National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

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

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



Case Details (Reverse Sorted by Onset Date)

This is page 28 out of 1,889

Result pages: prev   1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127   next


VAERS ID: 1238580 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-06
Onset:2021-04-17
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Amnesia, Feeling abnormal, Loss of consciousness, Speech disorder
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Relenta 50mg acetaminophen PRN gabapentin 600 mg metformin 500mb Ramipril 10 mg ASA 81 mg BP med Hydrochlorothiazide
Current Illness: RA, open wounds on feet
Preexisting Conditions: RA
Allergies: Amoxicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: 4/17/21 around 5 pm lost consciousness and did not knowingly awaken until a friend came to her home and said she was sitting on the bathroom floor and responding inappropriately. Pt has no memory of any events that occurred between Sat evening through Sunday morning . Feeling of being in a fog is slowly improving.


VAERS ID: 1238727 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-02
Onset:2021-04-17
   Days after vaccination:15
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: Other       Purchased by: ?
Symptoms: Burning sensation, Herpes zoster
SMQs:, Peripheral neuropathy (broad), Opportunistic infections (broad)

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

Write-up: I developed a mild case of shingles on the right side of my abdomen. It sometimes burns. It started around April 17th and is ongoing.


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: 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: 1239209 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-03
Onset:2021-04-17
   Days after vaccination:14
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: Other       Purchased by: ?
Symptoms: Deep vein thrombosis, Fibrin D dimer increased, Ultrasound scan
SMQs:, Haemorrhage laboratory terms (broad), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No prescriptions, supplements and or herbal remedies unknown
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data: DVT diagnosed by Ultra Sound, D-Dimer2300
CDC Split Type:

Write-up: DVT left leg, pt put on Eliquis by hospital ER


VAERS ID: 1240206 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-08
Onset:2021-04-17
   Days after vaccination:40
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN TO ME / 2 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None.
Current Illness: None.
Preexisting Conditions: None.
Allergies: None.
Diagnostic Lab Data: I haven''t had any tests done so far. I will go to the emergency room if this doesnt get better soon. I can sleep and I feel nervous.
CDC Split Type:

Write-up: I have a severe rash in multiple large areas on my body including buttocks, legs, and hands. These are extremely itchy, red, blistery, and the area under the skin is hard and painful to the touch. They have been growing every day since since the onset on Saturday (now it is Wednesday). some of them ha


VAERS ID: 1240223 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-04-16
Onset:2021-04-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: School       Purchased by: ?
Symptoms: Deafness unilateral, 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Biktarvy, Lipitor, Wellbutrin, Singulair
Current Illness:
Preexisting Conditions: HIV (undetected)
Allergies: None
Diagnostic Lab Data: 5/17: visual inspection by urgent care physician
CDC Split Type:

Write-up: Tinnitus on right ear and partial hearing loss on same ear.


VAERS ID: 1240256 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-15
Onset:2021-04-17
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Intermenstrual bleeding
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

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

Write-up: Got 2nd dose vaccine on 4/15/21. I started to have menstrual bleeding on 4/18/21. My last period JUST ended on 4/10/21. I NEVER had bleeding during ovulation in my entire life. Today is 4/21/21, it is getting heavier than beginning.


VAERS ID: 1240491 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-04-14
Onset:2021-04-17
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Abdominal pain lower, Flatulence, Headache
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Mirena IUD, Vitamin D, Allegra, Flonase, women?s multivitamin, FLO gummy vitamin
Current Illness:
Preexisting Conditions: Scoliosis, anemia
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: The day of the shot, felt little to no symptoms until developing a slight headache in the evening (around 6:30PM). Fell asleep early at 9PM. Had elevated temp overnight (99.7 at 3am) and chills, woke up with extreme headache that did not resolve until about 4:30PM following day. A few days later on Saturday, developed pain in lower left abdominal area ? felt like cramping or gas. Continued for the next 5 days on and off and is ongoing. Period is not expected for another 10 days and these are unusual symptoms. If pains continue, will seek medical advice.


VAERS ID: 1240701 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-07
Onset:2021-04-17
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Paraesthesia, Rash, Rash erythematous, Rash papular, Tenderness
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: topical finasteride
Current Illness: None
Preexisting Conditions: Childhood asthma, allergic to cats and dogs
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: I think shingles. I have a small patch of red, raised bumps on my right lower back. They don''t hurt but I can constantly feel them. They hurt to touch. My front right torso is also slightly tingly in certain spots to touch. Forget this.


VAERS ID: 1241268 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Arizona  
Vaccinated:0000-00-00
Onset:2021-04-17
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Pain in extremity, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Hay fever; Non-smoker
Preexisting Conditions: Comments: The patient had drug abuse or illicit drug usage
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210436703

Write-up: SORE ARM; ITCHING; GENERALIZED RASH; This spontaneous report received from a patient concerned a 56 year old female. The patient''s weight was 153 pounds, and height was 64 inches. The patient''s concurrent conditions included hay fever, non smoker, and non alcoholic, and other pre-existing medical conditions included the patient had drug abuse or illicit drug usage. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, and batch number: 205A21A expiry: UNKNOWN) dose was not reported, administered on 12-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 17-APR-2021, the subject experienced itching. On 17-APR-2021, the subject experienced generalized rash. On an unspecified date, the subject experienced sore arm. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from generalized rash, and the outcome of itching and sore arm was not reported. This report was non-serious.


VAERS ID: 1241276 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2021-04-17
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Rash maculo-papular
SMQs:, Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Alcohol use (Once a month); Kidney stones; Non-smoker
Preexisting Conditions: Comments: The patient had no known drug allergies and drug abuse or illicit drug use at the time of this report.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210436759

Write-up: MACULOPAPULAR RASH PATCH ON FACE, LEGS, ARMS; This spontaneous report received from a patient concerned a 60 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included tendency kidney stones, alcohol use, and non smoker, and other pre-existing medical conditions included the patient had no known drug allergies and drug abuse or illicit drug use at the time of this report. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, and batch number: 202A21A expiry: UNKNOWN) dose was not reported, administered on 10-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 17-APR-2021 17:00, the subject experienced maculopapular rash patch on face, legs, arms. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from maculopapular rash patch on face, legs, arms. This report was non-serious.


VAERS ID: 1241634 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-10
Onset:2021-04-17
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Blood disorder, Central venous catheterisation
SMQs:, Haematopoietic cytopenias affecting more than one type of blood cell (broad), Embolic and thrombotic events, venous (narrow)

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

Write-up: Systemic: Blood Disorder (diagnosed by MD)-Severe, Additional Details: Patient had PICC line placed on 4/13/21 and received IV antibiotics for prior infection.


VAERS ID: 1242755 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-12
Onset:2021-04-17
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 2024214 / N/A LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Deep vein thrombosis, Dyspnoea, Pain in extremity, Peripheral swelling, Ultrasound scan
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), 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: otherwise healthy
Allergies: none
Diagnostic Lab Data: Anticoagulation and CT to rule out PE have not been performed as of yet.
CDC Split Type:

Write-up: Developed transient SOB on 4/16 that resolved on 4/18. Developed left leg pain and swelling on 4/19. LE ultrasound revealed extensive DVT. Does report a 4 hour plane ride 4 weeks ago.


VAERS ID: 1242985 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-11
Onset:2021-04-17
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Pharyngeal swelling, Pruritus, Rash, Rash erythematous, Swelling, Swollen tongue, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril 10mg, glucosamine/chondriton, calcium citrate, fish oil, turmeric
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: I have an appointment with the allergy clinic scheduled for 5/6/21.
CDC Split Type:

Write-up: No events immediately following injection. Six days later I started to experience an allergic reaction for some unknown reason with red welts over body, swelling. and itching. On the 7th day, my tongue and throat started swelling and I went to Urgent Care. I was treated with prednisone and epinephrine on 4/18/21 and released. Prescription given for 5 days of prednisone. No further symptoms after 4/18/21. Physician recommended I file a report with VAERS.


VAERS ID: 1242992 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-07
Onset:2021-04-17
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Chest X-ray, Dyspnoea, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lithium carbonate 300mg Prozac 40mg
Current Illness:
Preexisting Conditions:
Allergies: sulfa antibiotics
Diagnostic Lab Data: chest xray
CDC Split Type:

Write-up: shortness of breath, body pain, fever


VAERS ID: 1243757 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-13
Onset:2021-04-17
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / -

Administered by: Private       Purchased by: ?
Symptoms: Menopause, Postmenopausal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

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

Write-up: Experienced full and ?normal?menstrual period during menopause more than one year since last period.


VAERS ID: 1243846 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Vermont  
Vaccinated:2021-04-10
Onset:2021-04-17
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / UNK LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood cholesterol normal, Coronary artery occlusion, Myocardial infarction
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: none at the time but I had COVID with symptoms in January of 2021.
Preexisting Conditions: none
Allergies: Pennicillan
Diagnostic Lab Data: I had numerous tests while I was in the hospital
CDC Split Type:

Write-up: 6 days after the injection I suffered a massive heart attack of the Left Anterior Descending Artery with no prior heart history, less than a month earlier I had a physical with bloodwork and all cholesterol levels were normal, the doctors have not been able to give a real reason as to why this happen except I had a blockage but no explanation of why as my cholesterol levels are normal.


VAERS ID: 1244373 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-04-10
Onset:2021-04-17
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Diplopia, Dizziness, Fatigue, Headache, Nausea, Vision blurred
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Ocular motility disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prescribed Medications: Heart related: 1. Atotvastatin, 20mg, 1-daily; 2. Olmesartan Medoxomil, 40mg, 1-daily; 3. Amlodipine Besylate, 5mg, 1-daily. Prostate/Bladder: Trospium Chloride 20mg, 1-tablet, twice daily. Various heart and h
Current Illness: None
Preexisting Conditions: Heart disease; LBP, arthritis, obesity (60lbs overweight)
Allergies: Cephalexin and -cillin drugs.
Diagnostic Lab Data: None yet
CDC Split Type:

Write-up: Had mild symptoms of headache, fatigue, nausea, light headedness for starting about 3 hrs. after shot given and lasting into evening of next nigh; No fever or shortness of breath experienced. Except for fatigue was generally OK for next 6 days. Then eyes started blurring down my vision, and started seeing double/triple vision... symptoms are intermittent; worse in evening when eyes are fatigued. Called medical center for info and course of action and was advised to report to medical center emergency Room. Will see what eyes are like in morning


VAERS ID: 1245173 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: California  
Vaccinated:0000-00-00
Onset:2021-04-17
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Lupus erythematosus
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210439032

Write-up: NAUSEA; HEADACHE; TIREDNESS; LIGHT FEVER; BODY ACHES/PAIN; DIARRHEA; This spontaneous report received from a consumer concerned a 52 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included lupus. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808980, expiry: UNKNOWN) dose was not reported, administered on 06-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 17-APR-2021, the subject experienced diarrhea. On an unspecified date, the subject experienced body aches/pain, nausea, headache, tiredness, and light fever. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from body aches/pain, nausea, headache, tiredness, diarrhea, and light fever. This report was non-serious.


VAERS ID: 1245244 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-17
Onset:2021-04-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0164 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Condition aggravated, Ehlers-Danlos syndrome, Mobility decreased, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Congenital, familial and genetic disorders (narrow), Parkinson-like events (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Estradiol (patch, 0.1mg), Vitamin D (5000 IU)
Current Illness: None
Preexisting Conditions: Ehlers-Danlos syndrome
Allergies: Gluten intolerance (not yet precisely diagnosed)
Diagnostic Lab Data:
CDC Split Type:

Write-up: Joint and muscle pain that is worse than I think is typical. Joint pain was somewhat similar to that caused by ciprofloxacin, in my knees. Muscle pain was intense enough that it caused mobility problems that lasted a few days after the side-effects themselves disappeared. Basically, the side-effects seemed to trigger an Ehlers-Danlos flareup that lasted several days where I was barely mobile. I''ve since recovered and feel normal again.


VAERS ID: 1245251 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: California  
Vaccinated:2021-02-22
Onset:2021-04-17
   Days after vaccination:54
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, Fatigue, Headache, Pain, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Taste and smell disorders (narrow), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: On April 17th, suspicious of my symptoms, I went and test positive for Covid-19 on a rapid test. To confirm the diagnosis, I got a PCR test. That test was also positive for Covid-19.
CDC Split Type:

Write-up: There was no place to enter the date of the two above vaccines. The 1st 1 was on 2-22-2021, the 2nd dose was on 3-13-2021. On April 17th, I started to have Covid-19 symptoms: runny nose, headache, exhaustion. On the 2nd day, body aches, congestion, headaches, exhaustion. On the third day, all symptoms continue and I lost my sense of smell and taste. No fever ever. On the 4th and 5th day, a runny nose has stopped. all other symptoms continue.


VAERS ID: 1245262 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Ohio  
Vaccinated:0000-00-00
Onset:2021-04-17
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Fibrin D dimer increased, Pain in extremity
SMQs:, Haemorrhage laboratory terms (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 202104191420; Test Name: Fibrin D dimer increased; Result Unstructured Data: Negative
CDC Split Type: USJNJFOC20210440109

Write-up: EXTREME PAIN IN UPPER RIGHT ARM; This spontaneous report received from a consumer. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 042A21A and expiry: UNKNOWN) dose was not reported, administered on 31-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 17-APR-2021, the subject experienced extreme pain in upper right arm. On 19-APR-2021 14:20, Laboratory data included: Fibrin D dimer increased (NR: not provided) Negative. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from extreme pain in upper right arm. This report was non-serious.


VAERS ID: 1245263 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-17
Onset:2021-04-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Lip swelling, Pruritus, Swelling face, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient had reaction after second dose of Pfizer- hives, pruritus, facial swelling, and swelling of the lips. Benadryl given and Epi given by EMS. Transported to ED and given Decadron in ED. Monitored for several hours and D/C''ed under stable condition.


VAERS ID: 1245267 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-04-16
Onset:2021-04-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016B21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Feeling abnormal, Gait disturbance, Headache, Joint stiffness, Limb discomfort, Movement disorder, Pain, Pain in extremity
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levoxyl, Flomax, bystolic, vitamin D, calcium, multivitamin, baby aspirin, fish oil, Metamucil
Current Illness:
Preexisting Conditions: Thyroid cancer, IBS, GERD, osteoporosis, irregular heartbeat
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Moderna COVID19 vaccine EUA Woke up at night to go to the bathroom. Had trouble getting out of bed and walking. Joints were stiff. Strangely my right hand was frozen open. Was unable to make a fist or grasp a water bottle. When I tried to close my right hand I had a weird sensation in my hand. It felt like electricity flowing down my hand and into my 4 fingers. Left hand was not effected. Had the same effect when I woke up a couple times during the night. When I got up on Saturday morning the problem with my hand was gone. Still a bit stiff, was fatigued, headache and body aches. Sore arm for a few days.


VAERS ID: 1245298 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-16
Onset:2021-04-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW1053 / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Chills, Discomfort, Hyperhidrosis, Lymph node pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Woken from sleep approx 11hrs after shot. Chills, mild fever, uncomfortable, joint pain including wrists and fingers, lymphnode in left armpit sore. As time went on alternated between chills and sweats. Symptoms continued for approx 36hrs. Lympnode soreness lasted approx 3days


VAERS ID: 1246374 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-16
Onset:2021-04-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048B21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Dyspnoea, Fatigue, Headache, Myalgia, Nausea, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: 6 hours after, I started experiencing persistent traveling muscle aches?from my chest, to abs, to left arm. 12 hours after, I had extreme fatigue, headache, mild nausea, along with full-body muscle soreness. 36 hours after, the initial symptoms eased and eventually disappeared, but then I started having shortness of breath/chest tightness whenever I would become mildly active (casual walk for less than 10 mins) or if I was wearing a mask or taking a shower. The chest tightness would persist after these events for roughly 30 mins. This activity-related chest tightness continued to occur until the 5th day after the shot.


VAERS ID: 1246575 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-08
Onset:2021-04-17
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Activated partial thromboplastin time shortened, Blood calcium normal, Blood creatinine normal, Blood fibrinogen increased, Blood potassium normal, Blood sodium normal, Epistaxis, Fatigue, Fibrin D dimer, HIV test negative, Haematocrit normal, Haemoglobin normal, Hepatitis C test negative, Immunoglobulin therapy, International normalised ratio normal, Mean cell volume normal, Mouth haemorrhage, Myalgia, Petechiae, Platelet count decreased, Pyrexia, Vaginal haemorrhage, White blood cell count increased, White blood cell count normal
SMQs:, Rhabdomyolysis/myopathy (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: levonorgestrel-ethinyl estradiol -- one tablet by mouth once daily
Current Illness: None
Preexisting Conditions: None
Allergies: No known allergies
Diagnostic Lab Data: 4/17/21 platelets <1000, INR 1.0, PTT 29. WBC 9.9, Hgb 12.9, HCT 38, MCV 88, fibrinogen 402, d-dimer 0.23, heparin level <0.10 4/18/21 platelets <10,000 (patient given prednisone 80 mg daily and IVIG) 4/19/21 platelets 53,000 (discharged on 4/19), WBC 11.2, Hgb 10.7, HCT 32 4/22/21 platelets 186 (this was taken after dischage) 4/17 Sodium, potassium, creatinine, calcium all within normal range. HIV and Hepatitis C negative Discharged on prednisone 80 mg daily with proton pump inhibitor and bactrim and to obtain daily CBC. Instructed to continue oral contraceptive
CDC Split Type:

Write-up: Patient presented on 4/17 to urgent care afer significant vaginal bleeding (soaking through a pad every 1 hour to 1.5 hours) and petechia on multiple extremeties. She also had a nose bleed and bleeding in mouth earlier in the day that resolved spontaneously. After obtaining CBC, platelets were <1000. She was on oral contraceptives. She is a non smoker. She received work up for thrombosis, not indication of thrombosis. She did have some muscle aches and fever and fatigue the day after vaccine. Histroy notable for mild diffuse petechiae on all 4 extremeties. As inpatient received solumedrol 125 mg (then switched to prednisone 80 mg daily), IVIG 1 g/kg x 2 doses. she was discharged on 4/19 d/t rising platelets, Vaginal bleeding slowing and Petechia much fainter.


VAERS ID: 1247210 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-09
Onset:2021-04-17
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: fluoxitine, rovatasum.
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: None. Consulted with my doctor on April. 22. He said to use benadryl and moisturizers.
CDC Split Type:

Write-up: the next morning and the following two mornings after the shot I had severe headaches. Theu went away without medication fairly quickly the first two days after I got up.. the third day after about an hour I went out and got some advil to get rid of it. About a week after the shot I started getting a rash under my arms and in the ground area. This got worse every dah and spread to .other parts of the body as time went on. Better today (april.23) but still very uncomfortable.


VAERS ID: 1247473 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-09
Onset:2021-04-17
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Nothing diagnosed but per caller she started developing stomach problems after getting the Gardasil vaccine.
Other Medications: none
Current Illness:
Preexisting Conditions:
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: 4/17 Chest pain when she takes deep breath that spreads to her left arm 4/20-Follow up call second attempt - Voicemail not set up yet; unable to leave a message.


VAERS ID: 1247700 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-04-07
Onset:2021-04-17
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram, Arthralgia, Asthenia, Dyspnoea, Electrocardiogram ST segment depression, Electrocardiogram abnormal, Fatigue, Fibrin D dimer, Pulmonary embolism, Pulmonary thrombosis
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Other ischaemic heart disease (broad), Arthritis (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid 100, Estarylla 0.25-35mg-mcg, started November 2020
Current Illness:
Preexisting Conditions: Hashimoto thyreotidis Ovarian cyst
Allergies:
Diagnostic Lab Data: April 17: D-Dimer quantitative , slightly elevated ECG: ST depressions in lateral leads CTA chest for PE: segmental and sub segmental PE in right lower lobe US upper extremity venous unilateral: acute basilic vein thrombosis, right
CDC Split Type:

Write-up: Shortness of breath for several days, feeling fatigue and week, pain in right elbow Diagnosed Apr. 17 in ER setting: acute segmental and subsegmental pulmonary embolism without acute cor pulmonale Acute thrombosis of superficial vena basilica right arm


VAERS ID: 1247922 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-09
Onset:2021-04-17
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Alanine aminotransferase normal, Anion gap, Aspartate aminotransferase normal, Basophil count decreased, Blood albumin decreased, Blood alkaline phosphatase normal, Blood bilirubin normal, Blood calcium, Blood chloride normal, Blood glucose increased, Blood iron decreased, Blood magnesium normal, Blood phosphorus normal, Blood potassium normal, Blood sodium normal, Blood urea increased, C-reactive protein increased, Carbon dioxide increased, Dizziness, EGFR status assay, Eosinophil count decreased, Fibrin D dimer, Haematocrit decreased, Haemoglobin decreased, Hypotension, Iron binding capacity total normal, Lymphocyte count, Lymphocyte count decreased, Lymphocyte percentage, Malaise, Mean cell haemoglobin concentration normal, Mean cell haemoglobin decreased, Mean cell volume decreased, Mean platelet volume normal, Monocyte count normal, Neutrophil count, Platelet count normal, Polychromic red blood cells present, Procalcitonin, Protein total decreased, Red blood cell count normal, Red blood cell nucleated morphology, Red cell distribution width increased, Serum ferritin normal, Transferrin saturation decreased, White blood cell count decreased
SMQs:, Acute renal failure (broad), Anaphylactic reaction (broad), Haematopoietic erythropenia (broad), Haematopoietic leukopenia (narrow), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Vestibular disorders (broad), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 325 mg tablet albuterol (PROVENTIL HFA,VENTOLIN HFA) 90 mcg/act inhaler amLODIPine (NORVASC) 5 mg tablet aspirin 81 MG tablet Calcium 280 MG TABS cholecalciferol (VITAMIN D3) 1,000 units tablet clopidogr
Current Illness: Barrett''s esophagus Endocrine Type 2 diabetes mellitus with diabetic polyneuropathy, with long-term current use of insulin (HCC) Respiratory Centrilobular emphysema (HCC) Seasonal allergic rhinitis due to pollen Asthma COPD (chronic obstructive pulmonary disease) (HCC) Chronic obstructive pulmonary disease (HCC) OSA (obstructive sleep apnea) Cardiovascular and Mediastinum Asymptomatic stenosis of right carotid artery Peripheral arteriosclerosis (HCC) PVC (premature ventricular contraction) Atherosclerosis of coronary artery bypass graft of native heart with angina pectoris (HCC) Hypertension Benign essential hypertension CAD (coronary artery disease) Peripheral vascular disease (HCC) Nervous and Auditory Polyneuropathy associated with underlying disease (HCC) ETD (Eustachian tube dysfunction), right Musculoskeletal and Integument Osteopenia Corns Pressure injury of right foot, stage 2 (HCC) Other Elevated liver enzymes Episodic mood disorder (HCC) Insomnia History of right-sided carotid endarterectomy Mixed hyperlipidemia Stented coronary artery History of PTCA with 13 stents Diverticulosis of intestine Erectile dysfunction of non-organic origin Former smoker Memory impairment Status post angioplasty Anemia Enlarged prostate without lower urinary tract symptoms, s/p TURP 3/11/21 COVID-19 virus infection
Preexisting Conditions: Barrett''s esophagus Endocrine Type 2 diabetes mellitus with diabetic polyneuropathy, with long-term current use of insulin (HCC) Respiratory Centrilobular emphysema (HCC) Seasonal allergic rhinitis due to pollen Asthma COPD (chronic obstructive pulmonary disease) (HCC) Chronic obstructive pulmonary disease (HCC) OSA (obstructive sleep apnea) Cardiovascular and Mediastinum Asymptomatic stenosis of right carotid artery Peripheral arteriosclerosis (HCC) PVC (premature ventricular contraction) Atherosclerosis of coronary artery bypass graft of native heart with angina pectoris (HCC) Hypertension Benign essential hypertension CAD (coronary artery disease) Peripheral vascular disease (HCC) Nervous and Auditory Polyneuropathy associated with underlying disease (HCC) ETD (Eustachian tube dysfunction), right Musculoskeletal and Integument Osteopenia Corns Pressure injury of right foot, stage 2 (HCC) Other Elevated liver enzymes Episodic mood disorder (HCC) Insomnia History of right-sided carotid endarterectomy Mixed hyperlipidemia Stented coronary artery History of PTCA with 13 stents Diverticulosis of intestine Erectile dysfunction of non-organic origin Former smoker Memory impairment Status post angioplasty Anemia Enlarged prostate without lower urinary tract symptoms, s/p TURP 3/11/21 COVID-19 virus infection
Allergies: Diphenhydramine Hyzaar [Losartan Potassium-hctz]Other (See Comments) Lipitor [Atorvastatin]Other (See Comments) OtherOther (See Comments) Sudafed [Pseudoephedrine Hcl]Anxiety
Diagnostic Lab Data: Results for pt.(MRN 1414438283) as of 4/23/2021 16:02 4/22/2021 05:48 Sodium: 138 Potassium: 3.7 Chloride: 106 CO2: 24 Anion Gap: 8 BUN: 24 Creatinine: 1.09 Glucose, Random: 107 Calcium: 8.0 (L) CORRECTED CALCIUM: 9.1 AST: 21 ALT: 30 Alkaline Phosphatase: 35 (L) Total Protein: 6.1 (L) Albumin: 2.6 (L) TOTAL BILIRUBIN: 0.37 eGFR: 67 Phosphorus: 4.3 (H) Magnesium: 1.9 Ferritin: 65 WBC: 4.78 Red Blood Cell Count: 4.81 Hemoglobin: 10.8 (L) HCT: 36.1 (L) MCV: 75 (L) MCH: 22.5 (L) MCHC: 29.9 (L) RDW: 17.2 (H) Platelet Count: 216 MPV: 9.8 Platelet Estimate: Adequate nRBC: 0 Segs Relative: 64 Abs Neutrophils: 3.11 Bands Relative: 1 Lymphocytes %: 27 Monocytes: 8 Eosinophils: 0 Basophils Relative: 0 Absolute Eosinophils: 0.00 Basophils Absolute: 0.00 Total Counted: 100 RBC Morphology: Present Polychromasia: Present C-REACTIVE PROTEIN: 15.0 (H) D-Dimer, Quant: 0.44 LYMPHOCYTES ABSOLUTE: 1.29 Monocytes Absolute: 0.38 4/22/2021 05:48 Iron: 21 (L) Ferritin: 66 Iron Saturation: 7 TIBC: 297 Procalcitonin: 0.06 4/22/2021 07:25 POC Glucose: 97 4/22/2021 08:39 Delivery Request Date: 04/22/2021 Delivery Note: Pend Item Description: Supplier Name: Supplier Phone Number: 4/22/2021 POC Glucose: 192 (H)
CDC Split Type:

Write-up: 72-year-old male history multiple medical problems including coronary artery disease with stents Barrett''s esophagus asthma enlarged prostate hypertension presents from the infusion center secondary to being found to have hypotension after receiving his immunoglobulin infusion today for COVID. Patient states he has been feeling ill for the past few days due to COVID he has been eating and drinking much. Patient states that he felt no different during his infusion or after but the blood pressure being low specially felt lightheaded when he stood up he was sent down to the ER for further evaluation. Patient denies any chest pain associated with this no palpitations he is awake alert and not diaphoretic in no significant distress on my evaluation. Patient denies any recent blood in stools. Note is the patient did receive the COVID vaccine Johnson and Johnson approximately 10 days ago. He was diagnosed with COVID infection 4 days after that.


VAERS ID: 1247937 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-04-04
Onset:2021-04-17
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ataxia, Blood test, Confusional state, Dysarthria, Headache, Intensive care, Lethargy, Lumbar puncture, Magnetic resonance imaging head
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Whey protein powder
Current Illness: none
Preexisting Conditions: none
Allergies: Allergic to penicillin and aspirin
Diagnostic Lab Data: 4/18/21 Hospital Admission with many tests and imaging done, including blood work, lumbar puncture and MRI brain
CDC Split Type:

Write-up: Headache Confusion/Lethargy Dysarthria and Ataxia Subsequent presentation to ER and Admission to medical ICU (see below)


VAERS ID: 1248027 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-04-12
Onset:2021-04-17
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Fatigue, Pain in extremity
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: sulfa drugs
Diagnostic Lab Data:
CDC Split Type:

Write-up: About a week after her vaccine she went to rehab and exercised which she then developed leg pain, she said it only lasted that day and has since gone away. She believes that was from the exercise. A few days later she experienced diarrhea without having any cramping or feeling ill, just out of the blue for about 6 hours and then it went away. She has been tired/ fatigued the entire time.


VAERS ID: 1248564 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-04-11
Onset:2021-04-17
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angiogram cerebral normal, Atelectasis, Blood calcitonin normal, Blood culture negative, Chest X-ray abnormal, Computerised tomogram abdomen, Computerised tomogram thorax abnormal, Echocardiogram abnormal, Electronic cigarette user, Headache, Hunt and Hess scale, Hydrocephalus, Hypoxia, Legionella test, Lung opacity, Oxygen saturation decreased, Oxygen therapy, Pleural effusion, Pulmonary arterial pressure abnormal, Pulmonary congestion, Pulmonary hypertension, Respiratory distress, SARS-CoV-2 test negative, Subarachnoid haemorrhage, Urine analysis normal, Ventricular drainage, Viral test, Viral test negative, Vomiting, Wheezing
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Asthma/bronchospasm (broad), Haemorrhage terms (excl laboratory terms) (narrow), Interstitial lung disease (narrow), Systemic lupus erythematosus (broad), Haemorrhagic central nervous system vascular conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tylenol
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: 4/21 Chest X-Ray - mild pulmonary congestion 4/22 CT chest/abd/pelvis - no pulmonary embolism, bilateral opacities/ground glass, bilateral pleural effusions, bil atelectasis 4/22 ECHO - Ejection Fraction 60-65%, normal biventricular function, mild pulmonary hypertension, PASP 36 4/22 Chest X-ray - diffuse, bilateral pulmonary congestion 4/23 Chest X-ray - improving pulmonary congestion COVID negative x 3 (4/17, 4/22, 4/23) VIRAL PCR negative 4/22 Blood Culture - no growth to date 4/22 Ua - neg 4/22 S. pneumoniae urine - negative 4/22 urine legionella - negative 4/22 procalcitonin < 0.1 (negative)
CDC Split Type:

Write-up: Patient was doing paperwork when he experienced the worst headache of his life on 4/17 with associated emesis. Patient found to have a Hunt Hess 3 Fisher Grade 3 Subarachnoid Hemorrhage with hydrocephalus s/p EVD, s/p cerebral angiogram on 4/18 negative for aneurysm/AVM. On the evening of 4/20, patient became acutely hypoxic with wheezing for which he required oxygen via 10L oxymask. During 4/21, his oxygen requirements continued to increase with increased work of breathing requiring high flow nasal cannula (HFNC) at 50L/60% + pulmonary congestion on imaging and he was treated with diuresis. On 4/22, oxygen needs increased requiring 70L/100% with worsening imaging. He was then started on steroids, antibiotics were broadened, epoprostenal started in addition to diuresis. On 4/23, patient reports improved breathing and is on non-rebreather. Antibiotics, steroids, and epoprostenal were discontinued as patient showed improvement of oxygenation without clear signs of infection. Of note, patient reports vaping in the past 2-3 months. Patient has also been intermittently febrile. Wife was concerned that these symptoms were possibly related to him getting the J&J vaccine on 4/11. Patient is currently still in hospital on day 6 of admission at this time.


VAERS ID: 1249109 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Nevada  
Vaccinated:2021-04-03
Onset:2021-04-17
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Chest pain, Computerised tomogram, Dyspnoea, Echocardiogram, Electrocardiogram, Heart rate increased, Laboratory test, Magnetic resonance imaging, Pulmonary embolism, Ultrasound scan
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Dehydration (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: None at time
Current Illness: None
Preexisting Conditions: None
Allergies: Arithmerisn
Diagnostic Lab Data: Echocardiogram, ekg, chest X-ray, full body ultrasound, mri, ct scan. Blood work. More unknown tests
CDC Split Type:

Write-up: Pulmonary embolism. Chest pain, shortness of breath, rapid heart rate.


VAERS ID: 1249159 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-10
Onset:2021-04-17
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

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

Write-up: Dizziness that turned into light headedness


VAERS ID: 1249430 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: North Carolina  
Vaccinated:0000-00-00
Onset:2021-04-17
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210439446

Write-up: BACK PAIN IN SHOULDER BLADES/SEVERE KNEE PAIN; SEVERE FOOT PAIN; CHEST PAIN; This spontaneous report received from a patient concerned a male of unspecified age. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported. Per procedure, no follow up will be requested for this case. No concomitant medications were reported. On 17-APR-2021, the subject experienced chest pain. On an unspecified date, the subject experienced back pain in shoulder blades/severe knee pain, and severe foot pain. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the back pain in shoulder blades/severe knee pain, severe foot pain and chest pain was not reported. This report was non-serious.


VAERS ID: 1249456 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2021-04-17
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: The patient had no known allergies.
Allergies:
Diagnostic Lab Data: Test Name: Body temperature; Result Unstructured Data: 98-99 F
CDC Split Type: USJNJFOC20210440624

Write-up: ACHY; FATIGUE; MILD HEADACHE; SLIGHT FEVER; This spontaneous report received from a patient concerned a 64 year old female. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included the patient had no known allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808609, and expiry: 09-JUN-2021) dose was not reported, administered on 31-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 17-APR-2021, the subject experienced achy. On 17-APR-2021, the subject experienced fatigue. On 17-APR-2021, the subject experienced mild headache. On 17-APR-2021, the subject experienced slight fever. Laboratory data (dates unspecified) included: Body temperature (NR: not provided) 98-99 F. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from mild headache, achy, fatigue, and slight fever. This report was non-serious.


VAERS ID: 1249500 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-04-17
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain upper, Chest pain, Pain in extremity
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Non-smoker
Preexisting Conditions: Comments: The patient did not known allergies and no drug abuse or illicit drug usage
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210442495

Write-up: CHEST PAIN; CHEST PAIN RADIATING TO STOMACH ON AND OFF; PAIN LIKE SENSITIVE TO TOUCH ON LOWER BACK OF LEGS BELOW KNEE (RIGHT LEG IS MORE SENSITIVE TO THE TOUCH THAN LEFT); This spontaneous report received from a patient concerned a 45 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included non-alcohol user, and non-smoker, and other pre-existing medical conditions included the patient did not known allergies and no drug abuse or illicit drug usage. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: UNKNOWN) dose was not reported, administered on 13-APR-2021 for prophylactic vaccination. The batch number was not reported, per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On 17-APR-2021, the subject experienced pain like sensitive to touch on lower back of legs below knee (right leg is more sensitive to the touch than left). On 20-APR-2021, the subject experienced chest pain. On 20-APR-2021, the subject experienced chest pain radiating to stomach on and off. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from pain like sensitive to touch on lower back of legs below knee (right leg is more sensitive to the touch than left), and chest pain, and the outcome of chest pain radiating to stomach on and off was not reported. This report was non-serious.


VAERS ID: 1249502 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Arizona  
Vaccinated:0000-00-00
Onset:2021-04-17
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Neck pain, Pain in extremity
SMQs:, Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210442509

Write-up: PAIN EXTENDING TO THE NECK; FEELING PAIN FROM SHOULDER TO ARM; This spontaneous report received from a patient concerned a 50 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: 202A21A expiry: 23-JUN-2021) dose was not reported, administered on 09-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 17-APR-2021, the subject experienced pain extending to the neck. On 17-APR-2021, the subject experienced feeling pain from shoulder to arm. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from feeling pain from shoulder to arm, and pain extending to the neck. This report was non-serious.


VAERS ID: 1249640 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-04-16
Onset:2021-04-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040B21A / 2 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Chills, Concussion, Limb injury, Loss of consciousness, Nausea, Pyrexia
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: No adverse event (no medical history)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20210

Write-up: blacked out twice in the morning; felt like they got a concussion; scraped their shoulder in the process; felt weaker than normal and weakness; fever; Chills; Nauseous; This spontaneous case was reported by a consumer and describes the occurrence of LOSS OF CONSCIOUSNESS (blacked out twice in the morning) in a 47-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 040B21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included No adverse event (no medical history). On 16-Apr-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 17-Apr-2021, the patient experienced LOSS OF CONSCIOUSNESS (blacked out twice in the morning) (seriousness criterion medically significant), CONCUSSION (felt like they got a concussion), LIMB INJURY (scraped their shoulder in the process), ASTHENIA (felt weaker than normal and weakness), PYREXIA (fever), CHILLS (Chills) and NAUSEA (Nauseous). The patient was treated with Bed rest (Hydration) for Limb injury. At the time of the report, LOSS OF CONSCIOUSNESS (blacked out twice in the morning), CONCUSSION (felt like they got a concussion), LIMB INJURY (scraped their shoulder in the process), ASTHENIA (felt weaker than normal and weakness), PYREXIA (fever), CHILLS (Chills) and NAUSEA (Nauseous) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. no concomitant medication given patient got hydration and taken rest. Based on the current available information and temporal association between the use of the product and the start date of these events, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of these events, a causal relationship cannot be excluded.


VAERS ID: 1249649 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-19
Onset:2021-04-17
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036A21A / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Gait disturbance, Intentional dose omission, Peripheral nerve lesion, Stress, Urinary tract infection
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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: No adverse reaction
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20210

Write-up: Urinary tract infection; sciatic nerve; stressed; can''t walk; Cancelled 2nd dose because sick in hospital; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of URINARY TRACT INFECTION (Urinary tract infection) in a 77-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 036A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included No adverse reaction. On 19-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 17-Apr-2021, the patient experienced URINARY TRACT INFECTION (Urinary tract infection) (seriousness criterion hospitalization). On an unknown date, the patient experienced PERIPHERAL NERVE LESION (sciatic nerve), STRESS (stressed), GAIT DISTURBANCE (can''t walk) and INTENTIONAL DOSE OMISSION (Cancelled 2nd dose because sick in hospital). The patient was hospitalized on 17-Apr-2021 due to URINARY TRACT INFECTION. At the time of the report, URINARY TRACT INFECTION (Urinary tract infection), PERIPHERAL NERVE LESION (sciatic nerve), STRESS (stressed) and GAIT DISTURBANCE (can''t walk) outcome was unknown and INTENTIONAL DOSE OMISSION (Cancelled 2nd dose because sick in hospital) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route), the reporter did not provide any causality assessments. Concomitant product is not provided. treatment includes IV Antibiotics Bactrim Limited information regarding the events has been provided at this time and a causal relationship cannot be excluded; Sender''s Comments: Limited information regarding the events has been provided at this time and a causal relationship cannot be excluded


VAERS ID: 1249650 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-04-16
Onset:2021-04-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Haemoperitoneum
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (narrow)

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

Write-up: Hemoperitoneum; This spontaneous case was reported by an other health care professional (subsequently medically confirmed) and describes the occurrence of HAEMOPERITONEUM (Hemoperitoneum) in a 39-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient''s past medical history included No adverse event (No relevant Medical history Reported). On 16-Apr-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) at an unspecified dose. On 17-Apr-2021, the patient experienced HAEMOPERITONEUM (Hemoperitoneum) (seriousness criterion hospitalization). The patient was hospitalized on 17-Apr-2021 due to HAEMOPERITONEUM. At the time of the report, HAEMOPERITONEUM (Hemoperitoneum) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. On the night of 16-Apr-2021 into the morning of 17-Apr-2021 patient began to experience severe abdominal pain. CT scan was preformed while the patient was in the emergency room and patient was diagnosed with a hemoperitoneum. The nurse practitioner was unsure of where the bleeding is coming from. Nurse practitioner did not have any information on the patient''s first dose of the Moderna vaccine. The patient was admitted to the hospital. Action taken with mRNA-1273 in response to the event was not applicable. No concomitant medications and treatment details were provided. Company comment: Based on the information provided which includes a strong temporal association between the use of mRNA-1273 vaccine and onset of the reported events, a causal relationship cannot be excluded.; Sender''s Comments: Based on the information provided which includes a strong temporal association between the use of mRNA-1273 vaccine and onset of the reported events, a causal relationship cannot be excluded.


VAERS ID: 1249655 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-03-24
Onset:2021-04-17
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Pneumonia, SARS-CoV-2 test, Secretion discharge
SMQs:, Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Congestive heart failure
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 2021; Test Name: SARS-CoV-2 RT-PCR; Test Result: Positive
CDC Split Type: USMODERNATX, INC.MOD20210

Write-up: Pneumonia; Positive for COVID; Had a lot of mucous; This spontaneous case was reported by a consumer and describes the occurrence of PNEUMONIA (Pneumonia) and COVID-19 (Positive for COVID) in an 88-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Congestive heart failure. On 24-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 17-Apr-2021, the patient experienced PNEUMONIA (Pneumonia) (seriousness criteria hospitalization and medically significant) and COVID-19 (Positive for COVID) (seriousness criterion hospitalization). On an unknown date, the patient experienced SECRETION DISCHARGE (Had a lot of mucous). The patient was hospitalized from 17-Apr-2021 to 19-Apr-2021 due to COVID-19 and PNEUMONIA. At the time of the report, PNEUMONIA (Pneumonia), COVID-19 (Positive for COVID) and SECRETION DISCHARGE (Had a lot of mucous) outcome was unknown. Not Provided DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): In 2021, SARS-CoV-2 test: Positive. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. There was no treatment information provided. Company comment: Limited information regarding the pneumonia and mucus secretion has been provided at this time and a causal relationship cannot be excluded. Positive Covid test unlikely related to vaccine administration; Sender''s Comments: Limited information regarding the pneumonia and mucus secretion has been provided at this time and a causal relationship cannot be excluded. Positive Covid test unlikely related to vaccine administration


VAERS ID: 1249679 (history)  
Form: Version 2.0  
Age: 95.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-03-17
Onset:2021-04-17
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Presyncope
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Almost blacks out/when the patient bends down to tie their shoe their dizziness get to the point where the patient almost blacks out; Dizziness/when the patient bends down to tie their shoe their dizziness get to the point where the patient almost blacks out; This spontaneous case was reported by a consumer and describes the occurrence of PRESYNCOPE (Almost blacks out/when the patient bends down to tie their shoe their dizziness get to the point where the patient almost blacks out) in a 95-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 040A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included No adverse event (No medical history was reported). On 17-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 14-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 17-Apr-2021, the patient experienced PRESYNCOPE (Almost blacks out/when the patient bends down to tie their shoe their dizziness get to the point where the patient almost blacks out) (seriousness criterion medically significant) and DIZZINESS (Dizziness/when the patient bends down to tie their shoe their dizziness get to the point where the patient almost blacks out). At the time of the report, PRESYNCOPE (Almost blacks out/when the patient bends down to tie their shoe their dizziness get to the point where the patient almost blacks out) and DIZZINESS (Dizziness/when the patient bends down to tie their shoe their dizziness get to the point where the patient almost blacks out) outcome was unknown. The action taken with mRNA-1273 in response to the events was not applicable. Company comment: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1249792 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-10
Onset:2021-04-17
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Atrial fibrillation, Cerebrovascular accident, Disorientation, Electrocardiogram abnormal, Feeling abnormal, Illiteracy, Impaired driving ability, Magnetic resonance imaging abnormal, Visual impairment
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lipitor, Calciuma, Vitamin C, Vitamin D
Current Illness: None, But did have Covid in 1/2021
Preexisting Conditions: Knee replacement 12/20
Allergies: None
Diagnostic Lab Data: MRI revealed stroke. EKG revealed AFib.
CDC Split Type:

Write-up: Patient complained of not being able to read 1 week after vaccine. 1 week and one day, became very disoriented. Taken to ER on 1 week and 2 days after the shot and diagnosed with a stroke in the left occipital lobe of brain. Also diagnosed with atrial fibrillation same day. (for first time.). Patient had no history of blood clotting disorders nor heart problems. This stroke rendered patient with restricted vision. She is now unable to drive, and still quite foggy, though she is likely to recover almost fully.


VAERS ID: 1251038 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-04
Onset:2021-04-17
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Deep vein thrombosis, Fibrin D dimer, Flank pain, Full blood count, Haemoglobin decreased, Headache, Human chorionic gonadotropin negative, Metabolic function test, Pain in extremity, Platelet count normal, Ultrasound Doppler abnormal, White blood cell count normal
SMQs:, Haematopoietic erythropenia (broad), Haemorrhage laboratory terms (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, 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: Birth control pills
Current Illness: none
Preexisting Conditions: none
Allergies: amoxicillin, azithromycin, sulfa
Diagnostic Lab Data: 4-19-2021 + D-dimer 0.8 4-19-2021 CBC with Hgb 9.9/platelets 322/WBC 7.2 4-19-2021 normal CMP 4-19-2021 negative HcG 4-19-2021 Doppler U/S Occlusive DVT in left gastrocnemius veins in the proximal to mid calf
CDC Split Type:

Write-up: Initial severe headache after vaccine- this resolved in 24-48 hours. Had some LEFT flank pain for a few days. This resolved on its own. Then awoke on 4-17-2021 with LEFT calf pain that was constant and persistent. Called triage on Monday 4-19-2021 for guidance- came to Urgent Care. D dimer done and was positive. Was then sent to ER for imaging with + Doppler U/S LLE DVT- started on Eliquis.


VAERS ID: 1252169 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-04-10
Onset:2021-04-17
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Discussion with primary care physician, no medical tests or lab done.
CDC Split Type:

Write-up: On Saturday, April 17 at some point overnight I developed hives. The hives started on my right thigh and left knee area lower back an buttocks. On Sunday, April 18 the hives continued to spread throughout my kegs, then in the evening at about 10PM worked their way to my arms and hands. I woke up with hives on my lower legs and feet face, and stomach. The hives remained until Monday, April 19 and Tuesday, April 20 but continued to lessen as the days progressed. The hives were gone by Wednesday, April 21. I took Benadryl to relieve symptoms.


VAERS ID: 1253223 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-09
Onset:2021-04-17
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Propanolol, Omeprazole, B12, multi-vitimin, Magnesium, Vitamin D, Pepcid AC, Nortriptyline, Singular
Current Illness: None
Preexisting Conditions: Migraines
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Abdominal pain/cramping that went to a 7 in intensity mid-day on April 17 and eventually weened down to a 3. On April 18 the pain remained around a 2-3. On April 19 there was no pain. On April 23 there was mild pain again that went up to a 5. On April 24 the pain ranged from 2-4.


VAERS ID: 1254711 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-27
Onset:2021-04-17
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Drug ineffective
SMQs:, Lack of efficacy/effect (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210417; Test Name: COVID-19; Result Unstructured Data: Test Result:Positive
CDC Split Type: USPFIZER INC2021382944

Write-up: diagnosed with COVID; diagnosed with COVID; This is a spontaneous report from a contactable consumer or other non hcp. A 62 year old female patient received the first dose of bnt162b2 (BNT162B2, Solution for injection) via an unspecified route of administration on 27Mar2021as SINGLE DOSE and was scheduled for her second dose on 17Apr2021 for covid-19 immunisation. The patient medical history and concomitant medications were not reported. On or about 17Apr2021, the patient underwent lab tests and procedures and diagnosed with covid positive which was considered serious as medically significant with an unknown outcome. Further patient asked if she can still take the second dose after more than 21 days. It was reported that patients husband also had COVID and was supposed to get vaccinated but had to cancel his appointment because of his diagnosis. The action taken in response to the event for bnt162b2 was not applicable. Follow up needed, further information was requested. information about lot/batch number needed.


VAERS ID: 1256709 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Wyoming  
Vaccinated:2021-04-10
Onset:2021-04-17
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, C-reactive protein increased, Chest pain, Hepatitis acute, Myalgia, Pleuritic pain, Pulmonary oedema, Red blood cell sedimentation rate increased, Systemic inflammatory response syndrome, Urticaria, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (narrow), Hepatitis, non-infectious (narrow), Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad), Tumour lysis syndrome (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Sepsis (broad), Opportunistic infections (broad)

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

Write-up: patient admitted 4/23 for a multitude of symptoms and signs suggestive of a multisystem autoimmune inflammatory disorder of unclear etiology. Her past medical history is relevant for mild intermittent asthma, history of recurrent idiopathic urticaria, history of migraine headaches, hypothyroidism on supplemental levothyroxine, history of bipolar affective disorder on antipsychotropic medications (lamotrigine) and ADHD on stimulant medication (Focalin). Notably, the patient received a Johnson and Johnson COVID19 vaccine on 4/10. She reports current symptom onset on 4/17. Symptoms include pleuritic type chest pain, myalgias, arthralgias, diffuse interstitial edema, urticaria and objectively evidence of diffuse inflammation manifested by rising leukocytosis 16,000, CRP 9.3 from 5.7 just days ago, ESR 71 from 34 just several days ago, and new acute hepatitis. Pt admitted to the hospital and hospitalist states "Unclear etiology definitively but the clinical features all developed approximately 1 week after administration of the Janssen/Johnson & Johnson COVID-19 adenovirus vaccine which raises suspicion for this vaccine setting off the disease process" and "Strongly recommend consideration for reporting of possible adverse reaction to the Johnson Johnson vaccine".


VAERS ID: 1257397 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-13
Onset:2021-04-17
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026B21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: amlopdipene 5 mg, vitamin d 5000,
Current Illness:
Preexisting Conditions: high blood pressure
Allergies: tetracycline, lisinopril,
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Appointment was at 1:30 pm on 4/13/2021 but was seen by nurse and received vaccine at 2:00 pm on 4/13/2021. All was well until Saturday 4/17/2021 at 3:00 am when my body broke out in hives. I took a generic loratadine 10 mg around 3:30 am and by morning it subsided. No other symptoms until 4/18/2021 when hives returned at 7:00 am but it was not as widespread or as severe and I was too sleepy to get up and do anything about it. It went away. Around 8:30 pm I felt body aches and fatigue but no fever. Did not take anything and the symptoms dissipated.


VAERS ID: 1258196 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-01
Onset:2021-04-17
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram head abnormal, Headache, Optic neuritis, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Optic nerve disorders (narrow), Demyelination (narrow), Lens disorders (broad), Retinal disorders (broad), Ocular infections (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Patient developed blurry vision and headaches 16 days after her vaccine. went to the ER a week later and was diagnosed with Optic Neuritis via CT imaging


VAERS ID: 1260364 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-09
Onset:2021-04-17
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Chest pain, Hyperhidrosis, Increased upper airway secretion, Oropharyngeal pain, Pyrexia, Sinusitis
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Started with pain in the abdomen and chest after sinusitis Flammable throat started The phlegm has already drained everything I had. Without sinusitis Only fever and sore throat Fever. sweating all night yet I''m using medicine for those sintomas


VAERS ID: 1260970 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-04-08
Onset:2021-04-17
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Axillary vein thrombosis, Pain in extremity, Peripheral swelling, Scan abnormal, Ultrasound Doppler
SMQs:, Cardiac failure (broad), Angioedema (broad), Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: claritin, crestor, mega red, omeprazole, perforomist, milk of magnesia, prenatal vitamin, rifaximin, ventolin, vitamin D, yupelri
Current Illness: None
Preexisting Conditions: Emphysema, IBS with diarrhea, gastroparesis
Allergies: Cefdinir, domperidone, bactrim, prednisone
Diagnostic Lab Data: 4-26-21 Exam indicated chronic appearing thrombus to right axillary extending into the proximal brachial veins. Platelet count and PF4 platelet antibody testing ordered on 4-26-21.
CDC Split Type:

Write-up: Right arm sharp pains began within 1 week of receipt of the vaccine. Pain present with laying on the arm. Right arm pain persisted with swelling presenting on 4-26-21.


VAERS ID: 1261298 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-04-17
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Headache, Myalgia, Neck pain, Rash macular, Somnolence, Thrombocytopenia
SMQs:, Rhabdomyolysis/myopathy (broad), Haematopoietic thrombocytopenia (narrow), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210437896

Write-up: POSSIBLE THROMBOCYTOPENIA; RASH FROM KNEE TO FEET /SPOTTY RED DOTS ON LEG; SLEEPINESS; NECK ACHE; TIREDNESS; MUSCLE ACHE; HEADACHE; This spontaneous self-report concerned a 53 year old male patient. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805029 expiry: UNKNOWN) dose was not reported, administered on 15-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 15-MAR-2021, the patient received the vaccine, waited at facility for 15 minutes, and everything was okay. On 17-APR-2021, the patient experienced neck ache, muscle ache and felt a sense of tiredness, headache, sleepiness, which he treated with Aleve (naproxen sodium). He also noticed his feet had a rash from his knee to feet, and according to his sister (who is a healthcare professional) it looked like small micro-embolisms (thrombocytopenia). The patient went to his physician who said the spotty red dots could be petechiae caused by thrombocytopenia. As recommended by his primary care physician, the patient has an appointment for lab work, including platelet counts, on 20-APR-2021. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from headache, tiredness, neck ache, rash from knee to feet (red dots), muscle ache, and possible thrombocytopenia, and the outcome of sleepiness was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0: This 53-year-old male patient was found to have petechiae-like rash on his knees to feet, that according to attending physician could be caused by thrombocytopenia, 2 days after receiving Janssen COVID-19 vaccine for the prevention of symptomatic SARS-CoV-2 virus infection. The patient underwent laboratory procedure including platelet count (results not reported). The patient complained of neck ache, muscle ache and felt a sense of tiredness, headache, sleepiness that he treated with Aleve (naproxen sodium) on the day the petechiae-like rash appeared. No other details reported. The information available precludes a complete and meaningful assessment. However, considering the temporal relationship and recently evolving theories in the literature about COVID infections and vaccinations, potential vaccine contribution cannot be excluded. Additional information as requested.


VAERS ID: 1261501 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-17
Onset:2021-04-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037B21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Anxiety, Blood pressure decreased, Blood pressure measurement, Breast induration, Dizziness, Erythema, Loss of consciousness, Pyrexia
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Date: 20210417; Test Name: blood pressure; Result Unstructured Data: blood pressure dropped
CDC Split Type: USMODERNATX, INC.MOD20210

Write-up: hard section on her left breast; whole left side of her chest and breast is red till her arm; had a "mini" anxiety; light headed, passed out and fell cold flat on the floor; Blood pressure dropped; fever; passed out and fell cold flat on the floor; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of LOSS OF CONSCIOUSNESS (passed out and fell cold flat on the floor) in a 28-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037B21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 17-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 17-Apr-2021, the patient experienced LOSS OF CONSCIOUSNESS (passed out and fell cold flat on the floor) (seriousness criterion medically significant), ANXIETY (had a "mini" anxiety), DIZZINESS (light headed, passed out and fell cold flat on the floor), BLOOD PRESSURE DECREASED (Blood pressure dropped) and PYREXIA (fever). On 20-Apr-2021, the patient experienced BREAST INDURATION (hard section on her left breast) and ERYTHEMA (whole left side of her chest and breast is red till her arm). On 17-Apr-2021, LOSS OF CONSCIOUSNESS (passed out and fell cold flat on the floor) outcome was unknown. At the time of the report, BREAST INDURATION (hard section on her left breast), ERYTHEMA (whole left side of her chest and breast is red till her arm), ANXIETY (had a "mini" anxiety), DIZZINESS (light headed, passed out and fell cold flat on the floor), BLOOD PRESSURE DECREASED (Blood pressure dropped) and PYREXIA (fever) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 17-Apr-2021, Blood pressure measurement: low blood pressure dropped. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Concomitant medications were not provided. Treatment included acetaminophen.


VAERS ID: 1261512 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-03-31
Onset:2021-04-17
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: USMODERNATX, INC.MOD20210

Write-up: shingles; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of HERPES ZOSTER (shingles) in an 88-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 31-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 17-Apr-2021, the patient experienced HERPES ZOSTER (shingles) (seriousness criterion medically significant). At the time of the report, HERPES ZOSTER (shingles) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments No concomitant medication reported. The patient was taking valacyclovir, gabapentin and hydrocodone for the treatment of shingles.


VAERS ID: 1261537 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: New Jersey  
Vaccinated:2021-03-22
Onset:2021-04-17
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026A219 / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Anxiety, Chest pain, Dysuria, Neurosis, Product dose omission issue
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Medication errors (broad), Hypoglycaemia (broad)

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

Write-up: Neurosis; Chest pain; kidney disease-Trouble urinating; Caller missed second vaccine appointment; Anxiety; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of NEUROSIS (Neurosis), CHEST PAIN (Chest pain) and DYSURIA (kidney disease-Trouble urinating) in a 54-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 026A219) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Mental disorder and Cancer. On 22-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 17-Apr-2021, the patient experienced NEUROSIS (Neurosis) (seriousness criterion hospitalization), CHEST PAIN (Chest pain) (seriousness criterion hospitalization), DYSURIA (kidney disease-Trouble urinating) (seriousness criterion hospitalization) and ANXIETY (Anxiety). On an unknown date, the patient experienced PRODUCT DOSE OMISSION ISSUE (Caller missed second vaccine appointment). The patient was hospitalized on 06-Apr-2021 due to CHEST PAIN, DYSURIA and NEUROSIS. At the time of the report, NEUROSIS (Neurosis), CHEST PAIN (Chest pain), DYSURIA (kidney disease-Trouble urinating), ANXIETY (Anxiety) and PRODUCT DOSE OMISSION ISSUE (Caller missed second vaccine appointment) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Treatment for the events was not provided. Company Comment: This report refers to a case of Product dose omission issue for mRNA-1273, lot # 026A219 with associated Adverse Events of Neurosis,Chest pain ,Dysuria, and Anxiety. Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.; Sender''s Comments: This report refers to a case of Product dose omission issue for mRNA-1273, lot # 026A219 with associated Adverse Events of Neurosis,Chest pain ,Dysuria, and Anxiety.Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1261816 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-07
Onset:2021-04-17
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / 2 RA / -

Administered by: Public       Purchased by: ?
Symptoms: Pulmonary embolism, Pulmonary thrombosis, SARS-CoV-2 test
SMQs:, Embolic and thrombotic events, venous (narrow), COVID-19 (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: none
Allergies:
Diagnostic Lab Data: Test Date: 20210417; Test Name: Nasal Swab; Test Result: Negative
CDC Split Type: USPFIZER INC2021438021

Write-up: had pulmonary embolism in both lungs; blood clots/blood clots in the lungs; This is a spontaneous report from a contactable consumer (patient). A 54-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection), dose 2 via an unspecified route of administration administered in arm right on 07Apr2021 at vaccination age of 54 years old (Lot Number: EN6208; Expiration Date: Jun2021) as single dose for covid-19 immunisation. There was no medical history. No known allergies. No Covid prior vaccination. The patient''s concomitant medications were not reported. The patient previously took BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 1 via an unspecified route of administration administered in arm left on 08Mar2021 14:00 at vaccination age of 54 years old (Lot Number: EN6205; Expiration Date: 30Jun2021) as single dose for covid-19 immunisation. No other vaccine in four weeks. No other medications in two weeks. The patient experienced had pulmonary embolism in both lungs on 17Apr2021 13:00, blood clots/blood clots in the lungs on 17Apr2021 13:00. Events resulted in emergency room/department or urgent care, hospitalization, life threatening illness (immediate risk of death from the event), disability or permanent damage. The patient had pulmonary embolism in both lungs. He was in the hospital for 3 days and now he will have to take blood thinners in definitely. He was admitted 17Apr2021 and discharged home 19Apr2021. He did not have history of blood clots and zero risk factors. Two doctors blamed the vaccine. He did not want to take blood thinners forever. He needed help figuring out how to determine if this was related to the vaccine. He had a reaction to the second shot and he had been in the hospital the last 3 days and the 2 different doctors that saw him said the only thing that was different was that he had received the COVID vaccine. He had blood clots in both of his lungs, he was in serious condition for a couple days there but his biggest concern now was that they were telling him that he will have to take medication forever to thin his blood because they didn''t think there was a genetic reason it happened and that was the protocol that healthcare providers have to follow. They were telling him that he might contact a hematologist and do a blood study but they said they were certain that it came from the vaccine because there was no history of this in his family or himself. He said the condition''s medical term was pulmonary embolism but he just said blood clots in the lungs because he thought he would make it easier to explain. Both doctors that saw him felt it was brought on the by the vaccine. He was not looking to sue or anything, he didn''t want to be taking a blood thinner for the rest of life. He was not doing this for any reason other than to get well. He realized this situation was very rare with Pfizer, it was like 4 in 1 million with Pfizer according to his physicians. Covid tested post vaccination: Nasal Swab on 17Apr2021 with negative result. Therapeutic measures were taken as a result of had pulmonary embolism in both lungs, blood clots/blood clots in the lungs. The outcome of events was recovered with sequelae.


VAERS ID: 1262233 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-17
Onset:2021-04-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / UNK LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Abdominal discomfort, Angina pectoris, Aphasia, Blood pressure decreased, Cold sweat, Coordination abnormal, Dizziness, Dyspnoea, Fatigue, Feeling abnormal, Heart rate increased, Hypoaesthesia, Hypotonia, Muscle spasms, Paraesthesia, Pulmonary hypertension, Restlessness, Tremor, Vision blurred
SMQs:, Anaphylactic reaction (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Akathisia (broad), Dystonia (broad), Parkinson-like events (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Acute central respiratory depression (broad), Pulmonary hypertension (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Other ischaemic heart disease (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (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: Multi-Vitamins
Current Illness: None
Preexisting Conditions: None
Allergies: Bee and Wasp allergy Epinephrine Medication sensitivity
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Dr consult EMS called to assess via 911 Dr visit in person Urgent Care Trouble breathing, dizziness, heart pain, numbness and tingling in extremities, blurred vision, muscle spasms, poor muscle tone, rapid heart rate, drop in blood pressure, elevated heart pressure, trouble talking, brain fog, intestinal upset, cold sweats, tremor, poor coordination, restlessness, fatigue Onset at time of vaccine administration Labeled NOT anaphylaxis


VAERS ID: 1262622 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-04-07
Onset:2021-04-17
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0153 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Electrocardiogram, Sinus tachycardia, Supraventricular tachycardia
SMQs:, Supraventricular tachyarrhythmias (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: Optavia Caramel Macchiato Shake
Current Illness: none
Preexisting Conditions: none until 4/17/2021
Allergies: none
Diagnostic Lab Data: Ambulance rides to the hospital on 4/17/2021, ER visit, blood work and EKG 4/20/2021 visit to primary doctor''s office 4/21/2021 blood work 4/22/2021 Holter monitor put on 4/23/2021 Back to emergency room , more blood work ran, EKG 4/26/2021 Returned holter monitor and saw cardiologist for consult
CDC Split Type:

Write-up: 10 days after my vaccine on 4/17/2021- I was driving and had my first ever episode of SVT-Subventricular Tachycardia. It lasted approximately 40 minutes of a heart rate of 187+. I then had a holter monitor put on on 4/22/2021. On 4/23/2021 I had a 2nd episode of SVT. Both times, I went to the emergency room. I was then in Sinus Tachycardia for several days until medications would kick in. Now waiting on my holter monitor results. Everything that causes this, I don''t do. (no stimulants, 1 cup of coffee per day)


VAERS ID: 1263068 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-12
Onset:2021-04-17
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Senior Living       Purchased by: ?
Symptoms: Fatigue, Pain in extremity, Skin mass
SMQs:, Extravasation events (injections, infusions and implants) (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Pain on right leg, between my knee and ankle, 3 round bumps, looked like blood clots....and fatigue


VAERS ID: 1263491 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-07
Onset:2021-04-17
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Alanine aminotransferase increased, Antinuclear antibody negative, Arthralgia, Aspartate aminotransferase increased, Blood alkaline phosphatase increased, Blood thyroid stimulating hormone normal, Dizziness, Erythema, Full blood count normal, Headache, Joint swelling, Pain in extremity, Rash, Rheumatoid factor negative, SARS-CoV-2 test negative, Streptococcus test negative, Throat irritation, Thyroxine normal
SMQs:, Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Biliary system related investigations, signs and symptoms (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin, Vitamin D, Fioricet, Levothyroxine
Current Illness:
Preexisting Conditions: Hypothyroidism, Migraines, Psoriasis
Allergies: Penicillin
Diagnostic Lab Data: AST 67, ALT 93, CRP 71. Alk phos 135. Remainder of CMP normal. TSH, T4, normal. CBC normal. ANA and RF negative. Lymes negative.
CDC Split Type:

Write-up: Patient states that she developed hand and wrist pain on Saturday--both hands and wrists. She also had a headache at that time. Sunday she continued to have joint pain as well as a scratchy throat. She also had a rash on both of her arms. Patient went to patient first for her symptoms. She had negative rapid Covid test and rapid strep test at patient first. Got J and J vaccine 4/7. Got menses 3/9 after taking med that GYN prescribed. Got menses last week (Friday) also without medication. Had a migraine also--went away with imitrex. Saturday had another migraine--went away with imitrex. Had mild dizziness Sat afternoon while in the kitchen. Had been scrubbing the shower on Saturday prior to joint pain. Works out 3x per week. Saturday night her ankles were also sore. Yesterday her throat was scratchy. Hands, wrists, and arms were more sore. Then notice all of her joints were sore. "Even my collarbone hurt." Rash on her arms yesterday--went away by the time she went to Pt First. Send out COVID test was sent out. Ankles were swollen last night also. Hands and feet were red last night. Knees hurt her to walk. Patient states that her joint pain was severe last night. Her husband had to help her transfer. Took an aspirin last night.


VAERS ID: 1263506 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-04-16
Onset:2021-04-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Deep vein thrombosis, Pain in extremity, Ultrasound scan abnormal
SMQs:, Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Thrombophlebitis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Hypertension
Allergies: Amlodipine
Diagnostic Lab Data: FINDINGS: Left leg - there is noncompressible thrombus in the popliteal vein. Patent calf veins. Patent greater saphenous vein. Normal compressibility and normal color Doppler imaging of the common femoral vein, femoral veins, posterior tibial, peroneal, and greater saphenous veins. Impression: Popliteal vein acute DVT in the left lower extremity. Results discussed with Dr. on 4/26/2021 4:32 PM GMT-7 Patient was started on Apixaban
CDC Split Type:

Write-up: Patient started to have left leg pain. Presented to facility on 4/26/21. Ultrasound examination showed DVT


VAERS ID: 1264406 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Massachusetts  
Vaccinated:0000-00-00
Onset:2021-04-17
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, SARS-CoV-2 test, Suspected COVID-19, Vaccination failure
SMQs:, Lack of efficacy/effect (narrow), Anticholinergic syndrome (broad), Vestibular disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210419; Test Name: COVID-19 virus test; Result Unstructured Data: Positive
CDC Split Type: USJNJFOC20210438110

Write-up: SUSPECTED CLINICAL VACCINATION FAILURE; SUSPECTED COVID-19 INFECTION; DIZZINESS; This spontaneous report received from a patient concerned a female of unspecified age. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805022, and expiry: UNKNOWN) dose was not reported, 1 total, administered on 05-MAR-2021 at left arm for prophylactic vaccination. No concomitant medications were reported. On 17-APR-2021, the patient experienced dizziness and suspected covid-19 infection (cough and difficulty breathing) and suspected clinical vaccination failure. On 19-APR-2021, Laboratory data included: COVID-19 virus test (NR: not provided) as Positive (units unspecified). Patient was referred to HCP to discuss further. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the suspected covid-19 infection, suspected clinical vaccination failure and dizziness was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0: - covid-19 vaccine ad26.cov2.s -Suspected clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS


VAERS ID: 1265163 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-03
Onset:2021-04-17
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / N/A LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Back pain, Chest pain, Dyspnoea, Lung disorder, Pain in extremity, Thrombosis
SMQs:, Anaphylactic reaction (broad), Retroperitoneal fibrosis (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: NA
Current Illness: NA
Preexisting Conditions: NA
Allergies: NA
Diagnostic Lab Data: Don''t have details
CDC Split Type:

Write-up: Blood clot in each lung, chest pain, labored breathing, leg pain and upper back pain.


VAERS ID: 1265601 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-17
Onset:2021-04-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 020B21A / UNK LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Arthralgia, Condition aggravated, Fatigue, Headache, Herpes virus infection, Lymphadenopathy
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

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

Write-up: Fatigue, swollen lymph nodes, mild pain in different parts of body; right shoulder, right hip, left side of abdomen, and mild headache with second dose. Herpes outbreak episode with both vaccines within a week of being vaccinated.


VAERS ID: 1266070 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-11
Onset:2021-04-17
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Appendicitis perforated, SARS-CoV-2 test
SMQs:, Gastrointestinal perforation (narrow), COVID-19 (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: covid tested; Result Unstructured Data: Test Result:Unknown results
CDC Split Type: USPFIZER INC2021448346

Write-up: Appendicitis. Perforated appendix that started 6 days after vaccination; This is a spontaneous report from a contactable consumer. A 38-year-old male consumer (patient) reported that he received BNT162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot number unknown) via an unspecified route of administration in left arm on 11Apr2021 10:00AM (at the age of 38-year-old) for COVID-19 immunisation. Relevant medical history and concomitant medications were not reported. The patient had not COVID prior vaccination. On 17Apr2021, the patient had perforated appendix that started 6 days after vaccination. The event resulted in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care, hospitalization, life threatening illness (immediate risk of death from the event). The patient was hospitalized for 6 days. Treatment included antibiotic and potential surgery upcoming. The patient was tested for COVID post vaccination (no results). The event was not resolved. Information on the lot/batch number has been requested.


VAERS ID: 1266545 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Mississippi  
Vaccinated:2021-04-12
Onset:2021-04-17
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Cerebrovascular accident, Computerised tomogram, Facial discomfort, Limb discomfort, Magnetic resonance imaging, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), 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: Amlodipine Atorvastatin Isosorbide Mononitrate Lisinopril Metformin
Current Illness: none
Preexisting Conditions: Hypertension Anxiety Depression Schizophrenia
Allergies: none
Diagnostic Lab Data: CT head 4/27/21 - Remote left basal ganglia infarction MRI head with/without contrast 4/27/21 - 2 x 5mm subacute ischemic lacunar infarct in the left thalamus, remote left basal ganglia lacunar infarcts.
CDC Split Type:

Write-up: Right side tingling past 10 days. Reports tingling to right face and right arm feels like intermittent pins and needles. Received Janssen COVID vaccine on 4/12/21 at an outside facility. Diagnostic workup revealed Cerebral Vascular Accident (CVA).


VAERS ID: 1266799 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-04-12
Onset:2021-04-17
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Fibrin D dimer increased, Ultrasound scan, Venous thrombosis limb
SMQs:, Haemorrhage laboratory terms (broad), Embolic and thrombotic events, 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? No
Previous Vaccinations:
Other Medications: Omeprazole
Current Illness:
Preexisting Conditions: BMI 34
Allergies: none
Diagnostic Lab Data: Ultrasound, elevater d-dimer
CDC Split Type:

Write-up: Venous thrombosis of proximal greater saphenous vein


VAERS ID: 1267368 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-04-07
Onset:2021-04-17
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 43A21A / N/A AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram cerebral abnormal, Aphasia, Cerebral artery occlusion, Cerebral infarction, Cerebrovascular accident, Computerised tomogram head abnormal, Dysarthria, Headache, International normalised ratio normal, Magnetic resonance imaging head abnormal, Motor dysfunction, Platelet count normal
SMQs:, Peripheral neuropathy (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypoglycaemia (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: Asmanex, Hydroxizine, Melatonin, Ropinirole, Disulfiram, Atorvastatin, ProAir, Lisinopril, Tramadol, Sildenafil, Metformin, Omeprazole, Tizanidine
Current Illness: Allergy symptoms, COVID exposure
Preexisting Conditions: Diabetes , HTN , Asthma, GERD, Anxiety
Allergies: Methocarbamol, Cyclobenzaprine
Diagnostic Lab Data: 4/19/2021 CT Head : Findings suspicious for a recent/acute cortical infarction involving the left posterior parietal lobe. 4/20/2021 CTA Head : Occlusion of one of the posterior branches of the M2 segment of the left middle cerebral artery. 4/21/2021 MRI Brain: Acute left posterior MCA infarct. Platelet counts: 4/20: 288 4/19 : 249 INR 4/19 1.0
CDC Split Type:

Write-up: Onset of severe headache , slurred speech on 4/17/2021. Became aphasic with motor deficits, was not a tpa candidate at hospital due to time of symptom onset. Dx with L MCA ischemic CVA


VAERS ID: 1267773 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-12
Onset:2021-04-17
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Dizziness, Headache
SMQs:, Anticholinergic syndrome (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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Staff received incoming call at clinic. Patient states s/p J&J vaccination 4/12/21 at EVC. C/O continuous HA that is worsening even with Tylenol 500 mg PO PRN. HA is worst at 8/10. C/O mild intermittent lightheadedness. C/O anxiety. Denies hx of HA, dizziness, anxiety. No other complaint. Advised to go to the nearest ED.


VAERS ID: 1267800 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-09
Onset:2021-04-17
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Atorvastatin 40 mg, amLodi pine 5mg
Current Illness: None
Preexisting Conditions: High cholesterol, high blood pressure
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Seven days after receiving vaccination I broke out in a rash that increased in severity for three days. It was located around my waist, down my legs and ankles. It started as raised red bumps that itched. By day four the clusters formed a flat mass of red- like blood pooling under my skin. The rash started Saturday night and I consulted with my healthcare provider in. I was in Denver for the week and she encouraged me to be evaluated. On Tuesday April 13 I saw Urgent Care. He seemed stumped - especially since the onset of rash was seven days after injection. He put me on a six day course of methylprednisolone. I began the course that day and that stopped the itching and the daily multiplication of spots and spreading blood like areas. Today, April 28 I am home in Portland and the spots are fading. Both health care providers went through list of common irritants and they did not apply. I was traveling with my husband who did not develop any rashes or spots.


VAERS ID: 1267824 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-10
Onset:2021-04-17
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / -

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

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

Write-up: dizziness


VAERS ID: 1268619 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-03-10
Onset:2021-04-17
   Days after vaccination:38
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK AR / SYR

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

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

Write-up: I got shingles.


VAERS ID: 1269638 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-16
Onset:2021-04-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040A21A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Balance disorder, Fatigue, Headache, Nausea, Oedema peripheral, Pain in extremity, Paraesthesia, Rash
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Divalproex, Black Cohosh, Sertraline, Atorvastatin, L-Thyroxine, Metformin, aspirin
Current Illness:
Preexisting Conditions: diabetes, seizures, high cholesterol, depression
Allergies: allergy to adhesives (Mastasol, bandaids,)
Diagnostic Lab Data: No tests required. Just a lot of sniveling to my husband.
CDC Split Type:

Write-up: Second vaccine on FRIDAY and left arm was sore later that evening. SATURDAY I slept a lot. I couldn''t drink water as it made me nauseated. I developed a headache in the early afternoon followed by nausea. Movement nauseated me. I managed three spoonfuls of soup and one piece of buttered bread. SUNDAY I felt better and was able to finish my soup and two slices of buttered bread. Still very sore. MONDAY I noticed a slight rash on the left side of my neck that had crawled up to my jaw and ear. It didn''t itch so much as it felt like the sensation of novocaine wearing off. Also noticed what appeared to be a rash on the back side of my armpit and a hard lump. I seemed to have some lack of balance - maybe from the rash that had gone into my ear. TUESDAY I noticed the rash had also claimed the right side of my neck and jaw though not as pronounced. FYI: I chose the Moderna because my 95 year old mother was given that vaccine and had only a sore arm - both times. I figured if I choose the Pfizer and had an adverse reaction she would tell me "You should have chosen the Moderna!" Well, I chose the Moderna and look what happened!! :-D


VAERS ID: 1269672 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-05
Onset:2021-04-17
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP7533 / 1 - / SYR

Administered by: Public       Purchased by: ?
Symptoms: Blood chloride increased, Blood magnesium normal, Blood potassium decreased, Blood thyroid stimulating hormone normal, C-reactive protein normal, Cortisol normal, Electrocardiogram, Full blood count normal, Glycosylated haemoglobin normal, Hypertension, Metabolic function test normal, Muscle twitching, Platelet count normal, Troponin I normal, Vibratory sense increased, Vitamin B12 normal, Vitamin D deficiency
SMQs:, Neuroleptic malignant syndrome (broad), Dyskinesia (broad), Dystonia (broad), Hypertension (narrow), Tubulointerstitial diseases (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: April 23 Basic Metabolic Panel (potassium 3.3 meq/l; chloride 109 meq/l) CBC/PLT/DIFF (OK) Tropinin I (OK) EKG April 27 Comprehensive Metabolic Panel (OK) Vitamin b-12 (OK) Cortisol (OK) Magnesium (OK) C Reactive protein (OK) Hemoglobin A1C (OK) Vitamin D (deficiency at 16ng/ml) TSH (OK)
CDC Split Type:

Write-up: It started with hand twitching the same week I got the Pfizer shot which I assumed was unrelated. Then on 4/17 I noticed an internal vibration sensation. This internal vibration sensation persisted and became more frequent (chest, lower half of head predominantly but sometimes whole body as well). April 23 to 25 was happening a lot even while sleeping. On April 23 I went to Urgent care for unexplained high blood pressure, ran tests, and was released. Consulted doctor on April 26 about high blood presure and internal vibration sensation (unclear if related) and ran more tests. Still unclear cause. Will see if symptoms continue to improve.


VAERS ID: 1270557 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-11
Onset:2021-04-17
   Days after vaccination:37
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN WNPLUTMD / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Blood test, Cardiac stress test, Cervical dysplasia, Cervix operation, Electrocardiogram, Fatigue, Hypertension, Immune system disorder, Lymphadenopathy, Night sweats, Skin disorder, Skin operation
SMQs:, Neuroleptic malignant syndrome (broad), Reproductive premalignant disorders (narrow), Hypertension (narrow), Uterine and fallopian tube malignant tumours (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: This is a continuation from report on 4/8 Pt has worsened symptoms. I went to Gynecologist on 4/19 still exp night sweats.The Gynecologist stated I have high disblasha on my cells I''m scheduled for cervical procedure on 5/17. I went to my physician EKG I''m scheduled on 5/6 Physical Stress test.I also went to dermatologist on 4/22 removed (burned) 9 places on my skin (face,chest stomach) that had abnormal cells.The dermatologist recommend have a upcoming scan for my lymph nodes. As of now my lymph nodes (both sides) are swollen still exp day and night sweats, joint pain and tired. I''m now on high blood pressure medication.Both doctors have stated the vaccine has sent me into "haywire with my immune system".


VAERS ID: 1270840 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-07
Onset:2021-04-17
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / N/A LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Head discomfort, Headache, Injection site pruritus, Injection site rash, Neck pain, Pain in extremity, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin Baby Aspirin
Current Illness:
Preexisting Conditions: Diabetes
Allergies:
Diagnostic Lab Data: Blood Tests
CDC Split Type:

Write-up: The second week after I got the vaccine I started to have a pressure headache on the side of my head and down my neck. My leg was painful by my knee and it lasted a week. I had the headache and the pain at the back of my neck for one week. The pain medication did not help with the pain. The headache was on both sides but much worse on the right. I had a bump on the back of my neck on the right that was painful. I had a rash on my arm around the site of the injection about an inch around which is still visible after three weeks. The rash was a little itchy.


VAERS ID: 1271487 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-13
Onset:2021-04-17
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Ageusia, Anosmia, Cough, Headache, Pain, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: On 4-19-21 patient tested PCR positive for COVID.
CDC Split Type:

Write-up: Patient living with two positive cases became symptomatic on 4-17-21. Patients symptoms consisted on cough, HA, body ache and loss of taste and smell.


VAERS ID: 1271753 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-04-09
Onset:2021-04-17
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Lumbar puncture abnormal, Magnetic resonance imaging spinal abnormal, Myelitis transverse, Paraplegia
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Demyelination (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: PANTOPRAZOLE (PROTONIX) 40 MG PO AC BK LISINOPRIL (ZESTRIL) 40 MG PO DAILY TOPIRAMATE (TOPAMAX) 100 MG PO BID ATORVASTATIN (LIPITOR) 20 MG PO BEDTIME ASPIRIN 81 MG PO DAILY
Current Illness:
Preexisting Conditions: Depression/mood disorder Hypertension, Headache disorder Biceps tendinitis left shoulder Carpal tunnel syndrome Peripheral arterial disease Pre-Diabetes Restless legs syndrome Tubular adenoma of colon
Allergies: Penicillins (UNKNOWN 01/14/21) cyclobenzaprine (From FLEXERIL) (UNKNOWN 06/14/19) ibuprofen (UNKNOWN 01/14/21) sumatriptan (From IMITREX) (UNKNOWN 01/14/21) zolpidem (UNKNOWN 01/14/21) tramadol (Intermediate, messes with kidneys per pt 01/14/21)
Diagnostic Lab Data: MRI of cervical/thoracic/lumbar spine 04/19/2021 Lumbar puncture 04/19/2021
CDC Split Type:

Write-up: Acute transverse myelitis resulting in T4-5 paraplegia


VAERS ID: 1272499 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Vermont  
Vaccinated:2021-04-10
Onset:2021-04-17
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Sleep disorder, Tinnitus
SMQs:, Hearing impairment (narrow)

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

Write-up: Tinnitus got significantly louder. I noticed it after about a week, and it went along with other side effects like fatigue and headache and chills. All the other side effects have gone away (it has been 19 days) and the tinnitus is still bad. It is very distracting and I have to try to mask it in order to sleep.


VAERS ID: 1272570 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-02
Onset:2021-04-17
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Caesarean section, Emergency care, Exposure during pregnancy, Premature delivery
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Ceclor, sulpha antibiotics
Diagnostic Lab Data: Countless, can provide if requested.
CDC Split Type:

Write-up: Event: REFRACTORY Pre-Eclampsia (Refractory Hellp Syndrome) Pregnancy History: Second pregnancy, first was a very early miscarriage on 9/11/2020 Due Date: 6/18/2021 Delivery Date: 4/22/2021 (emergency c section) Birth Weight: 3 lb 3.5 ounces


VAERS ID: 1272609 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-07
Onset:2021-04-17
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Blood blister, Fatigue, Joint stiffness, Myalgia, Rash, Rash vesicular, Urticaria
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Dulcolax, senna herbal laxative
Current Illness:
Preexisting Conditions: IGG-4 impacting GI system
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: 10 days after receiving the Janssen vaccine, patient experienced extreme / debilitating fatigue, muscle soreness, stiff joints that lasted 72 hours. At the same time as the fatigue onset, a severe rash with inflamed welts and blood-filled blisters covering torso and abdomen - front and back also appeared. The rash was severe for 3 days and slowly subsided; scars still visible today - red dots.


VAERS ID: 1274638 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-12
Onset:2021-04-17
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Breast pain, Postmenopausal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Lipodystrophy (broad)

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

Write-up: Post menopause period and extremely sore breast tissue


VAERS ID: 1276413 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Indiana  
Vaccinated:0000-00-00
Onset:2021-04-17
Submitted: 0000-00-00
Entered: 2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Bronchitis, COVID-19, SARS-CoV-2 test, Thrombosis
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: The patient was not pregnant at the time of report.
Allergies:
Diagnostic Lab Data: Test Date: 20210413; Test Name: Clot blood; Result Unstructured Data: Negative; Test Date: 20210416; Test Name: COVID-19 PCR test; Result Unstructured Data: POSITIVE
CDC Split Type: USJNJFOC20210443606

Write-up: COVID-19; BRONCHITIS; This spontaneous report received from a consumer (patient''s husband) concerned a 43 year old female. The patient''s height, and weight were not reported. The patient was not pregnant at the time of report. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of administration not reported, batch number: 042A21A, and expiry: 21-JUN-2021) dose was not reported, administered at Left Deltoid on 09-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 09-APR-2021, the patient was given a dose of the vaccine and she did not show up. On next day 10-APR-2021, she started shivering very badly and was feverish. On 11-APR-2021, the patient also had a headache. On 12-APR-2021, all symptoms gone. The next day on 13-APR-2021 when she got up she had chest tightness and went to doctor due to fever, chills, headache resumed. Since that day was the clot information in the news and they did testing for clot stuff which was all negative. Also the patient diagnosed with bronchitis. After the 13th she had ''on/off'' days of experiencing symptoms. On 16-APR-2021, she tested for covid-19 via ''non-rapid'' test and the results of test came on the 17th were positive for covid-19 (diarrhea, vomiting, chest tightness, shivering, chills, headache, feverish and nausea). On 17-APR-2021, she developed diarrhea and vomiting. By the 19-APR-2021, they went to the hospital where she received unspecified fluids and pain pills for the fever and to calm her down. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the bronchitis and covid-19 was not reported. This report was serious (Hospitalization Caused / Prolonged).; Sender''s Comments: V0- 20210443606 - Covid-19 vaccine ad26.cov2.s-Covid 19. This event is considered unassessable. The event has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event.


VAERS ID: 1276456 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Minnesota  
Vaccinated:0000-00-00
Onset:2021-04-17
Submitted: 0000-00-00
Entered: 2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: SARS-CoV-2 test, Suspected COVID-19
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210420; Test Name: COVID-19 virus test; Result Unstructured Data: Positive
CDC Split Type: USJNJFOC20210449595

Write-up: SUSPECTED COVID-19 INFECTION; This spontaneous report received from a patient concerned a 33 year old female. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 203A21A, and expiry: UNKNOWN) dose was not reported, administered on 09-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 17-APR-2021, the subject experienced suspected covid-19 infection. Treatment medications included: fexofenadine hydrochloride. On 20-APR-2021, Laboratory data included: COVID-19 virus test (NR: not provided) Positive. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from suspected covid-19 infection. This report was non-serious. This report was associated with product quality complaint: 90000177470 The suspected product quality complaint has been confirmed to be voided (did not meet PQC criteria) based on the PQC evaluation/investigation performed.; Sender''s Comments: V0: Medical assessment comment is not needed as per standard procedure since case is assessed as non-serious.


VAERS ID: 1276543 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Unknown  
Location: Arizona  
Vaccinated:0000-00-00
Onset:2021-04-17
Submitted: 0000-00-00
Entered: 2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Pulmonary thrombosis
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210454248

Write-up: BLOOD CLOTS IN THE LUNGS; CHEST PAIN; SHORTNESS OF BREATH; This spontaneous report received from a patient concerned a 52 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: unknown) dose was not reported, administered on 06-APR-2021 for prophylactic vaccination in the left arm. The batch number was not reported and has been requested. No concomitant medications were reported. On 17-APR-2021, the subject experienced chest pain and shortness of breath and was taken to the Emergency Room. The patient was hospitalized and a diagnosis of blood clots in the lungs was made. The patient was hospitalized for 4 days. Corrective treatment included blood thinners ( to be taken for 6 months) and a follow-up appointment with the pulmonologist was scheduled. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the blood clots in the lungs, chest pain and shortness of breath was not reported. This report was serious (Hospitalization Caused / Prolonged).; Sender''s Comments: V0: 20210454248-Covid-19 vaccine ad26.cov2.s-Blood clots in the lungs, chest pain and shortness of breath. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).


VAERS ID: 1276715 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-03-14
Onset:2021-04-17
   Days after vaccination:34
Submitted: 0000-00-00
Entered: 2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Drug reaction with eosinophilia and systemic symptoms, Erythema, Rash
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: CEFALEXIN; CARBIDOPA; VIAGRA [SILDENAFIL]; DILTIAZEM
Current Illness: Drug allergy (penicillin); Drug allergy (ampicillin); Parkinson''s disease
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20210

Write-up: They are suspecting Dress Syndrome; erythema all over his body; broke out into a rash, started as a bulls eye rash in the arm; This spontaneous case was reported by a physician (subsequently medically confirmed) and describes the occurrence of DRUG REACTION WITH EOSINOPHILIA AND SYSTEMIC SYMPTOMS (They are suspecting Dress Syndrome) in a 61-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Parkinson''s disease, Drug allergy (penicillin) and Drug allergy (ampicillin). Concomitant products included CEFALEXIN, CARBIDOPA, SILDENAFIL (VIAGRA [SILDENAFIL]) and DILTIAZEM for an unknown indication. On 14-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 17-Apr-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced DRUG REACTION WITH EOSINOPHILIA AND SYSTEMIC SYMPTOMS (They are suspecting Dress Syndrome) (seriousness criterion medically significant), ERYTHEMA (erythema all over his body) and RASH (broke out into a rash, started as a bulls eye rash in the arm). At the time of the report, DRUG REACTION WITH EOSINOPHILIA AND SYSTEMIC SYMPTOMS (They are suspecting Dress Syndrome), ERYTHEMA (erythema all over his body) and RASH (broke out into a rash, started as a bulls eye rash in the arm) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Reporter mentioned patient is a mostly healthy, active farmer. Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1276721 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-13
Onset:2021-04-17
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040B21A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Blood test, Cardiac function test, Chest X-ray, Computerised tomogram, Echocardiogram, Loss of consciousness, X-ray
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ASPIRIN [ACETYLSALICYLIC ACID]; SERTRALINE; GABAPENTIN; OCUVITE [ASCORBIC ACID;RETINOL;TOCOPHEROL]
Current Illness: Allergy; Allergy to antibiotic
Preexisting Conditions: Medical History/Concurrent Conditions: Bladder operation NOS; Broken foot (40 years prior to reporting time.); Carpal tunnel syndrome; Foot surgery; Hip replacement; Knee surgery NOS; Lung operation NOS; Nerve pain; Shoulder operation NOS; Tubal ligation
Allergies:
Diagnostic Lab Data: Test Name: blood tests; Result Unstructured Data: normal; Test Name: heart tests; Result Unstructured Data: normal; Test Name: CXR chest X-Ray; Result Unstructured Data: normal; Test Name: Cat Scan; Result Unstructured Data: normal; Test Name: CT Scan Cervical Spine; Result Unstructured Data: normal; Test Name: CT Scan Head/Brain with contrast; Result Unstructured Data: CT Scan Head/Brain with Contrast; Test Name: (EKG) Echocardiogram; Result Unstructured Data: normal; Test Name: right knee and right elbow X-Ray; Result Unstructured Data: normal
CDC Split Type: USMODERNATX, INC.MOD20210

Write-up: Passed out, blacked out, landed flat on her face, hospitalized due to the events; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of LOSS OF CONSCIOUSNESS (Passed out, blacked out, landed flat on her face, hospitalized due to the events) in a 68-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 040B21A) for COVID-19 vaccination. The patient''s past medical history included Nerve pain in July 2020, Carpal tunnel syndrome, Broken foot (40 years prior to reporting time.), Lung operation NOS in July 2020, Hip replacement in 2017, Hip replacement in December 2020, Bladder operation NOS in November 2020, Foot surgery, Knee surgery NOS, Shoulder operation NOS and Tubal ligation. Concurrent medical conditions included Allergy to antibiotic and Allergy. Concomitant products included ASPIRIN [ACETYLSALICYLIC ACID], SERTRALINE, GABAPENTIN and ASCORBIC ACID, RETINOL, TOCOPHEROL (OCUVITE [ASCORBIC ACID;RETINOL;TOCOPHEROL]) for an unknown indication. On 13-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 17-Apr-2021, the patient experienced LOSS OF CONSCIOUSNESS (Passed out, blacked out, landed flat on her face, hospitalized due to the events) (seriousness criterion hospitalization). The patient was hospitalized from 17-Apr-2021 to 19-Apr-2021 due to LOSS OF CONSCIOUSNESS. On 19-Apr-2021, LOSS OF CONSCIOUSNESS (Passed out, blacked out, landed flat on her face, hospitalized due to the events) had resolved. Not Provided DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Blood test: normal (normal) normal. On an unknown date, Cardiac function test: normal (normal) normal. On an unknown date, Chest X-ray: normal (normal) normal. On an unknown date, Computerised tomogram: normal (normal) normal, normal (normal) normal and normal (normal) CT Scan Head/Brain with Contrast. On an unknown date, Echocardiogram: normal (normal) normal. On an unknown date, X-ray: normal (normal) normal. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Patient''s Primary Care Physician scheduled an MRI and Carotid Artery Ultrasound after a week from the reporting time. She was also placed on a heart monitor for 30 days. This case concerns a 68-year-old female hospitalized with a serious unexpected event of Loss of consciousness. Event latency 5 days after first dose mRNA-1273. Event resolved. Based on current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.; Sender''s Comments: This case concerns a 68-year-old female hospitalized with a serious unexpected event of Loss of consciousness. Event latency 5 days after first dose mRNA-1273. Event resolved. Based on current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.


VAERS ID: 1276786 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-04-17
Submitted: 0000-00-00
Entered: 2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

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

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

Write-up: Unevaluable event; This spontaneous case was reported by an other health care professional and describes the occurrence of UNEVALUABLE EVENT (Unevaluable event) in a 72-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 047A21A) for COVID-19 vaccination. No Medical History information was reported. On 15-Apr-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 17-Apr-2021, the patient experienced UNEVALUABLE EVENT (Unevaluable event) (seriousness criterion disability). At the time of the report, UNEVALUABLE EVENT (Unevaluable event) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Company comment: Very limited information regarding this event has been provided at this time. Further information has been requested.; Sender''s Comments: Very limited information regarding this event has been provided at this time. Further information has been requested.


VAERS ID: 1278314 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-03-09
Onset:2021-04-17
   Days after vaccination:39
Submitted: 0000-00-00
Entered: 2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031` / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Balance disorder, Dizziness, Gait disturbance, Mobility decreased, Nausea, Pain in extremity, Tinnitus, Vertigo, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hearing impairment (narrow), Vestibular disorders (narrow), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data: none
CDC Split Type:

Write-up: 2 weeks ago on April 17th, I woke up feeling very dizzy and nauseous. The room was spinning. My left ear was ringing, My balance was off. Every time I bent over it was worse. I vomited after I ate. Spent the day and the next day in bed. On Monday I called my doctors office and explained how I was feeling and a tele visit was scheduled later in the day. During the tele visit, the doctor diagnosed my symptoms as vertigo. I never had vertigo in the past. She couldn''t tell me if it was from the vaccine or not. She did mention she had patients complaining of vertigo after getting the covid vaccine. Medication and exercises were given to me. A few days later, my big toe on my right foot was aching terribly. Each day it seems to be worse and I am at the point where I can barely walk. Today I did some research online and saw that it could be gout. I never had gout n the past. I read vaccines can cause gout. So here I am 2 weeks since my symptoms began and I am still dizzy and have the toe pain. Exercises and medication is not helping.


VAERS ID: 1278680 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-14
Onset:2021-04-17
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0161 / 1 RA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Diarrhoea haemorrhagic, Dizziness, Hyperhidrosis, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Vestibular disorders (broad), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: GABAPENTIN; NEURONTIN; EFFEXOR; SYNTHROID; RELPAX
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Fruit allergy (kiwi fruit); Migraine; Thyroid cancer
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021423966

Write-up: bloody diarrhea; lightheadedness; vomiting; sweating; This is a spontaneous report from a contactable consumer (patient). A 44-year-old female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in arm right on 14Apr2021 at 15:30 (Lot Number: EW0161) (at the age of 44-year-old) as single dose for COVID-19 immunisation. The patient was not pregnant. Medical history included migraine, thyroid cancer and fruit allergy (kiwi fruit), all from an unknown date and unknown if ongoing. Concomitant medication included gabapentin; gabapentin (NEURONTIN); venlafaxine hydrochloride (EFFEXOR); levothyroxine sodium (SYNTHROID); eletriptan hydrobromide (RELPAX), all concomitants were taken for an unspecified indication, start and stop date were not reported. On 17Apr2021 at 10:00, the patient experienced bloody diarrhea, lightheadedness, vomiting and sweating. No therapeutic measures were taken as a result of the events. The patient outcome of the events was unknown.


VAERS ID: 1278690 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-17
Onset:2021-04-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ERB8729 / UNK RA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: DIPHENHYDRAMINE
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021424010

Write-up: Fainted about 15 to 20 minutes after dose; This is a spontaneous report from a contactable consumer (patient himself). A 24-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection), via an unspecified route of administration, administered in the right arm on 17Apr2021 at 11:15 AM (Batch/Lot Number: ERB8729) as a single dose for COVID-19 immunization. The patient had no medical history. The patient had no known allergies. Concomitant medication included diphenhydramine taken for an unspecified indication, start and stop date were not reported. The patient had no other vaccine in four weeks. The patient had no COVID-19 prior vaccination. The patient was not tested for COVID-19 post vaccination. On 17Apr2021 at 11:30 AM, the patient fainted about 15 to 20 minutes after dose. The patient did not receive any treatment for the adverse event (AE). The patient recovered from the event on an unspecified date.


VAERS ID: 1278692 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-15
Onset:2021-04-17
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8731 / 1 LA / -

Administered by: Public       Purchased by: ?
Symptoms: Diarrhoea haemorrhagic
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Pseudomembranous colitis (broad), Gastrointestinal haemorrhage (narrow), Ischaemic colitis (broad), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: IBUPROFEN
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021424041

Write-up: Bloody diarrhea; This is a spontaneous report from a contactable consumer (patient). This 61-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 1 via an unspecified route of administration, administered in arm left on 15Apr2021 13:00 (Batch/Lot Number: ER8731) as a single dose for COVID-19 immunization. Patient has no medical history. Concomitant medication included ibuprofen. Patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient was not diagnosed with COVID-19 prior to vaccination. Patient has not been tested for COVID-19 since the vaccination. Patient has no known allergies. The patient experienced bloody diarrhea on 17Apr2021 10:00 with outcome of recovering.


VAERS ID: 1278693 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-04-17
Onset:2021-04-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 1 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021424044

Write-up: Syncope; This is a spontaneous report from a contactable nurse (patient). A 57-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection), dose 1 via an unspecified route of administration, administered in left arm on 17Apr2021 11:30 (Batch/Lot Number: ER8735) as single dose for COVID-19 immunisation. The patient''s medical history and concomitant medications were not reported. The patient was not diagnosed with COVID-19 prior to vaccination and had not been tested for COVID-19 since the vaccination. The patient experienced syncope on 17Apr2021 11:45. The event resulted in emergency room/department or urgent care. Therapeutic measures were taken as a result of syncope. Outcome of the event was unknown. No follow-up attempts are possible. No further information is expected.; Sender''s Comments: Based on the information currently available and the close temporal relationship, a possible contributory role of suspect product BNT162B2 to the reported ''syncope'' cannot be completely excluded. Case will be reassessed if additional information is received. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees, and Investigators, as appropriate.


VAERS ID: 1278704 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-04-17
Onset:2021-04-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8735 / 1 RA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Memory impairment, Road traffic accident, Seizure
SMQs:, Systemic lupus erythematosus (broad), Dementia (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Depression (excl suicide and self injury) (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? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: BUPROPION; EFFEXOR
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Penicillin allergy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021424222

Write-up: Seizure; crashed my car.; don''t remember 45 minutes of my life; This is a spontaneous report from a Contactable Consumer (patient). A 26-years-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 1 via an unspecified route of administration, administered in Arm Right on 17Apr2021 13:15 (Batch/Lot Number: ER8735) as SINGLE DOSE for covid-19 immunisation at a vaccine facility, at 26 years old. Medical history included known allergies: Penicillin from an unknown date. No other vaccine in four weeks. Patient did not COVID prior vaccination and has not been tested for COVID post vaccination. Concomitant medication included bupropion; and venlafaxine hydrochloride (EFFEXOR) taken for an unspecified indication, start and stop date were not reported. Patient waited 15 minutes and felt normal. Patient stopped for gas and soda and then patient stated to be honest he woke up surprised with EMT, police and fire just telling him he started having a seizure and crashed his car on 17Apr2021 13:30. Patient stated "that''s craziest laser I don''t remember 45 minutes of my life (onset 17Apr2021). Thought I would be like 140. It was 3 pm which leave a large gap. This is really scary for me and my family". The events resulted in emergency room visit for seizure and crashed his car. The patient was hospitalized for seizure and for crashed his car for 1 day. Therapeutic measures were taken as a result of seizure and crashed my car (Some things to regulate my heart rhythm). Outcome of the events seizure and crashed his car was not recovered while unknown for don''t remember 45 minutes of his life.


VAERS ID: 1278769 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-03
Onset:2021-04-17
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0150 / 1 LA / -

Administered by: School       Purchased by: ?
Symptoms: Haematochezia
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal haemorrhage (narrow), Ischaemic colitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NORVASC
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Blood pressure abnormal; Penicillin allergy
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021425298

Write-up: Blood in stool; This is a spontaneous report from a contactable consumer (patient). A 55-year-old male patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EW0150 and expiration date not provided) via an unspecified route of administration, administered in the left arm on 03Apr2021 11:30 as a single dose for COVID-19 immunization. Medical history included high blood pressure and allergies to Penicillin. Concomitant medication included amlodipine besilate (NORVASC). Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccine in 4 weeks prior to the COVID vaccine. The patient had blood in stool 14 days after first COVID shot on 17Apr2021 10:30. No treatment was given in response to the event. The patient has not been tested for COVID post vaccination. The outcome of the event was not recovered. Information about lot/batch number has been requested.


Result pages: prev   1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127   next

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?EVENTS=ON&PAGENO=28&PERPAGE=100&ESORT=ONSET-DATE&REVERSESORT=ON&VAX=COVID19&DIED=No


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