of the throat) and PYREXIA (Fever). On an unknown date, the patient experienced HELICOBACTER INFECTION (after the vaccine, she had a bacteria in her stomach) (seriousness criterion medically significant). At the time of the report, HELICOBACTER INFECTION (after the vaccine, she had a bacteria in her stomach), DYSPHONIA (Dysphonic), OROPHARYNGEAL DISCOMFORT (Woke up feeling bad of the throat) and PYREXIA (Fever) outcome was unknown. The action taken with mRNA-1273 (intramuscular) was unknown. Concomitant medications were not provided. Treatment for the events included Clarithromycin. This case was linked to MOD21-078280 (Patient Link).; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1250843 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-07
Onset:2021-04-18
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / SYR

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

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
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: Vyvanse wellbutrin Lorazepam
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Heart attack due to tear in major artery in heart


VAERS ID: 1251294 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-10
Onset:2021-04-18
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN FB201A21A / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Fatigue, Full blood count normal, Headache, Migraine, Pain, Pain in extremity, Platelet count normal, SARS-CoV-2 test negative
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (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: Multi-vitamin, Vitamin C and Vitamin D, no other meds
Current Illness: No
Preexisting Conditions: No
Allergies: Gluten and dairy sensitivity - no allergies
Diagnostic Lab Data: On Tuesday 4/20 I had a CBC test to check for low platelets and it came back normal.
CDC Split Type:

Write-up: On 4/10 I got the J&J shot at Medical Center at 8am. 12 hours later at 8pm I experienced the normal side effects - body aches, tired, arm pain. I slept it off and the next day felt better - took a nap, but no problems. 8 days later on Sunday (4/18) I started to get a headache, on the top of my head (where a hat would go) and the back of my head. It was on / off, but it''s out of character as I don''t normally get headaches. On Monday, it continued on/off so I wrote my doctor...on Tuesday it continued more "on" then off - she recommended I go get bloodwork for low platelets and I did (at medical center). They came back normal. On Wednesday (4/21), the headache became a migrane and was screaming at me - all day with no relief. I''ve never had a migrane in my life and needed to be in low light - screen time became hard to deal with. I did get a Covid Test to rule out that and it came back negative Thursday morning. Thursday morning - same....screaming headache. Friday, less screaming but still not great - I met with my doctor on telehealth and she recommended I go to the ER to get evaluated. I went to another hospital on Friday afternoon to get evaluated. Since my bloodwork from Tuesday was all clear - they believe the migrane was inflammation from my immune response to the vaccine - especially because i never had a migrane before. They gave me anti-inflammatory meds via IV to mellow out the pain. They said if the pain came back or if I had other symptoms in the coming week to check back and likely need imaging. Today is Saturday (4/24) - the anti-inflammatory meds have helped but not 100%. I do still have some throb on/off and had a few dizzy feelings earlier.


VAERS ID: 1251851 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-12
Onset:2021-04-18
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / N/A AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Activated partial thromboplastin time shortened, Angiogram cerebral abnormal, Blood fibrinogen decreased, Cerebral venous sinus thrombosis, Fibrin D dimer increased, Haemoglobin normal, Headache, Immune thrombocytopenia, International normalised ratio increased, Magnetic resonance imaging head abnormal, Platelet count decreased, Scan with contrast abnormal, Thrombocytopenia, Vaccination complication, Venogram, White blood cell count normal
SMQs:, Liver-related coagulation and bleeding disturbances (narrow), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Systemic lupus erythematosus (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Central nervous system vascular disorders, not specified as haemorrhagic or ischaemic (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Benign fatty liver
Allergies: NKDA
Diagnostic Lab Data: 4/23/2021: MAGNETIC RESONANCE IMAGING - MR BRAIN W WO CONT 04/23 1700 *** Report Impression - Status: SIGNED Entered: 04/23/2021 1905 IMPRESSION: 1. The superior sagittal sinus does not completely homogeneously enhance. Uncertain if this is related to flow phenomenon or this represents nonocclusive thrombosis. CT venogram can be considered. 2. The remainder of the brain is within normal limits. MAGNETIC RESONANCE IMAGING - MR ANGIO HEAD WO CONT 04/23 1800 *** Report Impression - Status: SIGNED Entered: 04/23/2021 1905 IMPRESSION: 1. The superior sagittal sinus does not completely homogeneously enhance. Uncertain if this is related to flow phenomenon or this represents nonocclusive thrombosis. CT venogram can be considered. 2. The remainder of the brain is within normal limits. COMPUTERIZED TOMOGRAPHY - CT VENOGRAM BRAIN 04/23 1954 *** Report Impression - Status: SIGNED Entered: 04/23/2021 2029 CBC: WBC 5.7, Hgb 13.9, platelets 22,000 INR 12, aPTT 26, D-dimer $g12.80, fibrinogen 104 mg/dL.
CDC Split Type:

Write-up: Progressive headache, leading to ER admission, diagnosis of Left sigmoid sinus thrombosis accompanied by severe thrombocytopenia. Diagnosis confirmed as vaccine-induced immune thrombocytopenia and thrombosis (VITT)/vaccine-associated thrombosis and thrombocytopenia (VATT).


VAERS ID: 1254026 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-18
Onset:2021-04-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 042B21-2A / 1 - / OT

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

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

Write-up: Tongue swelling; Face swelling; Chest pains left side of chest; This spontaneous case was reported by an other health care professional (subsequently medically confirmed) and describes the occurrence of SWOLLEN TONGUE (Tongue swelling) and SWELLING FACE (Face swelling) in a 57-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 042B21-2A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 18-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 18-Apr-2021, the patient experienced SWOLLEN TONGUE (Tongue swelling) (seriousness criterion hospitalization), SWELLING FACE (Face swelling) (seriousness criterion hospitalization) and CHEST PAIN (Chest pains left side of chest). At the time of the report, SWOLLEN TONGUE (Tongue swelling), SWELLING FACE (Face swelling) and CHEST PAIN (Chest pains left side of chest) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Concomitant product use was not provided. Treatment included Benadryl IM and Steroid IV. Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1255716 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-01
Onset:2021-04-18
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / -

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

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021427913

Write-up: Appendicitis the following Sunday requiring surgery; This is a spontaneous report from a contactable consumer (patient). A 28-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection), via an unspecified route of administration, administered in left arm on 01Apr2021 15:30 (Batch/Lot number was not reported) at the age of 28 years old, as single dose for COVID-19 immunisation. Medical history included COVID-19 from an unknown date and unknown if ongoing. The patient was not pregnant at the time of vaccination. The patient has no known allergies. The patient''s concomitant medications were none. No other medicines received within two weeks of vaccination. No other vaccines within 4 weeks prior to vaccination. The patient experienced appendicitis the following Sunday (18Apr2021 00:00) requiring surgery. The event resulted in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care, hospitalization, life threatening illness (immediate risk of death from the event). Treatment was surgery. It was unknown if the patient has been tested for COVID post vaccination. The patient was recovering from the event. Information on the lot/batch number has been requested.


VAERS ID: 1256059 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Vermont  
Vaccinated:2021-03-24
Onset:2021-04-18
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Fibrin D dimer increased, Liver function test increased, Pain in extremity, Peripheral swelling, Platelet count normal, Renal function test normal
SMQs:, Cardiac failure (broad), Liver related investigations, signs and symptoms (narrow), Angioedema (broad), Haemorrhage laboratory terms (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: Lisinopril 20mg daily Ibuprofen as need
Current Illness: None
Preexisting Conditions: Hypertension
Allergies: None
Diagnostic Lab Data: Elevated Ddimer, normal renal function, normal platelet count. Mildly elevated LFTs. Duplex ultrasound not available due to facility limitations.
CDC Split Type:

Write-up: Left lower extremity swelling and pain for 1 week, right lower extremity normal.


VAERS ID: 1256497 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-18
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 5ZRX / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal discomfort, Abdominal pain upper, Asthenia, Blood test, Cold sweat, Constipation, Decreased appetite, Dehydration, Dizziness, Feeling cold, Hyperhidrosis, Palpitations, Paraesthesia
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypoglycaemia (broad), Dehydration (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: No
Allergies: Penicillin
Diagnostic Lab Data: Blood test will be done on 4 26
CDC Split Type:

Write-up: Freezing ,hot ,cold, sweets disy ,lack of appetite constipation no energy inside feel like burning and boiling ,weak general stomach ache bad ,heart palpitations , tingling legs and feet , dehydrated


VAERS ID: 1256713 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-06
Onset:2021-04-18
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Acute disseminated encephalomyelitis, Bladder catheterisation, Blood glucose normal, CSF culture negative, Demyelination, Dysuria, Hyperaesthesia, Hypoaesthesia, Magnetic resonance imaging head abnormal, Magnetic resonance imaging spinal abnormal, Paraesthesia, Protein total increased, Urinary retention, Viral test negative, Vision blurred, White blood cell count increased
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (narrow), Glaucoma (broad), Optic nerve disorders (broad), Demyelination (narrow), Lens disorders (broad), Retinal disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Pt received vaccine on 4/6, on 4/18 started to develop paresthesias in legs, numbness, hyperesthesia, blurry vision and difficulty urinating. She was admitted on 4/23 and MRI of brain/C-spine/T-spine/L-spine showing widespread demyelinating lesions mostly in T-spine. ADEM was primary consideration. LP showed lymphocytic predominance with about 130 WBC, elevated protein and normal glucose. Viral PCR of CSF and nasal swab were negative. Culture negative. She had acute urinary retention requiring foley catheter. She will be discharged today 4/25 with plans to follow outpatient for final MS serologies and neuro/optho follow up for final diagnosis.


VAERS ID: 1257405 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-04-16
Onset:2021-04-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0162 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Muscle spasms, Polymenorrhoea
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Dystonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ibuprofen
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none, just rode it out. tried to make a video apt with my obgyn, but she moved clinics, was going to try to make an apt this week.
CDC Split Type:

Write-up: 2 days after 2nd dose, experienced sever, intense cramps, and profuse menstrual bleeding. only one week after my normal cycle had stopped. day 1 was unusually heavy, day 2 was extremely heavy the whole day and night. days 3 and 4 and 5 were heavy, but not as painful. the bleeding seems to have finally subsided now, day 9. my normal cycle usually only lasts a few days and is very light, rarely painful or with cramping.


VAERS ID: 1257429 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-09
Onset:2021-04-18
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Lymphadenopathy
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Singulair, Zyrtec, Omeprazole, Naproxen, Flonase
Current Illness: None
Preexisting Conditions: Allergic rhinitis, OSA, fibromyalgia
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: L axillary LA - starting day 9 after injection, continuing through present (Day 17)


VAERS ID: 1257986 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-09
Onset:2021-04-18
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Injection site pain, Joint range of motion decreased, Pain, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Sore upper arm/muscle, reduced range of motion. Symptoms (re)appeared on day 9-10 after vaccination and have continued through today (day 17), and appear to be getting slightly worse. Pain is mild to moderate but certain movements make it much worse. (This is beyond initial symptoms - fever, headache, muscle aches and sore injection site, which all resolved w/in approximately 36 hours of vaccine administration.)


VAERS ID: 1259409 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-04-17
Onset:2021-04-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Breast pain, Chest pain, Computerised tomogram, Dizziness, Musculoskeletal stiffness, Pulmonary embolism, Ultrasound scan
SMQs:, Anticholinergic syndrome (broad), Embolic and thrombotic events, venous (narrow), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Lipodystrophy (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: multivitamins, vit C
Current Illness: n/a
Preexisting Conditions: Lupus (In remission for a long time)
Allergies: Penicillin, latex
Diagnostic Lab Data: Scan with contrast for heart Blood panel ultra sound CT
CDC Split Type: VSAFE

Write-up: 4/17 Vaccination @ 530PM 4/18 woke up with stiff neck. Unsure if chest pain started on 4/18 or 4/19. Stiff neck felt like ''being choked''. 2 sharp pains in between breasts. Little pains on left breast, worked up to neck and ear. 4/19 ER. 4/20 ER ultra sound 4/21 cardiologist cb to tell me I had a pulmonary embolism. The Dr. said I needed to go to larger clinic. 4/22 Larger Clinic. They ran some scans with contrast of neck because of pain. CT. Taking blood clot medication. 4/26/2021 Extremely dizzy; going to have a CT scan today **dizziness is so bad right now. *4/29 appt with pulmonologist


VAERS ID: 1259526 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-04-03
Onset:2021-04-18
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Portal vein thrombosis, 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? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient developed portal vein thrombosis and thrombocytopenia


VAERS ID: 1259599 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-12
Onset:2021-04-18
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Computerised tomogram head, Computerised tomogram normal, Dizziness, Full blood count normal, Headache, Rash, Rash erythematous, Rash pruritic, Vertigo
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Vestibular disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: 6 days after vaccine developed itchy red rash left arm that spread to whole body lasted 2-3 days. Also developed dizziness/ vertigo/ headache that continued


VAERS ID: 1259769 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-13
Onset:2021-04-18
   Days after vaccination:36
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Headache, Nasal congestion, Paranasal sinus discomfort, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Taste and smell disorders (narrow), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness:
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data: tested positive for COVID-19 with a PCR test on 4/24 at Clinc.
CDC Split Type:

Write-up: Tested positive for COVID-19 after being fully vaccinated. Symptoms began on 4/18/21. Symptoms included; loss of smell, headache, runny nose, loss of taste, congestions, and sinus pressure.


VAERS ID: 1261383 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Illinois  
Vaccinated:0000-00-00
Onset:2021-04-18
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Pulmonary thrombosis, Ultrasound scan, Venous thrombosis limb
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? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Asthma; Blood pressure high; Diabetes mellitus; Penicillin allergy
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210419; Test Name: Ultrasound scan; Result Unstructured Data: blood clots in the leg and chest
CDC Split Type: USJNJFOC20210444880

Write-up: BLOOD CLOTS IN THE LEG; BLOOD CLOT IN THE CHEST; This spontaneous report received from a consumer (calling on behalf of her husband) concerned a 60 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included diabetes mellitus, asthma, high blood pressure, and penicillin allergy. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin: unknown, batch number: Unknown) on 12-APR-2021, into right arm, for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 18-APR-2021, the patient began experiencing pain and swelling in the left leg. His leg was very hot and red "like a fever" and the pain was radiating up to the chest and heart and also spread to the right side of the chest. The patient was experiencing a lot of pain and couldn''t breath. On 19-APR-2021 the patient''s wife called the doctor and he was admitted to hospital. An ultrasound was performed which confirmed blood clots in the leg and chest. At the time of this report patient was still in the hospital. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from blood clots in the leg, and blood clot in the chest. This report was serious (Hospitalization Caused / Prolonged).; Sender''s Comments: V0: This 60 year-old male with medical history significant for diabetes, high blood pressure, and asthma was hospitalized for blood clots in the leg and chest 7 days after receiving the Janssen Covid-19 vaccine. Concomitant medications were not reported. Six days post-vaccination, the patient began experiencing left leg pain and swelling. His leg was red and hot and the pain would radiate from his leg to his chest. He was also experiencing difficulty breathing. The following day (7 days post-vaccination), he was admitted to the hospital. An ultrasound confirmed blood clots in the leg and chest. Other diagnostic test results and corrective treatment were not reported. As of the time of this report, the patient was still in the hospital. Based on the limited information, the relationship with Janssen Covid-19 vaccine is considered indeterminant. More information (e.g. platelet count, D-dimer, fibrinogen, anti-platelet factor 4 antibodies, medical records) is being sought.


VAERS ID: 1261440 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Kentucky  
Vaccinated:0000-00-00
Onset:2021-04-18
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Allergy to insect sting (allergic to bees, wasps, hornets, bugs with stingers.); Lung disorder
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210448364

Write-up: ACUTE HIVES FROM HEAD TO TOE OF BODY; This spontaneous report received from a patient concerned a 27 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included permanent lung damage, and allergies to insect. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 207A21A, and expiry: UNKNOWN) dose was not reported, administered on 12-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 18-APR-2021, the subject experienced acute hives from head to toe of body. Treatment medications (dates unspecified) included: hydrocortisone, and diphenhydramine hydrochloride. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from acute hives from head to toe of body. This report was non-serious.


VAERS ID: 1261774 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-17
Onset:2021-04-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 045A21A / 2 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Fatigue, Headache, Injection site pain, Lymphadenopathy, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Effexor, Xyzal, Flonase Sensimist, b-12
Current Illness: N/a
Preexisting Conditions: Asthma
Allergies: N/a
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever (101) around 16 hours after second dose, fatigue, headache, swollen lymph nose on left side, pain at injection site


VAERS ID: 1261817 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-16
Onset:2021-04-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Balance disorder, Dizziness, Headache, Muscular weakness, Neck pain, Transient ischaemic attack, Vision blurred
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Arthritis (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ZYRTEC [LEVOCABASTINE HYDROCHLORIDE]
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021438084

Write-up: Possible TIA (diagnosed in Urgent Care); loss of balance; dizziness; headaches; neck pain; blurred vision/blurry eye (right); right arm/leg weakness; This is a spontaneous report from a contactable consumer (the patient). A 40-year-old non-pregnant female patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number unknown due to it was never shown vial, just administered injection by nurse) via an unspecified route of administration in left arm on 16Apr2021 18:00 at age of 40-year-old at single dose for COVID-19 immunisation. Relevant medical history was "none". No known allergies. Concomitant medications included levocabastine hydrochloride (ZYRTEC) taken for an unspecified indication from an unspecified date, and multivitamin. The patient did not take other vaccine in four weeks. No COVID prior vaccination. COVID not tested post vaccination. The patient experienced Possible TIA (diagnosed in Urgent Care), loss of balance, dizziness, headaches, neck pain, blurred vision, right arm/leg weakness, blurry eye (right). The events onset date was provided as "18Apr2021 10:00 a.m.". The events resulted in: Doctor or other healthcare professional office/clinic visit, Emergency room/department or urgent care, Life threatening illness (immediate risk of death from the event). No treatment received for the events. The outcome of the events was not recovered. Information about lot/batch number has been requested.


VAERS ID: 1261826 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-15
Onset:2021-04-18
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0161 / 2 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Cerebellar stroke, Computerised tomogram, Echocardiogram, Magnetic resonance imaging, SARS-CoV-2 test
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), COVID-19 (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: LYRICA; FLOMAX [MORNIFLUMATE]; NORTRIPTYLINE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: BPH; Fruit allergy; Neuropathy
Allergies:
Diagnostic Lab Data: Test Name: CT scan; Result Unstructured Data: Test Result:Unknown results; Test Name: TEE; Result Unstructured Data: Test Result:Unknown results; Test Name: MRI; Result Unstructured Data: Test Result:Unknown results; Test Date: 20210418; Test Name: Nasal Swab; Test Result: Negative
CDC Split Type: USPFIZER INC2021443848

Write-up: Cerebellar Stroke; This is a spontaneous report from a contactable consumer (patient). A 51-year-old male patient received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot Number: EW0161) via unspecified route of administration in the left arm on 15Apr2021 11:30AM at age of 51-year-old at single dose for COVID-19 immunisation. Medical history included known allergies to Mango. Other Medical history included neuropathy and benign prostatic hyperplasia (BPH). There was no covid prior vaccination. There was no other vaccine in four weeks. There were concomitant medications in two weeks: pregabalin (LYRICA), morniflumate (FLOMAX) and nortriptyline. Patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot Number: ER8730) in left arm on 25Mar2021 04:30PM at 51-year-old at single dose for COVID-19 immunisation. Patient experienced adverse event: cerebellar stroke on 18Apr2021 06:45PM. Patient resulted in Doctor or other healthcare professional office/clinic visit, Emergency room/department or urgent care, Hospitalization, Life threatening illness (immediate risk of death from the event). Hospitalization for 2 days. Patient received treatment included computerised tomogram (CT scan), magnetic resonance imaging (MRI), Echocardiogram (TEE) and MyCare Link. Covid test post vaccination included: Nasal Swab on 18Apr2021: Negative. Patient was recovering from event.


VAERS ID: 1261952 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: New Jersey  
Vaccinated:2021-03-19
Onset:2021-04-18
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039A21B / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Heart rate increased, Pyrexia, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: HUMIRA
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20210

Write-up: Fever; Fainting (15h post injection); Increased HR; This spontaneous case was reported by a consumer and describes the occurrence of SYNCOPE (Fainting (15h post injection)) in a 35-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 018B21A and 039A21B) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concomitant products included ADALIMUMAB (HUMIRA) for an unknown indication. On 19-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 18-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 18-Apr-2021, the patient experienced SYNCOPE (Fainting (15h post injection)) (seriousness criterion medically significant). 18-Apr-2021, the patient experienced HEART RATE INCREASED (Increased HR). On 19-Apr-2021, the patient experienced PYREXIA (Fever). At the time of the report, SYNCOPE (Fainting (15h post injection)) had resolved and HEART RATE INCREASED (Increased HR) and PYREXIA (Fever) outcome was unknown. Treatment received in response to the event was acetaminophen. Company Comment: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1262401 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-10
Onset:2021-04-18
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Deep vein thrombosis, Injection site mass, Injection site pain, Movement disorder, Pain, Thrombosis, Ultrasound Doppler
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Thrombophlebitis (broad), Extravasation events (injections, infusions and implants) (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: atenolol-chlorthalidone 100-25 alprazolam 1-3 mg for sleep only Januvia 50 mg
Current Illness:
Preexisting Conditions: Diabetes 2
Allergies: sulfa drugs metformin certain high blood pressure medicine, in medical charts, name unknown at the time
Diagnostic Lab Data: Vascular ultra sound down on left arm, covid vaccine arm.
CDC Split Type:

Write-up: Throbbing pain at injection site and entire arm. Unable to move up without assistance. Pain grew more and more intense. Went to urgent care on unspecified date. NP examined me and discovered a lump in my arm. Both the lump and the vaccination site hurt when she pressed on them. She prescribed presdone and gave me a work order for a vascular ultrasound to be performed on my left arm. I went on unspecified date for the scan. It was discovered that a DVT blood clot had formed in my brachial vein in the left arm. I was then prescribed eliquis, 20 mg a day for 7 days and told not to take the predesone. NP called my pcp, his office immediately called me and asked me to come in as they are concerned about the high dosage of the eliquis.


VAERS ID: 1262676 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-12
Onset:2021-04-18
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN LOT 206A21A EXP / 1 LA / SYR
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER E / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test abnormal, Procalcitonin increased, Pruritus, Rash, Skin irritation, Skin test negative, White blood cell count increased
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sepsis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lamictal, Junel
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Blood tests done. Allergy panel negative for allergic reaction. White blood cell and procalcitonin count high.
CDC Split Type:

Write-up: On 4/18 woke up with a rash on arms, legs, butt, and back. Went to Urgent care and was given a steroid and benadryll. That evening the rash intensified and went to the emergency room. Was admitted so they could monitor the rash. Was discharged on 4/20 with instruction to start a steroid pack and continue with benadryl cream, benadryl, claratin and pepcid. Rash is still continuning to appear as of 4/27/21. Very itchy and irritating. TRYING TO ENTER HOSPITALIZATION DATES IN PART 21 BUT IT WILL NOT ALLOW ME TO TYPE ANYTHING. , 2 DAYS STAY,


VAERS ID: 1263639 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-12
Onset:2021-04-18
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

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

Write-up: new daily, ongoing headache intensity varies between 2/10 and 8/10


VAERS ID: 1263858 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-01
Onset:2021-04-18
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anaphylactic reaction, Dyspnoea, Food allergy, Hypersensitivity, Obstructive airways disorder, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Asthma/bronchospasm (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Not previous to Janssen vaccine, but after eating a burrito with lobster from the ocean, suffered anaphalaxis and required a steroid immune suppressor injection due to swelling and blockage of respiratory system (sinuses and esophagus).
Diagnostic Lab Data: None yet but I may see an allergy specialist soon.
CDC Split Type:

Write-up: Ten days after vaccination I had an allergic shellfish reaction to a frozen lobster product. Never happened before and I''ve had other Lobster on the east coast before. I also ate shrimp a few days prior to vaccination with no reaction. I have eaten other Lobster all my life with no reaction. My sinuses and throat closed up making it very difficult to breathe. I didn''t know what was happening so I took decongestants and antihistamines then went to the doctor and got injected with a steroid immune suppressor. I now have epinephrine just in case it happens again.


VAERS ID: 1264039 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-03-17
Onset:2021-04-18
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Ataxia, Guillain-Barre syndrome, Immunoglobulin therapy, Lumbar puncture abnormal, Magnetic resonance imaging head normal, Magnetic resonance imaging spinal normal
SMQs:, Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Demyelination (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Omepraozole, Naproxen, Tadalafil, Atorvastatin, Aspirin
Current Illness: None
Preexisting Conditions: Hypertension, coronary artery disease, hypothyroidism
Allergies: None
Diagnostic Lab Data: MRI Lumbar Spine, MRI Brain, Lumbar Puncture
CDC Split Type:

Write-up: Patient developed ataxic gait determined to be Guillan-Barre syndrome. Was treated with course of IVIg with improvement but not resolution.


VAERS ID: 1264060 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-04-07
Onset:2021-04-18
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Deep vein thrombosis, Full blood count, Metabolic function test, Muscle spasms, Platelet count decreased, Swelling, Thrombocytopenia, Ultrasound Doppler abnormal
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haematopoietic thrombocytopenia (narrow), Systemic lupus erythematosus (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Dystonia (broad), Thrombophlebitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Finasteride, albuterol inhaler
Current Illness: None
Preexisting Conditions: Exercise induced asthma
Allergies: No known allergies
Diagnostic Lab Data: All labs from 04/26/2021: CBC: Platelets 74 K/uL Smear: Giant platelets BMP, Mg: within normal limits Hypercoagulability panel pending. Negative Factor V leiden and prothrombin US lower extremity venous Doppler bilateral: Nonocculsive DVT within the right popliteal vein extending to the gastrocnemius veins. Occlusive SVT of the right lesser saphenous vein. Nonocclusive DVT of the left popliteal vein extending into the gastrocnemius veins. Occlusive DVT of the left posterior tibial veins. Occlusive SVT of the greater saphenous vein.
CDC Split Type:

Write-up: Patient evaluated in ED 04/26 for bilateral leg cramping, swelling that started just over a week prior. Reviewed records from that visit. Work up was significant for bilateral lower extremity DVTs and thrombocytopenia. Patient was started on Xarelto at that time. Patient does not have any significant risk factors for blood clots. He is not obese, denies tobacco use, recent procedures, recent travel, prolonged immobility, family history of bleeding or clotting disease, etc. He is up to date on cancer screenings based on age/family hx. He did receive the Johnson and Johnson vaccine on 04/07.


VAERS ID: 1265624 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-16
Onset:2021-04-18
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin
Current Illness: None
Preexisting Conditions: None
Allergies: Not that I''m aware of
Diagnostic Lab Data:
CDC Split Type:

Write-up: I was nowhere near my menstrual cycle and yet I experienced a painful menstrual cramp


VAERS ID: 1266101 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-04-05
Onset:2021-04-18
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Condition aggravated, Diabetes mellitus, Diabetic ketoacidosis, Hepatic vein thrombosis, Platelet count decreased, Platelet factor 4, Portal vein thrombosis, Thrombocytopenia
SMQs:, Haematopoietic thrombocytopenia (narrow), 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), 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? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: metoprolol amlodipine spironolactone metformin empagliflozin l
Current Illness: no acute illness
Preexisting Conditions: Diabetes, Hypertension, Alcoholic Cirrhosis, Gout
Allergies: none
Diagnostic Lab Data: PF4 W/O HEPARIN: 1.578 (A) Platelet Count: 9
CDC Split Type:

Write-up: Vaccine- Induced Thrombotic Thrombocytopenia Portal and hepatic vein thromboses Diabetic Ketoacidosis


VAERS ID: 1266138 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-18
Onset:2021-04-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 2 LA / IM

Administered by: School       Purchased by: ?
Symptoms: Arthralgia, Chills, Feeling abnormal, Headache, Heart rate increased, Insomnia, Memory impairment, Pain, Pyrexia, Spinal pain, Toothache
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin, probiotics
Current Illness: No illnesses
Preexisting Conditions: Juvenile Rheumatoid Arthritis, onset age 7.
Allergies: No allergies
Diagnostic Lab Data: None
CDC Split Type:

Write-up: About 7 hours after my vaccine, I started experiencing chills and body aches. 9 hours after the vaccine, I felt as if I?d taken cold medicine. I was slow to react, felt ?foggy?, I had trouble recalling words and the names of household objects I was staring at, my movements weren?t coordinated and I dropped a few things. During the night, I was tired but had trouble sleeping. The body aches worsened and really concentrated in my joints, especially my spine. I stayed either in bed or on the couch the whole day following my vaccine but my heart rate (as read by my smart watch) would go from the 70?s to as high as 129 just from sitting up higher in bed. My normal resting heart rate is in the upper 50?s/lower 60?s and I don?t see 120+ unless I?m working out for at least 20 minutes. I didn?t take Tylenol or Motrin until 7 PM on April 19th (I took 800mg of Motrin) about 34 hours after my vaccine. I had a low grade fever and my head ached so bad all my teeth were throbbing before I took the Motrin. I started to feel better within a hour of taking Motrin and was fine from then on. I only took Motrin the one time.


VAERS ID: 1266284 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-04-18
Onset:2021-04-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Womens probiotics Multivitamin Fish oil Adderall
Current Illness: N/A
Preexisting Conditions: Celiac''s disease
Allergies: Penicillin Ceclor Wheat/gluten - celiac
Diagnostic Lab Data:
CDC Split Type:

Write-up: Extreme numbness in hands that is worsening over time. Causes extreme pins/needles, aching and inability to hold basic objects like a cell phone. Attempting to see a doctor for this immediately. Originally had this in December -- presumably with COVID that never got diagnosed. Worsened after 1st shot, worsened dramatically after 2nd shot.


VAERS ID: 1267819 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-04-10
Onset:2021-04-18
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / N/A LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cellulitis, Chest X-ray, Computerised tomogram, Laboratory test, Lymph gland infection, Obstructive airways disorder, Oedema, Swelling face, Throat tightness
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Furosemide, Klor-Con, Levothyroxine, Omeprazole, Loratadine, Losartan. Tylenol and or Advil
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 04/21/2021 and 04/22/2021 Lab work. IV treatment. Cat Scan. Chest X-ray Facial observation, my chin was resting on my chest it was so swollen. .
CDC Split Type:

Write-up: I ended up with an infection in the glands in my neck and throat. Caused edema and cellulitis ended up in the hospital for an overnight of IV antibiotics, steroids'' and pain meds because my throat was closing. The swelling was restricting my airway. I was instructed by my MD to file this report.


VAERS ID: 1267914 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-04-06
Onset:2021-04-18
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Bulbar palsy, Guillain-Barre syndrome, Hypoaesthesia
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: URI started on 3/31
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Guillain Barre syndrome- symptoms of BLE numbness with ascending bulbar weakness developed 4/18 and diagnosed on 4/27


VAERS ID: 1268089 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-10
Onset:2021-04-18
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Deep vein thrombosis, Gait disturbance, Pain in extremity, Peripheral swelling, Thrombosis, Ultrasound Doppler abnormal
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Parkinson-like events (broad), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Ultra sound conducted on 4/27/21 discovered thrombosis of the posterior tibial and perineal veins
CDC Split Type:

Write-up: Two blood clots in right leg below the knee, calf pain, swelling of lower leg and foot, painful to walk


VAERS ID: 1269151 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-04-18
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Fatigue, Headache, Hot flush, Insomnia
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ESTROGEN; PROGESTERONE
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210448502

Write-up: CHEST PAIN; SHORTNESS OF BREATH; TROUBLE FALLING ASLEEP; HOT FLASH; EXTREME FATIGUE; HEADACHE; This spontaneous report received from a patient concerned a 60 year old female. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unk) dose was not reported, administered on 07-APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. Concomitant medications included progesterone for prevent breast cancer, and estradiol for prevent osteoporosis. On 18-APR-2021, the subject experienced chest pain. On 18-APR-2021, the subject experienced shortness of breath. On 18-APR-2021, the subject experienced trouble falling asleep. On 18-APR-2021, the subject experienced hot flash. On 18-APR-2021, the subject experienced extreme fatigue. On 18-APR-2021, the subject experienced headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from headache, chest pain, and shortness of breath, and the outcome of extreme fatigue, trouble falling asleep and hot flash was not reported. This report was non-serious.; Sender''s Comments: V0: Medical assessment comment is not needed as per standard procedure since case is assessed as non-serious.


VAERS ID: 1269284 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-03-13
Onset:2021-04-18
   Days after vaccination:36
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Arrhythmia, Blood pressure measurement, Electrocardiogram ambulatory, Hypertensive crisis
SMQs:, Hypertension (narrow), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (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: LOSARTAN; METOPROLOL; SOTALOL; KLOR-CON; ELIQUIS; FUROSEMIDE
Current Illness:
Preexisting Conditions: Comments: No relevant medical history reported.
Allergies:
Diagnostic Lab Data: Test Date: 20210418; Test Name: blood pressure; Result Unstructured Data: 220-230 over 130-160; Test Date: 20210418; Test Name: blood pressure; Test Result: Inconclusive ; Result Unstructured Data: 111/60; Test Date: 20210418; Test Name: Holter monitor; Result Unstructured Data: showed premature ventricular contractions
CDC Split Type: USMODERNATX, INC.MOD20210

Write-up: Heart arrhythmia; Blood Pressure went up to as high as 230-220 over 160-130.; This spontaneous case was reported by a consumer and describes the occurrence of ARRHYTHMIA (Heart arrhythmia) and HYPERTENSIVE CRISIS (Blood Pressure went up to as high as 230-220 over 160-130.) in a 62-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No relevant medical history reported. Concomitant products included LOSARTAN, METOPROLOL, SOTALOL, POTASSIUM CHLORIDE (KLOR-CON), APIXABAN (ELIQUIS) and FUROSEMIDE for an unknown indication. On 13-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 13-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 18-Apr-2021, the patient experienced ARRHYTHMIA (Heart arrhythmia) (seriousness criterion medically significant) and HYPERTENSIVE CRISIS (Blood Pressure went up to as high as 230-220 over 160-130.) (seriousness criterion medically significant). At the time of the report, ARRHYTHMIA (Heart arrhythmia) outcome was unknown and HYPERTENSIVE CRISIS (Blood Pressure went up to as high as 230-220 over 160-130.) had resolved. Not Provided DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 18-Apr-2021, Blood pressure measurement: 220-230 over 130-160 (High) 220-230 over 130-160 and 111/60 (Inconclusive) 111/60. On 18-Apr-2021, Electrocardiogram ambulatory: abnormal (abnormal) showed premature ventricular contractions. Patient reported that his usual blood pressure was around 140/78-84". His doctor advised him to go to the hospital. He was given clonidine in the ER and his blood pressure dropped to 111/60. The caller was also hooked to a Holter monitor and it showed PVC. Once the blood pressure went down, he was sent home. The patient received both scheduled doses of mRNA-1273 prior to the events; therefore, action taken with the mRNA-1273 in response to the events was not applicable. Company comment: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1269429 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-04-05
Onset:2021-04-18
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Alcohol test negative, Blood test normal, Computerised tomogram normal, Drug screen negative, Dyskinesia, Electroencephalogram normal
SMQs:, Neuroleptic malignant syndrome (broad), Dyskinesia (narrow), Noninfectious encephalopathy/delirium (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: Zyrtec
Current Illness: had a cold within the month prior, was tested and it was not COVID
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CT scan, EEG, blood work, screened for drug and alcohol. All tests came back normal.
CDC Split Type:

Write-up: Dyskinesia for about 2 hours, with involuntary head, arm, leg movements


VAERS ID: 1269609 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-01
Onset:2021-04-18
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208, EP7533 / 2 - / -

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

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

Write-up: Shingles


VAERS ID: 1269667 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-31
Onset:2021-04-18
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Balance disorder, Blood test normal, Computerised tomogram normal, Coordination abnormal, Dizziness, Feeling abnormal, Gait disturbance, Headache, Magnetic resonance imaging normal, Motion sickness, Vertigo, Visual impairment
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Endometriosis, Possible autoimmune issues
Allergies: Wellbutrin
Diagnostic Lab Data: Emergency room visit on 4/19/2021, CT scan, blood tests - all clear MRI on 4/24 - all clear
CDC Split Type:

Write-up: Extreme vertigo event, acute headache, lack of coordination, balance and walking problems, dizziness, motion sickness, brain fog, difficulty looking at screens


VAERS ID: 1269669 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-04-05
Onset:2021-04-18
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: CSF test abnormal, Condition aggravated, Electromyogram abnormal, Full blood count abnormal, Generalised oedema, Guillain-Barre syndrome, Hypertension, Lumbar puncture abnormal, Motor dysfunction, Musculoskeletal disorder, Respiratory distress
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (broad), Haematopoietic leukopenia (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Guillain-Barre syndrome (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Demyelination (narrow), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 9 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Amlodipine, Prevacid , vitamin D,
Current Illness: None known
Preexisting Conditions: Hypertension, obesity, lymphedema, obstructive sleep apnea
Allergies: Amoxicillin
Diagnostic Lab Data: Abnormal EMG, abnormal CSF tap, abnormal CBC,
CDC Split Type:

Write-up: Guillain Barre syndrome. Severe progressive motor impairment upper and lower extremities. Respiratory distress severe widespread edema, hypertension increase,


VAERS ID: 1270428 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-12
Onset:2021-04-18
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Menstruation irregular, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Fertility disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None.
Preexisting Conditions: Post-covid long haul symptoms from March 2020.
Allergies: Amoxicillin, mushrooms, latex sensitivity
Diagnostic Lab Data:
CDC Split Type:

Write-up: 4/13/21 - Day after, started fever, chills, tiredness for 36 hours 4/18/21 - Period started [2 weeks after last period]


VAERS ID: 1271468 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-03-26
Onset:2021-04-18
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Fibrin D dimer, Full blood count, Phlebitis superficial, Ultrasound scan
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D, baby aspirin, cranberry, meclizine, sertraline, prednisone, topamax, lisinopril, simvastatin
Current Illness: NA
Preexisting Conditions: hypertension, psoriatic arthritis,
Allergies: Sulfa, hazelnuts
Diagnostic Lab Data: CBC, D-dimer, vascular US right lower leg
CDC Split Type:

Write-up: superficial phlebitis Right lower leg


VAERS ID: 1271545 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-09
Onset:2021-04-18
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

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

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

Write-up: red itchy spots spread all over body forming a rash. Has spread over the course of days once I start3ed seeing the spots. Very itchy!


VAERS ID: 1273461 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-17
Onset:2021-04-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 558885 / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Patient takes prescribed birth control pills.
Current Illness: None.
Preexisting Conditions: None.
Allergies: Allergic to raisins.
Diagnostic Lab Data: None.
CDC Split Type: vsafe

Write-up: Patient became very dizzy and fainted.


VAERS ID: 1274158 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-06
Onset:2021-04-18
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Musculoskeletal discomfort, Neck pain
SMQs:, Rhabdomyolysis/myopathy (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: I just went to doctor and they suggested reporting these symptoms.
CDC Split Type:

Write-up: In the weeks following my shot, I am feeling much discomfort and pain in my right shoulder blade, shoulder and neck.


VAERS ID: 1274194 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Alaska  
Vaccinated:2021-03-08
Onset:2021-04-18
   Days after vaccination:41
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Coagulopathy, Skin discolouration
SMQs:, Haemorrhage laboratory terms (broad), Hypotonic-hyporesponsive episode (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Daily multi vitamin, vitamin D 3 (50mg)
Current Illness: none
Preexisting Conditions: Chronic back pain, Raynaud''s disease
Allergies: NK
Diagnostic Lab Data:
CDC Split Type:

Write-up: blue purple discoloration of right thumb, right toe, left toe, no injury or bruises. Contacted Teledoc and provided pictures. Dr. described it abnormal findings, clotting vessels.


VAERS ID: 1274983 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-04-17
Onset:2021-04-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test normal, Chest X-ray normal, Chest discomfort, Condition aggravated, Dizziness, Dyspnoea, Electrocardiogram abnormal, Headache, Impaired work ability, Influenza like illness, Mania, Palpitations, Urine analysis
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Psychosis and psychotic disorders (broad), Pulmonary hypertension (broad), Hostility/aggression (broad), Cardiomyopathy (broad), Vestibular disorders (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: Risperidone
Current Illness: Bipolar
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data: I had two EKGs (one during ER visit and one during urgent care visit) showing I had premature atrial contractions (PAC), have had blood work twice checking for blood clots (no blood clots present) (One blood sample on one doctor''s visit and one during urgent care), urine analysis (During ER visit), and chest x ray (during ER visit)
CDC Split Type:

Write-up: At 3 am the night of the vaccine, I woke up with flu like symptoms, including a headache and shortness of breath. Two days later, I had a severe manic episode that lasted for three days (bipolar was well managed with medication at this point and I had not had a manic episode in months). Along with the manic episode, I developed chest pressure and shortness of breath, along with dizziness and a pounding sensation in my chest. Any physical activity or even a sip of coffee sets my heart off. I am still experiencing these symptoms to this day and caused me to lose my job because I am not able to perform the required tasks. I had a premature atrial contraction prior to the COVID vaccine, but it had cleared up and I had been off of the medication for months with no problems. I have been to the doctor''s office (primary care physician-4/15/21 and 4/20/21) twice, the emergency room once (4/26/21), urgent care (4/14/21), and now am seeing a cardiologist for this condition (first visit 4/29/21).


VAERS ID: 1276417 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-04-18
Submitted: 0000-00-00
Entered: 2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: SARS-CoV-2 test, Suspected COVID-19, Vaccination failure
SMQs:, Lack of efficacy/effect (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210418; Test Name: COVID-19 virus test; Result Unstructured Data: Positive
CDC Split Type: USJNJFOC20210444534

Write-up: SUSPECTED CLINICAL VACCINATION FAILURE; SUSPECTED COVID-19 INFECTION; This spontaneous report received from a patient concerned a female of unspecified age. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of administration not reported, batch number: 1805029, expiry: Unknown) frequency one total, dose was not reported, administered on 21-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. The patient reported that since 15-APR-2021, she had head cold with congestion and runny nose. On 18-APR-2021, the patient experienced suspected clinical vaccination failure and suspected covid-19 infection. Laboratory data included: Covid-19 virus test (NR: not provided) Positive. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from suspected covid-19 infection and outcome of suspected clinical vaccination failure was not reported. This report was serious (Other Medically Important Condition). This report was associated with a product quality compliant: 90000177213.; Sender''s Comments: V0:20210444534-COVID-19 VACCINE AD26.COV2.S-Suspected clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS


VAERS ID: 1276718 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-04-18
Onset:2021-04-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002B21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Headache, Hypotension, Loss of consciousness, Nasal congestion, Nasopharyngitis, Pain in extremity, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: No medical history was provided by the reporter
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20210

Write-up: cold like symptoms; stuffy nose; sore arm; headache; unconscious; fainted; blood pressure was low; This spontaneous case was reported by a consumer and describes the occurrence of LOSS OF CONSCIOUSNESS (unconscious) and SYNCOPE (fainted) in a 55-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 002B21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No medical history was provided by the reporter. On 18-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 18-Apr-2021, the patient experienced LOSS OF CONSCIOUSNESS (unconscious) (seriousness criterion medically significant), SYNCOPE (fainted) (seriousness criterion medically significant) and HYPOTENSION (blood pressure was low). On 19-Apr-2021, the patient experienced NASOPHARYNGITIS (cold like symptoms), NASAL CONGESTION (stuffy nose), PAIN IN EXTREMITY (sore arm) and HEADACHE (headache). On 23-Apr-2021, PAIN IN EXTREMITY (sore arm) and HEADACHE (headache) had resolved. At the time of the report, LOSS OF CONSCIOUSNESS (unconscious), SYNCOPE (fainted) and HYPOTENSION (blood pressure was low) had resolved and NASOPHARYNGITIS (cold like symptoms) and NASAL CONGESTION (stuffy nose) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were reported. As treatment, the patient took acetaminophen, ibuprofen and antihistamine. Company comment: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1276747 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-04-04
Onset:2021-04-18
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Asthma
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: medical history of patient was not provided by the reporter.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20210

Write-up: Asthma symptoms; This spontaneous case was reported by a consumer and describes the occurrence of ASTHMA (Asthma symptoms) in a 60-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. medical history of patient was not provided by the reporter. On 04-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 18-Apr-2021, the patient experienced ASTHMA (Asthma symptoms) (seriousness criterion hospitalization). On 23-Apr-2021, ASTHMA (Asthma symptoms) had resolved. mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown Route) dosing was delayed on an unknown date. No treatment information was provided.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1278754 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-17
Onset:2021-04-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injury, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: RECLIPSEN
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Birth control
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021424587

Write-up: Sometime after 8 am on 18Apr2021, more than 13 hrs after receiving the Pfizer vaccine, the patient fainted in her bathroom and hurt her forehead; hurt her forehead; This is a spontaneous report from a contactable consumer. A 33-year-old female patient received the first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE, Lot Number: ER8731), via an unspecified route of administration, on 17Apr2021 at 16:15 (at the age of 33-years-old) as a single dose in the right arm for COVID-19 immunization. Medical history included contraception from an unknown date and unknown if ongoing. The patient has no known allergies.The patient was not pregnant at the time of vaccination. Prior to vaccination the patient had not been diagnosed with COVID-19. Concomitant medication included desogestrel, ethinylestradiol (RECLIPSEN) taken for contraception, start and stop date were not reported. On 18Apr2021 at 08:15, more than 13 hours after receiving the Pfizer vaccine, the patient fainted in her bathroom and hurt her forehead. Treatment for the event fainted included wetting the patient''s face as well as the application of a cold towel to the patient''s forehead. Since the vaccination the patient has not tested positive for COVID-19. The clinical outcome of syncope was reported as recovering. The clinical outcome of injury was not provided.


VAERS ID: 1278771 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-17
Onset:2021-04-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Loss of consciousness, Pain
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021425341

Write-up: passed out at work; extreme fatigue; body aches for a few hours; This is a spontaneous report from a contactable consumer. An 18-year-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), first dose via an unspecified route of administration on 17Apr2021 (Batch/Lot number was not reported) as single dose for covid-19 immunisation. The patient''s medical history and concomitant medications were not reported. It was reported that the following day, 18Apr2021, the patient experienced extreme fatigue and body aches for a few hours, then she passed out at work. The outcome of the events was unknown. Information about lot/batch has been requested.


VAERS ID: 1278775 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-18
Onset:2021-04-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Feeling hot, Hyperhidrosis, Muscle twitching, Mydriasis, Pain in extremity, Syncope, Tremor, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021425494

Write-up: fainted; dizzy; warm; arms had seized up and were twitching; leg and body had also briefly been shaking; eyes were dilated; vomiting; arm is sore; sweaty; This is a spontaneous report from a non-contactable consumer (patient). A 28-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE), dose 2 via an unspecified route of administration, administered in Arm Left on 18Apr2021 11:00 (Batch/Lot Number: Unknown) as SINGLE DOSE for COVID-19 immunisation. The patient was not pregnant at time of vaccination Medical history was reported as none. There were no concomitant medications. The patient previously had first dose of BNT162B2 (Lot number: ER8727) on 28Mar2021 01:00 PM in the left arm at 28 years old for COVID-19 immunisation and experienced fainted. On 18Apr2021 11:15 AM, the patient fainted about 10 minutes after second dose was vaccinated. The patient became dizzy and very warm and then woke up about 5-7 seconds after had fainted. The patient''s arms had seized up and were twitching and leg and body had also briefly been shaking. The patient was very sweaty and warm. The patient''s eyes were dilated when woke up according to the overseeing nurse. The patient said it was scary. Half hour after, the patient felt fine but then began vomiting when got home. The patient''s arm is sore but nothing else has happened. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient has not been tested for COVID-19. The outcome of the events was recovering. No treatment was given to the patient for the events. No follow-up attempts are possible; information about lot/batch number cannot be obtained.


VAERS ID: 1280899 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-01
Onset:2021-04-18
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-05-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain, Headache, Hypoaesthesia, Paraesthesia, Skin discolouration, Sluggishness
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Retroperitoneal fibrosis (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)

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: Plavix Lipitor Nortriptyline Cardizem Imdur
Current Illness: None
Preexisting Conditions: SCAD
Allergies: Phernegen
Diagnostic Lab Data:
CDC Split Type:

Write-up: April 18- severe headaches, abd pain April 21- fingers turning white in both hands, going completely numb and tingling April 24- some fingers turning white and purple, cap refill sluggish longer than 5 secs May 1- whole hand turning white and numb May 2- hand and fingers taking longer to return to normal


VAERS ID: 1281514 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-16
Onset:2021-04-18
   Days after vaccination:33
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: I just got referred by my doctor to see a neurologist.
CDC Split Type:

Write-up: Left arm and left leg numbness. While I can do any activities normal, my left arm and leg feel different to my right side. I haven?t had any pain.


VAERS ID: 1281516 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-04-01
Onset:2021-04-18
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / UNK RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Aphasia, Headache, Intracardiac thrombus, Magnetic resonance imaging thoracic abnormal
SMQs:, Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ASA 81 mg daily, Backlofen QID, Neurontin 400mg TID, Detrol BID, Vitamins, diuretic daily, K daily, Prevacid, Lipitor daily.
Current Illness: Quadriplegic since MVA 1986, Stroke 4 yrs ago
Preexisting Conditions: Quadriplegia, wheelchair, out of bed with assistance, increases L sided upper body weakness since stroke 4 yrs ago
Allergies: none
Diagnostic Lab Data: MRI 4/19/21
CDC Split Type:

Write-up: Pt experienced sever headache, loss of speech transported to Medical Center. 4/19/21 Reports overnight stay and "blood clots" affecting speech, causing HA. Reports clots seen around his heart on MRI Discharged 4/20/21


VAERS ID: 1282369 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-04-08
Onset:2021-04-18
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Pain in extremity
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness:
Preexisting Conditions: High blood pressure, high cholesterol, heart condition
Allergies: No Allergies
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient stated on 04-18-21 that he had pain underneath the upper arm, under the biceps, and numbness in the tip of the left index finger. Symptoms started simultaneously. On good day, patient pain underneath the upper arm is minimal and there is no numbness in the tip of the left index finger. On bad days, the pain is 7/10 underneath the upper arm and there is numbness that he rates as a 4. He did not take any medications to alleviate symptoms.


VAERS ID: 1283741 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-04
Onset:2021-04-18
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Glyburide/metformin hyd, Bydureon BCise inj, Hydrochlorothiazide tab, Synthroid tabm25MCG, Synthroid tab 200MCG, Losarton, Simvastatin tab, Tolterodine tartrate tab. Aspirin 81mg, Calciumn 600mg, Centruim MV/MM, ZytrecD
Current Illness: None
Preexisting Conditions: Diabetic, high blood pressure, high chroestrol.
Allergies: Sulfur, Lodine
Diagnostic Lab Data: Didn''t report to doctor since it was on the weekend and didn''t today. Couldn''t go in to see him might throw up in car.
CDC Split Type:

Write-up: Dizziness, headache, nausea. Took meds all day for headache, nausea and dizziness. Finally slowly started to go away. Had it like 36 hours then was fine. This morning got up with it again and took meds all day again. Slowly going away but is just sickening to feel this way I can''t do anything. I have never had this until got this shot.


VAERS ID: 1291651 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-04-08
Onset:2021-04-18
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1487891223 / N/A LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Coma, Serotonin syndrome
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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: Exederine, Bupropion Lyrica, Wellbutrin, ***Meloxicam***
Current Illness: None Known
Preexisting Conditions: Depression
Allergies: Penicillin
Diagnostic Lab Data: 04/18/2021 to 04/27/2021
CDC Split Type:

Write-up: 4/18/20 Went to hospital. Had to be sedated. Intubated. Transferred to another unit. Spent 4 days in medically induced coma. Later diagnosed with serotonin syndrome.


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