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

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



Case Details

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VAERS ID: 1101989 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-13
Onset:2021-03-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Differential white blood cell count normal, Dyspnoea, Fibrin D dimer normal, Full blood count normal, Metabolic function test, Metabolic function test normal, Pain in extremity, Platelet count normal, Pulmonary pain, Pyrexia, Troponin I normal
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ClonazePAM and Tylenol
Current Illness: Depression and anxiety
Preexisting Conditions: Migraines, kidney stones, PTSD, and depression/anxiety
Allergies: IVP dye, NSAIDS, compazine and toradol. Shellfish, iodine, blue food dye, and bee-stings
Diagnostic Lab Data: CBC with platelet count+ automated diff, CMP, CBC w/ Auto differential, D?dimer, quantitative, Troponin I, all on 3/15/2021 all within normal limits
CDC Split Type:

Write-up: Day after vaccine Had low grade fever of 99.8, pain in leg and right lung. Rested and pain didn?t elevate with rest and Tylenol. Shortness of breath became worse went to the ER. Pain in lung causing shortness of breath. Leg pain. Labs, ECG, venous Doppler and chest X-ray. All returned in normal limits. Diagnosis: Acute chest pain. vaccine reaction, initial encounter. Still having shortness of breath and pain in right lung. Will follow up with primary care doctor


VAERS ID: 1102052 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-03-13
Onset:2021-03-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood glucose, Blood magnesium, Blood test, Differential white blood cell count, Dizziness, Electrocardiogram, Hyperhidrosis, Laboratory test, Metabolic function test, Nausea, Respiratory rate increased, Troponin
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Sertraline HCL 50 mg. Baby aspirin Multi-vitamins, fish oil, Vit-D3, CoQ-10
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: EKG: initial Fingerstick blood glucose Lab tests: basic metabolic panel, CB, platelet, and differential, hold blue top tube, hold green top tube, Lab add-on/write-in test Magnesium, Troponin performed 2 times
CDC Split Type:

Write-up: I became dizzy, nauseous, sweaty, and rapid breathing about 10 minutes after receiving the vaccine. I was given an EpiPen injection and taken by ambulance to a local ER


VAERS ID: 1102055 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-15
Onset:2021-03-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Dyspnoea, Fatigue, Nausea, Pulmonary physical examination, Vital signs measurement, Vomiting, Wheezing
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)

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

Write-up: 23 y/o female presents with nausea, vomiting, and shortness of breath since just after lunch time. SM reports 3 episodes of emesis, she ate fish for lunch. +wheezing/shortness of breath. Pt received Janssen COVID vaccine at around 0900 hours this morning. She did experience some fatigue a couple hours after vaccine. No other medications or allergies. PE pertinent for wheezing b/l on lung exam. VS normal. Due to current presentation and history suspect anaphylaxis 2/2 COVID vaccination. Pt given Epinephrine auto-injector in clinic, after which she reported resolution of wheezing and improved ability to take a full breath. Heart rate elevated to 124 BPM with BP of 142/95 and SPO2 stable at 100%, these VS subsequently normalized. Pt also given 125mg solumedrol and 50mg Benadryl both IV. Due to concern for progressive deterioration will transfer Pt to ER for improved monitoring and potential for other emergent treatment.


VAERS ID: 1102170 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-03-12
Onset:2021-03-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Blood pressure increased, Headache, Paraesthesia oral, Vision blurred, Vital signs measurement
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Glaucoma (broad), Hypertension (narrow), Lens disorders (broad), Retinal 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data: full work up in ED. Prior to discharge, pt felt back to baseline.
CDC Split Type:

Write-up: Within 10 minutes of receiving the vaccine, pt reported having tingling to left side of tongue and lips. BP 199/88 and continued to rise over the course of 15 minutes to 239/103. Pt denied shortness of breath, but tingling did not improve so Benadryl 50mg PO adminsitered but offered minimal relief. Pt then began to complain of blurry vision to left eye and headache. EMS called and manual BP was 258/100. Pt transported to local ED and treated. ED physician noted that he felt that this was a drug reaction related to the COVID vaccine.


VAERS ID: 1102269 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-03-15
Onset:2021-03-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 18055022 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Palpitations
SMQs:, Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad)

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

Write-up: PATIENT REPORTED FEELING FAINT AND A RAPID HEARTBEAT AFTER THE VACCINE WAS GIVEN. EMS WAS CALLED AND THEY EVALUATED PATIENT AND TOOK HER TO THE ER.


VAERS ID: 1102287 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-03-15
Onset:2021-03-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 18055022 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Paraesthesia, Paraesthesia oral, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (broad)

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

Write-up: PATIENT REPORTED TINGLING/PINS AND NEEDLES SENSATION IN TONGUE AND TIGHTNESS OF THROAT. EMS WAS CALLED AND PATIENT WAS TAKEN IN AMBULANCE BY EMS.


VAERS ID: 1102293 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-03-11
Onset:2021-03-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

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

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

Write-up: PATIENT RECEIVED J&J VACCINE ON 3.11.21 AND NOTED RASH AND SWELING OF THE FACE AND EXTREMITIES ON 03.12.21. PRESENTED TO THE EMERGENCY DEPT FOR EVALUATION ON 03.13.21. PATIENT WAS TREATED INTHE EMERGENCY DEPT WITH DECADRON 4 MG IM INJECTION AND BENADRYL 50 MG BY MOUTH. AT DISCHARGE FROM THE ER TO HOME THE PATIENT WAS GIVEN A PRESCRIPTION FOR MEDROL DOSE PACK.


VAERS ID: 1102479 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-03-10
Onset:2021-03-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest X-ray normal, Dyspnoea, Electrocardiogram normal, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec for allergies
Current Illness: None
Preexisting Conditions: None
Allergies: None known.
Diagnostic Lab Data: At the ER on Saturday March 13th they did an EKG and chest x-ray. Both were normal.
CDC Split Type:

Write-up: About 40 mins after I felt my throat closing and felt like I couldn''t breathe. Since then I have had several other instances of feeling similar (though none of them went to full anaphylaxis. I went to the ER Saturday and my PCP today, still for shortness of breath.


VAERS ID: 1102498 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-15
Onset:2021-03-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Tachycardia, Vital signs measurement
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Vestibular disorders (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Did not mention
Current Illness: Did not mention
Preexisting Conditions: Did not have due to mass vaccination site.
Allergies: answered no to the questionaire
Diagnostic Lab Data: Transported to ER for further evaluation
CDC Split Type:

Write-up: Lightheadedness and tachycardia noted 20 minutes after administration of Covid Vaccine. Emergency drugs available. Airway assessment done, vital signs obtained, cold, damp cloth placed on patient''s head and neck. Husband requested EMS to transport patient to ER for further evaluation. Patient stable when EMS arrived.


VAERS ID: 1102604 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-03-14
Onset:2021-03-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Confusional state, Heart rate increased, Pain, Pyrexia, Respiratory rate increased, Visual impairment
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: 11 hours post to injection, fever became elevated to 103?F, mentation became very confused, major aches through out body, elevated breathing and heart rate, some vision impairment


VAERS ID: 1102714 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-03-07
Onset:2021-03-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anaphylactic reaction, Blood test
SMQs:, Anaphylactic reaction (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypersensitivity (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Sulfasalazine Ortho-Cyclen
Current Illness: None
Preexisting Conditions: Currently meeting with rheumatologist for possible juvenile rheumatoid arthritis.
Allergies: None
Diagnostic Lab Data: Emergency Room Visit - 3/7/21 : Initial anaphylaxis reaction, blood work and given EpiPen, steroids'', Pepcid, Benadryl, and fluids requiring an overnight stay. Follow-up visit with general practitioner Emergency Room Visit - 3/12/21: Secondary anaphylaxis reaction, blood work and given steroids'', Pepcid, and Benadryl requiring 3-4 hours of observation
CDC Split Type:

Write-up: Janssen COVID-19 Vaccine EUA


VAERS ID: 1102815 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-03-05
Onset:2021-03-09
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Bilevel positive airway pressure, Blood lactic acid increased, Dyspnoea, Endotracheal intubation, General physical health deterioration, Human rhinovirus test positive, Lung infiltration, Oxygen saturation decreased, Procalcitonin increased, Pyrexia, Refusal of treatment by patient, Rhinovirus infection, Septic shock, Vasopressive therapy
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Lactic acidosis (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Toxic-septic shock conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Sepsis (narrow), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-12
   Days after onset: 3
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: Advair, Alprozolam, Amlodipine, Aspirin, Atorvastatin, Azithromycin, Biotin, Cefuroxime, Dexilant, Dymista, Fenofibrate, Fluticasone, Hydrochlorothiazide, Incruse Ellipta, Isosorbide Monoitrate, Levothyroxine, Lipitor, Loratadine, Magnesium
Current Illness: 2-3 weeks prior to vaccine was croupy and saw a pulmonologist and lungs were clear, on and off antibiotics from 2/12 to 3/5, failed stress test (occlusion of left anterior descending artery) and recommended cardiac cath and had a cardiac implant, possibly defibrillator.
Preexisting Conditions: COPD and Diastolic CHF, Pre-Diabetic, Hypertension
Allergies: Penicillin
Diagnostic Lab Data: 3/11/21 Positive for Rhinovirus 3/11/21 Procalcitonin 54.97 and lactic acid 33.5 3/12/21 Procalcitonin 98.61 and lactic acid 72.4
CDC Split Type:

Write-up: Patient presented to hospital on 3/11 with shortness of breath. History of chronic oxygen dependency at night. Became more sob over last several days and was not able to make it to md appointment. Had a recent abnormal stress test. Family states she was febrile at home. Was low on oxygen level on 2LNC, placed on non-rebreather and then BIPAP. Positive for Rhinovirus. Chest xray showed bilateral lower infiltrates. Patient detiorated through the night and was intubated and placed on vasopressors for septic shock. Patient was made DNR and family refused hemodialysis. Family then made decision to withdraw care.


VAERS ID: 1103106 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Male  
Location: Mississippi  
Vaccinated:2021-01-15
Onset:2021-01-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 UN / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Death, Malaise
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-24
   Days after onset: 8
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: NA
Preexisting Conditions: NA
Allergies: NA
Diagnostic Lab Data: UNK
CDC Split Type:

Write-up: Patient died on 01/24/2021. Began exhibiting symptoms similar to Covid 1 day after vaccination.


VAERS ID: 1103281 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-03-12
Onset:2021-03-15
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: prn xanax (taken once prior to today)
Current Illness: None reported
Preexisting Conditions: Anxiety
Allergies: NKA
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: Reported numbness/tingling and muscle cramps in arms and fingers. Assessment performed. No wheezing/stridor, hives, angioedema. BPs ranged 133-120/68-80, HR 78-104 bpm. 911 called by employee while patient remained under observation. EMS arrived and assessed patient with similar vital signs. O2 therapy applied by EMS. Patient declined ER at this time and took rx xanax. Husband at her side. I came into patient area with EMS present and spoke to patient who appeared less worried/anxious. She removed O2. I asked if she wants further evaluation and she said yes and was transferred to local ER by EMS. Husband in car


VAERS ID: 1103312 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-03-15
Onset:2021-03-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / IM

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

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

Write-up: AMI onsite Paramedics were approached by a 28 y/o female stating she was about to ?pass? out as she was kneeling approx. 10 mins after receiving the vaccination which was administered at 16:54. Pt was caught prior to losing consciousness for approx. 30 seconds post vaccination and presenting with sz like activity consisting of decorticate posturing and pupils dilated @6mm. Pt was carried onto available cot via two man carry where pt regained consciousness, coax4 of 4 GCS 15. Pt stated she felt lethargic and was diaphoretic and feeling nauseated, no emesis. Pt was placed left lateral and was placed on oxygen via N/C @2lpm while EMS responded. Pt denies allergies but states being hypersensitive to Augmentin, no meds taken, no prior medical hx but states she?s had similar episodes since the age of 17 being reported as sz like but never diagnosed and denies having a neurologist. Pt also stated that this was the worst episode. While awaiting EMS, pts nausea and diaphoresis had subsided but stated feeling ?heavy?. HEENT-unremarkable, Pupils now equal and reactive, neck-supple ,equal chest rise with clear equal lung sounds ,abd non tender, FROM to extremities x4 with equal weak strength. Upon EMS arrival, report was provided, EOR.


VAERS ID: 1103431 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-13
Onset:2021-03-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Chills, Dyspnoea, Electrocardiogram, Fatigue, Pyrexia, Vaccination complication
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Ibuprofen, antihistamines and women''s daily vitamins.
Current Illness: None.
Preexisting Conditions: History of asthma, eczema and seasonal allergies.
Allergies: None that I know of. Just seasonal allergies.
Diagnostic Lab Data: Tests at the ER on 3/15/21 at around 1am: EKG 12 OR MORE LEADS W INT & RPT Blood pressure 117/85 Pulse 63 Oxygen Stauration 98% Respiration 16 Diagnoses: CHEST PAIN, ATYPICAL VACCINE ADVERSE REACION
CDC Split Type:

Write-up: I had the expected side effects of fever and chills that evening around 8pm on the evening of the vaccine (3/13/21) and it went away by 1am. The next morning (3/14) I felt a bit tired but still had enough energy to go on my usual 8-mile run. Just when I thought the side effects had passed, I was woken up that night by chest tightness and shortness of breath. I had to go to the ER on the evening of 3/14/21and got discharged around 2am of 3/15/21. They did and EKG and they said my heart and lungs are all in great shape and that this is probably just a vaccine side effect. They said they see it more often in Moderna but I guess it can happen with this one too. I just hope I?m not one of the rare cases that ends up in death. I do have a history of allergies and asthma. I?m feeling better though, though I still feel something different in my chest.


VAERS ID: 1103544 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-03-15
Onset:2021-03-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Feeling abnormal, Presyncope
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Patient felt like he was going to "go down", he has a history of vasovagal response. Patient has a second vasovagal and EMS was contacted. Patient then stated he had been standing for the last 5 hours during a swim meet and did not take his Norvasc that was to be taken daily.


VAERS ID: 1103770 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-03-15
Onset:2021-03-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chapped lips, Dizziness, Fatigue
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Famodtidine 20mg, Omega 3 2 mini, estriadol /Testosterone pellet in skin
Current Illness: none
Preexisting Conditions: none
Allergies: Keflex and brazil nuts
Diagnostic Lab Data:
CDC Split Type:

Write-up: Tiredness, then dizziness and chapped lips. Next day, lips are swollen and chapped, still dizzy although less


VAERS ID: 1103788 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-03-08
Onset:2021-03-11
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Paraesthesia, Pruritus, Rash, Skin burning sensation
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? 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: Allergic: Itch (specify: facial area, extremeties)-Mild, Systemic: Allergic: Itch Generalized-Mild, Systemic: Allergic: Rash (specify: facial area, extremeties)-Mild, Systemic: Allergic: Rash Generalized-Mild, Systemic: Tingling (specify: facial area, extemities)-Medium, Additional Details: Patient reported to our store 5457 about a vaccine she got at 5434 last monday. She broke out with a rash the thursday after getting the vaccine and after a few days of vaccine she decided to go to urgent care since the /"burning wasn''t stopping/" and it spread to her chest. She was discharged with a script of prednisone and the rash seems to be getting a little better. I will follow up with her in 2 days to make sure it has cleared up.


VAERS ID: 1103848 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-15
Onset:2021-03-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 - / IM

Administered by: Military       Purchased by: ?
Symptoms: Abdominal discomfort, Abdominal tenderness, Aphasia, Chills, Dysphagia, Headache, Nausea, Oropharyngeal oedema, Pyrexia, Tachycardia, Urine analysis
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Ibuprofen
Current Illness:
Preexisting Conditions: None
Allergies: G6PD
Diagnostic Lab Data: Laboratory study was limited to urinalysis given our deployed environment. The test was unremarkable.
CDC Split Type:

Write-up: 19 y/o M AD USMC with Hx G6PD Def was brought in by ambulance with complaints of abdomen discomfort, chills, fever, dysphagia/dysphasia, nausea and headaches following administration of Janssen vaccine 7-8 hours prior. Evaluation significant for edema/inflammation of the oropharynx, abdomen tenderness, down-trending BP, fever ($g102 F), tachycardia ($g115), despite the fluid resuscitation IV, Epinephrine, steriods, Antipyretic and diphenhydramine. Vital signs and symptoms significantly improved 2.5 hours into the treatment. Over the evening care, member had a unremarkable observation. Vital signs maintained stable in the morning and he was discharged with appropriate therapies and follow up instructions.


VAERS ID: 1104320 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-11
Onset:2021-03-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 014M20A / 1 LA / IM

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

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

Write-up: Blistering , swelling and redness at injection site


VAERS ID: 1104374 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-15
Onset:2021-03-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Anosmia, Cardiac discomfort, Diarrhoea, Headache, Myalgia, Pain in jaw, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Osteonecrosis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin Biotin for menopausal hair loss Propranolol for occasional racing heart due to menopause
Current Illness: None known
Preexisting Conditions: None
Allergies: None known
Diagnostic Lab Data: Ambulance called by family members. Transit to hospital refused but they gave advice to reduce fever
CDC Split Type:

Write-up: Diarrhea Fever = 102.9 Intense muscle and jaw pain Intense headache Loss of smell Heart felt enlarged


VAERS ID: 1104430 (history)  
Form: Version 2.0  
Age: 98.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-12
Onset:2021-03-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / UNK LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-13
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Death Narrative: Patient has been admitted to a home hospice program since approximately 11/12/20 with an initial terminal diagnosis of dysphagia which was later changed in February 2021 to vascular dementia. Patient with significant past medical history of several CVA''s which led to aphasia and vascular dementia.


VAERS ID: 1104451 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-06
Onset:2021-03-10
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: MMR booster/ flu like for 3 weeks post
Other Medications: Many
Current Illness: None
Preexisting Conditions: Sarcoidosis Hyper sensitivitiy to Mold
Allergies: None
Diagnostic Lab Data: ER visit Steroids and Pepcid IV- increased hives Atarax po Followed by benydral iv
CDC Split Type:

Write-up: 4 days post hives. Not resolved with Otc bendryal. Day 5 chest tightening with full body.


VAERS ID: 1104590 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-03-07
Onset:2021-03-14
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test normal, Dyspepsia, Hypoaesthesia oral, Lip swelling, Ultrasound scan normal, X-ray normal
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific dysfunction (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: 365 Men''s Multivitamin
Current Illness: None
Preexisting Conditions: Migraines
Allergies: Shellfish
Diagnostic Lab Data: On 3/15, I visited the hospital to treat what I thought might''ve been a cardiac condition. Blood work, ultra sound, and x-rays were performed all coming back with nothing adverse having happened with regards to heart function leading me to believe this might''ve been an allergic reaction.
CDC Split Type:

Write-up: **Uncertain if it this is related to the vaccine** On 3/14/21, a week after vaccine was administered, I had a fast food meal I''ve had several times before. Around 30-40 minutes later, I began experiencing a reaction I''m not prone to. I had severe heartburn throughout most of the night and my lips began to swell which made me mistakenly assume I have had a cardiac event. While in the morning the pain had subsided, the numbness in the lips hadn''t and I went to the ER thinking it might''ve been a heart issue. No cardiac condition was noted at the hospital which leads me to believe I may have had a severe allergic reaction to foods or environmentals I''ve never had reactions to.


VAERS ID: 1104602 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-03-12
Onset:2021-03-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad)

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

Write-up: patient felt like her throat was closing. a few minutes after dose administered. she was given epi injection, ems was called and she was transferred top the hospital


VAERS ID: 1104637 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-11
Onset:2021-03-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Blood glucose normal, Gait disturbance, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Guillain-Barre syndrome (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:

Write-up: Patient noted to have unsteady gait - experienced syncopal episode. Placed in supine position, with BP 82/40 (pulse 46). Blood glucose 112. Given 500 mL normal saline. Sent to Medical center.


VAERS ID: 1104638 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-09
Onset:2021-03-15
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test positive
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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol, calcium, lasix, cozaar, potassium, multiple vitamin, kenalong cream, xarelto
Current Illness: husband has COVID,
Preexisting Conditions: HTN, a fib, diastolic disfunction, cardiomyopathy, chronic kidney disese, obesity
Allergies: bactrim
Diagnostic Lab Data: SARS-COV-2 by molecular
CDC Split Type:

Write-up: patient developed COVID


VAERS ID: 1104764 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-03-10
Onset:2021-03-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Other       Purchased by: ?
Symptoms: Condition aggravated, Immune thrombocytopenia, Immunoglobulin therapy, Petechiae, Platelet count decreased, Rash
SMQs:, Anaphylactic reaction (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vit D Calcium MVI Escitalopram Levothyroxine
Current Illness: UTI
Preexisting Conditions: ITP
Allergies: None
Diagnostic Lab Data: See above.
CDC Split Type:

Write-up: Patient with known history of ITP status post splenectomy in 2018, with stable platelet counts off treatment, developed petecchial rash in lower extremities 2 days after receiving COVID vaccine during a mass vaccination campaign. Platelet counts check 2 days after the vaccination was 1,000. Patient was admitted to the hospital for ITP, received 2 doses of IVIG and was initiated on prednisone with improvement in platelet count to 72,000 by 03/14/2021. Give


VAERS ID: 1105040 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-16
Onset:2021-03-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Electrocardiogram, Heart rate increased
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Prozac
Current Illness: Denies
Preexisting Conditions: SVT (Superventricular Tachycardia, MI
Allergies: NKA
Diagnostic Lab Data: None
CDC Split Type:

Write-up: @1340 client c/o rapid heart rate. Vitals obtained @1341: 114/85, 200 HR, 98% Room air. Called placed by (Site Superivsor) to 911 @1344. Client is AAOX4. NAD. Denies any other symptoms. Repeat vitals @1350: 124/86, 197, 98% RA. Fire engine arrived @1355. Facility completed and EKG, inserted a PIV to RAC 18g, started a IVF bolus of NS 0.9% and attempted the Vasal Vagual Manuver without any import net of heart rate. EMS vitals: 112/74, 192 HR, 19 RR, 100% RA. Ambulance rescue arrived @ 1405. Client agreed to be transported to the hospital for further treatment. Paramedics assumed care @1408. Client left AAOX4. NAD. Skin WNL, Respiratory WNL. No acute changes in condition. Patient transport to ambulance without further incidient. Other staff present RN, EMT, Site Supervisor.


VAERS ID: 1105066 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-03-15
Onset:2021-03-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Contusion, Eye movement disorder, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Haemorrhage terms (excl laboratory terms) (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), Accidents and injuries (narrow), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Norvasc 5 mg Q day
Current Illness: None
Preexisting Conditions: Hypertension, L eft prosthetic hip
Allergies: NKDA
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: Patient was standing with hands on knees and stated that he was "going down". Paramedic was standing nearby. Patient''s eyes rolled back into his head and paramedic helped to guide patient to the floor. Pt tried to crawl while on his hands and knees prior to rubbing his face into the carpet as he continued to crawl. Paramedic rolled patient over onto his back and patient rested there for about 10 minutes. Pt got up with standby assistance and sat in chair. After 5 minutes pt passed out again and was turned over on his back on the floor. Pt vital signs were taken and were stable. Ice pack placed on patient head. Pt had visible bruises to the face (nose, eye and forehead). Pt has a history of passing out with vaccines and stated that he had not taken his blood pressure medicine today. Pt placed in wheelchair and taken by EMS to the hospital.


VAERS ID: 1105088 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-03-16
Onset:2021-03-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 18OC08 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Dizziness, Exposure during pregnancy, Foetal monitoring, Hypotension, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (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:
Current Illness: Hypertension
Preexisting Conditions: Hypertension
Allergies: Mold
Diagnostic Lab Data: Blood work, fetal monitoring - 3/16/21
CDC Split Type:

Write-up: Janssen COVID-19 Vaccine EUA Extreme dizziness leading to fainting five minutes after the shot. Blood pressure was extremely low for about 20 minutes after episode. I?m 36 weeks and 3 days pregnant. Baby is expected on 04/10/2021.


VAERS ID: 1105117 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-13
Onset:2021-03-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 UN / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Atelectasis, Chest X-ray abnormal, Cough, Fatigue, Haemoglobin normal, Haemoptysis, Lung opacity, Myalgia, Pneumonia, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: atorvastatin 10 mg daily
Current Illness: none
Preexisting Conditions: hyperlipidemia
Allergies: none
Diagnostic Lab Data: Labs within normal limits, including normal hemoglobin. Patient has mild elevation of WBC 11, which is consistent with his previous labs. Chest x-ray shows a retrocardiac opacity which may represent atelectasis vs pneumonia. Given patient''s symptoms, will treat for community acquired pneumonia with amoxicillin
CDC Split Type:

Write-up: Patient received vaccine on 3/13, initially had fatigue and myalgia the day after, which resolved, but also on 3/14 began having mild intermittent coughing, nonproductive, occurring every two hours or less. Patient began having some blood in his sputum since this morning at 4AM, and that occurred twice more with intervals of a few hours, both continuously improving and less blood. No other symptoms. No history of TB, no exposure to sick contacts, no recent travel. Unlikely a pulmonary embolus given normal vital signs and no risk factors. Patient was doing outdoor work in his yard for the past few days before the symptom onset and was working on mulch and compost. Although unlikely to have fungal infection currently, may be bacterial pneumonia


VAERS ID: 1105118 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-16
Onset:2021-03-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Work       Purchased by: ?
Symptoms: Blood pressure increased, Dizziness, Dyspnoea, Paraesthesia, Throat irritation, Tremor
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Hypertension (narrow), Cardiomyopathy (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: Patient c/o dizziness. VS taken with elevated BP. No other symptoms reported. Observed for 45 min until BP drop to a decent reading. Sent patient home with son. Son return 15 min later and stated that mother dizziness return but now have SOB. Went to car with VS machine and anaphylactic kit. Patient c/o dizziness, SOB, tingling sensation of hands, itchy throat, and visibly shaking. VS taken with elevated BP again and HR 110-120. Administered Epi pen and called ambulance.


VAERS ID: 1105132 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-12
Onset:2021-03-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Skin laceration, Suture insertion, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Pt got vaccination at waited 15 minutes before leaving. She called me 4 days later to let me know that she fainted approximately 1 hour after getting the vaccination resulting in a trip to er and stiches to her face.


VAERS ID: 1105141 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-03-14
Onset:2021-03-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / UNK RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Bradycardia, Dizziness, Fall, Head injury, Hyperhidrosis, Pallor, Presyncope
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: vaccinated 1005 - walked to observation around 1008 vagal response in observation area - slipped to floor - attended by paramedic -small brush burn above eyebrow - no lumps joint head or neck pain - remained conscious throughout incident pulse bradycardic 40 - 50 C/O dizziness pale and sweaty - legs elevated - after 10 minutes symptoms resolved and patient assisted to her feet - symptoms returned - placed on stretcher legs elevated - EMS notifed - transported to ED around 1028 BP on transfer 98/46


VAERS ID: 1105301 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-03-11
Onset:2021-03-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Blood test, Computerised tomogram, Fatigue, Feeling hot, Fine motor skill dysfunction, Muscular weakness, Myalgia, Paraesthesia, Sleep disorder
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Shingles-felt like I had a case of the flu, body aches (2/2021)
Other Medications: Methotxsate Lucovorin Ibuprofen Detrol Nexum Vitamin D
Current Illness: Seasonal Allergies
Preexisting Conditions: Rheumatoid Arthritis Fibromyalgia Asthma
Allergies: Sula drugs Malaria associated drugs
Diagnostic Lab Data: Blood work CT scans
CDC Split Type: vsafe

Write-up: Within 12 hours I became to have severe muscle aches and joint aches. All my joint felt hot, it was bad enough I wasn''t able to sleep. I took Ibuprofen to help sleep. I slept most of Friday I has extreme fatigue. On Saturday I has muscle weakness and tingly in my hands, the muscle aches have gone away. I couldn''t knit ot fine motor skills, It bothered me. I woke up on Sunday where I had extremes muscle weakness in both my legs. I called my PCP, they were surprised by how the reaction was delayed. They wanted me to get a test for the strength in my legs and sent me to the ER. I wen to the Er they tested for stroke, blood work, scans, they were worried about Guillain Barre Syndrome. I stayed there about 5 hours. Yesterday afternoon the tingly went away from my hands but my legs are still kinda goofy. The muscle in my forearm and thigh feel like my muscle are really sore, like they have been tense


VAERS ID: 1105537 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-03-12
Onset:2021-03-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Gastrooesophageal reflux disease, Urticaria, Vaccination complication
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Gastrointestinal nonspecific dysfunction (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: omeprazole 20mg, amitriptyline 25mg, atenolol 50mg qhs, zolpidem 10mg, potassium, vitamin D3, magnesium, multivitamin,
Current Illness: UTI
Preexisting Conditions: high chlorestoral, GERD
Allergies: penicillin
Diagnostic Lab Data: no
CDC Split Type:

Write-up: pt stated she was fine the first day after taking the vax. She was fine next day as well. On 3/14/2021 she started itching and developed whelps around her waist, hands, wrist, feet and lower abdomen. She is also having severe acid reflux. Pt went to the Urgent Care. She was given a steroid shot along w/ a Pepcid tablet. They prescribed hydroxyzine hcl 25mg, prednisone 10mg, and Pepcid 20mg. Pt was diagnosed w/ reaction to the covid vax. Pt says she still has some whelps but the medication seems to be helping for now.


VAERS ID: 1105538 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-03-16
Onset:2021-03-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Palpitations
SMQs:, Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none known
Current Illness: Lupus & HTN
Preexisting Conditions: Lupus & HTN
Allergies: none known
Diagnostic Lab Data:
CDC Split Type:

Write-up: 0910 patient recieved vaccine. 0920 client described feeling woozy & like she had run fast. (hearting racing) Patient alert, talkative, denies swelling of mouth or tongue, no rash, no difficulty breathing. POX 98%, HR 120, BP 194/110. 0926 BP 200/120, Hr137. Called EMS. 0942 EMS brought her to Hospital. 1240 husband of patient called me to say "we are going home. She is doing better. The doctor said he did not think it was an allergic reaction to the vaccine."


VAERS ID: 1105686 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-03-09
Onset:2021-03-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 - / IM

Administered by: Other       Purchased by: ?
Symptoms: Alanine aminotransferase normal, Albumin globulin ratio normal, Aspartate aminotransferase normal, Bacterial test negative, Basophil count normal, Basophil percentage, Bilirubin urine, Blood albumin normal, Blood alkaline phosphatase normal, Blood bilirubin normal, Blood calcium normal, Blood chloride normal, Blood glucose normal, Blood magnesium normal, Blood potassium decreased, Blood sodium normal, Blood urea normal, Blood urine absent, Carbon dioxide normal, Chromaturia, Culture urine, Culture urine negative, Differential white blood cell count, Dizziness, Electrocardiogram, Eosinophil count normal, Eosinophil percentage, Full blood count, Glomerular filtration rate normal, Glucose urine absent, Haematocrit normal, Haemoglobin normal, Immature granulocyte count, Lymphocyte count normal, Lymphocyte percentage, Mean cell haemoglobin concentration normal, Mean cell haemoglobin normal, Mean cell volume normal, Mean platelet volume normal, Metabolic function test, Monocyte count normal, Monocyte percentage, Nausea, Neutrophil count normal, Neutrophil percentage, Nitrite urine absent, Nucleated red cells, Platelet count normal, Protein total normal, Protein urine absent, Red blood cell count normal, Red cell distribution width normal, Specific gravity urine normal, Troponin I normal, Urine ketone body absent, Urine leukocyte esterase, Urobilinogen urine decreased, Vertigo, Vomiting, White blood cell count decreased, White blood cells urine negative, pH urine normal
SMQs:, Rhabdomyolysis/myopathy (broad), Liver related investigations, signs and symptoms (broad), Acute pancreatitis (broad), Haematopoietic leukopenia (narrow), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Biliary system related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypokalaemia (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 Outpatient Medications: ? apixaban (ELIQUIS) 5 MG tablet, Take 1 tablet (5 mg) by mouth 2 times daily Indications: Atrial Fibrillation, Disp: 180 tablet, Rfl: 3 ? LINZESS 72 MCG capsule, TAKE 1 CAPSULE DAILY, Disp: 90 capsule, Rf
Current Illness:
Preexisting Conditions:
Allergies: Macrobid
Diagnostic Lab Data: Urinalysis with reflex to culture, if indicated (Abnormal) Collected: 03/12/21 1442 Order Status: Completed Specimen: URINE,CLEAN CATCH Updated: 03/12/21 1510 Glucose UA NEGATIVE NEGATIVE MG/DL Protein UA NEGATIVE NEGATIVE MG/DL Bilirubin UA NEGATIVE NEGATIVE Urobilinogen UA 0.2 0.2 - 1.0 MG/DL pH UA 7.0 5.0 - 8.0 Blood UA TRACEAbnormal NEGATIVE Ketones UA NEGATIVE NEGATIVE MG/DL Nitrite UA POSITIVEAbnormal NEGATIVE Leukocyte Esterase UA 1+Abnormal NEGATIVE UR Appearance CLEAR CLEAR Specific Gravity UA 1.025 1.000 - 1.030 Color YELLOW YELLOW Site VOIDED Comment, Urine Culture IN PROGRESS WBC Urine 21 to 30 <5 /HPF Bacteria MANYAbnormal NONE /HPF Comprehensive metabolic panel (Abnormal) Collected: 03/12/21 1402 Order Status: Completed Specimen: Blood Updated: 03/12/21 1432 Glucose 104High 65 - 100 MG/DL Blood Urea Nitrogen 16 7 - 18 MG/DL Creatinine 0.8 0.5 - 1.0 MG/DL Sodium 140 136 - 145 MMOL/L Potassium 3.4Low 3.5 - 5.1 MMOL/L Chloride 104 98 - 107 MMOL/L Co2 28 21 - 32 MMOL/L Calcium 9.0 8.5 - 10.1 MG/DL Protein Total 7.3 6.4 - 8.2 G/DL Albumin 3.9 3.4 - 5.0 G/DL A/G Ratio 1.1 0.8 - 2.0 Alkaline Phosphatase 95 46 - 116 U/L Alt (SGPT) 19 14 - 59 U/L AST(SGOT) 14Low 15 - 37 U/L Bilirubin, Total 0.3 0.2 - 1.0 MG/DL GFR Comment Est GFR 77Low $g90 ML/MIN/1.73sq.m Magnesium [234183071] Collected: 03/12/21 1402 Order Status: Completed Specimen: Blood Updated: 03/12/21 1432 Magnesium 1.9 1.8 - 2.4 MG/DL Troponin Series Collected: 03/12/21 1402 Order Status: Completed Specimen: Blood Updated: 03/12/21 1432 Troponin I 0.00 0.00 - 0.06 ng/mL Comment: 0.1 to 0.5 ng/mL shows an increased risk of AMI. 0.6 to 1.5 or greater is suggestive of AMI. CBC w Auto Diff Collected: 03/12/21 1402 Order Status: Completed Specimen: Blood Updated: 03/12/21 1412 White Blood Cell Count 4.7 4.3 - 10.5 THOUS/uL Red Blood Cell Count 4.39 3.93 - 5.07 MIL/uL Hemoglobin 12.2 11.8 - 14.8 GM/DL Hematocrit 37.2 35.6 - 45.0 % Mean Corpuscular Volume 84.7 83.5 - 95.9 FL Mean Corpuscular Hemoglobin 27.8 27.4 - 32.0 PG Mean Corpuscular Hemoglobin Conc 32.8 31.5 - 34.7 G/DL Rdwcv 13.2 11.8 - 14.2 % Rdwsd 40.8 37.2 - 47.8 FL Platelet Count 269 167 - 402 THOUS/uL Mean Platelet Volume 9.0 8.8 - 12.0 FL Nucleated Red Blood Cells 0.0 0.0 /100 WBC''S Abs NRBC 0.0 0.0 THOUS/uL Differential Type AUTO Neutrophils 57.7 34.0 - 67.9 % Lymphs 31.4 20.4 - 48.6 % Monocytes 8.2 5.0 - 11.5 % Eos 1.9 1.0 - 5.4 % Basos 0.6 0.2 - 1.3 % Neutrophils Absolute Count 2.7 2.1 - 6.6 THOUS/uL Lymphocytes Absolute Count 1.5 1.2 - 3.9 THOUS/uL Monocytes Absolute Count 0.4 0.3 - 0.8 THOUS/uL Eosinophils Absolute Count 0.1 0.1 - 0.4 THOUS/uL Basophils Absolute Count 0.0 0.0 - 0.1 THOUS/uL Imm Gran 0.2 0.1 - 0.7 % Abs Imm Gran 0.01 0.0 - 0.1 THOUS/uL EKG
CDC Split Type:

Write-up: 66 y.o. female who presents with DIZZINESS LIKE ROOM IS SPINNING. PT STATES IMPROVES WITH CLOSING EYES AND LAYING STILL. PT STATES HAS HAD SEVERAL TIMES BEFORE AND LAST TIME WAS ONE WEEK AGO AND TOOK A MOTION SICKNESS OVER THE COUNTER PILL AND DIZZINESS WAS RELIEVED. TODAY PT WAS AT WORK WHEN BECAME DIZZY AND NAUSEOUS AND VOMITED. PT DENIES CHEST PAIN BUT HAS PAST HISTORY OF CAD WITH PACEMAKER PLACEMENT.


VAERS ID: 1105748 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-03-16
Onset:2021-03-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Balance disorder, Blood test abnormal, Computerised tomogram abnormal, Dysarthria, Heart rate irregular, Ischaemic stroke, Magnetic resonance imaging abnormal, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Cardiac arrhythmia terms, nonspecific (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amlodipine (NORVASC) asprin (ECOTRIN) metoprolol (LOPRESSOR)
Current Illness: none
Preexisting Conditions: hypertension
Allergies: shellfish, iodine
Diagnostic Lab Data: CT Scan - March 11 MRI - March 11 Blood Tests - March 11-13
CDC Split Type:

Write-up: Thursday, March 11, 2021 (approximately 8:30 am) Patient experienced blurred vision, unbalance, and slurred speech and had an irregular heartbeat. March 11, 2021 (approximately 11:30 am) Patient was admitted to Hospital administered CT scan, MRI and multiple blood tests. Diagnosis - Ischemic Stroke


VAERS ID: 1105850 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-03-09
Onset:2021-03-13
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 - / IM

Administered by: Other       Purchased by: ?
Symptoms: Activated partial thromboplastin time, Alanine aminotransferase normal, Albumin globulin ratio, Aspartate aminotransferase normal, Basophil count decreased, Basophil percentage, Blood albumin normal, Blood alkaline phosphatase normal, Blood bilirubin normal, Blood calcium, Blood chloride normal, Blood creatine phosphokinase MB, Blood creatine phosphokinase normal, Blood creatinine increased, Blood glucose normal, Blood potassium normal, Blood sodium normal, Blood thyroid stimulating hormone, Blood urea increased, Brain natriuretic peptide increased, Carbon dioxide normal, Chest X-ray normal, Dry throat, Dysphonia, EGFR status assay, Electrocardiogram normal, Eosinophil count normal, Eosinophil percentage, Feeling abnormal, Haematocrit decreased, Haemoglobin increased, Immature granulocyte count increased, International normalised ratio normal, Lymphocyte count, Lymphocyte percentage, Mean cell haemoglobin, Mean cell haemoglobin concentration, Mean cell volume normal, Mean platelet volume normal, Monocyte count increased, Monocyte percentage, Neck pain, Neutrophil count, Neutrophil percentage, Platelet count normal, Protein total normal, Prothrombin time normal, Red blood cell count decreased, Red cell distribution width normal, Thyroxine free normal, Tinnitus, Troponin I normal, Visual impairment, White blood cell count normal
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Cardiac failure (broad), Haematopoietic erythropenia (narrow), Haematopoietic leukopenia (narrow), Haemorrhage laboratory terms (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Pulmonary hypertension (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Hearing impairment (narrow), Chronic kidney disease (broad), Arthritis (broad), Tumour lysis syndrome (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Current Outpatient Medications: ? allopurinol (ZYLOPRIM) 100 MG tablet, Take 1 tablet (100 mg) by mouth 2 times daily, Disp: 180 tablet, Rfl: 1 ? aspirin 81 MG tablet, Take 81 mg by mouth daily, Disp: , Rfl: ? cloNIDine (CATAPRES) 0.1
Current Illness:
Preexisting Conditions:
Allergies: Allergen Reactions ? Amoxicillin Rash ? Ciprofloxacin ? Septra [Sulfamethoxazole W/Trimethoprim]
Diagnostic Lab Data: TECHNIQUE: AP view of the chest. One image. COMPARISON: Chest radiograph November 9, 2017 FINDINGS: Lungs and pleura: Normal lung inflation. No focal consolidation, pleural effusion or pneumothorax Heart and mediastinum: Cardiomediastinal silhouette is normal size. Normal pulmonary vasculature Bones and chest wall: No acute osseous abnormalities. Scoliosis. Lines and tubes: None. IMPRESSION: No definite acute cardiopulmonary disease EKG Nothing acute. CBC W AUTO DIFF Collection Time: 03/13/21 4:20 PM Result Value Ref Range White Blood Cell Count 5.5 4.3 - 10.5 THOUS/uL Red Blood Cell Count 3.67 (L) 3.93 - 5.07 MIL/uL Hemoglobin 11.0 (L) 11.8 - 14.8 GM/DL Hematocrit 33.2 (L) 35.6 - 45.0 % Mean Corpuscular Volume 90.5 83.5 - 95.9 FL Mean Corpuscular Hemoglobin 30.0 27.4 - 32.0 PG Mean Corpuscular Hemoglobin Conc 33.1 31.5 - 34.7 G/DL Rdwcv 12.9 11.8 - 14.2 % Rdwsd 42.8 37.2 - 47.8 FL Platelet Count 216 167 - 402 THOUS/uL Mean Platelet Volume 9.5 8.8 - 12.0 FL Nucleated Red Blood Cells 0.0 0.0 /100 WBC''S Abs NRBC 0.0 0.0 THOUS/uL Differential Type AUTO Neutrophils 56.4 34.0 - 67.9 % Lymphs 32.1 20.4 - 48.6 % Monocytes 7.5 5.0 - 11.5 % Eos 2.9 1.0 - 5.4 % Basos 0.7 0.2 - 1.3 % Neutrophils Absolute Count 3.1 2.1 - 6.6 THOUS/uL Lymphocytes Absolute Count 1.8 1.2 - 3.9 THOUS/uL Monocytes Absolute Count 0.4 0.3 - 0.8 THOUS/uL Eosinophils Absolute Count 0.2 0.1 - 0.4 THOUS/uL Basophils Absolute Count 0.0 0.0 - 0.1 THOUS/uL Imm Gran 0.4 0.1 - 0.7 % Abs Imm Gran 0.02 0.0 - 0.1 THOUS/uL COMPREHENSIVE METABOLIC PANEL Collection Time: 03/13/21 4:20 PM Result Value Ref Range Glucose 100 65 - 100 MG/DL Blood Urea Nitrogen 28 (H) 7 - 18 MG/DL Creatinine 1.3 (H) 0.5 - 1.0 MG/DL Sodium 140 136 - 145 MMOL/L Potassium 4.2 3.5 - 5.1 MMOL/L Chloride 106 98 - 107 MMOL/L Co2 25 21 - 32 MMOL/L Calcium 9.3 8.5 - 10.1 MG/DL Protein Total 7.6 6.4 - 8.2 G/DL Albumin 3.8 3.4 - 5.0 G/DL A/G Ratio 1.0 0.8 - 2.0 Alkaline Phosphatase 58 46 - 116 U/L Alt (SGPT) 23 14 - 59 U/L AST(SGOT) 17 15 - 37 U/L Bilirubin, Total 0.3 0.2 - 1.0 MG/DL GFR Comment Est GFR 38 (L) $g90 ML/MIN/1.73sq.m PROTIME (PROTHROMBIN TIME) Collection Time: 03/13/21 4:20 PM Result Value Ref Range PROTIME 11.4 10.3 - 12.6 SEC INR 0.9 0.9 - 1.1 APTT Collection Time: 03/13/21 4:20 PM Result Value Ref Range APTT 34.9 25.4 - 38.4 SEC CK (CPK) CREATINE PHOSPHOKINASE Collection Time: 03/13/21 4:20 PM Result Value Ref Range Creatine Kinase Total 98 26 - 192 U/L CKMB Collection Time: 03/13/21 4:20 PM Result Value Ref Range Creatine Kinase-MB 1.0 0.0 - 3.6 NG/ML TROPONIN Collection Time: 03/13/21 4:20 PM Result Value Ref Range Troponin I 0.00 0.00 - 0.06 ng/mL BRAIN NATRIURETIC PEPTIDE (BNP) Collection Time: 03/13/21 4:20 PM Result Value Ref Range B-Type Natriuretic Peptide 202 (H) 0 - 100 PG/ML TSH THIRD GENERATION Collection Time: 03/13/21 4:20 PM Result Value Ref Range TSH 0.27 (L) 0.30 - 3.04 uIU/mL T4 FREE Collection Time: 03/13/21 4:20 PM Result Value Ref Range Free T4 0.97 0.76 - 1.46 NG/DL
CDC Split Type:

Write-up: 3/13/21 ER HPI: 83 y.o. female who presents to the Hospital Emergency Department by private auto with her daughter. The patient comes in because her blood pressure at home has been very high. It is actually not reading on her cuff. She has a very dull headache on the left side of her head, but states it is very mild. No chest pain. She might be a little bit short of breath, but not much more than normal. She denies any current neck pain. She states a few hours ago she had a little bit of pain in the left side of her neck that was just brief and then way. On my initial evaluation her systolic blood pressure was around 240. The patient does have a history of anxiety. She states she has had typical anxiety, but nothing new. 3/15 office followup note: Subjective: Patient is 83 y.o. year old female that is here for ER follow up. 2 ER visits over the weekend. BP was elevated into the systolic 200s. Has ringing in ears when BP was elevated On Saturday: Left side of throat dry Left side of face "doesn''t feel right", hard for patient to describe When she woke up on Saturday, couldn''t see out of left eye, this has improved Says her voice doesn''t sound the same, "gravely" She did not tell the ER doctor on Saturday about the neurologic symptoms. In her 1st ER visit she had a chest x-ray which showed no acute disease. Cardiac enzymes were negative. ER doctor increased her losartan dose and gave her p.r.n. clonidine. In the early morning hours on Sunday, she returned to the ER. Blood pressure was elevated again at 208/85. Patient was given sublingual nitro and a Norvasc 5 mg tablet. After the sublingual nitro, blood pressure was 144/84. ER doctor discharge patient with follow-up today.


VAERS ID: 1105866 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-13
Onset:2021-03-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / 1 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Supraventricular tachycardia
SMQs:, Supraventricular tachyarrhythmias (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ASA 81mg, Frankencense/Myrrh oil, Vit b-12, Vit C , Vit D3, Ne
Current Illness: SVT 3/11/21, Stent palacement 3/8/21
Preexisting Conditions: HTN, Dyslipidemia, Diabetes, Guillian Barre Syndrome, Urinary frequency, Anxiety
Allergies: Cipro, Erythromycin, tetramycin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient with history of stent placement on 3/8/21 who developed SVT on 3/11/21 and was treated in the ED, Presented for covid vaccination on 3/13/21 as recommended by his cardiologist. Came back to the hospital ED approximately 9 hours post vaccination with SVT.


VAERS ID: 1105944 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-03-06
Onset:2021-03-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Foaming at mouth, Gaze palsy, Seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Ocular motility disorders (narrow), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

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

Write-up: PATIENT HAD A SEIZURE ABOUT 45 MINUTES AFTER GETTIN THE VACCINE. PATIENT''S EYES ROLLED BACK AND STARTED FOAMING AT THE MOUTH. PATIENT HAD BEEN SEIZURE-FREE FOR 3 YEARS PRIOR TO GETTING THE VACCINE.


VAERS ID: 1105964 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-06
Onset:2021-03-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenopia, Hypoaesthesia eye
SMQs:, Guillain-Barre syndrome (broad), Corneal disorders (broad)

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

Write-up: PATIENT EXPERIENCE NUMBNESS AND HEAVINESS IN RIGHT EYE CAVITY THAT LASTED MORE THAN 15 MINUTES WHEN SHE REPORTED IT AND CONTINUED FOR AT LEAST 50 MINUTES


VAERS ID: 1106370 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-06
Onset:2021-03-12
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Computerised tomogram, Facial paralysis, Feeling abnormal, Head discomfort, Hypoaesthesia, Ocular discomfort, Panic attack, Urine analysis
SMQs:, Peripheral neuropathy (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unitroy Vitamin B Vitamin C
Current Illness:
Preexisting Conditions: Thyroid
Allergies: Pine trees Oak trees
Diagnostic Lab Data: CT scan urine test
CDC Split Type: vsafe

Write-up: About 7-8 minutes later I started feeling pressure in the right side of my head. It went away a bit. I was walking after the 15 minutes and started feeling weird in my face, I just sat in my car and waited because I had to drive. I started feeling numbness under my eye and down the rest of my face. The thing that worried me the most I had so much pressure under my eye like it was inside my brain. The numbness and pain caused me to freak out. I went to back to the convention center to let them know, they brought the Paramedic to me they started checking me and doing a work up. They told me I wasn''t a life threatening emergency and my vitals were ok. They offered to take me to the ER and I declined and I decided to leave because I have been there for 1hr 45mins. I felt like my symptoms were at 70%. When I got home I freaked out again because the numbness didn''t go away and my face looked like it was a little lower and had a panic attack and went to the ER. They checked on me and told me I didn''t have a stroke. They told me It was a side effect to the vaccine. They told me to follow up with the Neurologist if I have any more symptoms, I have an appointment with them in a couple weeks. I''m a little concerned because there is a minor pain that I didn''t have before on my right side and it worries me.


VAERS ID: 1106400 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-03-09
Onset:2021-03-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Pruritus, Pyrexia, Rash, Tenderness
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Fluoxetine
Current Illness: no
Preexisting Conditions: no
Allergies: nka
Diagnostic Lab Data:
CDC Split Type:

Write-up: After she waited 15 minutes after having the injection, she was fine. Starting driving home, she had a light headache. She had itching, tenderness, body rash and fever. She went to ER.


VAERS ID: 1106438 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-11
Onset:2021-03-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / N/A LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Chills, Ear pain, Ear swelling, Labyrinthitis, Night sweats, Otitis externa, Pain, Pyrexia
SMQs:, Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: I usually get flu like symptoms when I get flu shots and also after my 2nd dose of the Gardasil vaccine I had to be hospitalized
Other Medications: Metoprolol, Nuvaring, Vitamin C, Vitamin D3, Vitamin B12, Cranberry Supplement, Probiotic, Allegra
Current Illness: Sinus infection about 3 weeks before the vaccine
Preexisting Conditions: marphan syndrome
Allergies: no medications, environmental allergies. Allergic to trinax
Diagnostic Lab Data: None
CDC Split Type: vsafe

Write-up: Around 10PM I was on the phone and felt the body aches start. About an hour or so later it started to get pretty painful, my joints. I was trying to go to sleep and I started with chills. I had a heating pad and 2 blankets and was still shivering, I took my temp and it was 102.4F. I took some Tylenol and was able to sleep and woke up in the middle of the night sweating. Next morning I was again with 102.7F fever. I slept most o the day, and when awake I noticed the body aches were still present. Kept taking Tylenol. Next day my left ear started feeling to hurt and it felt like fluid. I decided to go get checked and that is when they told me I had an inner and outer ear infection. After meds were prescribed (oral antibiotics and ear drops) the swelling has been going down a lot and it is not as near as painful.


VAERS ID: 1106570 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-07
Onset:2021-03-12
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 180501A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Erythema, Flushing, Pruritus, Rash, Sleep disorder
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? 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: vsafe

Write-up: On Friday 03-12-2021, went to wash my face and my whole face was red, flushed and very itchy. I then went to sleep and on Saturday morning when I woke up my right wrist was itching a lot as well as my legs, buttocks and hands. All over my body was red and very itchy. I did not sleep due to the itchiness on Saturday night. I developed little red bumps on my entire body. I ate lentils for food but I do not think it was the food. I went to urgent care and saw a doctor who gave me Benadryl, took one dose and then it slowly started to go away.


VAERS ID: 1106671 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-03-16
Onset:2021-03-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Loss of consciousness, Pallor
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), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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

Write-up: Notified by pharmacy technician that patient had ''passed out'' in parking lot. Patient found lying on the ground, pale but awake. Patient had been instructed to wait in the store for 15 minutes after vaccination in case of any adverse reaction but, per police, decided to wait in the car instead. He then began to feel lightheaded and decided to come back into the clinic. He passed out on his way. Civilian notified policeman that patient was passed out and EMS was called. EMS arrived shortly after I went out to parking lot to check on the patient. Patient was alert and oriented for EMS, reported history of HTN. He continued to c/o feeling lightheaded and BP per EMS was 77/48mmHg. Patient taken by ambulance for further evaluation and treatment.


VAERS ID: 1106734 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-03-15
Onset:2021-03-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 - / -

Administered by: Work       Purchased by: ?
Symptoms: Blood test normal, Chest X-ray normal, Chills, Electrocardiogram normal, Laboratory test normal, Palpitations, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? Yes
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth control pill
Current Illness:
Preexisting Conditions:
Allergies: Codeine
Diagnostic Lab Data: The ER ran an EKG and took a chest x ray. I was given a bag of saline. All tests including blood work came back clear. 3/16/21
CDC Split Type:

Write-up: Chills and fever lasted for 7 hours, rapid racing heart for 5 hours. Started 12 hours after the vaccine was administered. Took tylenol for fever. Went to er for rapid heart rate after I could t lower it for 2 hours.


VAERS ID: 1106852 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-03-13
Onset:2021-03-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Computerised tomogram, Electrocardiogram, Fibrin D dimer increased, Laboratory test, Skin discolouration
SMQs:, Anaphylactic reaction (broad), Haemorrhage laboratory terms (broad), Hypotonic-hyporesponsive episode (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: HTN
Allergies: Augmentin, lactulose, morphine, Sudafed, sulfa
Diagnostic Lab Data: EKG without acute ischemia. D-dimer elevated. CT PE without evidence of pulmonary embolism or pneumonia. Bluish discoloration under tongue seen on exam consistent with blood vessel.
CDC Split Type:

Write-up: Patient developed chest tightness approximately 25 minutes after receiving the injection. This is been ongoing for a few days. Also developed a blue discoloration under the right side of her tongue that she was concerned was due to the vaccine. Patient presented to urgent care where blood work was done. Patient was found to have an elevated D-dimer and was thus sent to the ED. Elevated D-dimer confirmed.


VAERS ID: 1106866 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-15
Onset:2021-03-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Blood pressure increased, Chest discomfort, Dyspnoea, Electrocardiogram, Feeling of body temperature change, Flushing, Laboratory test, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Hypertension (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (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: Often take Allegra 24D allergy OTC but didn?t take it on the date of vaccine.
Current Illness: None
Preexisting Conditions: None
Allergies: Allergic to penicillin.
Diagnostic Lab Data: According to doctor, blood work, and EKG appeared to be fine.
CDC Split Type:

Write-up: 2 hours after receiving the vaccine I began to feel hot and cold flashes and a flush feeling as if I was going to faint. I went to the emergency room. The ER doctor did blood work, took my blood pressure (a little high at first) and EKG. Doctor said everything appeared to be fine. After I left the hospital I started feeling mild shortness of breath and tightness in my chest which has not stopped as of this writing. I also have moderate pain in the upper middle part of my back by the vertebrate.


VAERS ID: 1106904 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-16
Onset:2021-03-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Anaphylactic reaction, Electrocardiogram normal, Hypopnoea, Intensive care, Mental status changes, Rash, Respiratory rate increased, Tachycardia
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Dementia (broad), Acute central respiratory depression (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None/ NKDA
Diagnostic Lab Data: Awaiting Lab and Medical test from Hospital
CDC Split Type:

Write-up: High respiratory rate with shallow breaths, Rash on chest, Tachycardia, Altered Mental Status . The Patient that was suspected to have an adverse reaction. EKG displayed no abnormalities, IV was placed in patients L Arm and provided 1,000 ML of Normal Saline, and administered supplemental O2 via simple mask. An Epinephrine Auto Injector 0.3mg was also injected into the patients L thigh. Determination to transport to local treatment center was made by provider. Patient arrived at Medical Center approx. at 2245 and further evaluated there. Patient was then transferred to Level 3 Trauma facility to Hospital around 0100, 17 March. Admitted to the ICU for further evaluation. Update- Patient will be admitted until 18 Mar 2021. It was noted by Hospital Patient had a sever anaphylactic reaction.


VAERS ID: 1107317 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-13
Onset:2021-03-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Chest pain, Diarrhoea, Headache, Malaise, Nausea, Pain, Vomiting
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: aspirin, bisoprolol
Current Illness: none
Preexisting Conditions: Hypertension
Allergies: penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: 79 y.o. female who presents to ED on 3/16/2021 with body aches, headache and nausea/vomiting. Patient''s daughter reports patient received the Johnson & Johnson single-dose Covid vaccine 4 days ago (on 03/13/2021 at about 3 PM.) prior to ED visit. The next morning woke up not feeling well. Has had generalized body aches and headache. Has also had nausea and vomiting. Patient is able to tolerate some fluids, but anytime eats anything will vomit. Reports has had some loose stools. Denies blood in the stool or vomit. Reports aching pain to the abdomen, not worse in any particular area. Has pain to the right side of the chest that has been constant for the last 3 days. Chest pain is worse with movement and standing, but not worse with exertion. Denies difficulty breathing, cough, fever, sore throat or congestion.


VAERS ID: 1294878 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-13
Onset:2021-03-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Pyrexia, Seizure
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), 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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: presented to ER within 18 hours of vaccine with fever, and seizure.


VAERS ID: 1294879 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-11
Onset:2021-03-15
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Injection site rash, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)

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

Write-up: Patient went to local emergency room with a rash around injection site and swollen arm 4 days after the J&J one time vaccine. She had been taking Tylenol and was given ice packs.


VAERS ID: 1107347 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-07
Onset:2021-03-13
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dyspnoea, Lip swelling, Nausea, Paraesthesia oral, Retching, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Daily multi-vitamin Levothyroxine (50mcg, once daily)
Current Illness: Ear infection about in mid-late February
Preexisting Conditions: PCOS Hypothyrodism Obesity Sleep Apnea (Mild)
Allergies: Doxycycline Augmentin No food allergies
Diagnostic Lab Data: Pending allergist appointment for food allergy testing orders. Currently awaiting a call back from allergist office.
CDC Split Type:

Write-up: Was eating dinner (seasoned smoked chicken, broccoli, cauliflower, fries) and soon after, felt my lips starting to swell. I had seasonal allergies occurring that day, so I kept eating a bit longer. My tongue then started tingling. I took a dose of Children''s Benadryl (all I had for Benadryl at the time). I then waited about 10 minutes before I felt my throat starting to close. We headed straight to emergency room (5 mins away). By the time I got there, I started to have a little trouble taking breaths. When I got into the trauma room moments later, I became nauseous and dry heaving. They gave me an epinephrine shot, Benadryl, Pepto, and Prednisone. They watched me for a few hours before release. Upon discharge, they provided me a prescription for epi-pens, famotidine, prednisone, and fexofenadine (5-day prescriptions).


VAERS ID: 1107447 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-11
Onset:2021-03-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Diarrhoea, Headache, Laboratory test normal, Liver function test normal, Nausea, Vomiting, White blood cell count increased
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Laboratory tests normal except for white blood cell count of 13.8. Normal liver panel. Normal chemistry.
CDC Split Type:

Write-up: Nausea vomiting diarrhea headache and chest pain that began 15 minutes after vaccination and persisted over the next 7 days.


VAERS ID: 1107528 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-12
Onset:2021-03-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Nasal congestion, Pain, Productive cough, Pyrexia, Respiratory tract congestion, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: lasartin peraxatine hyrocoridzedine ibuprohine black cohash and beet juice metformine
Current Illness: none
Preexisting Conditions: high blood pressure anxiety diabetes
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: congestion fever stuffy nose wheezing body aches productive cough


VAERS ID: 1107565 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-08
Onset:2021-03-14
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Computerised tomogram thorax abnormal, Fibrin D dimer increased, Flank pain, Laboratory test, Lung infiltration, Pain, Painful respiration, Pulmonary embolism, White blood cell count increased, X-ray
SMQs:, Haemorrhage laboratory terms (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, venous (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: cortef 5mg tid florinef 0.5mg bid birth control pill (name unknown)
Current Illness: none
Preexisting Conditions: congenital adrenal hyperplasia
Allergies: nka
Diagnostic Lab Data: 03/16/2021 ct pe study: bilateral lower lung pulmonary emboli and lower lung patchy infiltrates 03/16/2021: wbc 14.8 03/16/2021: d dimer 3970
CDC Split Type:

Write-up: On 3/14/21 patient started with left flank pain that radiated to left shoulder and increased pain while taking a deep breath. Mother called on 3/16/21 and patient was seen in primary clinic for issue. She had labs and xray done. Xray showed possible mild opacity in left lower lobe and to do ct scan. Ct pe study done same day showing bilateral lower lung pulmonary emboli and lower lung patchy infiltrates. Patients pain progressively got worsened and was seen in the er to be transferred to outgoing facility for care.


VAERS ID: 1107753 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-03-12
Onset:2021-03-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Bacterial test positive, Blood test abnormal, Cough, Headache, Nausea, Urine analysis normal
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Infective pneumonia (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: enalapril, norvasc, low dose aspirin, crestor/daily meds
Current Illness: none
Preexisting Conditions: heart attack 2008
Allergies: no
Diagnostic Lab Data: lab tests taken 3/13/21 at emergency room blood labs - normal urine - showed some bacteria due to possible surgery i had had on 3/1/21 for bladder prolapse surgery - antiobiotics given for this
CDC Split Type:

Write-up: Excruciating headache, nausea, dry cough - entered emergency room around 11:00am driven by my husband treatment at nearest Emergency Room, Fluids given to me intraveniously mixed with pain meds and nausea meds mixed in with, vitals taken, blood taken, urine specimen - headache was a #10 on pain chart 4 hrs later around 4pm, headache was about a 3-4 pain chart, i left hospital given pain meds, nausea meds, cough meds, antibiotics


VAERS ID: 1107882 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-03-02
Onset:2021-03-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / IM

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

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

Write-up: JANSSEN COVID-19 VACCINE EUA: The patient received her vaccine dose on 030221 and within 3 hours, shortly after lunch, complained of not feeling well and nausea. She subsequently went home early from work. At about midnight, approximately 12 hours post-dose, she awakened with fever to 102. She subsequently presented to an emergency department at about 01:30 on 030321. She remained there for about 3 hours during which time she was monitored and received IV fluids, ibuprofen and acetaminophen. She returned to work on 030421 with improvement of symptoms.


VAERS ID: 1107909 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-03-15
Onset:2021-03-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1082068 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chills, Dizziness, Electrocardiogram, Headache, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: emlodipine, valsartan, protonix,
Current Illness: no
Preexisting Conditions: High blood-pressure,
Allergies: linsinopril
Diagnostic Lab Data: Iv fluids, Ibuprofen and EKG
CDC Split Type:

Write-up: Fever of 106.3, chills, headache, lightheaded, dizzy, sore arm


VAERS ID: 1107959 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-03-11
Onset:2021-03-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Arteriospasm coronary, Chest pain, Contusion, Hypertension, Laboratory test, Pain, Palpitations, Tachycardia
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypertension (narrow), Cardiomyopathy (broad), Other ischaemic heart disease (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: Client previously had Covid-19 within the last 90 days
Preexisting Conditions: N/A
Allergies: NKA
Diagnostic Lab Data: Lab test unknown but were conducted in ED.
CDC Split Type:

Write-up: Heart Palpitations, chest pain, tachycardia, hypertension, chest spasms and bruising. Heart attack like symptoms. Body aches and Covid-like symptoms.


VAERS ID: 1107983 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-15
Onset:2021-03-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Cold sweat, Headache, Nausea, Pain
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth control
Current Illness:
Preexisting Conditions: Passed out in November. Had bouts of nausea and severe dizziness every week or so for several months following.
Allergies: Penicillin Formaldehyde Nickel
Diagnostic Lab Data:
CDC Split Type:

Write-up: I had the expected things like body aches, cold sweats/chills, crazy headache, little bit of nausea. But my heart rate is all over the place. Every-time I stand up it jumps to 116. My resting heart rate was 113 for 8hours straight Monday night. So the j&j website lists that as an allergic reaction. The urgent care basically said wait it out and be careful cuz if I move like too fast I could pass out again cuz of the blood pressure


VAERS ID: 1108218 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-03-11
Onset:2021-03-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK AR / IM

Administered by: Public       Purchased by: ?
Symptoms: Bradycardia, Hypotension
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: hypotension and bradycardia. iv placed with 1 liter saline b olus sent t0o hospital via paramedics


VAERS ID: 1108331 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: D.C.  
Vaccinated:2021-03-06
Onset:2021-03-08
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Asthma, Chills, Dyspnoea, Migraine
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: montelukast, nuvaring, vitamin D
Current Illness:
Preexisting Conditions: asthma
Allergies: N/A
Diagnostic Lab Data: asthma attack
CDC Split Type:

Write-up: first started with severe migraine and chills and then experienced difficulty breathing and shortness of breathe. Had to go to the ER because I was unable to breathe when laying down


VAERS ID: 1108345 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-03-17
Onset:2021-03-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Condition aggravated, Fall, Head injury, Headache, Hyperhidrosis, Immediate post-injection reaction, Nausea, Panic attack, Skin mass, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: hx of panic attack
Preexisting Conditions: Diabetes, hx of panic attacks
Allergies: NKDA
Diagnostic Lab Data: transported to ER via EMS
CDC Split Type:

Write-up: Immediately after vaccination, pt was sitting in chair in clinic lobby, she states she felt like she was having a panic attack and that is the last thing she remembers. She fell out of chair and hit her head on the clinic floor. Staff responded to pt lying in the lobby floor with a quarter sized red knot on left side of forehead. Pt complained of a headache, was found to be diaphoretic and had nausea and small amount of emesis but had moderate nausea for 30 minutes after event. Vitals were obtained and WNL. EMS was called and pt agreed to be transported to ER for evaluation.


VAERS ID: 1108362 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-03-09
Onset:2021-03-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bedridden, Dizziness, Fatigue, Injection site swelling, Lethargy, Peripheral swelling, Petechiae
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: Day 1: no sx, Day 2: extreme fatigue . Dizzy lightheaded Day 3: profound lethargy + dizzy & lightheaded . bedridden Day 4: profound lethargy dizzy + lightheaded bedridden Day 5: visit to urgent care. rx for keflex for injection site sub cutaeneous lump. c/o right arm swollen, petechia, right torso petechia. dizzy lightheaded. Patient reports she is blood type AB negative Day 6: visit to PCP


VAERS ID: 1108386 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-03-16
Onset:2021-03-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Malaise, Seizure, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: levothyroxine that we are aware of
Current Illness: none aware of
Preexisting Conditions: none aware of
Allergies: none
Diagnostic Lab Data: 3/16 I took the blood pressure and it was 87/55 with a pulse around 60. The paramedics the second time had a reading of 89/41 with a pulse of 40.
CDC Split Type:

Write-up: After the injection the patient grabbed her arm and when she was asked if she was ok she didn''t respond and seemed slouched down. It didn''t seem like she passed out but she was slouching and not responding. She seemed like she was having convulsion that lasted less than 5 seconds. Then she calmed down and her breathing was fine. I got her to respond to me that she was awake and ok. She responded with head nods. She seemed to come to a little more after a minute and she said she was fine but I wanted to call 911. I called the paramedics. During the wait she seemed to get better, we gave her water and she was slowing starting to move around more. We asked her about any under lying issues or any problems with any vaccine before. She said no to everything. The paramedics came and took all of her vitals and she was cleared that everything was ok. She called her boyfriend and we asked him to come by to help her and give her a ride home and assist. He got here and she still didn''t feel totally better. After a few more minutes I took her blood pressure and it was 87/55 and her pulse was around 60. We called 911 again because she stated she wasn''t feeling well again. The paramedics came back and she had a 89/41 blood pressure with a pulse of 40. They indicated that she may be having a cardiac issue so they took her to the ER.


VAERS ID: 1108419 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-03-14
Onset:2021-03-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Fluoxetine, Lamotrigine, adderall
Current Illness: N/A
Preexisting Conditions: mental illness
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Extreme difficulty breathing and severe chest pain.


VAERS ID: 1108440 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-16
Onset:2021-03-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Bupropion
Current Illness: Unknown
Preexisting Conditions: Anxiety, depression, BPD, Anemia, Epistaxis
Allergies: Escitalopram Quetiapine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt has been vomiting and experiencing extreme body aches, headache and SOB


VAERS ID: 1108465 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-03-11
Onset:2021-03-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Atrial fibrillation, Blood test, Cerebrovascular accident, Computerised tomogram, Magnetic resonance imaging, Thrombosis
SMQs:, Supraventricular tachyarrhythmias (narrow), 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), Thrombophlebitis (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: NA
Current Illness: NA
Preexisting Conditions: NA
Allergies: NA
Diagnostic Lab Data: MRI, Cat Scan and blood tests
CDC Split Type:

Write-up: Heart was in A-fib, blood clot formed and had a Left Posterior Parietal Stroke


VAERS ID: 1108508 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-10
Onset:2021-03-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Dysphonia, Immediate post-injection reaction, Throat irritation
SMQs:, Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow)

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

Write-up: Janssen COVID-19 Vaccine EUA Patient received J&J COVID vaccination at 1430 on 3/10. Patient reports immediately feeling "scratchy throat and hoarse voice." Patient took 50 mg Benadryl PO, then went to urgent care where she received 10 mg dexamethasone PO and 40 mg famotidine PO. Patient reports symptomatic improvement, but continued scratchiness to throat and "voice sounding off." Patient presented to the ED and received 0.3 mg IM epinephrine. Epinephrine administered with significant symptomatic improvement. No findings of angioedema on exam. Patient breathing comfortably without signs of impending airway compromise. Patient observed for 4 hours following epinephrine administration. Hoarseness resolved. Patient discharged home.


VAERS ID: 1108961 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-03-09
Onset:2021-03-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Amnesia, Chest X-ray, Dyspnoea, Electrocardiogram normal, Feeling abnormal, Full blood count normal, Injection site erythema, Injection site swelling, Injection site warmth, Nasal congestion, Pyrexia, Swelling, Vomiting, Wheezing
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Cyclobenzaprine, welbutrin, Cymbalta, Benedryl, Levocetirizine, Levothyroxine, Birth Control, Biotin Supplement, Flovent, Flonase, Lisinopril, Albuterol Inhaler, Omeprazole
Current Illness: no
Preexisting Conditions: RA, Hypothyroidism, Hypertension, Poly Cystic Ovarian Syndrome, Post Covid Symdrome
Allergies: Midrin, Penicillin, Strawberrys, shrimp, Tree pollen
Diagnostic Lab Data: EKG-normal CBC-normal Chest X-Ray-unknown status
CDC Split Type: vsafe

Write-up: Shortly after the vaccine on the drive home the injection site got super hot, the arm began to swell and turn red. I developed a fever and my sinuses got really stuffy. I began to throw up profusely which made all symptoms from other issues occur causing me to swell all over and because I couldnt take any meds or keep anything down I went to the ER. While there I began wheezing and experiencing SOB which still is an issue today. I have foggy moments where my brain seems so foggy that I am having issues with my short term memory. I was administered IV fluids, IV morphine and IV ibuphropen to help with the symptoms and was hospitalized for less than a day further evaluation


VAERS ID: 1109009 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-03-09
Onset:2021-03-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea, Ear pain, Eye pain, Migraine, Muscle spasms, Nausea, Pain in extremity, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Noninfectious diarrhoea (narrow), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient went to the ER the morning after receiving the vaccine because she reports she was experiencing a severe migraine with ear and eye pain, nausea, vomiting, diarrhea, pain in hands and feet, and muscle spasms that last for 4 days.


VAERS ID: 1109010 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-03-13
Onset:2021-03-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeding disorder, Fluid intake reduced, Pharyngeal swelling, SARS-CoV-2 test negative, Streptococcus test negative
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Gabapentin, Lisinopril, Metformin, Duloxetine
Current Illness:
Preexisting Conditions: Depression, Fibromyalgia
Allergies: Morphine
Diagnostic Lab Data: Covid test, strep throat test which were negative
CDC Split Type: vsafe

Write-up: I woke up on 03-14-2021 with a "base-ball feeling in my throat". I could not eat or drink anything. I went to Urgent Care where they performed a Covid test as well as a strep throat test which came back as negative. Today I still have the "base-ball feeling in my throat.


VAERS ID: 1109385 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-03-11
Onset:2021-03-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Abdominal discomfort, Abdominal pain, Appendicectomy, Appendicitis, Computerised tomogram abnormal, Delirium, Dizziness, Eructation, Headache, Infection, Lethargy, Pain, Pyrexia, Tremor, Vomiting, White blood cell count abnormal
SMQs:, Acute pancreatitis (broad), Haematopoietic leukopenia (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Retroperitoneal fibrosis (broad), Dementia (broad), Parkinson-like events (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (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, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lexapro and Allegra
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: CT scan on the 16th. Appendectomy on the 16th. Released back home on the same day.
CDC Split Type:

Write-up: On March 11th at around 10pm I experienced severe shaking, fever, headache and delirium. The next day I improved but had a fever on and off of 99.1. I felt like I was stable, but felt dizziness increasing, and was lethargic through the weekend. Then on Monday the 15th, I had a noticeable cramp in my right abdomen. At around 8pm CST I began feeling like I needed to burp and that I had GI problems. The problems increased that night at around 10pm I had pain where the cramp started. Two hours later I started throwing up because of the pain and feeling of too much air inside of me. I could not stop vomiting after 2 hours so went to the Hospital ED at around 2:30 AM Tuesday the 16th. I was admitted after a CT scan showed and white cell counts confirmed and infection and drastically enlarged appendix. I was diagnosed with an appendicitis and they immediately scheduled me for surgery.


VAERS ID: 1109435 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: California  
Vaccinated:2021-02-25
Onset:2021-03-04
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 011AZ1A / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Feeling hot, Pruritus, Rash, Rash erythematous
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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: zoloft
Current Illness:
Preexisting Conditions:
Allergies: cipro
Diagnostic Lab Data:
CDC Split Type:

Write-up: rash over body, itchy: hot rash, traveling through body, internal hotness


VAERS ID: 1109475 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-16
Onset:2021-03-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / -

Administered by: Public       Purchased by: ?
Symptoms: Blood pressure decreased, Electrocardiogram abnormal, Heart rate decreased, Laboratory test normal, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad), Dehydration (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: INSULIN
Current Illness: NONE
Preexisting Conditions: DIABETES - TYPE 1
Allergies: NONE
Diagnostic Lab Data: All tests normal except EKG showed signs of early repolarization of the heart.
CDC Split Type:

Write-up: Passed out 5-10 seconds after injection. Passed out a 2nd time after waking up the first time. Blood pressure & heart rate dropped.


VAERS ID: 1109477 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-03-09
Onset:2021-03-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 RA / SYR

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

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

Write-up: diarrhea, vomiting 2 hours after vaccine, headache,


VAERS ID: 1109776 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-03-12
Onset:2021-03-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Blood lactic acid increased, Chills, Dyspnoea, Electrocardiogram, Full blood count, Nausea, Oropharyngeal pain, Pyrexia, Swelling face, Tachycardia, X-ray
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Lactic acidosis (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Motrin 800mg [1 tid prn pain], Restasis Multidose Ophth Emulsion [ 1 gtt OU BID], Admelog (INJ up to 134 units daily via insulin pump], Levothyroxine 137mcg [ 1 daily], Larin Fe [1 daily], Azelastine [2 sprays in each nostril BID], Centrum
Current Illness: none
Preexisting Conditions: Diabetes melitus type 1
Allergies: ceclor (rash/ vomiting), gluten (diarrhea/cramps)
Diagnostic Lab Data: In the emergency room patient was given IV fluids, EKG, CBC, Xray. Lactic acid levels were elevated
CDC Split Type:

Write-up: Patient woke up in the middle of the night with swelling in the face, tachycardia 125-130 bpm, BP 142/90, achy joints, sore throat, labored breathing, chills, nausea, fever 102.7


VAERS ID: 1109952 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-10
Onset:2021-03-15
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Erythema, Pruritus, Skin irritation, Skin warm, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Citalopram (Celexa)30 mg daily
Current Illness: NA
Preexisting Conditions: NA
Allergies: Benadryl
Diagnostic Lab Data: I was given a shot methylPREDNISolone sodium succinate at 5:07 p.m. to relieve the itching but it didn''t help much. I have also taken 40mg of prednisone each day since to help but my skin is still irritated.
CDC Split Type:

Write-up: 5 days after vaccine my skin got very hot, red, irritated and broke out in hives. It''s been three days and my skin is still irritated.


VAERS ID: 1266163 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-11
Onset:2021-03-15
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Injection site rash, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)

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

Write-up: Narrative: Patient went to local emergency room with a rash around injection site and swollen arm 4 days after the J&J one time vaccine. She had been taking Tylenol and was given ice packs.


VAERS ID: 1110136 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-18
Onset:2021-03-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Military       Purchased by: ?
Symptoms: Pruritus, Swelling face, Throat tightness, Urticaria, Vital signs measurement
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: 21 yo male presented to ED Face swelling, hives, facial pruritus, throat tightness starting approx. 30-40 minutes after J&J COVID shot. In ED vitals stable, pt not in distress. Good response w/ Epi pen and adjunct medications.


VAERS ID: 1110218 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-03-14
Onset:2021-03-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

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

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

Write-up: Patient experienced significant nausea and vomiting and 103 degree fever. Symptoms started about 4 hours after vaccination and built for the next 3 hours before patient went to the emergency room for treatment.


VAERS ID: 1110377 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-03-15
Onset:2021-03-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / UNK LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Crying, Fatigue, Hot flush, Myalgia, Pain, Pyrexia, Sleep disorder
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Concerta 36 mg ER
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: At 10 pm I started to experience some moderate body aches. By 1 am, I was in so much pain I could not sleep and started to develop a fever. I drank a ton of fluids, used OTC treatments (Ibuprofen and Motrin) but nothing alleviated the pain. By 10 am I had a sustained fever over 100 degrees. I was in so much pain I was crying in bed. By 3 pm my fever reached 102 degrees. I had to go to the emergency room for IV drip and medication because I couldn''t drink enough water to stay hydrated. Once given IV, my temperature plummeted. When the medication they administered wore off, my body started experiencing mild to moderate pains again. Body aches and soreness all over- my muscles feel like they are being squeezed from the inside. I am still feeling a lot of fatigue and pain but it is random and comes and goes along with "hot flashes".


VAERS ID: 1110966 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-13
Onset:2021-03-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anaphylactic shock, Blood test, Communication disorder, Electrocardiogram, Erythema, Pharyngeal swelling, Rash, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Aromosin, Lupron, Zometa
Current Illness: none
Preexisting Conditions: Breast Cancer Survivor
Allergies: Keflex, Avelox, Zithromax, Emend
Diagnostic Lab Data: Blood test and EKG 3.13.21
CDC Split Type:

Write-up: Anaphalatic Shock - Rash / Hives / redness / heat / inability to communicate / swelling of the throat. Epi pen , Epinephrane in Ambulance, Steroids and Benedryl, overnight stay


VAERS ID: 1111000 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-03-16
Onset:2021-03-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cold sweat, Dizziness, Heart rate abnormal, Hyperhidrosis, Loss of consciousness, Pallor, Syncope, Visual impairment
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), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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

Write-up: 07:40 patient reported to mother that he was "lightheaded and dim vision" then mother witnessed syncope. Nurse assessed patient LOC but breathing was recorded at approximately 1 minute with pallor, cool, and clammy skin. ED was notified of patient transport. Vitals were obtained BP - unobtainable, HR - 44 faint and thready, Resp -10. Patient regained consciousness and informed nurse that he had "white coat syndrome and history of fainting with blood drawn and doctor visits" he apologized for not notifying nurse prior to vaccination. 07:43 patient has second witnessed syncopal episode after reporting "dim vision", patient was lowered to floor with assistance from 3 nurses and bystanders. Vitals obtained - BP - 117/76, HR - 46 Resp - 12. LOC lasted 30 seconds, patient was pallor, skin was cool and clammy. Patient regained consciousness and was alert and oriented x 3. 07:48 patient was assisted to sitting position and then assisted to W/C and escorted to the ED with a nurse, CNA and family for examination and further treatment. Upon leaving patient had pink color, skin was warm, but diaphoretic. Pt entered ED at 07:55 VS BP - 141/83 MAP - 102 HR - 66 RR- 20 SPO2- 96% Temp - 97.9. Pt was observed in ED for an hour and was provided food and liquids after report of not eating or drinking since previous night.


VAERS ID: 1111002 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-03-17
Onset:2021-03-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 12805025 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Anosmia, Diarrhoea, Headache, Nausea, Oropharyngeal pain, Pain, SARS-CoV-2 test
SMQs:, Acute pancreatitis (broad), Taste and smell disorders (narrow), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Immune-mediated/autoimmune disorders (broad), COVID-19 (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: Augmentin, deloton
Diagnostic Lab Data: covid test
CDC Split Type:

Write-up: lost taste and smell, body aches, headaches, nauseous, throat hurts, diarrhea


VAERS ID: 1111480 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-03-13
Onset:2021-03-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chest discomfort, Chills, Dyspnoea, Feeling abnormal, Gait disturbance, Myalgia, Pain in extremity, Painful respiration, Paraesthesia, Peripheral coldness, Pyrexia, Respiratory rate increased, Sinus tachycardia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Supraventricular tachyarrhythmias (narrow), Dementia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: iron, vitamin C, ibuprofen, acetaminophen, famotidine
Current Illness: allergic rhinitis, heartburn
Preexisting Conditions: allergic rhinitis, heartburn, Gilbert''s disease
Allergies: none
Diagnostic Lab Data: Chest x-ray and bilateral duplex ultrasounds were negative. D-dimer and troponin were normal. Labs only abnormal for direct bilirubin elevated at 0.3 (normal range was 0.2 or less).
CDC Split Type:

Write-up: Around 7 pm on 3/13, I developed brain fog, trouble walking, and then fever, severe muscle pain worse in legs, and chills. Most of these symptoms seemed to improve on 3/14, but then on 3/15, I developed new onset of shortness of breath and chest discomfort. On 3/16 around 1 pm the shortness of breath worsened and I went to the emergency room. I felt that I couldn''t take a deep breath in and I had chest discomfort on the left side of my chest worse when taking a deep breath. My legs were hurting as well, especially my left leg. I had sinus tachycardia (heart rate 106-120) and increased respiratory rate (rate of 20) with O2 sats 100% on room air. My breathing and heart rate improved somewhat with 1 liter oxygen therapy, 1 liter of IV fluids, albuterol inhaler, and decadron 6 mg orally. It was thought that I had a delayed asthmatic/allergic reaction to the vaccine. I do not have a history of asthma. I was prescribed a Medrol dose pack and albuterol inhaler. My hands and feet are very cold and tingling on 3/18. Shortness of breath and chest pain seems to have improved but not completely gone as of the time of this submission on 3/18.


VAERS ID: 1111521 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-11
Onset:2021-03-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Diarrhoea, Dizziness, Electrocardiogram normal, Headache, Impaired work ability, Influenza like illness, Laboratory test normal, Loss of personal independence in daily activities, Pain, Pyrexia, Tremor, Vertigo, Vision blurred
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (narrow), Noninfectious diarrhoea (narrow), 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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Vestibular migraines
Allergies: Sulfa drugs Hair dye Shrimp Nickel
Diagnostic Lab Data: I went to the ER on Monday 3/22 as my doctor wanted to ensure it wasnt a blood clot. They did blood work, a d-dimer and EKG, all of which were normal. I have not done any more tests, but my symptoms have not improved at all.
CDC Split Type:

Write-up: Hi, I received the Johnson and Johnson vaccine one week ago, Thurs March 11. On friday, I experienced the typical flu like symptoms - chills aches pains and fever. These have slowly gone away, but a week later I still have chills and constantly shake, and diarrhea. The most significant side effect I want to report is extreme vertigo and dizziness and headaches. These have been present for a week now and have prevented me from working and doing daily activities. I constantly feel like Im going to fall over and cannot see clearly. I previously had vestibular migraines, but these have been mostly gone due to going to the chiropractor and taking my supplements. The vaccine brought them back now in full force. I read that this is becoming a commonality among other people and need answers on this. I want to make sure its not permanent or that I will have this as a serious side effect.


VAERS ID: 1111627 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-17
Onset:2021-03-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysarthria, Hypoaesthesia, Muscular weakness, Nausea, Paraesthesia, Speech disorder
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

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

Write-up: Patient presented to the pharmacy to report adverse reaction, but had a slurred speech/ difficulty to speak, tingling fingers, numbness in feet, muscle weakness, nausea


VAERS ID: 1111690 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-03-18
Onset:2021-03-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 10805025 / N/A LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Dizziness, Hyperhidrosis, Sensation of foreign body, Vital signs measurement
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: WITHIN 2-3 MINUTES OF ADMINISTRATION PATIENT BEGAN TO FEEL WEAK, LIGHTHEADED AND WAS SWEATING. PATIENT WAS EXAMINED AND ALL VITAL SIGNS WERE STABLE. WE SUPPLIED WET CLOTH AND COOL AIR. PATIENT THEN SAID HE THROAT FELT HEAVY AND LIKE SHE COULDNT SWALLOW. PT WAS ADMINISTERED EPI 0.3ML IM INTO R DELTOID. MONITORED PATIENT FOR ANOTHER 15 MINUTES AND TOLD TO GO TO ER FOR FUTHER WORKUP. PATIENT WAS STABLE AT THE TIME OF DICHARGE.


VAERS ID: 1111735 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-03-16
Onset:2021-03-16
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Dry mouth, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Flu vaccine- 20+ years previously
Other Medications: Albuterol, Coreg, flexeril, Flonase, Vistaril, robaxin
Current Illness: none
Preexisting Conditions: HTN, Asthma, Arthritis
Allergies: Clindamycin, Flu vaccine, morphine, PCN, Vit E, Citalopram, Codeine, Blueberries, honey, asparagus
Diagnostic Lab Data: No tests were obtained
CDC Split Type:

Write-up: Pt was at outside public health vaccination clinic- but was deemed high risk and was brought to the hospital to administer it. ER nurse gave vaccine and 10-15 mins after vaccine pt started to feel dry mouth and felt her throat closing off. She stated she had had anaphylaxis in the past and this was very similar. Pt was given EpiPen and admitted to the ER for further treatment. Pt''s symptoms slowly resolved. Pt was started on IV and given Benadryl 25mg IV and solumedrol 125mg IV. She was observed for 2 hours and had stable vitals and symptoms didn''t return. She received 1 liter of fluids.


VAERS ID: 1111756 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-03-11
Onset:2021-03-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ProAir
Current Illness:
Preexisting Conditions:
Allergies: Pt has hx of allergies but not known to person making report
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt experience respiratory distress approximately 5 minutes after receiving the vaccine. She self administered her prescription ProAir 5 times without relief. She then self-administered her own Epi pen. She began to show some signs of improvement but at about 5 min post-administration her respirations began to be more distressed. Benedryl, deep IM was administered. Again, after about 3 minutes there was some improvement but after 5 minutes a second dose of Epi was administered. By this time EMS had arrived and assumed care. Pt was taken to hospital.


VAERS ID: 1111847 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-18
Onset:2021-03-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Condition aggravated, Generalised tonic-clonic seizure, Seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine; Kepra 500mg; Lorazepam; Diavlproex 500mg; Eliquis 2.5mg
Current Illness: High and low blood sugar swings
Preexisting Conditions: Seizures; Blood clotting Factor 2 and Factor 5
Allergies: Iodine; shellfish; Phenergan
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Patient''s mother called nurse to vehicle to report daughter was having a seizure. Patient had 2 seizures in the car immediately after receiving Janssen Covid-19 vaccine. Patient then placed on the ground beside the vehicle and patient continued to have 3 more grand mal seizures. Nurses kept patient safe from any injuries. EMS called and responded. Patient transported to medical facility.


VAERS ID: 1111849 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-12
Onset:2021-03-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Chest pain, Dyspnoea, Hypertension, Influenza virus test, Injection site erythema, Peripheral swelling, Rash, SARS-CoV-2 test, Tilt table test
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (broad), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Symbicort in the morning at 7:00 a.m.
Current Illness: none
Preexisting Conditions: asthma
Allergies: none
Diagnostic Lab Data: IV with Benadryl, prednisone, a pain killer, and two breathing treatments. Chest xray, a heart rate test, blood work, COVID and flu swabs. Given prescriptions for epi pin, prednisone, Benadryl
CDC Split Type:

Write-up: My blood pressure went up very high, pain in my chest, shortness of breath, rash on my face, swollen arm and redness at injection site. Went to the hospital. Monday, March 15th at hospital from 2:00 p.m. until 7:00 p.m.


VAERS ID: 1112088 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-03-12
Onset:2021-03-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Dry mouth, Fatigue, Nausea, Pyrexia, Tremor
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Estradiol
Current Illness: None known
Preexisting Conditions: Low estrogen, anxiety
Allergies: Sudafed - makes my heart race
Diagnostic Lab Data: Went to Emergency room due to uncontrollable body shakes No medical testing was done
CDC Split Type:

Write-up: Continuous and uncontrollable body shaking Low grade fever Fatigue Dry mouth Nausea


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