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

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



Case Details

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VAERS ID: 1236163 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Arizona  
Vaccinated:0000-00-00
Onset:2021-04-06
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Chest discomfort, Dizziness, Fatigue, Hyperhidrosis, Limb discomfort, Pain in extremity, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Vestibular disorders (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Asthma; Chronic obstructive pulmonary disease; Gastrointestinal disorder; High cholesterol; Non-smoker; Pollen allergy
Preexisting Conditions: Comments: No drug abuse or illicit drug usage
Allergies:
Diagnostic Lab Data: Test Date: 20210405; Test Name: Blood test; Result Unstructured Data: high cholesterol
CDC Split Type: USJNJFOC20210426765

Write-up: CHEST TIGHTNESS; LEG HEAVINESS; LEG TIGHTNESS; TIREDNESS; THROAT CLOSING UP ON HIM; SWEATING; DIZZY; This spontaneous report received from a patient concerned a 61 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included high cholesterol, pollen allergy, asthma, chronic obstructive pulmonary disease, colon disorder, non smoker, and non alcoholic, and other pre-existing medical conditions included no drug abuse or illicit drug usage. The patient experienced drug allergy when treated with cefalexin. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805020, and expiry: 25-MAY-2021) dose was not reported, administered on 06-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 05-APR-2021, Laboratory data included: Blood test (NR: not provided) high cholesterol. On 06-APR-2021, the subject experienced throat closing up on him. On 06-APR-2021, the subject experienced sweating. On 06-APR-2021, the subject experienced dizzy. On 07-APR-2021, the subject experienced tiredness. On 13-APR-2021, the subject experienced chest tightness. On 13-APR-2021, the subject experienced leg heaviness. On 13-APR-2021, the subject experienced leg tightness. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from sweating, and dizzy on 06-APR-2021, and had not recovered from throat closing up on him, tiredness, chest tightness, leg heaviness, and leg tightness. This report was non-serious.


VAERS ID: 1236193 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Minnesota  
Vaccinated:0000-00-00
Onset:2021-04-08
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Dizziness, Fatigue, Gait disturbance, Headache, Malaise, Tremor
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Arthritis; Dyslexia; Intervertebral disc disorder
Preexisting Conditions: Medical History/Concurrent Conditions: Artificial cardiac pacemaker user
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210427676

Write-up: WHOLE BODY SHAKES; DIZZINESS; TROUBLE WALKING AND HAND TO WALK REAL SLOW; FEELING SICK; CHILLS/SHIVERS; TIREDNESS; HEADACHE; This spontaneous report received from a patient concerned a 67 year old female. The patient''s height, and weight were not reported. The patient''s past medical history included pace maker, and concurrent conditions included arthritis, herniating disk in the lower back, and dyslexia.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 203A21A expiry: 23-JUN-2021) dose was not reported, administered on 08-APR-2021 10:15 for prophylactic vaccination. No concomitant medications were reported. On 08-APR-2021 15:00, the subject experienced whole body shakes. On 08-APR-2021 15:00, the subject experienced dizziness. On 08-APR-2021 15:00, the subject experienced trouble walking and hand to walk real slow. On 08-APR-2021 15:00, the subject experienced feeling sick. On 08-APR-2021 15:00, the subject experienced chills/shivers. On 08-APR-2021 15:00, the subject experienced tiredness. On 08-APR-2021 15:00, the subject experienced headache. Treatment medications (dates unspecified) included: lorazepam, and diphenhydramine hydrochloride. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from whole body shakes, feeling sick, and headache, recovered with sequelae from chills/shivers, had not recovered from dizziness, and tiredness, and the outcome of trouble walking and hand to walk real slow was not reported. This report was non-serious.


VAERS ID: 1236205 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Ohio  
Vaccinated:0000-00-00
Onset:2021-03-01
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: The patient had no known drug allergies.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210427989

Write-up: LEFT FOOT SWELLING COMES AND GOES; LEFT FOOT SORENESS; LEFT FOOT FEELING HOT; This spontaneous report received from a patient concerned a 52 year old male. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included the patient had no known drug allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 042A21A expiry: UNKNOWN) dose was not reported, administered on 23-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On MAR-2021, the subject experienced left foot feeling hot. On 30-MAR-2021, the subject experienced left foot swelling comes and goes. On 30-MAR-2021, the subject experienced left foot soreness. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from left foot swelling comes and goes, and left foot soreness, and the outcome of left foot feeling hot was not reported. This report was non-serious.


VAERS ID: 1236296 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Virginia  
Vaccinated:0000-00-00
Onset:2021-04-07
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain upper, Chest pain, Decreased appetite, Diarrhoea, Dizziness, Dry mouth, Headache, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Noninfectious diarrhoea (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: METFORMIN
Current Illness: Diabetes (Controlled)
Preexisting Conditions: Comments: The patient had no known allergies.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210428968

Write-up: DIZZINESS; DIARRHEA; LOSS OF APPETITE; VOMITING; HEADACHE; NAUSEA; CHEST PAIN; DRY MOUTH; STOMACH PAIN; This spontaneous report received from a patient concerned a 58 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included diabetes, and other pre-existing medical conditions included the patient had no known allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 043A21A expiry: 21-JUN-2021) dose was not reported, administered on 02-APR-2021 for prophylactic vaccination. Concomitant medications included metformin for diabetes. On 07-APR-2021, the subject experienced chest pain. On 07-APR-2021, the subject experienced dry mouth. On 07-APR-2021, the subject experienced nausea. On 07-APR-2021, the subject experienced stomach pain. On 07-APR-2021, the subject experienced headache. On 12-APR-2021, the subject experienced dizziness. On 12-APR-2021, the subject experienced diarrhea. On 12-APR-2021, the subject experienced loss of appetite. On 12-APR-2021, the subject experienced vomiting. Treatment medications (dates unspecified) included: ibuprofen. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from dizziness, and dry mouth, and had not recovered from nausea, headache, vomiting, diarrhea, stomach pain, chest pain, and loss of appetite. This report was non-serious.


VAERS ID: 1236317 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-03
Onset:2021-04-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Blood potassium decreased, Chills, Hyperhidrosis, Laboratory test, Panic attack, Syncope, Tremor
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Hypokalaemia (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft, Progesterone, Probiotic, Multivitamin
Current Illness: none
Preexisting Conditions: none
Allergies: Sulfa, Gluten
Diagnostic Lab Data: Labs done--all normal except low potassium
CDC Split Type:

Write-up: Fainted within 5 minutes of receiving vaccine. Taken by ambulance to hospital. Have been sick with chills, severe shaking, panic attacks, sweating, since then (almost 3 weeks).


VAERS ID: 1236364 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-03-24
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chest discomfort, Fatigue, Headache, Hyperhidrosis, Hypoaesthesia, Pain, Pain in extremity, Pulmonary pain, Thirst
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Dehydration (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210429265

Write-up: SWEATY; BODY ACHES; EXTREMELY THIRSTY; LEFT ARM PAIN/LEGS BURNING; LEFT ARM NUMBNESS; HEADACHE; FATIGUE; LUNG PAIN; LUNG WEIGHT/PINCH IN THE HEART/CHEST DISCOMFORT; This spontaneous report received from a patient concerned a 52 year old male. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808609, and batch number: 1808609 expiry: UNKNOWN) dose was not reported, administered on 24-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 24-MAR-2021, the subject experienced lung pain. On 24-MAR-2021, the subject experienced lung weight/pinch in the heart/chest discomfort. On 24-MAR-2021, the subject experienced body aches. On 24-MAR-2021, the subject experienced extremely thirsty. On 24-MAR-2021, the subject experienced left arm pain/legs burning. On 24-MAR-2021, the subject experienced left arm numbness. On 24-MAR-2021, the subject experienced headache. On 24-MAR-2021, the subject experienced fatigue. On 25-MAR-2021, the subject experienced sweaty. Treatment medications (dates unspecified) included: acetylsalicylic acid, and paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from lung pain, lung weight/pinch in the heart/chest discomfort, headache, fatigue, sweaty, body aches, extremely thirsty, left arm pain/legs burning, and left arm numbness. This report was non-serious.


VAERS ID: 1236396 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Ohio  
Vaccinated:0000-00-00
Onset:2021-04-01
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Computerised tomogram, Fatigue, Headache, Insomnia, Lymphadenopathy, Muscle spasms, Pain, Pain in extremity, Paraesthesia, Pyrexia, Ultrasound scan, X-ray
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Arthritis
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 202104; Test Name: X-ray; Result Unstructured Data: Pre-existing arthritis; Test Date: 202104; Test Name: CAT scan; Result Unstructured Data: Pre-existing arthritis; Test Date: 20210414; Test Name: Diagnostic ultrasound; Result Unstructured Data: No problem in lymph node
CDC Split Type: USJNJFOC20210429928

Write-up: BODY ACHES; INSOMNIA; ENLARGED LYMPH NODE IN LEFT UNDERARM; TINGLING IN ARM; CHILLS; HEADACHE; FEVER; FATIGUE; MUSCLE SPASM; PAIN IN ARM; This spontaneous report received from a patient concerned a 66 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included pre existing arthritis. The patient experienced drug allergy when treated with hydrochlorothiazide/methyldopa, cefalexin, and diazepam. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808609, and batch number: 1808609 expiry: UNKNOWN) dose was not reported, administered on 01-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On APR-2021, the subject experienced muscle spasm. On APR-2021, the subject experienced pain in arm. Laboratory data included: CAT scan (NR: not provided) Pre-existing arthritis, and X-ray (NR: not provided) Pre-existing arthritis. On 01-APR-2021, the subject experienced body aches. On 01-APR-2021, the subject experienced insomnia. On 01-APR-2021, the subject experienced enlarged lymph node in left underarm. On 01-APR-2021, the subject experienced tingling in arm. On 01-APR-2021, the subject experienced chills. On 01-APR-2021, the subject experienced headache. On 01-APR-2021, the subject experienced fever. On 01-APR-2021, the subject experienced fatigue. On 14-APR-2021, Laboratory data included: Diagnostic ultrasound (NR: not provided) No problem in lymph node. Treatment medications (dates unspecified) included: paracetamol, and oxycodone. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from insomnia on 13-APR-2021, chills, and headache, and fever on 06-APR-2021, was recovering from fatigue, had not recovered from body aches, and enlarged lymph node in left underarm, and the outcome of pain in arm, tingling in arm and muscle spasm was not reported. This report was non-serious.


VAERS ID: 1236400 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Unknown  
Location: California  
Vaccinated:0000-00-00
Onset:2021-04-15
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Skin mass
SMQs:, Extravasation events (injections, infusions and implants) (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210429960

Write-up: HARD LUMP ON HAND; This spontaneous report received from a consumer concerned a 39 year old of unspecified sex. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 041A21A expiry: UNKNOWN) dose was not reported, administered on 08-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 15-APR-2021, the subject experienced hard lump on hand. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from hard lump on hand. This report was non-serious.


VAERS ID: 1236568 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-04-11
Onset:2021-04-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Back pain, Computerised tomogram normal, Headache, Nausea
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: they did blood cat scan and found me health.
CDC Split Type:

Write-up: Head aches, first the on 4/14 went to hospital for severe stomach and back pain which lasted about 6 Plus hours with nausea still had head ache for 2 more days. Had no insurance haven''t had any problems before injection.


VAERS ID: 1236650 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-03-06
Onset:2021-03-08
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / UNK LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Gabapentin for sleeplessness Tylenol
Current Illness: I fell on ice on Feb. 7 and had surgery on lower left leg. At time of vaccination, I was still no weight bearing on that leg. The blood clot I developed on March 8 was in my lower left leg
Preexisting Conditions: No other long standing/chronic health conditions
Allergies: None that I know of
Diagnostic Lab Data: Had ultrasound done on March 8th that found clot
CDC Split Type:

Write-up: I began having pain in my lower left leg later on Sunday (felt like a pulled muscle) but by Monday it was more painful. Since I had surgery (see above) my doctor sent me fir an ultrasound where a clot was found. Went to emergency room to further evaluate and get treated. Was given elequis and am taking for 3 months. Was told clot was likely related to immobility from injury, but wanted to report just for your consideration


VAERS ID: 1236681 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-07
Onset:2021-04-12
   Days after vaccination:5
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: Deep vein thrombosis, Ultrasound Doppler abnormal
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: dx 4/15/21 with LE venous duplex
CDC Split Type:

Write-up: RLE DVT--Acute, occlusive deep vein thrombosis in the right gastrocnemius vein--started on anticoagulant--apixaban


VAERS ID: 1236791 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood test, Chest pain, Coronary angioplasty, Coronary artery thrombosis, Electrocardiogram, Impaired work ability, Ultrasound scan abnormal
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Other ischaemic heart disease (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: 4/9 - 4/11/2021 - EKG, ultrasound, blood work
CDC Split Type:

Write-up: Client awoke with chest pain and visited local ER for suspect M.I. Transferred to Hospital for angioplasty, related to thrombosis in R) coronary artery. Treated for 3 days and released to home with 3 months of follow-up cardiac rehab. Scheduled to return back to work as an auto mechanic on 4/26/2021.


VAERS ID: 1236823 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-03-24
Onset:2021-04-20
   Days after vaccination:27
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Condition aggravated, Pleural effusion, Pulmonary embolism, Pulmonary fibrosis
SMQs:, Interstitial lung disease (narrow), Systemic lupus erythematosus (broad), Embolic and thrombotic events, venous (narrow), Pulmonary hypertension (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: 1. Azathioprine 100 mg daily. 2. Bystolic 5 mg daily. 3. Flovent 2 puffs BID. 4. Lasix 20 mg daily. 5. Ofev 150 mg BID. 6. Prednisone 10 mg daily. 7. Ramelteon 8 mg at bedtime. 8. Sildenafil 20 mg TID. 9. Tobramycin nebulizer 300 m
Current Illness: 1. Idiopathic pulmonary fibrosis, on chronic immunosuppressants and prednisone. 2. Pulmonary hypertension. 3. Depression and anxiety. 4. Hypertension. 5. pneumonia
Preexisting Conditions: see above
Allergies: 1. HEPARIN, WHICH HAS CAUSED HIT. 2. LUNESTA. 3. FLUTICASONE. 4. (inaudible) . 5. MONTELUKAST. 6. OXYCODONE 7. TRAMADOL. 8. ZOLPIDEM. HAVE ALL CAUSED RASH. 9. AMOXICILLIN CAUSES DIARRHEA. 10. CLINDAMYCIN HAS CAUSED NAUSEA.
Diagnostic Lab Data: CTA demonstrated a small acute left upper lobe PE with extensive pulmonary fibrotic changes, and a cavitary focus in the right apex seen from prior CT from March, but now containing a small amount of fluid
CDC Split Type:

Write-up: patient received vaccine 3/24/21, presented to the hospital with pulmonary embolism


VAERS ID: 1236887 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-08
Onset:2021-04-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Computerised tomogram thorax abnormal, Decreased activity, Gait disturbance, Pain in extremity, Peripheral swelling, Pulmonary thrombosis, Ultrasound Doppler normal
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, venous (narrow), Parkinson-like events (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? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lansoprozole 15 mg qd , lisinopril 40 mg qd, namenda 5 mg bid, beet root(supplement), turmeric 500 mg qd, doxazosin 4 mg qd, atorvastatin 10 mg qd, Vit D-3 qd. Salmon oil qd, Aricept 5 mg us, Tylenol prn.
Current Illness: None
Preexisting Conditions: Alzheimer?s, HTM
Allergies: Codiene (stomach cramps)
Diagnostic Lab Data: CT Scan of chest on 04/16/21 revealed pulmonary embolism x 3.
CDC Split Type:

Write-up: Extreme lower extremity swelling and pain. Evaluated in PCP office on 04/22/21, ultrasound of right LE was negative for blood clot. Patient?s symptoms worsened and PCP referred patient to ER on 04/16/21 and CT of cheat revealed 3 clots in the lungs. Patient was admitted to hospital and stated on heprin therapy. Still currently inpatient awaiting approval to transfer for inpatient rehab due to decreased endurance and bilateral lower extremity pain which is affecting ability to ambulated without assistance.


VAERS ID: 1236916 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-04-12
Onset:2021-04-16
   Days after vaccination:4
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: Activated partial thromboplastin time prolonged, Cardiac arrest, Cardioversion, Death, Endotracheal intubation, Fibrin D dimer, International normalised ratio normal, Platelet count normal, Prothrombin time prolonged, Resuscitation, Unresponsive to stimuli, Ventricular fibrillation
SMQs:, Torsade de pointes/QT prolongation (broad), Liver-related coagulation and bleeding disturbances (narrow), Anaphylactic reaction (broad), Angioedema (broad), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Ventricular tachyarrhythmias (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Respiratory failure (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-16
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Diabetes, Hypertension, CAD, and back pain
Allergies: NKDA
Diagnostic Lab Data: 4/16 10:35 AM: Platelet count 172,000; PT 12.6; INR 1.11; aPTT 45.1 4/16 11:00AM: D-Dimer, Quantitative: 4705
CDC Split Type:

Write-up: On 4/16 at around 10:24AM, patient presented to emergency department via EMS status post a witnessed cardiac arrest. After the witnessed cardiac arrest, EMS was called and reported that the patient was unresponsive. Per EMS, patient was immediately intubated and chest compressions started. EMS reports an initial cardiac rhythm of VFib and shocked patient once. Patient was given 3 epinephrine and brought into the ED. After prolonged CPR and resuscitation for more than hour and a half, the patient was made DNR/DNI and was pronounced dead at 11:45AM.


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: 1236988 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-06
Onset:2021-04-14
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Deep vein thrombosis, Ultrasound Doppler abnormal
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: diclofenac
Current Illness:
Preexisting Conditions: rosacea sleep apnea
Allergies: erythromycin peanuts sulfa tree nuts
Diagnostic Lab Data: Venous doppler
CDC Split Type:

Write-up: Acute deep vein thrombosis (DVT) of popliteal vein of left lower extremity


VAERS ID: 1237005 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-03
Onset:2021-04-10
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / IM

Administered by: Public       Purchased by: ?
Symptoms: Anxiety, Computerised tomogram head, Headache, Laboratory test
SMQs:, 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: unknown
Current Illness: Lyme''s disease
Preexisting Conditions: above
Allergies: none
Diagnostic Lab Data: CT head many lab work
CDC Split Type:

Write-up: States that soon after she has experienced really severe headaches and increase in anxiety


VAERS ID: 1237132 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-04-08
Onset:2021-04-19
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain, Pain in extremity
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: unnknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: none
Diagnostic Lab Data: unknown Follow up phone call on 04/20/21 patient reported going to urgent care facility and reports receiving no treatment despite lingering symptoms.
CDC Split Type:

Write-up: Pt phoned our office on 04/19/21 with complaints of abdominal pain and bilateral leg pain. Pt was instructed to seek immediate health care for evaluation. He refused. Pt was very agitated and concerned about covering costs of medical care despite having health care insurance. Pt again instructed to seek health care and he refused.


VAERS ID: 1237138 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-03-26
Onset:2021-04-09
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Headache, Transient ischaemic attack
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (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: Flu shot-caused pt to feel flu like symptoms following shot for at least 2 weeks
Other Medications: Eliquis
Current Illness: Unknown
Preexisting Conditions: Hx of stroke
Allergies: Allergies to iodine and benadryl
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt states that she experienced headaches off and on from 03/26/21-04/09/21. Pt states she went to hospital 04/09/21 and was diagnosed with TIA. Pt states that she is now showing signs of improvement with no more headaches (04/21/2021).


VAERS ID: 1237164 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-01
Onset:2021-04-21
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Blood fibrinogen increased, Computerised tomogram head abnormal, Dizziness, Fibrin D dimer increased, Haematocrit normal, Haemoglobin normal, International normalised ratio normal, Platelet count normal, Prothrombin level increased, Transverse sinus thrombosis, Vertigo, Vomiting, White blood cell count normal
SMQs:, Acute pancreatitis (broad), Haemorrhage laboratory terms (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, venous (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Central nervous system vascular disorders, not specified as haemorrhagic or ischaemic (narrow), Vestibular disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: METFORMIN, AMLODIPINE-BENAZEPRIL, GLIPIZIDE
Current Illness: N/A
Preexisting Conditions: DIABETES, HYPERTENSION
Allergies: OMEPRAZOLE
Diagnostic Lab Data: ALL LABS DRAWN ON 4/21/2021 : D-DIMER: 0.94 FIBRINOGEN: 413 INR: 1.06 PRO-THROMBIN 13.6 WBC: 7.7 HGB: 13.7 HCT: 43.9 PLATELETS: 323 PF4 ASSAY, DIC, IgM, PROTEIN C & S PENDING
CDC Split Type:

Write-up: PATIENT PRESENTED TO OUR EMERGENCY ROOM WITH COMPLAINTS OF DIZZINESS, VERTIGO, AND VOMITING WHICH ONSET WAS ONE DAY. PATIENT REPORTS RECEIVING JOHNSON & JOHNSON COVID VACCINE 2 WEEKS AGO . CTA OF HEAD SHOW POSSIBLE TRANSVERSE VENOUS SINUS THROMBOSIS ABOUT 7MM, PATIENT IS ADMITTED TO ICU FOR FURTHER WORK UP .


VAERS ID: 1237186 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-03-20
Onset:2021-04-21
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Erythema, Gait disturbance, Pain in extremity, Skin disorder
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Seroquel, Metoprolol tartrate, Nitroglycerin, Trazodone, Gabapentin, Latuda, Atorvastatin, Metformin, ProAir, Narcan PRN
Current Illness: Weight loss of unclear etiology, acute chest pain
Preexisting Conditions: Prediabetes, Mixed hyperlipidemia, osteoarthritis
Allergies: No known drug allergies
Diagnostic Lab Data: Patient was referred to emergency department by PCP after describing these symptoms during a telephone visit on 04/21/2021
CDC Split Type:

Write-up: The patient states that on March 20 he was vaccinated with the Johnson and Johnson COVID-19 vaccine. He states that over the past several days he has developed erythema of the palms and a change of appearance of the palms that ?looks like they aged 3 years.? He states that he has developed new onset pain of the thigh, which has made ambulation difficult. He states that these symptoms were not present prior to obtaining the vaccine.


VAERS ID: 1237338 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-04-02
Onset:2021-04-14
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Blood test, Chest X-ray, Chest pain, Electrocardiogram, Erythema, Inflammation
SMQs:, Anaphylactic reaction (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: EKG 4/15 Blood Test 4/15 Chest X-ray 4/15
CDC Split Type:

Write-up: Pain in chest and back began on Wednesday 4/14. What started out feeling like an uncomfortable pulled muscle in my back/chest area on Wednesday escalated rapidly to very sharp stabbing pains in my chest and back by Thursday afternoon 4/15. After discussing my symptoms with the office of my PCP Thursday afternoon, I was told to go to the Emergency Room for evaluation. I checked into the ER at approx 6pm that Thursday evening on 4/15. While there I underwent a blood test, EKG and a chest Xray. Upon evaluating the results of each test the Dr on assignment stated that there were no problems with major organs but could not diagnose. Small red marks began developing on the right side of my chest that same day and progressively expanded in quantity across the right side of my chest and back. A follow-up visit with my PCP was completed on Tuesday 4/20 and the diagnosis of Shingles was confirmed. Pain has not subsided and has only gotten worse as of 4/21. Prescription treatments began the evening of 4/20.


VAERS ID: 1237348 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-03-16
Onset:2021-03-31
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Deep vein thrombosis, Pain in extremity, Peripheral swelling, Ultrasound Doppler abnormal, X-ray
SMQs:, Cardiac failure (broad), Angioedema (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ambien, carvedilol, insulin, benazepril, cpap machine, Lasix, metformin, novolog, omeprazole, potassium, simvastatin, spironolactone, urine glucose.
Current Illness: none
Preexisting Conditions: diabetes, obesity, high blood pressure, hypercholesterolemia.
Allergies: no known allergies
Diagnostic Lab Data: x-ray hand 4/1/2021- normal us right arm 4/1/2021- forearm DVT
CDC Split Type:

Write-up: Patient reports right hand severe swelling starting one week after Johnson and Johnson covid vaccine with pain in the hand. She went to ER and US showed a DVT in forearm. Patient was placed on aspirin and states the swelling has improved some but still has some swelling and pain.


VAERS ID: 1237397 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-09
Onset:2021-04-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Contusion, Peripheral coldness, Swelling, Ultrasound scan
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), 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:
Current Illness:
Preexisting Conditions: HIGH BLOOD PRESSURE, HIGH CHOLESTEROL
Allergies:
Diagnostic Lab Data: ULTRASOUND AT URGENT CARE DETERMINED NO BLOOD CLOTS IN EITHER LEG PER FAMILY REPORT
CDC Split Type:

Write-up: CLIENT HURT HER ANKLE COMING OUT OF HER BED ON 4/10/21 AND DEVELOPED A BIG BRUISE, SWELLING, AND COOL TO TOUCH THAT DIDN''T HEAL AND REQUIRED A UREGENT CARE VISIT ON 4/21/21. SYMPTOMS HAVE STAYED THE SAME , NOT PROGRESSIVELY GETTING WORSE. CLIENT WENT TO SEE HER PRIMARY AND HE SAID IT WAS ''ANGRY'' AND NEEDED A VISIT TO URGENT CARE FOR AN ULTRASOUND TO RULE OUT A BLOOD CLOT.


VAERS ID: 1237416 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2021-04-01
Onset:2021-04-12
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Fibrin D dimer, Insomnia, Oedema, Peripheral swelling, Tendon pain, Ultrasound Doppler normal
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Tendinopathies and ligament disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lipitor, propranolol, famotidine
Current Illness: none
Preexisting Conditions: hyperlipidemia, migraines
Allergies: NKDA
Diagnostic Lab Data: ddimer + doppler neg for DVT
CDC Split Type:

Write-up: RLE swelling starting ankle then progressed to knee. Associated with pain in the Achilles tendon with ambulation. Severe enough to prevent sleep. Went to the ER and was evaluated. Given dose of lovenox and had formal doppler on 4/19/21 which showed no DVT. The pain and edema have improved but not resolved yet. There were no injuries around this time to explain the edema or pain.


VAERS ID: 1237425 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-04-08
Onset:2021-04-11
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vaccine was administered on 4/8/2021 and patient stated on vaccine questionnaire that she has had a severe reaction to a vaccine in the past. When interviewed, she indicated that her physician did recommend she receive the vaccine. We confirmed that she should wait 30 minutes, which she did. She was accompanied by her husband at the visit as well. It was later reported that Sunday, 4/11/2021, she began having a rash (hives) and some breathing difficulty which caused her to go to the ER. Her breathing continued to be an issue and she was hospitalized on Wednesday 4/14/2021 (admitted to PCU per husband).


VAERS ID: 1237450 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-03-04
Onset:2021-04-06
   Days after vaccination:33
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Deep vein thrombosis, Ultrasound scan
SMQs:, Embolic and thrombotic events, 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: lipitor 10mg daily metoprolol 100mg bid mycophenolate 720mg dr BID rapamune 1 mg daily
Current Illness: na
Preexisting Conditions: h/o kidney transplant 2007
Allergies: nkda
Diagnostic Lab Data: confirmed on Ultrasound 4/20/21
CDC Split Type:

Write-up: DVT right ulnar vein 4/6/21


VAERS ID: 1237454 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-03-22
Onset:2021-03-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test normal, Pain, Urine analysis
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin Neurontin Zofran Vitamin c Bcomplex Vitamin d Calcium Wellbutrin Prilosec Buspar Klonopin Remeron Fenofibrate Dicyclomine HCL
Current Illness: Type 2 Diabetes Depression Dissociative Identity Disorder Fibromyalgia Polymyalgia Rheumatica Cortico Steroid Myopathy Spinal Stenosis Tardive Dyskinesia
Preexisting Conditions: See # 11
Allergies: Elavil Demerol Statins Seroquel
Diagnostic Lab Data: 3 sets of blood tests were done and all came back normal A urinalysis came back normal
CDC Split Type:

Write-up: I woke up on 3/23/21 with every reaction listed on the paperwork they gave me except a fever. I had terrible body pain as the worse reaction and it lasted 2-1/2 weeks. It seemed to be going away for 3 days then slammed me again. When my dr put me on Predisone it helped tremendously I went to the hospital about 7 days after the vaccine and they said I was having a severe reaction


VAERS ID: 1237546 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Pain in extremity, Somnolence
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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: none
Current Illness: none
Preexisting Conditions: none
Allergies: acetophetamin
Diagnostic Lab Data: Went to urgent care and they gave me the all clear for no blood clots (as of 4/18/21).
CDC Split Type:

Write-up: extreme sleepiness (for 2 days), stomach pain (for 5 days), leg pain (1 day); scan on injection site (still present on 4/21/21 - 13 days post vaccine).


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

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

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

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


VAERS ID: 1237615 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram head, Gaze palsy, Nausea, Pain in extremity, Ultrasound scan
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ocular motility disorders (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Ashlyna -birth control Probiotics with prebiotics and cranberry pills Adrenal Health pills Women?s multi vitamins
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Went to urgent care (04/20) and got sent to radiology for a head ct and ultrasound on my leg. Scans came back normal and the doctor that treated me said she didn?t find anything wrong. I expressed my concerns (04/14) , my primary doctor, who said my reactions would pass.
CDC Split Type:

Write-up: Nausea, headaches, leg pain (04/08 - 04/10) Nonstop headaches, pain in lower right calf (04/08 - Currently)


VAERS ID: 1237628 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-06
Onset:2021-03-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Audiogram, Bell's palsy, Deafness, Laboratory test, Magnetic resonance imaging, Tinnitus
SMQs:, Hearing impairment (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Amberen, flovent, zyrtec
Current Illness: None
Preexisting Conditions: Graves disease in remission
Allergies: None
Diagnostic Lab Data: MRI, audiology exam, blood work
CDC Split Type:

Write-up: Bell''s palsy, tinnitus, and hearing loss


VAERS ID: 1237651 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Idaho  
Vaccinated:2021-03-26
Onset:2021-04-14
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram head abnormal, Magnetic resonance imaging head normal, Thrombosis, Venogram abnormal
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (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: warfarin
Current Illness:
Preexisting Conditions: Primary hypercoagulable state (HCC)
Allergies:
Diagnostic Lab Data: 4/14 CT Venogram Head: "nonocclusive appearance of filling defect in left transverse sinus could represent a small nonocclusive thrombus" 4/14 MRI Brain: "no mr evidence of dural venous sinus thrombosis 4/15 CT Venogram Head: "no change in size or appearance of the irregular nonocclusive filling defects involving the left transverse and sigmoid sinuses"
CDC Split Type:

Write-up: Possible cerebral venous sinus thrombosis


VAERS ID: 1237686 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-09
Onset:2021-03-15
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 RA / IM

Administered by: School       Purchased by: ?
Symptoms: Blood pressure increased, Chest pain, Dyspnoea, Headache, Hypertension
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypertension (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: blood pressure meds, lexapro, protonix
Current Illness: none
Preexisting Conditions: hypertension and gerd
Allergies: penicillin, doxycillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: 6 days after shot I got a debilitating headache (the worst headache of my life 10/10 pain). I went to the ER and they proceeded to do a CT scan and blood work. Nothing abnormal was found. The next day I went to Hospital ER due to the head pain, shortness of breath, chest pain and high blood pressure. They put me on steriods and pain meds and I was referred to a Cardiologist and neurologist. 4 days later I was in the ER again for head pain, my BP was 220/125 due to pain when entering the hospital. After about 2 weeks, I saw a neurologist. He prescribed various pain meds including anti- seizure meds and shots. The cardiologist feels that it is not a heart issue. I remain having daily headaches 6 weeks later but the intensity is lower (5/10). My BP is now back at a normal level. I am awaiting 2 more tests. MRV and spinal puncture test.


VAERS ID: 1237691 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-03-08
Onset:2021-03-16
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / N/A LA / JET

Administered by: Public       Purchased by: ?
Symptoms: Automatic positive airway pressure, C-reactive protein increased, COVID-19, Chest pain, Diplopia, Fatigue, Giant cell arteritis, Haemoglobin decreased, Headache, Hyperplasia, Influenza A virus test negative, Influenza B virus test, Insomnia, Lacrimation increased, Monocyte count increased, Nausea, Pathology test, Pyrexia, Red blood cell sedimentation rate increased, SARS-CoV-2 antibody test positive, Sinusitis, Vomiting
SMQs:, Acute pancreatitis (broad), Haematopoietic erythropenia (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Optic nerve disorders (broad), Cardiomyopathy (broad), Vasculitis (narrow), Lacrimal disorders (narrow), Ocular motility disorders (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (narrow), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Simvastatin 10mg
Current Illness: sciatica
Preexisting Conditions: chronic kidney stage 2
Allergies: Bactrim
Diagnostic Lab Data: 3/25: Covid 19 Ab IgG: POS; Covid 19 Ab IgM: POS; rapid Influenza A & B: NEG 3/26: SED rate: 70 mm/hr. Absolute Monocytes: 1380 cells/uL. Hemoglobin: 12.3 g/dL
CDC Split Type:

Write-up: 3/16 - 3/23 : fewer ( 100 -101 F), headache. used Tylenol 3/24 : fewer, headache, nausea, vomiting. used Tylenol 3/25 : fewer, headache, watery eye. stayed in ER. diagnosed sinus infection. treated with Amox/clav 875mg-125mg; claritin; Tylenol 3/26 - 3/28: fewer, serious headache, double vision. continue used butal/apap/caf 50-325-40; Amox/clav 875mg-125mg; waiting for schedule MRI. 3/29 - 3/31: fewer, serious headache, double vision. stayed in hospital. continue used butal/apap/caf 50-325-40; Amox/clav 875mg-125mg.


VAERS ID: 1237702 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-04-03
Onset:2021-04-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, Groin pain, Headache, Hepatomegaly, Muscle rigidity, Pain, Pain in extremity, Pyrexia, Renal pain, Skin discolouration, Testicular swelling, Ultrasound scan, Urinary retention, Urinary tract infection, Urine analysis
SMQs:, Liver related investigations, signs and symptoms (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Osteonecrosis (broad), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro 10mg 1/pd; Cozaar 100mg 1/pd
Current Illness: None
Preexisting Conditions: Fatty liver Elevated blood pressure
Allergies: None
Diagnostic Lab Data: Ultrasound Urine test
CDC Split Type:

Write-up: Persisted for three days: Arm soreness Headaches Body Aches Tiredness/fatigue These faded and on 4/7/2020, liver began to feel enlarged for two days. This was followed by UTI; pain in kidneys and groin; rigidity, discoloration, and extreme swelling in right testicle; inability to urinate; 100-degree fever. Remains on antibiotic (Keflex 500mg 4/pd) and Flomax. Testicle rigidity & some swelling remain.


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: 1237762 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-07
Onset:2021-03-21
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Dizziness, Dyspnoea, Hallucination, Oedema peripheral, Oxygen saturation decreased
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Psychosis and psychotic disorders (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Respiratory failure (broad), Infective pneumonia (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: Losartan, plaquenil, omeprazole, methotrexate, escitalopram
Current Illness: Depression, hypertension, rheumatoid arthritis, Gerd, obesity
Preexisting Conditions: Depression, hypertension, rheumatoid arthritis, Gerd, obesity
Allergies: None
Diagnostic Lab Data: Spo2 78% 4/21/2021
CDC Split Type:

Write-up: Hallucination, shortness of breath, dizziness, weakness, leg edema and low oxygen level. Patient sent to hospital for evaluation and treatment.


VAERS ID: 1237803 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-17
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Chest pain, Computerised tomogram thorax, Gene mutation identification test negative, Hypoaesthesia, Muscular weakness, Myocardial strain, Pulmonary embolism
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Embolic and thrombotic events, venous (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lexapro Trazodone Etonogestrel (implanted progestin)
Current Illness: None
Preexisting Conditions: Asthma GERD Migraines Anxiety Depression Obesity, BMI 31.6
Allergies: NKA
Diagnostic Lab Data: 4/18 CTA shows multifocal PE with right heart strain. Factor v Leiden and factor II mutation analyses were negative. No coagulopathy conditions identified.
CDC Split Type:

Write-up: Presented to ED 4/18 with severe L sided chest pain since 4/17. Arm weakness and numbness 4/18 that lasted a few hours but resolved. No vision changes. O2 sat was 100% on room air. Diagnosed with PE. No recent mobilization. Does not smoke or use illicit drugs. Was admitted to the hospital telemetry unit 4/18-4/20. Discharged on apixaban. I do not have any information on the vaccine Lot number received.


VAERS ID: 1237846 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-05
Onset:2021-04-21
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 UN / IM

Administered by: Other       Purchased by: ?
Symptoms: Headache, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Gianvi (drospirenone/ethinyl estradiol tablets)
Current Illness: Migraines
Preexisting Conditions: Migraines
Allergies: No known allergies to drugs or foods
Diagnostic Lab Data: Patient was sent to the emergency department for further testing and for an immediate medical evaluation. I do not have access to this records. The patient stated she would be going to the Hospital.
CDC Split Type:

Write-up: Patient received the Johnson & Johnson / Janssen COVID-19 vaccine on April 5, 2021. Patient woke up overnight with severe headache that was different than her typical migraines headaches. Headache was "like I never had before", "it''s really painful." When I asked if this was the worst headache of her life she responded "probably." No photophonia, no phonophobia, no nausea, and no vomiting, which she gets every time she has migraines. "This is a different type of headache," she said. "I usually throw up and my headaches get better." This headache feels like a "balloon in my head." She reported vision changes (blurred vision) 45 minutes prior to our visit which started at 8:19 a.m. on April 21, 2021. ("I was having a problem with peripheral vision, about 45 minutes ago," but not so much now. Patient denies loss of balance (dizziness), seizures, focal weakness, radicular symptoms, saddle anesthesia, sensory changes, slurred speech, numbness, chills, and fever. She was sent to the emergency department for further evaluation. She is a female patient with new, severe headache that is between 18 and 48 years of age, and has received the Ad26.COV2.S (COVID-19) vaccine within 3 weeks of headache onset.


VAERS ID: 1237920 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-03-31
Onset:2021-04-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Back pain, Blood urine present, Computerised tomogram, Culture urine
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Retroperitoneal fibrosis (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: Nuva Ring
Current Illness: None
Preexisting Conditions: None
Allergies: PCN
Diagnostic Lab Data: CT of abd 4/1/2021 and urine culture 4/2/2021
CDC Split Type:

Write-up: Blood in urine and back pain


VAERS ID: 1237936 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-04-08
Onset:2021-04-13
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Chest pain, Dyspnoea, Pain in extremity, Thrombosis
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: tylenol 650 mg
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: sulfa
Diagnostic Lab Data: blood work, imaging, medications
CDC Split Type:

Write-up: Blood clot in right arm , SOB, CHEST PAIN, arm pain,


VAERS ID: 1237941 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-03-16
Onset:2021-04-17
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Chest pain, Deep vein thrombosis, Discomfort, Ultrasound Doppler
SMQs:, Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: perforated PUD status post embolization and laparoscopic repair, previous alcohol abuse, alcoholic cirrhosis, hepatitis C, COPD, HTN, anxiety, chronic pain on methadone, chronic DVT/past PE post IVC filter, not on OAC.
Allergies: codeine
Diagnostic Lab Data: High-resolution venous duplex technique was used to investigate the right and left lower extremity venous systems where accessible to study. Chronic appearing thrombus is seen within the proximal, middle and distal portions of the right femoral vein. Clot in this vessel was seen on the prior study. Acute thrombus is present within the left popliteal vein, new from prior. The popliteal thrombus is nearly occlusive.
CDC Split Type:

Write-up: Patient presented to the ER with chest pain, non radiating, heavy weight. Patient was found to have acute DVT.


VAERS ID: 1237995 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
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: Abdominal pain, Blood test, Computerised tomogram, Fatigue, Headache, Hypoaesthesia, Neuralgia, Pain, Pain in extremity, Paraesthesia, Pyrexia, Ultrasound scan
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Compazine
Diagnostic Lab Data: Urine test CT scan Ultra sound Blood work
CDC Split Type: vsafe

Write-up: Within about 2 hours, I felt really tired. A couple hours later I got body aches and tingling sensation on the left leg. That night it got worse, hurt and some numbness. The following day I had abdominal pain and still had leg symptoms. On Saturday I needed up going to Urgent Care . They did a Urine test, that was negative, but did see traces of blood but she wasn''t concerned and did I send it our for a culture test. She sis an exam and a little concern because she wasn''t aware of the side effects and ordered an ultra sound. She told me to take Tylenol and sent me home. I was still experiencing all everything the next day and developed a headache. The Urgent care Dr had called me the next day asked me to go in and get the Ultra sound. They didn''t find anything. I did have another ultra sound scheduled and had it done, I got the results and it was fine. She thinks the vaccine effected my nerves. I also seen my Primary Physician because I had a fever as well, she did an exam and ordered Blood work and CT scan (abdomen). Everything came back normal. My OCO believes it''s my nerves as well. I believe it effected my mensural cycle as well because it''s earlier and heavier.


VAERS ID: 1238038 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Discomfort, Gait disturbance, Sciatica
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Patient states that she recently received her Johnson and Johnson covid vaccine on 4/8/21. After receiving the vaccine, she began experiencing right sided sciatica symptoms with painful sitting and ambulating. Did present to urgent care who evaluated and prescribed muscle relaxants. Today patient states that she is still very uncomfortable. Nighttime and using the bathroom (chair rise/sitting down) are the most painful. Symptoms discussed with PCP. Will continue prescribed Naproxen at this time and may also use tylenol. Should avoid any additional NSAIDS (ibuprofen, motrin). Rest and hydrate. Notified that we will check in with her on Thursday to see how she is progressing. Instructed to call wellness center sooner if symptoms are worsening.


VAERS ID: 1238098 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-04-21
Onset:2021-04-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chills, Electrocardiogram, Headache, Palpitations, Pyrexia, Urine analysis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Flu shot, unknown, extremely ill with the flu
Other Medications: Allegra 180 Mg x 1 daily Biotin 5000mcg x 1 daily Ezetimibe 10mg x 1 daily Glipizide 10mg x 1 daily Jardiance 25 mg x 1 daily Probiotic 1.5 billion cells x 1 daily Losartan 25mg x 1 daily Singulair 10mg x 1 daily Vitamin B12 1000 mcg x 1 da
Current Illness: None
Preexisting Conditions: Diabetes Type 2 Allergies - inhaled, environmental Factor V Leiden Asthma High Blood Pressure
Allergies: Morphine Iodine Iodine injectable Fish - All Shellfish - All Poppy Seeds
Diagnostic Lab Data: 4/13/2021 1:00am - 6:00am EKG x 2, IV fluids, IV Motrin, Blood work, Urinalysis, oral tylenol
CDC Split Type:

Write-up: 4:30 pm - 12:00am started with Chills, Fever at highest was 102.3, Headache, Heart Palpitations - resting heart rate of 134 bpm spoke with Telemed and referred to local ER Department


VAERS ID: 1238101 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram normal, Hypoaesthesia, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Ct scans 4-10-2021 negative
CDC Split Type:

Write-up: High fever, numbness on left side of body no feeling on my legs down to my feet


VAERS ID: 1238151 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-03
Onset:2021-04-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Cholelithiasis, Cold sweat, Dizziness, Dysstasia, Erythema, Fatigue, Headache, Hepatic steatosis, Nausea, Pain, Pyrexia, Ultrasound scan, Urine analysis, Vomiting
SMQs:, Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gallbladder related disorders (narrow), Gallstone related disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: tephra, abilify, prozac, hydroxyzine gabapentin, Benadryl, albuterol as needed
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: ultrasound - gall stones blood work and UA - normal blood clots - none
CDC Split Type: vsafe

Write-up: cold sweats fever fatigue nausea, vomitting, redness of skin, body aches, headaches, gall stones and fatty liver disease, all started happening within a couple of hours of getting the shot, symptoms lasted over a week. I went to the ER I couldn''t stand up I was about to pass out.


VAERS ID: 1238167 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chills, Electrocardiogram, Headache, Palpitations, Pyrexia, Urine analysis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Flu shot, unknown, extremely ill for 2 days following shot
Other Medications: Allegra 180mg x 1 daily Biotin 5000 mcg x 1 daily Ezetimibe 10mg x 1 daily Glipizide 10mg x 1 daily Jardiance 25mg x 1 daily Probiotic 1.5billion cells x 1 daily Losartan 25mg x 1 daily Singulair 10mg x 1 daily Vitamin B12 1000mcg x 1 daily
Current Illness: None
Preexisting Conditions: Diabetes Type 2 Asthma Allergies - Inhaled, Food, Environmental High Blood Pressure Factor V Leiden
Allergies: Iodine, topical Iodine, injectable Morphine Shellfish - All Fish - All Poppy Seeds
Diagnostic Lab Data: 4/13/2021 1:00am - 6:00am - ER visit - treated with EKG x 2 times, IV Fluids with IV Motrin given, Blood work, Urinalysis and oral Tylenol
CDC Split Type:

Write-up: 4:30pm - 12:30am - Started with Chills, went to Fever of 102.3 and worse chills, headache and heart palpitations with resting heart rate of 134 bpm. spoke with telemedicine doctor and referred to ER at 12:30am


VAERS ID: 1238210 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-03-07
Onset:2021-03-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / IM
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, Dizziness, Fall, Feeling abnormal, Head injury, Headache, Nausea, Tinnitus, Vertigo, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hearing impairment (narrow), Vestibular disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: no
Preexisting Conditions: Hepatitis C for 15 years from blood transfusion; cured 3 years
Allergies: Morphine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Night of vaccine, patient experienced weekness, dizziness, nausea/vomiting, felt "odd". prolonged symptoms, tinnitis, continues to get dizzy and fall. One fall resulted in hitting head leading to ER visit. continued vertigo to this day, new onset of headaches. has reported this to pcp.


VAERS ID: 1238256 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-03-21
Onset:2021-03-21
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: School       Purchased by: ?
Symptoms: Angiogram abnormal, Angiogram cerebral abnormal, Cerebral haemorrhage, Computerised tomogram head abnormal, Fatigue, Full blood count, Headache, Laboratory test, Magnetic resonance imaging head abnormal, Malaise, Maximal voluntary ventilation
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amlodepine, atenolol, ativan
Current Illness: none
Preexisting Conditions: hypertension
Allergies: none
Diagnostic Lab Data: CBC, Chem profile, CT Head, MRI Brian, MRA & MVV
CDC Split Type:

Write-up: headache, fatigue & malaise since day of vaccine until cerebral hemorrhage on 4/18/21


VAERS ID: 1238279 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-08
Onset:2021-04-14
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure fluctuation, Blood pressure increased, Computerised tomogram, Dizziness, Headache, Nausea
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Cardiomyopathy (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin C, Vitamin D
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data: CT Scan - April 16, 2021 - No hemorraging Further Tests pending
CDC Split Type:

Write-up: Sever Uncontrollable Headache, Elevated and erratic blood pressure (186/101) for 7 days followed by Moderate- Bad headache with severe nausea and lightheadedness, erratic blood pressure,, still ongoing


VAERS ID: 1238291 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-03-17
Onset:2021-03-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anosmia, Dyspnoea, Headache, Rhinorrhoea
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Patient sent to the ER for Headache and possible COVID testing as symptoms are indicative of COVID
CDC Split Type:

Write-up: Patient has had severe headache since vaccine - starting day after - "worst headache of his life". Now has loss of smell, shortness of breath and nasal drainage


VAERS ID: 1238326 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-06
Onset:2021-04-06
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory failure, Atrial flutter, Death, Generalised oedema, Hypothyroidism, Respiratory distress
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Supraventricular tachyarrhythmias (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypothyroidism (narrow), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-15
   Days after onset: 9
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: This 82 year old male hospice patient received the Covid shot on 3/6/21 and went to the ED on 4/6/21 and was admitted on 4/6/21 with respiratory distress, acute hypoxemic respiratory failure, anasarca, atrial flutter, hypothyroid and died on 4/15/21. Please refer to the other details submitted within this report and contact the person who submitted this report via email for additional follow up details and investigation.


VAERS ID: 1238359 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-03-30
Onset:2021-03-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / N/A RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Back pain, Blood urine present, Chills, Discomfort, Fatigue, Feeling abnormal, Headache, Micturition urgency, Musculoskeletal stiffness, Pain, Pain in extremity, SARS-CoV-2 test negative, Sleep disorder, Thirst, Urine analysis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Dehydration (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid
Current Illness: no
Preexisting Conditions: thyroid removed in 2004 (for thyroid cancer) - not affecting me anymore
Allergies: penicillin - sensitivity; seasonal allergies; cat allergies
Diagnostic Lab Data: 11th - Urgent Care - Urine specimen and culture - presence of blood and absence of nitrate; culture - didn''t show UTI Lab test - for antibodies - for COVID- came back negative (don''t know which test they ran)
CDC Split Type: vsafe

Write-up: About 9 pm I felt fatigue, I went to bed. I took 800 mg of ibuprofen and 1000 mg Tylenol as a pain medication. I drank a bunch of water and took an Emergen-C. I fell asleep by 10:00. I slept and I woke up - shocked awake around 04:30 am - I was super thirsty. My whole body was really sore and stiff and I had a headache. It was uncomfortable but not unmanageable. I decided to take more Tylenol and Ibuprofen and drink more water again. I got back in bed and was feeling a lot of symptoms - I was really sore in my thigh muscles, lower back, knees and forearms. I had slight chills; I was pretty uncomfortable. I couldn''t get back to sleep - I couldn''t sleep on my arm with the injection site. This was about 5 pm. I never actually had a fever. But just a lot of fatigue and body aches. For the next day or two - I took 800 mg of ibuprofen and 1000 mg Tylenol every 6 hours. Within 48 hours, the body aches started to subside. I still felt a bit fatigued and I still do feel fatigued to this day. Into the next week, I started feeling like (towards the middle of the week - about the 7th) I was having an urinary urgency feeling. It was a sensation in my lower back like a UTI was coming on. I haven''t gotten one in a long time ( I use to). On Friday or Saturday, when I wiped, I was seeing a slight pinkish hue - a trace of blood - in my urine. Decided to take probiotics and Vit C. and I started to feel better. But Sunday morning, I was back to feeling pretty bad. I visited the Urgent Care on Sunday, the 11th. In the visit, they took a urine specimen. Dr. saw blood in my urine from the test. And an absence of nitrates in the urine and she said it wasn''t a typical UTI. They decided to culture the urine specimen. Macrobid - 2 times a day for 7 days - antibiotics was prescribed. I felt a little better the second day of taking it, I thought, but it was up and down. Culture showed there was no UTI. Friday, the 16th, I had my annual visit with my PCP, I was feeling okay by this time. But I still had a sensation in my lower back - not a pain but a sensation and I still feel this sensation now (on my left side). She asked me to come back after the antibiotics to take another urine sample. Lab test. I feel some fatigue but I''m doing normal daily life.


VAERS ID: 1238366 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Hyperhidrosis, Incontinence, Pallor, Seizure, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

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

Write-up: Patient became pale, diaphoretic, and experienced a syncopal episode, laid flat and then had simple partial seizure lasting 10 seconds, became incontinent, IV started, A and O x4 , transported to hospital via ambulance


VAERS ID: 1238394 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-04-07
Onset:2021-04-21
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Cardiac imaging procedure abnormal, Catheterisation cardiac abnormal, Dyspnoea, Echocardiogram, Fibrosis, Mitral valve incompetence
SMQs:, Anaphylactic reaction (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: celecoxib (CeleBREX) 200 mg capsule Take 200 mg by mouth 2 (two) times a day. clonazePAM (KlonoPIN) 0.5 mg tablet 1 and 1/2 3 times a day diazePAM (VALIUM) 5 mg tablet 1-2 tablet PO prior to MRI, do not combine with klonopin EnbreL Mi
Current Illness: N/A
Preexisting Conditions: Previous diagnosis of spondyloarthropathy (our Rheumatology does not feel this is the case), COVID pneumonia 12/2020.
Allergies: Alprazolem, Zolpidem
Diagnostic Lab Data: 1/27/21: Normal TTE 4/7/21: Vaccination with J&J COVID vaccine 4/13/21: Develops severe symptoms of shortness of breath consistent with acute mitral regurgitation 4/14/21: TTE indicating acute severe mitral regurgitation 4/15: Right and left cardiac catherization showing normal coronary arteries and hemodynamics consistent with acute severe mitral regurgitation 4/16: cardiac MRI showing restricted motion of the posterior leaflet of the mitral valve as well as extensive chordae tendineae thickening of the anterior greater than posterior chordae tendineae with evidence of surface late gadolinium enhancement along the chordae tendineae and surfaces of the papillary muscles suggesting fibrosis. 4/20/21: Repeat TTE showing resolution of acute mitral regurgitation (now mild)
CDC Split Type:

Write-up: Patient had echocardiogram performed 6 weeks prior to vaccination which was essentially normal. One week post-vaccination developed torrential mitral regurgitation due to posterior mitral valve leaflet restriction. Two-weeks post-vaccination, mitral regurgitation is now improving and leaflet no longer appears restricted.


VAERS ID: 1238408 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-02
Onset:2021-04-15
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Bell's palsy, Blood test, Computerised tomogram, Facial paralysis, Headache, Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Have taken atorvastatin for blood pressure/cholesterol
Allergies: Ceclor
Diagnostic Lab Data: CT Scan and blood work concluding no tumor or clotting issues on 4/19/2021. Final diagnosis - Bell''s Palsy.
CDC Split Type:

Write-up: Bell''s Palsy diagnosis. Paralysis on left side of face. Severe headache behind left ear. Numbness in feet/toes.


VAERS ID: 1238425 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-09
Onset:2021-04-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK LA / IM

Administered by: School       Purchased by: ?
Symptoms: Blood test, Chest pain, Computerised tomogram, Dizziness, Electrocardiogram, Feeling abnormal, Feeling hot, Hypoaesthesia, Injection site pain, Malaise, Pain, Pain in extremity, Pain in jaw, Urine analysis
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Osteonecrosis (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Advil.
Current Illness: None
Preexisting Conditions: Neuropathy in groin.
Allergies: Morphine
Diagnostic Lab Data: All on 4.19. EKG, bloodwork, CT scan with and without contrast, urinalysis.
CDC Split Type:

Write-up: Injection Friday. No issues Friday, Saturday, or Sunday other than slight pain at the injection site and slight body aches on Sunday. Monday morning at approximately 0230 i woke up to what i can only describe as lightning pains in my legs. It was a very intense pain shooting from my upper thighs to my knees and slightly bending around to the top of my calves on the outside of the leg. Monday all day i did not feel well. Had a dull pain in center of chest, and my left arm from the shoulder blade to the elbow had what i can only describe as a slight warm sensation. I was also very "foggy" and light headed. On Tuesday the pain in my chest worsened. My left arm kept going numb (and still does today 04.21.2021), my jaw hurt, i was light headed and again very foggy. On Wednesday it was the same thing and I called the VA and they told me to come to the ER for evaluation.


VAERS ID: 1238430 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-04-08
Onset:2021-04-13
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Anion gap decreased, Blood sodium normal, Chest pain, Computerised tomogram thorax normal, Dyspnoea, Electrocardiogram repolarisation abnormality, Myalgia, Platelet count decreased, Troponin normal
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Haematopoietic thrombocytopenia (narrow), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (narrow), Conduction defects (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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 known
Diagnostic Lab Data: CT chest-- no pulmonary emboli, normal CT EKG- Ventricular rate of 88, repolarization abnormality noted, without any acute ST or T segment findings Troponin is within normal limits. CBC = platelet count = 98k, BMP = Sodium = 136, anion gap = 5.8
CDC Split Type:

Write-up: myalgias, sharp left sided chest pain, shortness of breath. Chest pain is worse with deep breathing. Patient is treated with normal saline fluids.


VAERS ID: 1238435 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-03-24
Onset:2021-03-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Atrial fibrillation, Cardioversion, Condition aggravated
SMQs:, Supraventricular tachyarrhythmias (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? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tadalafil, amlodipine besyate, aspirin, benlysta, cyanocobalamin, furosemide, gabapentin, hydroxychloroquine, jantoven, metoprolol tartrate, opsumit, pantoprazole, potassium, Prednisone, tramadol, valsartan, B-12, Iron.
Current Illness:
Preexisting Conditions: Systemic lupus Erythematosus, antiphospholipid Antiboby syndrome, hypertension, obstructive sleep apnea, peripheral neuropathy, atrial fibrillation, primary pulmonary hypertension
Allergies: Reglin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Caused me to go into Atrial Fibrillation Emergency room visit, Hospitalization, Cardiac Conversion


VAERS ID: 1238450 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-09
Onset:2021-04-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Haemorrhage, Haemorrhoids thrombosed, Pain
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Thrombosed Hemorrhoids. Extreme pain, bleeding. Went in to urgent care after 3 days and they cut them open to remove blood clots. There was no clear event that triggered these to appear.


VAERS ID: 1238480 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-09
Onset:2021-04-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / N/A RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Cough, Erythema, Eyelid oedema, Fatigue, Laboratory test normal, Lip swelling, Pain, Rash, Rhinorrhoea, Skin exfoliation, Throat irritation
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: 2011 - a flu shot - within about 20 minutes after receiving the shot, I started to have horrible flu-like symptoms. My body cou
Other Medications: No
Current Illness: No
Preexisting Conditions: Multiple Sclerosis
Allergies: mushrooms; bananas; morphine; latex
Diagnostic Lab Data: Labs on Wednesday April 14 - bloodwork - liver, kidneys, proteins, blood count etc - everything came back normal No tests were done when I went to ER
CDC Split Type: vsafe

Write-up: No pain or anything right after. They kept me an hour to observe due to past adverse event after vaccine. Body aches the next day - I took care of them with Tylenol. On Sunday, A rash started on my feet - little red dots. It didn''t itch. Dr. on Tuesday. Thursday, I was super tired and the rash was continuing to get worse. My doctor called and said the labs were normal. I was getting scratchy throat, runny nose, rash moved to stomach, my back (mainly in my shoulder blades) my upper arms; and my face was bright red -looked like it was peeling, and rash was on my scalp (in my hair). The inside of my lips were swelling and my eyelids were swelling and I felt like I needed to cough. I called the doctor and she told me to go to ER - Thursday, the 15th. I did. They gave me: Epi shot - IV with Benadryl, steroids, and Pepcid. I was there for about 3 hours. Everything worked with my reaction. Epi -Pen prescription; More steroids, Benadryl and Pepcid and I have been taking this through today (today is my last day of the steroids - I have two days of Benadryl left). My face is cleared up now, it''s still super dry. I still have the rash all over my body. It looks like I rolled around in a fire ant hill. I was told to carry the Epi-Pen with me for two weeks.


VAERS ID: 1238488 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-03-14
Onset:2021-03-28
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? 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 REPORTED
Current Illness: NON REPORTED
Preexisting Conditions: NON REPORTED
Allergies: NONE REPORTED
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patients daughter reported her mother had a stroke (cerebral thrombosis). Patient was admitted to hospital on 3/28/21. Patient has surgery and was admitted to the ICU. Patient also has rehabilitation. Patient is currently recovering at home .


VAERS ID: 1238492 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-09
Onset:2021-04-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / N/A RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Cough, Dry skin, Eyelid oedema, Fatigue, Laboratory test, Lip swelling, Pain, Rash, Rhinorrhoea, Skin exfoliation, Throat irritation
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: 2011 - flu shot - within 20 minutes - horrible flu like symptoms - needed to be ambulanced to hospital
Other Medications: no
Current Illness: no
Preexisting Conditions: Multiple Sclerosis
Allergies: mushrooms; bananas; morphine; latex
Diagnostic Lab Data: Labs on Wednesday April 14 - bloodwork - liver, kidneys, proteins, blood count etc - everything came back normal No tests were done when I went to ER
CDC Split Type: vsafe

Write-up: No pain or anything right after. They kept me an hour to observe due to past adverse event after vaccine. Body aches the next day - I took care of them with Tylenol. On Sunday, A rash started on my feet - little red dots. It didn''t itch. Dr. on Tuesday. Thursday, I was super tired and the rash was continuing to get worse. My doctor called and said the labs were normal. I was getting scratchy throat, runny nose, rash moved to stomach, my back (mainly in my shoulder blades) my upper arms; and my face was bright red -looked like it was peeling, and rash was on my scalp (in my hair). The inside of my lips were swelling and my eyelids were swelling and I felt like I needed to cough. I called the doctor and she told me to go to the ER - Thursday, the 15th. I did. They gave me: Epi shot - IV with Benadryl, steroids, and Pepcid. I was there for about 3 hours. Everything worked with my reaction. Epi -Pen prescription; More steroids, Benadryl and Pepcid and I have been taking this through today (today is my last day of the steroids - I have two days of Benadryl left). My face is cleared up now, it''s still super dry. I still have the rash all over my body. It looks like I rolled around in a fire ant hill.


VAERS ID: 1238499 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-07
Onset:2021-04-12
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? 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: Aspirin, Amlodipine, alendronate, atorvastatin,
Current Illness: None
Preexisting Conditions: Hypertension,
Allergies: None
Diagnostic Lab Data: MRI, CT
CDC Split Type:

Write-up: STROKE, left frontal


VAERS ID: 1238510 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-09
Onset:2021-04-11
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / UN

Administered by: Public       Purchased by: ?
Symptoms: Erythema, Infection, Localised infection, Peripheral swelling, Skin warm, Ultrasound scan
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), 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: ALLERGY MEDICATION, WOMAN VITEMANS
Current Illness: NOTHING
Preexisting Conditions: NOTHING
Allergies: SEPHPROSEL, AMOXICILLAN, ARTHOMIASINE
Diagnostic Lab Data: ultrasound infection in the ER on 4/13
CDC Split Type:

Write-up: On Sunday morning i woke up to my left arm being swollen, red, hot to the touch. Over the course of the next few days the swollen part got bigger to the size of a baseball Tuesday I called my doctor and they wanted me to get seen right away at the ER. They did an ultrasound right away and they ruled out a blood clot and an abscess. They figured it would just be an infection. They put me on an antibiotic for 7 days up to 4x a day. Today 4/21 I took my last dose of the 7 days. Called my doctor and they are starting me on another 5 days of antibiotic to get rid of this infection in my arm. It is now down to a quarter size or a little bigger. Hoping that in the next 5 days it will be completely gone. I don''t have the redness and heat anymore just a smallish lump.


VAERS ID: 1238585 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Nausea, Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Patient experienced a syncopal episode, assisted to ground, nauseated, vomited, IV started, transported to hospital via ambulance


VAERS ID: 1238599 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Unknown  
Location: New Mexico  
Vaccinated:2021-03-26
Onset:2021-03-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Dyspnoea, Hyperhidrosis, Pallor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Walk in patient for COVID Vaccine POD. Patient received Janssen Covid vaccine @ 1127 and self reported chest tightness, shortness of breath, diaphoresis and pallor AT 1136 to RN in observation area. Epipen dose given to patient in observation @ 1139 and care transferred to ED Charge RN. Chest tightness and shortness of breath subsided at time of entry.


VAERS ID: 1238647 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-09
Onset:2021-03-15
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Deep vein thrombosis, Laboratory test, Ultrasound Doppler
SMQs:, Embolic and thrombotic events, 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: fluoxetine, furosemide
Current Illness: none
Preexisting Conditions: obesity, h/o brain hemorrhage, htn, sleep apnea, aortic stenosis
Allergies: codeine
Diagnostic Lab Data: venous doppler and labs 4/15/2021
CDC Split Type:

Write-up: Large DVT left lower extremity


VAERS ID: 1238652 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-07
Onset:2021-04-12
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042421A / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: N/A
CDC Split Type:

Write-up: FATIGUE AND NUMBNESS IN THE LEFT ARM AND FINGER TIPS


VAERS ID: 1238658 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-05
Onset:2021-04-12
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Asthma, Cough, Dyspnoea, Fatigue, Headache, Pain, Pyrexia, SARS-CoV-2 test negative, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lamictal, Sertraline, triphala
Current Illness: N/A
Preexisting Conditions: Bipolar disorder/anxiety Eczema
Allergies: Sulfa
Diagnostic Lab Data: COVID-19 Rapid and PCR test: both negative (4/12 and 4/13)
CDC Split Type:

Write-up: -Fever (102) and body aches for 1 day post vaccine (4/6). -On 4/11 at 11pm started having shortness of breath/wheezing and severe dry cough. Reminiscent of asthma attacks I had as a child (but haven''t had in years). Used OTC inhaler with no relief. Wheezing died down after about 1.5h after starting and no chest symptoms after that. Headache/fatigue next day (4/12), then fine after that.


VAERS ID: 1238678 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-25
Onset:2021-03-27
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Abdominal pain upper, Blood test, Colitis ischaemic, Colonoscopy, Computerised tomogram, Diarrhoea haemorrhagic, Thrombosis
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Pseudomembranous colitis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Gastrointestinal haemorrhage (narrow), Thrombophlebitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (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? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Junel (birth control)
Current Illness: N/A
Preexisting Conditions: Reactive hypoglycemia
Allergies: N/A
Diagnostic Lab Data: Hospitalization: CT scan (28MAR2021), blood test (28MAR- 30MAR2021), colonoscopy (29MAR2021) Follow-up blood tests: 14APR2021
CDC Split Type:

Write-up: Adverse event: Ischemic Colitis most likely from a blood clot Symptoms: stomach pain -$g severe diarrhea -$g diarrhea of only blood, no stool for 24 hrs Symptoms began Saturday after vaccination (which was administered Thursday afternoon) Treatment: hospitalization, steroids, antibiotics


VAERS ID: 1238728 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-03-20
Onset:2021-03-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Disorientation, Headache, Hypoacusis, Hypovolaemic shock, Influenza like illness, Metabolic function test, Movement disorder, Unresponsive to stimuli, Visual impairment
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypovolaemic shock conditions (narrow), Dementia (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Hearing impairment (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: warfarin, amoxicillin, amiodarone, levothyroxine, torsemide
Current Illness: None, however due to a miscommunication with cardiologist and torsemide dosing, pt may have unknowingly been headed into hypovolemic shock at the time of immunization
Preexisting Conditions: Pulmonary Arterial Hypertension, tricuspid aphasia, born w/ patent ductus, has coronary stent
Allergies: NKA
Diagnostic Lab Data: CMP 3/21/21
CDC Split Type:

Write-up: Started with headache on 3/20 3/21 am - flu like sx 11:00 became unresponsive, disoriented, started having hearing & vision problems, left hand wasn''t working. Problems worse upon standing, dx w/ hypovolemic shock


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: 1238785 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-04-07
Onset:2021-04-15
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Activated partial thromboplastin time shortened, Anion gap, Arthralgia, Blood calcium normal, Blood chloride increased, Blood creatinine normal, Blood fibrinogen, Blood glucose increased, Blood magnesium normal, Blood phosphorus, Blood potassium normal, Blood sodium decreased, Blood urea decreased, Blood urea nitrogen/creatinine ratio, Carbon dioxide decreased, Chills, Contusion, Ecchymosis, Fibrin D dimer normal, Glomerular filtration rate decreased, Haematocrit normal, Haemoglobin normal, Headache, International normalised ratio normal, Lymphocyte percentage decreased, Mean cell haemoglobin concentration normal, Mean cell haemoglobin normal, Mean cell volume normal, Mean platelet volume increased, Monocyte percentage, Myalgia, Neutrophil percentage increased, Peripheral swelling, Platelet count decreased, Prothrombin time normal, Pyrexia, Red blood cell count normal, Red cell distribution width normal, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Cardiac failure (broad), Angioedema (broad), Haematopoietic leukopenia (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Hyponatraemia/SIADH (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Arthritis (broad), Tumour lysis syndrome (broad), Tubulointerstitial diseases (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vitamin C, Vitamin D, Oral phytonadione
Current Illness:
Preexisting Conditions: Hypothyroid
Allergies: NKDA
Diagnostic Lab Data: 04/21/21: Hematology-CBC Coag 04/21/21 General Chemistry 04/21/21 WBC:14.7 (H) D-Dimer, Quant.: <150 Sodium: 135 RBC: 4.35 Fibrinogen: 294 Potassium: 4 Hgb: 12.8 INR: 1 Chloride: 111 Hct: 38.8 PT: 11.2 CO2: 19 MCV: 89.2 PTT: 34.9 Anion Gap: 5 MCH: 29.5 Glucose Level:116 (H) MCHC: 33.0 BUN: 9 RDW: 13.8 Creatinine: .77 Plt:7 (!) BUN/Cr Ratio: 11.7 MPV:11.4 (H) eGFR Afr/Am: $g60 Neut%:84.4 (H) eGFR NonAfr/Am: $g60 Lymph%:10.2 (L) Calcium: 9.1 Mono%: 5.2 Phosphorus: 3.8 Eos%: 0.1 Mg: 1.9
CDC Split Type:

Write-up: The patient received the vaccine on April 7, 2021. Almost immediately after the vaccine, the patient developed some nonspecific complaints of headache, myalgias, arthralgias, fever and chills. The symptoms lasted for several days and then seemed to resolve. She was then at her baseline until approximately April 15, 2021 when she noted that she was becoming bruised. She had multiple ecchymoses on her lower extremities and this has never happened to her before. She apparently began taking aspirin at that time. According to the patient, she took 325 mg of aspirin on April 15th, 16th, and 17th. She did not take any aspirin on April 18th but then on April 19th, she took 650 mg of aspirin. On April 19, she had a telehealth visit. They recommended that she go to an urgent care. She went to an urgent care on the afternoon of April 19. They told her that they were ill equipped to take care of her and then sent her to the emergency department. On arrival in the ED on 04/20/21 she was afebrile. O2 saturation was 99% on room air. Her other vital signs were unremarkable. Her initial laboratory studies were notable for white count of 6.6 with a hemoglobin 15.2. Her initial platelet count was 5,000. Initial chemistry panel was completely unremarkable. She was not having any headache, dizziness, nausea, vomiting, blurred vision or any neurologic symptoms. She thinks that her lower extremities are swollen. She was not having any myalgias or arthralgias. Not having any abdominal pain, nausea vomiting, diarrhea, dysuria, urgency, frequency. . The patient has no other specific complaints.The patient was admitted on 04/20/21.


VAERS ID: 1238791 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-31
Onset:2021-04-16
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Blood test, Computerised tomogram thorax, Pulmonary embolism, Ultrasound Doppler, X-ray
SMQs:, Embolic and thrombotic events, venous (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: over the counter multi-vitamin, over the counter calcium chewable
Current Illness: fracture in the left foot, second metatarsal
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Xray, ultrasound of both calves, ct of chest, multiple blood tests
CDC Split Type:

Write-up: pulmonary embolism in left and right lungs- Day 17 after vaccine


VAERS ID: 1238792 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-06
Onset:2021-04-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chest X-ray normal, Nausea, Pain, Pain in extremity, Pyrexia, Ultrasound scan, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: Blood panel; negative Ultra sound; negative chest x-ray; negative
CDC Split Type: vsafe

Write-up: 4/6 Vaccination Later that afternoon, I experienced nausea, vomiting, feverish. 4/7 I woke up and my whole body felt sore, feverish. I slowly got better. 4/11 I woke up Sunday with leg pain; hurt to walk. L leg, L side. I have to take 1 stair at a time. SOB 4/13 I went to the ER. News reports of the clotting issues.


VAERS ID: 1238801 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-03-19
Onset:2021-04-21
   Days after vaccination:33
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Alendronate 70mg Anastrozole 1mg clopidogrel 75mg Synthroid 100mcg Sertralin 100mg Ezetimibe 10mg mirtazapine 7.5
Current Illness: N/A
Preexisting Conditions: Bovine Valve replacement knee replacement
Allergies: Statins
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient stated receiving J&J vaccine on 03/19/21. Patient came to ER with acute DVT in left lower extremity on 04/21/2021.


VAERS ID: 1238854 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: North Dakota  
Vaccinated:2021-03-10
Onset:2021-04-03
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / N/A LA / -

Administered by: Other       Purchased by: ?
Symptoms: Back pain, Blood test normal, Chest X-ray normal, Electrocardiogram normal, Heart rate increased, Hypertension, Malaise, Palpitations
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Hypertension (narrow), Cardiomyopathy (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: no
Current Illness: no
Preexisting Conditions: history of cancer - breast cancer - I''ve gone through treatments
Allergies: no
Diagnostic Lab Data: EKG - lots of bloodwork and a chest x-ray - - April 8th - tests came back normal that I wasn''t having a heart attack. I have a 2 week heart monitor I''m on - Zio Patch
CDC Split Type: vsafe

Write-up: Saturday, April 3, my heart rate went up and I didn''t feel well. My blood pressure was a little high. I did not go into the doctor at that time. My heartrate went basically normal that night. But it was doing things like that for a few days off and on after that. Two weeks ago this Thursday, (8th) I did go to ER - my back was starting to hurt and my blood pressure was high. I was prescribed a medication for heart palpitations - Propranolol. I''ve taken it a couple of weeks. The heart palpitations have not gone away. I''m having them quite a bit. I have to hit the button on the Zio Patch every time I have symptoms and I''ve had quite a few. Note: Shingrix vaccine on April 11th, injection on my left arm; and that was dose 1 or 2 - Lot # 444M2.


VAERS ID: 1238868 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Rhode Island  
Vaccinated:2021-04-10
Onset:2021-04-17
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Klonopin 2mg nightly, Seroquel 25mg nightly, Venlafaxine ER 225mg daily
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Emergency Room diagnosis of shingles
CDC Split Type:

Write-up: Unsure if related to vaccine but timing is very suspect. I am 25 years old and in good health but developed Shingles on 4/17/2021 (diagnosed at the emergency room on 4/20). Due to the very low likelihood of shingles at the age of 25 and my good health history I figured it could be worth a submission / a data point in the event others are experiencing the same.


VAERS ID: 1238875 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-04-05
Onset:2021-04-06
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood folate, Blood smear test normal, Blood thyroid stimulating hormone, Fibrin D dimer, Full blood count, Injection site erythema, Injection site swelling, International normalised ratio, Metabolic function test, Paraesthesia, Prothrombin time, Urine analysis, Vitamin B12
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (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: Generalized Non convulsive epilepsy
Allergies: None
Diagnostic Lab Data: All collected on 4/20/21: Urine dipstick Urine microscopic D dimer Peripheral blood smear Protime with INR Vitamin B12 Folate CBC CMP Hemaglobin A1-C TSH
CDC Split Type:

Write-up: Patient verbalized to clinic nurse that one day after vaccine was given she had tingling in the right arm. Patient verbalized that the tingling has been " coming and going" since the vaccine was given. Patient spoke with provider and also reported redness and swelling to the site. Patient was instruct to come to the urgent care to be further evaluated. Patient agreed and presented to the clinic on 4/20/21. Patient was assessed and had labs draw there are no abnormalities at this time. Patient was educated on signs and symptoms to monitor for and when to seek medical attention.


VAERS ID: 1238882 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2021-04-02
Onset:2021-04-14
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ischaemic stroke
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (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: Olmasartan,Tamsulosin,Metoprolo9,Lumigan,Alphagan
Current Illness: N/A
Preexisting Conditions: Severe Glaucoma, HTN, BPH
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Caregiver called and sai he suffered from three Ischemic stokes 12 days after recieving the vaccine. Spent a few days in the hospital but recovining with no significant deficiets.


VAERS ID: 1238887 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-16
Onset:2021-04-04
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Electrocardiogram, Fatigue, Headache, Hypertension
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Hypertension (narrow), Cardiomyopathy (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: diabetic medication, cholesterol
Current Illness:
Preexisting Conditions: diabetes II, high cholesterol,
Allergies: lisinopril (cough)
Diagnostic Lab Data: EKG
CDC Split Type: vsafe

Write-up: 3/16 vaccination 4/4 extreme HA, tired, High BP, dizzy. 4/6 went to the ER. Shot for headache. Tramadol for HA if got worse. I took Tylenol. I saw PCM on Friday Meloxicam 7.5 1 per day. Will go to 2 tablets per day if continues. Not consistent HA as of yet. Scheduled echocardiogram on 4/29/2021 *Usual BP runs 115-120 range. Never had issue with BP. Knee replacement sx 12/1/2020 and no issues with BP then. Since vaccine my BP has been in the 150''s. My BP has been consistently high since vaccine. Lowest has been 141 on 4/12/2021. I feel like I am out of breathe.


VAERS ID: 1238907 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-04-07
Onset:2021-04-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Asthenia, Blood test, Computerised tomogram, Fatigue, Headache
SMQs:, Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Flecainide, metoprolol, oxycodone, multivitamin, vitamin d, fish oil, doxycycline, Celebrex, restasis, elestat, voltaren
Current Illness: Psoriatic arthritis
Preexisting Conditions: Psoriatic arthritis
Allergies: Penicillin
Diagnostic Lab Data: Ct scan, bloodwork
CDC Split Type:

Write-up: Headaches fatigue extreme weakness


VAERS ID: 1238916 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-06
Onset:2021-04-14
   Days after vaccination:39
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1082068 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Cerebral venous sinus thrombosis, Headache, Jugular vein thrombosis, Magnetic resonance imaging head abnormal, Platelet count decreased, Syncope, Venogram abnormal
SMQs:, Torsade de pointes/QT prolongation (broad), Haematopoietic thrombocytopenia (narrow), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, venous (narrow), Cardiomyopathy (broad), Central nervous system vascular disorders, not specified as haemorrhagic or ischaemic (narrow), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Nifedipine, labetalol, furosemide, spironolactone, pravastatin
Current Illness:
Preexisting Conditions: DM2, HTN, HLD, HCV cirrhosis, CKD3
Allergies: Lisinopril
Diagnostic Lab Data: Platelet count on 4/13: 130 k/uL Platelet count on 4/14: 131 k/uL Platelet count on 4/15: 109 k/uL then later 125 k/uL No PF4 or SRA tests completed.
CDC Split Type:

Write-up: Pt has a history of DM2, HTN, HLD, HCV cirrhosis (sp treatment, Child Pugh A), CKD3 with baseline Cr 1.5 who presented to the ER after a syncopal episode and with headaches. She has no history of a positive COVID test. She reported receiving the J&J vaccine on 3/6 and reports headaches since then. She also had a syncopal episode that prompted her presentation to the ED. She underwent MRV of the brain looking for sinus thrombosis. The brain portion was normal but she was found to have a LIJ thrombus. She denies prior history of VTE. It is overall unclear if this thrombus is related the her symptoms, to the vaccine, or completely incidental. Pt was started on a heparin drip in the hospital...


VAERS ID: 1238921 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2021-04-05
Onset:2021-04-20
   Days after vaccination:15
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: Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? 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 reports having severe upper thigh pain that started 4/20/2021. Patient stated that there have been no other symptoms at this time. Patient was advised to go to the emergency room immediately to get further evaluation. Patient verbalized agreement and stated that he would go to the nearest ER right away.


VAERS ID: 1238979 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-08
Onset:2021-04-16
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Angiogram, Blood test, Cardiac discomfort, Chest pain, Echocardiogram, Electrocardiogram, Pericarditis, SARS-CoV-2 test
SMQs:, Systemic lupus erythematosus (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 04/16/2021 EKG 4/16/2021 Echocardiography 4/16/2021 Angiogram Blood work Covid Test - 2
CDC Split Type:

Write-up: Experienced chest pain. Went to ER. Was rushed in and determined to have Pericarditis - swelling and irritation around the heart.


VAERS ID: 1238996 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-04-05
Onset:2021-04-06
   Days after vaccination:1
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: Headache, On and off phenomenon
SMQs:, Parkinson-like events (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: Depressive disorder
Allergies: Methylphenidate
Diagnostic Lab Data: None known at this time
CDC Split Type:

Write-up: Patient reports having headaches "on and off" since she recieved her vaccine. Patient stated that she was not sure if that was normal for her. Provider spoke with patient and advised patient to go to the near ER as soon as possible for further evaluation. Patient agreed.


VAERS ID: 1239026 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
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: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Dizziness, Electrocardiogram, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Vestibular disorders (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: had taken St. John''s Wort, Glucosamine, Black Cohosh and Dong Quai regularly, but ceased taking them one week before vaccination (as a precaution)
Current Illness: none
Preexisting Conditions: slight asthma
Allergies: penicillin
Diagnostic Lab Data: EKG for chest tightness on April 13 at the hospital
CDC Split Type:

Write-up: Felt slightly dizzy or "woozy." It came and went for about 45 minutes as I sat in my car in the parking lot after vaccination. After about an hour, it completely subsided and I didn''t feel dizziness anymore. I did not receive any treatment for this. Also, on the fourth day after vaccination (April 13), I felt pressure/tightness in my chest. Because the blood clot cases had been publicized, I called my doctor, who advised me to go to the emergency room of our local hospital. They gave me an EKG, which looked fine, and said they thought the tightness might be related to my asthma (although that is not a symptom I have ever felt with my asthma before, which usually manifests as slight wheezing). The chest tightness lasted about two days and then went away completely without treatment.


VAERS ID: 1239029 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-31
Onset:2021-04-12
   Days after vaccination:12
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 upper, Headache, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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 pain in the right temple, nausea, vomiting, and upper abdomen pain since 4/12/21 that comes and goes. Patient spoke with provider and patient was advised to go to the nearest emergency room immediately. Patient verbalized agreement.


VAERS ID: 1239055 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-03-17
Onset:2021-03-18
   Days after vaccination:1
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: Headache, On and off phenomenon
SMQs:, Parkinson-like events (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: varenicline
Current Illness: None
Preexisting Conditions: Hyperlipidemia
Allergies: None
Diagnostic Lab Data: None known at this time
CDC Split Type:

Write-up: Patient reports have "bad" headaches "on and off" since recieving vaccine. Patient verbalized that headache are not normal for her. Provider was consulted and patient was told to go to the nearest emergency room right away. Patient stated that she would be able to go tomorrow. Patient encourage to go today but still refused.


VAERS ID: 1239060 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-11
Onset:2021-04-01
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 18050209 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Blood test, Cold sweat, Colitis, Computerised tomogram abdomen, Computerised tomogram pelvis, Diarrhoea, Discomfort, Muscle spasms, Sleep disorder, Urine analysis
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Dystonia (broad), Gastrointestinal nonspecific inflammation (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Aspirin 81mg, Nexium 40mg, Pepcid 20mg , Ubrelvy as needed
Current Illness:
Preexisting Conditions: Moya Moya
Allergies:
Diagnostic Lab Data: 04/02/2021 Lots of bloodwork, urinalysis, CT abdomen + pelvis w IV contrast
CDC Split Type:

Write-up: I woke up in the middle of the night with extreme abdominal pain, cramping, cold sweats, diarrhea. I thought it would pass but the next day things did not get any bettor so I went to the emergency room in the afternoon. Several hours and tests later I was sent home with colitis diagnosis a 10 day course of antibiotics. I still have the occasional discomfort but am feeling much better.


VAERS ID: 1239102 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-04-10
Onset:2021-04-16
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Allodynia, Arthralgia, Burning sensation, Dyspnoea, Erythema, Fibrin D dimer, Gait inability, Henoch-Schonlein purpura, Imaging procedure, Influenza like illness, Pain in extremity, Pain of skin, Palpable purpura, Peripheral swelling, Petechiae, Platelet count normal, Rash, Renal pain, Skin swelling, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Vasculitis (narrow), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Proair HFA, Lisinopril, Amlodipine, Voltaren Gel, Valium, Oxycodone
Current Illness: Paresthesia left arm
Preexisting Conditions: HTN, Pre-Diabetes, Chronic pain syndrome, lumbar spondylosis, hyperlipidemia, OSA, COPD, Anxiety, Tobacco smoker, DJD knees, Rt Arm injury, CRPS
Allergies: Fentanyl
Diagnostic Lab Data: She was not found to have any blood clots on multiple imaging studies, platelets were 356; D-Dimer=9.72 from Medical Center. Additional tests pending. Have referred to Dr(Allergy/Immunology) for further analysis.
CDC Split Type:

Write-up: Initially 1 day of flu-like sx''s. Then on 4/26 she had "left kidney pain". On 4/17 a burning redness and swelling of her legs bilaterally which worsened and she became unable to walk secondary to pain and swelling. Also reported shortness of breath. The rash was initially wheals spreading up legs with pain, burning and allodyina to light touch. It then spread to arms bilaterally. She admitted to Medical Center and discharged with dx of urticarial rash with petechiae. I saw her 4/19 with painful palpable purpura, significant diffuse joint pain, puffiness on all 4 extremities and starting to appear on abdomen. Areas on legs where condition originally started had began clearing. Likely Henoch Shonlein Purpura.


VAERS ID: 1239122 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Nevada  
Vaccinated:2021-03-31
Onset:2021-04-17
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Deep vein thrombosis, Muscle strain, Pain in extremity
SMQs:, Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Accidents and injuries (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: Chief complaint of worsening lower leg pain. Initially the patient though that he had pulled a muscle however he had complaints of claudication upon ambulation. Patient reports having J&J COVID vaccination approx 2.5 weeks prior. Patient reported his friend informed him that he might potentially have a blood clot and that he should come to the emergency department. Imaging consistent with acute DVT and patient taken to IR for tPA direct catheter infusion.


VAERS ID: 1239125 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Nebraska  
Vaccinated:2021-04-12
Onset:2021-04-21
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Deep vein thrombosis, Ultrasound Doppler, Ultrasound Doppler abnormal
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Cardiomyopathy (broad)

Life Threatening? 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: APAP, Aspirin, cipro, finasteride, simvastatin, losartan, tamsulosin, coenzyme q10.
Current Illness: hydronephrosis, urinary retention
Preexisting Conditions: Prostate cancer, bph, hyperlipidemia
Allergies: NKMA
Diagnostic Lab Data: Venous duplex
CDC Split Type:

Write-up: Patient admitted with DVT, acute occlusive venous thrombosis in the left posterior tibial and peroneal veins.


VAERS ID: 1239133 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-07
Onset:2021-04-16
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Computerised tomogram head, Computerised tomogram thorax, Migraine, On and off phenomenon, Pulmonary embolism, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, venous (narrow), Parkinson-like events (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: I received the vaccine on the 7th and in the night a migraine started along with fever on and off and on the 16th I went to the Emergency room with a migraine and chest pains and after running some tests I have pulmonary embolisms


VAERS ID: 1239152 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-03-18
Onset:2021-03-20
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blister, Cellulitis, Erythema, Laboratory test, Rash, Rash macular, SARS-CoV-2 test negative
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: mesalamine, omeprazole, Tamsulosin, multi vitamin, azelastine nasal spray
Current Illness:
Preexisting Conditions: Sinusitis Ulcerative colitis BPH GERD
Allergies: NKA
Diagnostic Lab Data: 4/20 lab results are pending 3/21-COVID test -negative
CDC Split Type:

Write-up: diffuse itchy body rash on arms, legs, back, stomach. Large areas of erythema, macular spots, raised blisters filled with clear fluid Seen 3/21-at Urgent Care-treated with abx for cellulitis of right calf; Seen 3/23 by PCP and started on steroids with referral to dermatology. Seen 3/24 by dermatology added topical steroid cream. Seen 4/13 by dermatology for flare up after steroids weaned; steroids restarted. Seen 4/20 rash not responding to steroid dose increased and dapsone added


VAERS ID: 1239184 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 UN / IM

Administered by: School       Purchased by: ?
Symptoms: Appendicitis perforated, Escherichia infection, Surgery
SMQs:, Gastrointestinal perforation (narrow), Infective pneumonia (broad), Opportunistic infections (broad)

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

Write-up: She may have had a reaction to the J&J covid shot. her appendix ruptured and she went into surgery on4/11/21. she went back to surgery on 4/16/21 and had two drainage tubes. later it was discovered that she had E Coli


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