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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: 1277948 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-09
Onset:2021-04-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Computerised tomogram, Dizziness, Drooling, Feeling cold, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: B-12
Current Illness: No
Preexisting Conditions: Hypertension, history of Belspalsy, pre diabetic
Allergies: No allergies
Diagnostic Lab Data: Ct scan-
CDC Split Type:

Write-up: The night after the COVID vaccine had fever 101.4, feeling cold, until the follow day. Went to the Emergency Department the following night because I noticed that I was drooling, feeling very dizzy and weak.


VAERS ID: 1277979 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-01
Onset:2021-05-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: none reported
Preexisting Conditions:
Allergies: unknown
Diagnostic Lab Data: Evaluated by Paramedic on site, 10:45 BP 100/50, pulse 64, resp rate 20, 11:00 BP 100/53; pulse 50s per medic 911 called and patient was transported to Hospital via ambulance
CDC Split Type:

Write-up: Dizziness, "felt faint", paleness


VAERS ID: 1278016 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-05-01
Onset:2021-05-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Flushing, Hyperhidrosis, Pallor, Vital signs measurement
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Allopurinol - Gout
Current Illness: NONE
Preexisting Conditions:
Allergies: None, seasonal allergies
Diagnostic Lab Data: evaluated by paramedic 10:31 BP: 103/67, Pulse 54, Resp rate 8, Pulse Ox: 97% 10:42 BP 124/83, pulse 75, resp rate 10 Pulse ox 98% 911 called ; transported to the hospital via ambulance
CDC Split Type:

Write-up: pale, diaphoretic, flushed


VAERS ID: 1278070 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-03-10
Onset:2021-03-22
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 AR / IM

Administered by: Other       Purchased by: ?
Symptoms: Arteriosclerotic retinopathy, Biopsy blood vessel, Computerised tomogram, Eye infarction, Headache, Magnetic resonance imaging, Ophthalmological examination normal, Photophobia, Retinal vascular thrombosis, Scan with contrast, Urinary tract infection, Vision blurred, Visual impairment
SMQs:, Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Noninfectious meningitis (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Corneal disorders (broad), Retinal disorders (narrow), Hypoglycaemia (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, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Myreetrig 25mg, Carvedilol 6.5mg, Ferrius Gluconate 38mg,
Current Illness:
Preexisting Conditions: Rumatoid Arthritus, Dementia, Osteoperosis, Syiatic Nerve
Allergies: Penicillin, Asprin, Codine, Trazodone, Fentanyl, Nefazodone,
Diagnostic Lab Data: Eye Exam 4/7/2021 (Nothing Abnormal Noted), Cat Scan 4/19/2021, Contrast Cat Scan 4/20/2021, MRI 4/21/2021, Right ear vein biopsy 4/22/2021. (No conclusion)
CDC Split Type:

Write-up: UTI 3/16/2021-3/20/2021. UTI 4/28/2021. Sensitivity to light 3/24/2021 - current. Blurry Vision 3/20/2021 - 3/24/2021. Partial blindness 4/04/2021 - current. Headaches 3/24/2021 - current. Doctor ruled not a stroke. Stroke of the eye due to blood clot or plaque build up is the highest suspected cause. No previous incidents of this nature had occured.


VAERS ID: 1278107 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-09
Onset:2021-04-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram, Echocardiogram, Electrocardiogram, Injection site pain, Magnetic resonance imaging, Paraesthesia, Ultrasound Doppler
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (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: Pneumococcal vaccine
Other Medications: Atenolol 25mg. Vasotec 20 mg. ASA 81mg. Potassium chloride 10meq B Complex Vitamin D 2000IU Doxepin Hcl 10mg Mirapex .025mg
Current Illness: n/a
Preexisting Conditions: HBP
Allergies: Celebrex Vantin Clindomycin Dilaudid Generic Requip Pneumococcal vaccine
Diagnostic Lab Data: MRI , CT scan , Doppler of legs. echocardiogram,. EKG, Bubble test.
CDC Split Type:

Write-up: Checked BP, was 199/99, was going to call Dr. in AM, but starting having tingling in left cheek. Went to ER, as my Mom died of stroke, where my BP registered 216/126. After CT scan, MRI, leg dopplers, echocardiogram, and bubble test, all which were uneventful. I was kept for observation until Tuesday afternoon. I was put on Plavix and Lipitor and released. I don''t know if this was just a coincidence, but figured I should report it just in case. At the time of my vaccination, i had NO pain at the injection site, but a week later and since have had a slight pain at the site.


VAERS ID: 1278278 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN CS15FQ4AIVQW1N / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Arthralgia, Headache, Neck pain, Pain, Pain in extremity
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: Atrovistatin 20mg 1 at night. Doxycycline 50mg 1 day. Metoprolol ER Succinate 100 mg 1 a day. Omeprazole 20 mg 1 a day. Amlodipine Besylate 10 mg 1 a day. Fluorometholone 0.1% Ophtsusp 5 ml.- 1 drop in eyes daily.
Current Illness: None
Preexisting Conditions: 2 rods and 6 pins due to low back surgery in 2009 . Thyroid surgery left nodule removed. Non- cancereous 5/6/2020
Allergies: Darvocet & Percocet = itching, shaking, dizziness, rapid heart beat & passes out. Iodine in X-ray & MRI = Severe itching & burning, fainting. Aspirin = shaking, Dilaudid = shaking, dizziness, fainting
Diagnostic Lab Data: None
CDC Split Type:

Write-up: I had a severe headache for 12 days, Tylenol was not helping. Went to Urgent care on 12th day was told it was a stress headache. 2 days after injection I had severe stomach cramps that lasted 1 day and body aches to right shoulder, hip and thighs. Today, May 1, 2021, I am still experencing headaches and neck, shoulder aches.


VAERS ID: 1279104 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-05-01
Onset:2021-05-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure measurement, Malaise, 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: The patient was sitting in the waiting area following her vaccination when shortly after receiving the vaccine, her mother flagged us down and said that she lost her vision. She was describing feeling unwell. I had her lay down on the floor in the immunization booth and her mother elevated her legs. I asked her to describe her symptoms and she said that she just saw all white. I asked if she wanted me to check her blood pressure and I had her sit up on the floor and it was low around 75/53 with a pulse of 53 but not sure how accurate it was since she was sitting on the floor. She fluctuated from starting to feel better and feeling unwell again and her vision going out again. I asked if they wanted me to call 911 and her mother said she wasn''t sure what to do, if she should take her to an urgent care. I said that it would be best if she was seen in an emergency room where they can better respond to this kind of situation. The patient was able to get up and walk with her mother''s assistance. I was going to help walk her out but she said that she was okay walking out with her mother''s help. About 10 minutes later, I called the patient to see how she was doing. Her mother said that she was doing okay and that they were on their way to the hospital just to make sure that she was checked and everything was okay.


VAERS ID: 1279458 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-01
Onset:2021-04-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Contusion, Platelet count decreased
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Accidents and injuries (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zyrtec prn
Current Illness:
Preexisting Conditions:
Allergies: No known allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient experienced bruising in the 2 weeks following vaccine with critical platelets of 8. No history of thrombocytopenia prior to receiving the vaccine


VAERS ID: 1279480 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-07
Onset:2021-04-16
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chest X-ray normal, Chills, Dizziness, Dyspnoea, Electrocardiogram normal, Fibrin D dimer normal, Full blood count normal, Paraesthesia, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Vestibular 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: Levothyroxine, Vit. D, Multivitamin
Current Illness: None
Preexisting Conditions: Hypothyroidism
Allergies: None
Diagnostic Lab Data: (1) On 4/29 afternoon: PCP performed CBC, D-Dimer was ordered, reports were normal. (2) On 4/29 night: ER Physicians performed chest x-ray, EKG and COVID-19 test (swab) ? reported ?negative?. ER Physician diagnosed ?shortness of breath?. Recommended ibuprofen 400mg every 8 hours.
CDC Split Type:

Write-up: Janssen COVID-19 vaccine taken on 4/7/2021. Shortness of breath started on Day 10 after the vaccine. The shortness of breath continued until time of this reporting. (1) On 4/29 afternoon, patient visited PCP for shortness of breath, the CBC, D-Dimer was ordered, reports were normal. (2) On the same night (4/29 around 10:30 pm EDT), patient experienced severe shortness of breath and also developed lightheadedness, tingling in hands and feet, body shivering and was rushed to the Emergency Room (4/29, 11 pm EDT). ER Physicians performed chest x-ray, EKG and COVID-19 test (swab) ? reported ?negative?. ER Physician diagnosed ?shortness of breath?. Recommended ibuprofen 400mg every 8 hours.


VAERS ID: 1279509 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-30
Onset:2021-05-01
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-05-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulation drug level, Blood creatine, Deep vein thrombosis, Full blood count, 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: Calcium 500mg daily
Current Illness: None
Preexisting Conditions: None
Allergies: NKDA
Diagnostic Lab Data: Venous doppler left lower extremity. CBC. Creatinine. Anticoagulation panel.
CDC Split Type:

Write-up: Left lower leg pain and swelling for 1 day. DVT


VAERS ID: 1279633 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Full blood count, Migraine, Muscle spasms, Nausea, Pain in extremity, Platelet count normal, Sleep disorder
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: Medications (very important) New medications from outside sources are available for reconciliation betamethasone, augmented, (DIPROLENE) 0.05 % ointment Apply 1 application topically 2 (two) times a day. botulinum toxin type A (BO
Current Illness: Cardiovascular and Mediastinum Sinus tachycardia Endocrine Hypothyroidism Carnitine deficiency Rheumatology Chronic interstitial cystitis Neuro and EENT Migraine Dysautonomia Narcolepsy Gastrointestinal Gastroesophageal reflux disease Genitourinary Vulvodynia Vaginitis and vulvovaginitis Behavioral and Developmental Anxiety Attention deficit hyperactivity disorder (ADHD), predominantly inattentive type Signs and Symptoms Chronic fatigue and malaise
Preexisting Conditions: see above
Allergies: Bactrim [Sulfamethoxazole-trimethoprim] Cetyl Alcohol LanolinRash Sulfa (Sulfonamide Antibiotics)Other (See Comments) Weed Pollen-short RagweedOther (See Comments)
Diagnostic Lab Data: CBC with differential PLT wnl 312 4/30/2021
CDC Split Type:

Write-up: Systemic Reaction o 7/10 pain, cramping both legs described as moderate interrupting sleep, started 7hrs post vaccine. Improved by next day. o Migraine with nausea, worse with bending over, however has chronic daily migraines, improved next morning. o 3/10 abdominal pain, resolved next morning.


VAERS ID: 1279688 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-07
Onset:2021-04-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain, Feeding disorder, Gastric ulcer, Sleep disorder
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal ulceration (narrow), 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: Fluoxetine, doxycycline
Current Illness:
Preexisting Conditions:
Allergies: Penicillin, latex
Diagnostic Lab Data:
CDC Split Type:

Write-up: I was experiencing severe abdominal pain that was preventing me from eating or sleeping for over two days, so I went into the emergency room. I was treated for stomach ulcers with pepcid and dietary restrictions.


VAERS ID: 1279696 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-03-27
Onset:2021-04-19
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-05-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / UNK RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: JnJ Covid-19 vaccine
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data: unknow but patient was treated for DVT in the leg
CDC Split Type:

Write-up: patient reported to the pharmacy that they had to go to ER for blood clot on 04/19/2021


VAERS ID: 1279703 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-09
Onset:2021-04-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angiogram, Dizziness, Full blood count, Headache, Metabolic function test, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Estrace (estrogen)
Current Illness: None
Preexisting Conditions: COPD - former smoker. Quit nicotine October 2010
Allergies: Skin irritation to Latex, elastic, nylon, elastic, nickel.
Diagnostic Lab Data: CT Angiogram head and neck 4/24/2021 CBC with Differential 4/24/2021 Basic Metabolic Panel 4/24/2021 Testing listed above was performed at Hospital Emergency Room on 4/24/2021
CDC Split Type:

Write-up: Severe Headache and Nausea, some dizziness lasting approximately 17 days from time of onset.


VAERS ID: 1279809 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-05-01
Onset:2021-05-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Confusional state, Dizziness, Dyspnoea, Fatigue, Flushing, Hyperhidrosis, Lethargy, Pain, Paraesthesia, Seizure, Syncope, Tachycardia, Tremor, Unresponsive to stimuli, Visual impairment
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (narrow), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Convulsions (narrow), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (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:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic: Allergic: Difficulty Breathing-Medium, Systemic: Body Aches Generalized-Medium, Systemic: Confusion-Medium, Systemic: Dizziness / Lightheadness-Severe, Systemic: Exhaustion / Lethargy-Severe, Systemic: Fainting / Unresponsive-Severe, Systemic: Flushed / Sweating-Medium, Systemic: Seizure-Severe, Systemic: Shakiness-Severe, Systemic: Tachycardia-Severe, Systemic: Tingling (specify: facial area, extemities)-Severe, Systemic: Visual Changes/Disturbances-Medium, Systemic: Weakness-Severe


VAERS ID: 1279812 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: New York  
Vaccinated:2021-05-01
Onset:2021-05-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Loss of consciousness, Seizure, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

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

Write-up: Systemic: Seizure-Severe, Additional Details: within 5 minutes after administration, he collapsed, lost conciousness and had a seizure which lasted 30-40 seconds. we protected his head and laid him flat on ground and called 9-1-1. he maintained breathing and pulse throughout. when EMTs arrived he walked out with them for further evaluation.


VAERS ID: 1279823 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-05-01
Onset:2021-05-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Asthenia, Flushing, Hyperhidrosis, Nausea, Syncope, Unresponsive to stimuli, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Abdominal Pain-Medium, Systemic: Fainting / Unresponsive-Mild, Systemic: Flushed / Sweating-Medium, Systemic: Nausea-Medium, Systemic: Vomiting-Severe, Systemic: Weakness-Medium, Additional Details: Called 911 once I discovered pt. Pt was vomitting severely and had her laying on her side on the floor. She complained of abdominal pain and severe nausea when I initially got to her. Paramedics arrived about 10-15 mins from initial discovery of the patient fainting. The paramedics took over the care of the patient.


VAERS ID: 1279836 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-01
Onset:2021-05-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1816022 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Confusional state, Dizziness, Fatigue, Feeling cold, Hypotension, Lethargy, Nausea, Paraesthesia, Syncope, Tremor, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: Systemic: Chills-Mild, Systemic: Confusion-Medium, Systemic: Dizziness / Lightheadness-Severe, Systemic: Exhaustion / Lethargy-Medium, Systemic: Fainting / Unresponsive-Severe, Systemic: Hypotension-Severe, Systemic: Nausea-Severe, Systemic: Shakiness-Medium, Systemic: Tingling (specify: facial area, extemities)-Severe, Systemic: Vomiting-Severe, Systemic: Weakness-Medium, Additional Details: Patient self-reported that she /"doesn''t do well with needles/". After about 5-10 minutes post-vaccine, she called for help feeling tingling all down her arms into her fingers. She was shaky and it seemed like she fainted but was still somewhat responsive. She was also dazed and shaking. After vomiting, she was more lucid but still felt poorly. EMTs arrived on scene and took her blood pressure & found that she was very hypotensive. Recommended that she be transported to hospital due to low BP.


VAERS ID: 1279927 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-03-31
Onset:2021-04-05
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-05-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / UNK RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test normal, Headache, Hypoaesthesia, Muscular weakness, Pain, Paraesthesia, Platelet count normal, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Not sure if this is considered an adverse event, but about 20 years ago I experienced hard painful swelling at injection site of
Other Medications: Multi vitamins, fish oil, probiotics, Vitamins C & D
Current Illness: None
Preexisting Conditions: Healthy
Allergies: None
Diagnostic Lab Data: 4/22/2021 - Blood tests - normal, including normal platelets.
CDC Split Type:

Write-up: My initial symptoms were very minor and occurred the day after I received the vaccine: 99.5 degree fever and very mild headache. But several days later, both legs felt strangely weak from the calves to the feet. I also experienced occasional tingly feelings, pain, and often numbness. It was subtle at first but increased in intensity until April 21. I began to fear Guillain Barre syndrome. I scheduled a doctor''s appointment for April 22, but the doctor''s office cancelled and told me to go to the ER. At the ER bloodwork was done, which was normal. I was told to follow up with a neurologist if needed. It is now May 2 and my symptoms have slowly improved. It was frightening to have the symptoms for about a month. I was prepared to possibly feel unwell for several days, but expected neither my symptoms nor their duration.


VAERS ID: 1280011 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-04-10
Onset:2021-04-15
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-05-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Cerebral thrombosis, Computerised tomogram head abnormal, Electrocardiogram, Haemorrhage intracranial, Magnetic resonance imaging, Speech disorder, Visual impairment
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Synthroid, lisinopril, Pantoprazole
Current Illness:
Preexisting Conditions: Hypertension, diabetes, hypothyroidism
Allergies:
Diagnostic Lab Data: Multiple CT scans, MRIs, Drug therapies, EKGs, over a 5 day hospital period, speech occupational , physical therapies
CDC Split Type:

Write-up: Blood clot in the brain resulting in inter-cranial bleeding... affected speech, processing , vision


VAERS ID: 1280018 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fall, 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:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient fainted for a moment and felt down while standing. Patient was conscious right after falling, was able to talk and did not feel any symptoms other than sweetness which could have caused by wearing hat that he was wearing. EMS took patient.


VAERS ID: 1280115 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-02
Onset:2021-04-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 AR / IM

Administered by: Public       Purchased by: ?
Symptoms: Angiogram cerebral abnormal, Aortic aneurysm, Arteriogram carotid abnormal, Arteriogram carotid normal, Ataxia, Balance disorder, Basal ganglia infarction, Blood pressure systolic normal, Cerebral artery stenosis, Computerised tomogram neck, Dysaesthesia, Dysstasia, Eye pain, Facial neuralgia, Gait disturbance, Haemoglobin decreased, Headache, Hyperaesthesia, Ischaemic stroke, Jugular vein thrombosis, Lacrimation increased, Lacunar stroke, Magnetic resonance imaging head abnormal, Muscular weakness, Pain, Photophobia, Photopsia, Retinitis pigmentosa, SARS-CoV-2 test negative, Tenderness, Tension headache, Thrombosis, Transverse sinus thrombosis, Vertigo, Visual acuity reduced, Visual field defect, Visual impairment, Vitreous floaters
SMQs:, Rhabdomyolysis/myopathy (broad), Haematopoietic erythropenia (broad), Peripheral neuropathy (broad), Haemorrhage laboratory terms (broad), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Congenital, familial and genetic disorders (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Parkinson-like events (broad), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Glaucoma (broad), Optic nerve disorders (broad), Demyelination (broad), Lens disorders (broad), Corneal disorders (broad), Retinal disorders (narrow), Central nervous system vascular disorders, not specified as haemorrhagic or ischaemic (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Vestibular disorders (narrow), Lacrimal disorders (narrow), Hypoglycaemia (broad), COVID-19 (broad)

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

Write-up: See below


VAERS ID: 1280144 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-10
Onset:2021-04-27
   Days after vaccination:48
Submitted: 0000-00-00
Entered: 2021-05-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Blood calcium decreased, Blood creatine phosphokinase MB increased, Blood creatine phosphokinase increased, Blood glucose normal, Brain natriuretic peptide increased, COVID-19, Full blood count, Haematocrit decreased, Haemoglobin decreased, Mean cell haemoglobin concentration decreased, Platelet count normal, Protein total decreased, Red blood cell count decreased, SARS-CoV-2 test positive, Troponin normal, White blood cell count decreased
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Liver related investigations, signs and symptoms (narrow), Haematopoietic erythropenia (narrow), Haematopoietic leukopenia (narrow), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Pulmonary hypertension (broad), Chronic kidney disease (broad), Tumour lysis syndrome (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: Protonix Trulicity Pen Tylenol with Codeine #4 Ultram Xanax allopurinol atorvastatin bisoprolol cyanocobalamin gabapentin glipiZIDE isosorbide mononitrate pramipexole zolpidem Effient Omega 3 Niacin Ranolazine
Current Illness:
Preexisting Conditions: Diabetes MI Hx of Cancer
Allergies: Azithromycin Peaches
Diagnostic Lab Data: 5/1/2021 - Abnormal Results: - SARS COVID PCR Testing - Positive - Chemistry: Glucose - 137, Calcium - 8.5, AST - 111, ALT - 59, Protein - 6.3, Total CK - $g2000, CKMB - 31.53, (negative troponin), BNP - 222 - CBC: WBC - 3.9, RBC - 3.35, HGB - 10.2, HCT 0 32.7, MCHC - 31.2 (platelets normal @ 185)
CDC Split Type:

Write-up: Pt. was diagnosed with COVID - via PCR - and required hospitalization.


VAERS ID: 1280194 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-30
Onset:2021-05-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 AR / IM

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

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

Write-up: Onset approx 24 hours following vaccine for COVID. All over urticaria, symmetric on all extremities, buttocks and a little on trunk. No oropharyngeal swelling, dyspnea, angioedema, or other severe symptoms. Treating with Benadryl and Pepcid. Deferred steroid treatment for now.


VAERS ID: 1280215 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Eye movement disorder, Flushing, Hyperhidrosis, Loss of consciousness, Pallor, Posture abnormal, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Pneumonia (hospitalized previously) but had been out of the hospital for 3 weeks
Preexisting Conditions: Esophageal cancer survivor (2004)
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient was administered the Johnson and Johnson Janssen COVID-19 vaccine. Shortly after, a few seconds, the patient stated he felt flushed and head started to fall back. Staff member cradled his head and called another staff member over. Staff member called 9-1-1. Patient went unconscious and his eyes rolled back for approximately 30 seconds. When aware, we (staff members) transferred patient from the chair to the floor where staff member supported his back and fanned him due to his profuse sweating. Staff member continued talking to him when he became unconscious again, this time gasping for air and turning pale. We kept saying his name until he came to again and was somewhat aware of his surroundings. He fainted one last time. After this time, he sat up on his own and seemed to be very coherent. The EMS arrived shortly after and took over. They said they would take him out to check him out but he seemed to be doing better. An EMS personnel let us know the patient did tell him that he has fainted from vaccines before. However, he did not disclose this to us on the PQCF form or when asked verbally.


VAERS ID: 1280289 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Aphasia, Asthenia, Blood pressure increased, Computerised tomogram abdomen normal, Computerised tomogram head normal, Disturbance in attention, Dizziness, Dysphemia, Dyspnoea, Feeling abnormal, Gait inability, Headache, Hemiplegic migraine, Hypoaesthesia, Illness, Infection, Influenza like illness, Laboratory test, Loss of consciousness, Lumbar puncture, Magnetic resonance imaging normal, Memory impairment, Nausea, Neurological symptom, Pain in extremity, Pyrexia, Scan with contrast normal, Ultrasound Doppler normal, Ultrasound scan normal, Urine analysis abnormal, Venogram normal, Vision blurred, Vomiting, Walking aid user
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Hypertension (narrow), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Spirulina (sporadic) Estradiol estrogen patch 0.05mg (twice weekly) Citalopram 40mg (daily)
Current Illness: I had a minor muscle spasm on my shoulder from trapping cats
Preexisting Conditions: I previously had endometriosis but had a full hysterectomy and have been fine for 2 years
Allergies: Penicillin Bananas
Diagnostic Lab Data: All CTs, scans, MRV and MRI were normal. I am unaware of lab results. The infection in my urine wasn''t discussed with me until after they started me on IV antibiotics. PT assessment was that I am just barely able to be left alone and not in a rehab facility.
CDC Split Type:

Write-up: I was very ill on Friday night after receiving the vaccination. Flu-like symptoms, high fever, shortness of breath, pain in my abdomen, horrible headache, nausea, dizziness, loss of consciousness and leg pain (both legs). The flu-like symptoms passed on Saturday, but by Tuesday, April 13 I was continuing to have a terrible headache, abdominal pain and leg pain. I saw my primary doctor on the 13th and was sent over to the hospital for an ultrasound of my leg. No clots were found and I was told to continue trying to recover at home unless it got worse. I was seen at the emergency room on April 14th for abdominal pain, leg pain, dizziness and headache. The nurse told me I was probably hysterical over the vaccination being pulled, and I told him this was not the case. They performed CT (without contrast) on my abdomen and head, then released me with instructions to return if I was worse. By the 16th I was unable to walk as my left side was completely numb. I went back to the ER. I had a CT of my abdomen and head with and without contrast. I had a lumbar puncture and several labs. I was given IV antibiotics for some infection they found in my urine. I was given fluids and pain meds, and my BP was shooting up to 145/94 (which is very high for me), when standing. My vision was blurry and I was unable to remember much of the last week. I was admitted from the 16th through the 20th and had an MRV, 2 MRIs, more lab work and medicine for my headache. I was released on the 20th and the headache was unbearable and I was still numb on my left side, going back to my doctor on the 22nd. He suggested the ER, and the ER admitted me back to the stroke unit. I was released on the 22nd with a diagnosis of a hemiplegic migraine that could cause stroke-like symptoms (ZERO history of headaches previously). I was sent home with a walker and home health services. PT visited on April 30th and ordered two visits per week for the next month. I am unable to walk without a walker. I cannot shower or use the stairs without assistance. My memory is still foggy. I am unable to concentrate for long. I often stutter and can''t remember basic words. I have also stopped and forgotten where I am at a given moment. I am on Depakote nightly for the headaches, and they have lessened slightly, but when they flare up it is debilitating and I often vomit. I have instructions to follow up with my primary tomorrow morning and see what the next steps are.


VAERS ID: 1280344 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-27
Onset:2021-04-29
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Audiogram abnormal, Deafness unilateral, Ear discomfort, Head discomfort, Inflammation, Neuritis, Tinnitus
SMQs:, Peripheral neuropathy (narrow), Hearing impairment (narrow), Immune-mediated/autoimmune 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: Synthroid 125mg
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Was first diagnosed with Tinnitus at Urgent Care. Then did an audio test with the ENT group LA - Tarzana (Dr.), who prescribed me with Prednisone for the hearing loss and tinnitus. I was told it''s a viral reaction causing inflammation which is affecting my nerve.
CDC Split Type:

Write-up: 48 hrs after the vaccine, I experienced intense pressure in my head and then hearing loss in my left ear. By the evening on April 29, I had lost almost all hearing in my left ear and was experiencing intense ringing in my left ear and pressure in my right ear. Woke up April 30th and the symptoms were worse and had lost all hearing in my left ear.


VAERS ID: 1280403 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-03-25
Onset:2021-05-01
   Days after vaccination:37
Submitted: 0000-00-00
Entered: 2021-05-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Arteriogram carotid normal, Cerebral artery occlusion, Cerebrovascular accident, Coagulation test normal, Computerised tomogram normal, Full blood count normal, Perfusion brain scan abnormal
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic 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)

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: Daily marijuana use from dispensary
Current Illness: Neck pain- seen by ortho
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: CT without contrast _ no acute process, CT perfusion- 1. Abrupt occlusion of the right distal M1 and M2 MCA segments, with reconstitution of a few distal MCA branches. 2. Unremarkable CT appearance of the neck arteries., Normal CBC, Normal Coag
CDC Split Type:

Write-up: patient presented to ed on 5/1/2021 with acute stroke, no family history of stroke. P


VAERS ID: 1280438 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: New Hampshire  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure measurement, Dizziness, Hyperhidrosis, Malaise, Pallor, Respiratory rate decreased
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Respiratory failure (narrow), Hypoglycaemia (broad)

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

Write-up: About 5 minutes after receiving the vaccine patient approached the pharmacy and said he wasn''t feeling well. I asked him if he would like some water and he accepted. He returned to the chair in front of the pharmacy and sipped on the water. He looked like he was pale and breathing more slowly. I went out front to check on him and his breathing appeared labored, he was sweating profusely and he said he felt lightheaded and his hands were tingling. I told him to relax and take some breaths. His hands were very shaky and I took him BP (94/61 and HR 54). At this point I had my technician call 911. Between the time the paramedics arrived he went unresponsive for approx 20-30 seconds. I yelled his name and slapped his leg. No response. I checked for a pulse and if he was breathing. He did have a pulse and was breathing. After coming to the paramedics arrived and took him to the hospital for evalution.


VAERS ID: 1280576 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anaphylactic reaction, Chills, Dizziness, Dyspnoea, Paraesthesia
SMQs:, Anaphylactic reaction (narrow), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Duloxetine 30mg, celecoxib 100mg, dicyclomine 20mg, Nucynta 50mg, sertraline 50mg,
Current Illness:
Preexisting Conditions: Depression, anxiety, chronic pain
Allergies: morphine, ketorolac, meperidine, latex
Diagnostic Lab Data: Epipen administered
CDC Split Type:

Write-up: Anaphylaxis. Patient experienced shortness of breath, tingling in hands and arms, cold chills, and feeling faint.


VAERS ID: 1280599 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-08
Onset:2021-04-15
   Days after vaccination:38
Submitted: 0000-00-00
Entered: 2021-05-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: 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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Factor V Leiden
Allergies: ASA, NSAIDs
Diagnostic Lab Data:
CDC Split Type:

Write-up: Deep venous thrombosis


VAERS ID: 1280655 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-28
Onset:2021-04-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Dysstasia, Erythema, Headache, Limb discomfort, Pain, Pain in extremity, Peripheral swelling, Pyrexia, Thrombosis
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: First 2 days: fever 101.5, whole left side pain, abdominal pain, headache, lower right leg pain 3rd day: low grade fever 100.5, lower right leg pain, left arm pain 4th day: lower right leg pain increased along with redness, swelling, red lines, and eventually I couldn''t apply weight on my right leg. After visiting Urgent Care hospital, blood clots were found in my small veins.


VAERS ID: 1280662 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / -

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

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

Write-up: PALE, LOST OF CONSCIOUSNESS X5 SECONDS. CODE GREEN CALLED, DIAPHORETIC, BP 116/80, HR 78, GLUCOSE 83, ALSO C/O DIZZINESS. IV ON LEFT ANTCUBITAL WITH NS, TRANSPORTED TO HOSPITAL.


VAERS ID: 1280702 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-04-07
Onset:2021-04-15
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-05-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Myocardial necrosis marker normal
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (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, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Pepcid, Nexium
Current Illness: N/a
Preexisting Conditions: GERD
Allergies: Codeine, Cymbalta, NSAIDS, Lisinopril
Diagnostic Lab Data:
CDC Split Type:

Write-up: Presented with chest pain on April 15, 2021, was evaluated in the ER, and discharged home. Presented again on April 18, 2021, and at that time chest pain is more persistent, therefore patient was admitted. Had serial enzymes performed and was discharged the following day to follow-up with cardiology. Unknown further outcomes beyond this.


VAERS ID: 1280879 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fall, Heart rate increased, Hypotonia, Loss of consciousness, Mydriasis, Seizure, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Patient states about 2 years ago, he fainted after receiving the Typhoid vaccine.
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was administered the Janssen COVID vaccine at 403 pm. I returned back to the pharmacy to prep his partner''s vaccine and when I came back at 405 pm, he was loopy with his head swaying. He wasn''t responding to verbal communication by his spouse and me nor through touch as I shook his shoulder. He then lost consciousness and so I lifted his head to check for breathing and pulse which he had. I asked my technician to call 911, and asked my other tech to help me transition him to the floor so we can raise his legs to provide blood flow to his head. Mid-transition, he had a seizure. We brought him completely to the floor and just as I was about to turn him to his side, he regained consciousness. Pupils were dilated, breathing normal, pulse elevated. He also was able to speak immediately and confirmed feeling "okay". I then had my technician remain outside with him laying on the ground as I returned back inside the pharmacy to call management and my technician was still on the phone with EMS. Paramedics and management arrived within 10 minutes upon which patient was then taken to the hospital. Wife followed and we rescheduled her vaccine.


VAERS ID: 1280899 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-01
Onset:2021-04-18
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-05-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain, Headache, Hypoaesthesia, Paraesthesia, Skin discolouration, Sluggishness
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Sexual dysfunction (broad)

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

Write-up: April 18- severe headaches, abd pain April 21- fingers turning white in both hands, going completely numb and tingling April 24- some fingers turning white and purple, cap refill sluggish longer than 5 secs May 1- whole hand turning white and numb May 2- hand and fingers taking longer to return to normal


VAERS ID: 1280987 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-06
Onset:2021-04-16
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / -

Administered by: Other       Purchased by: ?
Symptoms: Dysmenorrhoea, Menstrual disorder, Pain
SMQs:

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: Fish oil, Vit B, cranberry
Current Illness:
Preexisting Conditions: MS
Allergies: N/A
Diagnostic Lab Data: It started with groin pain so I went to the ER worried about clotting and they rAn a battery of tests and said I was fine.
CDC Split Type:

Write-up: Ten days after the shot I had intense stomach, groin, neck, and low back pain and I started the most painful period of my lifetime after being in menopause for one year. I bled profusely for six days. Still having random debilitating pain.


VAERS ID: 1281002 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-10
Onset:2021-04-26
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Back pain, Blood glucose normal, Blood test, Computerised tomogram, Decreased appetite, Heart rate increased, Myalgia, Palpitations, Pancreatitis, Ultrasound abdomen
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: Within 24 hours, normal side effects including, muscle pain and aches; Resolved after 1 day On 4/23/2021, 14 days after vaccine, patient began experiencing loss of appetite On 4/26/2021, 16 days after vaccine midday on 2, patient began experiencing sudden onset of upper stomach pain, heart palpitations 4/29/2021, patient went to ER due to extreme upper abdominal pain and intermittent back pain and intermittent heart racing. Prior to going to hospital, patient was healthy with no prior health issues or diagnoses. She also took baby aspirin, 81 mg several days prior to being admitted, took 2 chewable gas- except tablets and had her glucose checked which was a 96. Patient was not admitted and discharged the same day with a diagnosis of acute pancreatitis. She has had 2 children in the last 3 1/2 years and still nursing a 14 month old and hasn''t count alcohol in years. Pain meds prescribed but using them every 8 hours to manage pain and barely eating or drinking, yet pain still persists.


VAERS ID: 1281288 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-09
Onset:2021-04-16
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Barium swallow, Blood test, Chest X-ray, Computerised tomogram, Dizziness, Dysphagia, Dysphonia, Electrocardiogram, Endoscopy, Oropharyngeal pain, Throat tightness, Tinnitus
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hearing impairment (narrow), Vestibular disorders (broad), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vit D
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: Ba swallow, endoscopy, chest X-ray, ekg, blood work Next ct scan
CDC Split Type:

Write-up: Throat tightening , difficulty swallowing, sore throat, hoarseness, ringing in ears, dizziness


VAERS ID: 1281336 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-08
Onset:2021-04-01
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Activated partial thromboplastin time, Anticoagulant therapy, Chest pain, Computerised tomogram, Dyspnoea, Fatigue, Pain in extremity, Pulmonary thrombosis, Ultrasound scan
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), 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, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Atorvastatin TRULICITY Vitamin D2
Current Illness:
Preexisting Conditions:
Allergies: Penicillin Ceclor Sulfa
Diagnostic Lab Data: Ultrasound CT scan ATPP
CDC Split Type:

Write-up: Overly tired, shortness of breath, chest pain, leg pain After 3wks of symptoms patient(self) went to hospital and it has been discovered patient has ( self) has a blood clot in Right lung. Patient (self) has no record or history of blood clots. Was treated with heparin while in hospital. Has since been discharged and sent home with a prescription for anticoagulant.


VAERS ID: 1281404 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-24
Onset:2021-04-24
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Atorvastatin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: ER visit on 4/24 ENT evaluation on 4/26
CDC Split Type:

Write-up: Left side Bell''s Palsy


VAERS ID: 1281599 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-07
Onset:2021-04-23
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 AR / SYR

Administered by: Work       Purchased by: ?
Symptoms: Catheterisation cardiac abnormal, Chest pain, Coronary artery dissection, Intracardiac thrombus, Myocardial infarction, Myocardial necrosis marker increased, Pain in extremity, Troponin increased
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Other ischaemic heart disease (narrow), 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, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Cardiac panel with increased enzymes included troponin increases. Heart Catheter test came back showing blood clot as well as coronary spontaneous arterial dissection.
CDC Split Type:

Write-up: Culminated in myocardial infarction. Chest pains started next day and leg pains. By April 23, I had severe chest pains and had to see medical at work. On April 30, 2021 was at emergency department for heart attack symptoms. Was transferred for myocardial infarction. Test results show myocardial infarction, coronary spontaneous arterial dissection, and blood clot.


VAERS ID: 1281674 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-03-26
Onset:2021-04-26
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Computerised tomogram thorax abnormal, Full blood count normal, Platelet count normal, Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow), Cardiomyopathy (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: Cytomel; Synthroid, Lipitor, Pepcid
Current Illness:
Preexisting Conditions:
Allergies: NKA
Diagnostic Lab Data: CT scan 5/2/21; Nomal CBC including platelets
CDC Split Type:

Write-up: Large Volume Pulmonary Embolus


VAERS ID: 1281688 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-08
Onset:2021-04-19
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (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? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ReliOn Insulin Syringe 1ML/31G Miscellaneous USE AS DIRECTED. Insulin Syringe 31G X 5/16 Miscellaneous as directed. Reglan 10 MG Tablet as directed Orally 4 times a day as needed. Diphenhydramine Cit-Aspirin 38.3-500
Current Illness:
Preexisting Conditions: COPD Asthma
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: pulmonary embolism


VAERS ID: 1281748 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: New York  
Vaccinated:2021-03-09
Onset:2021-03-18
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Aortic dissection, Cardiac arrest, Muscle twitching, Pain in extremity, Road traffic accident
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), Dyskinesia (broad), Dystonia (broad), Acute central respiratory depression (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Respiratory failure (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-19
   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: Ozempic Zinc Atorvastatin Calcium Metformin HCL Lisinopril Jardiance was prescribed on 3/16 but hadn''t picked it up yet
Current Illness: none
Preexisting Conditions: diabetic ulcer on foot
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: "Janssen COVID-19 Vaccine EUA" 3/18 twitching of foot...severe leg pain 7:45 PM 3/19 involved in a motor vehicle accident with cardiac arrest and a dissecting aortic aneurysm 12;45 PM


VAERS ID: 1281791 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-03-31
Onset:2021-04-06
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Diarrhoea, Headache, Lip swelling, Malaise, Oropharyngeal pain, Pain, Paraesthesia oral, Rash, Rash erythematous, Rash pruritic, Swollen tongue
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Pseudomembranous colitis (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Not sure if adverse, but similar "flu-like" aches/malaise after TDAP in 2002.
Other Medications: Synthroid 137 mcg once a day metoprolol tartrate 25 mg twice a day pravastatin sodium 40 mg nightly TUMS 1000 mg 2-3 most days vitamin D3 1000 mg 1-2 a few times a week
Current Illness: None
Preexisting Conditions: surgically induced hypothyroidism (total thyroidectomy 1990) supraventricular tachycardia treated with beta-blocker high cholesterol intermittently high blood pressure
Allergies: epinephrine sensitivity bananas, melons, tree nuts (probably oral allergy syndrome, as these didn''t bother me when cooked -- haven''t eaten any of them in years, though) some adhesives if left in one spot on my torso more than a day or two cause redness and itching (Holter monitor leads, etc.)
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 9 hours later began feeling a general "ick" like when coming down with something, then moderate headache and body aches, especially my back. This lasted less than 2 days. Other things, mostly starting 5 or 6 days later and some cropping up as late as 4/11. Random itchy red rashes on each shoulder and back of upper arm that would go away within an hour or 2. Itching and possibly bumps on buttocks and thighs. Intensely itching palms for a little while on 2 or 3 different days. Sudden appearance of a 4 x 4 inch patch of 15-20 bumps of various sizes in the crook of my left elbow (injection arm) with bright red skin. These looked similar to mosquito bites or blisters but didn''t itch. It completely disappeared without a trace within an hour. Tingling tongue followed by tongue swelling on 4/6/21. I had eaten my bran flakes with some rice pudding a little bit before this, both of which I''d eaten every day for the past week or so and had had several times in the past. On the advice of my doctor''s nurse, my husband drove me to an urgent care center. By the time we got there, probably 1.5 hours after this started, the swelling was some better. The nurse practitioner that I saw prescribed an antihistamine and 3 days of one 20 mg prednisone pill a day. I''ve never had a tingling or swelling tongue before in my life. I took only a half of one prednisone on 4/6, no Allegra. On 4/7 the random itchy red rashes mostly on arms/shoulders happened once or twice and disappeared fairly quickly, but my upper lip swelled. I could feel it happening as I sat in my recliner in the morning. I hadn''t had anything to eat yet. The doctor advised I take my Allegra and prednisone I received at urgent care on 4/6, so I did. The lip swelling gradually went down over a few days, but it still feels irritated on the inside of the lip as of 4/11. Diarrhea beginning around 1:30 a.m. 4/8. Lasted about 3 days. I only very very rarely have diarrhea. Mild sore throat starting Friday 4/10. Better by Saturday. Sore throats are so rare for me that I can''t remember the last one, possibly several years ago.


VAERS ID: 1281824 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-06
Onset:2021-04-13
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Cardiac arrest, Death
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), Respiratory failure (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-13
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Pt. did not know at the time of vaccination on 04/06/2021 that he had been exposed to Covid-19 prior to receiving the Johnson & Johnson Covid-19 vaccine .
Preexisting Conditions: COPD , Morbid Obesity
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt. in cardiac arrest on 04/13/2021. Pt. was pronounced dead at Hospital on 04/13/2021.


VAERS ID: 1281929 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-24
Onset:2021-05-02
   Days after vaccination:39
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Atrial fibrillation, Compression fracture, Cough, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Supraventricular tachyarrhythmias (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Accidents and injuries (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Admitted with intractable back pain (known compression fracture). Per ED note, patient found to have cough and labored breathing. New onset A fib


VAERS ID: 1281975 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-04-09
Onset:2021-04-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / N/A LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Computerised tomogram, Mobility decreased, Pain, Pain in extremity, Sleep disorder, Tinnitus
SMQs:, Parkinson-like events (broad), Hearing impairment (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: Insulin Novolog Levemir
Current Illness:
Preexisting Conditions: Diabetes
Allergies: Sulfa
Diagnostic Lab Data: Blood Tests CT Scan-04/29/2021
CDC Split Type: vsafe

Write-up: The day after the vaccine my left arm hurt, and I thought it was normal. After two days I was in a lot of pain and I couldn''t lift my arm up. I have to lay on the other side at nights because it hurts. It is constant pain and Motrin does not help the pain. It is still painful at the end of the day after three weeks. I went to the ER and they thought that it was nerve damage from the vaccine administration. I was given Steroids which helped a little at first but then the pain returned. It was only a three day course because I am Diabetic and it effects my blood sugar. I can raise my arm a little now but not above my head. Three weeks after the vaccine my right ear started to ring and it was very intense and I couldn''t hear for about four hours. I went to the ER and all the tests were negative. The ringing in my ears is still coming and going. It is very sensitive to sound and it is hard for me to hear. If there is any loud noise the ringing becomes very uncomfortable. It feels like I need to pop my ear all the time. I was told it might be related to the vaccine. I have never experienced anything like this before.


VAERS ID: 1282091 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Formication, Hyperhidrosis, Paraesthesia, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (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: Levothyroxine
Current Illness: No
Preexisting Conditions: Thyroid
Allergies: Codeine, kiwi
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fainted, sweating, lightheaded, dizzy, tingling all over, felt like bugs were crawling under her skin


VAERS ID: 1282158 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-04-06
Onset:2021-04-16
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Guillain-Barre syndrome, Hypoaesthesia, Immunoglobulin therapy, Monoplegia, Transfusion
SMQs:, Peripheral neuropathy (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Immune-mediated/autoimmune disorders (narrow), 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? Yes, 14 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Ceclore/Ceflacon
Diagnostic Lab Data: Guillan Barre Syndrome. Hospitalized. IVIG 5 day treatment. 5 day treatment Plasma Ferisis transfusions.
CDC Split Type:

Write-up: Guillan Barre Syndrome. Hospitalized. IVIG 5 day treatment. 5 day treatment Plasma Ferisis transfusions. Numb Feet- Leg Paralysis- Numb Hands


VAERS ID: 1282181 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Aphasia, Blood test, Electrocardiogram normal, Feeling abnormal, Headache, Hypoaesthesia, Induration, Magnetic resonance imaging, Muscle spasms, Musculoskeletal stiffness, Myalgia, Pain, Paraesthesia, Ultrasound scan
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: 100 mg Losarton, Airborne Immune system supplement, Vitamin D3, IUD
Current Illness: Hypertension
Preexisting Conditions: None
Allergies: Penincillin, sulfa, aspirin, ibuprofin
Diagnostic Lab Data: MRI, blood test, ultra sound, EKG came out normal. Doctor diagnose it is ''Paresthesia".
CDC Split Type:

Write-up: Calf and forearm muscle stiff and harden, numbness on fee and hand and fuzzy feeling on leg and arm. Fingertips tingling, leg cramp if walk, can''t form word, sharp pain on collar bone (only happen once). Janssen vaccine was administered on Apr 12, 2021. On the same day I have severe headache and mild pain on muscle. Severe headache extends to the next day and occasionally happen during the first week along with mild to moderate muscle pain. On the second week (Apr 19 to Apr 23, 2021) have frequent muscle pain, muscle on calf becomes stiff and harden and occur more frequent. It alternates between right calf and right forearm. I also often have tingling on fingertips, numbness on hand and feeling fuzzy on arm, legs. Symptoms comes and goes but get worse if have short walk. Foot and back of the knee on right leg cramp and more stiffness and more pain. On May 2, I woke up with numbness on my right foot and discover red spot on the instep. This prompt me to go to Urgent care. Since numbness and feeling of fuzzy along arms and legs but at the urgent care could not diagnose since they don''t have tools to run the test so they advise if it bothers me, I should go to the ER. I worry about high cost of ER so I went home and plan to go see family doctor on Monday but just 5 minutes away from urgent care, I have trouble saying out the word that I want to say. It just doesn''t come out although I try to form a word. At that point I more concern if I would have stroke so I ask my husband to turn around to go to Emergency Room. While waiting to be treated, numbness occurs more on feet and under of the forearms, Doctor run blood test, order ultrasounds, MRI scan on the head and EKG. All result came back normal but numbness and headache still persistent. I was discharge in the evening but still have no idea what cause it. The discharge paper indicate that it is "Paresthesia" and I believe Janssen vaccine is the cause for all the symptoms that I have. I still have numbness on feet and leg stiffness still occur even sit down for less than 5 minutes. Should the staff administered the Moderna type that I have signed up for. I believe this side effect won''t happen to me. I signed up for Moderna but after check in, the staff show a note "L@837" to the fire fighter. I don''t know what it means but heard their conversation that "We don''t do that today" then after vaccine was administered, I found out that it is Janssen that I have not signed up for.


VAERS ID: 1282273 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-03-30
Onset:2021-04-24
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Limb discomfort, 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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Insulin, BP med, high cholesterol pt unsure of names of meds
Current Illness: stage 5 renal disease
Preexisting Conditions: DM , HTN, Renal disease
Allergies: sufur
Diagnostic Lab Data: Ultrasound of right leg on 04/27/2021 at Hospital
CDC Split Type:

Write-up: Blood Clot in Right Leg


VAERS ID: 1282301 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-04-06
Onset:2021-04-25
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Catheterisation cardiac, Chest pain, Computerised tomogram, Diarrhoea, Magnetic resonance imaging heart, Myocarditis, Troponin increased
SMQs:, Myocardial infarction (narrow), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune 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? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Truvada
Current Illness: N/a
Preexisting Conditions: N/a
Allergies: Avocado
Diagnostic Lab Data: mri, catscan, cardiac catherterization - april 29th
CDC Split Type:

Write-up: Mycrocarditis, truponin levels were at 20, Diahreah , chest pain, back pain -1 werk


VAERS ID: 1282308 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-12
Onset:2021-05-03
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 20TA21A / 1 UN / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Discomfort, Full blood count, Headache, Magnetic resonance imaging, Metabolic function test, Pregnancy test, Syncope, Troponin
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: N/A
Preexisting Conditions: None
Allergies: NKA
Diagnostic Lab Data: Initially seen at Urgent Care (EKG) In Emergency Department at Hospital: CBC, BMP, Serum pregnancy, troponin MRI and MRV
CDC Split Type: 20TA21A

Write-up: Patient had syncopal episode with left-sided headache and left-sided heaviness on 5/3/2021.


VAERS ID: 1282322 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-30
Onset:2021-04-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Military       Purchased by: ?
Symptoms: Blood pressure increased, Blood test, Chest discomfort, Dry mouth, Electrocardiogram, Heart rate increased, Paraesthesia oral, Visual impairment
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Glaucoma (broad), Hypertension (narrow), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: chest feeling heavy, vision change, increase BP, Increase heart rate, dry mouth, tongue felt funny


VAERS ID: 1282344 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Hypoaesthesia, Immediate post-injection reaction
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), 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:
Preexisting Conditions: Anxiety
Allergies: None
Diagnostic Lab Data: Blood pressure reading 125/87 mmHg 30 minutes after receiving the dose.
CDC Split Type:

Write-up: Chest pain immediately after receiving the vaccine described as a 6/10 on pain scale. (10 being the highest) Patient also reported her arm feeling numb after receiving the dose.


VAERS ID: 1282349 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-07
Onset:2021-04-22
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Amnesia, Computerised tomogram, Feeling abnormal, Hypersomnia, Hypoaesthesia, Laboratory test, Movement disorder
SMQs:, Peripheral neuropathy (broad), Dementia (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (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: None
Allergies: None
Diagnostic Lab Data: Ct scan head Labs
CDC Split Type:

Write-up: I woke up on April 22 and could not feel or move my entire body. This lasted from the time I woke up (5:15am) until I was discharged from the hospital later that night. I was weak and in a brain fog the entire weekend (Thursday, Friday, and Saturday). I slept all weekend and have no memory of the entire weekend.


VAERS ID: 1282451 (history)  
Form: Version 2.0  
Age: 89.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-04-06
Onset:2021-05-01
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Acute kidney injury, Anticoagulant therapy, Asthenia, Computerised tomogram thorax normal, Cystitis, Deep vein thrombosis, Gait disturbance, Oedema peripheral, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (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), Parkinson-like events (broad), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tumour lysis syndrome (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: APRIIN 81MG DAILY, COLACE 100MG BID PRN, SEE PAGE 2
Current Illness:
Preexisting Conditions: DIABETES,CHF,HTN,
Allergies: NO KNOWN ALLERGIES
Diagnostic Lab Data: CONSULT MADE TO VASCULAR SURGEON NO PLANNED SURGICAL INTERVENTION AT THIS TIME WILL PROCEED WITH CONSERVATIVE TR, STARTED ON ELIQUIS 20MG PO BID THEN WILL TRANSITION TO 5MG PO BID,
CDC Split Type:

Write-up: BLE EDMEA/PAIN, GAIT DISTURBANCE, GENERALIZED WEAKNESS PRESENTED TO ER ON 5/1/2021 SYMPTOMS STARTED ON 4/30/2021. SHE WAS FOUND TO HAVE BLE DVT. NO EVIDENCE OF CT PE. REPORTED HAD J&J COVID VACCINE ON 4/6/2021. RECENT HOSPITAL ADMIT FROM 4/28/2021 TO 4/30/2021 WITH ACUTE RENAL FAILURE AND ACUTE CYSTITIS. PT ADMITTED TO MED SURG FLOOR. CALL REC''D FROM PROVIDER NOTIFIING OF RECENT COVID VACCINE AND NEEDED VAERS REPORT COMPLETED.


VAERS ID: 1282506 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-04-01
Onset:2021-04-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Ischaemic stroke, Rhabdomyolysis
SMQs:, Rhabdomyolysis/myopathy (narrow), Neuroleptic malignant syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Crestor, atenolol
Current Illness: Unknown.
Preexisting Conditions: Essential hypertension, Depression
Allergies: No known allergies.
Diagnostic Lab Data:
CDC Split Type:

Write-up: The patient reports receiving the Johnson & Johnson Covid 19 vaccine in early April 2021. The patient presented to the local emergency department on 4/28/21 and had suffered an ischemic stroke. Patient had been laying on the floor for a few days prior to hospitalization. Also had traumatic rhabdomyolysis. He was discharged from the hospital and now recovering at a skilled nursing facility.


VAERS ID: 1282509 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Pruritus, Swelling, Urticaria, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: PT STATED SHE EXPERIENCED VOMITTING THE DAY OF THE VACCINE IN THE EVENING. SHE ALSO STATED IT PROGRESSED OVER THE NEXT DAY INTO HIVES AND SWELLING. THE ITCHING/SWELLING/HIVES CONTINUED TO BECOME WORSE TO WHICH SHE THEN VISITED THE LOCAL EMERGENCY DEPARTMENT. THE GAVE STERIODS AND OTHER MEDICATIONS BASED ON THE PATIENTS INFORMATION. AS OF 5/3/2021 WHEN THIS IS BEING REPORTED SHE IS STILL ON A STERIOD AND IS STILL HAVING SYMPTOMS RELATED TO THE HIVES AND ITCHINESS.


VAERS ID: 1282510 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-03-08
Onset:2021-03-28
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cerebrovascular accident, Computerised tomogram head abnormal, Confusional state, Dizziness, Electrocardiogram, Facial paralysis, Headache, Hypoaesthesia, Laboratory test, Magnetic resonance imaging head abnormal, Nausea, X-ray
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hearing impairment (broad), Vestibular disorders (broad), Hypoglycaemia (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, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: levothyroxine, amlodipine,
Current Illness:
Preexisting Conditions:
Allergies: nka
Diagnostic Lab Data: CT MRI Lab work X-ray EKG
CDC Split Type:

Write-up: pt says she had a few episodes of feeling dizzy before having a stroke. Pts right hand became numb, she had some confusion, she was nauseated and had a severe headache several days prior to going to the emergency room. On 3/28/21 her face was dropping on the right side so was brought ER. She was admitted and given CT and multiple test. She was treated for a Stroke and stayed for about 3 days. She was discharged to FU w/ Neurologist next week.


VAERS ID: 1282515 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chills, Fatigue, Migraine, Platelet count normal, Pyrexia, Seizure
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Trintillex 20mg, Wellbutrin XL
Current Illness: none
Preexisting Conditions: POTS
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: April 10th - 6 hours post vaccine - chills, fever, and migraine 7 days post vaccine - fatigue and constant migraine, causing missed work 16 days post vaccine - After taking Rizatriptan, migraine is still debilitating, patient seeks help from the ER April 26th - patient receives Compazine, Toradol, and Benedryl in the ER. Patient starts convulsing after a dosage of Compazine. Receives IV fluid, and is sent home when migraine recedes. Pallete blood test taken in ER and results come back normal. April 29th - patient''s migraine returns worse than before, patient works with a neurologist, takes 20 mg of Rizatriptan and then returns to Urgent care, receiving a 25mg shot of Phenergan, which relieves migraine temporarily. May 3rd - patient continues to have headaches and fatigue, neurologist has prescribed a protocol of 10mg of Propranolol 3x daily as preventative. Rizatriptans are prescribed to quell migraines.


VAERS ID: 1282614 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood thyroid stimulating hormone, Computerised tomogram head, Fatigue, Full blood count normal, Headache, Influenza virus test, Metabolic function test, Monocyte count normal, SARS-CoV-2 test negative, Thyroxine normal
SMQs:, 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: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: 4/30/2021 - CT head with contrast, CBC, CMP, Mono, Flu, COVID PCR, TSH, T4, all normal at Medical Center
CDC Split Type:

Write-up: Headache for 3.5 weeks, fatigue which is profound and persists.


VAERS ID: 1282626 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-13
Onset:2021-04-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Headache, Magnetic resonance imaging, Migraine
SMQs:

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: Pepcid 40 mg
Current Illness:
Preexisting Conditions:
Allergies: Doxycycline Epinephrine Amoxicillin
Diagnostic Lab Data: MRI 4/17/2021
CDC Split Type:

Write-up: Within hours of my vaccination I got a headache, fatigue and within five days after my vaccination I got a severe migraine which lasted a total of eight days. I went to the hospital to get an MRI which was clear of a blood clot. All side effects have passed now.


VAERS ID: 1282755 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-04-07
Onset:2021-04-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Blood chloride increased, Blood creatinine normal, C-reactive protein normal, Computerised tomogram head, Computerised tomogram neck, Full blood count normal, Haematocrit increased, Migraine, Red blood cell sedimentation rate normal
SMQs:, Tubulointerstitial diseases (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: hydroxyzine, ibuprofen, lamotrigine, Mirena
Current Illness: none reported
Preexisting Conditions: migraine
Allergies: penicillin G
Diagnostic Lab Data: CT venography head/neck: No evidence of dural venous sinus thrombosis. Absence of flow related signal on the comparison MRV brain is demonstrated to be related to hypoplastic left transverse and sigmoid sinuses. In ED: CBC within normal ranges except hematocrit 47.4% Electrolytes: chloride 111 mmol/L, creatinine 0.54 mg/dL, rest within normal limits In clinic: CRP and ESR within normal limits
CDC Split Type:

Write-up: Janssen COVID-19 Vaccine EUA: Janssen COVID-19 Vaccine EUA: at clinic visit fifteen days after vaccination patient reports headache starting soon after vaccination. Referred to emergency department (ED). In ED patient presents with vital signs within normal ranges. Physical exam unremarkable. Diagnosed with migraine headache, administered intravenous fluids, NSAID, antiemetics, and antihistamines, prescribed prednisone, and discharged stable.


VAERS ID: 1282765 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Burning sensation, Dizziness, Flushing, Heart rate increased, Incorrect dose administered, Incorrect product formulation administered
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Vestibular disorders (broad), Hypersensitivity (broad), Medication errors (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Pfizer Covid 19 (dose 1)--flushing, burning in the lower limbs
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: no known drug allergies
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: Patient received J&J Covid Vaccine at 1:46 pm. At approx. 2:05 pm she stated she had an increased HR (wears wrist monitor) and was light headed. Spoke to patient about if she had previously felt this way after a vaccine and she stated she felt this after her "first covid vaccine". After questioning, she stated that she had received a Pfized Covid Vaccine in February which was not noted in her consent form. She also did not note that she had been hospitalized post-vaccination for a burning sensation and flushing that would not cease. She received the J&J vaccine at the advice of her primary care physician but had not advised pharmacy staff. After discussing it with the patient, it was determine that EMS would be called. EMS came to evaluate patient.


VAERS ID: 1282840 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-09
Onset:2021-04-20
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Computerised tomogram normal, Lipase increased, Nausea
SMQs:, Acute pancreatitis (narrow), 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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin, lisinopril, singulair, prandin, vit D
Current Illness:
Preexisting Conditions: DM, NASH, asthma, HTN
Allergies: None
Diagnostic Lab Data: Elevated lipase levels. CT abd/pel was performed and unremarkable. No other risk factors for acute pancreatitis.
CDC Split Type:

Write-up: Within 10-14 days of J&J vaccination patient began experiencing abdominal pain. Pain was localizing to RUQ and epigastrium with mild nausea. Unrelated to food.


VAERS ID: 1282884 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-10
Onset:2021-04-25
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Computerised tomogram thorax, Deep vein thrombosis, Pulmonary embolism, Thrombectomy, Ultrasound scan, Uterine leiomyoma
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Alvesco and albuterol inhaler as needed
Current Illness: None
Preexisting Conditions: asthma, found to have large fibrous uterus compressing on IVC
Allergies: eggs, penicillins and tetracyclines
Diagnostic Lab Data: Ultrasounds of bilateral lower extremities and CT chest done on 4/28 and 4/30
CDC Split Type:

Write-up: Large DVT and pulmonary embolism requiring anticoagulation and hospitalization. Also found to have a large fibroid uterus compressing IVC which likely contributed to IVC. Patient ended up needing mechanical thrombectomy to help relieve clot burden.


VAERS ID: 1282888 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-04-03
Onset:2021-04-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Blood lactic acid decreased, C-reactive protein increased, Dizziness, Headache, Hypertension, Malaise, Palpitations, Rash, Urticaria
SMQs:, Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hypertension (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Albuterol HFA inhaler Cholecalciferol (Vitamin D3) Cyanocobalamin (Vitamin B12) Folic acid Levothyroxine Metformin Methocarbamol Methotrexate Renflexis (infliximab-abda) Sucralfate
Current Illness: None
Preexisting Conditions: Crohn''s disease, obesity, asthma, GERD, hypothyroidism, arthritis, hypertension
Allergies: Acetaminophen Chlorhexidine Nuts Penicillins Shellfish
Diagnostic Lab Data: 4/5: AST 84, ALT 99, C-reactive protein 5.33 4/6: BP 179/129, AST 67, ALT 94, lactate 2.4
CDC Split Type:

Write-up: Patient experienced hives/rash within first half-hour of receiving the vaccine. She took Benadryl and rash subsided. Pt woke up the next day (4/4/21) feeling ill with heart racing, hypertension, and headache. She was scheduled to have an infusion appointment 4/5/21, which was canceled when she was found to have elevated liver enzymes and very high blood pressure. Patient went to ED on 4/6/21 for high blood pressure, lightheadedness, and headache.


VAERS ID: 1282927 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-06
Onset:2021-04-08
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chills, Facial pain, Hypoaesthesia, Pain, Paraesthesia, Sleep disorder, Trigeminal neuralgia, Vitamin B12 decreased
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Demyelination (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lamotrigine/lamictal
Current Illness: n/a
Preexisting Conditions: mild bi-polar
Allergies: n/a
Diagnostic Lab Data: 4/27/2021 Blood panel; B12 was a little bit low
CDC Split Type: vsafe

Write-up: 4/6/2021 vaccination 4/7/2021 body aches and chills 4/8/2021 That morning, I woke up because I had R side of my face, in my teeth; Trigeminal Neuralgia. Lasted for several hours. I found some codeine in medicine cabinet to help with pain and I could go back to sleep. It was achy on that side my face, throbbing for 48 hours. It tapered off by that Saturday 4/10/2021 4/16/2021 I started having tingling in my face again. Largely numb on R side of my face and low ache. Lasted till presently and still presenting but not as persistent; 2 weeks. Constant ache but not sharp as it had been at the beginning. The numbness went from my ear to my nose 4/23/2021. I went to urgent care. They confirmed it was Trigeminal Neuralgia. Dr. ordered blood test and referral to see a neurologist. *Appt with NEW PCP 05/14/2021 telehealth **still waiting on appt with neurologist


VAERS ID: 1282998 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-04-06
Onset:2021-04-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chest discomfort, Discomfort, Dyspnoea, Eosinophil count normal, Haemoglobin decreased, Influenza like illness, Laboratory test, Lymphocyte count normal, Nausea, Pharyngeal swelling, Platelet count normal, Retching, Swelling face
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Haematopoietic erythropenia (broad), Haemorrhage laboratory terms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), 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: Flu shot in 1993, after symptoms what I can remember feeling horrible for a couple of months
Other Medications: Tirosint 50mcg (took around 8:30am-9:00am)
Current Illness:
Preexisting Conditions: I have issues with brain fog, sleeping for 22 hours a day, have trouble walking and breathing, cannot lift anything. I also have hypothyroidism
Allergies: Steroids, penicillin, erythromycin, sulfa
Diagnostic Lab Data: lab work, steroids, My MCHCand low platelets was fairly normal, lymphocytes were normal along with eosinophils and immature granulocytes
CDC Split Type: vsafe

Write-up: I felt nauseated right after my J&J vaccine. I also have dry heaviness. I also experienced flu like symptoms. My chin also swelled up really big and I had hard time breathing. I went to the ER due to my throat swelling up and my difficulty to breathe for three days straight and also felt a pressure sensation in my throat and chest. At the ER they performed lab work, gave me a Toradol injection and also gave me steroids. I also took a homeopathic remedy which was given to me by a friend who is a doctor and my symptoms started to get better. On another note, my sister also had the J&J vaccine and she also had nausea symptoms but only lasted 3-4 days but I do not know if this is a genetic component.


VAERS ID: 1283008 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-11
Onset:2021-03-15
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiac monitoring, Echocardiogram, Electrocardiogram, Palpitations, Stress echocardiogram
SMQs:, Arrhythmia related investigations, signs and symptoms (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: Levothyroxine, Atorvastatin, low dose aspirin
Current Illness: Pulmonary Valve regurgitation Fatty Liver (NASH) Carotid stenosis
Preexisting Conditions: Pulmonary Valve regurgitation Fatty Liver (NASH) Carotid stenosis Asthma
Allergies: Penicillin, Peanuts
Diagnostic Lab Data: EKG, Stress Echo, Echo (4/22/2021) Zio monitor (4/23/2021-5/7/2021) ongoing
CDC Split Type:

Write-up: Heart Palpitations


VAERS ID: 1283019 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-03-30
Onset:2021-04-29
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Pain in extremity, 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), 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: Mirena IUD
Current Illness: none
Preexisting Conditions: none
Allergies: NKDA
Diagnostic Lab Data: Patient present to ED on 5/3 with leg pain. found to have blood clot in left leg via ultrasound. started on rivaroxaban and discharged
CDC Split Type:

Write-up: Patient present to ED on 5/3 with leg pain. found to have blood clot in left leg via ultrasound. started on rivaroxaban and discharged


VAERS ID: 1283021 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Chest discomfort, Chest pain, Contusion, Dizziness, Dyspnoea, Electrocardiogram, Epistaxis, Feeling abnormal, Headache, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Borderline Hypertension
Allergies: Lactose-suspected Pineapple Beans
Diagnostic Lab Data: Blood Test EKG
CDC Split Type: vsafe

Write-up: On the way home after my vaccine, I had Chest pain. The next day I felt unusual early the next day and normal symptoms in the afternoon. On the third day I had a slight headache in the morning. I then got a significant nosebleed, and my right leg was painful. On the fourth day I tried to work out and I felt lightheaded and got some chest pain and tightness with shortness of breath. I seemed to bruise easily. I was advised to see my doctor and I went to the ER. I followed up with my doctor and she advised that there were no signs of blood clots.


VAERS ID: 1283045 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-03-28
Onset:2021-03-30
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure decreased, Decreased appetite, Dyspnoea, Haemorrhage, Headache, Oxygen saturation decreased, Pneumonia, Pulmonary thrombosis, Somnolence, Syncope, Transfusion
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 32 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Metformin, Glipizide, Prednisone, Potassium, Atorvastatin, Carvedilol, Enalapril
Current Illness: Diabetes, autoimmune, high blood pressure.
Preexisting Conditions: Diabetes, autoimmune, high blood pressure
Allergies: No allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: On March 30th the patient had loss of appetite and headache. On March 31st the patient collapsed and was taken to the ER, the patient''s oxygen was low. Patient''s blood pressure had dropped and you could not wake him up all afternoon. The Ambulance took him to the hospital on April 1st where he had shortness of breath and blood clots in lungs. On April 1-2 the patient was leaking blood but the hospital staff could not find where so they gave him 3 units of blood. Patient also received 3 antibiotics for a rare pneumonia.


VAERS ID: 1283077 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-28
Onset:2021-04-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1809101 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Dyspnoea, Hypoaesthesia, Nausea, Nervousness, Pain in extremity, Retching, Throat tightness
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (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? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Per pt: glipizide, synthroid
Current Illness: Per pt: past medical history includes diabetes & thyroid problem. No cardiac history
Preexisting Conditions: Per pt: past medical history includes diabetes & thyroid problem. No cardiac history
Allergies: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: Dose given at 1:43pm. Symptoms started around 1:50pm. Symptoms include arm numbness and chest pressure. Pulse ox: 98 Bp: 168/95 Heart rate: 89 Pain: 8 of 10 chest pain moving to left Arm Pt reports numbness in the left arm all the way to shoulder & in the right arm numb to elbow. Pt states having breathing problems. Gave pt oxygen. Pt reports pain with inhalation and exhalation. Pmh: diabetes, no cardiac hx, thyroid problem Per pt, took medications today, ate quesadilla for breakfast, & was feeling good before vaccine administration. Pt has never felt these type of symptoms. No fever, no cough Medications per pt: glipizide, synthroid Recommended to go to the hospital; sounds like anxiety but pt wants to go to the hospital. Pt feels tightness of throat, but o2 is sat is 99@2:02 Pt was very nervous and didn''t want to get the vaccine. Her legs are numb/falling asleep 2:05pm Nauseous at 2:08pm but dry heaving, no actual vomit 911 called at 2:10pm. Chest pain @ 2:11pm is 8 out of 10 and numbness is still present in hands and feet, per pt. o2: 99 and pulse: 87 at 2:13pm Temp: 36.0 BG 8am before breakfast: 118 Ambulance arrived @ 2:19pm and transported pt to hospital


VAERS ID: 1283108 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-02
Onset:2021-04-08
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Facial paralysis, Headache, Lacrimation increased, Pain, Rash
SMQs:, Anaphylactic reaction (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad), Lacrimal 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? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: tylenol 325mg
Current Illness:
Preexisting Conditions: high blood pressure
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: 4/2/21 She experienced headache, body ache watery eyes, 4/8/21 face and neck rash, mouth shifted to the left hand side, headache (allergy was gone). then 4/10/21 went to urgent care md prescribed prednisone 20mg 2 tab daily for 3 days then 1 tablet daily for 4 days pt did not mention to md of covid vaccine


VAERS ID: 1283117 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-05-02
Onset:2021-05-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: no known
Current Illness: not known
Preexisting Conditions: not known
Allergies: NKDA or other allergens listed on consent form
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient had vasovagal syncope reaction to a Janssen Covid 19 vaccine. Patient was waiting in a chair in the pharmacy''s waiting area where he fainted a few minutes after receiving his vaccine. The pharmacist rushed to assist the patient while staff called EMS. Patient recovered and was aware of where he was and what happened. Patient was pale and sweating. Patient was given a few sips of water and concentrated on deep breathing. Shortly after this, patient fainted again while waiting on ambulance. Patient was lucid and conscious when paramedics arrived. The paramedics checked patient vitals and took patient away by ambulance.


VAERS ID: 1283154 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-01
Onset:2021-04-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Headache, Nasal congestion, 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: TYLENOL 500MG AND TAMOXIFEN 20MG
Current Illness: NONE
Preexisting Conditions: BREAST CANCER SURVIVOR
Allergies: ASPIRIN
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: ON 4/1/2021 PATIENT WENT HOME FELT A BIT TIRED FELL ASLEEP WOKE UP AROUND 9PM WITH ARM PAIN AND HEADACHE, ATE A LITTLE AND TOOK TYLENOL 500MG AND WENT BACK TO SLEEP WOKE UP THE NEXT DAY WITH EXTREME ARM PAIN CONGESTION AND HEADACHE. SHE TOOK TYLENOL EVERY 6 HOURS AROUND THE CLOCK. PATIENT ARM PAIN BECAME LESS PAINFUL HOWEVER THE HEADACHE LINGERED. PATIENT WENT TO URGENT CARE ON 4/29 MD PRESCRIBED NAPROXEN 500MG BID AND SUGGESTED TO SEE PCP IN A WEEK.


VAERS ID: 1283160 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-04-21
Onset:2021-04-29
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Malaise, Pain in extremity, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (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: None known
Preexisting Conditions: DM2, HTN, CHF
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient is a 58-year-old male with history of DM2 on insulin, bovine aortic valve replacement, nonischemic cardiomyopathy (unknown EF), hypertension, obesity, presented to Medical Center on 4/26/21 for left leg pain and swelling. Symptoms began about 2 days ago when he drove to visit some friends and started to " feel under the weather" hence drove back yesterday. He then had acute onset of left leg swelling and pain which prompted him to present to the ED. He was reportedly concerned about " having a clot" as he just received the Johnson & Johnson Covid vaccine this past week.


VAERS ID: 1283202 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-02
Onset:2021-04-04
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Electrocardiogram, Headache, Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Arthritis (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: HIGH BLOOD PRESSURE, CHOLESTEROL, FRACTURED BACK PAIN DISC 4.AND ANXIETY
Allergies: NONE
Diagnostic Lab Data: EKG WAS PERFORMED WITH RESULTS BEING FORWARDED TO PCP DR
CDC Split Type:

Write-up: ON 4/4/21 PT EXPERIENCED SHOULDER PAIN, HEADACHE AND ANKLE PAIN AND NUMBING ON HANDS, ON 4/27 PT WENT TO URGENT CARE MD PRESCRIBED MEDROL DOSE PACK, AND MOTRIN. PT WAS INSTRUCTED TO FOLLOW UP WITH DR AND RECOMMENDED TO GET AN MRI 4/29 PT DEVELOPED COUGH


VAERS ID: 1283203 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-02
Onset:2021-04-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / N/A RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood test normal, Computerised tomogram normal, Condition aggravated, Electrocardiogram normal, Fatigue, Groin pain, Headache, Migraine, Muscular weakness, Nausea, Pain in extremity, Rash, Rash erythematous, Rash pruritic, Ultrasound Doppler normal
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Osteonecrosis (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: If Polyethylene Glycol
Other Medications: Junel Hydrochlorothiazide
Current Illness:
Preexisting Conditions: Hypertension Tension Headaches
Allergies: Aspirin-Anaphylactic Polyethylene Glycol Nuts Adhesive
Diagnostic Lab Data: Blood Tests CT Scan Doppler of Leg EKG
CDC Split Type: vsafe

Write-up: I had the expected side effects for four days. The headache and Nausea lasted the full four days. I had a rash on my right shoulder four days after the shot. It was a red patch that was itchy and lasted for two days. Two weeks after the shot I had leg fatigue and weakness. I normally get tension headaches but the pain in my left leg was from my knee to my groin. It started as a sharp pain and then it became a dull ache that was there all day. The leg pain was spreading, and my headache had been there for four days. I was advised to go the ER because of family history and the current news about the vaccine. I was discharged after eight hours and all tests were negative. I was told that the headache had progressed to a Migraine and prescribed Toradol.


VAERS ID: 1283479 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-04-09
Onset:2021-04-14
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Blood test, Gait inability, Hypoaesthesia, Muscle twitching, Nerve conduction studies, Neuralgia, Pain, Pain in extremity, Peripheral coldness, Ultrasound Doppler normal, X-ray limb
SMQs:, Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Dyskinesia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Arthritis (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? No
Previous Vaccinations:
Other Medications: Zyrtec, vitamin d, vitamin c
Current Illness: None
Preexisting Conditions: Asthma
Allergies: Penicillin Keflex Sulfa Flagyl Lanolin Formaldehyde
Diagnostic Lab Data: Three ultrasounds on my left leg: April 19 and 20th Leg x-rays on April 20 Nerve conduction study on April 21 Blood taken on April 20
CDC Split Type:

Write-up: On Day give I began having left leg pain, shooting pains starting at my knee going down my leg. As the next few days progressed my leg began to get numb and go cold as ice. I have lost my ability to walk and my leg still has shooting nerve pains, gets numb, and twitches. I have gone to the ER, the doctor twice, and a neurologist. Nobody seems to have any answers for me. It is not a blood clot but that is the only thing that has been ruled out.


VAERS ID: 1283671 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anaphylactoid reaction, Hypertension, Stomatitis, Throat tightness
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (narrow), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypertension (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: no
Preexisting Conditions: n/a
Allergies: had anaphylactic reaction but not sure what it was from.
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: The patient was given Janssen vaccine @ 11:38am. She stated she had anaphylaxis reaction before after colonoscopy was not sure exactly what from. Made sure this vaccine didn''t have PEG in it. Asked her to stay for 30 minutes after vaccine so I could monitor her. Around 12:10pm she said her mouth felt like anaphylaxis may happen. Asked her if she felt like she could swallow she said yes gave her (2) 25mg diphenhydramine. Had her sit and took her blood pressure which was BP 202/101 hr 70 I asked her if maybe she was anxious she said no she was very calm. Around 12:20pm she said felt throat was closing like before told partner to call 911. Got out Epi pen 0.3mg but she had her own administered 1 dose in right thigh. Shortly after EMS arrived and took over. The whole time she was awake and alert and responsive. Spoke to her around 4pm she was just leaving ER and said she was doing better.


VAERS ID: 1283679 (history)  
Form: Version 2.0  
Age: 90.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-31
Onset:2021-04-29
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Anticoagulant therapy, Dyspnoea, Pulmonary embolism
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CT angiogram on 5/1/21 showing bilateral pulmonary embolism
CDC Split Type:

Write-up: Shortness of breath leading to primary care physician clinic visit. Continued shortness of breath leading to ED visit. CT angiogram done shows bilateral pulmonary embolism. Patient is currently being treated with Eliquis.


VAERS ID: 1283733 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-03-18
Onset:2021-04-01
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Death, Dyspnoea, Eye movement disorder, Peripheral coldness
SMQs:, Anaphylactic reaction (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Ocular motility disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-02
   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: Hydrochlorothiazide
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: on April 2nd patient woke up at around 4:30 am and complained of pain in his back. I rubbed his back and he wondered if it was just something he ate. He then tried to calm down and got back into bed . He was holding my hand when suddenly his hand felt cold. I turned on the light to find his eyes rolled back and he was gasping his last breath . This was about 5:20 AM . Patient was a healthy active man.


VAERS ID: 1283764 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Loss of consciousness, Seizure, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: not available
Current Illness: none known
Preexisting Conditions: none known
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received dose in right arm with no complications. However, about 1-2 minutes after vaccination patient reported feeling lightheaded. As I was instructing her to remain seated, she passed out and was unresponsive. She appeared to be having a seizure immediately after that lasted about 1 minute. Once this episode passed, she became responsive and could talk. EMS arrived and took over.


VAERS ID: 1284268 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: North Dakota  
Vaccinated:2021-04-06
Onset:2021-04-12
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: C-reactive protein, Dyspnoea, Fatigue, Full blood count, Metabolic function test, Pain in extremity, Pregnancy test, 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? 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: Escitalopram DEPO-PROVERA IM
Current Illness: None
Preexisting Conditions: No
Allergies: Kiwi
Diagnostic Lab Data: At Clinic HEPARIN-PF4 IGG AB 4/20/2021 HEMOGRAM/DIFF (Complete Blood Count) 4/20/2021 At ER: C-REACTIVE PROTEIN (INFLAMMATION) 4/20/2021 COMPLETE BLOOD COUNT 4/20/2021 COMPREHENSIVE METABOLIC PANEL 4/20/2021 HCG SCREEN 4/20/2021
CDC Split Type:

Write-up: Was was pain in calf area and having a hard time breathing and very tired.. went to doctor on 4/20/2021 Doctors Diagnosed with Pulmonary Embolism


VAERS ID: 1284281 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-04-07
Onset:2021-04-22
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Antinuclear antibody positive, Arthralgia, Pain, Viral titre
SMQs:, Systemic lupus erythematosus (narrow), Arthritis (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Fluticasone, allegra
Current Illness: none
Preexisting Conditions: COPD
Allergies: none
Diagnostic Lab Data: positive ANA, 1:160 Titer, Homogenous pattern
CDC Split Type:

Write-up: Janssen COVID-19 Vaccine EUA Pain started in right shoulder joint, by next morning was in right hip joint. Went to ER, given oxy and toradol, next day, pain was diminished in right but migrated to left shoulder joint, and wrist joints and finger joints of both hands. Minimal swelling in hands. Went to PCP on day 5, prescribed prednisone that helped greatly, pain still present but markedly less. Joint pain now in knee joints also.


VAERS ID: 1284433 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-04-05
Onset:2021-05-03
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Adverse drug reaction, Adverse food reaction, Amnesia, Anaphylactic shock, Blood test, Computerised tomogram, Confusional state, Facial paralysis, Headache, Hypoaesthesia, Magnetic resonance imaging, Paraesthesia, Seizure, Spinal pain, Swelling face, Tremor, Urinary incontinence, Vomiting
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Dementia (broad), Convulsions (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hearing impairment (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: anxiety,depression,PTSD
Allergies: Amoxicllian as of 4-7-21 morphine oxycoten oxycoden randome food after vaccinated
Diagnostic Lab Data: Blood work -every er visit MRI - 4-14-21 CAT SCAN
CDC Split Type:

Write-up: 4-5-21 vommiting ,headache 4-6-21 spine pain , headache cont ,vomiting 4-7-21 spine pain , headache cont ,vomiting reaction to morphine and oxy (anaphalactic shock ) x 2 er visits 4-8-21 spine pain , headache cont ,vomiting, seizures/ trimmers ,confussion/memory loss ,bladder incont. numb and teng in right side face and arm. facale swelling and drooping Er Visit 4-9-21 spine pain , headache cont ,vomiting, seizures/ trimmers ,confussion/memory loss ,bladder incont. numb and teng in right side face and arm. facale swelling and drooping 4-10-21 spine pain , headache cont ,vomiting, seizures/ trimmers ,confussion/memory loss ,bladder incont. numb and teng in right side face and arm. facale swelling and drooping ER 4-11-21- 4-14-21 spine pain , headache cont ,vomiting, seizures/ trimmers ,confussion/memory loss ,bladder incont. numb and teng in right side face and arm. facale swelling and drooping 4-14-21 spine pain , headache cont ,vomiting, seizures/ trimmers ,confussion/memory loss ,bladder incont. numb and teng in right side face and arm. facale swelling and drooping went to my PCP she sent me staright to hospital due to facial drooping and swelling in Face and convosiont/trimmeres. 4-22-21 spine pain , headache cont ,vomiting (min), seizures/ trimmers ,confussion/memory loss ,bladder i numb and teng in right side face and arm. facale swelling and drooping Fallow up with pcp waiting to see nerology for sezure activity 4-23-21-5-2-21 spine pain , headache cont ,vomiting, seizures/ trimmers ,confussion/memory loss . numb and teng in right side face and arm. facale swelling and drooping


VAERS ID: 1284443 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-06
Onset:2021-04-30
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram abdomen abnormal, Magnetic resonance imaging abdominal abnormal, Pancreatitis acute
SMQs:, Acute pancreatitis (narrow), Retroperitoneal fibrosis (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? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Fluoxetine-80mg Hailey 1.5/30 Adderall XR-30mg
Current Illness:
Preexisting Conditions: polycystic ovarian syndrome depression anxiety OCD
Allergies: Amoxicillin
Diagnostic Lab Data: CT scan- 4/30/2021 MRI- 5/1/2021
CDC Split Type:

Write-up: acute pancreatitis


VAERS ID: 1291651 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-04-08
Onset:2021-04-18
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1487891223 / N/A LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Coma, Serotonin syndrome
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Exederine, Bupropion Lyrica, Wellbutrin, ***Meloxicam***
Current Illness: None Known
Preexisting Conditions: Depression
Allergies: Penicillin
Diagnostic Lab Data: 04/18/2021 to 04/27/2021
CDC Split Type:

Write-up: 4/18/20 Went to hospital. Had to be sedated. Intubated. Transferred to another unit. Spent 4 days in medically induced coma. Later diagnosed with serotonin syndrome.


VAERS ID: 1284647 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-03-01
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Catheterisation cardiac, Chest pain, Myocardial infarction
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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: LISINOPRIL
Current Illness:
Preexisting Conditions: Comments: The patient did not had allergies to medications, food, or other products, did not had other illnesses at the time of vaccination, up to one month prior and did not had spleen.
Allergies:
Diagnostic Lab Data: Test Name: Cardiac catheterisation; Result Unstructured Data: 20 TO 30 PERCENTAGE BLOCKAGE
CDC Split Type: USJNJFOC20210439984

Write-up: CHEST PAIN; TWO HEART ATTACKS; This spontaneous report received from a patient via the VAERS (Vaccine Adverse Event Reporting System; VAERS ID 1202551] concerned a 54 year old white not Hispanic or Latino male. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included the patient did not had allergies to medications, food, or other products, did not had other illnesses at the time of vaccination, up to one month prior and did not had spleen. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 1802070, expiry: UNKNOWN) dose was not reported, administered on 10-MAR-2021 12:00 for prophylactic vaccination on right arm. Concomitant medications included lisinopril for drug used for unknown indication. On MAR-2021, the patient experienced two heart attacks, first attack was on day of vaccine and another was the day after the vaccine and was hospitalized (date unspecified). On 16-MAR-2021 04:00, the patient experienced chest pain prior to each heart attack but had never suffered chest pain before. He further reported that he was continuing to suffer from periods of chest pain at rest. Laboratory data (dates unspecified) included: Cardiac catheterization (NR: not provided) 20 to 30 percentage blockage. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from two heart attacks. This report was serious (Hospitalization Caused / Prolonged, Life Threatening, and Disability Or Permanent Damage).; Sender''s Comments: V0. 20210439984-covid-19 vaccine ad26.cov2.s -Two heart attacks, Chest pain- This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).


VAERS ID: 1284648 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-03-07
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure measurement, Blood test, Chest X-ray, Computerised tomogram, Cor pulmonale acute, Cough, Dizziness, Echocardiogram, Heart rate, Hypoxia, Pulmonary embolism, SARS-CoV-2 test negative, Thrombosis, Ultrasound scan
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Respiratory failure (broad), Infective pneumonia (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? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: AMITRIPTYLINE; ZOMIG
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210312; Test Name: COVID-19 virus test negative; Result Unstructured Data: Negative; Test Name: Heart rate; Result Unstructured Data: elevated; Test Name: Echocardiography; Result Unstructured Data: Increased pressure on the right side of heart due to blood clots; Test Name: Blood pressure; Result Unstructured Data: normal; Test Name: CT scan; Result Unstructured Data: Pulmonary Embolism; Test Name: Diagnostic ultrasound; Result Unstructured Data: No blood clots or vein thrombosis; Test Name: Blood test; Result Unstructured Data: normal; Test Name: Chest X-ray; Result Unstructured Data: normal
CDC Split Type: USJNJFOC20210441745

Write-up: PULMONARY EMBOLISM; THROMBOSIS; COR PULMONALE ACUTE/ DYSPNOEA; HYPOXIA; DIZZINESS; COUGHING; This spontaneous report received from a patient via a Regulatory Authority Vaccine Adverse Event Reporting System (VAERS) (VAER reference number 1120494) concerned a 68 year old female unknown ethnicity. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 1805020, and expiry: UNKNOWN) dose was not reported, administered on 06-MAR-2021 14:15 for prophylactic vaccination. Concomitant medications included amitriptyline for sleep, and zolmitriptan for migraine. On 07-MAR-2021 08:30, the subject experienced pulmonary embolism, thrombosis, cor pulmonale acute/ dyspnoea, hypoxia, dizziness, coughing, and was hospitalized (date unspecified). On 12-MAR-2021, Laboratory data included: COVID-19 virus test negative (NR: not provided) Negative. Laboratory data (dates unspecified) included: Blood pressure (NR: not provided) normal, Blood test (NR: not provided) normal, CT scan (NR: not provided) Pulmonary Embolism, Chest X-ray (NR: not provided) normal, Diagnostic ultrasound (NR: not provided) No blood clots or vein thrombosis, Echocardiography (NR: not provided) Increased pressure on the right side of heart due to blood clots, and Heart rate (NR: not provided) elevated. Treatment medications (dates unspecified) included: oxygen, salbutamol, and rivaroxaban. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the pulmonary embolism, thrombosis, cor pulmonale acute/ dyspnoea, hypoxia, dizziness, coughing was not reported. This report was serious (Hospitalization Caused / Prolonged, and Other Medically Important Condition); Sender''s Comments: V2:Additional version created for MAC update. This updated information does not alter the causality of previously reported events. 20210441745-Covid-19 vaccine ad26.cov2.s-Thrombosis, pulmonary embolism ,Cor pulmonale acute, Hypoxia, dizziness, cough. These events are considered unassessable. These events has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the events.


VAERS ID: 1284653 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Michigan  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Autoimmune disorder, Lung infiltration
SMQs:, Interstitial lung disease (narrow), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Patient did not have autoimmune disorder prior to receiving the Janssen Covid-19 vaccine.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210451619

Write-up: AUTOIMMUNE DISORDER; BILATERAL INFILTRATES; This spontaneous report received from a physician concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included patient did not have autoimmune disorder prior to receiving the Janssen covid-19 vaccine. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On an unspecified date, the patient experienced autoimmune disorder and bilateral infiltrates and visited emergency room. The action taken with covid-19 vaccine ad26.cov2.s was not reported. The outcome of the autoimmune disorder and bilateral infiltrates was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0: 20210451619-covid-19 vaccine ad26.cov2.s-autoimmune disorder. This event is considered unassessable. The event has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event.


VAERS ID: 1284655 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-04-06
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Anaphylactic shock, Idiopathic intracranial hypertension
SMQs:, Anaphylactic reaction (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210452704

Write-up: RECURRENT ANAPHYLACTIC SHOCK; IDIOPATHIC INTRACRANIAL HYPERTENSION; This spontaneous report received via company representative from a patient concerned a patient of unspecified age and sex. The patients weight, height, and medical history were not reported. The patient received COVID-19 VACCINE AD26.COV2.S (suspension for injection, route of admin not reported, batch number: 042A21A, expiry: UNKNOWN)dose was not reported, 1 total administered on 06-Apr-2021;11:54 for prophylactic vaccination. No concomitant medications were reported. On 06-APR-2021 at 12:10pm the patient was reacting to the vaccine and was hospitalized and received treatment for extreme Anaphylactic Shock ( had 3 bounceback reactions over the course of the next 24 hours. Patient was treated with Epinephrine (iv drip), Steroids and multiple Nebulizer treatments. Patient was in the ICU for 3days and a regular room for e additional days. Hospitalized from 6Apr through 11Apr.I was home for several days and was again hospitalized 19Apr through 22Apr for a severe headache, ringing in ears, numbness in left arm, leg, an leg. Also for blurry/double vision in right eye. On 19-APR-2021, the patient was again hospitalized for a severe headache, ringing in ears, numbness in left arm, and leg, blurry/double vision in right eye. It was determined to be Idiopathic Intracranial Hypertension and still being treated for it and will be attending Occupational and Physical therapy to get vision, arm and leg to work properly again. Patient was hospitalized for 3 days. The action taken with COVID-19 VACCINE AD26.COV2.S was not applicable. The patient had not recovered from idiopathic intracranial hypertension, and the outcome of recurrent anaphylactic shock was not reported. This report was serious (Hospitalization Caused / Prolonged).; Sender''s Comments: 20210452704-Covid-19 vaccine ad26.cov2.s-Idiopathic intracranial hypertension. This event(s) is considered unassessable. The event(s) has an unknown/unclear temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s). 20210452704-Covid-19 vaccine ad26.cov2.s-Anaphylactic reaction. This event(s) is considered related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and is scientifically plausible. There is no information on any other factors potentially associated with the event(s).


VAERS ID: 1284659 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: Idaho  
Vaccinated:0000-00-00
Onset:2021-04-03
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Appendicitis, Asthenia, Chest pain, Contusion, Headache, Pain, Rash macular
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Drug allergy (unknown reaction); Non-smoker
Preexisting Conditions: Comments: The patient had no relevant medical history.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210456304

Write-up: APPENDICITIS; CHEST PAIN; WEAKNESS; BODY ACHES; SKIN BLOTCHES; BRUISES; HEADACHE; This spontaneous report received from a consumer concerned a 27 year old white, hispanic or latino female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included allergic to aspirin (unknown reaction), no alcohol use, and non smoker, and other pre-existing medical conditions included the patient had no relevant medical history. The patient was not pregnant at the time of reporting. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 1808980, expiry: 20-JUN-2021) dose was not reported, 1 total administered on 02-APR-2021 on right arm for prophylactic vaccination. No concomitant medications were reported. It was reported that, the patient experienced side effects that developed after receiving covid-19 vaccine ad26.cov2.s. On 03-APR-2021, the patient experienced headache. On 06-APR-2021, the patient experienced skin blotches and bruises. On 07-APR-2021, the patient experienced body aches. On 14-APR-2021, the patient experienced weakness. On 19-APR-2021, the patient experienced chest pain. On 27-APR-2021, the patient experienced appendicitis and had a hospitalization that resulted in surgery for appendectomy. The patient had visited emergency room/department or urgent care and doctor/healthcare professional office. The patient was hospitalized for 1 day and was discharged on 28-APR-2021. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from skin blotches, bruises, and appendicitis, and had not recovered from headache, chest pain, body aches, and weakness. This report was serious (Hospitalization Caused / Prolonged).; Sender''s Comments: V0 20210456304- COVID-19 VACCINE AD26.COV2.S-Appendicitis. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).


VAERS ID: 1284661 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-04-07
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Chest discomfort, Condition aggravated, Dyspnoea, Nervousness
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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: USJNJFOC20210457126

Write-up: ANXIETY; NERVOUS; SHORTNESS OF BREATH; CONDITION AGGRAVATED; CHEST TIGHTNESS; This spontaneous report received from a patient concerned a 24 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: 041A21A, expiry: UNKNOWN) dose was not reported, administered on 04-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 07-APR-2021, the subject experienced chest tightness. On 24-APR-2021, the subject experienced shortness of breath. On 24-APR-2021, the subject experienced condition aggravated. On an unspecified date, the subject experienced anxiety, and nervous. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the chest tightness, shortness of breath, anxiety, nervous and condition aggravated was not reported. This report was non-serious.; Sender''s Comments: V0: Medical Assessment comment was not required as per standard procedure as the case assessed as non-serious


VAERS ID: 1284665 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-04-19
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Cardiac stress test, Chest discomfort, Chest pain, Electrocardiogram
SMQs:, Anaphylactic reaction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210419; Test Name: Blood test; Result Unstructured Data: Normal; Test Date: 20210419; Test Name: EKG; Result Unstructured Data: Normal; Test Name: Stress test; Result Unstructured Data: not reported
CDC Split Type: USJNJFOC20210458883

Write-up: CHEST PAIN; CHEST PRESSURE; This spontaneous report received from a consumer concerned a 58 year old female. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808978, expiry: UNKNOWN) dose was not reported, administered on 02-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 19-APR-2021, the subject experienced chest pain. On 19-APR-2021, the subject experienced chest pressure. Laboratory data included: Blood test (NR: not provided) Normal, and EKG (NR: not provided) Normal. Laboratory data (dates unspecified) included: Stress test (NR: not provided) not reported. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from chest pain, and chest pressure. This report was non-serious.; Sender''s Comments: MAC not required as per standard procedure as case was assessed as non-serious.


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