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From the 4/30/2021 release of VAERS data:

Found 153,440 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

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VAERS ID: 1272046 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-04-25
Onset:2021-04-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 - / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chills, Hyperhidrosis, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Nora B birth control
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: No
CDC Split Type:

Write-up: Extreme chills to excessive sweats back and forth. Vomiting every couple of hours. Started at 11:00pm after day of shot (Sunday) stopped 10am 2 days later (Tuesday). No outside treatment. Water, gaterade, crackers and over the counter pain reliever.


VAERS ID: 1251684 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-12
Onset:2021-04-24
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Arthralgia, Fatigue, Headache, Myalgia, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tetsosterone, Pantoprorazole 20 mg
Current Illness: none
Preexisting Conditions: Prostate cancer
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Muscle pain in both arms/shoulders, headache for 3 days, fatigue, stomach aches for 3 days (since 4/21/21)


VAERS ID: 1255952 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-30
Onset:2021-04-24
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram thorax abnormal, Myocardial strain, Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Letrozole, Medrol, Levothyroxine, Atenolol, Omeprazole, Simvastatin, Trandolapril, Gabapentin
Current Illness: N/A
Preexisting Conditions: HTN, Hypothyroidism, Breast Ca s/p mastectomy
Allergies: NKDA
Diagnostic Lab Data: CT PE Study 4/24 - Saddle PE with right heart strain
CDC Split Type:

Write-up: Approximately 3.5 weeks after JANSSEN covid vaccine, patient developed an acute pulmonary embolism.


VAERS ID: 1256679 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-04-10
Onset:2021-04-24
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203821A / 1 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Anion gap decreased, Blood calcium decreased, Blood chloride normal, Blood creatinine normal, Blood glucose normal, Blood potassium normal, Blood urea normal, Carbon dioxide normal, Cerebrovascular accident, Dysmetria, Glomerular filtration rate normal, Haematocrit normal, Haemoglobin decreased, Hemiparaesthesia, International normalised ratio normal, Magnetic resonance imaging head abnormal, Mean cell haemoglobin concentration normal, Mean cell haemoglobin normal, Mean cell volume normal, Platelet count normal, Red blood cell count decreased, Red cell distribution width normal, Skin sensitisation, Thalamic infarction, Troponin normal, White blood cell count normal
SMQs:, Rhabdomyolysis/myopathy (broad), Haematopoietic erythropenia (narrow), Haemorrhage laboratory terms (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Noninfectious encephalitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Chronic kidney disease (broad), Tumour lysis syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: lisinopril, atorvastatin
Current Illness: NA
Preexisting Conditions: HTN, HLD
Allergies: NKDA or food allergies
Diagnostic Lab Data: Brain MRI: IMPRESSION:Acute left thalamic infarction. Approximate age of 12 hours and no hemorrhagic transformation. Lab Results Component Value Date WBC 5.22 04/25/2021 NRBCPCT 0 04/25/2021 RBCT 4.40 04/25/2021 HEMOGLOBIN 13.2 (L) 04/25/2021 HEMATOCRIT 40.8 (L) 04/25/2021 MCV 92.7 04/25/2021 MCH 30.0 04/25/2021 MCHC 32.4 04/25/2021 PLT 189 04/25/2021 RDW 11.8 04/25/2021 Lab Results Component Value Date GLUCOSE 106 (H) 04/25/2021 CALCIUM 8.2 (L) 04/25/2021 K 4.1 04/25/2021 CO2 27.0 04/25/2021 CL 101 04/25/2021 BUN 17 04/25/2021 CREATININE 1.1 04/25/2021 ANIONGAP 7.0 04/25/2021 EGFR $g60 04/25/2021 Lab Results Component Value Date INR 1.1 04/25/2021 Lab Results Component Value Date TROPONINI <0.012 04/25/2021
CDC Split Type:

Write-up: R sided paresthesias started at 8pm on 4/24/21 and worsened to entire R side of body on 4/25/21 am. He was evaluated and admitted to the hospital 4/25/21 and found to have left thalamic stroke. No weakness in arm noted but some R hand dysmetria along with decreased sensation.


VAERS ID: 1257022 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-11
Onset:2021-04-24
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Blister rupture, Blood blister, Fibrin D dimer normal, Gingival blister, Haematocrit increased, International normalised ratio normal, Laboratory test normal, Petechiae, Platelet count decreased, White blood cell count normal
SMQs:, Severe cutaneous adverse reactions (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Gingival disorders (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: He was in his usual state of excellent health until yesterday. He noticed a small blister over his left upper gum. This burst and was clearly filled with blood. Over the ensuing 24 hours, he has had multiple such blisters and came to the Emergency Room for fear of a reaction to the COVID vaccine that he had had 13 days ago. This was Johnson and Johnson. He had no major reactions to it. On coming to the Emergency Room today, he noticed significant petechiae forming over the lower extremities as well as scattered petechiae forming elsewhere. He presented to the Emergency Room and there was noted to have a CBC showing hematocrit of 51, 4000 platelets, and a white count of 7.7 with an unremarkable differential. INR is 1.1. D-dimer was 0.33. Chemistries were limited, but were within normal limits.


VAERS ID: 1257712 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Indiana  
Vaccinated:2021-04-24
Onset:2021-04-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Fatigue, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Fatigue, fever, muscle aches and joint pain.


VAERS ID: 1257720 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-04-24
Onset:2021-04-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Lethargy, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Chills, fever, lethargy for approx 24 hours


VAERS ID: 1257755 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-10
Onset:2021-04-24
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Burning sensation, Contusion, Erythema, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Oct. 2014 flu shot- pt had an convulsing episode and vomiting from having an allergic reaction to taking vax.
Other Medications: Sotalol, nifedipine, potassium chloride, furosemide, Eliquis,
Current Illness:
Preexisting Conditions: AFIB, HBP
Allergies: multiple blood pressure medications, statins, bromine, erythymican, formaldehyde ,
Diagnostic Lab Data:
CDC Split Type:

Write-up: a couple of weeks after taking the vaccine her right arm was so sore it was almost paralyzed. It was bruised then turned red and painful. The pain is like a burning sensation. It was sore from elbow to shoulder blade. She has been applying hot packs and seems to help. She says her symptoms are getting better.


VAERS ID: 1257788 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-04-24
Onset:2021-04-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chest pain, Chills, Headache, Heart rate increased, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

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

Write-up: 12 hours after vaccination, had a fever, chills, increased heart rate (roughly 50 bpm higher than normal), headache, pain in chest. This lasted roughly 12 hours through the night and into the morning


VAERS ID: 1257830 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-24
Onset:2021-04-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / UN

Administered by: Public       Purchased by: ?
Symptoms: Chills, Migraine, Nausea, Pain, 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Citalopram 10mg 1xday
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Around 5pm after getting the vaccine, I developed a fever of 101 and got chills, body aches, a migraine, and severe nausea (no vomiting). It lasted about 14 hours.


VAERS ID: 1257852 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-24
Onset:2021-04-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

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

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

Write-up: Fever, body chills, body aches and pain, fatigue


VAERS ID: 1258221 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-24
Onset:2021-04-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Myalgia, Pyrexia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: I vomited multiple times over the course of a couple days and I had a fever of 101 with lots of sore muscles


VAERS ID: 1258354 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-04-24
Onset:2021-04-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / SYR

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

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

Write-up: Fever, headache, body aches, beginning 7 hours after vaccine, lasting 24-36 hours


VAERS ID: 1258447 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-08
Onset:2021-04-24
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Brain natriuretic peptide, Corticosteroid binding globulin test, Echocardiogram, Fibrin D dimer, Full blood count, Glycosylated haemoglobin, Hemianopia, Hemiparesis, Lipids, Liver function test, Magnetic resonance imaging head, Metabolic function test, Myocardial necrosis marker, Thyroid function test, Ultrasound Doppler, Visual field defect
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Noninfectious encephalitis (broad), Optic nerve disorders (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: PMH: asthma, seizure disorder, TBI, remote ETOH abuse
Allergies: naprosyn, vicodin, morphine
Diagnostic Lab Data: Echo, MRI Brain wo contrast, US Carotid Bilateral, BMP, LFT, CBC, Cardia Enzymes, BNP, CBG, D-Dimer, HgbA1C, Lipid Profile, Thyroid,
CDC Split Type:

Write-up: patient reported acute onset of left sided weakness with associated left visual field deficit with left sided lateral hemianopsia.


VAERS ID: 1259531 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-04-10
Onset:2021-04-24
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Bell's palsy
SMQs:, Hearing impairment (broad)

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

Write-up: Bell''s Palsy symptoms


VAERS ID: 1260758 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-12
Onset:2021-04-24
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Cognitive disorder, Dizziness, Epistaxis, Headache, Pain in extremity, Vision blurred
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

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

Write-up: Nose bleed at work 12 days post vaccine, never had a nose bleed before in my life. Pain in left shoulder and right leg on day 11. Persistent headache for two days. Occasional light-headedness, blurred vision, slow cognitive abilities for 2 days since nose bleed.


VAERS ID: 1261863 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-04-24
Onset:2021-04-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Injection site pain, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Fever, chills, fatigue, muscle aches, headache, a little sore at injection point on arm. No medication taken. Took approximately 36 hours for adverse effects to subside.


VAERS ID: 1263287 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-24
Onset:2021-04-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Myalgia, Nausea, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Severe Fatigue, Severe nausea and vommitting, severe muscle aches and pains, fever-like symptoms


VAERS ID: 1263648 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-23
Onset:2021-04-24
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Immune thrombocytopenia, Immunology test, Platelet factor 4
SMQs:, 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 500 MG tablet Take 500 mg by mouth every 8 (eight) hours as needed albuterol sulfate 90 mcg inhaler Inhale 2 puffs into the lungs every 6 (six) hours as needed for Wheezing ARIPiprazole (ABILIFY) 30 MG
Current Illness:
Preexisting Conditions: Anxiety ? Arthritis ? Bipolar disorder (HCC-CMS) ? COPD (chronic obstructive pulmonary disease) (HCC-CMS) ? Depression ? Diabetes mellitus (HCC-CMS) ? Dyslipidemia ? Hypothyroidism ? Kidney disorder ? PID (pelvic inflammatory disease) Hx Secondary to Chlamydia, S/P Surgery ? Ulcer Hx
Allergies: Atorvastatin Nausea and/or Vomiting Not Specified ... Iodinated Contrast Media Nausea and/or Vomiting Not Specified Betadine [Povidone-iodine] Rash (flat, red, speckled area) Low
Diagnostic Lab Data: sent elisa platelet factor 4
CDC Split Type:

Write-up: ITP, steroids, might need IVIG


VAERS ID: 1264491 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Washington  
Vaccinated:0000-00-00
Onset:2021-04-24
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Feeling of body temperature change, Neurological symptom
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210450249

Write-up: FATIGUE; OUTER NERVE SENSATION; WARM AND COLDNESS OF ELBOW AND 2 FINGERS; This spontaneous report received from a patient concerned a 38 year old female. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, and batch number: 202A21A expiry: UNKNOWN) dose was not reported, administered on 24-APR-2021 14:30 for prophylactic vaccination. No concomitant medications were reported. On 24-APR-2021 15:30, the subject experienced outer nerve sensation. On 24-APR-2021 15:30, the subject experienced warm and coldness of elbow and 2 fingers. On 25-APR-2021, the subject experienced fatigue. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from fatigue, and outer nerve sensation, and the outcome of warm and coldness of elbow and 2 fingers was not reported. This report was non-serious.


VAERS ID: 1264672 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-06
Onset:2021-04-24
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Chest pain, Cold sweat, Dizziness, Electrocardiogram, Hyperhidrosis, Musculoskeletal discomfort, Sleep disorder
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), 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: Bio Identical Hormones, Vtms, herbal teas about 3x wk
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: EKG, Chest X- Ray and Blood work-2 x... first blood results showed elevated enzymes? tromponin? then on second blood draw- normal.. at 7 am nurse offers aspirin... and explained Dr prescribed it at 3 am but it had not been given to me.. wow.. I was discharged @ 8:15 am
CDC Split Type:

Write-up: On 04/26/21 @ 2 am.. felt a sharp pain on left side of chest.. felt weird . Got out of bed to see if Id feel better... began to get clammy/sweaty- especially behind my neck... felt faint and dizzy- woke my husband up and told him my symptoms in case I d pass out.. he helped me to car and took me to hospital...


VAERS ID: 1266126 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-23
Onset:2021-04-24
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 008C21A / 2 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Hypotension, Myalgia, Nausea, Pallor, Pyrexia, Syncope, Thirst, Tremor
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ZYRTEC [CETIRIZINE HYDROCHLORIDE]; ALLEGRA; CLARITIN [CLARITHROMYCIN]; MONTELUKAST; VITAMIN D [COLECALCIFEROL]
Current Illness: Dust allergy (environmental allergy); Pollen allergy (environmental allergy)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20210

Write-up: Fainted; Thirsty; Shaking; Look pale; Hypotension; Arm soreness; Nausea; CHILLS; Fever; This spontaneous case was reported by a consumer and describes the occurrence of SYNCOPE (Fainted) in a 22-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 008C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Pollen allergy (environmental allergy) and Dust allergy (environmental allergy). Concomitant products included CETIRIZINE HYDROCHLORIDE (ZYRTEC [CETIRIZINE HYDROCHLORIDE]), FEXOFENADINE HYDROCHLORIDE (ALLEGRA) and CLARITHROMYCIN (CLARITIN [CLARITHROMYCIN]) for Allergy, MONTELUKAST for Asthma, COLECALCIFEROL (VITAMIN D [COLECALCIFEROL]) for Supplementation therapy. On 23-Apr-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) at an unspecified dose. On 24-Apr-2021, the patient experienced SYNCOPE (Fainted) (seriousness criterion medically significant), THIRST (Thirsty), TREMOR (Shaking), PALLOR (Look pale), HYPOTENSION (Hypotension), MYALGIA (Arm soreness), NAUSEA (Nausea), CHILLS (CHILLS) and PYREXIA (Fever). On 24-Apr-2021, SYNCOPE (Fainted), TREMOR (Shaking), PALLOR (Look pale) and HYPOTENSION (Hypotension) had resolved. At the time of the report, THIRST (Thirsty), MYALGIA (Arm soreness), NAUSEA (Nausea), CHILLS (CHILLS) and PYREXIA (Fever) outcome was unknown. The action taken with mRNA-1273 in response to the event was not applicable. The treatment medications included Tylenol (paracetamol) and Advil (Ibuprofen). Company comment: Based on the information provided which includes a temporal association between the use of mRNA-1273 vaccine and onset of the reported events, a causal relationship cannot be excluded. Headache, nausea, myalgia, pyrexia and chills are consistent with the product safety profile.; Sender''s Comments: Based on the information provided which includes a temporal association between the use of mRNA-1273 vaccine and onset of the reported events, a causal relationship cannot be excluded. Headache, nausea, myalgia, pyrexia and chills are consistent with the product safety profile


VAERS ID: 1266463 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-06
Onset:2021-04-24
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: CSF protein increased, Lumbar puncture, Magnetic resonance imaging thoracic normal, Paraesthesia, Sensory level abnormal, Serology test, Urinary retention
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: history of transverse myelitis 27 years ago
Allergies: none
Diagnostic Lab Data: MRI thoracic spine negative Lumbar puncture Serologies Further work up underway
CDC Split Type:

Write-up: Tingling, thoracic sensory level loss, urinary retention. CSF protein elevated to 90. Started approximately 3 weeks from time of vaccine. Drug store provided vaccine 04/06/2021 Admitted to hospital 04/27/21


VAERS ID: 1267659 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-24
Onset:2021-04-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chills, Fatigue, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine 137; Estradiol .025 every other day; Medroxyprgesterone 1.25 every other day Naproxen sodium 440; Famotidine 20; Docusate sodium 100; Stress B Complex
Current Illness: No
Preexisting Conditions: Hashimotos Hypothyroidism, Menopause
Allergies: No
Diagnostic Lab Data: No
CDC Split Type:

Write-up: Low grade fever (never got to 101*), chills, muscle aches, fatigue


VAERS ID: 1268046 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-16
Onset:2021-04-24
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 02706704 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Elavil 50 mg Levothyroxine 100 mg
Current Illness:
Preexisting Conditions: depression hypothyroid
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Abd. pain, nausea started last pm. No vomiting.


VAERS ID: 1268363 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-03-05
Onset:2021-04-24
   Days after vaccination:50
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK UN / UN

Administered by: Private       Purchased by: ?
Symptoms: Abdominal discomfort, Abdominal pain, Diarrhoea, Headache, Magnetic resonance imaging, Nausea, Thrombosis, Vein disorder, Vomiting
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Thrombophlebitis (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: possible NASH, HTN, h/o prostate cancer (on Q3month Lupron), Asthma
Allergies:
Diagnostic Lab Data: MRI of abdomen with left portal vein thrombosis, benign liver cyst PF for antibodies, 7 weeks after vaccination, mildly elevated and inconclusive
CDC Split Type:

Write-up: Patient received Johnson Johnson COVID vaccination on March 5th (Its not listed as an option for me to choose - Hence Janssen). Two weeks later patient and wife described symptoms of significant abdominal pain and headache, which improved after 24 hours, since then, abdominal pain on and off with worsening, nausea vomiting and diarrhea. Presented to Hospital with sepsis, negative evaluation, possibly GI etiology, given symptoms. MRI of the abdomen shows left portal vein thrombosis/which is an unusual site. Patient has no liver cirrhosis or metastatic cancer. Is being investigated for idiopathic or acquired thrombophilia


VAERS ID: 1269176 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Colorado  
Vaccinated:0000-00-00
Onset:2021-04-24
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Anger, Cognitive disorder, Crying, Depression, Dyspnoea, Gait inability, Malaise, Muscular weakness, Nasopharyngitis, Oropharyngeal pain, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (narrow), Cardiomyopathy (broad), Depression (excl suicide and self injury) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Alcohol use (Occasional); Non-smoker
Preexisting Conditions: Comments: The patient had no known drug allergies and she is pretty healthy, very athletic and has not been ill in the last 20 years.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210452494

Write-up: SHORTNESS OF BREATH; COULDN''T WALK; COLD; CAN''T COMPREHEND/THINK; FEELS DEPRESSED; ANGRY; CRYING; NOT FEELING WELL; MUSCLE WEAKNESS; THROWING UP; SORE THROAT; This spontaneous report received from a patient concerned a 55 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included alcohol user, and non smoker, and other pre-existing medical conditions included the patient had no known drug allergies and she is pretty healthy, very athletic and has not been ill in the last 20 years.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 205A21A, and batch number: 205A21A expiry: UNKNOWN) dose was not reported, administered on 09-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 24-APR-2021, the subject experienced throwing up. On 24-APR-2021, the subject experienced sore throat. On 24-APR-2021, the subject experienced muscle weakness. On an unspecified date, the subject experienced shortness of breath, couldn''t walk, cold, can''t comprehend/think, feels depressed, angry, crying, and not feeling well. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from muscle weakness, throwing up, and sore throat, and the outcome of shortness of breath, not feeling well, couldn''t walk, cold, can''t comprehend/think, angry, crying and feels depressed was not reported. This report was non-serious.


VAERS ID: 1269974 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Connecticut  
Vaccinated:0000-00-00
Onset:2021-04-24
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Head discomfort, Paraesthesia, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210451813

Write-up: WHEEZING FEELING; WOOZY; HEAD FEELS TINGLY; LIGHTHEADEDNESS; FEELING OF PRESSURE ON HEAD; This spontaneous report received from a patient concerned a 28 year old female. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: UNKNOWN) dose was not reported, administered on 10-APR-2021 for prophylactic vaccination. Batch number was not reported. The company has requested follow-up for batch number. No concomitant medications were reported. On 24-APR-2021, the subject experienced wheezing feeling. On 24-APR-2021, the subject experienced woozy. On 24-APR-2021, the subject experienced head feels tingly. On 24-APR-2021, the subject experienced lightheadedness. On 24-APR-2021, the subject experienced feeling of pressure on head. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from wheezing feeling, woozy, head feels tingly, lightheadedness, and feeling of pressure on head. This report was non-serious.


VAERS ID: 1269984 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-04-24
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Oropharyngeal pain, Rhinorrhoea
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210452239

Write-up: THROAT HAS BEEN HURTING; RUNNY NOSE; FEELS WEAK; This spontaneous report received from a patient concerned a 58 year old female. The patient''s weight, height, and medical history were not reported. The patient received Covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 043A21A, and expiry: UNKNOWN) dose was not reported, administered on 05-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 24-APR-2021, the subject experienced throat pain. On 24-APR-2021, the subject experienced runny nose. On 24-APR-2021, the subject experienced feeling weak. The action taken with Covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the throat pain, runny nose and feeling weak was not reported. This report was non-serious.


VAERS ID: 1270035 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-03-27
Onset:2021-04-24
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

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

Write-up: Developed shingles three weeks after vaccine


VAERS ID: 1272504 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-10
Onset:2021-04-24
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Injection site pain, Mobility decreased, Pain, Pain in extremity
SMQs:, Parkinson-like events (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Omeprazole (20mg/day); Nortriptyline (20mg/day); Flaxseed Oil (1000mg/day); Calcium Carbonite + D (600mg/day); Multi-vitamin 50+ for women (1/day); Probiotic (generic for Align - 1/day); Biotin (1000mg/day)
Current Illness: none
Preexisting Conditions: IBS
Allergies: Sulfa
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Injection site sore for about 5 days - then 5 days later shoulder became very sore and achy. Arm now aches continuously and is very weak. Mobility without pain is limited. Have not contacted my doctor yet - but will do so soon. No doctor visit planned yet. (Suspecting this is SIRVA????)


VAERS ID: 1245277 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-23
Onset:2021-04-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray, Full blood count, Gait disturbance, Pain in extremity, Tachycardia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (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: Famotidine 40 MG Levoxyl .125 MG Breo 100mg Albuterol Sulfate 90mcg Lorazepam 1mg Monelukast 10 mg
Current Illness: I had double lower lobe pneumonia dated 1/11/2021 but was told I no longer had it in 2/14/2021
Preexisting Conditions: Asthma
Allergies: Shell fish Levaquin
Diagnostic Lab Data: 4/21/21 22401 Chest x-ray CBC 4/22/21 D dimer
CDC Split Type:

Write-up: Pain in bottom of feet for weeks that I could barely walk Tachycardia (pulse 113; normal pulse in 80''s)


VAERS ID: 1245319 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-04-22
Onset:2021-04-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / SYR

Administered by: Other       Purchased by: ?
Symptoms: Bruxism, Chills, Pain
SMQs:

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

Write-up: Chills so bad I had to put a mouthguard in to prevent me from grinding my teeth the whole time and body aches worse than when j hurt my back and had a discetomy


VAERS ID: 1245955 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-23
Onset:2021-04-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Arthralgia, Autoimmune disorder, Blood calcium increased, Blood test, Computerised tomogram normal, Fatigue, Heart rate increased, Hypertension, Malaise, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Dehydration (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Armour estradiol multivitamin vitamin D
Current Illness:
Preexisting Conditions: Hashimoto autoimmune
Allergies: Erythromycin codeine morphine Sulfur-based drugs eggs
Diagnostic Lab Data: CAT scan normal. Bloodwork showed elevated blood calcium but all other values were normal.
CDC Split Type:

Write-up: Rapid heartbeat 24 hours severe stomach pain two weeks muscle and joint pain two weeks extreme high blood pressure two weeks. Extreme fatigue two weeks. The vaccine triggered an auto immune response. It triggered a flareup in my body and I was very ill for several weeks. Because of my severe stomach pain and blood pressure soaring my doctor ordered a CAT scan and blood work up. I am now three weeks post vaccine and my body seems to be calming down my blood pressure has returned to normal and the stomach pain has stopped. The extreme fatigue muscle and joint pain is still present but much better.


VAERS ID: 1245981 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-21
Onset:2021-04-23
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Other       Purchased by: ?
Symptoms: Atrial fibrillation
SMQs:, Supraventricular tachyarrhythmias (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Dilizatem ER 180
Current Illness: None
Preexisting Conditions: Past Acute AFIB. No issue for 3 years.
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: AFIB event confirmed via Smart Device.


VAERS ID: 1246770 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-03-19
Onset:2021-04-23
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Hypersensitivity, Rash
SMQs:, Anaphylactic reaction (broad), Angioedema (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:

Write-up: ED Course/MDM: -Rash appears as an allergic reaction. The patient is given Solu-Medrol and observed for period of time. She continued to improve and I do feel she can be further evaluated as an outpatient. The patient is placed on a prednisone burst and to continue antihistamines. -The patient will follow up with their PCP and is to return for any new or worsening symptoms. The patient is discharged in stable condition. Final Impression: 1. Allergic reaction


VAERS ID: 1246774 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-07
Onset:2021-04-23
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK RA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Disturbance in attention, Dizziness, Feeling abnormal, Headache, Injection site bruising, Injection site pain, Limb discomfort, Piloerection
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Depression (excl suicide and self injury) (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderall, 30 mg 3x/day
Current Illness:
Preexisting Conditions:
Allergies: Very mild latex skin allergy
Diagnostic Lab Data:
CDC Split Type:

Write-up: Immediately felt sore arm after injection. I could almost feel the vaccine going into my arm. It felt very heavy. A few hours after vaccine, felt weird ''brain fog''. This lasted through the following day. Not a typical headache. 6 days later -- experience ''brain fog'' experience again... again lasted 24-36 hours. Still able to work as normal , just harder to focus. Also had weird sensations of goosebumps randomly when not cold. 15 days later -- notice that if I rubbed arm near injection site it was sore. Arm not sore at all unless touching it. Then notice a bruise at the site of injection the following day. Also feeling light-headed.


VAERS ID: 1246812 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-20
Onset:2021-04-23
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 2 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Condition aggravated, Dysmenorrhoea, Extra dose administered
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Medication errors (narrow)

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

Write-up: Very painful menstrual cramps with no bleeding. Same thing happened after first injection.


VAERS ID: 1247125 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-10
Onset:2021-04-23
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Abnormal dreams, Activated partial thromboplastin time, Anxiety, Blood magnesium increased, Blood osmolarity decreased, Blood thyroid stimulating hormone, Chest X-ray, Chills, Confusional state, Cyanosis, Cystitis, Diarrhoea, Disorientation, Dizziness, Dyspnoea, Electrocardiogram abnormal, Eye swelling, Fatigue, Feeling abnormal, Feeling cold, Feeling of body temperature change, Fibrin D dimer, Globulin, Haematuria, Headache, Human chorionic gonadotropin negative, Hyperhidrosis, Impaired work ability, Injection site pain, International normalised ratio, Lymphocyte percentage, Malaise, Metabolic function test, Muscle spasms, Muscle tightness, Myalgia, Nasal congestion, Pain, Phobia of driving, Platelet count normal, Platelet morphology normal, Protein total increased, Pyrexia, Secretion discharge, Vaginal discharge
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Pseudomembranous colitis (broad), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hyponatraemia/SIADH (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Tubulointerstitial diseases (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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Amphetamine Salts 10mg, Zicam lozenges
Current Illness: Coming off a short cold that began approx 5 days prior
Preexisting Conditions: ADHD, Anxiety/Depression
Allergies: Penicillin
Diagnostic Lab Data: 4/15 XR CHEST PA & LATERAL for shortness of breath Results: THE CARDIOMEDIASTINAL SILHOUETTE IS WITHIN NORMAL LIMITS. NO FOCAL CONSOLIDATION, PLEURAL EFFUSION, PULMONARY EDEMA, OR PNEUMOTHORAX. MILD DEXTROCURVATURE OF THE THORACIC SPINE. NO ACUTE OSSEOUS ABNORMALITIES. OVERALL, NO RADIOGRAPHIC EVIDENCE OF ACUTE CARDIOPULMONARY PROCESS Lab: TSH ? Results within Standard Range Lab: PROTIME-INR Lab: POCT HCG? URINE Lab: MANUAL DIFFERENTIAL Some results for reference: Lymphocytes 39 % OCCASIONAL ATYPICAL LYMPHOCYTES SEEN Platelet Morphology NORMAL PLATELET MORPH. Lab: MAGNESIUM Result: 2.4 MG/DL EKG Results: Sinus tachycardia with 1st degree A-V block Rightward axis Nonspecific ST abnormality Abnormal ECG Lab: D-DIMER,QUANTITATIVE Results: 0.29 UG/ML FEUs ? indicated CT not needed for now Lab: COMPREHENSIVE METABOLIC PANEL Some results for reference: Protein, Total 8.6 G/DL * High Globulin 4.1 G/DL * High Calculated Osmolality 273 MOSM/KG *low Lab: CBC WITH DIFFERENTIAL Some results for reference: Platelet Count 184 10^3/uL Lab: LAPTT
CDC Split Type:

Write-up: Saturday 4/10: 3:00 pm- first sign of headache -anxious and fatigued, series of falling asleep and waking up confused 10:41pm: First sign of chills and running ?hot and cold? Sleep was disturbed with intense vivid dreams and waking to sweat and running hot and freezing cold Sunday 4/11: 2:15 pm: Headache, sweating, diarrhea 6:51 pm: experienced confusion, brain fog, muscle tightness all over body Monday 4/12: 8:15 am: Woke up to muscle soreness, brain fog, and stuffy nose with green mucus. Left arm from at injection sight still sore. 8:53 am: Experienced disorientation and concern about safety driving to work 10:53 am: Dizziness and overall feeling of being unwell. Series of running hot and ?clammy? Expressed that everything seemed like a dream-like state. Experienced forgetfulness, confusion and uncertainty. 11:59 am: Ran hot and cold going from sweating to shivering cold. 12:02 pm: Questioned ?what?s real and what?s imagined?, hard to grasp reality. Fatigued, confused and trouble at work concentrating. 12:35- 1pm: Shivering cold, difficulty regulating body temp 2:30 pm: Starting feeling a little better, body temp started to go back to somewhat normal Tuesday 4/13 1:13 am: woke up sweating drenched and anxious, confused and achy. Experienced unusual amount of milky discharge not usually present in between menses. Throughout the day experienced less confusion as before, but still sore and not well overall in general Wednesday 4/14 4:15 am: woke up with major feet cramps, toes curling in without release for over an hour. Intense pain that had not been experienced before with the length of the duration of the cramp in both feet. 7:15 am: Feet cramped on and off, noticed left eye swollen (previously has happened before but not sure reason why). Took a Claritin and drank water to help with the cramping. Experienced immense anxiety about driving vehicle to work due to the muscle spasms now mostly on the left foot. 8:07 pm: Left foot was still cramping up sporadically throughout the day with lingering pain when muscle was relaxed Sleep throughout the night was accompanied by vivid intense dreams and waking up with more cramping in feet, more the left foot now Thursday 4/15 7am: Cramps in feet were still present, decided to check in to an urgent care to check it out 9:30 am: MD Now Urgent care visit- ran urine analysis and blood tests. 10:30 am: Discharged from Urgent care with following diagnosis: Acute cystitis without hematuria, abnormal urinalysis adverse effect of vaccine, initial encounter cyanosis of skin, shortness of breath and protein found in urinalysis. Instructed to immediately get CT angiogram to rule out blood clot. 12: pm Admitted to Mount Sinai Emergency Room-blood work, XRay and IV given. details below Discharged with the following diagnosis: Foot cramps - Primary Local reaction to COVID-19 vaccine Friday 4/16 Subtle and lingering muscle spasm on left food. Experienced chills and consistent headache throughout the day Saturday 4/17 10 pm: Began to run a fever however did not check the temperature. Radiated heat and friend took care of me throughout the night as I sweated with confusion Sunday 4/19 Complete fatigue and tiredness, cramping in the foot seemed to have subsided. Still was running hot throughout the day. Monday 4/20 Took off work due to exhaustion and muscle ache and what seemed to be a fever Thursday 4/23 Followed up with General Practitioner Dr. Franco and was advised to report my experience with the Johnson and Johnson vaccine. Feeling better as of Friday 4/24 with slight fatigue but body temperature seems to be ok. No signs of the lingering cramping in the left foot but still slightly achy all over the body.


VAERS ID: 1247944 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-06
Onset:2021-04-23
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Odynophagia, Swelling, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: losartan 100mg, metoprolol er 100mg, xarelto 20mg, amlodipine 5mg , methimazole 5mg
Current Illness: na
Preexisting Conditions: blood pressure thyroid
Allergies: none
Diagnostic Lab Data: patient going to dentist this monday 4/26/21
CDC Split Type:

Write-up: patients left neck , jaw, is exremely swollen and hurts to swallow. Recommended for patient to go to urgent care and I followed up with her primary care doctor within a hour of her reporting.


VAERS ID: 1247971 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-03-30
Onset:2021-04-23
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Infection, 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin; Citalopram; HCTZ; Lisinopril; Amlodipine
Current Illness: No
Preexisting Conditions: DM2; Hypertension; Dyslipidemia; Obesity
Allergies: NKDA
Diagnostic Lab Data: Rapid Test- NP swab
CDC Split Type:

Write-up: Breakthrough Coronavirus infection more than 2 weeks after vaccine


VAERS ID: 1248552 (history)  
Form: Version 2.0  
Age: 95.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-12
Onset:2021-04-23
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 - / IM

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

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: prednisone, glipizide, ondansetron, vitamin D3, pantoprazole, furosemide, simvastatin, acetaminophen, albuterol sulfate hand held nebulizer
Current Illness: asthma, polymyalgia rheumatica, osteoarthritis, hypertension, diabetes, hyperlipidemia
Preexisting Conditions: History of breast cancer 2009
Allergies: amlodipine, anastrozole, ciprofloxacin, lisinopril
Diagnostic Lab Data: 4/23/21 right lower extremity ultrasound
CDC Split Type:

Write-up: Developed severe right leg pain within two days after the vaccine. She had confirmed deep venous thrombosis on ultrasound confirmed on 4/23/21 without other known provocation.


VAERS ID: 1250956 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-06
Onset:2021-04-23
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Discomfort, Pain, Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad)

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

Write-up: Left leg began hurting and throbbing, both legs began hurting, feeling pressure in legs


VAERS ID: 1251619 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-01
Onset:2021-04-23
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram cerebral abnormal, Aphasia, Blood gases, Blood magnesium, Blood phosphorus, Cerebral haemorrhage, Cerebral mass effect, Chest X-ray, Computerised tomogram, Computerised tomogram head abnormal, Facial paralysis, Full blood count, Gaze palsy, Glycosylated haemoglobin, Hemiparesis, Heparin-induced thrombocytopenia test, International normalised ratio, Laboratory test, Lipids, Mental status changes, Metabolic function test, Platelet factor 4, Prothrombin time, Superior sagittal sinus thrombosis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Central nervous system vascular disorders, not specified as haemorrhagic or ischaemic (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Hearing impairment (broad), Ocular motility disorders (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Hypertension, Hyperlipidemia
Allergies: None
Diagnostic Lab Data: ED labs done at outside hospital NCHCT CTA CXR NCHCT LABS - CBC, BMP, Mag, Phos, PT/INR, Xa, ABG, A1C, Lipid panel, PF4, HITT labs
CDC Split Type:

Write-up: At unspecified date the patient''s nephew noticed acute onset change in the patient''s mental status. Upon arrival to unspecified hospital by EMS she was aphasic with right facial droop, right gaze preference, right sided weakness. CT and CTA showed Intraparenchymal hemorrhage with 3mm midline shift as well as superior sagittal dural sinus thrombus in the anterior 3rd. Repeat NCHCT showed bilateral parenchymal hemorrhages.


VAERS ID: 1252161 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-09
Onset:2021-04-23
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / SYR

Administered by: Public       Purchased by: ?
Symptoms: Dissociation, Fatigue, Feeling abnormal, Vertigo
SMQs:, Dementia (broad), Vestibular disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Flonase- not taken day of or following day after vaccine
Current Illness:
Preexisting Conditions: Seasonal/environmental allergies, depression
Allergies: Adhesives
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 2 weeks after the vaccine, had vertigo after waking up. Treated this with an anti-vert medication (meclizine HCL, 25mg) that made me drowsy. The following day, still felt fatigued and had spells of feeling foggy/disassociated, ?out of it.? Unsure if this reaction was due to the medication or not.


VAERS ID: 1255841 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-10
Onset:2021-04-23
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Blood pressure increased, COVID-19, Fatigue, Influenza like illness, Oropharyngeal pain, SARS-CoV-2 test positive
SMQs:, Neuroleptic malignant syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypertension (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec, Levixthyrone, Hydrochlorithiazde
Current Illness: None
Preexisting Conditions: High BP, Thyroid, Sjorgens Autoimmune
Allergies: Penicillin & all N-Saids
Diagnostic Lab Data: I had a COVID test11/2/2020 with a positive results. I quarantined 14 days. Due to 13 days since Janssen vaccine (4/10/21) Will schedule a COVID test since I am experiencing the same symptoms as 10/30/2020
CDC Split Type: 10411880

Write-up: 4/23/2021 felt rundown & tired. 4/24/2021 flu like symptoms, sore throat, high bp 152/98 . So far no fever if my thermometer is accurate. 97.8.


VAERS ID: 1256205 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-04-08
Onset:2021-04-23
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test normal, Petechiae, Rash, White blood cell count
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Pregabalin, Northiptyline, Finasteride, amitriptyline, aspirin, tamsulosin, furosemide, famotidine Keytruda (at least 6 months)
Current Illness: Non Small Cell Lung Cancer
Preexisting Conditions: Arthritis, emphysema
Allergies: N/A
Diagnostic Lab Data: April 23 th blood work at urgent care. BW WNL
CDC Split Type:

Write-up: April 23 th my dad woke up with Non-painful rash/petichia on both ankles going half way up calves


VAERS ID: 1256522 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-07
Onset:2021-04-23
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Menstrual disorder
SMQs:

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

Write-up: I had my period on 4/9 at the time of vaccine and have it again as of 4/23 which was only 14 days later and this has never happened before. I thought it was worth reporting


VAERS ID: 1257208 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-11
Onset:2021-04-23
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

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

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

Write-up: Noticed a couple days ago that there?s a lump on the front of my thigh


VAERS ID: 1257764 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-12
Onset:2021-04-23
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cerebrovascular accident, Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Pravastatin 200mg nightly
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: I''m reporting just in case others had a mini stroke after receiving this Johnson and Johnson shot, doctors at hospital say they have seen it causing Big strokes but not mini strokes but if J&J shots causes big strokes it can also cause mini strokes I believe, A stroke is a stroke. My husband is a healthy 60 year old with no real heath issues. all his test in hospital showed no reason for his stroke and they did them all...?..but test did show he had a stroke His arm and leg went numb at about 8 pm Friday at home so I took him to hospital and test showed he had a spot on his brain saying it was a stroke, they kept him 2 days running test and they found no reason he had a stroke but he did and I believe it was caused by the COVID-19 vaccine shot from Johnson and Jonson


VAERS ID: 1258299 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-08
Onset:2021-04-23
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: hypertension
Allergies:
Diagnostic Lab Data: COVID-19 RNA DETECTION BDMAX posiitve 04/23/2021
CDC Split Type:

Write-up: Pt is currently Covid 19 positive


VAERS ID: 1258970 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-12
Onset:2021-04-23
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Cough, Dyspnoea, Exposure to SARS-CoV-2, Hypoxia, Pain, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), 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), Opportunistic infections (broad), COVID-19 (narrow)

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

Write-up: Patient received the J&J COVID vaccine on 4/12/21 and she started feeling COVID symptoms on 4/18/21 (fever, cough, body aches, and dyspnea). She has 3 members of her family who tested positive for COVID. Patient tested positive for COVID as well on 4/18/21. She presented to the ED for worsening symptoms on 4/23/21 and was admitted to the hospital for COVID treatment since she was hypoxic in the ED.


VAERS ID: 1258999 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-09
Onset:2021-04-23
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: tamoxifen, pioglitazone, losartan, glimepiride, metformin
Current Illness: none
Preexisting Conditions: diabetes, copd , htn, high cholesterol
Allergies: pcn
Diagnostic Lab Data:
CDC Split Type:

Write-up: rt calf / leg pain - seen in urgent care, sent to ER to r/o DVT


VAERS ID: 1259020 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-02
Onset:2021-04-23
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Limb discomfort
SMQs:, Anaphylactic reaction (broad)

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

Write-up: 84 y.o. female with PMH of coronary artery disease with prior RCA stent in 2019, atrial fibrillation s/p pacemaker, type 2 DM with diabetic nephropathy, and CKD 4 who was admitted on 4/23/2021 with chest pressure radiating to the arm.


VAERS ID: 1259785 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-04-08
Onset:2021-04-23
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Bell's palsy, Computerised tomogram head, Facial paralysis, Full blood count
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (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: Dulera Inhaler
Current Illness: none
Preexisting Conditions: Asthma
Allergies: none
Diagnostic Lab Data: Lab Test: CBC with Differential Imaging: CT Head without Contrast
CDC Split Type:

Write-up: Bell Palsy, left side of face severe paralysis. Treatment Prednisone 20MG Tablets (7 days) / follow up with primary care doctor.


VAERS ID: 1261000 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-04-02
Onset:2021-04-23
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: SARS-CoV-2 antibody test, SARS-CoV-2 antibody test negative, Unevaluable event
SMQs:, 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tamsulosin, Allopurinol, 81 mg aspirin, One-A-Day vitamin, Atorvastatin, 400mg Magnesium
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: 4/23/21: EasyFill rapid Covid-19 anti-body test 70100135: result: IGG antibody- negative, IGM antibody-negative. 4/24/21: Quest Diagnostics SARS COV 2 Serology Test: result: IGG negative, IGM negative
CDC Split Type:

Write-up: I had an uneasy feeling about the pharmacist because he was alone and running back and forth filling prescriptions and giving vaccines. He also seemed unsure of himself. After three weeks I have a rapid anti-body test and then a blood drawn anti-body test. Both tests were negative. I am now going to get another vaccine (Pfizer). I am concerned that this might have been a bad batch of vaccine and others that were vaccinated think they are protected but are not!


VAERS ID: 1261014 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-04-12
Onset:2021-04-23
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 RA / IM

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

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

Write-up: New minor tingling in digits 1-3 and surrounding area of left foot starting 04-23-2021 approximately 09:00 AM, subsided approximately at 10:30 AM. Minor tingling returned in same area 04-24-2021 approximately 09:00 AM, subsided approximately 10:30 AM. Minor tingling returned in same area 04-25-2021 approximately 09:00 AM, minor tingling remains in sole of foot by 1st metatarsal as of this report (04-26-2021 at 10:00 PM).


VAERS ID: 1261459 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Virginia  
Vaccinated:0000-00-00
Onset:2021-04-23
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ENALAPRIL; FLUOXETINE; LETROZOLE
Current Illness: Alcohol use (Occasionally); Blood pressure high; Drug allergy
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210448612

Write-up: DIZZINESS; NAUSEA; This spontaneous report received from a patient concerned a female of unspecified age. The patient''s height, and weight were not reported. The patient''s past medical history included codeine allergy, and concurrent conditions included alcohol consumption, and high blood pressure. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 202A21A, expiry: UNKNOWN) dose was not reported, administered on 09-APR-2021 for prophylactic vaccination. Concomitant medications included letrozole for drug used for unknown indication, enalapril for high blood pressure, and fluoxetine. On 23-APR-2021, the subject experienced dizziness. On 23-APR-2021, the subject experienced nausea. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from dizziness, and nausea. This report was non-serious.


VAERS ID: 1261942 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Ohio  
Vaccinated:2021-04-22
Onset:2021-04-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Dyspnoea, Gastric dilatation, Gastrointestinal inflammation, Headache, Hyperhidrosis, Muscle spasms, Pain
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific inflammation (broad), Gastrointestinal nonspecific dysfunction (broad), Ischaemic colitis (broad), Cardiomyopathy (broad), Noninfectious diarrhoea (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19 (had reoccurring covid for the weeks following with symptoms coming and going.)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20210

Write-up: hard to breathe, trouble breathing; distended stomach; looks like he is 9 months pregnant like he is going to pop; Sweating; feels like he has pins and needles; Cramps; Headache; Chills; This spontaneous case was reported by a consumer and describes the occurrence of DYSPNOEA (hard to breathe, trouble breathing) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient''s past medical history included COVID-19 (had reoccurring covid for the weeks following with symptoms coming and going. ) on 09-Mar-2021. On 22-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 23-Apr-2021, the patient experienced DYSPNOEA (hard to breathe, trouble breathing) (seriousness criterion medically significant), GASTRIC DILATATION (distended stomach), GASTROINTESTINAL INFLAMMATION (looks like he is 9 months pregnant like he is going to pop), HYPERHIDROSIS (Sweating), PAIN (feels like he has pins and needles), MUSCLE SPASMS (Cramps), HEADACHE (Headache) and CHILLS (Chills). At the time of the report, DYSPNOEA (hard to breathe, trouble breathing), GASTRIC DILATATION (distended stomach), GASTROINTESTINAL INFLAMMATION (looks like he is 9 months pregnant like he is going to pop), HYPERHIDROSIS (Sweating), PAIN (feels like he has pins and needles), MUSCLE SPASMS (Cramps), HEADACHE (Headache) and CHILLS (Chills) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Treatment included continuous positive airway pressure (CPAP) to help patient breathe.; Sender''s Comments: Based on the information provided which includes a temporal association between the use of mRNA-1273 vaccine and onset of the reported events, a causal relationship cannot be excluded. Chills and headache are consistent with the product safety profile


VAERS ID: 1261944 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-23
Onset:2021-04-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038B214 / 1 RA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Feeling of body temperature change, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: now chilly and then warm; Itching; tired; Worst case of hives the doctor had ever seen; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of URTICARIA (Worst case of hives the doctor had ever seen) in a 46-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 038B214) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 23-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 23-Apr-2021, the patient experienced URTICARIA (Worst case of hives the doctor had ever seen) (seriousness criterion medically significant). On 24-Apr-2021, the patient experienced FEELING OF BODY TEMPERATURE CHANGE (now chilly and then warm), PRURITUS (Itching) and FATIGUE (tired). At the time of the report, URTICARIA (Worst case of hives the doctor had ever seen) had resolved and FEELING OF BODY TEMPERATURE CHANGE (now chilly and then warm), PRURITUS (Itching) and FATIGUE (tired) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medications were provided Treatment medications included were intravenous drip( IV), prednisone, diphenhydramine, famotidine and was given epinephrine pen on discharge, just in case needed to use it(has not used it). Company comment: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1262195 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-03
Onset:2021-04-23
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN JOHNSON / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Crohn?s
Allergies: None
Diagnostic Lab Data: April 25, 2021 ultrasound
CDC Split Type:

Write-up: Deep vein thrombosis


VAERS ID: 1262361 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-01
Onset:2021-04-23
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Guillain-Barre syndrome, Intensive care, Mechanical ventilation
SMQs:, Peripheral neuropathy (narrow), Acute central respiratory depression (broad), Guillain-Barre syndrome (narrow), Demyelination (narrow), Respiratory failure (broad), Immune-mediated/autoimmune disorders (narrow)

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

Write-up: I was informed by CPT, that a patient who received the vaccine was in critical care and diagnosed with Guillian Barre Syndrome and is now on ventilator. Attempts to reach the DR or patient have been unsuccesful at this point but we will continue to try. I have no PMHx of the patient or current medications


VAERS ID: 1263150 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-09
Onset:2021-04-23
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Angiogram pulmonary normal, Anticoagulant therapy, Arteriogram carotid normal, Computerised tomogram neck, Computerised tomogram thorax, Deep vein thrombosis, Magnetic resonance imaging head normal, Platelet count normal, Scan with contrast normal, Ultrasound Doppler, Ultrasound scan abnormal, Vascular access site thrombosis
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Thrombophlebitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Apixaban, Citalopram, Lisinopril, Lorazepam, Melatonin, KCL, Prednisone, Senna-c Completed Chemotherapy with Taxol 2 days prior.
Current Illness: Breast cancer Hypertension Rheumatoid arthritis Vascular port related clot Depression
Preexisting Conditions: Breast cancer Hypertension Rheumatoid arthritis ADHD Depression
Allergies: No Known Allergies
Diagnostic Lab Data: Ultrasound duplex revealed multifocal deep venous thrombosis of left upper extremity CTA chest: No acute pulmonary embolism; there is no infiltrate, effusion or pneumothorax CTA head neck with without contrast: No evidence of cerebral venous sinus thrombosis MRI Brain w/w/o contrast:No hemorrhage, demyelination or acute stroke detected in the brain. No abnormal enhancement detected in the brain after contrast injection Platelet count on CBC:16000(4/25/2021), 18000(4/26/2021), 27000(4/27/2021)
CDC Split Type:

Write-up: Deep venous thrombosis at the site of vascular access line-Initially started on heparin, now switched to Rivaroxaban Thrombocytopenia-Supportive treatment and monitoring


VAERS ID: 1263162 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-10
Onset:2021-04-23
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Gait inability, Intensive care, Magnetic resonance imaging, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: SULFA,REGLAN
Diagnostic Lab Data: MRI AND SOME OTHER TESTS HUSBANT IS NOT SURE.
CDC Split Type:

Write-up: PATIENT COUDN''T WALK SINCE 23RD, 12DAYS AFTER RECEIVING VACCINE. LEFT LEG SWEELLED UP. HUSBAND TOOK HER TO EMERGENCY DR''S DID FULL STROKE PROTOCOL. PATIENT IS STILL IN ICU.


VAERS ID: 1263250 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-01
Onset:2021-04-23
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Platelet count decreased, Thrombocytopenia
SMQs:, Haematopoietic thrombocytopenia (narrow), Systemic lupus erythematosus (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ferrous sulfate
Current Illness:
Preexisting Conditions: history of thrombocytopenia on previous admission (79K-129K) 2/2021
Allergies: no known allergies
Diagnostic Lab Data: Plt 18K on admission
CDC Split Type:

Write-up: severe thrombocytopenia


VAERS ID: 1263595 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-09
Onset:2021-04-23
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / N/A LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Deep vein thrombosis, Ecchymosis, Feeling hot, Pain, Pain in extremity, Peripheral swelling, Ultrasound scan abnormal
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Thrombophlebitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: MEDROXYPROGESTERONE 10MG TABLETS; VENLAFAXIMINE75 MG
Current Illness: NONE
Preexisting Conditions: NONE KNOWN
Allergies: ACESULFAME,ASPARTAME,CEPHALEXIN, HYDROXYZINE, SULFA, SENNA
Diagnostic Lab Data: An U/S to R/O DVT is positive for a DVT in the right post tibial vein.
CDC Split Type:

Write-up: Pt. developed right lower medial leg pain on Friday. She states the pain radiated up her leg and she felt there was warmth to the area. She denies injury. She states she had the J&J covid vaccine two weeks ago and has concerns of a DVT. There is minimal swelling and ecchymosis in the area. There is no redness or warmth noted. There is no tenderness, redness or warmth noted in her calf area. She has good pedal pulse and good capillary refill of her nail beds. She has no significant PMH and denies any recent air travel, long car rides or prolonged sitting. She states she is active.


VAERS ID: 1264082 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-06
Onset:2021-04-23
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Swelling, Thrombosis
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: not aware of any OTC or herbal products taken at the time
Current Illness: none aware of
Preexisting Conditions: non aware of at the time
Allergies: no known allergies
Diagnostic Lab Data: none performed
CDC Split Type:

Write-up: The pt said she developed a blood clot on her posterior hand. I asked her if it was a bruise on the back of her hand and she said it was a blood clot. She said she slapped the bumb/clot and it subsequently went down/away.


VAERS ID: 1264467 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Colorado  
Vaccinated:0000-00-00
Onset:2021-04-23
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210448631

Write-up: ACHY LEGS FROM THE HIP DOWNS THAT FEELS LIKE GOWNING PAINS; HEADACHE; This spontaneous report received from a consumer concerned a 34 year old female. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unk) dose was not reported, administered on 02-APR-2021 for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On 23-APR-2021, the subject experienced achy legs from the hip downs that feels like gowning pains. On 23-APR-2021, the subject experienced headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the headache and achy legs from the hip downs that feels like gowning pains was not reported. This report was non-serious.


VAERS ID: 1264470 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-04-23
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Nausea, Pain
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210449139

Write-up: ACHES; CHILLS; NAUSEA; This spontaneous report received from a parent concerned a 27 year old female. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 08-APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 23-APR-2021, the subject experienced aches. On 23-APR-2021, the subject experienced chills. On 23-APR-2021, the subject experienced nausea. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from chills, aches, and nausea. This report was non-serious.


VAERS ID: 1264472 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Nebraska  
Vaccinated:0000-00-00
Onset:2021-04-23
Submitted: 0000-00-00
Entered: 2021-04-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN ER8729 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Fibrin D dimer increased, Pulmonary embolism
SMQs:, Haemorrhage laboratory terms (broad), Embolic and thrombotic events, venous (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210423; Test Name: Fibrin D dimer high; Result Unstructured Data: Elevated
CDC Split Type: USJNJFOC20210449259

Write-up: POSSIBLE PULMONARY EMBOLISM; ELEVATED D-DIMER; This spontaneous report received from a patient concerned a 55 year old female. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: ER8729, and expiry: UNKNOWN) dose was not reported, 1 total administered on 07-APR-2021 at around 10:00 on left arm for prophylactic vaccination. No concomitant medications were reported. On 16-APR-2021, the patient experienced shortness of breath that worsened with exertion, and at the time of reporting at rest. Patient called her physician (MD) (internist) and went to the office on 23-APR-2021 for some testing. She had an elevated d-dimer level. Laboratory data included: Fibrin D dimer high (NR: not provided) Elevated. The physician treated her for possible pulmonary embolism. On same day she experienced pressure in her chest. At the time of reporting patient had shortness of breath and occasionally some pressure in her chest. Patient did not take any medications for her symptoms. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from elevated d-dimer, and possible pulmonary embolism. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0: This spontaneous case describes a 55-year-old female who experienced shortness of breath which worsened with exertion 9 days after receiving the Janssen COVID-19 vaccine. She then experienced chest pressure 16 days after vaccine administration, and saw her physician that day. D-dimer level was elevated, and the physician treated her for a possible pulmonary embolism. Medical history and concomitant medications were not provided. The patient had not recovered from the events. There are insufficient details in the case to make a meaningful medical assessment. The case will be assessed further when additional information is received.


VAERS ID: 1266318 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-09
Onset:2021-04-23
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Nausea, Rhinorrhoea, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: Pt called Call center on 4/23/21 regarding concerns about his symptoms. Pt complains of vomiting/nausea once a week since 1 and 1/2 month ago after eating and sometimes runny nose. Pt mentioned coming back from a trip out of the country on 3/25/21 and getting Johnson and Johnson vaccine on 4/9/21 and had concerns about the symptoms. Vomiting and nausea started before getting the vaccine and frequency didn''t change afterwards. No doctor appt within 24 hrs at the time of call. Advised pt to go to ED.


VAERS ID: 1266433 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-01
Onset:2021-04-23
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 8108978 / 1 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Angiogram cerebral abnormal, Cardiac telemetry abnormal, Cerebral infarction, Computerised tomogram head abnormal, Echocardiogram normal, Electrocardiogram ambulatory, Headache, Magnetic resonance imaging head abnormal, Postictal state, Seizure, Ultrasound Doppler normal
SMQs:, Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Ischaemic central nervous system vascular conditions (narrow), Convulsions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: MRI/MRA, CT head, ECHO
CDC Split Type:

Write-up: Patient presents on 4/21 with sudden onset of severe headache start about 4 days ago and has been persistent since. The pain is all over her head with no particular focal area. CT head: RIGHT PARIETAL CORTICAL INFARCT She had an echo on 4/21/2021 showed normal LV size and function with LVEF 55-60% with no regional wall motion abnormalities. Normal RV structure and function. 1+ AI. No PFO by color doppler. No valvular issues. No history of atrial fibrillation. Patient then had two episodes of seizure on telemetry unit on 4/23/2021 followed by post-ictal phase Patient was discharge 5/26/21 to home with neurology follow-up scheduled in 2-4 weeks. Patient will also receive a Holter for 2 weeks.


VAERS ID: 1266646 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-03-22
Onset:2021-04-23
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Irritability, Lethargy, Platelet count decreased, Thrombocytopenia
SMQs:, Haematopoietic thrombocytopenia (narrow), Systemic lupus erythematosus (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fluoxetine 20mg QD (PMS) Vitamin D3 2000u QD, Ambien 10mg PRN (insomnia), tylenol 1000mg PRN q8h (headache x 2 weeks), xoponex PRN wheeze
Current Illness: NONE
Preexisting Conditions: craniotomy 2009 for Chiari Malformation, asthma
Allergies: NKDA
Diagnostic Lab Data: Labs: Thrombocytopenia: PLT 85 4/23/21, repeat PLT 4/26/21 75, repeat PLT 4/28/21 pending
CDC Split Type:

Write-up: weakness, Lethargy, uncharacteristic irritability beginning one day post vaccine 3/23/21. Labs: Thrombocytopenia: PLT 85 4/23/21, repeat PLT 4/26/21 75, repeat PLT 4/28/21 pending


VAERS ID: 1266856 (history)  
Form: Version 2.0  
Age: 92.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-03-30
Onset:2021-04-23
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Deep vein thrombosis, Lymphocyte count decreased, Neutrophil count increased, Peripheral swelling, Platelet count normal, White blood cell count increased
SMQs:, Cardiac failure (broad), Angioedema (broad), Haematopoietic leukopenia (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (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: Unknown
Current Illness: NA
Preexisting Conditions: NA
Allergies: NKA
Diagnostic Lab Data: 04.23.2021: Platelets 162 k/ul WBC 15.43 Abs neut 13.29; abs lymph 0.98
CDC Split Type:

Write-up: On 04.23.2021, developed leg swelling and was diagnosed with Right lower DVT. Was not admitted to the hospital. Was give RX for Eliquis


VAERS ID: 1268029 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-09
Onset:2021-04-23
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Fatigue, Injection site pain, Neck pain, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol and Tums
Current Illness: none reported
Preexisting Conditions: Fibromyalgia
Allergies: NKA, just sensitivities to things (gets upset stomach).
Diagnostic Lab Data: SHE IS WAITING TO HEAR BACK FROM HER DOCTOR THAT SHE CALLED THIS A.M.
CDC Split Type:

Write-up: CLIENT REPORTS THAT 4-5 DAYS AGO SHE STARTED HAVING EXTREME FATIGUE, AND RIGHT NECK, SHOULDER, PAIN THAT IS POUNDING AND REQUIRES TYLENOL PO Q 3 HOURS. ICE HELPS A LITTLE BUT ONCE MEDICATION WEARS OFF SHE HAD SEVERE PAIN IN THESE AREAS. IT STOPS AT THE LOCATION OF THE SHOT ON HER RIGHT SIDE/ARM.


VAERS ID: 1268216 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-12
Onset:2021-04-23
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

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

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

Write-up: Patient received Janssen vaccine on 4/12 and developed left arm pain a few days later. Presented to the ED with left arm swelling 10 days after vaccination and was found to have a left upper extremity DVT.


VAERS ID: 1268618 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-13
Onset:2021-04-23
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Estrogen and progesterone prescription products. Unknown other medications
Current Illness: no
Preexisting Conditions: post menopausal other unknown
Allergies: nkda
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient is post menopausal and has not experienced vaginal bleeding for years. She experienced vaginal bleeding beginning about 9 days after being vaccinated.


VAERS ID: 1269772 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-04-23
Onset:2021-04-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 2 LA / OT

Administered by: Private       Purchased by: ?
Symptoms: Arrhythmia, Body temperature, Cardiac arrest, Computerised tomogram head, Echocardiogram, Electrocardiogram, Exercise electrocardiogram abnormal, Fall, Investigation, Pyrexia, SARS-CoV-2 test, Seizure, Troponin
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Convulsions (narrow), Acute central respiratory depression (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Other ischaemic heart disease (broad), Generalised convulsive seizures following immunisation (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Obstructive sleep apnea syndrome; Peanut allergy; Sneezing
Allergies:
Diagnostic Lab Data: Test Date: 20210423; Test Name: Febrile; Result Unstructured Data: Test Result:38+; Comments: on arrival requiring active cooling measures to maintain normothermia; Test Date: 20210423; Test Name: CT of head; Test Result: Negative ; Comments: for acute intracranial process; Test Date: 20210423; Test Name: Transthoracic echo; Result Unstructured Data: Test Result:Without regional wall abnormalities; Comments: or significant findings; Test Date: 20210423; Test Name: EKG; Result Unstructured Data: Test Result:without ischemic changes, arrhythmia; Test Date: 20210423; Test Name: Rhythm; Result Unstructured Data: Test Result:PEA; Test Date: 20210423; Test Name: PCR; Test Result: Negative ; Comments: Nasal Swab; Test Date: 20210423; Test Name: Troponin; Result Unstructured Data: Test Result:12
CDC Split Type: USPFIZER INC2021458331

Write-up: Seizure; Cardiac arrest; Arrhythmia; Began convulsing and then tipped over; Began convulsing and then tipped over; 12 lead EKG without ischemic changes, arrhythmia; Febrile 38+; This is a spontaneous report from a contactable other HCP. A 43-years-old male patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot Number: EW0169) via intramuscular route in arm left on 23Apr2021 at 12:45 as single dose for covid-19 immunisation. Historical Vaccine included first dose of bnt162b2 (Lot Number: EW0150) via intramuscular, administered in arm left on 02Apr2021at 14:15 for covid-19 immunisation. Medical history included obstructive sleep apnea, food allergy and intolerant of peanuts-causes sneezing and there were no concomitant medications. On 23Apr2021 at 18:30 the patient experienced a seizure resulting in cardiac arrest. Witnesses described patient began convulsing and then tipped over. AED applied with no shock advised. Unknown down time prior to initiation of CPR. Rhythm PEA upon arrival of EMS. 7 mins CPR before ROSC obtained. Initial Troponin 12. 12 lead EKG without ischemic changes, arrhythmia, etc. Transthoracic echo without regional wall abnormalities or significant findings. CT of head negative for acute intracranial process. No history of seizure, cardiac issues, drug use, etc. Intubated and sedated. Febrile 38+ on arrival requiring active cooling measures to maintain normothermia. The case classified as serious emergency room/department or urgent care, Hospitalization, Life threatening illness (immediate risk of death from the event). On 23Apr2021, the patient underwent lab tests and procedures which included body temperature: 38+ on arrival requiring active cooling measures to maintain normothermia, computerised tomogram head: negative for acute intracranial process, echocardiogram: without regional wall abnormalities or significant findings, electrocardiogram: without ischemic changes, arrhythmia, investigation: pea, sars-cov-2 test: negative Nasal Swab and troponin: 12. Treatment received included multiple life support measures, treatment for seizures, etc. No covid prior vaccination. Patient had covid tested post vaccination. No other vaccine in four weeks. The outcome of the events was not recovered.; Sender''s Comments: Based on strong temporal association the causal association between the reported events seizure, cardiac arrest, arrhythmia, began convulsing and then tipped over, febrile 38+ and the usage of the vaccine are considered related. The case will be reassessed once new information is available. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.


VAERS ID: 1269952 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-04-23
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Dyspnoea, Feeling hot, Gangrene, Heart rate increased, Peripheral swelling, Rhinorrhoea, Thrombosis
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), 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? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: TRICOR [FENOFIBRATE]; LANTUS; NOVOLOG; EMPAGLIFLOZIN; PIOGLITAZONE HCL; LOSARTAN; AMLODIPINE BESYLATE
Current Illness: Blood pressure high; Diabetes
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210448390

Write-up: BLOOD CLOT IN LEG; SHORTNESS OF BREATH; HEART RATE INCREASED; GANGRENE IN TOE; RIGHT LEG SWOLLEN; RIGHT FOOT SWOLLEN; CHILLS; RUNNY NOSE; FEELING HOT; This spontaneous report received from a patient concerned a 50 year old male. The patient''s height and weight were not reported. The patient''s concurrent conditions included high blood pressure and diabetes. The patient received COVID-19 vaccine Ad26.CoV2.S (suspension for injection, route of administration not reported, batch number 1802070, expiry date unknown), dose not reported, 1 total administered on 19-APR-2021 for prophylactic vaccination on left arm. Concomitant medications included amlodipine besilate for drug used for unknown indication, empagliflozin for drug used for unknown indication, fenofibrate for drug used for unknown indication, insulin aspart for drug used for unknown indication, insulin glargine for drug used for unknown indication, losartan for drug used for unknown indication, and pioglitazone hydrochloride for drug used for unknown indication. On an unspecified date (reported as 22-MAR-2021; 28 days prior to vaccination), the patient experienced shortness of breath, heart rate increased, runny nose, chills and was hospitalized (date unspecified). He reported that on this past Saturday, 17-APR-2021 (2 days prior to vaccination), he went to the emergency room. He reported that his toenails were coming off, the skin on his toes was coming off, and he had swelling in his right foot and up his leg. He says there was no circulation going to his toe and he was diagnosed with having a blood clot in his right leg. He says he had surgery to open up the arteries in his leg, and also reported gangrene in his toe. The subject was discharged on 21-APR-2021. On 23-APR-2021, the patient experienced feeling hot. He also reported that he may need to have his right pinky (fifth) toe amputated because it has gangrene. He reported that he is going to go back to the hospital, to which he would seek medical attention if he was having issues. Treatment medications (dates unspecified) included paracetamol. When called back due to his vaccination dates being after event start dates, the patient said that his memory is not too good, so he ''had to take his time to remember the correct dates''. The action taken with COVID-19 vaccine Ad26.CoV2.S was not applicable. The patient was recovering from blood clot in leg, and had not recovered from runny nose, shortness of breath, heart rate increased, chills, feeling hot, gangrene in toe, right leg swollen, and right foot swollen. This report was serious (caused hospitalization).; Sender''s Comments: V0: This 50-year-old hypertensive and diabetic male patient reported that he was feeling hot and may need to have his fifth toe amputated because it has gangrene 4 days after receiving COVID-19 VACCINE AD26.COV2.S for the prevention of symptomatic SARS-CoV-2 virus infection and 2 days after discharge form the hospital. The patient was hospitalized for shortness of breath, heart rate increased, runny nose, and chills 28 days prior to vaccination. The patient went to the emergency room 2 days prior to vaccination because his toenails/skin on his toes were coming off, swelling in his right foot and up his leg, gangrene in his toe; he reported that there was no circulation going to his toe and was diagnosed with having a blood clot in his right leg; the patient reported he had surgery to "open up" the arteries in his leg. Four days after vaccination, the patient felt hot and reported reported that he may need to have his right pinky (fifth) toe amputated because it has gangrene. The patient is taking paracetamol as treatment. No other details was reported. Based on the lack of temporal association, the causality is considered not related for the events blood clot in leg, shortness of breath, heart rate increased, right leg swelling, right foot swelling, chills, and runny nose. The information available regarding event gangrent of fifth toe and feeling hot precludes a complete and meaningful assessment. However, considering the temporal relationship and recently evolving theories in the literature about COVID infections and vaccinations, potential vaccine contribution cannot be excluded. Additional information was requested.


VAERS ID: 1270009 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Florida  
Vaccinated:2021-04-23
Onset:2021-04-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Eye contusion, Eye haemorrhage, Ocular hyperaemia
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Glaucoma (broad), Retinal disorders (broad)

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

Write-up: rupture in blood vessels; one eye is black; blood shot; This spontaneous case was reported by a consumer and describes the occurrence of EYE HAEMORRHAGE (rupture in blood vessels) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 23-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 23-Apr-2021, the patient experienced EYE HAEMORRHAGE (rupture in blood vessels) (seriousness criterion medically significant), EYE CONTUSION (one eye is black) and OCULAR HYPERAEMIA (blood shot). At the time of the report, EYE HAEMORRHAGE (rupture in blood vessels), EYE CONTUSION (one eye is black) and OCULAR HYPERAEMIA (blood shot) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No treatment information was provided. No concomitant medication was provided. Company Comment Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.


VAERS ID: 1270012 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: New York  
Vaccinated:2021-02-11
Onset:2021-04-23
   Days after vaccination:71
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004M20A / 2 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Appendicitis, Computerised tomogram
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: No medical history was reported
Allergies:
Diagnostic Lab Data: Test Date: 20210424; Test Name: CT; Result Unstructured Data: Acute Appendicitis
CDC Split Type: USMODERNATX, INC.MOD20210

Write-up: Abdominal Pain; This spontaneous case was reported by a health care professional and describes the occurrence of APPENDICITIS (Abdominal Pain) in a 55-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 004M20A) for COVID-19 vaccination. No medical history was reported. On 11-Feb-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 23-Apr-2021, the patient experienced APPENDICITIS (Abdominal Pain) (seriousness criteria hospitalization and medically significant). The patient was hospitalized on 24-Apr-2021 due to APPENDICITIS. The patient was treated with Surgery (Appendectomy) for Appendicitis. At the time of the report, APPENDICITIS (Abdominal Pain) was resolving. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 24-Apr-2021, Computerised tomogram: abnormal (abnormal) Acute Appendicitis. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Company comment: Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded; Sender''s Comments: Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded


VAERS ID: 1270153 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-03-11
Onset:2021-04-23
   Days after vaccination:43
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 RA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Pravastatin 20 mg and vitamin D
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Went to minor care they sent me to the hospital had an ultrasound done say that I had a blood clot
CDC Split Type:

Write-up: Left leg start swelling And hurting


VAERS ID: 1270699 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-08
Onset:2021-04-23
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Thrombophlebitis superficial, Ultrasound scan
SMQs:, Embolic and thrombotic events, venous (narrow), Thrombophlebitis (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: went in to ER had sonogram showed not deep thrombosis only superficial
CDC Split Type:

Write-up: superficial blood clot in right leg


VAERS ID: 1272516 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-07
Onset:2021-04-23
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-04-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Tinnitus
SMQs:, Hearing impairment (narrow)

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

Write-up: Tinnitus in right ear


VAERS ID: 1228898 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-12
Onset:2021-04-22
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Asthenia, Blood test abnormal, Dehydration, Diarrhoea, Dyspnoea, Gait inability, Lymphocyte count increased, Red blood cell count increased
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (narrow)

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

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


VAERS ID: 1240228 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-04-19
Onset:2021-04-22
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 04213211 / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Sertraline 50 mg
Current Illness: No
Preexisting Conditions: None
Allergies: Latex
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Raised rash appeared at injection site


VAERS ID: 1240237 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-04-21
Onset:2021-04-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Diarrhoea
SMQs:, 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Famotidine 20 MG
Current Illness: None
Preexisting Conditions: IBS
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Diarrhea after the second dose. No reaction from first dose


VAERS ID: 1240251 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-21
Onset:2021-04-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / 2 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Diarrhoea, Fatigue, Injection site pain, Muscle fatigue
SMQs:, Rhabdomyolysis/myopathy (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (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? No
Hospitalized? No
Previous Vaccinations: Fatigue
Other Medications: Buspar
Current Illness: A cold one week prior
Preexisting Conditions: Orthostatic hypotension
Allergies: Lactose sensitivity, allergic to Cipro
Diagnostic Lab Data:
CDC Split Type:

Write-up: Sore injection site, muscle fatigue, tired, diarrhea


VAERS ID: 1240486 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-20
Onset:2021-04-22
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro, prenatal, Buspirone
Current Illness: Miscarriage
Preexisting Conditions: PE, EOE, GERD, PMDD, PCOS, DDD, obesity
Allergies: Corn, soy, peanuts, watermelon Clindamyocin, Wellbutrin, Abilify, morphine, diladid, xarelto
Diagnostic Lab Data:
CDC Split Type:

Write-up: I am having extreme shortness of breath and sharp chest and right shoulder pains. I also feel congested and really exhausted.


VAERS ID: 1240497 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-17
Onset:2021-04-22
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / IM

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

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

Write-up: I felt an nodule on my left collarbone its was moving while I moved my neck , It is not painful and pea sized I didn?t get it checked by a doctor yet


VAERS ID: 1240705 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-21
Onset:2021-04-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / SYR

Administered by: School       Purchased by: ?
Symptoms: Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: Vomiting approx 18 hours after 2nd dose. Did not eat anything unusual or different and drank plenty of water and gatorade


VAERS ID: 1241106 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-21
Onset:2021-04-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Headache, Nausea, Pain in extremity, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Fever, chills, nausea, headache, and arm soreness. Teeth chattering from chills.


VAERS ID: 1241114 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-04-22
Onset:2021-04-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chills, Fatigue, Feeling cold, Feeling hot, Headache, Hyperhidrosis, Neck pain, Paranasal sinus discomfort
SMQs:, Neuroleptic malignant syndrome (broad), Arthritis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lamotrogine, Preponanol, turmeric, vitamin C, fish oil, apple cider vinegar
Current Illness: N/A
Preexisting Conditions: Bipolar I disorder
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Around 6:30 pmI began feeling chills and incredibly tired. I became sore all over and began shaking uncontrollably because of the chills. I went to sleep around 7pm and woke up 20 minutes laterwith the worst fever I ever had. I was extremely hot but when I lifted the covers I would immediately get cold. I got out of bed around 3am because I was very thirsty and completly stuffed up in my head and sinuses. I used vicks sinex and drank water and tea. I was very cold when i got out of bed. I went back to bed and woke up every 30 mins or so very hot and chilly when I lifted the covers. I finally got out of bed at 6am. At that point I had sweated through two shirts, my sheets and comforter. When i got out of bed I was no longer chilly. I had a mild headache, sinus pressure and soreness throughout my neck and shoulders. Throughout the day (April 21, 2021) I would get chills and then get hot. I continued to havce sinus pressure and a mild headache. I went to bed around 8:30pm and woke up at 3:00am. when I woke up I had sweated through half my shirt. At the time of writing (April 22, 2021 @ 6:08am) I feel slight sinus pressure, no headache and get chills and hot from time to time.


VAERS ID: 1241117 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-04-14
Onset:2021-04-22
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030B21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Axillary pain, Dizziness, Headache, Injection site rash, Injection site swelling, Lethargy, Pain in extremity
SMQs:, 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), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin d, b-complex
Current Illness: Extreme headache, dizziness, fatigue, pain at injection site, and then an achey pain deep in armpit (lymph?) and finally a large itchy swelling (looks like the ?COVID arm?).
Preexisting Conditions: I have had high blood pressure in the past.
Allergies: Pennicilins
Diagnostic Lab Data:
CDC Split Type:

Write-up: Within minutes of injection developed sore arm. Next day I had an extreme headache, dizziness, lethargy. About four or five days later I developed a pain in my left armpit and wasn?t sure if it was my lymph nodes or a scapular muscle. I woke up a weeke later with a large swollen rash at the injection site, about 2? in diameter.


VAERS ID: 1241680 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-22
Onset:2021-04-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Nausea, Pharyngeal swelling
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Generic brand of benicar for HTN. No other medications reported.
Current Illness: none reported
Preexisting Conditions: Hypertension
Allergies: None reported
Diagnostic Lab Data:
CDC Split Type:

Write-up: Client states that 5 minutes post vaccination he began to feel swelling of the throat, dizziness and nausea. Observation area leads alerted by nurse and MD notified. Client evaluated by observation leads and given Benadryl 50 mg/1ml. Symptoms improved and client released by Dr.


VAERS ID: 1241696 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-22
Onset:2021-04-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0161 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Hypertension, Limb discomfort, Nervousness, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Hypertension (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: 55 y/o female, with no past medical history, who presents with Right arm tingling post vaccination. Patient states that this is her first dose in the two-dose series. Patient denies previous vaccination reactions. Patient received her vaccination to the Right arm. Patient states that she also feels anxious and nervous. Patient denies sore throat, difficulty swallowing, chest pain or difficulty breathing. NP and Paramedics at patient side. Patient provided with a bottle of water and legs were elevated. Within 3 minutes patient stated that tingling resolved. Patient noted to be hypertensive (172/104) with all other vital signs normal. Patient denies medical history of hypertension. Patient moved to the partitioned off area and placed on cot. Patient vitals monitored every 5 mins for 1 hour. Patient became normotensive and stated that symptoms had resolved. Patient discharged home in stable condition.


VAERS ID: 1241705 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-22
Onset:2021-04-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0165 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Cataplexy, Fear of injection, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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

Write-up: PT SEEMED TO BE AFRAID OF NEEDLE HE CLOSED HIS EYES AND LOOKED AWAY WHILE PRIMARY NURSE DID INJECTION AFTER INJECTION HE STATED "I FEEL SOMETHING" HIS BODY THEN WENT LIMP SECONDARY NURSE WAS BY HIS SIDE ALREADY HELP HIM UP AND CODE GREEN WAS CALLED. PT WAS TRANSFERED TO SUPINE POSITION CONSCIOUS AT THIS POINT WHEN LAYED DOWN. VSS WITH EMT. PT WAS MONITORED X30 MIN WAS COHERENT, WHEELED TO CAR PARTNER DROVE HIM HOME, REFUSED HOSPITAL.


VAERS ID: 1241927 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-01
Onset:2021-04-22
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Injection site streaking
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Had red streaks on left arm day after immunization - no pain and did go away


VAERS ID: 1242136 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-08
Onset:2021-04-22
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chills, Fatigue, Nausea, Pain, Rash, Retching, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: initial side effects chills, achy, fatigue lasting approximately 48 hours. 4/8-4/10/2021 startled awake from sleep with feeling of vomit in throat that was gagging me that I was able to swallow back down. the nauseous wasn''t going away so went to bathroom and vomited around 12am Thursday 4/22/2021 for about 15 minutes, woke up with rash on my face and neck


VAERS ID: 1242227 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-22
Onset:2021-04-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8736 / 1 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Injection site rash, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: The patient had a localized rash near the injection site. The patient was told to monitor the rash and report to the ED if symptoms continue or worsen.


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