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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: 1284917 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-04-01
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: Ammonia, Antithrombin III decreased, Cataract, Chest pain, Eye pain, Factor V Leiden mutation, Fibrin D dimer increased, Headache, Magnetic resonance imaging, Palpitations, Platelet count, Protein C, Protein S, Red blood cell sedimentation rate, Serotonin syndrome
SMQs:, Liver-related coagulation and bleeding disturbances (narrow), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (narrow), Arrhythmia related investigations, signs and symptoms (broad), Congenital, familial and genetic disorders (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: High cholesterol
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210426; Test Name: Magnetic resonance imaging; Result Unstructured Data: grossly abnormal indicative of clot; Test Date: 20210426; Test Name: Platelet count; Result Unstructured Data: 251000 on admisssion; Test Date: 20210427; Test Name: Magnetic resonance imaging; Result Unstructured Data: No evidence of thrombus, mild white matter; Test Date: 20210427; Test Name: Platelet count; Result Unstructured Data: 246,000; Test Date: 20210428; Test Name: Fibrin D dimer abnormal; Result Unstructured Data: 0.29((normal 0-0.49); Test Date: 20210428; Test Name: Platelet count; Result Unstructured Data: 227,000; Test Date: 20210428; Test Name: Erythrocyte sedimentation rate; Result Unstructured Data: 21(normal); Test Date: 20210428; Test Name: Protein C; Result Unstructured Data: unknown; Test Date: 20210428; Test Name: Protein S antigen; Result Unstructured Data: unknown; Test Date: 20210428; Test Name: Antithrombin III decreased; Result Unstructured Data: unknown; Test Date: 20210428; Test Name: Factor V Leiden mutation; Result Unstructured Data: unknown; Test Date: 20210428; Test Name: Serotonin syndrome; Result Unstructured Data: unknown; Test Name: Ammonia; Result Unstructured Data: high ammonia level
CDC Split Type: USJNJFOC20210451865

Write-up: PALPITATIONS; CHEST PAIN; CATARACTS; BILATERAL EYE PAIN; INTERMITTENT HEADACHE/LIGHTHEADEDNESS; This spontaneous report received from a pharmacist concerned a Vietnamese female of unspecified age. The patient''s weight, height, and medical history were not reported. The patient''s concurrent conditions included high cholesterol. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of administration and vaccination site not reported, batch number: Unknown) dose was not reported, 1 total, administered in APR-2021 (reported as approximately 2 weeks prior to the date of the report) for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. In APR-2021, reported as 5 days ago, the patient experienced with intermittent headache, bilateral eye pain and blurry vision, in addition to chest pain and palpitations. She was seen in the emergency Room on 26-APR-2021, and was subsequently diagnosed with acute cavernous venous thrombosis. Patient was hospitalized and number of days were unspecified. On an unspecified date, the patient experienced bilateral eye pain, blurry vision, cataracts, and intermittent headache/lightheadedness. On 26-APR-2021, Laboratory data included: Magnetic resonance imaging (NR: not provided) grossly abnormal indicative of clot, and Platelet count (NR: not provided) 251000 on admission. On 27-APR-2021, Laboratory data included: Magnetic resonance imaging (NR: not provided) no evidence of thrombus, mild white matter (units unspecified), and platelet count (NR: not provided) 246,000. On 28-APR-2021, Laboratory data included: Anti-thrombin III decreased (NR: not provided) unknown, erythrocyte sedimentation rate (nr: not provided) 21 (normal), factor V leiden mutation (NR: not provided) unknown, Fibrin D dimer abnormal (NR: not provided) 0.29 (unit not reported) (normal 0-0.49), Platelet count (NR: not provided) 227,000, Protein C (NR: not provided) unknown, Protein S antigen (NR: not provided) unknown, and Serotonin syndrome (NR: not provided) unknown. Laboratory data (dates unspecified) included: Ammonia (NR: not provided) high ammonia level. Treatment medications (dates unspecified) included: acetylsalicylic acid. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from intermittent headache/lightheadedness on 28-APR-2021, and the outcome of chest pain, palpitations, bilateral eye pain and cataracts was not reported. This report was serious (Hospitalization Caused / Prolonged, and Other Medically Important Condition).; Sender''s Comments: V0.20210451865-covid-19 vaccine ad26.cov2.s-cataract,palpitations,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: 1284918 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-04-01
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: Allergy to vaccine, Arthralgia, Asthenia, Burning sensation, Chest X-ray, Chills, Computerised tomogram, Dizziness, Electrocardiogram, Gait disturbance, Headache, Impaired driving ability, Laboratory test, Malaise, Nasopharyngitis, Pain, Painful respiration, Pneumothorax, Speech disorder, Tremor, Vision blurred
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Arthritis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210417; Test Name: EKG; Result Unstructured Data: NOT REPORTED; Test Date: 20210417; Test Name: Laboratory test; Result Unstructured Data: NOT REPORTED; Test Date: 20210417; Test Name: CT scan; Result Unstructured Data: NOT REPORTED; Test Date: 20210417; Test Name: Chest X-ray; Result Unstructured Data: NOT REPORTED
CDC Split Type: USJNJFOC20210456498

Write-up: ALLERGIC REACTION TO VACCINE; COLLAPSED LUNG; HURT TO BREATHE; BURNING SENSATION ON RIB CAGE GOING TO BACK; NOT FEELING GOOD; WEAKNESS; SEVERE HEADACHE; KNEES BREAKING; TEETH SHATTERING; VERY COLD; HURT TO WALK; BLURRED VISION; SHAKY; DIZZINESS; HURT TO TALK; HURT TO DRIVE; PAIN; This spontaneous report received from a patient via email concerned a patient of unspecified age and sex. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: UNKNOWN and expiry : unknown) dose was not reported, administered on 08-APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On an unspecified date in Apr-2021, the patient experienced hurt to walk, blurred vision, shaky, dizziness, hurt to talk, hurt to drive, and pain. On 08-APR-2021, the patient experienced very cold, knees breaking, teeth shattering, severe headache. On 09-APR-2021, the patient experienced not feeling good, weakness. On 15-APR-2021, the patient experienced hurt to breathe, burning sensation on rib cage going to back. On 17-APR-2021, the patient experienced collapsed lung on same day the patient visited emergency room and the doctor gave something for pain via intravenous. The doctor has said to take deep breaths every hour on the hour and to drink lots of water. Laboratory data included: CT scan (NR: not provided) NOT REPORTED, Chest X-ray (NR: not provided) NOT REPORTED, EKG (NR: not provided) NOT REPORTED, and Laboratory test (NR: not provided) NOT REPORTED. On 22-APR-2021, the patient experienced allergic reaction to vaccine. The patient has visited the family doctor on 22-Apr-2021 and doctor gave Gabapentin 100mg 3 times a day and Tramadol every 6 hours for pain. The patient called the doctor as the patient was having pain and is taking 300 mg of gabapentin twice a day and it was still not working. The patient was having an appointment with Dr. Hughston again on 30-Apr-2021. Treatment medications (dates unspecified) included: tramadol, and gabapentin. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from weakness, hurt to breathe, burning sensation on rib cage going to back, hurt to walk, blurred vision, shaky, dizziness, hurt to talk, hurt to drive, and pain, and the outcome of very cold, teeth shattering, severe headache, knees breaking, not feeling good, collapsed lung and allergic reaction to vaccine was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0 20210456498-COVID-19 VACCINE AD26.COV2.S-collapsed lung. 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: 1284922 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Minnesota  
Vaccinated:0000-00-00
Onset:2021-03-11
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chills, Dehydration, Headache, Nausea, Pain assessment, Positron emission tomogram
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Dehydration (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Migraine
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210311; Test Name: PET scan; Result Unstructured Data: unknown; Test Date: 20210411; Test Name: Pain scale; Result Unstructured Data: 10/10
CDC Split Type: USJNJFOC20210458937

Write-up: DEHYDRATION; SEVERE HEADACHE; NAUSEA; MASSIVE CHILLS; This spontaneous report received from a patient concerned a 58 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included migraines. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805025, and expiry: 25-MAY-2021) dose was not reported, 1 total administered on 10-MAR-2021 at left arm for prophylactic vaccination. No concomitant medications were reported. Right after Vaccine administration no side effects but the patient spent the next day at Emergency Room. On 11-MAR-2021, the patient was sicker than dog and had experienced dehydration, massive chills, severe headache, and nausea. On the same day PET scan was performed for headache and pain was 10/10. Patient was given cold medicine and 2 unspecified intravenous medication. After that patient was well enough to go home. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from dehydration, massive chills, severe headache, and nausea on 11-MAR-2021. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0: 20210458937-COVID-19 VACCINE AD26.COV2.S-DEHYDRATION. 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). 20210458937-COVID-19 VACCINE AD26.COV2.S-20210458937-COVID-19 VACCINE AD26.COV2.S-SEVERE HEADACHE, NAUSEA, MASSIVE CHILLS. This event(s) is labeled per RSI and is therefore considered potentially related.


VAERS ID: 1285180 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-23
Onset:2021-03-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

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

Write-up: pulsatile tinnitus, left ear with associated headaches


VAERS ID: 1285183 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Confusional state, Dizziness, Fatigue, Lethargy, Seizure, Syncope, 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), Dementia (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Systemic: Chills-Severe, Systemic: Confusion-Severe, Systemic: Dizziness / Lightheadness-Severe, Systemic: Exhaustion / Lethargy-Severe, Systemic: Fainting / Unresponsive-Severe, Systemic: Seizure-Severe


VAERS ID: 1285193 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-04-08
Onset:2021-04-25
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK AR / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Death, Intracardiac thrombus, Pulmonary thrombosis
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-04-30
   Days after onset: 5
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: Carvedilol, Doxazosin, Benicar, Lasix, Rosuvastatin, Bupropion, Hydralazine
Current Illness: Stage 4 kidney failure
Preexisting Conditions: Kidney Failure
Allergies: Morphine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Multiple Blood Clots in Right Lung, clots passed through his heart and caused his death


VAERS ID: 1285207 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Flushing, Hyperhidrosis, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (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: Dizziness / Lightheadness-Mild, Systemic: Fainting / Unresponsive-Mild, Systemic: Flushed / Sweating-Severe, Additional Details: IMMEDIATELY UPON INJECT THE PT FAINTED. I GOT HIM ON THE FLOOR AND ELEVATED HIS FEET. CHECKED HIS PULSE AND BREATHING. GAVE HIM WATER. HIS MOTHER KEPT CALLING HIS NAME. WHEN HE SAID HE WAS FINE. HE SAT DOWN THEN FAINTED AGAIN. 911 WAS CALLED. EMT ARRIVED AND TOOK CARE OF HIM. HIS MOTHER DROVE HIM HOME. MOTHER STATED HE DOES THIS EVERY TIME HE GETS A SHOT


VAERS ID: 1285227 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-01
Onset:2021-05-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Hypotension, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), 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? 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: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Severe, Systemic: Hypotension-Medium


VAERS ID: 1285261 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-04-06
Onset:2021-04-27
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Activated partial thromboplastin time, Angiogram cerebral, Arteriogram carotid, Borrelia test, Calcium ionised, Computerised tomogram head, Computerised tomogram neck, Differential white blood cell count, Electrocardiogram, Facial paralysis, Full blood count, Headache, International normalised ratio, Magnetic resonance imaging head, Metabolic function test, Prothrombin time, Scan with contrast
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vitamin D. 5000
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Basic Metabolic panel 4/29/2021 CBC W Auto Differential 4/29/21 CT Heat Without Contrast 4/29/21 CTA Head with Contrast 4/29/21 CTA Neck with Contrast 4/29/21 EKG 12-lead 4/29/21 Calcium Ionized 4/30/21 APTT 4/30/21 Protime- INR 4/30/21 CBC W/ Auto Differential 4/30/21 Comprehensive Metabolic Panel 4/30/21 Lyme Disease Acute Reflexive panel 4/30/21 MRI Brain without Contrast 4/30/21
CDC Split Type:

Write-up: Headache Bilateral facial palsy 30 days after administration of vaccine


VAERS ID: 1285414 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-07
Onset:2021-04-26
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 UN / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test normal, Chest X-ray normal, Computerised tomogram head, Pyrexia, Seizure
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Fiber and probiotic supplements, OCP
Current Illness: Covid-19 DX 3/18/2021 with positive Ag
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: All blood tests, chest film, and head CT were normal.
CDC Split Type:

Write-up: Case had Covid-19 dx on 3/18/21. No SXS. Had Janssen vaccine administered on 4/7/21. Approx 2 wks later c/o fevers and a seizure on 4/26/2021. Was eval in medical facility then at another for seizure. Her fever was 102.7 about 1 hr prior to her seizure.


VAERS ID: 1285493 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-03-07
Onset:2021-04-01
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 186207L / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Discomfort, Joint stiffness, Muscle swelling, Musculoskeletal stiffness, Pain, Peripheral swelling, Ultrasound scan normal
SMQs:, Cardiac failure (broad), Angioedema (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Amlodopine, Atenolol, Aspirin (low dosage)
Current Illness: N/A
Preexisting Conditions: Hypertension
Allergies: Procardia
Diagnostic Lab Data: An ultrasound was done to rule out possibility of blood clot in my leg.
CDC Split Type:

Write-up: (1) Approximately one month after vaccine, swelling in the muscle behind my left leg. I went to my Primary Care doctor, he examined my leg and immediately sent me to hospital ER because he was concerned that it might be a blood clot. They performed an ultrasound, but the results were negative and showed no signs of any blood clots. (2) Approximately three weeks after vaccine, I developed stiffness on the left side of my body in my arm, thigh and hip area. The stiffness was intense, uncomfortable and bothersome enough for me to take Tylenol for the pain the next 5 days and it lasted for about a week.


VAERS ID: 1285497 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-04-12
Onset:2021-04-23
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Computerised tomogram abnormal, Cough, Lymphadenopathy, Mass, Night sweats, Pyrexia, X-ray abnormal
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), 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? No
Previous Vaccinations:
Other Medications: Arm our Thyroid, levothyroxine, Testosterone cypionate, anastrazole, Pregablin
Current Illness: Non
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: X- ray, CT Scan
CDC Split Type:

Write-up: Night sweats, fever, cough, chills, swollen lymph nodes, mass located on lymph node


VAERS ID: 1285514 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-04-30
Onset:2021-05-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 10808978 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Dyspnoea, Laboratory test, Migraine
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

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

Write-up: Shortness of breath, heaviness of chest, migraine, felt like couldn''t breathe


VAERS ID: 1285576 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-03-08
Onset:2021-04-23
   Days after vaccination:46
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Pulmonary thrombosis
SMQs:, Embolic and thrombotic events, venous (narrow), 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? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ALodipine 10mg daily Pravastatin 80 mg, daily Eliquis 5 mg daily Lisinopril 10 mg, daily Metoprolol 25 mg twice a day
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Lots of testing
CDC Split Type:

Write-up: Shot on 3/8/21 & on 4/23/21 had pain in chest. MWH tested & NOT heart UT LUNGS that a clot in each.


VAERS ID: 1285587 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-04-29
Onset:2021-04-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 RA / IM

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

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

Write-up: Facial swelling on the right side, arm showed no swelling


VAERS ID: 1285619 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-03-30
Onset:2021-04-29
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / UNK LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: PLAN: Based on current clinical presentation and HPI, patient is presenting with pain of Lt upper arm and acute headache. Given the presentation with negative neurological exam and stable vital signs with no signs of infection to injection site, patient safe for discharge. ED precautions regarding neurological changes. Advised ibuprofen for arm pain.
CDC Split Type:

Write-up: 33 y.o. female presenting alone with complaint of Lt arm pain and intermittent headaches x 2 weeks. She is wondering if symptoms are related to Janssen COVID Vaccine that she received on 4/30 (Lt deltoid). Reports similar symptoms right after vaccination, but symptoms resolved completely. Two weeks ago, symptoms started again, including headaches and pain to Lt upper arm. No vision changes or neurological changes. Pain level at this time is zero.


VAERS ID: 1285644 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-07
Onset:2021-04-28
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal discomfort, Blood glucose decreased, Headache, Hypophagia, Limb mass, Nausea, Pain in extremity, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: RE-EVALUATION & FINAL ASSESSMENT: 11:57 PM Today''s work-up is overall reassuring. No evidence of diverticulitis, enteritis. Findings were discussed with the patient with a interpreter. I feel that she is appropriate for discharge at this time and the patient is comfortable with this plan. She will be given medications for HA and nausea. She has been provided with a prescription for Zofran. I advised her that if she ends up having decreased p.o. intake over the next couple days secondary to this illness, then she should withhold her glipizide. I advised her that the Metformin should not cause her to be hypoglycemic, and her Lantus is slow acting and it should not cause hypoglycemia either. The glipizide would be the most concerning. Advised her that if she eats as usual then she should take all of her medicines as usual. She verbalized understanding. The patient has also been advised to follow up with her PCP for further evaluation. Home care instructions and return precautions were discussed prior to discharge.
CDC Split Type:

Write-up: The patient is a 50 y.o. female who presents to the Emergency Department with 3 days of a low abdominal discomfort with nausea and vomiting just today. She says that she had decreased oral intake today due to her other symptoms and she had a low blood sugar of 65 earlier today. She did not take her evening Lantus because of this. She had already taken her usual Metformin and glipizide. She denies any fevers, denies any diarrhea. Her last bowel movement was this morning and normal. Denies any blood in the stools. Denies any significant cough or breathing difficulty. Denies urinary symptoms, dysuria, hematuria. She reports that she is also had about 2 weeks of a left arm pain that comes and goes, and it seems to radiate to her trapezius. She says that when the pain comes she feels a lump in her left outer arm. She did see her PCP for this and was started on diclofenac about 1 week ago. She says that this does help some.


VAERS ID: 1285674 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-08
Onset:2021-04-14
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Diarrhoea, Full blood count normal, Metabolic function test, Nausea, Pain, Pyrexia, SARS-CoV-2 test negative, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin
Current Illness: None.
Preexisting Conditions: None.
Allergies: None.
Diagnostic Lab Data: 04/14/2021: CBC, metabolic panel, covid test. All normal/negative.
CDC Split Type:

Write-up: Day 6 post vaccine: nausea, vomiting, diarrhea, chills, body aches, fever.


VAERS ID: 1285676 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-07
Onset:2021-04-28
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Hypertension, Paraesthesia, Peripheral swelling, Rash, X-ray normal
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (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? 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: RE-EVALUATION & FINAL ASSESSMENT: 3:15 AM - Patient''s work up today is reassuring, her xray is unremarkable and there are no signs of DVT on her doppler. Work up results were discussed with the patient and they verbalized understanding. Upon final assessment the patient appears well and her blood pressure has improved after the dose of Labetalol. The rest of her vital signs are normal and I believe she is appropriate for discharge home to follow up with her PCP. I answered all questions, discussed supportive care, gave strict return precautions for any new or worsening symptoms, and advised patient to follow up with PCP closely. Patient is agreeable with plan.
CDC Split Type:

Write-up: The patient is a 36 y.o. female w/ hx of migraines, renal artery stenosis s/p right renal artery stent placement, and HTN who presents to the Emergency Department with left leg swelling and rash. Patient reports that while shaving her legs this morning she noticed that there was a rash to her left lower leg anteriorly. It has persisted throughout the day, and tonight she also noticed that her LLE appeared to be more swollen than her RLE. Patient denies any pain of her LLE, but reports that she has some paresthesia in it. She denies any associated fevers, chills, SOB, or chest pain. Patient has not been diagnosed with any autoimmune disorders, and has never had a DVT. She also denies any recent long periods of immobility, recent surgeries, and any oral contraceptive use. Patient presents significantly hypertensive with SBP in the 220s, but she notes that this is in the setting that she has not taken her nightly dose of Labetalol.


VAERS ID: 1285689 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-07
Onset:2021-04-28
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 59676-580-05 / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Suicidal ideation
SMQs:, Suicide/self-injury (narrow)

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

Write-up: SUICIDAL


VAERS ID: 1285704 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: School       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Lymphadenopathy, Myalgia, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Diverticulosis
Allergies: Allergic to Aspirin
Diagnostic Lab Data: No tests were recommended at urgent care.
CDC Split Type:

Write-up: I had chills, fatigue, headache, and bilateral calf and thigh muscle pain that started about 6 hours after the vaccination and lasted about 36-48 hours. I took Tylenol 500mg after the onset of symptoms and three times a day. The symptoms went away by mid-day on 4/13/2021. Since then, I have been experiencing bilateral calf muscle pain off and on. I also had an enlarged axillary lymph node n the left side (side of vaccination). I reported it to urgent care on 4/18/2021 and was told the muscle pain was unlikely to be a clot since it was bilateral and there was no swelling or discoloration. I was told to hydrate and follow up with my primary care provider if it continues. The calf muscle pain has continued - almost every other day - and responds to Advil. I have an appointment to talk to an MD tomorrow (May 5th)


VAERS ID: 1285711 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-31
Onset:2021-04-10
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Abnormal loss of weight, Acute respiratory failure, COVID-19, Computerised tomogram thorax abnormal, Cough, Dyspnoea, Hypoxia, Inflammatory marker increased, Lung opacity, Malaise, Myalgia, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Interstitial lung disease (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (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, 3 days
   Extended hospital stay? No
Previous Vaccinations: influenza vaccine (N/V)
Other Medications: alendronate, aspirin, atorvastatin, clopidogrel, famotidine, levothyroxine, lisinopril, omeprazole, sertraline
Current Illness: Hx of lower GI bleed (2/2021)
Preexisting Conditions: Hypthyroidism, HTN, osteoporosis, hx of CVA, hyperlipidemia
Allergies: sulfa (rash)
Diagnostic Lab Data: 4/23/21: SARS CoV 2 RNA PCR- positive 4/24: CT Chest: Bilateral airspace opacities mid-lower lungs concerning for infectious process.
CDC Split Type:

Write-up: Pt presented to ED w/2 week hx of malaise, myalgias, weight loss associated w/dyspnea and dry cough. Found to be hypoxic, in which she responded well with 2L O2. Labs confirmed COVID-19 positive w/elevated inflammotory markers (lactic acid). Pt had received Janssen vaccine (3/31/21). Was admitted for additional management of her acute hypoxemic respiratory failure w/COVID-19 on 4/23/21. Was treated with dexamethasone, remdesivir and empiric antibiotics which were stopped early. Pt ultimately discharged 3 days later w/follow-up scheduled in 3-5 days.


VAERS ID: 1285759 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-04-07
Onset:2021-04-26
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Computerised tomogram thorax abnormal, Deep vein thrombosis, Dyspnoea, Joint swelling, Pain in extremity, Peripheral swelling, Pulmonary embolism, Scan with contrast abnormal, Tachycardia, Ultrasound Doppler abnormal, X-ray limb abnormal
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Osteonecrosis (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Bisoprolol 5mg morning/ 2.5mg night, aspirin 81mg, vitamin C 500mg, magnesium 400mg, alprazolam .25mg, Tylenol 500mg
Current Illness:
Preexisting Conditions: Mitral valve prolapse, heart murmur, hydrocephalus, paralysis right side from nerve damage at birth, vp shunt, spinal fusion of C1 & C2,
Allergies: Latex, morphine, trazodone
Diagnostic Lab Data: April 28th Ultrasound on leg, ct w/contrast lungs, X-ray ankle & foot Records available upon request.
CDC Split Type:

Write-up: Aching left heel: April 26, progress into calf with swelling of foot, ankle & calf: evening April 27, dvt found in left leg, pulmonary emboli in both lungs, right worse than left lung, shortness of breathe, tachycardia


VAERS ID: 1285878 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-26
Onset:2021-05-03
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / N/A LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Computerised tomogram head, Impaired work ability, Loss of personal independence in daily activities, Migraine
SMQs:, Dementia (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: Bariatric Fusion daily vitamins
Current Illness: Ear infection 2 weeks before
Preexisting Conditions: None
Allergies: Amphicillain Keflex Morphine
Diagnostic Lab Data: Blood work drawn. Ct scan of head
CDC Split Type:

Write-up: Janssen COVID-19 Vaccine EUA. 7 days after shot I have the worst headache/migraine. I have gone to Er for CT scans that show clear so no blog clots. I do not have a history of migraines. I am unable to move. Work. Do anything. This is day 2. Idk how I''m to get thru this!!


VAERS ID: 1285884 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-10
Onset:2021-04-26
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cerebral infarction, Hemiparesis, Mental status changes, Speech disorder
SMQs:, Ischaemic 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), Noninfectious meningitis (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow)

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

Write-up: R41.82 - Altered mental status R53.1 - Left-sided weakness R47.9 - Speech difficult to understand I63.9 - Cerebral infarction, unspecified


VAERS ID: 1286040 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-03-27
Onset:2021-03-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / N/A - / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Flushing
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received dose initially with no concerns. Left clinic and returned ~1 hour later complaining of flushing and dizziness. Patient was reassured, given diphenydramine 25 mg PO, and left clinic with normal vital signs and exam


VAERS ID: 1286066 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-03-17
Onset:2021-03-22
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, COVID-19 pneumonia, Chest X-ray abnormal, Computerised tomogram thorax, Cough, Deep vein thrombosis, Dyspnoea, Echocardiogram, Fatigue, Laboratory test, Pain in extremity, Peripheral swelling, Pulmonary embolism, Ultrasound Doppler, Ultrasound Doppler abnormal
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Augmented Betamethasone Dipropionate 0.05 % Vitamin B12 500 mcg Flunisolide 25 mcg/Act (0.025%) Azelastine HCL (Nasal) 0.15 % Furosemide 20 mg
Current Illness: None
Preexisting Conditions: Varicose veins, allergic rhinitis, atopic dermatitis, mitral and tricuspid valve regurgitation (trace)
Allergies: None
Diagnostic Lab Data: 4/1/21 CXR and labs 4/20/21 Non invasive venous u/s right lower extremity CTA chest and CXR 4/20/21 Echo 4/21/21
CDC Split Type:

Write-up: Cough, fatigue and dyspnea on 3/22/21 ER visit on 4/1/21 diagnosed with COVID pneumonia Pain and swelling in right leg Positive for DVT in lower extremity Hospitalized and diagnosed with PE


VAERS ID: 1286115 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-13
Onset:2021-03-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / 1 UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Computerised tomogram normal, Computerised tomogram thorax, Diarrhoea, Dyspnoea, Electrocardiogram abnormal, Headache, Malaise, Nausea, Pain, Pyrexia, Sinus tachycardia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: HYDROcodone-acetaminophen (NORCO) 5-325 MG per tablet ibuprofen (ADVIL,MOTRIN) 600 MG tablet Prenatal Vit-Fe Fumarate-FA (PRENAPLUS) 27-1 MG TABS ranitidine (ZANTAC) 150 MG capsule oral contraceptives
Current Illness: none
Preexisting Conditions: Smoker Obesity (117.9kg)
Allergies: Latex
Diagnostic Lab Data: CT angiogram resulted and shows no pulmonary embolus and no pulmonary infiltrate. EKG shows sinus tachycardia
CDC Split Type:

Write-up: In the ED 3/14/21 Patient states yesterday she got the Johnson & Johnson Covid vaccine. She says that today she started having fevers chills generalized body aches generalized malaise and headache. She says she is otherwise healthy denies any sick significant medical history. She endorses some mild shortness of breath associated as well as some nausea and diarrhea but denies vomiting. IV fluid bolus, acetaminophen and ibuprofen


VAERS ID: 1286201 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-04-01
Onset:2021-04-04
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Contusion, Induration, International normalised ratio increased, Oedema peripheral, Ultrasound scan normal
SMQs:, Cardiac failure (broad), Liver-related coagulation and bleeding disturbances (narrow), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NORVASC 5MG, COUMADIN 5MG, LOSARTAN 100MG,ASPIRIN 81MG, PRAVASTATIN 30MG, KLOR-CON 20MEQ
Current Illness:
Preexisting Conditions: HYPERTENSION, TRIPLE BYPASS 10 YEAR +, HYPERCHOLESTEREMIA, PREVIOUS HISTORY OF BLOOD CLOT IN LEG AND LUNGS POST OP
Allergies:
Diagnostic Lab Data: tests INR from home, INR prior to vaccination was 2.3; after the vaccination INR was 3.1; ultrasound performed and verified no blood clots
CDC Split Type:

Write-up: 3 days after vaccination, patient had edema in legs, excessive bruising (9 spots) in legs, knots in forearms (5 total, one 9cm in diameter and one smaller), one knot initiated in wrist and moved upward on forearm; patient consulted with cardiologist who referred her to ER on April 28, 2021. Patient has not experienced shortness of breath or difficulty breathing.


VAERS ID: 1286209 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Angioedema, Dyspnoea, Headache, Pain in extremity, Periorbital oedema, Swelling face
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Severe arm pain, headache, swollen cheeks, periorbital rash, lip angioedema, and shortness of breath all within 1 hour of receiving the vaccine


VAERS ID: 1286309 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-30
Onset:2021-04-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chills, Dehydration, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (narrow)

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

Write-up: Fever, chills, severe nausea, dehydration; required trip to ER to receive fluids and anti-nausea meds


VAERS ID: 1286315 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-02
Onset:2021-04-09
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Biopsy, Hypersensitivity vasculitis, Oropharyngeal pain
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Vasculitis (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? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: asthma, allergies
Allergies: aspirin
Diagnostic Lab Data: Biopsy on 4/27/21 which reveals eosinophil vasculitis.
CDC Split Type:

Write-up: Pt with sore throat approximately one week post vaccination. Currently ongoing workup requiring biopsy and imaging


VAERS ID: 1286417 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: New York  
Vaccinated:2021-03-29
Onset:2021-04-14
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Atrophy of globe, Cerebral small vessel ischaemic disease, Computerised tomogram head abnormal, Condition aggravated, Dysarthria, Dysphagia, Fall, Hyponatraemia, Hypoxia, Immunoglobulin therapy, Laboratory test normal, Leukocytosis, Myasthenia gravis, Oxygen saturation decreased, Viral test negative, Walking aid user
SMQs:, Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hyponatraemia/SIADH (narrow), Eosinophilic pneumonia (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Chronic kidney disease (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ? acetaminophen (TYLENOL) tablet 650 mg ? aspirin enteric coated tablet 81 mg ? famotidine (PEPCID) injection 20 mg ? metoprolol succinate (TOPROL-XL) extended release tablet 25 mg ? predniSONE (DELTASONE) tablet 5 mg ? white petrolat
Current Illness: none
Preexisting Conditions: ? A-fib ? Hypertension ? Myasthenia gravis ? Metastatic squamous cell carcinoma in situ Congenital Oculocutaneous Albinism
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient with history of myasthenia gravis with multiple prior myasthenic crises requiring IVIG and one requiring intubation experienced myasthenia gravis exacerbation with no apparent trigger that began two weeks after receiving J&J vaccine. Daughters noticed he was having progressive difficulty swallowing, slurred speech, and generalized weakness. O2 sats were also noted to be lower than normal with pulse oximeter at home (92% compared to baseline of 95%). On day of admission patient had a mechanical fall while carrying a tray with his walker. Hypoxic to 88% on arrival. Labs notable for leukocytosis (13.68), hyponatremia to 127 and negative infectious workup. CTH with chronic microvascular changes and global atrophy but negative for acute process. He was admitted and continued on prednisone 5mg daily (outpatient regimen). Patient was started on a three day course of IVIG on 5/3/21 due to concern for myasthenia exacerbation with subsequent improvement.


VAERS ID: 1286424 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-04-29
Onset:2021-05-04
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Hypertension, Pruritus, Skin burning sensation, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), 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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: None
Preexisting Conditions: None
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Janssen COVID-19 vaccine EUA: Hives with associated itching and burning, hypertension Treated with IM Solu-Medrol and Benadryl, sent home on Prednisone taper


VAERS ID: 1286453 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-30
Onset:2021-03-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / UNK LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Blood test, Contusion, Erythema, Induration, Pain in extremity, Ultrasound scan
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: I had a red, hard, spot on my arm that lasted over two weeks. I also had a bruise that was changing colors. My arm was painful and the redness was spreading. I was given antibiotics for ten days afterwards. My mother also had a rash at the injection site, and was given same shot as me on same day. The lot number for my shot is 1808609. I have many pictures of the reaction if you want me to upload. Furthermore, the doctor said that my reaction would be aligned with a "moderna" reaction but is NOT typical of a J and J reaction (which is the shot that I had received and obtained a record of receiving from the Pharmacy). I got an ultrasound and blood test around two weeks after vaccine, no blood clot found.


VAERS ID: 1286535 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-03-13
Onset:2021-04-12
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / 1 LA / IM
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test normal, Chest X-ray, Echocardiogram, Electrocardiogram, Hypertension, Palpitations, Scan
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hypertension (narrow), 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: nexium,pepcid,effexor xr,crestor,losartan, viatmin d, calcium
Current Illness: none
Preexisting Conditions: asthma
Allergies: ceftin,motrin,shellfish
Diagnostic Lab Data: 4/12/2021 ER visit and holter placed. ECHO, treadmill and Nuclear scan done 5/4/2021
CDC Split Type:

Write-up: Sudden onset of heart palpations that lasted for 1 hour. Went to ER and BP was very elevated. CXR, EKG, blood work ok. Followed up with physician and cardiologist. Placed on additional medicine for SVT and BP. Had stress test, ECHO and nuclear heart scan. Also had a 48 hour holter monitor placed


VAERS ID: 1286571 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-06
Onset:2021-04-14
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / N/A RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Computerised tomogram, Dehydration, Dizziness, Electrocardiogram normal, Fall, Fatigue, Fibrin D dimer normal, Hypotension, Impaired driving ability, Loss of consciousness, Sinus bradycardia
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Disorders of sinus node function (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad), Dehydration (narrow), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Probiotic
Current Illness:
Preexisting Conditions:
Allergies: Lidocaine-Anaphylactic Peanuts and Tree Nuts-Anaphylactic
Diagnostic Lab Data: EKG Blood Work CT Scan D-Dimer-normal
CDC Split Type: vsafe

Write-up: Eight days after the vaccine, I started to feel light headed and I thought I was just fatigued. I woke up at 3am and started to pass out and I couldn''t see and falling down. I went to the ER and my pulse and blood pressure were low and I was mildly dehydrated. I had Sinus Bradycardia which they said may be transient. I have never had an unusual rhythm readings. I experienced the lightheadedness for about a week. I did not drive or ride my bike because I might need to lay down. Three weeks after the vaccine it seemed to get better a little a time and the events were less frequent. It has been four weeks and I feel fine now and I have resumed my normal activities.


VAERS ID: 1286577 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-05
Onset:2021-04-06
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Contusion, Headache, Laboratory test, Paraesthesia, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Patient states that tests weredone is waiting for results.
CDC Split Type:

Write-up: Patient described having a severe headache about 36 hours after vaccine. She also stated that she had a bruise appear on her left leg within 4 days of vaccine. A day after, she appeared to have a bump on her left hip that looked like a bug bite. She developed parathesia and was so severe that she went to the ER 04/14/2021. She returned for a second visit to the ER on 04/16/2021.


VAERS ID: 1286578 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure increased, Blood test, Cardiac stress test, Chest X-ray, Chest pain, Computerised tomogram, Condition aggravated, Dyspnoea, Echocardiogram, Electrocardiogram abnormal, Fatigue, Hypertensive crisis, Magnetic resonance imaging, Migraine, Nausea, Ultrasound scan, Urine analysis
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Cardiomyopathy (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: Creon 24000 units Estradiol 1mg Zoloft 150mg Maxalt 10mg as needed Metoprolol 50 mg
Current Illness: Sinus infection within the last month
Preexisting Conditions: Migraines since age 12
Allergies: Sulfa Levaquin Zithromax Bandage adhesive
Diagnostic Lab Data: I ended up in the emergency room on the 23rd and was hospitalized for 5 days. Between the 23rd and the 27th, the hospital performed multiple chest X-rays, CT scans, EKGs, a stress test, ultrasounds, echocardiograms, MRIs, blood tests, and urine tests. None of the results were conclusive.
CDC Split Type:

Write-up: At 12:30PM, I started getting a migraine, nauseated, and fatigued. By 1:15PM, I was having a hypertensive crisis. I went to my doctor''s office with a blood pressure of 191/109. I was administered an EKG, which came out abnormal. I was prescribed new blood pressure medication and sent home. My blood pressure continued to spike out of control, and I had chest pains, shortness of breath and nausea. I went back to my doctor on the 15th and had another abnormal EKG. She sent referred me to a cardiologist, who I saw on the 16th. She prescribed new blood pressure medication. I made an appointment for additional testing, but ended up hospitalized on the 23rd when my symptoms worsened.


VAERS ID: 1286637 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-04
Onset:2021-05-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 OT / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Fall, Loss of consciousness, Syncope
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), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Cardiomyopathy (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: passed out in car. felt weak and fell over (according to spouse) syncope. Evaluated by EMS- Transported to Emergency room/department or urgent care.


VAERS ID: 1286641 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-08
Onset:2021-04-30
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Fibrin D dimer, Throat tightness, Urticaria, White blood cell count increased
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Scoliosis
Allergies: None
Diagnostic Lab Data: D dimer 1450 WBC elevated
CDC Split Type:

Write-up: Broke out in hives consistently, shortness of breath, throat tightening. Hives are not clearing up. D dimer 1450.


VAERS ID: 1286660 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-09
Onset:2021-04-16
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808979 / 1 LA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Chills, Headache, Influenza A virus test negative, Influenza B virus test, Influenza virus test negative, Mental impairment, Pain, Panic attack, Pyrexia, SARS-CoV-2 test negative
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Advil, Tylenol, Aleve, Xanax. It was JJ vaccine. #1808979. There?s a light headache that continues to come back.
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: After 2nd delayed reaction. I went to urgent care and tested negative for covid and flu.
CDC Split Type:

Write-up: First day after shot was normal expectations as described to me. But, 7 days later I had another reaction. The symptoms were significantly worse. Much higher fever, chills, body aches, Light headache. But occasionally, that same light headache keeps coming back. It?s worrying me. Affecting my mental health. And I had panic attack today. I?m also unemployed and have no insurance. I wanna know if this is normal. Has it been reported by other ?


VAERS ID: 1286865 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-03-12
Onset:2021-03-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Alcohol test negative, Fatigue, Loss of consciousness, Malaise, Road traffic accident, Toxicologic test normal
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), Accidents and injuries (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Soma, seroquil, ibuprofen, suboxone,
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Was taken to the ER where I was tested for illicit drugs or alcohol in my system. Which was negative so I was sent home.
CDC Split Type:

Write-up: I felt sick and fatigue after getting the shot. And the next morning I passed out on my way to work and wrecked my truck.


VAERS ID: 1287062 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-11
Onset:2021-04-15
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Balance disorder, Computerised tomogram normal, Disorientation, Dizziness, Hypoaesthesia, Hypoaesthesia oral, Nausea, Platelet count normal
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypoglycaemia (broad), Dehydration (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: Atorvastatin 10 mg 1x/day for high cholesterol Alendronate 70 mg 1x/week for osteopenia Flonase Nasal Spray for seasonal allergy Multivitamin (Centrum), Vit D3, Vit C, Vit B12
Current Illness: none
Preexisting Conditions: overall excellent health
Allergies: trees and grasses (seasonal fall mostly) cats
Diagnostic Lab Data: The hospital ER blood tests were normal, including PLT were 274. CT scan with contrast was normal. They referred me to a neurologist for follow-up and an MRI, unfortunately I will have to wait until May 28 to get a neurology appointment.
CDC Split Type:

Write-up: About 4 and a half weeks after getting the J&J vaccine, I began to experience marked symptoms: dizziness and disorientation,, balance problems, bilateral numbness in hands, feet and tip of tongue, awareness of left side of brain, intermittent mild nausea (likely related to dizziness). These symptoms had a sudden onset. I am normally very healthy and active so these unusual symptoms without any illness were quite a departure from my normal health. They have, to date, persisted continually since onset over the past 3 weeks. They are very concerning. Last night I went to the ER to be seen since I could not get an appt. with a neurologist for several months and I am concerned about my sudden change in health status.


VAERS ID: 1287136 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-07
Onset:2021-04-10
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arrhythmia, Atrial fibrillation, Chest X-ray, Chest pain, Dizziness, Electrocardiogram, Headache, Hyperhidrosis, Influenza like illness, Laboratory test, Nausea, Palpitations, Supraventricular tachycardia, White blood cell count, White blood cell count decreased
SMQs:, Acute pancreatitis (broad), Haematopoietic leukopenia (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: multi vit, b12, zinc, cal/mag, vit c, biotin, d3, evening primrose, iron, omega 3
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Labs and ekg 4/10/21 and 4/24/21, 4/13/21 wbc f/u. chest xray 4/24/21
CDC Split Type:

Write-up: flu like symptoms with headache 4/8/21. Chest pain, nausea, sweating, lightheadedness started 4/10/21, was seen in ER and discharged home. White count was noted as 2.8. Chest pain went away after 24 hours and palpitations started 4/11/21, severe at times for several hours at a time. Saw my cardiologist on 4/15/21 for severe palpitations and he ordered a halter monitor to be worn for 2 weeks. I stated to him that I felt like I was in SVT, or something stronger than just palpitations. This continued for several hours a day from 4/11/21 to 4/24/21, when I was on the telemetry pack at work and went into an arrythmia that was later evaluated by my cardiologist as SVT and A FIB. On 4/25/21, I had mild "palpitations" but have not had any incidences since. I am now on metoprolol to control it and did not have a cardiac issue prior to receiving the vaccine.


VAERS ID: 1287331 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-26
Onset:2021-04-29
   Days after vaccination:34
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

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

Write-up: Pt with miscarriage at approx 7-8 weeks GA after J&J covid vaccine 3/26/21 LMP 2/27/21


VAERS ID: 1287350 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Incorrect route of product administration, Injection site pain, Movement disorder
SMQs:, Anticholinergic syndrome (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Drug abuse and dependence (broad), Extravasation events (injections, infusions and implants) (broad), Vestibular disorders (broad), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Asthma
Allergies: None
Diagnostic Lab Data: None yet, I attempted to go to an urgent care facility today (5/4/2021) and when I told them my symptoms, I was told they cannot do anything for me.
CDC Split Type:

Write-up: Injection was very painful and felt immediately as if it was improperly administered causing my arm to go limp (so to speak) right away. The pain was so intense that I became extremely lightheaded almost to the point of fainting. Within 15 minutes following the vaccination, I started experiencing excruciating arm pain at the injection site . The pain has persisted for the past month with little to no relief, I now have limited range of motion and cannot make certain movements with my arm.


VAERS ID: 1287356 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-04
Onset:2021-05-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test abnormal, Computerised tomogram normal, Fall, Hyperhidrosis, Loss of consciousness, Unresponsive to stimuli
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), 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 (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: lexapro
Current Illness: none stated
Preexisting Conditions: none stated
Allergies: none stated
Diagnostic Lab Data: Examined by EMS , was able to stand and ambulate to the stretcher and was transported to the local emergency room. Contacted patient that evening he stated he had a CT scan and blood work done. CT scan was unremarkable and blood work showed he was dehydrated. He stated he was feeling much better and had no residual effects from the incident or vaccine.
CDC Split Type:

Write-up: Within 2 minutes or patient receiving the vaccine he passed out and fell out of the post vaccine waiting chair onto the floor. He was unresponsive for approximately 10 seconds. Upon becoming responsive he was alert and oriented x3. Blood pressure was monitored while waiting for EMS to arrive. Blood pressure was 150/94 heart, heart rate of 98, he was diaphoretic.


VAERS ID: 1287978 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Unknown  
Location: Utah  
Vaccinated:2021-04-05
Onset:2021-04-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042421.4 / 4 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Fatigue, Metamorphopsia, Ocular discomfort, Photopsia, Vision blurred, Visual field defect, Vitreous floaters
SMQs:, Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens 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? No
Previous Vaccinations:
Other Medications: Hydrocodone, Tramadol, Ibuprofen 800, Trazadone
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 3 Eye Exams and another scheduled visit in 2 weeks
CDC Split Type:

Write-up: Within 3 hrs after receiving the vaccine my vision in what seemed to be both eyes was 80% cloudy and I was very exhausted. The following day most of the vision issued returned to normal but I had distortion and floating objects in my right eye along with bright flashes and pressure in my right eye. After following up with our prescribed online health care service twice I was told to contact a specialists. I was able to get into the eye ER Clinic and have had 3 visits including one with a Retina specialist. I still have lost part of my peripheral vision in my right eye and continue to have follow up care.


VAERS ID: 1287981 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-08
Onset:2021-03-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Amnesia, Anticoagulant therapy, Aphasia, Balance disorder, Cerebrovascular accident, Computerised tomogram head abnormal, Disability, Disorganised speech, Dizziness, Dysarthria, Dysphagia, Dyspnoea, Echocardiogram normal, Feeling abnormal, Gait disturbance, Hemiparesis, Hypersomnia, Lethargy, Magnetic resonance imaging head abnormal, Muscular weakness, Palpitations, Paraesthesia, Visual field defect, Walking aid user
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (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), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Psychosis and psychotic disorders (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Metformin, amlodipine
Current Illness: n/a
Preexisting Conditions: DIabetes, Hypertension
Allergies: Lisinopril
Diagnostic Lab Data: CT Scan (3/10) old stroke. She had one years earlier. MRI (3/11) strokes on both sides of her brain in the frontal, parietal and occipital lobes. 2D Echo (312) Normal heart function
CDC Split Type:

Write-up: Shortly after getting the shot she reported feeling "off" as she was driving she started feeling short of breath and her heart was racing. When she got home around 5 PM she was still feeling short of breath and reported that her heart was racing. She was unable to speak clearly, but was stating that it was due to be being short of breath. She also reported feeling lethargic and fell asleep until the next morning. She slept until approximately 12 pm the next day. When she woke up she reported feeling right sided cheek tingling. At that time she thought she had just slept wrong. When she attempted to walk down stairs she was limping and reported just feeling very weak on her left side. On Wednesday she slept in late again complaining of lethargy. When she awoke that Wednesday (3/10) her speech was markedly slurred. She was also saying things that didn''t make sense. She was dragging her left leg when she tried to walk. We immediately took her to the ER and she was worked up for stroke. When she was triaged in the ER we mentioned that she had just had her COVID vaccine and voiced concerned that maybe she had a reaction to her COVID vaccine. She was admitted to hospital on 3/10 for a possible stroke. Her MRI was done later on 3/11, Her MRI showed that she has strokes on both sides of her brain in the frontal, parietal and occipital lobes. The doctor referred to her stroke as being caused by a "showering of clots". The doctor said this usually only happens to someone with cardiac issues. My mom has no cardiac history. Her doctor ordered an 2D Echo of her heart and no abnormalities were found (3/12). She is still disabled from her stroke. She was hospitalized from 3/10 - 3/16. She was the discharged to other care facility from 3/16-3/26. She is currently needing outpatient rehab in a day neuro program. She attends this at outpatient facility. She has to walk with a cane due to persistent left leg weakness. Her speech has a slight slur, and she suffers from short term memory loss. She intermittently has trouble with her equilibrium and reports feeling dizzy. She sometimes has a hard time swallowing or says that it doesn''t feel right when she swallows. She also trouble with word retrieval. She has left-sided neglect which correlates left eye visual deficits. She currently requires care from a general physician, neurologist, physical therapist, occupational therapist, speech therapist, neuro ophthalmologist and neuo psychologist. She was started on a new medication regime 325 mg aspirin daily, plavix for 21 days (now completed), metformin, amlodipine, coreg and losartan. She is going to need outpatient rehab until at least June from the last update we received from her rehab doctor.


VAERS ID: 1287918 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: California  
Vaccinated:0000-00-00
Onset:2021-04-10
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain upper, Blood test, Chest pain, Circumoral swelling, Computerised tomogram, Dyspnoea, Fatigue, Fibrin D dimer increased, Headache, Oropharyngeal pain, Pain assessment, Pain in extremity, Paraesthesia, Paraesthesia oral, Peripheral swelling, Pharyngeal swelling, Platelet count, Rash pruritic, Tremor
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Peripheral neuropathy (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Alcohol use (2-3 glasses of week.); Non-smoker
Preexisting Conditions: Medical History/Concurrent Conditions: Cyst ovary; Left salpingo-oophorectomy (left ovary and fallopian tube was removed due to cyst in the ovary.); Comments: The patient had no known drug allergies. The patient did not have any history of drug abuse or illicit drug use.
Allergies:
Diagnostic Lab Data: Test Date: 202104; Test Name: Pain scale; Result Unstructured Data: 7/10; Test Date: 20210412; Test Name: Platelet count; Result Unstructured Data: Normal; Test Date: 20210412; Test Name: Fibrin D dimer high; Result Unstructured Data: elevated; Test Date: 20210413; Test Name: Blood test; Result Unstructured Data: Normal; Test Date: 20210414; Test Name: CAT scan; Result Unstructured Data: Normal
CDC Split Type: USJNJFOC20210456268

Write-up: TREMBLING; BOTTOM OF FEET PAINFUL; BAD/SEVERE HEADACHE; EXTREME FATIGUE; SWELLING AROUND MOUTH; SWOLLEN HANDS AND FEET; ITCHY ON THE TOP FEET WITH RED BLOTCHY RASHES; NUMBNESS AND TINGLING SENSATION AT LEFT SIDE OF EXTREMITIES AND BODY; SWOLLEN THROAT; SEVERE SHARP STOMACH PAIN; TINGLING AROUND MOUTH; SEVERE SHARP CHEST PAIN (STERNUM AREA); SORE THROAT; DIFFICULTY IN BREATHING; This spontaneous report received from a patient concerned a 33 year old female. The patient''s weight was 130 pounds, and height was 169 centimeters. The patient''s past medical history included surgical removal of left ovary and fallopian tube, and cyst in ovary, and concurrent conditions included alcohol user, and non-smoker, and other pre-existing medical conditions included the patient had no known drug allergies. the patient did not have any history of drug abuse or illicit drug use. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, and batch number: 042A21A expiry: UNKNOWN) dose was not reported, administered on 03-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On APR-2021, Laboratory data included: Pain scale (NR: not provided) 7/10. On 10-APR-2021, the subject experienced severe sharp chest pain (sternum area). On 10-APR-2021, the subject experienced sore throat. On 10-APR-2021, the subject experienced difficulty in breathing. On 10-APR-2021, the subject experienced tingling around mouth. On 10-APR-2021, the subject experienced swollen throat. On 10-APR-2021, the subject experienced severe sharp stomach pain. On 11-APR-2021, the subject experienced swelling around mouth. On 11-APR-2021, the subject experienced swollen hands and feet. On 11-APR-2021, the subject experienced itchy on the top feet with red blotchy rashes. On 11-APR-2021, the subject experienced numbness and tingling sensation at left side of extremities and body. On 11-APR-2021, the subject experienced bottom of feet painful. On 11-APR-2021, the subject experienced bad/severe headache. On 11-APR-2021, the subject experienced extreme fatigue. Treatment medications included: bismuth subsalicylate, diphenhydramine hydrochloride, famotidine, and ibuprofen. On 12-APR-2021, the subject experienced trembling. Laboratory data included: Fibrin D dimer high (NR: not provided) elevated, and Platelet count (NR: not provided) Normal. On 13-APR-2021, Laboratory data included: Blood test (NR: not provided) Normal. On 14-APR-2021, Laboratory data included: CAT scan (NR: not provided) Normal. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from severe sharp chest pain (sternum area), sore throat, swelling around mouth, tingling around mouth, itchy on the top feet with red blotchy rashes, and severe sharp stomach pain on 13-APR-2021, difficulty in breathing, swollen hands and feet, numbness and tingling sensation at left side of extremities and body, swollen throat, bottom of feet painful, bad/severe headache, and extreme fatigue on 20-APR-2021, and trembling on 16-APR-2021. This report was non-serious.; Sender''s Comments: V0: Medical assessment comment is not required as per standard procedure as case assessed as non-serious.


VAERS ID: 1287955 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Ohio  
Vaccinated:0000-00-00
Onset:2021-04-23
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210502944

Write-up: LEG FATIGUE/FATIGUE ELSEWHERE; This spontaneous report received from a patient concerned a 55 year old male. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808978, expiry: UNKNOWN) dose was not reported, administered on 07-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 23-APR-2021, the subject experienced leg fatigue/fatigue elsewhere. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from leg fatigue/fatigue elsewhere. This report was non-serious.


VAERS ID: 1287977 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Ohio  
Vaccinated:0000-00-00
Onset:2021-04-11
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Fatigue, Headache, Malaise, Urine analysis
SMQs:

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: MULTIVITAMINS [VITAMINS NOS]
Current Illness:
Preexisting Conditions: Comments: The patient had no known allergies.
Allergies:
Diagnostic Lab Data: Test Date: 20210417; Test Name: Blood test; Result Unstructured Data: no infection; Test Date: 20210417; Test Name: Urine analysis; Result Unstructured Data: no infection; Test Date: 20210417; Test Name: Chest X-ray; Result Unstructured Data: no infection
CDC Split Type: USJNJFOC20210503894

Write-up: FEELING VERY SICK; HEADACHE; FATIGUE; This spontaneous report received from a patient concerned a 59 year old male. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included the patient had no known allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, and batch number: 201A21A expiry: 23/JUN/2021) dose was not reported, administered on 10-APR-2021 for prophylactic vaccination. Concomitant medications included vitamins nos. On 11-APR-2021, the subject experienced fatigue. On 11-APR-2021, the subject experienced headache. On 15-APR-2021, the subject experienced feeling very sick. On 17-APR-2021, Laboratory data included: Blood test (NR: not provided) no infection, Chest X-ray (NR: not provided) no infection, and Urine analysis (NR: not provided) no infection. Treatment medications (dates unspecified) included: paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from fatigue, feeling very sick, and headache on 25-APR-2021. This report was non-serious.


VAERS ID: 1288043 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-03-24
Onset:2021-04-07
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Blood culture, Blood gases, Chest X-ray, Cough, Dyspnoea, Electrocardiogram, Full blood count, Metabolic function test, Pyrexia, Respiratory distress
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Respiratory failure (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, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Eliquis,sotolal,pepcid,lasix,albuterol,trelegy,k+,
Current Illness: Copd,afib,acid reflux,
Preexisting Conditions: Copd
Allergies: None
Diagnostic Lab Data: Cbc,cxr,bmp,ekg,blood cultures,abgs,4/12/2021,4/13/2013,4/14/2021,4/15/2021,416/2021,
CDC Split Type:

Write-up: Fever,coughing,sob,severe weakness over 4day perios,went into resp distress,unable to raise up became no strength


VAERS ID: 1288342 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-03
Onset:2021-05-05
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

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

Write-up: flu like symptoms followed by hives


VAERS ID: 1288634 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: California  
Vaccinated:0000-00-00
Onset:2021-04-01
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Cardiovascular evaluation, Computerised tomogram thorax, Dizziness, Dyspnoea, Ear, nose and throat examination, Fibrin D dimer, Haemodynamic test, Neurological examination, Platelet count, Pulmonary embolism
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 202104; Test Name: Chest CT; Result Unstructured Data: positive for RLL Pulm embolus; Test Date: 202104; Test Name: ENT examination; Result Unstructured Data: negative; Test Date: 202104; Test Name: Platelet count; Result Unstructured Data: 197; Test Date: 202104; Test Name: Neurological examination; Result Unstructured Data: negative; Test Date: 202104; Test Name: Hemodynamic test; Result Unstructured Data: stable; Test Date: 202104; Test Name: Cardiovascular evaluation; Result Unstructured Data: negative; Test Date: 202104; Test Name: Fibrin D dimer; Result Unstructured Data: 560
CDC Split Type: USJNJFOC20210461153

Write-up: DIZZINESS; SHORTNESS OF BREATH; PULMONARY EMBOLISM; This spontaneous report received from a physician concerned a 48 year old male. 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: Unknown) dose was not reported, 1 total administered on 12-MAR-2021 for prophylactic vaccination. Vaccination site was not reported. The batch number was not reported and has been requested. No concomitant medications were reported. On APR-2021, the patient experienced pulmonary embolism. Laboratory data included: Computerized tomogram thorax (NR: not provided) positive, Ear, nose and throat examination (NR: not provided) negative and Platelet count (NR: not provided) 197. On 04-APR-2021, the patient experienced dizziness and shortness of breath. Full neuro, cardiac, Ear, nose and throat workup and evaluation was negative in Erectile dysfunction and follow up clinics. Patient had a Wells Criteria of zero, and was hemodynamically stable, platelet was 197. Patient started with DDIMER which was 560 and later chest Computerized tomogram thorax was positive for right lower lobe Pulmonary embolus. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the dizziness, shortness of breath and pulmonary embolism was not reported. This report was serious (Other Medically Important Condition). Sender''s Comments: V0: -Covid-19 vaccine ad26.cov2.s-Pulmonary embolism. 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: 1288641 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-03-11
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Blood test, Computerised tomogram, Depression, Electrocardiogram, Head discomfort, Heart rate variability test, Pulmonary function test, Pyrexia, Scan with contrast, Sensory disturbance, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Depression (excl suicide and self injury) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Non-smoker
Preexisting Conditions: Comments: The patient had no known drug allergies The patient did not have any history of illicit drug usage
Allergies:
Diagnostic Lab Data: Test Name: Blood test; Result Unstructured Data: normal; Test Name: CT scan; Result Unstructured Data: NORMAL; Test Name: Scan with contrast; Result Unstructured Data: normal; Test Name: Pulmonary function test; Result Unstructured Data: NORMAL; Test Name: Heart rate variability test; Result Unstructured Data: NORMAL; Test Name: EKG; Result Unstructured Data: NORMAL
CDC Split Type: USJNJFOC20210502135

Write-up: PRESSURE BEHIND LEFT-SIDE OF HEAD; ANXIETY; DEPRESSION; SENSATION RADIATING FROM HEAD TO NECK; HIVES; FEVER; This spontaneous report received from a patient concerned a 37 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included non smoker, and non alcohol user, and other pre-existing medical conditions included the patient had no known drug allergies the patient did not have any history of illicit drug usage.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unk) dose was not reported, administered on 11-MAR-2021 for prophylactic vaccination. Batch number was not reported and has been requested. No concomitant medications were reported. On 11-MAR-2021, the subject experienced fever. On 14-MAR-2021, the subject experienced hives. On APR-2021, the subject experienced sensation radiating from head to neck. On APR-2021, the subject experienced depression. On an unspecified date, the subject experienced pressure behind left-side of head, and anxiety. Laboratory data (dates unspecified) included: Blood test (NR: not provided) normal, CT scan (NR: not provided) NORMAL, EKG (NR: not provided) NORMAL, Heart rate variability test (NR: not provided) NORMAL, Pulmonary function test (NR: not provided) NORMAL, and Scan with contrast (NR: not provided) normal. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from hives on 21-MAR-2021, and fever on 14-MAR-2021, and the outcome of sensation radiating from head to neck, pressure behind left-side of head, depression and anxiety was not reported. This report was non-serious. This case, from the same reporter is linked to 20210503208.


VAERS ID: 1288696 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: New Jersey  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210503; Test Name: ECG; Result Unstructured Data: normal; Test Date: 20210503; Test Name: X-ray; Result Unstructured Data: normal
CDC Split Type: USJNJFOC20210507618

Write-up: SHORTNESS OF BREATH; LITTLE CHEST PAIN; This spontaneous report received from a consumer concerned a female of unspecified age. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: not reported) dose was not reported, administered on 03-APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 03-MAY-2021, Laboratory data included: ECG (NR: not provided) normal, and X-ray (NR: not provided) normal. On an unspecified date, the subject experienced shortness of breath, and little chest pain. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the shortness of breath and little chest pain was not reported. This report was non-serious.


VAERS ID: 1288821 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-07
Onset:2021-04-20
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute kidney injury, Asthenia, COVID-19, Cardiac failure acute, Cardiac failure congestive, Chest X-ray normal, Confusional state, Decreased appetite, Metabolic encephalopathy, Renal impairment
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Cardiac failure (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (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), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Cardiomyopathy (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Dehydration (broad), Opportunistic infections (broad), COVID-19 (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, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: spironolactone, sertraline, metoprolol, furosemide, metolazone
Current Illness: hypertension, COPD
Preexisting Conditions: Afib, diastolic CHF, anemia, COPD, depression, HTN, valvular heart disease, sleep apnea
Allergies: digoxin, penicillin, adhesive tape
Diagnostic Lab Data: 4/24: SARS CoV 2 RNA PCR- positive
CDC Split Type:

Write-up: Pt w/significant cardiac hx p/w from LTC facility w/increasing confusion, decreased appetite, weakness over 4-5 days. No reported hx of cough, SOB, N/V, fever, or URI symptoms. CXR findings were clear. Ther was concern for dehydration due to worsening renal function. Pt tested positive for COVID-19 (4/24) despite Janssen vaccine (4/7) and pt stating they had COVID in December 2020. Pt admitted for additional management of COVID-19 infection w/acute metabolic encephalopathy, acute on chronic CHF, & AKI. Treated w/dexamethasone & remdesivir. Ultimately discharged 5 days later (4/28).


VAERS ID: 1288826 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / N/A AR / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Alanine aminotransferase normal, Anion gap normal, Aspartate aminotransferase normal, Basophil count decreased, Bilirubin conjugated normal, Blood albumin normal, Blood alkaline phosphatase normal, Blood bilirubin normal, Blood calcium decreased, Blood chloride increased, Blood creatine phosphokinase normal, Blood creatinine normal, Blood glucose normal, Blood magnesium normal, Blood phosphorus, Blood potassium decreased, Blood sodium normal, Blood urea decreased, Borrelia test negative, Carbon dioxide normal, Chest X-ray normal, Eosinophil count normal, Eosinophil percentage decreased, Fatigue, Glomerular filtration rate, Haematocrit normal, Haemoglobin normal, Human chorionic gonadotropin negative, Lipase normal, Lymphocyte count increased, Lymphocyte percentage, Mean cell haemoglobin concentration normal, Mean cell haemoglobin normal, Mean cell volume normal, Mean platelet volume normal, Monocyte count increased, Monocyte percentage, Neutrophil percentage decreased, Platelet count increased, Protein total normal, Pyrexia, Red blood cell count normal, Red cell distribution width normal, Troponin I decreased, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Agranulocytosis (broad), Haematopoietic leukopenia (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Tubulointerstitial diseases (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypokalaemia (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Dosage calcium-vitamin D 500 mg(1,250mg) -200 unit per tablet Take 1 tablet by mouth daily. doxycycline (VIBRAMYCIN) 100 MG capsule Take 100 mg by mouth once daily. acne erenumab-aooe 70 mg/mL AtIn Inject 70 mg under the skin every 28 days.
Current Illness:
Preexisting Conditions: Migraine without aura not intractable, Acne vulgaris, Fibromyalgia
Allergies: Ragweed, Codeine, Hydrocodone
Diagnostic Lab Data: Patient was seen at Hospital 4/19/21 with a negative infectious work-up that included: blood cultures, UA C/S, chest xray, Lyme, RPR, ehrlichia, parasites. Admission on 04/19/2021, Discharged on 04/19/2021 Component Date Value Ref Range Status ? RR Interval 04/19/2021 759 ms Final ? Atrial Rate 04/19/2021 78 ms Final ? P-R Interval 04/19/2021 188 ms Final ? P Duration 04/19/2021 256 ms Final ? P Horizontal Axis 04/19/2021 -41 deg Final ? P Front Axis 04/19/2021 19 deg Final ? QRS Axis 04/19/2021 508 ms Final ? QRSD Interval 04/19/2021 84 ms Final ? QT Interval 04/19/2021 384 ms Final ? QTcB 04/19/2021 441 ms Final ? QTcF 04/19/2021 421 ms Final ? QRS Horizontal Axis 04/19/2021 -24 deg Final ? QRS Axis 04/19/2021 39 deg Final ? I-40 Horizontal Axis 04/19/2021 51 deg Final ? I-40 Front Axis 04/19/2021 1 deg Final ? T-40 Horizontal Axis 04/19/2021 -38 deg Final ? T-40 Front Axis 04/19/2021 99 deg Final ? T Horizontal Axis 04/19/2021 53 deg Final ? T Wave Axis 04/19/2021 18 deg Final ? S-T Horizontal Axis 04/19/2021 81 deg Final ? S-T Front Axis 04/19/2021 13 deg Final ? ECG Impression 04/19/2021 - BORDERLINE ECG - Final ? WBC 04/19/2021 11.8* 3.5 - 11.0 x10exp9/L Final ? RBC 04/19/2021 4.66 3.70 - 5.00 x10exp12/L Final ? Hemoglobin 04/19/2021 14.0 11.0 - 15.0 G/DL Final ? Hematocrit 04/19/2021 41.7 32 - 45 % Final ? MCV 04/19/2021 89.5 80.0 - 98.0 fL Final ? MCH 04/19/2021 30.0 26.0 - 34.0 PG Final ? MCHC 04/19/2021 33.6 32 - 36 G/DL Final ? RDW 04/19/2021 13.3 11.5 - 14.5 % Final ? Platelets 04/19/2021 415* 150 - 400 x10exp9/L Final ? MPV 04/19/2021 8.8 7.4 - 10.4 fL Final ? Seg Neutrophils % 04/19/2021 54.0 % Final ? Lymphocytes % 04/19/2021 38.2 % Final ? Monocytes % 04/19/2021 6.6 % Final ? Eosinophils % 04/19/2021 0.8 % Final ? Basophils % 04/19/2021 0.4 % Final ? Segs Absolute 04/19/2021 6.4 1 - 7 x10exp9/L Final ? Lymphocytes Absolute 04/19/2021 4.5* 1.0 - 4.0 x10exp9/L Final ? Monocytes Absolute 04/19/2021 0.8 0.20 - 0.80 K/uL Final ? Eosinophils Absolute 04/19/2021 0.1 0 - 0 K/uL Final ? Basophils Absolute 04/19/2021 0.0 0.00 - 0.20 x10exp9/L Final ? Glucose 04/19/2021 91 67 - 99 MG/DL Final ? BUN 04/19/2021 7 6 - 24 MG/DL Final ? Creatinine 04/19/2021 0.50 0.44 - 1.03 MG/DL Final ? Sodium 04/19/2021 139 135 - 145 MEQ/L Final ? Potassium 04/19/2021 3.4* 3.6 - 5.1 MEQ/L Final ? Chloride 04/19/2021 106 98 - 110 MEQ/L Final ? CO2 04/19/2021 24 22 - 32 MEQ/L Final ? Anion Gap 04/19/2021 9 3 - 13 Final ? Calcium 04/19/2021 8.8 8.5 - 10.5 MG/DL Final ? eGFR 04/19/2021 $g60 Abnormal <60 ML/MIN/1.73M Final ? Troponin I 04/19/2021 <0.006 0.006 - 0.060 NG/ML Final ? Albumin 04/19/2021 4.1 3.5 - 5.0 G/DL Final ? Bilirubin, Total 04/19/2021 0.3 0.2 - 1.3 MG/DL Final ? Bilirubin, Direct 04/19/2021 <0.1 0.0 - 0.3 MG/DL Final ? Alkaline Phosphatase 04/19/2021 50 34 - 104 IU/L Final ? Protein, Total 04/19/2021 7.5 6.0 - 8.0 G/DL Final ? ALT 04/19/2021 17 6 - 45 IU/L Final ? AST (SGOT) 04/19/2021 21 10 - 42 IU/L Final ? Lipase 04/19/2021 12 10 - 60 IU/L Final ? Magnesium Level 04/19/2021 1.7 1.3 - 1.9 MEQ/L Final ? Phosphorus 04/19/2021 2.4 2.4 - 4.8 MG/DL Final ? hCG Qualitative, Serum 04/19/2021 negative negative Final ? CK Total 04/19/2021 22 20.0 - 165.0 IU/L Final ? Color, Ur 04/19/2021 yellow yellow Final ? Appearance, Ur 04/19/2021 clear slightly cloudy Final ? Glucose, Ur 04/19/2021 negative negative Final ? Bilirubin, Ur 04/19/2021 negative negative Final ? Ketones, Ur 04/19/2021 negative negative Final ? Specific Gravity, Ur 04/19/2021 1.010 1.010 - 1.030 Final ? Blood, Ur 04/19/2021 negative negative Final ? pH, Ur 04/19/2021 6.0 5.0 - 8.0 Final ? Protein, Ur 04/19/2021 negative <10 MG/DL Final ? Urobilinogen, Ur 04/19/2021 negative negative Final ? Nitrite Level, Ur 04/19/2021 negative negative Final ? Leukocytes Est, Ur 04/19/2021 negative negative Final ? LYME Total Antibodies 04/19/2021 0.5 0.0 - 0.8 Final ? LYME Total Comnt 04/19/2021 Footnote Final Comment: Reference Range Antibody Index (AI) Non-Reactive: < 0.9 No serological evidence of Borrelia infection. A non-reactive result does not exclude the possibility of Borrelia infection and cannot exclude early infection with B. burgdorferi. If Lyme borreliosis is suspected, a second sample should be collected and tested 2-4 weeks later. Equivocal: 0.9 - 1.0 Presumptive evidence of infection. Additional testing/confirmation by Westerm Blot has been reflexed. Positive: = or $g 1.1 Presumptive evidence of infection. Additional testing/confirmation by Western Blot has been reflexed. ? Respiratory Pathogen Panel Comment 04/19/2021 Footnote Final Comment: The Respiratory Pathogen PCR Panel 2 is only for use under a Food and Drug Administration Emergency Use Authorization. The performance characteristics of the assay were verified by the Clinical Microbiology Laboratory Medical Center. Results should be used in conjunction with the patient?s clinical symptoms, medical history and other clinical/laboratory findings to determine an overall clinical diagnosis. Negative results do not preclude infection with SARS-CoV-2. Test parameters have not been validated for screening in asymptomatic patients. ? SARS-CoV-2 04/19/2021 Not Detected Final ? Adenovirus 04/19/2021 Not Detected Final ? Chlamydia Pneumoniae 04/19/2021 Not Detected Final ? Coronavirus (229E, HKU1, NL63, OC4* 04/19/2021 Not Detected Final ? Human Metapneumovirus 04/19/2021 Not Detected Final ? Human Rhinovirus/Enterovirus 04/19/2021 Not Detected Final ? Influenza A 04/19/2021 Not Detected Final ? Influenza A Subtype H1 04/19/2021 Not Detected Final ? Influenza A Subtype 2009 H1N1 04/19/2021 Not Detected Final ? Influenza A Subtype H3 04/19/2021 Not Detected Final ? Influenza B 04/19/2021 Not Detected Final ? Mycoplasma pneumoniae 04/19/2021 Not Detected Final ? Parainfluenza Virus 1 04/19/2021 Not Detected Final ? Parainfluenza Virus 2 04/19/2021 Not Detected Final ? Parainfluenza Virus 3 04/19/2021 Not Detected Final ? Parainfluenza Virus 4 04/19/2021 Not Detected Final ? Respiratory Syncytial Virus A 04/19/2021 Not Detected Final ? Respiratory Syncytial Virus B 04/19/2021 Not Detected Final ? Heterophile Antibodies 04/19/2021 negative negative Final ? Blood Parasite Prep 04/19/2021 none seen none seen Final ? Thick Smear for Bld Parasite 04/19/2021 none seen none seen Final ? CRP 04/19/2021 9.47 0.00 - 10.00 MG/L Final Reference range for monitoring inflammation, infection, etc. ? Sed Rate 04/19/2021 34* 0 - 20 mm/h Final ? Blood Culture 04/19/2021 No growth after 5 days. Final ? Blood Culture 04/19/2021 No growth after 5 days. Final ? Urine Culture 04/19/2021 Final Value:10,000 to <100,000 cfu/mL of growth suggestive of normal urogenital flora or fecal contamination. Recollect specimen for repeat culture if clinically indicated. Transport to the microbiology lab should be within 2 hours of collection and refrigeration is necessary if a delay is expected. ? A. phagocytophilum by PCR 04/19/2021 Not Detected Final ? Ehrlichia chaffeensis by PCR 04/19/2021 Not Detected Final ? Ehrlichia ewingii/canis by PCR 04/19/2021 Not Detected Final ? Ehrlichia muris-like by PCR 04/19/2021 Not Detected Final Comment: INTERPRETIVE INFORMATION: Ehrlichia and Anaplasma Species by PCR A negative result does not rule out the presence of PCR inhibitors in the patient specimen or test-specific nucleic acid in concentrations below the level of detection by this assay. This test was developed and its performance characteristics determined by ARUP Laboratories. It has not been cleared or approved by the US Food and Drug Administration. This test was performed in a CLIA certified laboratory and is intended for clinical purposes. Performed by ARUP Laboratories, 500 Chipeta Way, SLC,UT 84108 800-522-2787 www.aruplab.com, Tracy George, MD - Lab. Director Imaging Information: XR: Chest PA & Lateral Result Date: 4/19/2021 X-RAY CHEST PA AND LATERAL HISTORY: Chest Pain TECHNIQUE: Frontal and lateral views of the chest. COMPARISON: None FINDINGS: Lines/tubes: None. Lungs: The lungs are well inflated and clear. There is no evidence of pneumonia or pulmonary edema. Pleura: There is no pleural effusion or pneumothorax. Heart and mediastinum: The heart and the mediastinum are normal. Bones: No acute abnormality. IMPRESSION: Normal chest. RADCAT Grade:RADCAT1: Normal study. Date Signed:4/19/2021 8:37 PM Patient MRN:70000453563 Accession Number:54412751 DOS:4/19/2021 8:30 PM Exam:IMG36 X-RAY CHEST PA AND LATERAL
CDC Split Type:

Write-up: 32 y.o. female reported fevers and fatigue which started the day following receiving Johnson & Johnson COVID vaccine on 4/10/21. Fevers (100-103) were minimally responsive to antipyretics and lasted for 3 weeks.


VAERS ID: 1288886 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-04
Onset:2021-05-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Confusional state, Dizziness, Dyspnoea, Fall, Fatigue, Flushing, Headache, Hyperhidrosis, Lethargy, Loss of consciousness, Seizure, Skin discolouration, Syncope, Tremor, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), 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), Accidents and injuries (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), 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: Allergic: Difficulty Breathing-Mild, Systemic: Confusion-Mild, Systemic: Dizziness / Lightheadness-Severe, Systemic: Exhaustion / Lethargy-Medium, Systemic: Fainting / Unresponsive-Severe, Systemic: Flushed / Sweating-Mild, Systemic: Headache-Mild, Systemic: Seizure-Mild, Systemic: Shakiness-Medium, Additional Details: About 5 minutes after the shot, the patient lost conciousness, fell face forward on the ground. Face appeared grey, was unresponsive, but was making grunting sounds. His body appeared to be shaking lightly, possible seizure, was not responsive. Oral benadryl was not possible at this point. Turned patient on back/side in order to adminster the epipen. Patient quickly became alert and responded. No injection site reaction. Paramedics arrived shortly to check vitals and transfer him


VAERS ID: 1288889 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-05-04
Onset:2021-05-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Fall, Flushing, Hyperhidrosis, Hypotension, Syncope, Unresponsive to stimuli
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), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: Systemic: Fainting / Unresponsive-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Hypotension-Severe, Additional Details: light headed started to fall sweating called 911 paramedics took to hospital as blood pressure too long could not leave her


VAERS ID: 1288899 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-04-29
Onset:2021-04-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Flushing, Hyperhidrosis
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (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: Flushed / Sweating-Severe


VAERS ID: 1288934 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-27
Onset:2021-05-04
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: Extreme pain in upper right leg-Severe, Additional Details: sudden upper right leg pain came on today. Doesn''t remember straining her leg. Sent to urgent care for evaluation for possible rare blood clot. Pt called and said tests came back negative for blood clot. Told to rest, elevate, and ice leg.


VAERS ID: 1288937 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-05-04
Onset:2021-05-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling hot, Hyperhidrosis, Pallor, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Fainting / Unresponsive-Severe, Systemic: Very pale upon awakening, sweaty, feeling "hot"-Severe


VAERS ID: 1288941 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-05-04
Onset:2021-05-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling hot, Hyperhidrosis, Pallor, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Fainting / Unresponsive-Severe, Systemic: very pale, sweaty, feeling "hot"-Severe


VAERS ID: 1288974 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-09
Onset:2021-04-16
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Contusion, Dizziness, Ear pain, Headache, Loss of consciousness, Oropharyngeal pain
SMQs:, Torsade de pointes/QT prolongation (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: WAS TESTED IN A HOSPITAL AND RELEASED WITH NO MAJOR COMPLICATIONS.
CDC Split Type:

Write-up: 1 WEEK AFTER VACCINATION- EXPERIENCED HEAD ACHES , SORE THROAT AND EAR ACHES. AROUND 2 WEEKS- PATIENT. FELT DIZZY AND PASSED OUT. STILL HAS SOME BRUISING IN THE ARM NEAR BICEPS.


VAERS ID: 1289118 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-05-01
Onset:2021-05-02
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood test normal, Electrocardiogram normal, Headache, Heart rate irregular, Pyrexia, Urine analysis normal, X-ray normal
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Cardiac arrhythmia terms, nonspecific (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None.
Current Illness: None.
Preexisting Conditions: Asthma.
Allergies: None.
Diagnostic Lab Data: All tests came back normal. Lung x-rays, EKG''s, blood and urine and everything was normal.
CDC Split Type:

Write-up: He got the vaccine, at first for about 6 hours he felt okay, did not feel anything, felt fine. Then that day he started getting a headache, feverish, took Tylenol and felt better. The next day he noticed his heart rate would not go down, it will not go down below 100, will shoot up to 130. He went to the ER and at one point went to 150. They prescribed him some medicine to lower his blood pressure and he has been taking that and it has not been helping. He also went to his doctor and told him that it was probably anxiety, and his heart rate will still not go down. He has not had any other reactions other than this and he''s scared.


VAERS ID: 1289192 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-03-18
Onset:2021-04-01
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Cerebrovascular accident, Chest X-ray, Computerised tomogram, Cough, Dizziness, Feeling cold, Magnetic resonance imaging, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Vestibular 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Chest Xray 04/11 CT Scan 04/18 MRI 05/04
CDC Split Type:

Write-up: Fever, Chills, Cough, Dizziness, Stroke


VAERS ID: 1289336 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-29
Onset:2021-04-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram, Dizziness, Eyelid function disorder, Hyperacusis, Lumbar puncture, Magnetic resonance imaging, Migraine, Nausea, Photophobia, Thunderclap headache, Vision blurred
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Corneal disorders (broad), Retinal disorders (broad), Hearing impairment (narrow), Vestibular disorders (broad), Periorbital and eyelid disorders (narrow), Ocular motility disorders (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: Sertraline, Bupropion
Current Illness: None
Preexisting Conditions: Anxiety, OCD, and General Panic Disorder
Allergies: Sulfa
Diagnostic Lab Data: 04/30/2021 - MRI, CT Scan, CT Scan with contrast, Lumbar Puncture
CDC Split Type:

Write-up: Thunderclap Migraine, Blurred vision in right eye, right eye lid would not remain open. Sensitivity to light and sound. Dizziness. Nauseous. Started at 1:00 am, called Primary. Advised since I do not suffer from migraines to go to the ER. I was given a Migraine Cocktail. An MRI of my brain, and CT scan. They attempted the lumbar puncture and were unsuccessful in retrieving.


VAERS ID: 1289347 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-03-19
Onset:2021-04-06
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 UN / IM

Administered by: Other       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Anticoagulant therapy, Blood creatinine increased, Brain natriuretic peptide normal, Chest X-ray normal, Coagulation test normal, Cor pulmonale acute, Full blood count normal, Gene mutation identification test, Glomerular filtration rate decreased, Metabolic function test, Pulmonary artery thrombosis, Pulmonary embolism, Ultrasound Doppler normal
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Cardiac failure (narrow), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, venous (narrow), Pulmonary hypertension (narrow), Chronic kidney disease (broad), Tumour lysis syndrome (broad), 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: Abilify, atorvastatin, melatonin, metformin, Naprosyn, famotidine, quetiapine, Remeron, lisinopril, Zoloft, Zyrtec
Current Illness: No illness
Preexisting Conditions: Type 2 diabetes, hyperlipidemia, morbid obesity, gastroesophageal reflux, schizoaffective disorder
Allergies: None known
Diagnostic Lab Data: CTA of the chest: Significant pulmonary emboli. Thrombus begins in the distal right and distal left main pulmonary arteries bilaterally. Thrombus extends into the lobar branches of all lobes bilaterally. Bilateral lower extremity doppler negative for DVT. Coagulopathy panel negative, Factor V Leiden mutation pending. CBC normal, creatinine 1.51, GFR 55, basic metabolic panel otherwise normal, BNP 59 (normal), chest x-ray normal.
CDC Split Type:

Write-up: Acute saddle pulmonary embolus with acute cor pulmonale diagnosed 4/14/2021. Treated with anticoagulation, now on Eliquis for 6 months.


VAERS ID: 1289387 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-05
Onset:2021-04-10
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram head abnormal, Death, Subarachnoid haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhagic central nervous system vascular conditions (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-10
   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: unsure, I am her sister and she is deceased. armour thyroid, something for high blood pressure, tylenol for pain
Current Illness:
Preexisting Conditions: chronic back pain, arthritis, hypothyroidism managed , high blood pressure managed
Allergies: none
Diagnostic Lab Data: ct scan at least one possibly with contrast, I am unsure what tests were performed but Dr has reports and discussed with me after her death.
CDC Split Type:

Write-up: Patient had a subarachnoid hemorrhage and died at hospital on the afternoon of saturday April 10


VAERS ID: 1289398 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Delaware  
Vaccinated:2021-04-07
Onset:2021-04-28
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN L808982 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dysgeusia, Facial paralysis, Laboratory test, Urinary tract infection
SMQs:, Taste and smell disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Methadone Melatonin Medical Cannabis Benadryl Unisom
Current Illness: None
Preexisting Conditions: Crohn''s Disease Intermittent cellulitis in both legs after standing long periods
Allergies: None
Diagnostic Lab Data: He was seen at hospital emergency room for evaluation per recommendation of his PCP. He reports having lab work done, was observed, and prescribed Prednisone. He is in care with his PCP for additional testing and monitoring.
CDC Split Type:

Write-up: Approximately 2 weeks after vaccination, patient diagnosed with UTI. Was prescribed a course of Cephalexin. Patient did not take full course but symptoms resolved one day after initiation. Approximately one week later, he began to experience a metallic taste for about 1.5 days, followed by right sided facial palsy. As of date of this report, facial palsy has not resolved.


VAERS ID: 1289492 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: New York  
Vaccinated:2021-03-21
Onset:2021-03-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / N/A LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Laboratory test, Transfusion, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: No
Allergies: Codeine and Erythromycin
Diagnostic Lab Data: Labs done; Tests done Labs done by Dr. Office Tests done by Hospital
CDC Split Type:

Write-up: Heavy vaginal bleeding a day or so later. The bleeding was like a pouring out of blood so severe that it caused me to need a blood transfusion in the emergency room at hospital.


VAERS ID: 1289506 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-05
Onset:2021-05-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 4 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Head injury, Loss of consciousness, Seizure like phenomena, Tremor
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), Convulsions (narrow), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), 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: She stated she has fainted in the past but was younger and received 3 vaccines at that visit.
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Amoxil
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient was waiting the 15 minutes after her vaccination and lost consciousness. She began to shake slightly which concerned me and we called 911. She came to within a minute and was aware of her surroundings. She stated she felt ok but her head hurt from hitting the floor. We gave her an ice pack for her head. After about 5 minutes she got back in the chair and was here until EMS arrived. While they were there questioning her she lost consciousness again two separate times and displayed potential seizure activity again. They put her on the stretcher and took her to the hospital. She reported she has not had seizures in the past but has fainted from a vaccination in the past but was younger and received 3 immunizations.


VAERS ID: 1289578 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-12
Onset:2021-04-21
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Asthenia, Dyspnoea, Fatigue, Fibrin D dimer increased, Headache, Neck pain, Pulmonary embolism
SMQs:, Anaphylactic reaction (broad), Haemorrhage laboratory terms (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Arthritis (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: albuterol-ipratropium amLODIPine atenolol cephalexin cilostazol clopidogrel
Current Illness: None
Preexisting Conditions: Benign hypertension COPD GERD Hypercholesterolemia Hypothyroidism Non-insulin dependent type 2 diabetes mellitus Right carotis bruit Thrombocytopenia TIA
Allergies: codeine, Dilaudid
Diagnostic Lab Data: 04.21.2021 D-dime 3.46 CT angiogram of the chest - small PE in right middle lobar pulmonary artery
CDC Split Type:

Write-up: Presented to ER with weakness and tired last couple of days. Left side of neck pain and headache, shortness of breath.


VAERS ID: 1289586 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-04-09
Onset:2021-04-20
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Headache, Heparin-induced thrombocytopenia test, Myalgia, Syncope, Venogram normal
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: CONJ. ESTROGEN/MEDROXYPROGESTERONE 0.3/1.5 TAB TAKE ONE (1) TABLET BY MOUTH EVERY DAY FOR HORMONE REPLACEMENT Quantity: 28 Days: 28 Refills: 11 *Chronic Med: YES Dispense as Written: NO Indication: Menopause present SUMATRIPTAN TAB 50MG T
Current Illness: Penicillin - reaction unknown Sulfamethoxazole - reaction unknown
Preexisting Conditions: Menopause Migraine
Allergies:
Diagnostic Lab Data: Patient''s heparin antibody assay was found to be negative and CT venogram showed no evidence of clot. Please contact Medical Center if additional information is needed as this is a part of their records.
CDC Split Type:

Write-up: Patient had headache and muscle pains following vaccination. On day 11, patient had a syncopal episode after which she woke up laying on her left hand. Patient was seen in the urgent care and transferred to Medical Center.


VAERS ID: 1289718 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-05
Onset:2021-04-10
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chest discomfort, Cough, Dyspnoea, Muscle spasms
SMQs:, Anaphylactic reaction (broad), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Prednisone Albuterol Claritin
Current Illness: Lyme Disease
Preexisting Conditions:
Allergies: No known medication or food allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: cough, shortness of breath, chest tightness, unable to take a full breath, feels like her neck has a spasm


VAERS ID: 1289722 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-17
Onset:2021-03-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / N/A - / IM

Administered by: Private       Purchased by: ?
Symptoms: Ageusia, Anosmia, Chills, Fatigue, Headache, Myalgia, Rash, Throat tightness, Urticaria
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Taste and smell disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: The evening I got headaches, chills, muscle, loss of smell and taste. The third day I woke up with swelling like hives and rash around my right eye. I took 10mg of Claritin. The hives spread around the back of my neck and the rest of my body over the course of the morning. Within a few hours it had spread to my chest and my throat felt like it was closing. I had taken Benadryl but it didn''t seem to help. I was also fatigued but had no shortness of breath. I had not eaten anything before the hives started. It had been 48 hours after the shot that I was in the Emergency Room, the hives started around 36 hours. I was given Epinephrine 3mg, Prednisone and Famotidine and given steroids for a few days. I have not had any problems since the first three days after the ER visit.


VAERS ID: 1289739 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-13
Onset:2021-04-09
   Days after vaccination:27
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Full blood count normal, Muscle spasms, Ultrasound scan abnormal
SMQs:, Malignancy related therapeutic and diagnostic procedures (narrow), Dystonia (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: ferrous sulfate
Current Illness:
Preexisting Conditions: pre-diabetes, iron deficiency anemia
Allergies: tizanidine
Diagnostic Lab Data: 05/03/21 normal CBC 04/27/21 venous ultrasound left leg
CDC Split Type:

Write-up: recurrent left leg DVT


VAERS ID: 1289777 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-03-16
Onset:2021-04-27
   Days after vaccination:42
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood glucose normal, COVID-19, Chest discomfort, Chills, Dizziness, Ear pain, Fatigue, Headache, Malaise, Pain in extremity, Productive cough, Pyrexia, SARS-CoV-2 test positive, Sputum discoloured
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: levothyroxine PO QD metformin PO QD
Current Illness:
Preexisting Conditions: Asthma DM Type 2 Hypothyroidism Depression Anxiety Bipolar
Allergies: Trileptal - rash
Diagnostic Lab Data: See above
CDC Split Type:

Write-up: J&J COVID-19 Vaccine EUA J&J Dose 3/16/21 (1805018) COVID Positive 5/3/21 5/3/21: Presented to ED. 35-year-old female presents the ER with chief complaint of cough. Patient stated symptoms started 1 week ago. Fiancee has similar symptoms. Other associated symptoms include pleuritic chest discomfort, lightheaded upon standing, fever 102, chills, bilateral ear pain, headache, general malaise, bilateral leg pain, and fatigue. Cough is described as productive producing yellow green phlegm. No prior history of DVT or PE. No recent travels or surgeries. Patient is on Depo. She has no reports of unilateral leg pain or swelling. Patient is a diabetic type 2 with blood sugars running in the 170s 2 days ago. Normal is 100-200. She takes metformin and glipizide. She also has a history of anxiety, depression, bipolar, hypothyroidism. Discharged to home with albuterol, doxycycline, prednisone.


VAERS ID: 1289792 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 59676-0580-05 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chills, Cholecystitis acute, Computerised tomogram abdomen abnormal, Computerised tomogram neck, Fatigue, Feeling abnormal, Myalgia, Oropharyngeal pain, Respiratory tract congestion, Skin warm, Vertebral artery dissection, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Infectious biliary disorders (narrow), Gallbladder related disorders (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: High blood pressure
Allergies:
Diagnostic Lab Data: CAT Scans & blood tests
CDC Split Type:

Write-up: April 10- shot administered at store; waited the obligatory 10 minutes. On the way home my upper arm got extremely hot, felt a bit foggy, major fatigue. April 11- vomiting, fatigue, congestion April 12- vomiting, fatigue, congestion April 13- vomiting, fatigue, congestion April 14- vomiting, fatigue, congestion, sore throat/ telehealth visit; dr. prescribes nausea meds April 15- fatigue, congestion April 16-fatigue, congestion, muscle pain April 17- congestion, muscle pain April 18- feeling 50% active. congestion April 19- feeling 70% active, still fatigue & congestion April 20- vomiting, fatigue, congestion April 21- vomiting, fatigue, congestion/ spoke w/ doctor, nausea meds refilled April 22- [didn?t record] April 23- 70% active, congestion April 24- 80% active, congestion April 25- 90% active, congestion April 26- vomiting, congestion April 27- 80% active, congestion April 28- 90% active, congestion April 29- 90% active, congestion April 30- vomiting, congestion, fatigue, chills/ went to hospital 7:30 pm- 4:15 am May 2- Admitted to Hospital Diagnosis 1. Dissection of vertebral artery & 2. Acute cholecystitis


VAERS ID: 1289927 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-04-12
Onset:2021-04-24
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Arthralgia, Chemotherapy, Dyspnoea, Gait disturbance, Neck pain, Pain in extremity, Pulmonary embolism, Thrombosis, Tremor
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Parkinson-like events (broad), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Colon Ca
Allergies:
Diagnostic Lab Data: Pt
CDC Split Type:

Write-up: Patient was discharged from the hospital after massive PE. She went to the hospital at 2am last Saturday. Patient described unbelievable pain from shoulder neck and arms. She could hardly walk to her car. Went to ER. There they ran tests and found many blood clots in lungs. Blood clots had stopped the blood in that area. They were not definitive but said it sounded like that. Got a breathing apparatus after because it''s been hard to breathe and she has been shaky. Her shot was administered 04/12 during chemo. Hospital April 24. She was discharged and given a blood thinner and pain medication - Oxycodone & Eliquis.


VAERS ID: 1290038 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-05-05
Onset:2021-05-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Muscle tightness
SMQs:, Anaphylactic reaction (broad), Dystonia (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 known
Preexisting Conditions: no indicated health conditions
Allergies: none known
Diagnostic Lab Data: none known at this time.
CDC Split Type:

Write-up: Patient returned to pharmacy 30 to 40 minutes following injection after sitting in the pharmacy area for 15 to 20 minutes and reported a little tightness at the top of the rib cage bottom of the neck. She did not report any shortness of breath/dizziness/light headedness, patient color was good, injection site was not inflamed and pulse was normal. Patient sat for 20 additional minutes and reported that tightness may have been elevating. I requested her two friends to take her to the nearest emergency room at Hospital for monitoring.


VAERS ID: 1290073 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-05
Onset:2021-05-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Balance disorder, Dizziness, Hyperhidrosis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Patient did not indicate which vaccine/could not recall
Other Medications:
Current Illness: no
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Evaluated by EMS
CDC Split Type:

Write-up: Patient became very dizzy, lightheaded, lost balance, sweating. emergency services was contacted and was evalualted by EMS. EMS left scene, patient felt completely recovered after waiting in the store for 45 mins and left facility . Patient mentioned after the incident that this has occured with other vaccines. Patient did not indicate this history prior to covid vaccine adminsitration or episode


VAERS ID: 1290173 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-03-26
Onset:2021-03-27
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abortion spontaneous, Exposure during pregnancy, Fatigue, Human chorionic gonadotropin, Malaise, Pain, Ultrasound scan abnormal, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Termination of pregnancy and risk of abortion (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Pre-Natal Vitamins
Current Illness: No
Preexisting Conditions: Chronic Migraines for 15 yrs.
Allergies: Allergic to Gold , Cipro antibiotic , Gab pinto and Tigerton
Diagnostic Lab Data: 03-30-2021 HCG and the did an ultra sound and they could not locate a heart beat and they indicated her hormones levels was off for the timeframe of pregnancy timeframe. Another HCG Test Thursday 04-01-2021 she had a miscarriage it was confirmed that she was having a miscarriage.
CDC Split Type: vsafe

Write-up: 7 weeks at vaccination due date 11/14/2021 was due third pregnancy had successful pregnancy, Normal pregnancy and next two days was very sick, body aches, fatigue, Tues. Tuesday 03-30-2021 she experienced bleeding and at that time was 7 weeks 2 days pregnant ER went to the doctor and they indicated that she would need to return, then on Thursday 04-01-2021 she had a miscarriage and it was confirmed that she was having a miscarriage.


VAERS ID: 1290174 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-05
Onset:2021-05-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Hyperhidrosis
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: PATIENT WAS WAS VERY DIZZY, SWEATING, TROUBLE BREATHING. GAVE EPIPEN AND CALLED AMBULANCE


VAERS ID: 1290199 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-03-13
Onset:2021-03-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / N/A LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Asthma, Computerised tomogram normal, Hypertension, Influenza like illness, Magnetic resonance imaging, Migraine, Rash
SMQs:, Anaphylactic reaction (narrow), Asthma/bronchospasm (narrow), Neuroleptic malignant syndrome (broad), Hypertension (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft; Metoprolol; Alvesco
Current Illness: migraines
Preexisting Conditions: chronic migraines
Allergies: Penicillin; trazadone; oxycodone; Amoxicillin
Diagnostic Lab Data: CT scan; MRI April 12, 2021 - normal results
CDC Split Type: vsafe

Write-up: The first few days, I had flu-like symptoms. After I got the vaccine - my migraines became very severe - they would last for days. They became unmanageable and I had to go to ER. I have asthma - it''s a lot harder to breathe - this is on and off. It used to be once in awhile I need my inhaler but now I need to use it more. It feels like I''m catching my breath a lot more now.. My rashes went away - but I had had rashes (random places - arms/legs) that came and went for the first two weeks after the vaccine. I went to hospital ER on the 12th of April - because my migraines were so bad that my blood pressure went up to 200 something and they had to clear me to make sure I wasn''t having a stroke. I have always had migraines but the only thing different that has changed the severity is the vaccine. I just finished off the steroids'' - Progesterone that the neurologist (at ER)(the one that called the cold stroke) prescribed to me. But that didn''t really help. I''m waiting for approval from insurance for another medication. Saw another neurologist - after the ER visit.


VAERS ID: 1290207 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-05-04
Onset:2021-05-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Communication disorder, Dizziness, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: lisinopril-hctz 20/25 1qd buspirone 10 mg tab 1 bid
Current Illness: none provided on pqcf, pts profile shows pt taking lisinopril/hctz and buspirone
Preexisting Conditions: none provided on pqcf, pts profile shows pt taking lisinopril/hctz and buspirone
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: PT called pharmacy complaining of light headed, dizziness, and trouble breathing and asking what to do. She had received the shot about 24 hours ago before experiencing any side effects. Informed pt to seek out her doctor.


VAERS ID: 1290266 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-04-08
Onset:2021-04-20
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / N/A UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Anti-glomerular basement membrane disease, Bell's palsy, Blood creatine phosphokinase increased, Confusional state, Headache, Intrusive thoughts, Magnetic resonance imaging spinal abnormal, Myalgia, Neuralgia, Neurological examination abnormal, Pain, Paraesthesia, Urinary hesitation, Urinary retention
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Hearing impairment (broad), Vasculitis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: exercise induced asthma
Allergies: none
Diagnostic Lab Data: CK 656 Lumbar MRI showed cauda equina enhancement consistent with ascending infectious or inflammatory process like GBM
CDC Split Type:

Write-up: 4/8 got vaccine. Then on 4/20 patient developed myalgias in back, legs, and jaw and headaches, tingling in hands, normal strength. Then on 4/25 developed Bells palsy treated with prednisone and valcyclovir for possible meningitis (no LP). Full body pain particularly in LE persisted even though Bells palsy resolved. He then developed confusion and intrusive thoughts, as well as urinary retention. He was direct admitted to our hospital. Neuro exam was notable for diffuse myalgias and 1+ patellar reflexes bilaterally. Patient was treated with gabapentin for neuropathic pain control, urinary hesitancy improved, no strength deficits. Lumbar MRI showed cauda equina enhancement consistent with ascending infectious or inflammatory process like GBM.


VAERS ID: 1290340 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-04-12
Onset:2021-04-29
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Mydayis 50mg, Atomoxetine 100mg, Bupropion 450mg, Metformin 1G
Current Illness: None
Preexisting Conditions: Pre-diabetes, now under control
Allergies: None
Diagnostic Lab Data: CT Scans with and without IV contrast
CDC Split Type:

Write-up: Developed Bell''s Palsy on morning of 4/29, with left side of face paralyzed. Was examined by emergency room physicians for stroke and blood clot, cleared and given prescription for Valacyclovir 1GM (3x day 7days) and Prednisone 50mg (1x day 5 days). As of 5/5 condition has improved significantly, though paralysis around mouth and neck areas persists.


VAERS ID: 1290382 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-03
Onset:2021-05-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Crying, Dyspnoea, Feeling of body temperature change, Hyperhidrosis, Oedema peripheral, Pyrexia, Screaming, Sleep disorder, Tension, Tremor
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Depression (excl suicide and self injury) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Fever headache swelling I can''t breathe
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: I got the vaccine at 2pm. At 12am when I was asleep, I woke up shaking, crying, screaming, I couldn''t breathe, I was very cold and hot at the same time. I was sweating too much. My wife at home tried to calm down, I took my blood pressure and it was 170-160. As a result of this we went to the hospital where they admitted me for more than 4 hours, while they controlled my tension and fever. The next day a large swelling appeared under my left arm, a gland or I don''t know what it will be, but it is a very large swelling


VAERS ID: 1290386 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-15
Onset:2021-03-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Asthenia, Chills, Diarrhoea, Dizziness, Erythema, Headache, Hypersensitivity, Laboratory test, Menstrual disorder, Nausea, Pruritus, Rash, SARS-CoV-2 test negative, Ultrasound scan vagina, Vaginal haemorrhage
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Flu shot- i get a cold lasting three days
Other Medications:
Current Illness: Had Covid in December 2020
Preexisting Conditions:
Allergies: Penicillin
Diagnostic Lab Data: lab work, transvaginal ultrasound, covid test; negative
CDC Split Type: vsafe

Write-up: I experienced headaches, nausea, diarrhea, chills. I felt very weak. On the second day, my symptoms were the same. On the third day i started to feel itchy and was super red. On Monday morning, I woke up with the rash all over my body and feeling very dizzy. I went to urgent care and he checked me that I had an allergic reaction to the J&J vaccine. I also experienced vaginal bleeding, uncontrollably and he did the exams and I was told it was my menstrual cycle which lasted one week. I have not gotten my menstrual cycle since the J&J vaccine. I do not have my lot # at the moment.


VAERS ID: 1290425 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-05-05
Onset:2021-05-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling abnormal, Hyperhidrosis, Pallor, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: after about 5-6 minutes, he started feeling weird, then started to get pale and sweating, didn''t pass out but did vomit. took a ride to er with the ambulance, came back to let me know he was ok and thank me.


VAERS ID: 1290448 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-05-04
Onset:2021-05-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / ID

Administered by: Senior Living       Purchased by: ?
Symptoms: Catheter site erythema, Catheter site swelling, Catheter site warmth, Central venous catheter removal, Central venous catheterisation, Death
SMQs:, Embolic and thrombotic events, venous (narrow), Extravasation events (injections, infusions and implants) (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-05
   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:
Current Illness: OTHER ACUTE OSTEOMYELITIS, LEFT ANKLE AND FOOT; OTHER ACUTE OSTEOMYELITIS, LEFT ANKLE AND FOO
Preexisting Conditions: CHRONIC KIDNEY DISEASE, STAGE 3A : HYPERLIPIDEMIA, UNSPECIFIED; ESSENTIAL (PRIMARY) HYPERTENSION; HYPERTENSIVE HEART DISEASE WITHOUT HEART FAILURE; MORBID (SEVERE) OBESITY DUE TO EXCESS CALORIES
Allergies: NKA/NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: 5/4 : Resident with PICC line following course of IV ABX for osteomylitis. Resident was administered Jassen vaccine at 1100am. Resident had PICC line and PIV removed at aprox 1700. He was followed up by nursing staff at 2000 at which time he complained of swelling, redness, and heat to the PICC site. On-call provider was notified and ordered transportation to Emergency Department for evaluation. Facility was notified of passing at 0200 on 5/5


VAERS ID: 1290465 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-03-08
Onset:2021-04-03
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN JJ1805022 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Amnesia, Blood test, Catheterisation cardiac normal, Chest pain, Computerised tomogram, Differential white blood cell count, Dizziness, Full blood count, Haematocrit decreased, Haemoglobin decreased, Hypotension, Loss of consciousness, Magnetic resonance imaging, Nausea, Troponin, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Haematopoietic erythropenia (broad), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 9 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: asprin, vitamin d3, montelask, lexapro, stiolto respimat, ezetimibe, lovastatin, levothyroxine
Current Illness:
Preexisting Conditions: copd
Allergies: penicillin
Diagnostic Lab Data: MRI/CT Scans/blood work/ all between 04/08 - current
CDC Split Type:

Write-up: STARTING AROUND 4/3 she started to experience dizziness, nausea and memory loss. On 04/06 She passed out while sitting in her chair, woke up and began throwing up. Had extreme short term memory loss and low blood pressure. On 04/08 while at her primary care Dr, he suggested a hospital visit with suspicion of possible stroke. Was admitted and released the following day. Dr advised possible mini strokes but could also be dehydration. CBC with differential showed other results than dehydration. Starting around 04/20 she started having chest pains and thought it was heart burn, after medication and another visit to her pcp she was admitted to the hospital again on 04/23. Her troponin levels indicated a possible heart attack. She had a heart catherization and was found to have a healthy heart. Again, her blood pressure has been decreased since, her hgb and hct has also been low with a history of it being high. A high WBC since all of this has started among other unexplained blood results.


VAERS ID: 1290656 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-05-05
Onset:2021-05-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: PT FAINTED AND VOMITED


VAERS ID: 1290693 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-06
Onset:2021-05-01
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Mobility decreased, Pain in extremity, Peripheral swelling, Ultrasound scan
SMQs:, Cardiac failure (broad), Angioedema (broad), Parkinson-like events (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: Synthoid, HCTZ, Enalapril, B12, MVI
Current Illness: None
Preexisting Conditions: HTN, Hypothyroidism
Allergies: None
Diagnostic Lab Data: Sent for Ultrasound of RT upper extremity
CDC Split Type:

Write-up: Severe swelling and pain at the RT arm with decrease ROM


VAERS ID: 1290710 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-05
Onset:2021-05-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Feeling abnormal, Flushing, Headache
SMQs:, Anaphylactic reaction (narrow), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (broad)

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

Write-up: The patient received the Janssen vaccine lot # 1808980 in his left deltoid muscle at 1250pm on the side of the road from our mobile foot team. He was seated on the sidewalk during vaccination and remained seated for his observation period. At 1301 the patient said he felt "fuzzy," and "light headed" but said "I do not feel like I''m going to pass out." The patient refused to lay down. He was offered a mat or the back of the car to lie down on. He was also given water by RNs and a snack by the police. He drank a few sips of water and refused the snack. His BP was 150/100, HR 76 and regular per palpation, RR 16 and unlabored. No signs of respiratory distress. The patients skin was dry and color was appropriate for ethnicity. At 1306 the patient said " I feel the same, a little light headed." RNs and asked him to describe what he meant by light headed as he still denied feeling like he was going to pass out. He said "I feel dizzy." RNs asked patient if he felt like he was spinning but he said no. BP 158/90, RR 18 and unlabored, HR 74 and regular per palpation. Pt still declined to lay down. At 1311 the patient still felt the same. RNs asked the patient to lie down again. The patient agreed to lay down in the back of the car. The patient stood up and said he felt short of breath upon standing. He has a Hx of COPD and said that he often feels SOB when he first stands. He took his own Ventolin Inhaler before laying down in the back of the car with the air conditioning on. It was 1316 when he laid down and vitals were taken again. BP 130/90, HR 70 and regular per palpation, RR 18 and unlabored. At 1321 the patient said "I feel a little better but still light headed and my head is throbbing but I get headaches every day." Vitals: 138/90, HR 70, Spo298%. At 1326 the patient tried to sit up but became flushed and said he felt "weird." Vitals were 144/90, HR 75, RR 18, Spo2 97%. RNs assisted the patient to lay back down. At 1328 RN asked the police to call 911 while RN placed a call to our lead RN. Vitals were taken again at 1331 BP 150/90, RR 18 and unlabored, HR 81, Spo2 98%. At 1337 the paramedics arrived with the ambulance and resumed care. The patient was transported to Hospital.


VAERS ID: 1290875 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-03-16
Onset:2021-03-28
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / SYR

Administered by: Senior Living       Purchased by: ?
Symptoms: Pulmonary embolism, Thromboembolectomy
SMQs:, Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, venous (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lisinopril, Amlodipine
Current Illness: No
Preexisting Conditions: Hypertension
Allergies: N/A
Diagnostic Lab Data: 4/29/21-5/2/21 Pulmonary embolism. Had surgery to remove blood clots in lungs
CDC Split Type:

Write-up: Pulmonary embolism. Had surgery to remove blood clots in lungs


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