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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: 1252416 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-04-12
Onset:2021-04-21
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 20201103MC01 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Aggression, Anxiety, Blood test, Computerised tomogram, Decreased appetite, Dyspnoea, Electrocardiogram, Facial paralysis, Gait disturbance, Hypophagia, Incoherent, Insomnia, Pyrexia, Tremor
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Psychosis and psychotic disorders (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (narrow), Cardiomyopathy (broad), Hearing impairment (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: NO MEDICATION
Current Illness: NO
Preexisting Conditions: NO
Allergies: NO
Diagnostic Lab Data: CT SCAN, BLOOD TEST AND EKG THEN ONLY MEDICATED WITH SEDATIVE AND PUT IN THE DEPARTMENT OF PSYCHIATRY WITHOUT DOING AN (MRA) A DEEP STUDY OF THE BRAIN HE IS FOR 5 DAYS IN THE DEPARTMENT OF PSYCHIATRY WITHOUT SEEING A DIFFERENT DOCTOR
CDC Split Type:

Write-up: THE FIRST TWO DAYS AFTER THE VACCINE PATIENT HAD FEVER AND THEN HE COULDN''T SLEEP FOR ALMOST THREE DAYS IN A ROW, HE LOST THE APPETITE, HE DIDN''T EAT, HE WAS ANXIOUS AND STARTED TO SAY INCOHERENT THINGS, THE THUMB OF HIS HAND DOES NOT STOP SHAKING AND HIS FEET WOULD NOT STOP SHAKING, HE HAD A BREATHING PROBLEM AND HE START MAKING A GESTURE AS IF HE HAD FACIAL PARALYSIS, HIS TONGUE WAS STICKING OUT OF HIS MOUTH AND HIS FACIAL GESTURE WAS AS IF HE HAD A THROMBOSIS ATTACK, THEN HE GOT AGGRESSIVE AND HE KICKED HIS FATHER IN CHEST AND WHEN THE AMBULANCE CAME AND TOOK HIM TO THE HOSPITAL HE ALMOST COULDN''T WALK.


VAERS ID: 1252520 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: New Mexico  
Vaccinated:0000-00-00
Onset:2021-03-13
Submitted: 0000-00-00
Entered: 2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Alanine aminotransferase, Aspartate aminotransferase, Blood alkaline phosphatase, Blood bilirubin, Blood pressure diastolic, Blood pressure systolic, Blood test, Body temperature, Brain natriuretic peptide, Chest X-ray, Dizziness, Frequent bowel movements, Heart rate, Hyperglycaemia, Hypertension, Nausea, Oxygen saturation, Respiratory rate, Troponin I, Urine analysis, Vomiting
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Vestibular disorders (broad), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: BYSTOLIC
Current Illness: Alcohol use (One glass of wine daily.); Blood pressure high; Cholesterol high; Hyperlipidemia; Hypertension; Non-smoker
Preexisting Conditions: Comments: Patient had no drug abuse.
Allergies:
Diagnostic Lab Data: Test Date: 20210313; Test Name: Blood test; Result Unstructured Data: Normal; Test Date: 20210313; Test Name: High sensitive troponin I; Result Unstructured Data: <0.003 ng/mL; Test Date: 20210313; Test Name: Chest X-ray; Result Unstructured Data: Normal; Test Date: 20210313; Test Name: Body temperature; Result Unstructured Data: 34.4 F; Test Date: 20210313; Test Name: Urinalysis; Result Unstructured Data: Normal; Test Date: 20210313; Test Name: Respiratory rate; Result Unstructured Data: Bq, 18 br/min,17 br/min; Test Date: 20210313; Test Name: Systolic blood pressure; Result Unstructured Data: 250,160,130,96,103,150,130 mmHg; Test Date: 20210313; Test Name: Diastolic blood pressure; Result Unstructured Data: 99,88,68,59,43,67,57 mmHg; Test Date: 20210313; Test Name: Oxygen saturation; Result Unstructured Data: 92,91,93,91 %; Test Date: 20210313; Test Name: Heart rate; Result Unstructured Data: 70bpm,65 bpm; Test Date: 20210313; Test Name: Alkaline phosphatase; Result Unstructured Data: 80 IU/L; Test Date: 20210313; Test Name: Alanine aminotransferase; Result Unstructured Data: 52 IU/L; Test Date: 20210313; Test Name: Aspartate aminotransferase; Result Unstructured Data: 42 IU/L; Test Date: 20210313; Test Name: Bilirubin total; Result Unstructured Data: 1.2 mg/dL; Test Date: 20210313; Test Name: Brain natriuretic peptide; Result Unstructured Data: 34 pg/mL; Test Date: 202103131138; Test Name: Pulse rate; Result Unstructured Data: 62 pm, bpm
CDC Split Type: USJNJFOC20210327466

Write-up: EXTREME DIZZINESS; HIGH BLOOD PRESSURE; VOMITED 3 TIMES; FOUR BOWEL MOVEMENTS; HYPERGLYCEMIA; NAUSEA; This spontaneous report received from a patient concerned a 79 year old female. The patient''s weight was 65.5 kilograms, and height was 157.48 centimeters. The patient''s concurrent conditions included high blood pressure, elevated cholesterol, non-smoker, alcohol user, hyperlipidemia, and hypertension, and other pre-existing medical conditions included patient had no drug abuse. The patient was previously treated with codeine, and acetylsalicylic acid. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 10-MAR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. Concomitant medications included nebivolol hydrochloride for high blood pressure. On 13-MAR-2021, the subject experienced extreme dizziness. On 13-MAR-2021, the subject experienced high blood pressure. On 13-MAR-2021, the subject experienced vomited 3 times. On 13-MAR-2021, the subject experienced four bowel movements. On 13-MAR-2021, the subject experienced hyperglycemia. On 13-MAR-2021, the subject experienced nausea. Laboratory data included: Alanine aminotransferase (NR: not provided) 52 IU/L, Alkaline phosphatase (NR: not provided) 80 IU/L, Aspartate aminotransferase (NR: not provided) 42 IU/L, Bilirubin total (NR: not provided) 1.2 mg/dL, Blood test (NR: not provided) Normal, Body temperature (NR: not provided) 34.4 F, Brain natriuretic peptide (NR: not provided) 34 pg/mL, Chest X-ray (NR: not provided) Normal, Diastolic blood pressure (NR: not provided) 99, 88, 68, 59, 43, 67, 57 mmHg, Heart rate (NR: not provided) 70bpm, 65 bpm, High sensitive troponin I (NR: not provided) <0.003 ng/mL, Oxygen saturation (NR: not provided) 92, 91, 93, 91 %, Respiratory rate (NR: not provided), Systolic blood pressure (NR: not provided) 250, 160, 130, 96, 103, 150, 130 mmHg, and Urinalysis (NR: not provided) Normal. On 13-MAR-2021 11:38, Laboratory data included: Pulse rate (NR: not provided) 62 pm. Treatment medications (dates unspecified) included: hydrochlorothiazide/triamterene, valsartan, omega-3 triglycerides, oyster shell, diclofenac, celecoxib, potassium chloride, ubidecarenone, xantofyl/zeaxanthin, simvastatin, and ascorbic acid/betacarotene/biotin/calcium/chlorine/chromium/copper/cyanocobalamin/dl-alpha tocopheryl acetate/folic acid/iodine/magnesium/manganese/molybdenum/nickel/nicotinamide/pantothenic acid/phosphorus/phytomenadione/potassium/pyridoxine hydrochloride/retinol/riboflavin/selenium/silicon/thiamine/vanadium/vitamin d nos/xantofyl/zinc. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from extreme dizziness, high blood pressure, vomited 3 times, and nausea on 16-MAR-2021, and the outcome of four bowel movements and hyperglycemia was not reported. This report was non-serious.


VAERS ID: 1252574 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-03-14
Submitted: 0000-00-00
Entered: 2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210328319

Write-up: FULL BODY RASH; This spontaneous report received from a consumer via a company representative 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: Unk) dose was not reported, administered on 11-MAR-2021 for prophylactic vaccination. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On 14-MAR-2021, the subject experienced full body rash. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of full body rash was not reported. This report was non-serious.


VAERS ID: 1252632 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-06
Onset:2021-04-12
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Burning sensation, Head discomfort, Headache, Muscle spasms, Nasal discomfort, Pain, Pain in extremity, Paraesthesia, Ultrasound scan normal
SMQs:, Peripheral neuropathy (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Junel 1.5/30 Levothyroxine 50 mcg
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: Ultrasound of leg with no clots reported on 4/15/2021. Physical neurological exam on 4/15/2021 and 4/18/2021. Nothing of concern on either exam. Ultimately prescribed Butabital-Acetaminophen and Gabapentin for the persistent headache.
CDC Split Type:

Write-up: Mild headache and mild leg pain started on 4/12/2021 at around 23:00. Leg pain can best be described as cramping, shooting pain in the back of the calf and thigh, at times radiating through the rest of the leg. Headache was a dull throbbing on right side of the head. Pain increased to moderate in both areas in the following days. Headache and Leg pain persisted through 4/23/2021. The leg pain continued to be sharp/shooting/cramping, but the headache transformed from a dull throbbing on the side of the head to a moderate sharp, burning feeling in the temples. This was also accompanied by a burning feeling in the nasal cavity and a "pins and needles"/heaviness feeling around the ears. Pain was not severe enough to be debilitating but required frequent pain medication to manage. The headache and leg pain appear to have ceased as of 4/24/2021.


VAERS ID: 1252634 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-03-16
Onset:2021-03-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Neuropathy peripheral
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (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: Hepatitis A, Typhoid age 72 October 2019
Other Medications: Levothyroxine Cromolyn Pilocarpine Azopt
Current Illness: Mast Cell Activation Syndrome Postural Orthostatic Hypotension
Preexisting Conditions: Mast Cell Activation Syndrome Postural Orthostatic Hypotension
Allergies: Gluten, Fructose, Soy
Diagnostic Lab Data: EMG scheduled
CDC Split Type:

Write-up: Neuropathy first of lower leg and feet then of hands and arms.


VAERS ID: 1252948 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-03-09
Submitted: 0000-00-00
Entered: 2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: USJNJFOC20210332938

Write-up: LETHARGIC; CHILLS; LOW GRADE FEVER; This spontaneous report received from a consumer 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: 1805022 expiry: UNKNOWN) dose was not reported, administered on 08-MAR-2021 02:48 to right deltoid for prophylactic vaccination. No concomitant medications were reported. On 09-MAR-2021, the subject experienced lethargic. On 09-MAR-2021, the subject experienced chills. On 09-MAR-2021, the subject experienced low grade fever. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from lethargic, chills, and low grade fever. This report was non-serious.; Sender''s Comments: V0: Medical assessment comment not required as per standard procedure since case was assessed as non serious.


VAERS ID: 1252978 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: California  
Vaccinated:0000-00-00
Onset:2021-03-14
Submitted: 0000-00-00
Entered: 2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: No preexisting condition
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210333317

Write-up: FULL BODY RASH WHICH WAS DESCRIBED AS ALLERGIC REACTION; This spontaneous report received from a patient via a company representative concerned a 67 year old male. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included no preexisting condition. 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 13-MAR-2021 for prophylactic vaccination. The batch number was not reported. We are unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On 14-MAR-2021, the subject experienced full body rash which was described as allergic reaction. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from full body rash which was described as allergic reaction on 16-MAR-2021. This report was non-serious.


VAERS ID: 1253062 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: North Carolina  
Vaccinated:0000-00-00
Onset:2021-03-13
Submitted: 0000-00-00
Entered: 2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature, Chest discomfort, Chills, Cold sweat, Dehydration, Dizziness, Dyspnoea, Fatigue, Finger deformity, Foot deformity, Headache, Hyperhidrosis, Pain, Paraesthesia, Pyrexia, Rash, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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: 20210313; Test Name: Body temperature; Result Unstructured Data: 101 F
CDC Split Type: USJNJFOC20210334296

Write-up: HIVES; RASH; FATIGUE; CHILLS; HEADACHE; 101F FEVER; COLD SWEATS; SHORTNESS OF BREATH; DIZZINESS; TINGLINESS; SEVERE BODY PAIN; DEHYDRATION; CHEST TIGHTNESS; FINGERS CURLING UP; TOES CURLING UP; SWEATING; 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: 1805018, expiry: 25-MAY-2021) dose was not reported, administered on 13-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 13-MAR-2021, the subject experienced cold sweats. On 13-MAR-2021, the subject experienced shortness of breath. On 13-MAR-2021, the subject experienced dizziness. On 13-MAR-2021, the subject experienced tingliness. On 13-MAR-2021, the subject experienced severe body pain. On 13-MAR-2021, the subject experienced dehydration. On 13-MAR-2021, the subject experienced chest tightness. On 13-MAR-2021, the subject experienced fingers curling up. On 13-MAR-2021, the subject experienced toes curling up. On 13-MAR-2021, the subject experienced sweating. On 13-MAR-2021, the subject experienced chills. On 13-MAR-2021, the subject experienced headache. On 13-MAR-2021, the subject experienced 101f fever. Laboratory data included: Body temperature (NR: not provided) 101 F. On 14-MAR-2021, the subject experienced fatigue. On 15-MAR-2021, the subject experienced rash. On 15-MAR-2021, the subject experienced hives. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from cold sweats, shortness of breath, dizziness, tingliness, and chest tightness on 13-MAR-2021, and severe body pain, dehydration, fingers curling up, toes curling up, sweating, chills, headache, and 101f fever on 14-MAR-2021, and was recovering from fatigue, rash, and hives. 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: 1253204 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-09
Onset:2021-04-16
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Computerised tomogram normal, Fibrin D dimer increased, Headache
SMQs:, Haemorrhage laboratory terms (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: Levothyroxine, Wellbutrin, lamictal, lithium
Current Illness: None
Preexisting Conditions: Bipolar 2 Mild TBI
Allergies: Anoxicilin
Diagnostic Lab Data: Ct scan was negative D dimer was elevated
CDC Split Type:

Write-up: Chills and moderate headache within 6 hours of vaccine. Lasted about 6 hours Severe headache 6 days later that lasted 1 day


VAERS ID: 1253220 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Illinois  
Vaccinated:0000-00-00
Onset:2021-03-15
Submitted: 0000-00-00
Entered: 2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Body temperature, Dizziness, Dyspnoea, Heart rate increased, Pyrexia, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), 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? No
Previous Vaccinations:
Other Medications:
Current Illness: Renal insufficiency (Stage3 renal insufficiency)
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210317; Test Name: Body temperature; Result Unstructured Data: 101.5 F
CDC Split Type: USJNJFOC20210336771

Write-up: FEVER; WEAKNESS; DIZZINESS; DIFFICULTY BREATHING; VOMITING; HEART RATE INCREASED; This spontaneous report received from a parent concerned a 30 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included renal insufficiency. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805018 and expiry: UNKNOWN) dose was not reported, administered on 14-MAR-2021 for prophylactic vaccination. The patient vaccinated on left arm at approx 13:45 -14:15. No concomitant medications were reported. On 15-MAR-2021, the subject experienced vomiting. On 15-MAR-2021, the subject experienced heart rate increased. On 15-MAR-2021 04:30, the subject experienced dizziness. On 15-MAR-2021 04:30, the subject experienced weakness. On 15-MAR-2021 04:30, the subject experienced difficulty breathing. On 17-MAR-2021, the subject experienced fever. Laboratory data included: Body temperature (NR: not provided) 101.5 F. Treatment medications (dates unspecified) included: paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from fever, and had not recovered from dizziness, weakness, difficulty breathing, vomiting, and heart rate increased. This report was non-serious.


VAERS ID: 1253229 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Mississippi  
Vaccinated:0000-00-00
Onset:2021-03-16
Submitted: 0000-00-00
Entered: 2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Cold sweat, Dizziness, Fatigue, Heart rate increased, Injection site erythema, Myalgia, Swelling, Urticaria
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Allergy to vaccine (When patient was infant)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210336777

Write-up: MUSCLE ACHE; TIREDNESS; GENERALIZED SWELLING ALL OVER HIS BODY; DIZZINESS; COLD SWEAT; RAPID HEART BEAT; INJECTION SITE REDNESS (UPPER LEFT ARM); HIVES; This spontaneous report received from a patient concerned a male of unspecified age. The patient''s height, and weight were not reported. The patient''s past medical history included similar allergic reaction to tetanus shot. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805029) dose was not reported, administered on 16-MAR-2021 at upper left arm for prophylactic vaccination. No concomitant medications were reported. On 16-MAR-2021, the subject experienced generalized swelling all over his body. On 16-MAR-2021, the subject experienced dizziness. On 16-MAR-2021, the subject experienced cold sweat. On 16-MAR-2021, the subject experienced rapid heart beat. On 16-MAR-2021, the subject experienced injection site redness (upper left arm). On 16-MAR-2021, the subject experienced hives. On 17-MAR-2021, the subject experienced muscle ache. On 17-MAR-2021, the subject experienced tiredness. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from generalized swelling all over his body, dizziness, cold sweat, rapid heart beat, injection site redness (upper left arm), and hives on 16-MAR-2021, and had not recovered from muscle ache, and tiredness. 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: 1253488 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-03-17
Submitted: 0000-00-00
Entered: 2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210342582

Write-up: VOMITING; ACHES; NAUSEA; 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 was not reported, administered on 17-MAR-2021 for prophylactic vaccination. The batch number was not reported and it has been requested. No concomitant medications were reported. On 17-MAR-2021, the subject experienced vomiting. On 17-MAR-2021, the subject experienced aches. On 17-MAR-2021, the subject experienced nausea. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the nausea, vomiting and aches 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: 1253547 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: South Carolina  
Vaccinated:0000-00-00
Onset:2021-03-18
Submitted: 0000-00-00
Entered: 2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Erythema, Headache, Hypoaesthesia oral, Joint swelling
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210343467

Write-up: SWOLLEN ELBOW WITH REDNESS (LEFT ARM); REDNESS (LEFT ARM); HEADACHE; LIPS NUMB; This spontaneous report received from a patient concerned a female of unspecified age. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805022 expiry: 26-MAY-2021) dose was not reported, administered on right arm on 18-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 18-MAR-2021, the subject experienced lips numb. On 18-MAR-2021, the subject experienced headache. On 22-MAR-2021, the subject experienced swollen elbow with redness (left arm). On 22-MAR-2021, the subject experienced redness (left arm). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from headache, had not recovered from lips numb, and the outcome of swollen elbow with redness (left arm) and redness (left arm) was not reported. This report was non-serious.


VAERS ID: 1253569 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Arizona  
Vaccinated:0000-00-00
Onset:2021-03-22
Submitted: 0000-00-00
Entered: 2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Dyspnoea, Oropharyngeal pain, Pain in extremity, Pharyngeal swelling, Pyrexia
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210343711

Write-up: DIFFICULTY BREATHING; SORE THROAT; SWELLING OF THE THROAT; FEVER; SORE ARM; This spontaneous report received from a parent concerned a 26 year old female. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown, and expiry: Unknown) dose was not reported, once a total administered, start therapy date not reported for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 22-MAR-2021, the subject experienced difficulty breathing. On 22-MAR-2021, the subject experienced sore throat. On 22-MAR-2021, the subject experienced swelling of the throat. On 22-MAR-2021, the subject experienced fever. On 22-MAR-2021, the subject experienced sore arm. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from sore throat, swelling of the throat, fever, and sore arm, and the outcome of difficulty breathing was not reported. This report was non-serious.; Sender''s Comments: V0: Medical assessment comment not required as per the standard procedure as the case is assessed as non-serious.


VAERS ID: 1253642 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Georgia  
Vaccinated:0000-00-00
Onset:2021-03-18
Submitted: 0000-00-00
Entered: 2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Headache
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Nonsmoker
Preexisting Conditions: Comments: The patient had no known allergies and not any drug abuse or illicit drug usage
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210345693

Write-up: HEADACHE; EXTREME TIRED; 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 no smoking, and non alcohol user, and other pre-existing medical conditions included the patient had no known allergies and not any 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: 1805029 expiry: UNKNOWN) dose was not reported, administered on 18-MAR-2021 at right arm for prophylactic vaccination. No concomitant medications were reported. On 18-MAR-2021, the subject experienced headache. On 18-MAR-2021, the subject experienced extreme tired. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from headache, and extreme tired. This report was non-serious.


VAERS ID: 1253825 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Chest X-ray, Chest discomfort, Dizziness, Electrocardiogram, Laboratory test, Peripheral swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: facial injury 4/1/2021
Preexisting Conditions: aortic valve repair. asthma
Allergies:
Diagnostic Lab Data: EKG, lab, CXR
CDC Split Type:

Write-up: Patient had weakness, chest discomfort, dizziness, weakness, moderate severity. same day of the vaccination. pt complained of left leg swelling.


VAERS ID: 1253837 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-03-12
Onset:2021-03-16
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Balance disorder, Blood test, Hypoaesthesia, Intervertebral disc operation, Magnetic resonance imaging, Mobility decreased, Motor dysfunction, Paraesthesia, Walking aid user
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 40 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amLODIPine 10mg, ascorbic acid 1000mg, atorvastatin 40mg, esomeprazole 40mg, gabapentin 800mg, meclizine 25mg, potassium chloride 10meq,dicyclomine 10mg, hydrocodone-acetaminophen 10mg-325mg, ibuprofen 800mg, LORazepam 1mg,
Current Illness:
Preexisting Conditions: blood pressure, high cholesterol, arthritis, acid reflux, anxiety
Allergies: Morphine, red dye
Diagnostic Lab Data: ER surgery, MRI, blood work, 17 tubes of blood work at one time in ER, they did the blood work multiple times
CDC Split Type:

Write-up: 4 days after vaccine couldn''t grasp with hands, numbness, tingle throughout arms and hands, loss of balance, now uses a walker, can not sit up alone. Had to have emergency surgery ACDF of C4/5 and C5/6


VAERS ID: 1253958 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-03-22
Submitted: 0000-00-00
Entered: 2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Allergic reaction to bee sting
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210353908

Write-up: ITCHINESS ON LOWER EXTREMITIES, UPPER EXTREMITIES AND EARS; HIVES ON LOWER EXTREMITIES, UPPER EXTREMITIES AND EARS; This spontaneous report received from a patient concerned a 66 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included bee sting allergy. 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 13-MAR-2021 to left deltoid for prophylactic vaccination. No concomitant medications were reported. On 22-MAR-2021, the subject experienced itchiness on lower extremities, upper extremities and ears. On 22-MAR-2021, the subject experienced hives on lower extremities, upper extremities and ears. Treatment medications (dates unspecified) included: famotidine, diphenhydramine hydrochloride, and cetirizine. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from itchiness on lower extremities, upper extremities and ears, and hives on lower extremities, upper extremities and ears. This report was non-serious.


VAERS ID: 1253976 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-03-28
Submitted: 0000-00-00
Entered: 2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Capillary fragility, Chills, Gastroenteritis viral, Hypophagia, Injection site erythema, Injection site pain, Injection site swelling, Migraine, Petechiae, Pyrexia, Urine output decreased
SMQs:, Acute renal failure (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ZOFRAN [ONDANSETRON]; PROMETHAZINE
Current Illness: Drug allergy; Immunocompromised; Lupus erythematosus; Migraine; Nausea; Thyroid disorder; Vomiting
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Name: Blood test; Result Unstructured Data: NORMAL
CDC Split Type: USJNJFOC20210419954

Write-up: POPPED/BURST CAPPILLARIES IN CHEEKS; MIGRAINE; INJECTION SITE REDNESS; INJECTION SITE SORENESS; INJECTION SITE SWELLING; HOT TEMPERATURE; PETECHIAE ON HER CHEEKS AND ARMS; CHILLS; URINE OUTPUT DECREASED; VOMITING, LOSS OF APPETITE/NAUSEA, DEHYDRATION, LOWER ABDOMINAL PAIN, SWELLING IN ABDOMEN; ORAL INTAKE REDUCED; This spontaneous report received from a patient concerned a 45 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included immunocompromised, nausea, vomiting, migraine, lupus, drug allergy to tegretol, ritalin, adderall , sporanox, latex contact long term and thyroid. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805029 and expiry: UNKNOWN) dose was not reported, administered on 14-MAR-2021 for prophylactic vaccination. Concomitant medications included ondansetron for vomiting, and nausea, and promethazine for vomiting, and nausea. On 28-MAR-2021, the subject experienced vomiting, loss of appetite/nausea, dehydration, lower abdominal pain, swelling in abdomen. On 28-MAR-2021, the subject experienced oral intake reduced. On 28-MAR-2021, the subject experienced urine output decreased. On 28-MAR-2021, the subject experienced petechiae on her cheeks and arms. On 28-MAR-2021, the subject experienced chills. On 28-MAR-2021, the subject experienced hot temperature. On an unspecified date, the subject experienced popped/burst capillaries in cheeks, migraine, injection site redness, injection site soreness, and injection site swelling. Laboratory data (dates unspecified) included: Blood test (NR: not provided) NORMAL. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from oral intake reduced, and hot temperature, and injection site redness, injection site soreness, and injection site swelling on 21-MAR-2021, was recovering from vomiting, loss of appetite/nausea, dehydration, lower abdominal pain, swelling in abdomen, chills, urine output decreased, popped/burst capillaries in cheeks, and petechiae on her cheeks and arms, and the outcome of migraine was not reported. 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: 1253978 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Maine  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Groin pain, Pain in extremity
SMQs:, 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:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210424562

Write-up: SEVERE,INTENSE PAIN IN LEG OR GROIN AREA; SEVERE,INTENSE PAIN IN LEG OR GROIN AREA; This spontaneous report received from a patient via a company representative 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: Unk) dose was not reported, administered on 10-APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On an unspecified date, the subject experienced severe, intense pain in leg or groin area, and severe, intense pain in leg or groin area. Treatment medications (dates unspecified) included: paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from severe,intense pain in leg or groin area, and severe,intense pain in leg or groin area. 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: 1253979 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-03-22
Submitted: 0000-00-00
Entered: 2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure measurement, Echocardiogram, Peripheral swelling, Skin ulcer, Thrombocytopenia
SMQs:, Cardiac failure (broad), Angioedema (broad), Haematopoietic thrombocytopenia (narrow), Systemic lupus erythematosus (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? 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: The patient has chronic conditions like PMHX of hx of HLD/HTN/ Type II DM, CAD with recent STEMI LAD s/p PCI, low EF 30% from 60% s/p Single chamber ICD 6/202
Allergies:
Diagnostic Lab Data: Test Name: Blood pressure; Result Unstructured Data: Moderate to severe pulmonary HTN; Test Name: Echocardiogram; Result Unstructured Data: worsening EF- 15% from 30%m Moderate MR
CDC Split Type: USJNJFOC20210424804

Write-up: SWELLING OF LEGS; VENOUS STASIS ULCERS; THROMBOCYTOPENIA; This spontaneous report received from a patient concerned a 66 year old female. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included the patient has chronic conditions like Patient Medical History of Hyperlipidaemia, hypertension, type II diabetes, coronary artery disease with recent segment elevation myocardial infarction left anterior descending s/p Percutaneous coronary intervention, low ejection fraction 30% from 60% s/p single chamber 6/202. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 1805018, expiry: UNKNOWN) dose was not reported, administered on 06-MAR-2021 10:29 for prophylactic vaccination. No concomitant medications were reported. On 22-MAR-2021, the patient experienced swelling of legs, venous stasis ulcers, and thrombocytopenia. The patient on unspecified date was shifted in emergency room and later she was hospitalized. Number of days in hospital the patient was admitted was unknown. Laboratory data (dates unspecified) included: Blood pressure (NR: not provided) Moderate to severe pulmonary HTN, and Echocardiogram (NR: not provided) worsening EF- 15% from 30%m Moderate MR. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from swelling of legs, venous stasis ulcers, and thrombocytopenia. This report was serious (Hospitalization Caused / Prolonged).; Sender''s Comments: V0: A 66 year old female, unspecified ethnicity, was diagnosed with venous stasis ulcers and thrombocytopenia 16 days after receiving the covid-19 vaccine ad26.cov2.s. The patient went to the emergency room for the leg swelling (start date unknown) that was progressing over 2 days. Medical history includes hyperlipidemia, hypertension, and type II diabetes. Patient also has coronary artery disease with recent segment elevation myocardial infarction left anterior descending (STEMI LAD) s/p Percutaneous Coronary Intervention, low Ejection Fraction 30% (from 60%), s/p Single Chamber ICD. Concomitant medications not reported. Smoking history not provided. Echocardiogram revealed worsening EF - 15% from 30%, Moderate MR, Moderate to Severe Pulmonary Hypertension. Thrombocytopenia was reported without a reported platelet count. The patient was subsequently admitted to the hospital for unspecified number of days and was reported to have recovered from all events. Given the patient''s extensive medical history, there is a plausible alternate explanation for swelling of legs and venous stasis ulcers, and there is limited information to make a meaningful assessment of the report of thrombocytopenia. Additional information is requested.


VAERS ID: 1253988 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-04-10
Submitted: 0000-00-00
Entered: 2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Dizziness, Headache, Nausea, Pain, Tunnel vision, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Optic nerve disorders (broad), Retinal disorders (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:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210428952

Write-up: TUNNEL VISION; EXTREME BODY ACHE; DIZZINESS; VOMITING; CHILLS; HEADACHE; NAUSEA; This spontaneous report received from a parent concerned a 19 year old female. The patient''s weight was 112 pounds and height was 66 inches. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of administration not reported, batch number: Unknown) frequency one total, dose was not reported, administered on 10-APR-2021 at11:30a.m.in left arm for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. The parent reported that the patient on 10-APR-2021 experienced tunnel vision, extreme body ache, dizziness, vomiting, chills, headache and nausea for which eight hours later patient went to the emergency room where the patient was given two bags of intravenous fluid and rotated ibuprofen and paracetamol when awake. The patient was also given Benadryl at evenings. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from tunnel vision on 11-APR-2021, and vomiting, and chills on 10-APR-2021, was recovering from extreme body ache, headache, and dizziness, and had not recovered from nausea. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0:20210428952- covid-19 vaccine ad26.cov2.s-Tunnel vision, extreme body ache, dizziness, vomiting. These events are considered unassessable. The events have a compatible/suggestive temporal relationship, are unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the events. 20210428952- covid-19 vaccine ad26.cov2.s-chills, headache, nausea. These events are labeled per RSI and are therefore considered potentially related.


VAERS ID: 1253995 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: California  
Vaccinated:0000-00-00
Onset:2021-04-01
Submitted: 0000-00-00
Entered: 2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain, Back pain, Blood test, Breast pain, Chest pain, Fatigue, Headache, Pain in extremity
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Lipodystrophy (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: Test Date: 202104; Test Name: Blood test; Result Unstructured Data: platelets were normal
CDC Split Type: USJNJFOC20210437045

Write-up: WHEN TAKEN DEEP BREATH LEFT PAIN INSIDE OF THE LEFT BREAST (CENTER OF CHEST); CHEST PAIN, SORENESS OF CHEST; LOWER BACK PAIN; SORE ARM; MILD HEADACHE; FATIGUE; MILD ABDOMINAL DISCOMFORMT (SIDE STITCH) ON LEFT SIDE TO RIGHT; This spontaneous report received from a patient concerned a 45 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: 205A21A expiry: UNKNOWN) dose was not reported, administered on 09-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On APR-2021, Laboratory data included: Blood test (NR: not provided) platelets were normal. On APR-2021, treatment medications included: naproxen sodium. On 09-APR-2021, the subject experienced sore arm. On 09-APR-2021, the subject experienced mild headache. On 09-APR-2021, the subject experienced fatigue. On 10-APR-2021, the subject experienced lower back pain. On 17-APR-2021, the subject experienced chest pain, soreness of chest. On 17-APR-2021, the subject experienced when taken deep breath left pain inside of the left breast (center of chest). On APR-2021, the subject experienced mild abdominal discomformt (side stitch) on left side to right. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from lower back pain on 10-APR-2021, when taken deep breath left pain inside of the left breast (center of chest) on 17-APR-2021, and sore arm, and mild headache on APR-2021, and had not recovered from chest pain, soreness of chest, fatigue, and mild abdominal discomformt (side stitch) on left side to right. This report was non-serious.


VAERS ID: 1254004 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Michigan  
Vaccinated:0000-00-00
Onset:2021-03-30
Submitted: 0000-00-00
Entered: 2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chest pain, Cough, Dyspnoea, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Respiration abnormal
Preexisting Conditions: Medical History/Concurrent Conditions: Nonsmoker; Pneumonia; Comments: The patient had not known any drug allergy.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210442424

Write-up: DIFFICULTY BREATHING/HARD TIME BREATHING; COUGHING; CHEST PAIN; WHEEZING; This spontaneous report received from a parent concerned a 21 year old male. The patient''s weight was 180 pounds, and height was 70 inches. The patient''s past medical history included untreated pneumonia during childhood, and concurrent conditions included lungs not in great shape, no alcohol use, and no smoking, and other pre-existing medical conditions included the patient had not known any drug allergy. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 1802072, expiry: UNKNOWN) dose was not reported, administered on 20-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 2021, the subject experienced wheezing. On 30-MAR-2021, the subject experienced difficulty breathing/hard time breathing. On 30-MAR-2021, the subject experienced coughing. On 30-MAR-2021, the subject experienced chest pain. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from difficulty breathing/hard time breathing, wheezing, coughing, and chest pain. This report was non-serious.


VAERS ID: 1254006 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: West Virginia  
Vaccinated:0000-00-00
Onset:2021-04-01
Submitted: 0000-00-00
Entered: 2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 202104; Test Name: Blood test; Result Unstructured Data: NORMAL; Test Date: 202104; Test Name: Scan; Result Unstructured Data: NORMAL
CDC Split Type: USJNJFOC20210443339

Write-up: ACHES; SHORT OF BREATH; CHILLS; HEADACHE; EXTREME FATIGUE; This spontaneous report received from a consumer via a company representative 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 not reported, batch number: Unk) dose was not reported, administered on 09-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 aches. On APR-2021, the subject experienced short of breath. On APR-2021, the subject experienced chills. On APR-2021, the subject experienced headache. On APR-2021, the subject experienced extreme fatigue. Laboratory data included: Blood test (NR: not provided) NORMAL, and Scan (NR: not provided) NORMAL. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the aches, headache, chills, short of breath and extreme fatigue was not reported. This report was non-serious.


VAERS ID: 1254009 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: New Jersey  
Vaccinated:0000-00-00
Onset:2021-04-01
Submitted: 0000-00-00
Entered: 2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Penile rash, Peripheral swelling, Pruritus genital, Rash pruritic
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: USJNJFOC20210444308

Write-up: ITCHING ON PRIVATE PARTS; RASH ON ALL OVER THE PRIVATE PART; ITCHING IN BOTH HANDS, FEET AND INSIDE THIGH AREA/RASH IN BOTH HANDS, FEET AND INSIDE THIGH AREA/RASH IN THIS AREA ARE RED ITCHY; HANDS AND FEET ARE BIT SWOLLEN; This spontaneous report received from a patient concerned a 60 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: 206A21A 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 hands and feet are bit swollen. On 19-APR-2021, the subject experienced itching on private part. On 19-APR-2021, the subject experienced rash on all over the private part. On 19-APR-2021, the subject experienced itching in both hands, feet and inside thigh area/rash in both hands, feet and inside thigh area/rash in this area are red itchy. On 20-APR-2021, treatment medications included: diphenhydramine hydrochloride. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from rash on all over the penis, and itching in both hands, feet and inside thigh area/rash in both hands, feet and inside thigh area/rash in this area are red itchy, and the outcome of hands and feet are bit swollen and itching on penis was not reported. This report was non-serious.


VAERS ID: 1254014 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Michigan  
Vaccinated:0000-00-00
Onset:2021-04-11
Submitted: 0000-00-00
Entered: 2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure increased, Blood pressure measurement, Headache, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (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: FENOFIBRATE
Current Illness: Blood cholesterol abnormal
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Name: Blood pressure; Result Unstructured Data: 150/110 mmHg; Comments: Fluctuating BP upto 150/110
CDC Split Type: USJNJFOC20210445254

Write-up: VOMIT; HEADACHE; INCREASE IN BLOOD PRESSURE; This spontaneous report received from a patient concerned a male of unspecified age. The patient''s height, and weight were not reported. The patient''s concurrent conditions included abnormal cholesterol. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 10-APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. Concomitant medications included fenofibrate for abnormal cholesterol. On 11-APR-2021, the subject experienced increase in blood pressure. On 11-APR-2021, the subject experienced headache. On 18-APR-2021, the subject experienced vomit. Laboratory data (dates unspecified) included: Blood pressure (NR: not provided) 150/110 mmHg. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from increase in blood pressure, headache, and vomit. This report was non-serious.


VAERS ID: 1254999 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-02
Onset:2021-04-12
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / -

Administered by: Public       Purchased by: ?
Symptoms: Acute kidney injury, Asthenia, Blood glucose increased, Blood pressure increased, Blood test, Cerebrovascular accident, Computerised tomogram head abnormal, Condition aggravated, Dysstasia, Hypoaesthesia, Magnetic resonance imaging head abnormal, Muscular weakness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (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), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypertension (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad), Sexual dysfunction (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Enalapril 10 by mouth daily for high blood pressure
Current Illness:
Preexisting Conditions: High blood pressure controlled by Enalapril
Allergies:
Diagnostic Lab Data: CT Scan, MRI, blood work- hospital stay 04/15-21/2021 CT Scan and blood work 04/24/2021
CDC Split Type:

Write-up: We were vaccinated on April 2 in the morning. On April 12, 2021 we came home from work in the morning and he complained of numbness in his left. We thought it was related to the weather getting warm and we work the night shift, so he rested and increased his water intake. He was able to go to work on Monday night and return home and continued to rest on Tuesday. On Tuesday, there was no numbness, but there was weakness in both his legs. On Wednesday, he felt weakness throughout his body, especially in his legs. On Thursday, he collapsed. He did not lose consciences but his legs gave out under him and he was not able to get up up. He was taken to the hospital. He was diagnosed with a stroke, increased sugars (diabetes he has never had before), acute kidney injury, and uncontrolled increased blood pressure. He was hospitalized and discharged April 19, 2021. He was readmitted 04/24/2021 for another stroke.


VAERS ID: 1255047 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-22
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Gait disturbance, Pain in extremity
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

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

Write-up: Sudden loss of walking ability. I can not walk. My legs below knee are hurting a lot. This has escalated in last few days


VAERS ID: 1256047 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-04-25
Onset:2021-04-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Cardiac monitoring, Fall, Head injury, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: syncopal episode
Other Medications: Unk
Current Illness: None
Preexisting Conditions: None known
Allergies: NKDA
Diagnostic Lab Data: Cardiac monitor, physical exam, vital signs. Transported via ambulance to local hospital.
CDC Split Type:

Write-up: Syncopal episode after vaccination, fell from chair striking head on gymnasium floor.


VAERS ID: 1256059 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Vermont  
Vaccinated:2021-03-24
Onset:2021-04-18
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Fibrin D dimer increased, Liver function test increased, Pain in extremity, Peripheral swelling, Platelet count normal, Renal function test normal
SMQs:, Cardiac failure (broad), Liver related investigations, signs and symptoms (narrow), Angioedema (broad), Haemorrhage laboratory terms (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril 20mg daily Ibuprofen as need
Current Illness: None
Preexisting Conditions: Hypertension
Allergies: None
Diagnostic Lab Data: Elevated Ddimer, normal renal function, normal platelet count. Mildly elevated LFTs. Duplex ultrasound not available due to facility limitations.
CDC Split Type:

Write-up: Left lower extremity swelling and pain for 1 week, right lower extremity normal.


VAERS ID: 1256081 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-08
Onset:2021-04-14
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK AR / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anticoagulant therapy, Atrioventricular block, Blood pressure decreased, Cerebral thrombosis, Coronary arterial stent insertion, Coronary artery occlusion, Dizziness, Hypoaesthesia, Intracardiac thrombus, Transient ischaemic attack
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Conduction defects (narrow), Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Other ischaemic heart disease (narrow), Vestibular disorders (broad), Dehydration (broad), Sexual dysfunction (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, 9 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Yes
Current Illness: High blood pressure
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: April 14, my sister was transported to hospital feeling faint and numbness in her left leg. As a result, she was admitted and treated for: ? blood pressure readings as low as 82/43, 76/50 while standing ? blood clots on her heart that traveled to her brain that were causing multiple mini strokes ? 95% blockage in her right heart vessel which required a stent ? 50% and 60% blockage in other chambers that will require attention She was given heparin and then switched to a different blood thinner to dissolve the clots. she was discharged on April 23rd with instructions to followup with her cardiologist and neurologist.


VAERS ID: 1256117 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Epistaxis, Insomnia, Pain in extremity, Vision blurred
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (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: Fish oil
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Bloody nose Left leg / foot pain Entire left side of body not correct Chest pain Shortness of breath Blurred vision Can''t sleep


VAERS ID: 1256299 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-30
Onset:2021-04-01
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Blood test, Haematoma, Pain in extremity, Ultrasound scan
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: warfarin, sumatriptan
Current Illness:
Preexisting Conditions: blood clotting condition
Allergies:
Diagnostic Lab Data: Ultrasound and blood work to determine if it was a blood clot.
CDC Split Type:

Write-up: Leg pain in left thigh began about two days after vaccine shot was administered. Hematoma formed and due to sever pain went to emergency room. MD did an ultrasound and determined that pain was due to hematoma. Morphine was given at hospital and Tramadol 50mg was prescribed.


VAERS ID: 1256350 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-07
Onset:2021-04-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN LOT 201A21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Breast pain, Chills, Fatigue, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Lipodystrophy (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: None
Current Illness: None
Preexisting Conditions: None
Allergies: Paroxetine, fluoxetine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever of 106.3 for 3 days. Sever chills, fatigue, breasts sore.


VAERS ID: 1256422 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-04-06
Onset:2021-04-08
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Computerised tomogram, Full blood count normal, Lymphadenopathy, Ultrasound scan, Urine analysis
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine 137mcg One tablet daily Atenolol-Chlorthalidone 100-25 One tablet daily Amlodipine 5 MG One tablet 2x daily Simvastatin 20 MG One tablet daily Sildenafil 20 MG One to three tablets as needed BioTe ADK 10 1 tab daily
Current Illness:
Preexisting Conditions: Hypertension Hypothyroidism Cervical radicalopothy Degenerative disc disease
Allergies: Inapsine Gabapentin
Diagnostic Lab Data: 04/10/21 CBC, Urinalysis, Ultrasound, CT scan. Lab results normal. CT scan revealed inflamed lymph nodes in abdominal cavity.
CDC Split Type:

Write-up: Severe Abdominal pain. CT scan and ultrasound revealed inflamed lymph nodes in abdominal cavity. Pain medicine prescribed. Pain is still present today, 04/25/21


VAERS ID: 1256458 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-03-27
Onset:2021-03-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Body temperature decreased, Chest X-ray, Chest discomfort, Chest pain, Chills, Cough, Disturbance in attention, Fatigue, Headache, Hypoaesthesia, Laboratory test, Malaise, Pain, Pain in extremity, Ultrasound scan
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Depression (excl suicide and self injury) (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: Pertussis
Other Medications: Xolair 300 mg, , methotrexate, vitamin D, topomax 25mg, Synthroid 75 mg, advair 250 mcg, folic acid 2 mg, Cymbalta 10 mg, amytriptline, hydroxychloroquire 400 mg
Current Illness: IGA Nephropathy w/ benign hematuria, RA, APS, Allergic Asthma, Inflammatory arthritis, acquired hypothyroidism,fibromyalgia,
Preexisting Conditions: See above
Allergies: PNC, tree nuts, hydrocodone, previous reaction to pertussis vaccine in college, sesame, ragweed, oral allergy syndrome
Diagnostic Lab Data: Ultrasound of the legs, labs, chest X-ray,
CDC Split Type:

Write-up: Early the next morning around 6 am started feeling unwell with chills, headache took Tylenol but did not help symptoms increased. Took migraine meds. March 28-30th severe chills and headaches, chest pain on left side with tight chest increase cough along with increased joint pain. April 1st appointment with Dr. for my Xolair injection, discussed symptoms seemed to be resolving some and lung function test normal. Took xolair. April 2-5 th increased tight chest headaches, low body temp, arm and leg numbness, right side, later very sore. April 7 -15th right side leg pain comes and goes increase hip pain, chest tightness, extremely tired, lack of concentration with continues headaches. On April 15th went to ED after Dr contacted me to go there after information had been released about other cases of reactions similar.


VAERS ID: 1256512 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-04-07
Onset:2021-04-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood magnesium normal, Burning sensation, Condition aggravated, Differential white blood cell count normal, Feeling abnormal, Fibrin D dimer normal, Full blood count normal, Headache, Hypoaesthesia, Influenza A virus test negative, Influenza B virus test, Lipase normal, Metabolic function test, Pain, Pain in extremity, Platelet count normal, SARS-CoV-2 test negative, Sleep disorder
SMQs:, Peripheral neuropathy (broad), Dementia (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad), COVID-19 (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: SPINAL STENOSIS HOWEVER HAD EPIDURAL IN JULY 2017, A SMALL RETURN OF NUMBNESS IN MY LEFT FOOT IN JULY 2018, WHICH WENT AWAY AFTER A FEW WEEKS. SINCE AUGUST 2018 I''VE BEEN FINE UNTIL VACCINATION.
Allergies: NONE
Diagnostic Lab Data: CBC with platelets & diff, D-Dimer, Comprehensive Metabolic Profile, Lipase, Magnesium Serum, and tested for COVID-19, Influenza A and B FIA SOFIA, All blood work was normal and other tests were negative. I''m reporting 18 days post-vaccination, 7 days post ER visit, and I still do not feel like myself. I still have leg, arm, and back pain as well as numbness with a burning sensation in both hands and feet. My symptoms are a bit better than a week ago . Last night I had abdominal and neck pain as well as a headache in addition to the issues in my arms and legs. I plan to visit my doctor soon for a consult.
CDC Split Type:

Write-up: Day one post vaccination - dull headache, leg pain, abdominal pain, back pain - these symptoms continued for a few days, I started to feel a bit better, did not take any pain reliever medications because I didn''t want to mask symptoms. On 4/14/21, 7 days post vaccination, my leg pain in both legs worsened including numbness and a burning sensation in both feet. Back pain continued, arm pain started in both arms with numbness in both hands however the pain on my left side with legs and arms is worse. I''ve had intermittent shooting pains in my left ear, left jaw, left temple and across the left side of my face. I''ve also experienced shoulder and neck pain. The abdominal pain is intermittent and mild. On 4/15 - 4/18 the pain in my legs was so bad that it was waking me up at night and my arm pain was occurring more frequently. I decided to go to the ER on 4/18, day 11 post vaccination, due to my concern of a possible DVT or other type of blood clot. The ER physician''s assistant did not look at my legs but did several blood tests and other tests.


VAERS ID: 1256586 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-07
Onset:2021-04-21
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Balance disorder, COVID-19, Chills, Cough, Influenza like illness, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Daily vitamins
Current Illness: None
Preexisting Conditions: None
Allergies: Codeine
Diagnostic Lab Data: As indicated COVID-19 Rapid Test was given by the facility.
CDC Split Type:

Write-up: My wife has been sick for a few days with a slight fever, chills, weakness and cough. We figured she may have caught the Flu. Today she woke up and had no balance with the other symptoms listed. They went over her symptoms with her and gave her a rapid COVID test , according to their test she was found to be POSITIVE for COVID-19. Just can''t understand this as she received her vaccination on the 7th.


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

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

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

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


VAERS ID: 1256728 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-03-26
Onset:2021-04-01
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arrhythmia, Blood test, Cardiac assistance device user, Cardioversion, Echocardiogram, Electrocardiogram abnormal, Ventricular tachycardia
SMQs:, Torsade de pointes/QT prolongation (narrow), Arrhythmia related investigations, signs and symptoms (broad), Ventricular tachyarrhythmias (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Torsade de pointes, shock-associated conditions (narrow), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Aldactone 25 mg 1x daily; Amaryl 4 mg 1x day; Coreg 25 mg 2x day; Eiquis 5 mg. 2xday; Entresto 97/103 2xday; Lanoxin 0.125 1xday; Lasix 20 mg as needed; Levemir 30-40 units as needed; Betapace 120 mg 1x day; Januvia 100 mg 1x day; Viagra 10
Current Illness: none
Preexisting Conditions: Congestive heart failure; Type II Diabetes; one kidney (former cancer)
Allergies: none
Diagnostic Lab Data: Defibrillator download; Echocardiagram, EKG, multiple blood work for levels 4-1-21; 4-12-21; & 4-17-21
CDC Split Type:

Write-up: 6 days after receiving the Covid19 J&J vaccine I had sustained arrhythmia of 142bpm for 2 hours & received emergency intervention at the Hospital and 1 night observation. They were able to cardiovert me with abimondiron drip. 17 days later my heart started racing again & I received 2 consecutive shocks from my internal defibrillator and was transported to the hospital and stayed 1 night for observation. 22 days after receiving the above vaccine, I again developed a ventricular tachycardia rhythm & received 2 consecutive shocks and was transported to the hospital and stayed 2 nights. I do have a history of v-tach but prior to being vaccinated it had been two years without any incident of VTach or therapy.


VAERS ID: 1256740 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-03-12
Onset:2021-04-21
   Days after vaccination:40
Submitted: 0000-00-00
Entered: 2021-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Bell's palsy, Chest X-ray, Computerised tomogram
SMQs:, Hearing impairment (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Sertraline 50 mg
Current Illness: None
Preexisting Conditions: Low iron
Allergies: None
Diagnostic Lab Data: Friday, April 23. Chest c-ray, CT scan
CDC Split Type:

Write-up: Bell?s Palsy


VAERS ID: 1256906 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chest pain, Electrocardiogram, Fatigue, Heart rate increased, Sleep disorder, Troponin
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: cashews, prednisone, bactrum, erythromycin
Diagnostic Lab Data: EKG blood panel troponin levels
CDC Split Type: vsafe

Write-up: 4/9 vaccination. Twelve hours later, I had fast pulse over 130 BPM. Woke me up at night. My resting is at the low 60''s; normal. chest pain. I was so tired. Tried to go back to sleep. Kept having episode. I woke up husband and said we need to go to the ER. Ran tests. Referred to cardiologist. They gave me Tylenol and baby aspirin. *Went to ER 4/10 and 4/12 4/16 appt with cardiologist; 24 hour HR monitor. Waiting on results 4/26 Echocardiogram scheduled **Dr. (cardiologist)


VAERS ID: 1256960 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal discomfort, Abdominal pain, Amylase normal, Anxiety, Asthenia, Blood ketone body, Blood lactate dehydrogenase normal, Blood urine, Chest X-ray normal, Chills, Diarrhoea, Dizziness, Dysgeusia, Electrocardiogram normal, Erythema, Faeces pale, Fatigue, Feeding disorder, Flushing, Full blood count normal, Headache, Hyperhidrosis, Laboratory test normal, Lipase normal, Metabolic function test, Myalgia, Nausea, Pallor, Palpitations, Pyrexia, Skin discolouration, Syncope, Taste disorder, Urine analysis, Vomiting, Weight decreased, Yellow skin
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Cholestasis and jaundice of hepatic origin (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Biliary system related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: probiotics
Current Illness: had been having recurrent hypoglycemia and perimenopausal symptoms
Preexisting Conditions: migraines controlled
Allergies: none
Diagnostic Lab Data: Labs Quest 4/16/2021-normal cbc, cmp, amylase, lipase, LD, U/A just trace ketones and blood ER 4/17/2021-similar
CDC Split Type:

Write-up: Within 24hours pt with fever, myalgia, chills, rigors, weakness and extreme dizziness with headache and episode of syncope. Had waves of flushing in body with central abdominal pain and redness and pale extremities. Abdominal pain "burning" recurrent for 6 days with diarrhea, nausea and vomiting and stools pale. In clinic 4/16/2021 pt appeared greenish/yellowish on day 6 and had weight loss from baseline 4lbs in 9 days when she was last seen. Pt labs done and normal. Night of 4/16/2021 started with palpitations racing heart. 4/17/2021 presented to ER for worsening palpitations with flushing and diaphoresis. Labs CXR normal. send home. Anxiety like symptoms fluctuating. Was given diazepam. 4/21/2021 seen in clinic again feeling slightly better. Still with nausea and also now dysgeusia. EKG normal. palpitations better. 4/23/2021 seen on video appt doing better. able to keep food down but still tired and weak. no longer needing diazepam. Taste improving.


VAERS ID: 1257111 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-03-31
Onset:2021-04-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 0331211/1808980 / N/A RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Computerised tomogram, Seizure, X-ray
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Keppra Vimpat
Current Illness: None
Preexisting Conditions: Hydrocephalus Epilepsy
Allergies: None
Diagnostic Lab Data: Blood works, CAT scans and x-rays were ordered and showed nolong term effects, an EEG has been ordered
CDC Split Type:

Write-up: Recieved the vaccine and the following morning around 5am had a seizure which lasted for about 20 minutes. Was transported by ambulance to medical center and recieved care until he was stable and able to go home, but told to follow up with his neurologist as soon as possible. The neurologist saw him within 2 weeks and increased the dosage of his Vimpat and has ordered for him to have a 3 day EEG as soon as possible.


VAERS ID: 1257193 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cold sweat, Dyspnoea, Fatigue, Feeling abnormal, Gait disturbance, Laboratory test, Limb discomfort, Muscle spasms, Muscle twitching, Pain, Pyrexia, Swelling, X-ray
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Allegra, albuterol, Zomig, Emgality, Vitamins C and D, Magnesium, calcium, melatonion, zinc
Current Illness:
Preexisting Conditions: Asthma, allergies, eosinophilic esophagitis, chronic headache migraines
Allergies: Penicillin, cephalosporins, dairy, wheat, shrimp, clindamycin, septra, latex, bananas
Diagnostic Lab Data: Xrays and lab work have been done results have been with in normal limits
CDC Split Type:

Write-up: I woke up at 3 am Friday with cold sweats and body aches. Took 1000 mg Tylenol. Woke up again at 10:30 am to a fever still and this odd extremity feeling. Felt like I had a compression body suit on and weight of 50 pounds around my arms and legs, Mild shortness of breath. I felt like I was swollen but did not see any. I called my PCP and vaccine line and both nurses said go to the ER. I went to the ER they ran tests. The time of the ER I started getting leg cramping and spasming. Those symptoms continued to the weekend. On Sunday the weight and swelling feeling went away. I still had bad muscle cramping and swelling. I did telehealth on Tuesday with PCP and was given muscle relaxer which helped some throughout the rest of the week. Thursday night I have a temp pf 99.6 and went up to 100.6 on Friday morning. On Friday I became shortness of breath and fatigued. It became difficult to go up and down stairs or walking about 20 ft without difficulty breathing. I now have a lower right leg muscle twitch/spasm that comes and goes. I switched to a different PCP, he ran more blood work on Wednesday 4/21. And discussed the next steps for treatment and monitoring.


VAERS ID: 1257219 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-03
Onset:2021-04-11
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Back pain, Computerised tomogram, Dizziness, Headache, Illness, Laboratory test, Nausea, Pain in extremity
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (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: Aspirin 81mg, Cetirizine 10mg, Drospirenone-Ethinyl Estradiol Anticonceptives 3mg
Current Illness: Fatty liver, high cholesterol, high triglycerides, kidney stones, high platelets, anxiety
Preexisting Conditions:
Allergies: no
Diagnostic Lab Data:
CDC Split Type:

Write-up: Back pain from the bottom to the neck, arm pain (more on the right side), leg pain (more on the right side), body sickness, headache (not severe), dizziness, a little nausea and a little stomach ache. I went to the emergency room on 04/15/2021 at 2:51 p.m. I had a laboratory and CT scan prescribed Naproxen 500 and Soma 350mg but until now I still have pain.


VAERS ID: 1257314 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-06
Onset:2021-04-12
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Computerised tomogram, Disturbance in attention, Dizziness, Head discomfort, Headache, Hypertension, Ultrasound scan
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalopathy/delirium (broad), Hypertension (narrow), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Blood test, CT scan - April 18 More blood tests - April 22 Leg ultrasound - April 25
CDC Split Type:

Write-up: Severe pressure headache, lightheaded, trouble concentrating, elevated blood pressure


VAERS ID: 1257385 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-03-20
Onset:2021-03-23
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / UNK RA / -

Administered by: Public       Purchased by: ?
Symptoms: Atrial fibrillation, Heart rate increased, Heart rate irregular
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Cardiac arrhythmia terms, nonspecific (narrow), 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: Vitamin B complex Senior multi vitamin Vitamin D Bone strength Calcium vitamin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: I visited a cardiologist twice: Dr. virtually. And a follow up appointment with my regular medical doctor Dr., she told me she would make a report that I was concerned, since it was so soon after the Covid vaccine.
CDC Split Type:

Write-up: Two days after my vaccine, on March 23 at approximately 2 AM, I had to call 911 because my heartbeat was rapid and irregular and had never happened before. I was concerned it was a result of the vaccine because it was two days after the vaccine. An emergency vehicle came took me to the hospital and they said I had atrial fibrillation and they had to reset my heart by jumping it. Very frightening.


VAERS ID: 1257440 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-10
Onset:2021-03-14
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / UNK LA / -

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain upper, Appendicectomy, Appendicitis, Computerised tomogram, Headache, Magnetic resonance imaging head
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Flecainide. Atorvastatin
Current Illness:
Preexisting Conditions: Heart palpitations
Allergies: Penicillin. Sulfa
Diagnostic Lab Data: CT scan, MRI, Appendectomy
CDC Split Type:

Write-up: Severe stomach pains, resulting in appendicitis and emergency appendectomy. Ongoing headaches., scheduled for a brain MRI


VAERS ID: 1257473 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-03-12
Onset:2021-03-28
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Cardiac failure congestive, Chest X-ray abnormal, Electrocardiogram abnormal
SMQs:, Cardiac failure (narrow), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Infective pneumonia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Multi-vitamin, Losartin, Clopidogrel, Clonidine, zinc, Levocitrizine, Carvedolol, Glimepiride, Lantus,
Current Illness: Vascular and cardiovascular disease, kidney disease, diabetes, bronchial asthma, rashes (unknown causes 9 mo-1yr severe to legs and hands)
Preexisting Conditions: Vascular and cardiovascular disease, kidney disease, diabetes, bronchial asthma, rashes (unknown causes 9 mo-1yr severe to legs and hands)
Allergies: eggs, bananas, tomatoes, milk
Diagnostic Lab Data: EKG and X-ray 03/26-27/21 (one of the two days)
CDC Split Type:

Write-up: Two weeks and two days after I was hospitalized for congestive heart failure. Never before diagnosed. I was treated during a hospital stay and then sent home.


VAERS ID: 1257659 (history)  
Form: Version 2.0  
Age: 98.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-16
Onset:2021-04-21
   Days after vaccination:36
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: alendronate (FOSAMAX) 70 mg by mouth once a week furosemide (Lasix) 20 mg tablet Take 1 tablet (20 mg total) by mouth daily NIFEdipine (ADALAT CC) 30 mg ER tablet Take 1 tablet (30 mg total) by mouth daily omeprazole (PriLOSEC) 40 mg
Current Illness: NA
Preexisting Conditions: hypertension, osteoporosis
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Acute occlusive deep vein thrombosis noted in the left proximal and mid femoral and gastrocnemius veins. There is also evidence of acute partially occlusive deep vein thrombosis noted in the left common femoral and distal femoral veins. Patient was initially started on enoxaparin transitioned to apixiban for discharge.


VAERS ID: 1257664 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-02
Onset:2021-04-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Ibprophen, sertraline, Vitamin D, magnesium, multi vitamin
Current Illness: Nine
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Severe Headache. Pain from nose up throughout that half of the head from front, sides, and back of head. Excederin did not help. Nausea and eventually threw up everything in stomach. Went to ER, recieved fluids, toradol, Reglan by IV, and tylonal by mouth. After the ER visit, the pain went away.


VAERS ID: 1257669 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-04-06
Onset:2021-04-15
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril 10 mg daily
Current Illness:
Preexisting Conditions: HTN
Allergies: NKDA
Diagnostic Lab Data: Venous doppler on 04/15/2021
CDC Split Type:

Write-up: Pt had vaccine on April 6, 2021 and was in the ER on April 15, 2021 with a right popliteal blood clot


VAERS ID: 1257728 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-08
Onset:2021-04-14
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

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

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

Write-up: Patient awoke on the morning of 4/14/21 and noted swelling of the lip/left facial region; swelling got worse throughout the day. Patient received epinephrine inhalation, famotidine IV, methylprednisolone IV, and diphenhydramine IV. Discharged 4/14/21.


VAERS ID: 1257873 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-11
Onset:2021-04-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Cerebrovascular accident, Glycosylated haemoglobin normal, Headache, Immediate post-injection reaction, Influenza like illness, Intensive care
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Hypersensitivity (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Sulfa Allergy
Diagnostic Lab Data: Hemoglobin A1c was 5.8%: No other lab results were given with discharge paperwork.
CDC Split Type:

Write-up: Immediately following vaccination: Flu like symptoms. 24 Hours after vaccination: Very severe headaches started and continued. 12 Days after vaccination severe Stroke/Hospitalization/ICU


VAERS ID: 1257905 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-09
Onset:2021-04-14
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Amylase, Back pain, Computerised tomogram normal, Fatigue, Fibrin D dimer normal, Full blood count, Lipase normal, Metabolic function test, Oedema peripheral, Petechiae, Ultrasound Doppler
SMQs:, Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: alendrone, vitamin d, biotin, buspar, Cymbalta, prociotic, loratadine, milk thistle, mutlvitamin, nicotine patch, oxycodone, lyrica, turmeric, b12, d3, magnesium zinc
Current Illness:
Preexisting Conditions: chronic pain, arthritis, depression and anxiety
Allergies: sulfa, cefazolin, penicillin
Diagnostic Lab Data: 4/14/21 bilateral venous doppler ultrasounds negative, Chest CT negative, d-dimer negative. CMP, cbc, amylase, lipase normal.
CDC Split Type:

Write-up: petechial rash with bilateral lower extremity edema, abdominal pain, back pain, fatigue.


VAERS ID: 1258007 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-08
Onset:2021-04-11
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Transverse sinus thrombosis
SMQs:, Embolic and thrombotic events, venous (narrow), Central nervous system vascular disorders, not specified as haemorrhagic or ischaemic (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: aurovela fe 1/20
Current Illness:
Preexisting Conditions:
Allergies: flagyl
Diagnostic Lab Data:
CDC Split Type:

Write-up: diagnosed with transverse sinus thrombosis, outcome unknown transferred to Hospital upstate


VAERS ID: 1258077 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Fall
SMQs:, Accidents and injuries (narrow)

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

Write-up: Member fell to floor after covid vaccine. Member alert and oriented to time and plce. member denies distress and brought to holding room. Member states had similar reaction when getting tattoo. Member observed x1hr and d/c''d by Dr.


VAERS ID: 1258089 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-10
Onset:2021-04-22
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Deep vein thrombosis, Pain in extremity, Peripheral swelling, Ultrasound Doppler
SMQs:, Cardiac failure (broad), Angioedema (broad), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol OTC
Current Illness: None stated
Preexisting Conditions: GERD
Allergies: NKDA
Diagnostic Lab Data: Doppler study 04252021
CDC Split Type:

Write-up: Client complained of pain and swelling in right calf area 2 -3 days before going to ER , at ER. Doppler study confirmed popliteal DVT


VAERS ID: 1258288 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / 1 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abnormal behaviour, Angiogram cerebral abnormal, Cerebral artery thrombosis, Cerebrovascular accident, Computerised tomogram head abnormal, Drooling, Facial paralysis, Mental status changes
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hearing impairment (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: CYMBALTA, LIPITOR, ASPIRIN SUBSTANCE ABUSE: MARIJUANA
Current Illness: PTSD MARIJUANA ABUSE
Preexisting Conditions: PTSD
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: PATIENT BROUGHT TO ED DEPARTMENT: HISTORY LIMITED TO PATIENT MENTAL STATUS CHANGES. PATIENT PRESENTS TO THE ED AFTER BEING FOUND ROLLING AROUND ON GROUND OUTSIDE OF APT. COMPLEX. SEVERAL HOURS INTO PATIENT STAY, HE BEGAN DROOLING. PATIENT HAD A RIGHT-SIDED FACIAL DROOP. CT ANGIOGRAM ORDERED WHICH SHOWED A THROMBUS IN THE LEFT MCA. VACCINATION OF JANSSEN VACCINE APPROX. 1 WEEK PRIOR TO PRESENTING PER PATIENTS MOTHER. UNKNOWN WHERE HE RECEIVED VACCINATION. PATIENT DIAGNOSED WITH ACUTE CVA


VAERS ID: 1258374 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-12
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Chest X-ray, Chills, Computerised tomogram head, Confusional state, Fracture, Laboratory test, Magnetic resonance imaging abnormal, Pain, Retching, Seizure, Venous thrombosis, Vomiting, X-ray
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Embolic and thrombotic events, venous (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Osteoporosis/osteopenia (broad), Generalised convulsive seizures following immunisation (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: Flomax 0.4mg, lipitor 40mg, lisinopril 20mg, melatonin 5mg, red rice yeast 600mg, CoQ10 30mg
Current Illness: none
Preexisting Conditions: controlled hypertension
Allergies: none
Diagnostic Lab Data: 4/12, labs, chest x-ray, shoulder x-ray, 4/13 CT head, and Adomnal MRI with contrast. 4/ 15 Head MRI with contrast
CDC Split Type:

Write-up: 4/9 thru 4/12, body aches, chills. 4/12 0400 throwing up stomach pain from dry heaving throughout the day, confusion starting at 6pm on 4/12. Seizure on 4/12 at 8 pm. 911, ambulance. to Hospital Seizure so severe caused a Fracture in the Right Scapula. MRI on 4/15 showed a venous thrombosis partial occlusion in the brain.


VAERS ID: 1258387 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-03-08
Onset:2021-03-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

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

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
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: 3 Blood clots formed in the bottom of my left leg.


VAERS ID: 1258420 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-03-09
Onset:2021-04-15
   Days after vaccination:37
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram thorax, Deep vein thrombosis, Fibrin D dimer, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Embolic and thrombotic events, 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? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: acetaminophen, albuterol, ascorbic acid, symbicort, cholecalciferol, ferrous sulfate, gabapentin, furosemide, liraglutide, losartan, metformin, multivitamin, sertraline, tramadol
Current Illness: n/a
Preexisting Conditions: diabetes type II, history of DVT lower ext(treated with warfarin for 3 months), chronic hypoxic respiratory failure, chronic kidney disease, hypertension, morbid obesity, anemia of chronic disease
Allergies: tetracycline, statins, lisinopril
Diagnostic Lab Data: D-dimer 3.95 4/26/2021 CTA chest pending 4/26/2021 Left upper ext u/s 4/26/2021 Positive for left upper extremity DVT
CDC Split Type:

Write-up: Patient received covid-19 vaccine in left arm on March 9th. He alerted health care provider of left arm swelling on April 19th that started 4-5 days prior. There was no redness or warmth, reported as non pitting left arm swelling. Venous duplex revealed Left upper extremity DVT predominately effecting subclavian and axillary vein.


VAERS ID: 1258442 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-06
Onset:2021-04-14
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / N/A LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril Hydrochlorothiazide Sertraline Vitamin D Melatonin
Current Illness: Sinus Infection two weeks before vaccine and prescribed Amoxicillin.
Preexisting Conditions: Hypertension
Allergies:
Diagnostic Lab Data: Covid-19 negative 04/19/2021
CDC Split Type: vsafe

Write-up: I got a rash eight days after the vaccine. It was a rash that started on my left ankle. It spread to my legs and arms. It was itchy and blistered in a bite like rash that was in clusters. After days I went to Urgent Care four days after the rash started because it was all over both extremities and starting to spread to my torso. I was given an oral steroid and I took Benadryl and Claritin. The rash is better after twelve days but the skin on my hands and feet where rash was are peeling. It is still slightly itchy in all the places where it was present.


VAERS ID: 1258458 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-03-31
Onset:2021-04-22
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / N/A LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Abdominal tenderness, Angiogram pulmonary abnormal, Anticoagulant therapy, Atelectasis, Back pain, Chest pain, Computerised tomogram thorax abnormal, Cough, Dizziness, Dyspnoea, Dysuria, Hypopnoea, Lung opacity, Painful respiration, Peripheral embolism, Platelet count normal, Pleural effusion, Pneumonia, Pneumonitis, Pulmonary embolism, Pyrexia, SARS-CoV-2 test negative, Scan with contrast, Scan with contrast abnormal
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (narrow), Vestibular disorders (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: mesalamine, azathioprine, dicyclomine, multivitamin
Current Illness: unknown
Preexisting Conditions: Crohn''s disease
Allergies: Remicade
Diagnostic Lab Data: 2021-04-23 CTA chest w/ and w/out contrast: Central and peripheral pulmonary emboli in the right lower lobe. No CT evidence of right heart strain. Groundglass opacities within theright lower lobe which are somewhat bandlike in appearance and concerning for early pulmonary infarcts. Alternatively this may relate to subsegmental atelectasis or less likely an inflammatory/infectious process. Small right pleural effusion. No acute inflammatory process in the abdomen or pelvis. 2021-04-23 platelets 252k/mcL 2021-04-23 COVID test - negative
CDC Split Type:

Write-up: 2021-04-23 Patient presents to the ED with right-sided mid-back pain and shortness of breath starting 2021-04-22 evening. Pain is sharp and worsens with coughing and deep inspiration; she feels that she is taking shallow breaths. On ED presentation, no shortness of breath, chest pain, dizziness, fevers, dysuria, or abdominal pain. She does have reproducible pain on her right mid-back area. There is some mild diffuse tenderness in her abdomen, but reports that she always has a tender abdomen due to Crohn''s disease. No peritoneal signs. No recent travel. Patient was found to have pulmonary embolism. Hematology/Oncology specialist was consulted and recommended initiation of argatroban for treatment of pulmonary embolism. Patient was admitted to inpatient.


VAERS ID: 1258536 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-07
Onset:2021-04-01
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / SYR

Administered by: Senior Living       Purchased by: ?
Symptoms: Arthralgia, Dizziness, Laboratory test, Migraine, Musculoskeletal discomfort, Pain in extremity, Paraesthesia, Peripheral swelling, Skin discolouration
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (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: Lithium Prozac
Current Illness: None
Preexisting Conditions: None
Allergies: Sulfa
Diagnostic Lab Data: Labs
CDC Split Type:

Write-up: Had mmr vaccine 1 week prior. Purple swollen feet hands. Severe pain in arms and legs. Hip and joint pain. Tingling in appendages. Light headed. Migraines.


VAERS ID: 1258576 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-04-09
Onset:2021-04-21
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 UN / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Atrial fibrillation, Cerebral infarction, Intensive care, Thrombosis
SMQs:, Supraventricular tachyarrhythmias (narrow), Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (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? No
Previous Vaccinations:
Other Medications: There are several for the long term conditions listed below. I can submit that information a little later today.
Current Illness: None
Preexisting Conditions: Diabetes High blood pressure High Cholesterol
Allergies: None
Diagnostic Lab Data: We will have to get the from the hospital.
CDC Split Type:

Write-up: Heart went into Atrial fibrillation causing blood clotting. He has no prior heart condition. A blood clot traveled to his brain causing a Posterior Cerebral Artery Stroke. He has been in ICU since 04/22/2021.


VAERS ID: 1258608 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-11
Onset:2021-04-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Blood creatine phosphokinase normal, Blood magnesium normal, Blood test normal, Differential white blood cell count normal, Erythema, Fatigue, Fibrin D dimer normal, Full blood count normal, Headache, Metabolic function test
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: Blood test for blood clots - negative result on 4/21/2021 These test were normal: CBC w/ auto diff, CPK, Comprehensive Metabolic Panel, D DIMER, Mg. D DIMER, QUANTITATIVE Magnesium Test results are negative.
CDC Split Type:

Write-up: He has had the following symptoms from the 4/12/2021 till present time: constant headache and fatigue. Intermittent low fever (99F). On 4/21/2021, his primary care doctor recommended that we take him to Emergency Room because she was concerned about thrombosis as side effects from the vaccine. His legs had some red patches on the back of the ankles area. At ER, doctor did blood test for blood clot and result was negative. He got an IV injection less headache.


VAERS ID: 1258614 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-01
Onset:2021-04-25
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Cardiac arrest, Life support, Syncope
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), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Respiratory failure (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-26
   Days after onset: 1
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vienva
Current Illness: Appendicitis, fall from 12 foot ladder resulting in fracture of olecranon process of left ulna requiring admission to skilled nursing facility
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient presented to ED for 2 syncopal episodes and went into cardiac arrest 5 minutes prior to ED arrival in ambulance. She received ACLS measures and alteplase was mixed and administered for pulmonary embolism concern.


VAERS ID: 1258621 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Maine  
Vaccinated:2021-04-26
Onset:2021-04-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / N/A LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood glucose increased, Cardiac arrest, Cardiac monitoring abnormal, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Respiratory failure (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? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: NKDA
Diagnostic Lab Data: Cardiac monitor, IV, blood glucose (107), transport to ER via ambulance.
CDC Split Type:

Write-up: Syncopal episode with spontaneous recovery. Second syncopal episode associated with 15 seconds of asystole on cardiac monitor.


VAERS ID: 1258629 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-03-14
Onset:2021-04-22
   Days after vaccination:39
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 RA / SYR

Administered by: School       Purchased by: ?
Symptoms: Computerised tomogram thorax abnormal, Pulmonary thrombosis, Thrombosis, Ultrasound Doppler abnormal
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Cardiomyopathy (broad)

Life Threatening? 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: Vitamin D
Current Illness: None
Preexisting Conditions: None
Allergies: Advil, metronidaz, amlodipine, fessalon, hydrocodone-norco, nadolol, lisinopril, spriospirondactone.
Diagnostic Lab Data: Cat scans for the lungs and ultrasound on the legs.
CDC Split Type: 1805018

Write-up: Blood clots in the left leg and in the lungs.


VAERS ID: 1258647 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-03-26
Onset:2021-04-09
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angiogram, Computerised tomogram, Full blood count, Headache, Visual impairment
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Daily multivitamin Daily omega fatty acid supplement
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: chem/CBC, CT and CTA
CDC Split Type:

Write-up: 04/19/2021 - 2 weeks post vaccine severe left sided headache and left sided visual disturbances - no previous history of migraines/ocular migraines


VAERS ID: 1258699 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-04-26
Onset:2021-04-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / N/A LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Cardiac monitoring, Dizziness, Electrocardiogram, Heart rate irregular
SMQs:, Anticholinergic syndrome (broad), Cardiac arrhythmia terms, nonspecific (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: Unk
Current Illness: unk
Preexisting Conditions: unk
Allergies: NKDA
Diagnostic Lab Data: Cardiac monitor, ECG, transport via ambulance to ER
CDC Split Type:

Write-up: Lightheaded, irregular heart rate/rhythm


VAERS ID: 1258715 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-10
Onset:2021-04-13
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK AR / -

Administered by: Unknown       Purchased by: ?
Symptoms: Joint swelling, Pain in extremity
SMQs:, Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Abilify 5 mg tab Lexapro 10 mg tab Remeron 45 mg tab pantoprazole 40 mg oral suspension Seroquel 50 mg tab EpiPen
Current Illness: None known
Preexisting Conditions: GERD
Allergies: Penicillin Azithromycin Augmentin
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: R ankle swelling, bilat calf pain


VAERS ID: 1258731 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-10
Onset:2021-04-13
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 AR / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Abilify 5 mg tab Seroquel 50 mg tab Remeron 45 mg tab Lexapro 10 mg tab Epipen prn pantoprazole 40 mg suspension
Current Illness: None known
Preexisting Conditions: GERD
Allergies: Augmentin Pencillin Azithromycin
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: R thigh pain, bilat calf pain


VAERS ID: 1258786 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-03-29
Onset:2021-04-10
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Dysstasia, Full blood count normal, Gait inability, Menstrual disorder, Muscle spasms, Pain in extremity, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), 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: Fue al sala de emergencias y me realizaron un CBC el cual ella indicio que todo esta bien, le explique la situaci?n y lo de la vacuna pero no me realizo mas estudios
CDC Split Type:

Write-up: Dolor de piernas, calambre en piernas, fall? al levantarme para caminar, en la pierna derecha en la parte de atr?s se me formo un chich?n el cual me dolio, hace unos d?as tuve mi periodo, regularmente soy una persona que sangra bastante, esta vez fue muy distinta, pude estar bastante horas con una misma toalla yabque cada vez que iba al ba?o estaba limpia, pero al secarme es donde se pod?a apreciar la sangre, como que no me bajo bien la sangre, nunca me hab?a ocurrido algo similar.


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

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Cough, Dyspnoea, Exposure to SARS-CoV-2, Hypoxia, Pain, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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

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


VAERS ID: 1258978 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-03
Onset:2021-04-05
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Anxiety, Confusional state, Coordination abnormal, Dizziness, Headache, Musculoskeletal stiffness, Myalgia, Pain in jaw, Palpitations, Sinus pain, Vision blurred
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Vestibular disorders (broad), Osteonecrosis (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: venlafaxine multi vitamin fish oil zinc vitamin d turmeric excedrin
Current Illness: Lyme Disease Covid
Preexisting Conditions: Lyme Disease
Allergies: None
Diagnostic Lab Data: Emergency Room visit 4/17/21
CDC Split Type:

Write-up: Crushing headaches, dizziness, blurred vision, confusion, anxiety. Muscle pain and stiffness, heart palpitations, loss of coordination. Sinus and jaw pain.


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

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

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

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


VAERS ID: 1259030 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-17
Onset:2021-04-11
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Cerebral haemorrhage, Computerised tomogram head abnormal, Dizziness, Drooling, Headache, Hemiparesis, Magnetic resonance imaging head abnormal, Nausea, Reduction of increased intracranial pressure
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Vestibular disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-04-24
   Days after onset: 13
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: Per my aunt, the hospital will give them a detailed report regarding my uncle''s event soon. Based on what I know so far, CT scan for the head was done on 4/11/21 morning and found there is massive hemorrhage on the right side of the brain, but the doctor is unable to find out the origin/cause of the hemorrhage. On the same day afternoon, MRI was done showing the hemorrhage continued. Doctor decided to perform surgery to relieve the intracranial pressure in the same day evening.
CDC Split Type:

Write-up: Per my aunt (uncle''s wife), my uncle complained of severe headache especially on the right temple area, nausea, and dizziness at around 6am on 4/11/2021. Soon afterward, she noted my uncle has left side weakness and drooling when drinking.


VAERS ID: 1259054 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-04-11
Onset:2021-04-13
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Cough, Dyspnoea, Malaise, Nausea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (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? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: unsure
CDC Split Type:

Write-up: Per pt''s wife - reported to pharmacy - 2 days after receiving vaccine - pt experienced shortness of breath, coughing, nausea. Patient was not feeling well in general. 2 days after this (so about 5 days after receiving the vaccine) - pt was COVID positive - and is at the moment in the ER.


VAERS ID: 1259176 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-31
Onset:2021-04-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, C-reactive protein increased, Chills, Computerised tomogram head normal, Computerised tomogram thorax abnormal, Diarrhoea, Dizziness, Dyspnoea, Dyspnoea exertional, Fatigue, Fibrin D dimer, Full blood count normal, Injection site swelling, Malaise, Metabolic function test, Myalgia, Nausea, Pregnancy test, Red blood cell sedimentation rate abnormal, SARS-CoV-2 antibody test negative, Tension headache, Urine analysis, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (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: Estarylla, Prozac, docusate sodium
Current Illness: None
Preexisting Conditions: Obesity, seasonal/perennial allergies, headaches
Allergies: Penicillin, Ceftin, Latex
Diagnostic Lab Data: 4/13/21: CBC, Chem 14, CRP, sed rate. Abnormal sed rate 32, CRP 15; others WNL. Anti-SARS-CoV2 total antibodies - negative, no evidence of past infection. 4/14/21: CTA chest, CT head, UA, pregnancy, D-dimer, Chem 14, and CBC. All labs normal. CT head normal, CTA chest - no pulmonary embolism or acute process, noted 6 mm ground glass nodule to left upper lung.
CDC Split Type:

Write-up: 4/5/21: Office visit for myalgias, headache, and localized swelling/erythema to injection site (left deltoid). Bactrim DS prescribed for possible infection with symptom management. 4/13/21: Office visit for continued myalgia as well as chills, malaise, abdominal pain, N/V/D and dizziness. Decadron 10 mg IM given in office and prescribed prednisone. 4/14/21: ED visit for headache and shortness of breath. CTA chest, CT head, UA, urine pregnancy, D-dimer, Chem 14, and CBC done. Diagnosed wtih episodic tension headache and abnormal CT chest (6 mm ground glass nodule to upper left lung). 4/15/21: Office visit with c/o fatigue, dyspnea with moderate exertion, allergy symptoms, and headaches - follow up from ED for abnormal CT results - informed inflammation, infection - will repeat CT in 3-6 months. Prescribed Z-Pak, medrol pak, and promethazine.


VAERS ID: 1259278 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-27
Onset:2021-03-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: cetrizine
Current Illness: none
Preexisting Conditions: hypertension, allergies seasonal
Allergies: iodine- seizure 1998
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient started feeling dizziness, feeling hot, paased out 20 secs. Legs raised, alert and active, no seizure. BP 94/76, P- 70 1:03 Has M/O feeling dizziness when she wakes up in the morning at times. No signs of stridor, no seizures, no vomiting or nausea. 1:14 82/68, P- 70 Alert, active, sweating, color is pink, no change in color, no Shortness of breath, no stridor 1:23 104/76 P-70 Alert, Oriented x 3 1:28 110/80, P-70 1:32 cold and sweaty 1:35 sitting on chair, feel well. Alert, active, oriented x 3 1:42 92/68 P- sitting position chair 1:46 103/72 P-64 lying down 1:50 Vomiting, feel better afterwards 2:01 105/82, P-65


VAERS ID: 1259350 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-01
Onset:2021-04-22
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Erythema, Headache, Sleep disorder
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Fluoxetine, Vicodin, Lorazepam, Zolpidem, Finasteride,
Current Illness: None
Preexisting Conditions: Endometriosis, fibromyalgia, hidradenitis, hyperhydrosis,
Allergies: Sulfa: angioedema Azithromycin: palpitations
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient presents with concern for Covid vaccine reaction. Patient states she had the Johnson & Johnson vaccine about 2 weeks ago. Patient reports she had a headache about 1 week ago that woke her up from sleep about 1 AM but resolved by 4:30 AM. Patient denies having a headache since then. Patient noticed some small red dots on her nose today and was concerned when her friend told her this could be from the vaccine. Patient called her PCP who advised her to come to the ED for evaluation for thrombotic thrombocytopenia.


VAERS ID: 1259409 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-04-17
Onset:2021-04-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Breast pain, Chest pain, Computerised tomogram, Dizziness, Musculoskeletal stiffness, Pulmonary embolism, Ultrasound scan
SMQs:, Anticholinergic syndrome (broad), Embolic and thrombotic events, venous (narrow), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Lipodystrophy (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: multivitamins, vit C
Current Illness: n/a
Preexisting Conditions: Lupus (In remission for a long time)
Allergies: Penicillin, latex
Diagnostic Lab Data: Scan with contrast for heart Blood panel ultra sound CT
CDC Split Type: vsafe

Write-up: 4/17 Vaccination @ 530PM 4/18 woke up with stiff neck. Unsure if chest pain started on 4/18 or 4/19. Stiff neck felt like ''being choked''. 2 sharp pains in between breasts. Little pains on left breast, worked up to neck and ear. 4/19 ER. 4/20 ER ultra sound 4/21 cardiologist cb to tell me I had a pulmonary embolism. The Dr. said I needed to go to larger clinic. 4/22 Larger Clinic. They ran some scans with contrast of neck because of pain. CT. Taking blood clot medication. 4/26/2021 Extremely dizzy; going to have a CT scan today **dizziness is so bad right now. *4/29 appt with pulmonologist


VAERS ID: 1259456 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Maine  
Vaccinated:2021-04-26
Onset:2021-04-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / N/A LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Electrocardiogram, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Valsartan 80 mg daily, Albuterol 1-2 puffs as needed, Zyrtec 10 mg daily
Current Illness: Hypertension, medication started 2 weeks ago.
Preexisting Conditions: HTN, asthma
Allergies: NKDA
Diagnostic Lab Data: As above
CDC Split Type:

Write-up: Syncopal episode after receiving vaccine. Regained consciousness, but had persistent dizziness. IV established with 250cc bolus. Positive orthostatic. EKG with possible RBBB. Additional 250 cc NS, transport to ER via ambulance.


VAERS ID: 1259504 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Wyoming  
Vaccinated:2021-03-16
Onset:2021-04-19
   Days after vaccination:34
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / N/A LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Activated partial thromboplastin time shortened, Acute respiratory failure, Angiogram pulmonary abnormal, Atelectasis, Chest discomfort, Dyspnoea, International normalised ratio normal, Oropharyngeal pain, Pain in extremity, Platelet count decreased, Prothrombin time shortened, Pulmonary embolism, Rhinorrhoea
SMQs:, Anaphylactic reaction (broad), Haematopoietic thrombocytopenia (narrow), Systemic lupus erythematosus (broad), 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, venous (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Respiratory failure (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: "shingles 2 dose series" Flu like symptoms for 2 days after. Vaccinated in < 5years ago.
Other Medications: Amlodipine 5 mg oral tab 1 tab once a day; Over the counter supplements: Cinnamon; Beet powder capsule; cranberry tablets; Kidney formula from Long-jevity
Current Illness: None
Preexisting Conditions: Hypertensive disorder; Poor kidney function; Hysterectomy; Breast lumpectomy bilateral; breast implants.
Allergies: Ibuprofen contraindicated due to her poor kidney function
Diagnostic Lab Data: 04/25/2021 @ 2312 CTA of chest with contrast w/ "Pulmonary embolism mo0re prominent on the right side. I do not see evidence of significant right heart strain. Subtle atelectasis involving the lung bases; possible infarct involving the right lung base. Saddle embolus of pulmonary artery 04/25/2021 @ PT = 10.3; INR = 0.99; PTT = 20.2. Platelets =137
CDC Split Type:

Write-up: 1 week post vaccine had 1 day with a sore throat and runny nose. Developed right calf pain 04/19/2021. Presented to ER on 04/25/2021 w/ a 2 day history of shortness of breath and some chest tightness worse with exertion, with worsening symptoms at time of ER visit. Admitted for observation with "Pulmonary embolism without acute cor pulmonale and Acute respiratory failure with hypoxia"


VAERS ID: 1259560 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Nevada  
Vaccinated:2021-04-08
Onset:2021-04-26
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Thrombosis, Ultrasound scan abnormal
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Thrombophlebitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Skin Cancer Sleep Apnea
Allergies:
Diagnostic Lab Data: Ultrasound - 4/26/21
CDC Split Type:

Write-up: ultrasound the left lower extremity shows extensive occlusive lower extremity DVT involving multiple veins. Labs otherwise unremarkable, patient appears well, denies chest pain or shortness of breath. He had the J+J vaccine less than 3 weeks ago.


VAERS ID: 1259570 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-04-06
Onset:2021-04-21
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Blood test, Computerised tomogram, Dyspnoea, Fatigue, Musculoskeletal chest pain
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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamins
Current Illness: None. Going to physician for sinus issues.
Preexisting Conditions: None.
Allergies: Penicillin
Diagnostic Lab Data: Did blood tests and CT on 4/23/2021.
CDC Split Type:

Write-up: On Wednesday the 21st he came home and was tired. It got gradually worse on the 22nd. Was also feeling rib pain on the right side. Was a little bit short of breath. Went to the ER on 4/23 and they gave him IV fluids and pain medications. Put him on Tylenol, Naproxen, and Eliquis. States today 4/26 he is feeling a little bit better.


VAERS ID: 1259599 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-12
Onset:2021-04-18
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Computerised tomogram head, Computerised tomogram normal, Dizziness, Full blood count normal, Headache, Rash, Rash erythematous, Rash pruritic, Vertigo
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Vestibular 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: None
Current Illness: None
Preexisting Conditions: Obesity Neuropathy
Allergies: No
Diagnostic Lab Data: Ct brain normal CBC bmp normal
CDC Split Type:

Write-up: 6 days after vaccine developed itchy red rash left arm that spread to whole body lasted 2-3 days. Also developed dizziness/ vertigo/ headache that continued


VAERS ID: 1259610 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-03-12
Onset:2021-03-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 RA / IM

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

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

Write-up: Severe right lower abdominal pain that started approximately 2-3 days after vaccine administered. Over a month after the vaccine, she continues to have dull lower right abdominal pain that was not present prior to having the vaccine.


VAERS ID: 1259681 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-03-05
Onset:2021-03-20
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN K605020 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Computerised tomogram thorax abnormal, Dyspnoea, Pain in extremity, Pulmonary embolism
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: sertraline, losartan , pregabalin, terazosin , vitamin D, fish oil
Current Illness: na
Preexisting Conditions: hypertension, depression , dementia, obesity
Allergies: erythromycin, asa, ibuprofen
Diagnostic Lab Data: CT angiogram of chest
CDC Split Type:

Write-up: arm pain follwed by shortness of breath 2 weeks later and pulmonary embolism


VAERS ID: 1259704 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-02
Onset:2021-04-09
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Chest X-ray normal, Computerised tomogram thorax normal, Cough, Dyspnoea, Pain in extremity, Thrombosis, Ultrasound Doppler abnormal
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (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: None
Current Illness: None
Preexisting Conditions: Asthma
Allergies: Percocet
Diagnostic Lab Data: Ultrasound done on leg April 23 rd. Blood test done on April 11th and April 23rd . Chest X-ray on April 11 th and cat scan on April 23rd
CDC Split Type:

Write-up: Went to er on April 11 th for cough and shortness of breathe they said nothing was wrong and sent me home. Did a virtual apt on 21st because my leg hurt and shortness of breathe. They told me to go see doctor in person . Went to Er April 23rd and was diagnosed with a massive blood clot in my lower right leg.they prescribed xarelto.


VAERS ID: 1259746 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-10
Onset:2021-04-19
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Pain in extremity
SMQs:, Retroperitoneal fibrosis (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: Bisoprolol Trazadone
Current Illness: None
Preexisting Conditions: High blood pressure
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: Lower back and left leg pain


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

Administered by: Private       Purchased by: ?
Symptoms: Bell's palsy, Computerised tomogram head, Facial paralysis, Full blood count
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Dulera Inhaler
Current Illness: none
Preexisting Conditions: Asthma
Allergies: none
Diagnostic Lab Data: Lab Test: CBC with Differential Imaging: CT Head without Contrast
CDC Split Type:

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


VAERS ID: 1259796 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-12
Onset:2021-04-15
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Asthma, Chest X-ray
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: 10mg Zyrtec 450mg Welbutrin 50mg Adderal XR 60mg Cymbalta
Current Illness: Mental health decline (depression) resulted in changes to medication. Cymbalta was a new medication, nearing end of 3rd week, at time of vaccination.
Preexisting Conditions: Environmental and animal-dander allergies Chronic & severe allergy-, exercise-, and stress-induced asthma C-PTSD Major clinical depression ADHD
Allergies: Hydrocodone/Vicodin Qvar (Beclomethasone dipropionate)
Diagnostic Lab Data: chest xrays showed no pneumonia
CDC Split Type:

Write-up: asthma attack, not responsive to at-home medical treatment including inhalers and nebulizer received medicinal treatment discharged a few hours later with updated prescriptions and improved breathing


VAERS ID: 1259979 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-23
Onset:2021-04-26
   Days after vaccination:34
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Headache, Injection site pain, Ocular hyperaemia
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Glaucoma (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: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt called the office reporting injection site pain, headache, and right eye redness. Started with the red eye then injection site arm hurting/pain, and headache. Pt was told to go to her PCP and/or the emergency room to be seen and treatment.


VAERS ID: 1260021 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain, Blood gases, Cardiac monitoring, Chest pain, Chills, Computerised tomogram thorax, Differential white blood cell count, Dyspnoea, Electrocardiogram, Fatigue, Feeling of body temperature change, Full blood count, Headache, Metabolic function test, Pregnancy test urine, Urine analysis
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: One A Day Women''s complete Multivitamin/ Estradiol 0.5 mg tab/Goli Apple Cider Vimegar (2 gummies)
Current Illness: none
Preexisting Conditions: Irritable bowel syndrome/acid reflux
Allergies: Penicillin/ Adhesive Tape/Egg/Pistachio Nut/Lactose intolerance
Diagnostic Lab Data: Basic metabolic panel/chemical urialysis/complete blood count with differential/urine pregnancy screen/venous blood gas/ct chest pe protocol/ekg standard/cardiac monitor/oxygen/saline lock insert/ iohexol (omnipaque) /prednisone/saline flush/nacl 0.9%
CDC Split Type:

Write-up: Got Johnson and Johnson shot 4/10/2021: 4/11/21-4/12/21 headache, hot and cold chills 4/13/21- abdominal pain and shortness of breath 4/14/21- shortness of breath (sob) 4/15/21- headache, pain right side chest 4/16/21- fatigue, pain left side chest 4/17/21- sob (bad) 4/18/21- 4/21/21 sob 4/22/21 -woke up struggling to breath. Family Physician sent me to hospital. She was thinking blood clot lungs 4/23/21-current sob


VAERS ID: 1260051 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-10
Onset:2021-04-14
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth control - tricyclin
Current Illness: covid 1 month prior
Preexisting Conditions:
Allergies: Allergies to amoxicillin and raspberries
Diagnostic Lab Data:
CDC Split Type:

Write-up: Leg numbness/pins and needles in both legs and feet


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