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

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



Case Details

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VAERS ID: 1243563 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-12
Onset:2021-04-16
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / 1 UN / UN

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Blood creatine phosphokinase normal, Chest X-ray normal, Chest discomfort, Computerised tomogram head normal, Electrocardiogram normal, Headache, Muscle twitching, Paraesthesia, Troponin, White blood cell count decreased
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Haematopoietic leukopenia (narrow), Peripheral neuropathy (broad), Systemic lupus erythematosus (broad), Retroperitoneal fibrosis (broad), Dyskinesia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: Hypertension, alcoholism, prostatitis
Allergies: Bactrim DS, Cipro
Diagnostic Lab Data: ekg-normal sinus rythym chest xray-unremarkable Abdominal series-fecal filled colon. ct head-no acute hemorrhage CK-110 troponin-<0.01 wbc-4.9
CDC Split Type:

Write-up: pins & needles sensation and "twitching" in muscles of bilateral lower extremeties, chest discomfort, abdominal pain, headache


VAERS ID: 1243678 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-09
Onset:2021-04-14
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Ecchymosis, Full blood count, Haematuria, Platelet count decreased, Reticulocyte count, Urine analysis
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Tubulointerstitial diseases (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Try-Estreylla
Current Illness: none
Preexisting Conditions: none
Allergies: None
Diagnostic Lab Data: CBC, urinalysis, reticulocyte count (4/14/2021)
CDC Split Type:

Write-up: Significant ecchymosis posterior legs and buttocks without trauma along with hematuria. Slightly low platelet count. Spontaneous resolution.


VAERS ID: 1243702 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-03-30
Onset:2021-04-13
   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 / IM

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, Headache, Muscular weakness, Pain in extremity, Peripheral swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Rosuvastatin, calcium, Zetia, gabapentin, xanax, fioricet, pantoprazole
Current Illness:
Preexisting Conditions: migraine, gerd, hyperlipidemia, MDD, Anxiety, cervical spinal stenosis, back pain, chronic fatigue, vit d deficiency, osteoporosis
Allergies: sulfa drugs, tetracycline, demerol, codeine, vicodin, ibuprofen, nitrofurantoin
Diagnostic Lab Data:
CDC Split Type:

Write-up: severe headache, fatigue, left arm pain and weakness, leg swelling


VAERS ID: 1243796 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-06
Onset:2021-03-31
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Mobility decreased, Pain, Pruritus
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

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

Write-up: itching all over skin, numbness ad pain, couldn''t move hands


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

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

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

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


VAERS ID: 1243927 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Facial paralysis, Gingival ulceration, Headache, Hypoaesthesia, Oropharyngeal pain, Pyrexia, Vision blurred
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gingival disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hearing impairment (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Low dose naltrxon 3 mg, Vitamin D, Omega 3, Multivitamin
Current Illness: N/a
Preexisting Conditions: Multiple Sclerosis
Allergies: N/a
Diagnostic Lab Data:
CDC Split Type:

Write-up: The night following my vaccination I ended up with a fever of over 100 degrees Fahrenheit and also suffered from a severe headache and sore throat. The fever and headache subsided after 24 hours, but the sore throat and ulcers on my gum line remained for the next 3-4 days. 9 days after I had gotten the vaccine, I started suffering from what I thought was a significant MS relapse. The left side of my face went numb and started drooping, my legs went completely numb, and my vision went blurry.


VAERS ID: 1243966 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test normal, Chest X-ray normal, Chills, Dizziness, Dyspnoea, Headache, Oropharyngeal pain
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lorazepam(Atvian), Escitalopram(Lexapro) ,Ashwagandha
Current Illness: none
Preexisting Conditions: Generalized Anxiety Disorder
Allergies: pollen
Diagnostic Lab Data: blood tests and chest xray by doctor(Apr 14, 2021) normal blood tests and chest xray by er (April 18,2021) normal
CDC Split Type:

Write-up: right after vaccine(April 7): chills, dizziness day after vaccine(April 8):headache, sore throat, chills, shortness of breath, lightheadedness dizziness varying in intensity by day until today(April 9-22):shortness of breath, lightheadedness, dizziness


VAERS ID: 1243975 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-02
Onset:2021-04-12
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Blood test abnormal, Computerised tomogram thorax abnormal, Echocardiogram, Electrocardiogram, Pulmonary embolism, SARS-CoV-2 test, Ultrasound Doppler
SMQs:, Embolic and thrombotic events, venous (narrow), Pulmonary hypertension (broad), Cardiomyopathy (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Cortef 15mg daily, doxycycline 100mg x2 daily, Omeprazole 20mg daily, Finasteride 1/5mg daily, Allegra allergy, Nasacort at night. The various IV treatments and supplements I take for chronic fatigue have since been reviewed by my Hematolo
Current Illness: Unconfirmed tick bite that looked like Lyme disease (doxycycline started April 7) and mild acid reflux (Omeprazole started in late March)
Preexisting Conditions: Chronic Fatigue Syndrome
Allergies: Valium, erythromycin
Diagnostic Lab Data: See above. Ultrasound of legs, blood tests, right heart "echo" scan, EKGs, COVID-19 test and other tests performed. Do not have a full list. Damage to right lung tissue.
CDC Split Type:

Write-up: Pulmonary embolism symptoms felt April 12, 13. Pulmonary infarction felt night of April 15th forward. Blood test was positive for possible clots done April 16th. CT/CTA chest scan done at hospital (also April 16th) confirmed the above embolism and infarction. Blood thinner via shots, then via tablet (Xarelto) until discharge on April 17th. Continuing on Xarelto.


VAERS ID: 1244000 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-03-09
Onset:2021-04-15
   Days after vaccination:37
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: 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)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: allegra, fluticasone, protonix, Toprol XL, amlodipine, metformin, insulin-lantus, actos, Lipitor, biotin, aspirin, vitamin D3, fish oil, nitroglycerin as needed.
Current Illness: None
Preexisting Conditions: Coronary arteriosclerosis, hypertension, Type II Diabetes mellitis with hyperglycemia.
Allergies: jardiance, trulicity
Diagnostic Lab Data: Ultrasound to rule out clots. Diagnosis: superficial clots.
CDC Split Type:

Write-up: Swelling in ankle, then in right leg.


VAERS ID: 1244022 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-10
Onset:2021-04-21
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Fatigue, Feeling abnormal, Hypoaesthesia, Pain in extremity
SMQs:, Peripheral neuropathy (broad), Dementia (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

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

Write-up: Reports bilateral calf pain with numbness concerning for bilateral DVT. Symptoms began night of 4/21/21. Reports feeling brain fog and fatigue.


VAERS ID: 1244060 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-04-10
Onset:2021-04-13
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Acute kidney injury, Anticoagulant therapy, Blood creatinine increased, Blood potassium increased, Blood urea increased, Cellulitis, Deep vein thrombosis, Erythema, Hydronephrosis, Hyperkalaemia, Limb injury, Peripheral swelling, Platelet count normal, Ultrasound Doppler abnormal, Ultrasound kidney abnormal, Ventilation/perfusion scan normal
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Retroperitoneal fibrosis (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Chronic kidney disease (broad), Hypersensitivity (broad), Tumour lysis syndrome (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: tamsulosin, simvastatin, potassium chloride ER, fish oil, multivitamin, midodrine, lisinopril, furosemide, ferrous sulfate, digoxin
Current Illness:
Preexisting Conditions: COPD, hypertension, bladder cancer, OSA, anemia, atrial fibrillation
Allergies: penicillins
Diagnostic Lab Data: 4/22/21: Renal ultrasound: bilateral hydronephrosis SCr: 4.59; BUN: 87 K: 6.1 Platelets: 178 V/Q scan: low probability of PE Lower extremity doppler: left superficial femoral vein thrombus
CDC Split Type:

Write-up: Patient received the vaccine on 4/10/21 and a few days later hit his leg, which subsequently became erythematous and swollen. He went to urgent care on 4/13/21 and received a prescription for doxycycline which he stopped taking prior to resolution of symptoms due to side effects from the medication. He was prescribed clindamycin, but did not start this medication. Patient had outpatient labwork this morning which revealed an elevated SCr, for which he was sent to the ED. The patient was found to have AKI with hyperkalemia, as well as left lower extremity DVT and cellulitis. Patient is being treated with heparin and linezolid, as well as Kayexalate. The patient is being admitted to the hospital for treatment.


VAERS ID: 1244066 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-07
Onset:2021-04-21
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 RA / IM

Administered by: Pharmacy       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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: None
Preexisting Conditions: Past history of cardiac event
Allergies: None
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: pain in lower extremity for more than one day


VAERS ID: 1244067 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Hypotension, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: Patient experienced syncope and hypotension, transported to hospital via ambulance


VAERS ID: 1244271 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-12
Onset:2021-04-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram head abnormal, Immune thrombocytopenia, Immunoglobulin therapy, Platelet count decreased, Subdural haematoma
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Haemorrhagic central nervous system vascular conditions (narrow), Accidents and injuries (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ibuprofen 600mg PO BID
Current Illness: none
Preexisting Conditions: Obesity, arthritis
Allergies: penicillins
Diagnostic Lab Data: Platelets 2000 4/14, Head CT 4/14: SDH of left frontal lobe Platelets 23K 4/15 after transfusion, 10mg dexamethasone q6h Platelets 48K 4/16 prior to starting IVIG. After 4 days of IVIG and dexamethasone, platelets recovered at 156K.
CDC Split Type:

Write-up: ITP with platelet count of 2K. Presented with subdural hematoma. Platelets recovered with dexamethasone 40mg PO daily and IVIG 400mg/m2 daily x 4 days. No further brain bleed.


VAERS ID: 1244300 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 19 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Abnormal faeces, Blood test, Decreased appetite, Dizziness, Headache, Hyperhidrosis, Hypersomnia, Movement disorder, X-ray
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Biliary system related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Noninfectious diarrhoea (broad), Hypoglycaemia (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, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Meds/Baclofen-20mg 3 times a day /muscle spasm daily for pain. Ibuprofen 8 hours for pain Special diet rice potatoes and pastas and broth
Current Illness: Headache light breath pain in upper neck area and sharp pain on left side of body
Preexisting Conditions: CAnt stand for long due to pain in arm and neck
Allergies: Noun
Diagnostic Lab Data: Went to hospital had to be tested and on machines X-rays and vitals blood with draw
CDC Split Type:

Write-up: Light headed rocking back and forth sweating pooping can?t eat headache sleeping more


VAERS ID: 1244325 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-18
Onset:2021-03-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Dizziness, Dyspnoea, Flushing, Palpitations
SMQs:, Anaphylactic reaction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (broad)

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

Write-up: Patient felt sudden onset of flushing with palpitations and chest tightness. She also reported shortness of breath and dizziness.


VAERS ID: 1244351 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-03-31
Onset:2021-03-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain, Alopecia, Arthralgia, Asthenia, Back pain, Contusion, Dizziness, Dyspnoea, Fatigue, Fibrin D dimer, Headache, Hypoaesthesia, Neck pain, Pain in extremity, Peripheral swelling, Petechiae, Tremor
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: SULFA DRUGS (RASH)
Diagnostic Lab Data: I have ran multiple labs on the patient to include Chemistry, Hematology, COAGs, and other testing on her first visit with me on April 6, 2021. After I referred her case to another Dr. on April 13, 2021, a DDIMER was ordered and was positive at 277 ng/mL. I did refer the pt to Hematology for expert evaluation on April 20, 2021. She returns today, April 21, 2021, at my request, to have repeat labs drawn. I did repeat the DDIMER being it was positive last week at 277ng/mL. Again, the DDIMER was positive at 259ng/mL today. I received a call from Dr., Hematology/Oncology at Oncology this AM. Dr. had read my consult note and recommended that the pt be sent to a larger facility that could do more in-depth testing; he noted his facility has limited testing ability. Dr. also recommended that an MRI of head be ordered due to neuro symptoms being displayed with head and neck pains, tremors, and dizziness. Case management is working new referral to possibly Hematology for MRI and more in-depth Evaluation and Management.
CDC Split Type:

Write-up: ** Backache - As of this visit today, April 21, 2021, pt still has c/o continuous back pains all down her spine since receiving the Johnson & Johnson COVID-19 Vaccine on March 31, 2021. patient continues to report pain in her neck (cervical), thoracic, and lumbar spine. She insists that the cervical pain radiates into both shoulders and down to her arms bilaterally. She states these pains started almost immediately after receiving the vaccine and persists as of today. On a scale of 0-10, patient rates her spine and shoulder pains at 3 continuously. -- I''ve added methocarbamol 750mg tid for muscle relaxant with ibuprofen 400mg q6h. ** Severe headache - As previously noted in my previous findings with patient she reported having moderate headaches for two days after receiving the J&J COVID-19 Vaccine on March 31, 2021 but she states her headaches have now subsided. *** Other: On my first visit with patient on April 6, 2021, she was very concerned about a sudden loss of hair since taking the J&J Vaccine in addition to the spine pains and bruising. ** Leg swelling - patient reported both leg and hand swelling for 2 days after receiving J&J COVID-19 Vaccine with some new neurologic symptoms as noted below: ** New neurologic symptoms -patient continues to report significant weakness and fatigue. -- Her headaches that were present after receiving the vaccine have subsided after the first two days following the vaccine being administered. -- She reported new numbness x 2 days in both fingers and toes bilaterally with both hands and legs swelling immediately after receiving the vaccine. -- She also reported 2 hours of dizziness immediately after receiving the vaccine on March 31, 2021. -- patient reported a new onset of hand tremors that suddenly came on a week ago Sunday, April 11, 2021 while fishing that lasted for a few hours. She stated that the tremors would come and go for a while. -- patient has been and is currently negative for loss of consciousness, seizures, and migraines. ** Severe abdominal pain - patient initially reported episodic sharp shooting pains in abdominal area on multiple occasions after receiving the vaccine but have mostly now subsided. However, today, April 21, 2021 she reports more abdominal shooting "Sharp Pains" in her RUQ this morning that she rated 3/10 pain, and LLQ "Sharp Shooting" pain last Friday, 4/16/21. She states that the shooting pains last approximately 3 minutes in duration. ** Shortness of breath ? patient has continuous episodic shortness of breath complaints that have persisted since receiving the vaccine on March 31, 2021. Her last episode was again this morning, April 21, 2021 and she also states she is feeling like she is having trouble breathing during the exam today. Her SaO2 is 98% on Room Air during triage. She also reported yesterday, the same at the Clinic. She reported being at work on Monday, April 19, 2021 and became short of breath and had to lay down on the floor to breath easier. patient is a Kindergarden teacher. She also became short of breath Monday evening while at home while cleaning her closet. -- Yesterday, April 20, 2021 at Clinic I added a rescue inhaler for her shortness of breath. ** Petechiae (tiny red spots on the skin) - patient reported a new eruption on her upper back and shoulders after receiving J&J Vaccine. While the red spots are not bleeding, there was a significant notable rash to bilateral shoulders and upper back when I last saw her a week ago on April 13, 2021 at the Clinic. Today, the rash has cleared significantly. She was prescribed TRIAMCINOLONE 0.025% (80GM) OINT,TOP in Urgent Care last week, when I referred her to Dr. in the ER. ** New or easy bruising - multiple new bruising noted today on her left bicep arm. Yesterday, April 20, 2021 at the Clinic, I noted new bruising on lower extremities in addition to the bruising noted the week prior. The bruising started after receiving the J&J COVID-19 Vaccine that I noted in my previous findings last week.


VAERS ID: 1244361 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-19
   Days after vaccination:11
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: Public       Purchased by: ?
Symptoms: Abdominal pain upper, Blood test normal, Chest X-ray, Dizziness, Electrocardiogram normal, Hyperaesthesia, Pain, Platelet count increased, Ultrasound abdomen normal
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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Wellbutrin Gabapentin Vitamin B12 Vitamin D Fish Oil
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: ECG - normal Full bloodwork panel - normal, except for elevated platelet count Chest x-ray - normal Ultrasound of abdomen - normal
CDC Split Type:

Write-up: Monday April 19, I started feeling woozy/dizzy, uncomfortable. Tuesday April 20, I went to Urgent Care in the afternoon, as I was also experiencing a stomachache. I feel achey, like I have the flu, but I don''t have a fever, or any congestion. My pain sensitivity is heightened (ie, bumping my knee is much more painful than usual).


VAERS ID: 1244714 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test normal, Body temperature decreased, Bone pain, Chest X-ray normal, Chest pain, Chills, Electrocardiogram normal, Feeling abnormal, Feeling cold, Headache, Hypertension, Mobility decreased, Pain in extremity, Rectal haemorrhage, Ultrasound Doppler, Ultrasound scan normal
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Dementia (broad), Parkinson-like events (broad), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Ischaemic colitis (broad), Hypertension (narrow), Cardiomyopathy (broad), Osteonecrosis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: multi vitamin, birth control pill, probiotic
Current Illness: non known
Preexisting Conditions: non known
Allergies: penicillin
Diagnostic Lab Data: EKG - April 16th Chest Xray - April 16th Blood Work - April 16th Vascular Ultrasound - April 19th
CDC Split Type:

Write-up: by 4:45 pm I felt off. By 6:30 pm I felt like I couldn''t move very well. It affected all the bones I have ever broken or sprained before. Had cold chills, my temperature was 95.1. I felt like my blood pressure was high. I had a bad headache and took advil. April 11th I still felt off and had a headache. Around 4:30 pm I had rectal bleeding. Wednesday April 14th I had very bad leg pain in my right leg. Friday April 16th I went to urgent care for Leg pain and slight chest pain. They sent me to the ER. I had a chest Xray and ekg done and both came back normal. I was able to have a vascular ultrasound Monday April 19th in right leg and it showed no blood clots. I still have leg pain April 22nd.


VAERS ID: 1244815 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-03-21
Onset:2021-04-14
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Cerebral haemorrhage, Communication disorder, Computerised tomogram head abnormal, Magnetic resonance imaging head abnormal
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhagic central nervous system vascular conditions (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: 81 mg of aspirin daily
Current Illness: None
Preexisting Conditions: Polycystic kidney disorder, aneurysm
Allergies: None
Diagnostic Lab Data: Multiple CT scans, MRI, and blood samples.
CDC Split Type:

Write-up: Pt had a brain bleed on April 14th at approximately 2:00 in the afternoon and was emergency airlifted to Medical Facility. She stayed at hospital until April 21st. Pt is currently unable to read and recall information such as words, and her own birthday.


VAERS ID: 1244824 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-04
Onset:2021-04-16
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Computerised tomogram, Ear pain, Electrocardiogram, Fibrin D dimer normal, Headache, Vertigo
SMQs:, Vestibular disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Prednisone
Diagnostic Lab Data: Yes. Er twice. D-timer test negative Ct scan EKG
CDC Split Type:

Write-up: Vertigo current Ear pain Headache


VAERS ID: 1244923 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: South Carolina  
Vaccinated:0000-00-00
Onset:2021-04-04
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abnormal dreams, Body temperature, COVID-19, Eructation, Feeling abnormal, Gastrointestinal sounds abnormal, Hypersomnia, Influenza virus test, Night sweats, Nightmare, SARS-CoV-2 test, Sleep talking
SMQs:, Acute pancreatitis (broad), Dementia (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (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: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210403; Test Name: Body temperature; Result Unstructured Data: 102.7 F; Test Date: 20210404; Test Name: Body temperature; Result Unstructured Data: 102 F; Comments: Tuesday at 3:40 am.; Test Date: 20210404; Test Name: Body temperature; Result Unstructured Data: 101 F; Comments: Tuesday at noon.; Test Date: 20210405; Test Name: Body temperature; Result Unstructured Data: upto 102.7 F; Test Date: 20210406; Test Name: Body temperature; Result Unstructured Data: 101 F; Test Date: 202104060340; Test Name: Body temperature; Result Unstructured Data: 102 F; Test Date: 20210407; Test Name: Rapid influenza diagnostic test; Result Unstructured Data: Negative; Comments: Went to urgent care yesterday (Wednesday morning), for flu test and was negative.; Test Date: 20210408; Test Name: Body temperature; Result Unstructured Data: 100 F; Test Date: 20210408; Test Name: COVID-19 virus test; Result Unstructured Data: Positive
CDC Split Type: USJNJFOC20210413330

Write-up: COVID INFECTION; STOMACH GURGLING; BURPING; SLEPT ALL DAY; BRAIN FOG; 2 NIGHTS OF BAD DREAMS; TALKING IN SLEEP; BROKE INTO A SWEAT/ SWEATED TERRIBLY LAST NIGHT; VIVID DREAMS; This spontaneous report received from a patient''s wife concerned a 53 year old male. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: unknown) dose was not reported, administered to right arm on 02-APR-2021 around 15:00 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 03-APR-2021, the patient experienced 102.7 fever, some dry cough. Laboratory data included: Body temperature (NR: not provided) 102.7 F. On 04-APR-2021, the patient experienced chills, broke into a sweat and had vivid dreams. Laboratory data included: Body temperature (NR: not provided) 102 F, 101 F. On 05-APR-2021, the patient also had brain fog, two nights of bad dreams, talking in sleep, back pain, fatigue, slept all day. Laboratory data included: Body temperature (NR: not provided) upto 102.7 F. On 06-APR-2021, the patient experienced stomach gurgling, diarrhea, weakness, burping, body ache. Laboratory data included: Body temperature (NR: not provided) 101 F. On 06-APR-2021 03:40, Laboratory data included: Body temperature (NR: not provided) 102 F. On 07-APR-2021, the patient experienced muscle aches, back ache was at level 9, sweated terribly at night and the patient went to urgent care and they did flu test. Laboratory data included: Rapid influenza diagnostic test (NR: not provided) Negative. On 08/Apr-2021, the patient had stomach still gurgling, back ache was at level 9, tiredness, weakness, achiness, brain fog, fever was back at a 100F and diarrhea. On the same day, the patient was tested positive for Covid-19 (coded to confirmed Covid-19 Infection: chills, fever, muscle aches, joint pain, diarrhea, back pain/ back ache, dry cough, fatigue/ tiredness, weakness, and body ache/ achiness). Laboratory data included: COVID-19 virus test (NR: not provided) Positive. On 12-Apr-2021 he was hospitalized. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from brain fog, Covid infection, stomach gurgling, and broke into a sweat/ sweated terribly last night, and the outcome of 2 nights of bad dreams, talking in sleep, vivid dreams, slept all day and burping was not reported. This report was serious (Hospitalization Caused / Prolonged). Initial information was received on 07-APR-2021. With additional information obtained via telephone follow up from a wife on 15-Apr-2021 case was assessed as serious.; Sender''s Comments: 20210413330- Covid-19 vaccine ad26.cov2.s- Covid infection. This event is considered unassessable. The event has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event.


VAERS ID: 1244927 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-04-01
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chest discomfort, Fatigue, Musculoskeletal pain
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210420593

Write-up: The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808609 and expiry: UNKNOWN) dose was not reported, administered on 03-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On APR-2021, the subject experienced chest tightness. On APR-2021, the subject experienced muscle pain in butt. On APR-2021, the subject experienced overly tired. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from chest tightness, muscle pain in butt, and overly tired. This report was non-serious.; Sender''s Comments: V0- Medical Assessment comment not required as per standard procedure as the case assessed as non-serious.


VAERS ID: 1244931 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-04-07
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Blood test, Body temperature, Chest discomfort, Chest pain, Chills, Cough, Feeling abnormal, Headache, Hypoaesthesia, Incorrect dose administered, Injection site bruising, Malaise, Off label use, Pain, Paraesthesia, Pyrexia, Sleep disorder, Tremor, White blood cell count increased
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Arthritis (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Alcoholic (occasionally); Allergic reaction to antibiotics; Asthma (diagnosed at 5 to 6 years of age. unspecified inhaler.); Drug allergy; Seasonal allergy
Preexisting Conditions: Medical History/Concurrent Conditions: Ankle operation; Comments: The patient received 2nd shot of vaccination.
Allergies:
Diagnostic Lab Data: Test Date: 20210407; Test Name: Body temperature; Result Unstructured Data: 104 F; Test Date: 20210409; Test Name: Blood test; Result Unstructured Data: Elevated WBC otherwise negative
CDC Split Type: USJNJFOC20210420786

Write-up: WBC INCREASED; COUGH; OFF LABEL USE; INAPPROPRIATE DOSE OF DRUG ADMINISTERED; RIGHT SHOULDER HURT FROM THE INJECTION SITE TO THE BICEP; NUMB FROM HEAD TO TOE; BRUISED AT THE INJECTION; TINGLING; TREMORS IN HIS HANDS; GENERAL BODY PAIN; FELT LIKE HE WAS HIT BY A FREIGHT TRAIN; SLEEP DISTURBANCE; NOT CLEAR HEADED; CHEST DISCOMFORT; CHILLS; HEADACHE; FEVER; CHEST KINDA BOTHERED HIM; This spontaneous report received from a patient concerned a 25 year old male. The patient''s height, and weight were not reported. The patient''s past medical history included ankle surgery, and concurrent conditions included asthma, alcoholic, outdoor allergy, keflex allergies, and augmentin allergies, and other pre-existing medical conditions included the patient received 2nd shot of vaccination. The patient was previously treated with cefalexin, and amoxicillin/clavulanic acid. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 201A21A, and batch number: 201A21A expiry: UNKNOWN) dose was not reported, administered on 07-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 07-APR-2021, the subject experienced felt like he was hit by a freight train. On 07-APR-2021, the subject experienced sleep disturbance. On 07-APR-2021, the subject experienced not clear headed. On 07-APR-2021, the subject experienced chest discomfort. On 07-APR-2021, the subject experienced general body pain. On 07-APR-2021, the subject experienced chest kinda bothered him. On 07-APR-2021, the subject experienced chills. On 07-APR-2021, the subject experienced headache. On 07-APR-2021, the subject experienced fever. Laboratory data included: Body temperature (NR: not provided) 104 F. Treatment medications included: ibuprofen. On 09-APR-2021, the subject experienced numb from head to toe. On 09-APR-2021, the subject experienced bruised at the injection. On 09-APR-2021, the subject experienced tingling. On 09-APR-2021, the subject experienced tremors in his hands. On 09-APR-2021, the subject experienced right shoulder hurt from the injection site to the bicep. Laboratory data included: Blood test (NR: not provided) Elevated white blood cell otherwise negative. On an unspecified date, the subject experienced wbc increased, cough, inappropriate dose of drug administered, and off label use. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from general body pain on 09-APR-2021, and chills, was recovering from tingling, had not recovered from headache, sleep disturbance, not clear headed, chest discomfort, cough, bruised at the injection, right shoulder hurt from the injection site to the bicep, and chest kinda bothered him, and the outcome of fever, felt like he was hit by a freight train, numb from head to toe, tremors in his hands, wbc increased, inappropriate dose of drug administered and off label use was not reported. This report was non-serious.; Sender''s Comments: V0 Medical Assessment comment not required as per standard procedure as the case assessed as non-serious.


VAERS ID: 1244939 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Headache, Myalgia, Paraesthesia, Pruritus, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210421263

Write-up: TINGLING SENSATION OF PINS AND NEEDLE; HEADACHE; FEVER; MUSCULAR ACHES; ITCHING; This spontaneous report received from a patient concerned a female of unspecified age. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 201A21A expiry: UNKNOWN) dose was not reported, administered on 07-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On an unspecified date, the subject experienced tingling sensation of pins and needle, headache, fever, muscular aches, and itching. Treatment medications (dates unspecified) included: diphenhydramine hydrochloride. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the headache, fever, muscular aches, itching and tingling sensation of pins and needle was not reported. This report was non-serious.; Sender''s Comments: V0: Medical Assessment comment not required per standard procedure as the case is assessed as non-serious.


VAERS ID: 1244953 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-04-01
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Hypoaesthesia, Hypokinesia
SMQs:, Peripheral neuropathy (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210430083

Write-up: DIFFICULTY IN MOVING RIGHT ARM; NUMBNESS IN ARM; This spontaneous report received from a parent concerned a 22 year old male. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 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 APR-2021, the subject experienced difficulty in moving right arm. On APR-2021, the subject experienced numbness in arm. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the difficulty in moving right arm and numbness in arm was not reported. This report was non-serious.; Sender''s Comments: V0 Medical Assessment comment not required as per standard procedure as the case assessed as non-serious.


VAERS ID: 1244964 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Ohio  
Vaccinated:0000-00-00
Onset:2021-04-01
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Headache, Lethargy, Nausea, Presyncope, Therapeutic product effect decreased, Vitreous floaters
SMQs:, Acute pancreatitis (broad), Lack of efficacy/effect (narrow), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Retinal disorders (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Allergic reaction to antibiotics; Non-smoker
Preexisting Conditions: Comments: The patient did not have any drug abuse/illicit drug.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210430758

Write-up: LETHARGIC; EYE FLOATERS; ALMOST PASSED OUT; MIGRAINE TYPE OF HEADACHE; FELT NAUSEOUS; LOSS OF EFFECT; This spontaneous report received from a patient concerned a 57 year old female. The patient''s concurrent conditions included sulfa allergy, non alcohol user, and non smoker, and other pre-existing medical conditions included the patient did not have any drug abuse/illicit drug. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 1808978, and expiry: UNKNOWN) dose was not reported, administered on 07-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On APR-2021, the subject experienced loss of effect. On 08-APR-2021, the subject experienced lethargic. On 08-APR-2021, the subject experienced eye floaters. On 08-APR-2021, the subject experienced almost passed out. On 08-APR-2021, the subject experienced migraine type of headache. On 08-APR-2021, the subject experienced felt nauseous. Treatment medications (dates unspecified) included: paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from eye floaters, and felt nauseous on 09-APR-2021, had not recovered from migraine type of headache, and lethargic, and the outcome of almost passed out and loss of effect was not reported. This report was non-serious.


VAERS ID: 1244965 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: North Carolina  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-04-22
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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210431054

Write-up: LEG PAIN; SEVERE HEAD PAIN; This spontaneous report received from a consumer via a company representative concerned a 20 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, start therapy date were not reported for prophylactic vaccination. No concomitant medications were reported. On an unspecified date, the subject experienced leg pain, and severe head pain. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from severe head pain, and the outcome of leg pain was not reported. This report was non-serious.; Sender''s Comments: V0- Medical Assessment Comment not required as per standard procedure as the case assessed as non-serious.


VAERS ID: 1244979 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-10
Onset:2021-04-14
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blindness unilateral, Blood test normal, Headache, Magnetic resonance imaging normal, Mydriasis, Neuropathy peripheral, Pain, Sinus pain
SMQs:, Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Retinal disorders (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Clindamycin lotion form
Current Illness: None
Preexisting Conditions: Mild asthma
Allergies: None
Diagnostic Lab Data: MRI 4/17 MRI 4/19 results normal. Blood tests 4/17 including for white blood cells and blood sugar, normal. Eyes dilated 4/19 normal
CDC Split Type:

Write-up: Nueropathy (numbness weakness tingling) on right side. Loss of vision 30 minutes right side. Headaches, temple pain, sinus pain. Shots of random pain throughout body.


VAERS ID: 1245008 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-04-09
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Ageusia, Computerised tomogram, Dehydration, Fatigue, Headache, Lumbar puncture, Vomiting
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Taste and smell disorders (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Dehydration (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: Medical History/Concurrent Conditions: Dehydration
Allergies:
Diagnostic Lab Data: Test Date: 20210410; Test Name: Spinal tap; Result Unstructured Data: Normal; Test Date: 20210410; Test Name: CAT scan; Result Unstructured Data: Normal
CDC Split Type: USJNJFOC20210431354

Write-up: DEHYDRATION; HAVE NOT HAD ANY TASTE; VOMITING/COULD NOT KEEP ANYTHING DOWN; HEADACHE; EXTREME EXHAUSTION; This spontaneous report received from a patient concerned a 58 year old female. The patient''s height, and weight were not reported. The patient''s past medical history included dehydrated.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 203A21A, and batch number: 203A21A expiry: UNKNOWN) dose was not reported, administered on 08-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 09-APR-2021, the subject experienced dehydration. On 09-APR-2021, the subject experienced have not had any taste. On 09-APR-2021, the subject experienced vomiting/could not keep anything down. On 09-APR-2021, the subject experienced headache. On 09-APR-2021, the subject experienced extreme exhaustion. On 10-APR-2021, Laboratory data included: CAT scan (NR: not provided) Normal, and Spinal tap (NR: not provided) Normal. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from vomiting/could not keep anything down on 10-APR-2021, was recovering from have not had any taste, and dehydration, and had not recovered from headache, and extreme exhaustion. This report was non-serious.


VAERS ID: 1245064 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Unknown  
Location: Maryland  
Vaccinated:0000-00-00
Onset:2021-03-23
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Dizziness, Dry mouth, Somnolence, Tongue oedema, Tremor, Vertigo, Vision blurred
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: INFLUENZA VACCINE; ASPRIN
Current Illness: Abstains from alcohol; Non-smoker
Preexisting Conditions: Comments: The patient had no known allergies and no drug abuse or illicit drug usage.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210431651

Write-up: FELT DIZZY/FELT FAINTING; HEAD SPINNING; HANDS SHAKING; DROWSY; VISION BLURRED; MOUTH DRY; ONE SIDE OF TONGUE WAS HEAVY; WEAKNESS; This spontaneous report received from a patient concerned a 65 year old of unspecified sex. The patient''s height, and weight were not reported. The patient''s concurrent conditions included non-smoker, and non-alcoholic, and other pre-existing medical conditions included the patient had no known allergies and no drug abuse or illicit drug usage. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 23-MAR-2021 for prophylactic vaccination. The batch number was not reported. The company is unable to perform follow-up to request batch/lot number. Concomitant medications included influenza vaccine for prophylactic vaccination, and acetylsalicylic acid. On 23-MAR-2021, the subject experienced felt dizzy/felt fainting. On 23-MAR-2021, the subject experienced head spinning. On 23-MAR-2021, the subject experienced hands shaking. On 23-MAR-2021, the subject experienced drowsy. On 23-MAR-2021, the subject experienced vision blurred. On 23-MAR-2021, the subject experienced mouth dry. On 23-MAR-2021, the subject experienced one side of tongue was heavy. On 23-MAR-2021, the subject experienced weakness. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from felt dizzy/felt fainting, drowsy, vision blurred, mouth dry, one side of tongue was heavy, hands shaking, head spinning, and weakness. This report was non-serious.; Sender''s Comments: V0: Medical assessment comments not required as per standard procedure as the case is considered non serious.


VAERS ID: 1245087 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Contusion, Pain, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210432429

Write-up: LEGS BRUISED; LEGS SWOLLEN; IN AGONY; This spontaneous report received from a patient concerned a female of unspecified age. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On an unspecified date, the subject experienced legs bruised, legs swollen, and in agony. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from legs bruised, legs swollen, and in agony. This report was non-serious.


VAERS ID: 1245107 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Arkansas  
Vaccinated:0000-00-00
Onset:2021-04-01
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chest discomfort, Coordination abnormal, Dizziness, Dyspnoea, Euphoric mood, Fatigue, Headache, Magnetic resonance imaging, Migraine, Nausea, Pain, Tongue ulceration, Vision blurred
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (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), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Muscle contracture (Clenching of the jaws during sleep.)
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210415; Test Name: MRI; Result Unstructured Data: NEGATIVE
CDC Split Type: USJNJFOC20210436186

Write-up: HEADACHE; DIZZINESS; BLURRED VISION; SHORTNESS OF BREATHE; CHEST TIGHTNESS; EUPHORIA; UNCOORDINATION; BODY ACHES AND BODY PAIN; FATIGUE AND FELT TRIED; NAUSEA; SEVERE MIGRAINE; SORES ON TONGUE; 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 concurrent conditions included clenching of the jaws.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported and batch number: 1805020 expiry: UNKNOWN) dose was not reported, administered on 01-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On APR-2021, the subject experienced sores on tongue. On 01-APR-2021, the subject experienced severe migraine. On 01-APR-2021, the subject experienced euphoria. On 01-APR-2021, the subject experienced uncoordination. On 01-APR-2021, the subject experienced body aches and body pain. On 01-APR-2021, the subject experienced fatigue and felt tried. On 01-APR-2021, the subject experienced nausea. On 03-APR-2021, the subject experienced shortness of breathe. On 03-APR-2021, the subject experienced chest tightness. On 11-APR-2021, the subject experienced dizziness. On 11-APR-2021, the subject experienced blurred vision. On 15-APR-2021, Laboratory data included: MRI (NR: not provided) NEGATIVE. On an unspecified date, the subject experienced headache. Treatment medications (dates unspecified) included: meglumine gadoterate. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from shortness of breathe, and chest tightness on 04-APR-2021, euphoria, uncoordination, body aches and body pain, and nausea on 03-APR-2021, and dizziness, and blurred vision on APR-2021, had not recovered from severe migraine, fatigue and felt tried, and headache, and the outcome of sores on tongue was not reported. This report was non-serious.


VAERS ID: 1333011 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-09
Onset:2021-03-15
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain, Diarrhoea, Haematochezia, Leukocytosis, Orthostatic hypotension
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Hypokalaemia (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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Abdominal Pain Narrative: Patient is a 70 year old male who received Janssen COVID-19 Vaccine (Lot# 1802070) on 3/9/21. Vaccine was administered with no complications and patient was advised to remain in facility for 15 minutes following administration. On 3/15/21 patient contacted hospital reporting that he has had diarrhea every day since his vaccination. Reported bowels on 3/15 turning pink and noted blood in stool with most recent BM. Patient also reports occasionally abdominal pain (4/10). States no improvement after taking Imodium. Patient was recommended to visit hospital for evaluation. Patient was admitted to hospital from 3/15 for observation with dx of leukocytosis, diarrhea and orthostatic hypotension. No complications during stay and diarrhea resolved resulting in discharge on 3/17.


VAERS ID: 1353934 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-07
Onset:2021-04-15
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

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

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

Write-up: Narrative: 36 year old male with no pertinent pmhx who presented to ER on 4/19/21 with a four day history of headache and left eye visual blurring which began last night. Blurring peripheral in nature. Patient denied nausea, dizziness, no antecedent trauma. He reported no occupational exposure history nor migraine headache hx. Location of pain was the top of the head, intensity is 6/10, he had taken no medications to ameliorate symptoms nor had he endorsed any antecedent drug tobacco or alcohol use. Patient noted that he received the johnson and johnson covid 19 vaccine 4/7/21 (vaccine was not received from the specific facility). ER physician followed up with patient day after presenting to ED today, and patient reported he was doing well. ER presentation may represent a simple tension type headache given his single episode, relief with NSAID and the location that the patient described the pain.


VAERS ID: 1245130 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: New Jersey  
Vaccinated:0000-00-00
Onset:2021-04-07
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Back pain, Erythema, Feeling hot, Head discomfort, Headache, Hypoaesthesia, Limb discomfort, Palpitations, Paraesthesia, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210436908

Write-up: JOINT PAIN; HEAVINESS IN CALVES; DULL HEADACHE; SWELLING FOREHEAD/ SWOLLEN FACE/ LEFT CHEEK SWOLLEN; HEART RACING; PRESSURE IN HEAD; RED FACE; TINGLING IN CALVES AND FEET; NUMBNESS IN FEET; SHORT SHOOTING PAIN IN BACK; FEELING OF WARMTH/ LEFT CHEEK WARM; This spontaneous report received from a patient concerned a 56 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: 1805018 expiry: UNKNOWN) dose was not reported, administered on 07-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 07-APR-2021, the subject experienced swelling forehead/ swollen face/ left cheek swollen. On 07-APR-2021, the subject experienced heart racing. On 07-APR-2021, the subject experienced pressure in head. On 07-APR-2021, the subject experienced red face. On 07-APR-2021, the subject experienced tingling in calves and feet. On 07-APR-2021, the subject experienced numbness in feet. On 07-APR-2021, the subject experienced short shooting pain in back. On 07-APR-2021, the subject experienced feeling of warmth/ left cheek warm. On 07-APR-2021, the subject experienced joint pain. On 07-APR-2021, the subject experienced heaviness in calves. On 07-APR-2021, the subject experienced dull headache. Treatment medications (dates unspecified) included: famotidine, prednisone, and diphenhydramine hydrochloride. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from heart racing, and short shooting pain in back on APR-2021, and had not recovered from pressure in head, dull headache, swelling forehead/ swollen face/ left cheek swollen, red face, joint pain, heaviness in calves, tingling in calves and feet, numbness in feet, and feeling of warmth/ left cheek warm. This report was non-serious.; Sender''s Comments: V0: Medical assessment comment not required as per standard procedure as case assessed as non-serious.


VAERS ID: 1245148 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: North Carolina  
Vaccinated:0000-00-00
Onset:2021-04-08
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Headache, Malaise, 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210438055

Write-up: PAIN ON RIGHT SIDE OF BODY/HURT ALL OVER; FELT SICK; SEVERE HEADACHE; This spontaneous report received from a patient concerned a 56 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: 043A21A expiry: UNKNOWN) dose was not reported, administered on 07-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 08-APR-2021, the subject experienced pain on right side of body/hurt all over. On 08-APR-2021, the subject experienced felt sick. On 08-APR-2021, the subject experienced severe headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from pain on right side of body/hurt all over, and felt sick on 18-APR-2021, and was recovering from severe headache. This report was non-serious.


VAERS ID: 1245163 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Missouri  
Vaccinated:0000-00-00
Onset:2021-04-01
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Contusion, Feeling hot, Headache, Influenza like illness, Pain in extremity, Paraesthesia, Varicose vein
SMQs:, Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: SPIRONOLACTONE
Current Illness: Acne; Allergic reaction to antibiotics; Migraine; Non-smoker
Preexisting Conditions: Medical History/Concurrent Conditions: Anemia
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210438862

Write-up: TINGLING SENSATION IN LEGS; VARICOSE VEINS; BRUISING; LEG PAIN; TEETH CHATTERING/ CHILLS; HEADACHE; FEELING HOT; FLU LIKE SYMPTOMS; This spontaneous report received from a patient concerned a 35 year old female. The patient''s height, and weight were not reported. The patient''s past medical history included anemia, and concurrent conditions included acne, amoxicillin allergy, non-smoker, and migraine. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 042A21A, and batch number: 042A21A expiry: UNKNOWN) dose was not reported, administered on 31-MAR-2021 14:30 for prophylactic vaccination. Concomitant medications included spironolactone for topical acne. On 01-APR-2021 03:00, the subject experienced feeling hot. On 01-APR-2021 03:00, the subject experienced flu like symptoms. On 01-APR-2021 03:00, the subject experienced teeth chattering/ chills. On 01-APR-2021 03:00, the subject experienced headache. On 05-APR-2021, the subject experienced tingling sensation in legs. On 05-APR-2021, the subject experienced varicose veins. On 05-APR-2021, the subject experienced bruising. On 05-APR-2021, the subject experienced leg pain. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from feeling hot, flu like symptoms, and teeth chattering/ chills on 02-APR-2021, and was recovering from headache, leg pain, tingling sensation in legs, varicose veins, and bruising. This report was non-serious.


VAERS ID: 1245165 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2021-04-11
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Balance disorder, Dyspnoea, Fatigue, Feeling abnormal, Head discomfort, Headache, Pain, Vertigo
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Vestibular disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210438913

Write-up: SHORTNESS OF BREATH (SLIGHT AND NOT ALL THE TIME); VERTIGO; FELT OFF BALANCE; PRESSURE PRIMARILY ON LEFT SIDE OF HEAD; LOCALIZED HEADACHE PRIMARILY TO THE LEFT SIDE; TIRED; ACHES AND PAIN; FOGGY; This spontaneous report received from a patient concerned a 50 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: 202A21A, and expiry: UNKNOWN) dose was not reported, administered on 10-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 11-APR-2021, the subject experienced aches and pain. On 11-APR-2021, the subject experienced foggy. On 11-APR-2021, the subject experienced tired. On 12-APR-2021, the subject experienced pressure primarily on left side of head. On 12-APR-2021, the subject experienced localized headache primarily to the left side. On 14-APR-2021, the subject experienced vertigo. On 14-APR-2021, the subject experienced felt off balance. On 18-APR-2021, the subject experienced shortness of breath (slight and not all the time). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from aches and pain, foggy, and tired on 11-APR-2021, and vertigo, and felt off balance on 14-APR-2021, was recovering from shortness of breath (slight and not all the time), and had not recovered from pressure primarily on left side of head, and localized headache primarily to the left side. This report was non-serious.


VAERS ID: 1245170 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-04-09
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chest X-ray, Chest discomfort, Cough, Dyspnoea, Echocardiogram, Electrocardiogram, Fibrin D dimer, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210412; Test Name: Electrocardiogram; Result Unstructured Data: Normal; Test Date: 20210412; Test Name: Chest X-ray; Result Unstructured Data: Normal; Test Date: 20210412; Test Name: Fibrin D dimer; Result Unstructured Data: Normal; Test Date: 20210412; Test Name: Echocardiogram; Result Unstructured Data: Normal; Test Date: 20210414; Test Name: COVID-19 virus test; Result Unstructured Data: Negative
CDC Split Type: USJNJFOC20210438966

Write-up: CHEST TIGHTNESS AND DISCOMFORT; SLIGHT SHORTNESS OF BREATH; DRY COUGH; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin, and batch number were not reported) dose was not reported, administered on 07-APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 09-APR-2021, the patient experienced chest tightness and discomfort. On 09-APR-2021, the patient experienced slight shortness of breath. On 09-APR-2021, the patient experienced dry cough. On 12-APR-2021, Laboratory data included: Chest X-ray (NR: not provided) Normal, Echocardiogram (NR: not provided) Normal, Electrocardiogram (NR: not provided) Normal, and Fibrin D dimer (NR: not provided) Normal. On 14-APR-2021, Laboratory data included: COVID-19 virus test (NR: not provided) Negative. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from chest tightness and discomfort, slight shortness of breath, and dry cough. This report was non-serious.


VAERS ID: 1245179 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2021-04-09
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Chest pain, Chills, Computerised tomogram, Dehydration, Electrocardiogram, Headache, Malaise
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Dehydration (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: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210419; Test Name: EKG; Result Unstructured Data: UNKNOWN; Test Date: 20210419; Test Name: CT scan; Result Unstructured Data: UNKNOWN
CDC Split Type: USJNJFOC20210439185

Write-up: MALAISE; MILD DEHYDRATION; CHEST PAIN; CHILLS; GENERALIZED WEAKNESS; HEADACHE; This spontaneous report received from a physician concerned a female of unspecified age. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 043A21A, expiry: UNKNOWN) dose was not reported, administered on 07-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 09-APR-2021, the patient experienced chest pain. On 09-APR-2021, the patient experienced chills. On 09-APR-2021, the patient experienced generalized weakness. On 09-APR-2021, the patient experienced headache. On 19-APR-2021, the patient experienced mild dehydration. On 19-APR-2021, the patient experienced malaise. Laboratory data included: CT scan (NR: not provided) UNKNOWN, and EKG (NR: not provided) UNKNOWN. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the headache, generalized weakness, chills, chest pain, malaise and mild dehydration was not reported. This report was non-serious.


VAERS ID: 1245247 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-08
Onset:2021-03-14
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dyspnoea, Headache, Muscle spasms, Pain, Pharyngeal swelling, Pyrexia
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Women''s multivitamin, D3, Vitamin C and Prilosec
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Do not take any test
CDC Split Type:

Write-up: I had a fever, headache, chills, swollen throat, full-body aches, and spasm, severe shortness of breath. I took ibuprofen and tylenol but it did not work. I went to the Urgent Care ER for help nearby and was given antibiotics, zpack, and inhaler and told to go to a larger facility if this did not help.


VAERS ID: 1245290 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-04-09
Onset:2021-04-19
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Anticoagulant therapy, Blood test, Cardiac function test, Computerised tomogram, Dyspnoea, Electrocardiogram, Oxygen saturation decreased, Pulmonary embolism, Pulmonary infarction, Thrombosis, Ultrasound scan
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Respiratory failure (broad), Infective pneumonia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lexapro 15mg per day, multi-vitamin, milk thistle, tumeric, colace, fiber capsules, elderberry
Current Illness: sleep apnea and depression
Preexisting Conditions: sleep apnea and depression
Allergies: No known allergies
Diagnostic Lab Data: ER blood work, cardiac work up, ultrasound of bilateral legs, CT scan of abdomen, multiple EKGs. Diagnosis of multiple PEs in bilateral lungs with lung infarct in right lower lung and superficial blood clot in the right groin area.
CDC Split Type:

Write-up: Multiple pulmonary embolisms in bilateral lungs with lung infart, superficial blood clot in the right groin area, significant right abdominal pain, shortness of breath, low oxygen saturation levels admitted 3 days in the hospital. 36 hours of Lovanox injections followed by transition to Eliquis 10 mg twice per day, respiratory exercises, oxycodone given for pain Pain has diminished in lower right lung area, clotting appears to be under control


VAERS ID: 1246242 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-06
Onset:2021-04-08
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: EKG normal needs to be re evaluated in two weeks
CDC Split Type:

Write-up: After getting the vaccine patient didnt feel well which was expected, but shortly after she begin to complain about feeling dizzy, fatigue. and heart palpitations


VAERS ID: 1246269 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-05
Onset:2021-04-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood glucose normal, Electrocardiogram, Hyperhidrosis, Muscle spasms, Seizure, Syncope, Urine analysis
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Dystonia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Osteoarthritis
Allergies: Kefflex
Diagnostic Lab Data: 4/5/21 (immediately following): EKG, urine
CDC Split Type:

Write-up: I?m writing this as a former, trained healthcare professional (physical therapist). 30sec-after injection I raised my left (injected) arm and my deltoid/bicep had a sudden hard spasm. I told my husband (who was in the middle of getting his shot) and the administrator that I was passing out. I blacked out. They ran over. They said 5 minutes passed in which my eyes were wide open and dilated. I suddenly began profuse sweating and convulsions/ severe full body shaking. They could not keep me lucid, and called 911. Paramedics came and got a systolic BP of 36 (I?m unaware of the diastolic BP) with blood sugar at 111 ish. I could not form words and kept going in and out of consciousness. I was transported by ambulance to the ER. A few minutes into the ambulance ride I was able to form words, and vitals stared to return. I?ve passed out a few times and this WAS NOT a normal episode of syncope.


VAERS ID: 1246375 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Alaska  
Vaccinated:2021-04-06
Onset:2021-04-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Electrocardiogram normal, Heart rate increased, Palpitations
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Dehydration (broad)

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

Write-up: The day after the vaccine was administered, she had increased heart rate and dizziness prompting her to get evaluated at Regional ER. On 4/21/21, she was seen in primary care- she complains of ongoing increased palpitations. EKG performed and was normal.


VAERS ID: 1246380 (history)  
Form: Version 2.0  
Age: 90.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-11
Onset:2021-04-20
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Troponin increased, Vascular occlusion
SMQs:, Myocardial infarction (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: Tylenol 325 mg prn
Current Illness: none
Preexisting Conditions: varicose veins, bowel obstruction, abdominal hernia, cataract, arthritis, UTI
Allergies: Keflex, naproxen
Diagnostic Lab Data:
CDC Split Type:

Write-up: right radial occlusion, elevated troponin


VAERS ID: 1246385 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-07
Onset:2021-04-22
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Computerised tomogram abnormal, Condition aggravated, Cough, Deep vein thrombosis, Dyspnoea, Pain in extremity, Peripheral swelling, Pulmonary embolism, Ultrasound scan abnormal
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: History of DVT and PE
Allergies:
Diagnostic Lab Data: CT imaging indicative of PE on 4/22/2021. Ultrasound imaging indicative of right DVT on 4/22/2021.
CDC Split Type:

Write-up: Patient presented to ED on 4/22/2021 with non-productive cough, mild shortness of breath x 10 days. Acute onset chest pain x 1 day. Chronic bilateral leg swelling, but worsening leg pain. Hx of DVT and PE, not on anti-coagulation.


VAERS ID: 1246459 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Androgenetic alopecia, Apathy, Appetite disorder, Blood test, Fatigue, Headache, Hot flush, Hypertension, Pyrexia, Scan, Sexual dysfunction, Skin odour abnormal, Sleep disorder
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypertension (narrow), Depression (excl suicide and self injury) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Fish oil and vitamin d.
Current Illness: None
Preexisting Conditions: ASD
Allergies: None
Diagnostic Lab Data: Standard blood panel and FMV scan to rule out large clots or bleeds.
CDC Split Type:

Write-up: T+ 4 to 6 hours: mild fever, fatigue. T+ 1 days: mild fever continues, hot flashes begin, mostly at night interrupting sleep. T+ 2 days - 7 days: fever subsides, hot flashes increase in intensity significantly, continuing to interfere with sleep. Other possible androgenic symptoms begin to arise: change in body odor, sex drive, motivations, appetite. T+ 7 days till current: previous symptoms of days 2-7 continue, extremely gradual onset headache begins one night. Making sure to rule out hydration and electrolyte imbalance expecting headache to be gone in the morning after sleep, I found that it was only worse and that an interpolation of the two pain points from when I went to sleep and woke up would have created a almost imperceptibly gradual but linear increase between the two points. The headache was of a type I had never had before, located in the center of my head just barely dorsal to the spinal insertion. It felt deeper than any headache I had had before which usually occur in the frontal lobe/neocortex zone. I do not regularly suffer headaches getting maybe a couple per year. Once I recognized androgenic involvement and the headache were continuing I took myself to the ER where I was evaluated and despite presenting with continuous hypertension and the symptoms mentioned above, I could not get them to perform a estrogen test and they let me leave with hypertension without any investigation. I''m returning today to their urgent care facility to try again to get my estrogen levels checked. I had left a message on the phone line of VAERS prior to the original ER visit but had not heard back from anyone so I felt it was prudent to file a written report here.


VAERS ID: 1246465 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / UNK - / IM

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Blood pressure increased, Burning sensation, Cardiac stress test, Condition aggravated, Feeling hot, Flushing, Malaise, Oral discomfort, Rash, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypertension (narrow), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Day after Janssen vaccine: Patient called the Health Department on 4-9-21 at 11:45am to report that last night she reported that her face and lips were "hot" to touch, felt sunburnt, and when applying lotion it burns her face. I encouraged her to use cold compresses to face and if short of breath or swelling of tongue to immediately seek emergency medical attention. Encouraged her to reach out to PCP if rash symptoms worsen. Patient, presented to the ER on 4-16-21 due to rash to her neck, torso, and BUE and pain to her joints. The patient reported that she received the Janssen Vaccine 8 days ago and within 15 minutes of receiving it she became flushed and feeling unwell. The nurse at the vaccination clinic monitored her. The patient saw her PCP 4-15-21 and was started on Hydroxyzine q6. The patient states that she was feeling better, but now her symptoms are increasing with severity. The patient denies that she is currently on steroids and says she does better with liquid steroids. The patient BP was elevated on arrival at 171/107. The patient reports that her BP is high in clinical settings . She had a stress test by Dr that was normal and her PCP is going to have her monitor her BP at home before starting antihypertensives. No other complaints at this time.


VAERS ID: 1246617 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN NA / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Dizziness postural, Hyperhidrosis, Immediate post-injection reaction, Mobility decreased, Nausea, Visual impairment, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

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

Write-up: Patient has a history of allergic reactions to iodine and presented to the ED for evaluation of lightheadedness, dizziness, nausea, vomiting. Patient states that this afternoon she received the Johnson and Johnson COVID-19 vaccine at the Arena and within a minute she began to have a reaction. Patient describes the event as she got up to walk to the observation room and was unable to make it to her chair before she began to sweat profusely, become exceptionally nauseous, and dizzy. She describes her dizziness as so severe that she was unable to stand or move at all. Patient also endorses seeing "black spots" in her vision and saying that she was going to pass out. Patient reports several episodes of vomiting that did stop until the staff present placed an IV and gave her Zofran. Patient denies any throat swelling, wheezing or trouble breathing. On examination patient reports that all of her symptoms resolved within 40 minutes of onset without any other treatment than Zofran.


VAERS ID: 1246686 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-03-08
Onset:2021-03-17
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Cerebral haemorrhage, Cerebral mass effect, Cerebral venous sinus thrombosis, Computerised tomogram abnormal, Electroencephalogram, Mechanical ventilation, Sedation, Seizure, Visual impairment, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Haemorrhagic central nervous system vascular conditions (narrow), Convulsions (narrow), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Central nervous system vascular disorders, not specified as haemorrhagic or ischaemic (narrow), Generalised convulsive seizures following immunisation (narrow), Respiratory failure (broad), Hypoglycaemia (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, 30 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Florastor (Probiotic), Jolessa (Birth Control), Sentraline
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vomiting, vision impairment (read very slow to me), and seizure(s). Rushed to ER in ambulance. Was put on a ventilator (sedation). Received a CT scan showing a CVST and hemorrhaging in her right temporal lobe. Life-Lined to Hospital. Wore an EEG on her head to monitor seizure activity for 4-5 days. Was put on 4 types of seizure medication and blood thinner for the clot. Did another CT scan which showed her Mid-Line shift was pushing into the left side of the brain by 15mm. Discharged from Hospital on 3/27/21 to Rehabilitation Hospital. She was discharged to home with a caregiver on 4/16/21. She will continue outpatient therapy at the rehabilitation hospital. She will see Speech, Vision, PT, and OT every week until further notice.


VAERS ID: 1246731 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
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: Unknown       Purchased by: ?
Symptoms: Blood test, Chills, Diarrhoea, Fatigue, Headache, Heart rate, Injection site pain, Loss of personal independence in daily activities, Nausea, Pain in extremity, Sleep disorder
SMQs:, Acute pancreatitis (broad), Dementia (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: The night of the vaccine I woke up around 1am with chills and a lot of pain on the vaccine site I could not sleep that night. The next day when I tried to work I couldn''t go down the stairs because my legs where hurting a lot. I also had a huge headache I couldn''t eat I felt very nauseas. My worst symptoms were my headaches it was a sever headache. On 4/12/2021 & 4/13/2021 I had diarrhea. On 04/1 4/2021 I went to the ER they did blood work they did a heart exam everything came out good and they just said it was just a reaction to the vaccine. I kept drinking Tylenol for my headache. On 4/17/2021 is when I did not feel the headache anymore. Now I just feel very fatigue.


VAERS ID: 1246754 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-04-11
Onset:2021-04-20
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Ibuprofen
Current Illness: None
Preexisting Conditions: None
Allergies: Possible seasonal, never diagnosed
Diagnostic Lab Data: No testing administered yet
CDC Split Type:

Write-up: Hives, swelling in lips, face, metallic taste in mouth. Continuing even after ER visit at 4 am Wednesday morning and taking meds to control reaction


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: 1246898 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-06
Onset:2021-04-22
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

Administered by: Pharmacy       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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Famotidine
Current Illness: None
Preexisting Conditions: Migraines, hiatal hernia
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Right sided Bell''s palsy. Treated with antiviral and prednisone.


VAERS ID: 1246983 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-05
Onset:2021-04-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Chills, Computerised tomogram, Diarrhoea, Feeling abnormal, Influenza like illness, Nausea, Peripheral swelling, Pyrexia, Thrombosis, Tremor, Ultrasound scan, Vomiting
SMQs:, Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Parkinson-like events (broad), Thrombophlebitis (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: no
Current Illness: no
Preexisting Conditions: Lower radiopathy left and right - back issues from spinal injury, PTSD, GERD
Allergies: no
Diagnostic Lab Data: CAT and Ultrasound at both hospitals
CDC Split Type:

Write-up: After vaccination, at 10pm I started feeling flu like symptoms, fever chills shakes feeling miserable and this lasted 3 days straight, I also had diarrhea, nausea and vomiting. I woke up with a swollen juggler vein that ended up being a blood clot, 10 days later my arm was swollen up twice the size of my leg, the juggler was still swollen. I call the urgent care nurse they said to go to ER. I went to hospital got a CAT scan and ultrasound, I was given a shot of warfarin that was supposed to last for 12 hours. I went home and the next morning instead of going to the hospital, I went to hospital and they found 2 blood clots in brain, arm and leg and neck. I have had no history of blood clots and this all happened after the J&J vaccine. They did a procedure where they tried to put a balloon to relieve the pressure. The blood clots in the brain cannot be removed because of their location and it would be dangerous to remove and I am on blood thinners for the rest of my life. Multiple blood clots in body brain, arm and shoulder.


VAERS ID: 1247073 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-01
Onset:2021-04-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / UNK LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood magnesium normal, Blood thyroid stimulating hormone normal, Chest X-ray normal, Computerised tomogram head normal, Computerised tomogram thorax normal, Dizziness, Electrocardiogram normal, Fall, Fibrin D dimer increased, Flushing, Full blood count normal, Head injury, Immediate post-injection reaction, Iron binding capacity total normal, Lipids normal, Metabolic function test normal, Serum serotonin, Spinal myelogram normal, Syncope, Troponin normal, Ultrasound scan normal, Vitamin B12 normal, Vitamin D
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Haemorrhage laboratory terms (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: CBC, CMP, Troponin-1, CT of head/cervical spine, ECG, chest x-ray all WNL. Body temperature 99.0 F. D-Dimer elevated to 748 ng/mL. Serotonin serum, iron-binding TIBC, lipids, TSH, Vitamin B12 & D all WNL. CBC, CMP, Magnesium, Troponin-1, CT of chest, ultrasound of legs, ECG, all showed no signs of concern and were WNL.
CDC Split Type:

Write-up: Patient experienced two episodes of syncope 5 minutes after receiving immunization and approximately 2 minutes apart from each other. Patient fell out of chair as result and reportedly hit head. Blood pressure upon initial evaluation was 88/50. EMS was called. Upon arrival and assessment by EMS, vital signs were WNL. Patient was transported to local hospital. Patient was not evaluated at hospital. Patient has since been to E.R. 2 times after incident and to PCP 1 time since incident. Patient continues to feel "flushed, faint, and dizzy" at times.


VAERS ID: 1247075 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-01
Onset:2021-04-12
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Diverticulitis, Scan abdomen abnormal
SMQs:, Retroperitoneal fibrosis (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Gastrointestinal nonspecific inflammation (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: enalapril, celexa, ASA
Current Illness:
Preexisting Conditions: Depression HTN
Allergies: None
Diagnostic Lab Data: CT consistent with acute sigmoid diverticultitis
CDC Split Type:

Write-up: Patient diagnosed via CT scan with acute diverticulitis about 4/14/21


VAERS ID: 1247080 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-07
Onset:2021-04-19
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Computerised tomogram, Herpes zoster, Rash, Rash pruritic, Skin burning sensation, X-ray
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: 100mg sertraline 2 mg lorazepam 40 mg omeprazole 25 mg hydrochlorathiazide 5 mg glipizide
Current Illness: None
Preexisting Conditions: Chronic ear infections Type 2 diabetes Hypertension Depression Anxiety ADHD Non alcoholic fatty liver disease Arthritis Urinary in continuance
Allergies: Tramadol Dogs Seasonal Penicillin Chantix Cymbalta
Diagnostic Lab Data: Labs, ct scan, X-ray during er visit and external exam at both Er and office visit
CDC Split Type:

Write-up: Shingles, I?m on day 4, treatment is anti viral med and nerve pain med. I have a large patch of painful itchy bumps under my left shoulder blade and it is spreading to my left side and under my left breast. It burns on the skin and internally feels like someone is squeezing my kidney and spine.


VAERS ID: 1247103 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-31
Onset:2021-04-08
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / UNK RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Haematocrit normal, Haemoglobin normal, Petechiae, Platelet count normal, Purpura, White blood cell count normal
SMQs:, Haemorrhage terms (excl laboratory terms) (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: Vitamin D3, Cranberry supplement
Current Illness: none
Preexisting Conditions: none
Allergies: wasp stings
Diagnostic Lab Data: WBC-8.2 , Hgb 13.4, Hct 39.5, Platelets-239,000
CDC Split Type:

Write-up: Petechial/purpuric rash on both lower extremities, treated with Prednisone


VAERS ID: 1247121 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-02
Onset:2021-04-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Blood glucose, Dizziness, Dysarthria, Electrocardiogram, Hyperhidrosis, Hypoaesthesia, Pallor, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

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

Write-up: Client received Jansen Covid Vaccine on the Left arm and immediately started to feel "weak and lightheaded" client looked pale and sweaty. Position client laying on a cot and elevated her legs. Her BP was 113/75, client is responding appropriately to questions and indicates that is starting to feel better. 5 to 10 minutes later, client indicates that she her Left arm is "numb and tingling" as we are asking her to describe her symptoms she is starting to slurred her words and she said that she can not feel her left side. 911 has been called and on-site paramedics are evaluating the client. Engine on site and transported client to the hospital.


VAERS ID: 1247123 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 0188982 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Ageusia, Blood test, Chills, Cough, Decreased appetite, Diarrhoea, Feeling abnormal, Night sweats, Pain, SARS-CoV-2 test, Urinary incontinence, X-ray
SMQs:, Anaphylactic reaction (broad), Taste and smell disorders (narrow), Dementia (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: do not wish to disclose
Current Illness:
Preexisting Conditions: AFIB, High White Platelet count
Allergies: nka
Diagnostic Lab Data: Blood work Covid Test X-RAY
CDC Split Type:

Write-up: pt says on 4/8/21 he got chills and dry cough. On 4/9/21 day he got body aches and pain w/chills. He had loss of appetite and had no taste. On 4/10 he developed night sweats. By 4/11/21 he was not able to control his bladder. On 4/12/21 he had diarhea. He went to Urgent Care. They did Covid Test, blood work and X-ray w/ negative. He was given a shot of penicillin. He was prescribed Cefuroxime Axetil 200mg. He feels like he is getting better but still has no taste. Pt says he has never felt like this bad in his life.


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: 1247139 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-03-08
Onset:2021-03-17
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Cough, Influenza virus test negative, Pyrexia, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Micardis, HCTZ, D3, Aspirin, Crestor, Multi-vitamin
Current Illness: None
Preexisting Conditions: High blood-pressure and high cholesterol
Allergies: Ampicillin, Lisinopril
Diagnostic Lab Data: 3/23/21 - Rapid COVID-19 test and regular COVID-19 test were both negative as well as the Influenza test.
CDC Split Type:

Write-up: Cough began on 3/17/21 and lasted a month; chills and fever began 3/18 (102.5 on 3/23/21) and lasted 2 weeks. Took Ibuprofen from 3/18/21 thru 2nd week of April because feeling of chills/fever would occur when I stopped taking it.


VAERS ID: 1247201 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-01
Onset:2021-04-16
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Pelvic pain, Uterine spasm
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Sexual dysfunction (broad)

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

Write-up: Employee reported on 4/16 that after receiving the J&J vaccine she was having uterine contractions and pelvic pain. She went to her primary which put her on baby aspirin. Employee then called out for chest pain on 4/20. She went to the ER on 4/19/21 . ER stated she did not have a blood clot and it was muscle related. She was put on medication. She was put out of work for 3 days. Upon her return on 4/23 she returned to work and stated she was advised by her primary to get an MRI.


VAERS ID: 1247245 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-03-31
Onset:2021-04-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNWN / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Fatigue, Haematocrit normal, Haemoglobin normal, Lymphocyte count normal, Lymphocyte percentage, Mean cell haemoglobin concentration decreased, Mean cell haemoglobin normal, Mean cell volume normal, Mean platelet volume increased, Monocyte count normal, Monocyte percentage, Neutrophil count normal, Neutrophil percentage, Pain in extremity, Platelet count normal, Red blood cell count normal, Red cell distribution width increased, White blood cell count normal
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: HEALTHY
Preexisting Conditions: NONE
Allergies: NKA
Diagnostic Lab Data: WBC (3.80 - 10.80 x10^3 cells/uL) (6690-2) 7.90 LY% (20.00 - 45.00 %) 35.40 MO% (0.00 - 12.00 %) 3.20 GR% (40.00 - 83.00 %) 61.40 LY# (0.85 - 3.90 x10^3 cells/uL) 2.80 MO# (0.20 - 0.95 x10^3 cells/uL) 0.30 GR# (1.52 - 8.55 x10^3 cells/uL) 4.90 RBC (4.20 - 5.80 x10^6 cells/uL) (789-8) 4.82 HGB (13.2 - 17.1 g/dL) (718-7) 13.7 HCT (38.5 - 50.0 %) (4544-3) 43.9 MCV (80.00 - 100.00 fL) (787-2) 91.00 MCH (27.00 - 33.00 pg) (785-6) 28.50 MCHC (32.00 - 36.00 g/dL) (786-4) 31.30 RDW (11.0 - 15.0 %) (788-0) 16.1 PLT (140.00 - 400.00 x10^3 cells/uL) 272.00 MPV (7.50 - 11.50 fL) 10.90
CDC Split Type:

Write-up: PATIENT RECEIVED VACCINE AT HIGH SCHOOL ON 3/31/2021. UNKNOWN VACCINE LOT NUMBER. PATIENT HAS HAD FATIGUE AND ARM PAIN SINCE TWO DAYS LATER. VACCINE WAS INJECTED INTO LEFT ARM. PATIENT WITH RIGHT SIDED PAIN. PATIENT SEEN IN OFFICE 4/20/2021. NO NEURO DEFICITS NOTED, ABDOMINAL PAIN, SOB, LEG SWELLING, PETECHIAE NOTED. CBC DONE 4/20/2021, NO ELEVATED PLT COUNT. ON F/U CALL 4/23/2021 PATIENT REPORTS INCREASING PAIN IN RIGHT ARM AND NEW CHEST PAIN. PATIENT INSTRUCTED TO REPORT TO EMERGENCY DEPARTMENT FOR EVALUATION.


VAERS ID: 1247262 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-01
Onset:2021-04-16
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Over the counter migraine medication
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Went to the emergency room, had a full work up. Negative for blood clot. Has to schedule appointment for follow up at the clinic.
CDC Split Type:

Write-up: Reported she has been having severe headaches for the past week. She complained of SOB shortly after. She was advised to seek medical attention.


VAERS ID: 1247275 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-01
Onset:2021-04-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Computerised tomogram, Dizziness, Magnetic resonance imaging, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular 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? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vit C 10000/day Vit A Vit D, Magnesium
Current Illness: COPD, Arthritis, Osteoporosis
Preexisting Conditions: Bronchostenosis
Allergies: Nucala Injection
Diagnostic Lab Data: CT Scan, MRI
CDC Split Type:

Write-up: Day 1 chills Day 2 4am morning Dizziness and Vomiting --- contiues and still she feels dizzy. She was admitted on day 13 to ER for observation.


VAERS ID: 1247371 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-03-30
Onset:2021-04-02
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Abdominal pain upper, Back pain, Cardiac stress test, Chest X-ray normal, Computerised tomogram normal, Dyspnoea, Electrocardiogram abnormal, Headache, Heart injury, Musculoskeletal chest pain, Pain, Pyrexia, Troponin I increased, Troponin T normal
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations: Flu like symptoms following flu shot
Other Medications: Levothyroxine, Omeprazole, Vitamin c, Multivitamin
Current Illness:
Preexisting Conditions: Hypothyroidism
Allergies:
Diagnostic Lab Data: Troponin-I on 4.16: 0.13 and 0.14, on 4.23: 0.098 (ULN = .01)
CDC Split Type:

Write-up: One day after vaccine I missed worked, was in bed all day with fever of 101.8, headache, body aches, abdominal pain etc. On 4.2, I couldn?t breathe after attempting a lower-than-normal intensity elliptical workout (I do 60+ min elliptical workouts 5x/week and 6+ mile walks the other 2 days/week). Following that event I had significant trouble getting a full breath and had dull upper left back pain and very localized pain in upper left abdominal area/lower left rib area that got worse at night. I had a telemedicine appointment with my pcp on 4.14, was Rx?d advair and albuterol. Had another telemedicine with my pcp on 4.16 because breathing and localized pain were more concerning. PCP sent me to the ER. At the hospital ER they found elevated troponin-I and an abnormal ekg (normal chest X-ray and cat scan) and diagnosed me with an NSTEMI heart attack. They transferred me the other hospital where they did more testing. Troponin-t was normal, ekg was determined to be a normal atypical variant. I completed an exercise stress test and the cardiologist determined that I would not have been able to complete the full 15 min with no abnormalities if I?d just had an NSTEMI so they changed the diagnosis to Acute Myocardial Injury. On 4.23 lab results showed troponin-I is still elevated. I still cannot Get a full breath and still have some left back and lower rib pain


VAERS ID: 1247382 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-03-10
Onset:2021-04-06
   Days after vaccination:27
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / UNK RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Abortion spontaneous, Exposure during pregnancy, Hypertension
SMQs:, Neuroleptic malignant syndrome (broad), Hypertension (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Termination of pregnancy and risk of abortion (narrow)

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

Write-up: Had a miscarriage (due date was 12/02/21) Have had high blood pressure which required er visit since getting vaccine


VAERS ID: 1247450 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-03-30
Onset:2021-04-05
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Blood test, Blood urine present, Chest X-ray, Dyspnoea, Feeling abnormal, Headache, Muscle spasms, Nausea, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Dementia (broad), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Eliquis
Current Illness:
Preexisting Conditions: AFIB
Allergies: erythymican, Flagel,
Diagnostic Lab Data: Blood Test Chest X-ray
CDC Split Type:

Write-up: pt says on the 6th day she woke up w/ a headache and nauseated. She started vomiting and took Medizine which seem to help. On 4/11/21 she started having cramps in her stomachs like a spasm and SOB. She went to hospital ER. They did blood work and Chest X-Ray which came back negative results. She was told she did not have the same blood disorder as the other people who have had blood clots after taking the vax. She was told she had blood in her urine but had no infection. She will FU w/ PCP in June. Pt says her only symptoms now are some nausea and still does not feel normal.


VAERS ID: 1247456 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-09
Onset:2021-04-16
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Nausea
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: n/a
CDC Split Type:

Write-up: Patient called stating she began having severe nausea and pounding headaches 1 week post-vaccination. She said she went to urgent care due to nausea. They tested her BP and it was fine. Said she is still having the headaches now, 1 week after they started.


VAERS ID: 1247460 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-03
Onset:2021-04-09
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / UNK LA / IM

Administered by: School       Purchased by: ?
Symptoms: Deep vein thrombosis, Laboratory test, Pain in extremity, Peripheral swelling, Ultrasound scan abnormal
SMQs:, Cardiac failure (broad), Angioedema (broad), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Sprintec
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Left leg ultrasound, lab work completed on 4/16/21.
CDC Split Type:

Write-up: Left calf and thigh pain and swelling on the 6th day following vaccine which continued intermittently for a total of 12 days. I was seen at an urgent care, a left leg ultrasound was completed and I was diagnosed with deep venous thrombosis. I was prescribed Xarelto.


VAERS ID: 1247470 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-04-05
Onset:2021-04-06
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Chest discomfort, Chest pain, Computerised tomogram thorax, Disorientation, Dizziness, Electrocardiogram, Eye swelling, Fatigue, Feeling abnormal, Feeling hot, Gastrooesophageal reflux disease, Haemoptysis, Headache, Hypertension, Injection site rash, Loss of personal independence in daily activities, Muscular weakness, Myalgia, Nausea, Ocular hyperaemia, Pain in extremity, Rash, SARS-CoV-2 test negative, Ultrasound scan, Vision blurred
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Hypertension (narrow), Cardiomyopathy (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Dehydration (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Torn meniscus--right knee
Allergies: None up to the Janssen vaccine
Diagnostic Lab Data: Two ER visits--4/8/2021 4/14/21 Three primary care doctor visits Ultrasound of legs and chest x-rays Chest CT without contrast as contrast may aggravate reaction more EKGS, bloodwork One covid test--negative
CDC Split Type:

Write-up: 4/5/2021--Received Janssen vaccine. Felt very hot during the day. 4/6/2021--Woke up with very bad headache and rash on the injected arm plus on my stomach. Went for a walk and felt pain in my left calf and achilles tendon. Went to work. 4/7/2021--Started my work day as a Personal Trainer/Fitness Instructor at 6am as usual. Taught cycling classes and trained a few clients. Went for walk. Still had a headache. When I got in my car to head home, my vision was super blurry and I felt very dizzy. I ate an orange and peanuts and hydrated more. I was not even sure I could drive home. I got home told my family how I was feeling. My husband noticed my eyes were very red and swollen. I took a shower, drank a smoothie and ate a salad. Used my aunt''s BP cuff to check my BP and it was 148/99. I have NEVER had HBP. 4/8/21--Woke up feeling disoriented as if the left side of my face, body were off--neurological stuff. I went to reach for grapes in the refrigerator and could not grab them. I felt like I have never felt before and ask my husband to drive me to the ER. While at the waiting room at the ER, I felt chest tightness and pain and nauseous. My BP was 153/111. Again, I have never been diagnosed or been treated for hypertension. They did EKG, lab tests, chest X-ray. Once my BP came down, they sent me home. This is before all the JJ Janssen vaccine "news" came out and the reasons it was paused. I developed a very bad cough about two hours after I got home from the ER. 4/9/11--Made appointment with a brand new primary care doctor. Saw her on Monday 4/12/2021 as recommended by ER. I had never met her before. She prescribed a very low dose of BP medication, which I did not take because the number one side-effect is dry-cough. I was already coughing a lot, later on with blood. 4/11/2021--Still feeling pretty bad, I woke up to the news of the Janssen vaccine being paused. Frankly, I felt relieved that I was not going crazy. This truly has been one of the hardest things I have ever gone (and still am) going through. I became concerned about the pain in the left calf and heel could be a clot. Called primary care doctor. Had ultrasound of legs and chest x-ray the following day 4/12/2021--Had persistent cough with blood. Went to ER at 9pm. Had EKG, blood work, CT without contrast of chest, covid test--negative. Got home around 2am. 4/19/21--Followed up with primary care doctor who after explaining to her I am extremely fatigued, still blurry vision, dizzy, cough better but not gone, chest discomfort on the left side, she referred me to an ophtamologist and cardiologist. My insurance and this poorly established referral system is very difficult to navigate. Up to now I am still waiting for the referral and pre-aurhtorization to the opthtamologist. (4/23/2021). I want to say, I am pretty healthy. I have worked in fitness and wellness for over 30 years. I have never drank alcohol, smoked or done any drugs. Prior to this no physician has told me I have HBP or any issues for which I have to be medicated. I take zero medications. Even when I had the bad headache from the vaccine I took nothing. I have not worked in two weeks and had not driven until last saturday. If I don''t work, I don''t get paid. I pay for almost $600/month for my insurance in the marketplace. This has been another stressor of this storm. Getting providers to really listen and insurance companies to take situations like this seriously. I could not drive at night. This has been rough and I look forward to being myself soon. This reaction felt like a heart attack/stroke with extreme fatigue, acid reflux, cough with some blood, muscular pain. The rash and headaches were the least of my concerns. I am not yet recovered from all of this. I sure hope there is no permanent damage and that this too shall pass. It is important to note that I have tried reporting this event several times to the VAERS website online. I completed the 4-5 pages multiple times and it would not let me submit. I also called the VAERS 1-800 number to report and they told me to go back to the online form. I left several messages when I could not get it done online and to this date no one has called me back. I called to report my adverse reaction and they told me they do not take that info. I also called the health dept. After several phone calls to them a nurse called me back but did not take a formal report. When someone is feeling pretty sick, this is a lot to ask of. I persisted because I feel this is important to be reported.


VAERS ID: 1247491 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

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

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

Write-up: Client was leaving the parking lot post vaccination waiting period when he felt lightheaded. Wife indicates that client passed out twice in the car. Client reports feeling dizzy and hot and he looks pale and sweaty. His BP is 60/40. Client does not have any other medical history and is not taking any medications currently. He is allergic to sulfa. EMS on site evaluated client and was determined that 911 needed to be called. EMS responded and client was transported to the hospital.


VAERS ID: 1247505 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

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

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: tylenol, coreg, b12, garlic, levothyroxine, lovastatin, miralax, potassium, cialis, tamsulosin,
Current Illness: no
Preexisting Conditions: chrons, nonischemic cardiomyopathy, diabetes, sleep apnea, OA of knees, hypothyroidism, hypertension, BPH, b12 deficiency
Allergies: lisinopril, cocunut
Diagnostic Lab Data: Venous duplex at ER 4/18/21
CDC Split Type:

Write-up: DVT within 24 hours of vaccine


VAERS ID: 1247525 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Malaise, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: none
Preexisting Conditions: no
Allergies: none
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Patient been feeling ver sick, with high ever, muscle ache and abdominal pain lasting over a week after the administration


VAERS ID: 1247546 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fibrin D dimer normal, Laboratory test, Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid
Current Illness: No
Preexisting Conditions: Hypothyroidism and Hashimoto''s Disease
Allergies: No
Diagnostic Lab Data: D-Dimer was normal.
CDC Split Type:

Write-up: I had very severe pain in both legs. This lasted for a few days before I ended up in the emergency room. They only drew labs and determined I did not have a blood clot. I''m taking ibuprofen and a baby aspirin but I do still have pain in both of my legs.


VAERS ID: 1247561 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-12
Onset:2021-04-13
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Bell's palsy, Dry eye, Facial paralysis, Headache, Ophthalmoplegia
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Corneal disorders (broad), Hearing impairment (broad), Conjunctival disorders (narrow), Lacrimal disorders (narrow), Ocular motility disorders (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Prednisone 20 mg tab qd for bells palsy Atorvastatin Aspirin Prilosec
Current Illness:
Preexisting Conditions: Hyperlipidemia
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Bells palsy happening on left side of his face, everything is paralyzed, small pain behind left ear, left eye will not close(drys out), and is still going on with no improvement Went to ER because they thought it was a stroke .


VAERS ID: 1247582 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-03-30
Onset:2021-04-05
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Blood test, Chest X-ray, Dyspnoea, Electrocardiogram, Nausea, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Eliquis
Current Illness:
Preexisting Conditions: AFIB, Heart Flutter
Allergies: erythymican, Flagel,
Diagnostic Lab Data: Chest X-ray blood test EKG
CDC Split Type:

Write-up: about 6 days after taking vax she had nausea and vomiting. On 4/11/2021 she had SOB and cramping in her stomach. She went to ER. They did blood work, EKG and Chest-X-RAY. She was told that she did not have the blood disorder that people with the blood clots have after taking the vax. She was released and told to FU w PCP. She still has some nausea that comes and goes and does not feel back to normal.


VAERS ID: 1247623 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-03
Onset:2021-04-21
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / 1 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Epistaxis, Gingival bleeding, Headache, Immunoglobulin therapy, Immunology test, Platelet count decreased, Platelet transfusion, Thrombocytopenia
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Gingival disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: lisinopril 10 mg daily vitamin d 2,000 units daily tumeric 500 mg twice daily
Current Illness: unknown
Preexisting Conditions: hypertension
Allergies: codeine
Diagnostic Lab Data: PLT = 2 (on admission), 29 (as of April 23rd AM) ELISA assay sent (send out lab, no results as of April 23rd afternoon)
CDC Split Type:

Write-up: Patient states she received the Johnson & Johnson COVID vaccine on April 3rd. Patient states on April 8th she went to her dentist for cleaning and do not expiring any gum bleeding at this time. Patient states 2 day ago (April 19th) her gums were bleeding so bad that she could not see her teeth and patient states she had a nose bleed as well. Patient also states she was experiencing headaches. Patient presented the the Emergency Department on April 21st . Patient was found to have thrombocytopenia (PLT = 2). Patient was admitted to Hospital on April 21st (as of April 23rd, patient is still admitted). Hematology was consulted for further management of thrombocytopenia. Patient received 2 platelet transfusions, IVIG x 2 doses, and is receiving corticosteroids.


VAERS ID: 1247645 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Discomfort, Ear discomfort, Eye irritation, Fatigue, Headache, Hypoaesthesia, Insomnia, Laboratory test, Pain, Somnolence, Ultrasound scan, Vision blurred
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Lens disorders (broad), Corneal disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Asthma (it is controlled)
Allergies: Vicoden
Diagnostic Lab Data: Ultrasound of my right leg, lab work
CDC Split Type: vsafe

Write-up: On the night of my J&J my vaccine , I felt very tired and sleepy but I could not sleep. The next morning I felt a burning sensation to my eyes as well to my right ear and that went away. I went to see my PCP that day as well because I was having a pressure sensation down my right calf and leg. On Wednesday I felt numbness sensation down my right arm and the right side of my body was weak. On Thursday, I called my PCP who advised me to go to the ER and to get monitored for thrombosis. I also began to have headaches and blurry vision. At the ER they performed an ultrasound and did lab work. The ultrasound exam did not show evidence of thrombosis or blood clots. The ER physicians told me to rest and elevate my legs. I also noticed that my BP was 130/90 which I never had before. To this day I still have throbbing sensation to my right calf and leg. I again went to the ER and thy monitored me. They told me to take Ibuprofen for pain and again did an ultrasound which did not show any blood clots. I then started to have a burning sensation to my skull and scalp and also my left arm. I have not fully recovered from my symptoms.


VAERS ID: 1247659 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-08
Onset:2021-03-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: AST to platelet ratio index increased, Alanine aminotransferase increased, Chills, Condition aggravated, Contusion, Dizziness, Fatigue, Headache, Laboratory test, Nausea, Petechiae, Platelet count decreased, Platelet morphology, Vision blurred, Vomiting
SMQs:, Liver related investigations, signs and symptoms (narrow), Acute pancreatitis (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Varicella 11/03/1999; Diagnosed with ITP within 1 month of receiving vaccine
Other Medications: Wellbutrin 150 mg, Pristiq 100 mg, Vyvanse 20 mg
Current Illness: N/A
Preexisting Conditions: Immune Thrombocytopenia Purpura (ITP): Low platelets (Diagnosed at age 3)
Allergies: N/A
Diagnostic Lab Data: Labs at Hospital: Platelet count was 42K (When healthy, my usual platelet count is over 150K) Follow-up labs on 3/11/21 with Doctor: Platelet count 38K, Platelet morphology: Few large; Elevated AST and ALT liver enzymes: AST= 125, ALT= 148
CDC Split Type:

Write-up: Janssen COVID-19 Vaccine EUA 8pm 3/8/21: Nausea, vomiting, chills began; slept for 10+ hours 8 am 3/9/21: Fatigue, nausea, headache; noticed petechiae on arms and abnormal bruising on legs 8 am 3/10/21: Blurry vision, headache (unlike usual throbbing headaches, consistent pain on top of head), lightheaded/dizzy 10 am 3/10/21: Asked friend to drive me to ED at Hospital; Labs were drawn showing platelet count of 42K and I was released from ED and told to follow up with Hematologist


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

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

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

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


VAERS ID: 1247816 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-08
Onset:2021-04-23
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Blindness, Cardiac arrest, Death, Pain, Sickle cell anaemia with crisis
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Retinal disorders (broad), Respiratory failure (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-23
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: folic acid hydroxyurea Lisinopril MS contin Camila oxycodone xarelto voxeletor
Current Illness:
Preexisting Conditions: sickle cell anemia (hgb SS) , obesity avascular necrosis, proteinuria history of Pulmonary embolism on anticoagulation
Allergies: penicillin- rash
Diagnostic Lab Data: none
CDC Split Type:

Write-up: patient called EMS with pain crisis and noted that she had lost vision in both eyes. was transported to Emergency room by EMS and had cardiac arrest and died.


VAERS ID: 1247841 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-11
Onset:2021-04-22
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 20A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19 treatment, Chest X-ray abnormal, Cough, Dyspnoea, Feeling abnormal, Hypoxia, Lung infiltration, Pyrexia
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (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), 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, 5 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 Johnson & Johnson COVID vaccine on 4/11/21 and developed dyspnea, fevers, and nonproductive cough about 2 days later. He continued to feel worse over time and presented to urgent care on 4/22/21. He had a chest X-ray done which showed bilateral infiltrates and he was found to be hypoxic, so he was sent to the ED. Patient was then admitted to the hospital for COVID treatment since he required 4 L O2 in the ED.


VAERS ID: 1247921 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-03-11
Onset:2021-04-15
   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: Public       Purchased by: ?
Symptoms: Aphasia, Bruxism, Cerebrovascular accident, Dysphagia, Eye movement disorder, Facial paralysis, Gaze palsy, Laboratory test, Magnetic resonance imaging head abnormal, Mental status changes, Thrombosis, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hearing impairment (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: probenecid/colchicine
Current Illness: hip fracture 2/15/2021
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: complete medical workup including labs and MRI for stroke-like symptoms
CDC Split Type:

Write-up: 4/15/2021 approximately 1030 am client found to be AMS, non-responsive, aphasic, aphagic, left-sided facial droop, teeth clenched, left eye closes, right eye with deviated gaze. 911 called, client to hospital ER, work up/evaluation, admission for stroke related to blood clots found left frontal and right temporal lobes, per spouse. Client discharged 4 days later to home s/p CVA, bed-bound, remains aphasic, aphagic, non-communicative, no response to verbal stimuli. PLEASE NOTE: hospital admission. Unable to complete section 21. Admit for 4 days.


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

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

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

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


VAERS ID: 1247991 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-02
Onset:2021-04-05
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Contusion, Fall, Head injury, Loss of consciousness, Rash, Tooth injury, Urticaria
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Angioedema (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: 2 days after the vaccine developed severe rash and hives. Went to see a doctor. 6 days after vaccine sudden lost of consciousness, felt on the sidewalk. Lost 4 front teeth, multiple bruises. Ended up in the emergency room


VAERS ID: 1248006 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-06
Onset:2021-04-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / N/A LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test normal, Chills, Fatigue, Hypersensitivity, Migraine, Myalgia, Rash
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: no
Current Illness: no
Preexisting Conditions: PCOS
Allergies: no
Diagnostic Lab Data: At my Doctor on Monday, she did Bloodwork and that all came back normal.
CDC Split Type: vsafe

Write-up: Day of the shot: Muscle aches, fatigue and chills. The next day, I was feeling better. Day 3, I had migraine headache. Day four I was better. Day five, I broke out in a full body rash - Saturday evening. It started on the right arm and it spread all over my body. It lasted off and on for thirty-six hours. It migrated over my body. I went to the ER, and they said I was having a reaction to the vaccine. She prescribed me steroids, I didn''t take them because I was hoping the rash would get better without them. I went to my Dr. the next day - by the time I did see my doctor the rash was getting better so she said I didn''t have to take the steroids. I was taking Benadryl from the time the rash started and continued until it was gone. The rash ended on day 7. Once the rash went away, I had fatigue for four days.


VAERS ID: 1248011 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-03-05
Onset:2021-03-27
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chest X-ray, Exposure to SARS-CoV-2, Headache, Laboratory test, Myalgia, Oropharyngeal pain, Pneumonia, Pyrexia, SARS-CoV-2 test positive, Tachycardia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Dehydration (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: aspirin 81 mg PO QD carvedilol 25 mg PO BID multivitamin 1 tab PO QD mycophenolate mofetil 1000 mg PO BID omeprazle 40 mg PO QD prednisone 5 mg PO QD Bactrim DS 1 tab PO QMWF tacrolimus 0.5 mg PO Q12h
Current Illness:
Preexisting Conditions: bilateral lung transplant renal transplant
Allergies: NKA
Diagnostic Lab Data: See above
CDC Split Type:

Write-up: J&J vaccine 3/5/2021 COVID Positive 3/29/21 3/29/21: COVID positive. This is a 35-year-old male with complex past medical history including bilateral lung transplant and renal transplant performed several years ago. He both of them and regarding his transplant management. He is on immunosuppressive medications. He is here today out of concern for exposure to COVID. He was vaccinated with Johnson Johnson vaccine on 3/4. He is here cause overnight he started developed fever headache sore throat muscle aches. If continued through today. He was test in the outpatient setting but the results have not yet returned. He is here today with continued symptoms. He is well-appearing on exam but mildly tachycardic, low-grade temperature here no significant increased work of breathing no conversational dyspnea lungs are clear heart is regular but tachycardic without murmur he has no signs or symptoms of DVT currently. His chest x-ray shows all isolated left lower lobe infiltrate. His labs are unremarkable with normal renal function, normal electrolytes but is rapid COVID test is positive. Given his immunosuppressive status in infiltrate seen on x-ray initially recommended admission for observation even though he is not initially on any supplemental oxygen is work of breathing is quite comfortable. I was able to discuss with his transplant surgeon In addition I talked to admitting physician who then discussed with pulmonology here . In their opinion the best management for the patient would be to provide him with the monoclonal antibody treatment but this can only be performed in the outpatient setting given he has no increased work of breathing no supple ox requirement currently that he is stable for discharge. He has a pulse monitor at home will also enroll him in a COVID home program. Pulmonology will call him for follow-up tomorrow. When I discussed with they currently do not have any beds available at the hospital for transport. The patient does not want to go to an outside facility that has a transplant team other than the risks of. Ultimately the patient would like to go home. I will add doxycycline for bacterial possibility of his pneumonia seen on x-ray today. He also had very strict return precautions. He understands likely had a possibility of worsening symptoms understands to return immediately if any new or worsening symptoms or no improvement. Patient was given the monoclonal antibody treatment in the ER after ordered by Dr.. He will ultimately be discharged with very close follow-up.


VAERS ID: 1248045 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Culture stool negative, Dizziness, Electrocardiogram normal, Epidural blood patch, Fibrin D dimer normal, Haematochezia, Headache, Idiopathic intracranial hypertension, Lumbar puncture, Magnetic resonance imaging head abnormal, Platelet count normal, Post lumbar puncture syndrome, Presyncope, Spinal pain, Troponin normal, Venogram normal
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Ischaemic colitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad), Noninfectious diarrhoea (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: clonazepam 0.5 mg PO HS lacosamide 100 mg PO BID progesterone 100 mg vaginal suppository PRN topiramate 25 mg O QD zolmitriptan 5 mg PO QD
Current Illness:
Preexisting Conditions: Ulcerative colitis in remission epileptic seizures
Allergies: topiramate - insomnia, headache
Diagnostic Lab Data: see above. of note, plts were never below 200 - were 236, 209, 243
CDC Split Type:

Write-up: J&J COVID Vaccine EUA J&J Vaccine 4/10/2021 4/13/21: Believes she is having a reaction to her Johnson and Johnson COVID-19 vaccination. This vaccination was given on 04/10/2021. Patient is 39-year-old female with a past medical history significant for ulcerative colitis that has been in remission since the patient was 21 years of age, epileptic seizures on Vimpat and clonazepam. Patient comes in as a transfer with a chief complaint of possible reaction to Johnson and Johnson COVID-19 vaccine. Patient presents with multiple complaints. The patient states that upon receiving the vaccine on 04/10/2021 she suddenly developed presyncopal episodes where she felt like she was about to pass out but that subsided later on. 12 hours following the shot she had intense headache which was frontal and then later on travel to the back of her head and traveled down her spine. Patient described the headache to be the worse headache of her life, stated that it was worse than going through labor. Patient stated that she received morphine which helped her with the headache. Patient also complained of chest pain which was left-sided with no radiation, constant. No history of previous myocardial infarctions. Her troponins that were conducted were negative. Patient also complained of experiencing blood in her stool. She stated that when she wiped herself on the morning of 04/13/2021 she experience blood on the toilet paper and blood in the bowel. However, her stool occult blood that was conducted was negative. Patient is being followed by Neurology, she contacted her neurologist and they recommended to come to the ED with concerns of thromboembolism. Patient''s D-dimer was negative. Patient denied any recent travel anywhere or coming into contact with anyone sick. She denied developing any fevers cough shortness of breath abdominal pain nausea vomiting or any urinary concerns. 4/15/21: Patient is a 39-year-old female with a past medical history significant for ulcerative colitis that has been in remission since the patient was 21 years of age, epileptic seizures on Vimpat and clonazepam. Patient comes in as a transfer with a chief complaint of possible reaction to Johnson and Johnson COVID-19 vaccine. Headache: MRI brain and MRI venogram was ordered. MRI brain did show concerning signed for idiopathic intracranial hypertension. Neurology was consulted. Patient had high volume LP. Patient responded well post LP. Patient will be discharged on topiramate with a taper instructions per neurology. Patient will make appointment with Ophthalmology. Patient will follow up with Neurology as well. Chest pain concerning for ACS: Negative troponin. EKG normal sinus rhythm. Concern for vaccine reaction: Patient has J&J vaccine. No clots were noted. Patient''s symptoms are most likely are secondary to idiopathic intracranial hypertension and history of migraines. 4/16/2021: 39-year-old female presents emergency room with chief complaint of headache. Onset this morning. Headache is generalized. Headache is constant. Headache is worth with position change. Such as moving head side to side or with changing from lying to sitting and sitting to standing. Headache improves with lying supine. To has tried pushing fluids, taking over-the-counter medication, and also increasing her caffeine intake to offset the headache. She denies any of these helping with her symptoms. Patient''s pain is right an 8 out of 10. The patient denies anything additional alleviating and or aggravating factors to chief complaint. Today when the patient''s headache started. She contacted her neurologist. She was told to come to the emergency department for a blood patch. The patient added that her neurologist felt that she needs a blood patch not only because of the recent lumbar puncture but because there was at minimum 25 mL of spinal fluid removed at the time of her lumbar puncture. This lumbar puncture occurred under fluoroscopy. However, they had difficulty getting the pressure gauge on thus, more than 25 mL was removed.. Pain Pain Scale: 8 /10. Timing: constant. gradual. Character: mild. 4/19/21: patient reports intense headaches she attributes to the spinal tap. Ketorolac, DHE, ondansetron given.


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

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

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

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


VAERS ID: 1248063 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-03
Onset:2021-04-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / N/A LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Headache, Magnetic resonance imaging, 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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lavora - birth control
Current Illness:
Preexisting Conditions:
Allergies: Sulfa
Diagnostic Lab Data: MRI Blood Test
CDC Split Type: vsafe

Write-up: Twenty four hours after the shot I had a high fever ,body aches and nausea which lasted 48 hours. I felt better for a few days and five or six days after the shot I started to get headaches again. The headaches got progressively worse and more frequent. I don''t normally get headaches. It was pain at the lower back side of my head which was dull but got worse and throbbing in periods. My pain level was an eight or nine. They lasted most of the day. I am still getting a few headaches after three weeks. I have been taking Tylenol and Ibuprofen and it is starting to get better. It is still every day and the mornings are worse before I take a pain reliever. My pain level with the headaches is more like a 3-5 range level of pain.


VAERS ID: 1248089 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-08
Onset:2021-04-20
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Gait disturbance, Lethargy, Myalgia, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

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

Write-up: Back pain, severe leg pain (muscle pain) , patient wobbles when he walks. Lethargy.


VAERS ID: 1248108 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-03-18
Onset:2021-03-23
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood glucose increased, Chills, Computerised tomogram, Computerised tomogram head, Decreased appetite, Diarrhoea, Dizziness, Dyspnoea, Fatigue, Gastrointestinal pain, Glomerular filtration rate, Headache, Hypotension, Insomnia, Laboratory test, Malaise, Parosmia, Pyrexia, Tinnitus
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hearing impairment (narrow), Vestibular disorders (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: I take Lumigan eye drops, but did not take the day before vaccination or for three weeks after.
Current Illness: None
Preexisting Conditions: Just Glaucoma
Allergies: None
Diagnostic Lab Data: ENT and audiology exam. ER visit with head CT. 4 doctor visits, may lab tests and a CT of pelvic/abdomen with contrast.
CDC Split Type:

Write-up: Day 5 after vaccine I got fever, chills, and loud ringing(tinnitus) in both ears. Followed by headache, fatigue, dizziness, strange ammonia like smell in my nose, shortness of breath, yellow diarrhea, intestinal pain, insomnia, and lack of appetite. Have been very sick for the last 4 weeks and continuing. Have had lowered Blood pressure, elevated fasting glucose, and kidney GFR effected also. The constant ear ringing is just horrible!!!


VAERS ID: 1248162 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Cerebral haemorrhage, Diarrhoea, Haematemesis, Magnetic resonance imaging head abnormal, Malaise, Nausea
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Pseudomembranous colitis (broad), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Clinical depression
Allergies: Latex Levaquin Percocet
Diagnostic Lab Data: Bloodwork, MRI 4/19 Another MRI scheduled 4/26
CDC Split Type:

Write-up: Very sick for three days as reported through CDC checking site. On 4/18 I began feeling extremely nauseous and had diarrhea and then began vomiting blood for over twelve hours. I went to the ER on 4/19 where they did an MRI and found two hemmorhaging lesions on the right side of my brain.


VAERS ID: 1248189 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-03-13
Onset:2021-04-01
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / N/A LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? 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: Blood clot in superficial vein in right heel of foot


VAERS ID: 1248222 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-05
Onset:2021-04-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043AZ1A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal distension, Asthenia, Blood test normal, Chills, Computerised tomogram normal, Ear discomfort, Fatigue, Feeling abnormal, Headache, Hypoaesthesia, Magnetic resonance imaging normal, Nausea, Pain, Parosmia, Pyrexia
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal vitamin
Current Illness: None
Preexisting Conditions: None
Allergies: Reglan
Diagnostic Lab Data: April 13th 2021- CT scan of head at hospital, blood work completed. Normal except for vitamin d low. April 21st- MRI of head completed. Normal. More blood work normal.
CDC Split Type:

Write-up: Night of vaccine had chills, body aches, fever, headache, nausea, bloating in stomach, fatigued. Next day started numbness and tingling in left leg/foot, left arm and hand, pressure/ fullness in left ear and headache on left side. Very Fatigued, weakness, and brain fog, sensitive to scents.


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