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From the 10/8/2021 release of VAERS data:

Found 7,946 cases where Vaccine is COVID19 and Manufacturer is JANSSEN and Emergency Room/Doctor Visit



Case Details

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VAERS ID: 1291364 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
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 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Epistaxis, Fall, Head injury, Movement disorder, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Accidents and injuries (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: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: None
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: Patient was administered Janssen COVID 19 vaccine by a nurse conducting an on site clinic. The patient was seated for about 5 minutes into her mandatory 15 minute waiting period when she fell face first off the chair & onto the floor. The nurse detected no movement & administered an Epipen. 911 was called. After the Epipen administration the patient "woke" & was able to answer questions. She was given ice to apply to a bump on her forehead & napkins for her bloody nose. EMT arrived & she was assessed & transported to the hospital.


VAERS ID: 1291397 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-03-09
Onset:2021-03-19
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Deafness, Headache, Magnetic resonance imaging, Migraine, Pyrexia, Tinnitus, Vertigo, Visual impairment, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Hearing impairment (narrow), Vestibular disorders (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: oxycodone, aspirin, Tylenol, iron, niacin, vitamin C, biotin, B12
Current Illness: None
Preexisting Conditions: osteoarthritis of hip
Allergies: sulfa antibiotics
Diagnostic Lab Data: Saw ENT and have hearing loss in tinnitus ear. MRI on April 18. No blood clots.
CDC Split Type: vsafe

Write-up: Severe headache from about day 3 after vaccine. Felt like a vice across back of head. On March 19 headache with with vomiting. Went to emergency room on March 20 on advice of primary care doctor. Diagnosed with a migraine. Given fluids, Toradol, Compazine and potassium. Headache was preceded by visual disturbance. Relief for 3 days. Fever on April 4. Migraine again on April 17. Also, developed tinnitus in left ear around week 2 after vaccine. Still have tinnitus. Have had vertigo off and on. Last episode was May 2.


VAERS ID: 1291467 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Computerised tomogram normal, Illness, Immediate post-injection reaction, Nerve injury, Nerve stimulation test abnormal, Pain, Pain in extremity, Radial nerve injury, Ultrasound Doppler normal
SMQs:, Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 4/14/21 - went to chiropractor who would not adjust me and recommended i go to the doctor for a mri bc he said it the symptoms sounded like nerve damage. 4/16/21 - went to urgent care bc of the pain and they said it was damage to the radial nerve from the vaccine. Send me immediately to the ER 4/16/21 - went to the ER and they did an ultrasound to rule out blood clots. They then performed a CT scan. They prescribed me gabapentin and recommend i follow up with a neurologist for a nerve test. 4/20/21 - went to general practitioner who scheduled a nerve test. Upped medication from 300mg gabapentin to 1200mg gabapentin. 4/24/21 - nerve test performed.
CDC Split Type:

Write-up: 4/12/21 immediately following the vaccine it felt like I had a ?dead arm?. I had radiating pain in my arm and down to my fingers. I did get really sick after from the side effects but when that went away the pain in my left arm stayed.


VAERS ID: 1291590 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Headache, Magnetic resonance imaging
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:
Allergies:
Diagnostic Lab Data: Test Date: 2021; Test Name: MRI; Result Unstructured Data: normal; Test Date: 2021; Test Name: Blood test; Result Unstructured Data: normal
CDC Split Type: USJNJFOC20210504198

Write-up: HEADACHE; This spontaneous report received from a patient via social media a concerned a female of unspecified age. The patient''s weight, height and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On an unspecified date, the subject experienced side affect and head ache. On 2021, Laboratory data included: Blood test (NR: not provided) normal and MRI (NR: not provided) normal. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the head ache and side affect was not reported. This report was non-serious.


VAERS ID: 1291625 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-23
Onset:2021-03-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / UNK - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Guillain-Barre syndrome
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow), 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, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: - Albuterol HFA - Calcium citrate vitamin D3 - Cyclosporine - Epipen 2-pak - Allegra - Flucelvax quad 2020-2021 - Glucosamine/chondrotin sulfate - Hydocholathiazide - Losartan - Mometasone formoterol - Montelukast - MVI adult 1 with Vita
Current Illness:
Preexisting Conditions: - Essential hypertension - Moderate persistent asthma - Obesity - Thyroid nodule
Allergies: - Pollen - Prednisone- frequent urination
Diagnostic Lab Data:
CDC Split Type:

Write-up: GBS/AIDP


VAERS ID: 1291949 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-07
Onset:2021-04-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 5 LA / SYR

Administered by: Military       Purchased by: ?
Symptoms: Chest X-ray, Chest discomfort, Chest pain, Chills, Dizziness, Dyspnoea, Full blood count, Headache, Heart rate increased, Pain in extremity, Palpitations, Urticaria, Vertigo
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ASAqd 181mg, qd atorvastain,metoprolol 50mg 1bid, clopidogrel75mg qd Zinic Vitamin D3
Current Illness: GERD Cardiovascular (2heart stents)
Preexisting Conditions: GERD Cardiovascular Allergies Neuropathy legs
Allergies: Dairy products, spicy foods, plastic tape I am a long hauler.
Diagnostic Lab Data: Complete Blood panel Chest XRay
CDC Split Type:

Write-up: Taken to directly to the ER from the site SOB Headache Chills Chest pain Dry hives Faintness Aching legs Heavy feeling in chest Vertigo following day Increase HR-as though heart was pounding in my chest


VAERS ID: 1291958 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-05-01
Onset:2021-05-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood glucose normal, Computerised tomogram normal, Confusional state, Electrocardiogram normal, Fall, Fatigue, Headache, Nausea, Night sweats, Pain, Pyrexia, Seizure
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: 60mg Duloxetine
Current Illness: HSP
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: May 5th, 2021 Tests Conducted: CT scan (normal) Glucose test (normal) EKG (normal)
CDC Split Type:

Write-up: About 10-15 hours after injection - Came down with headache, fever, body aches, fatigue, and night sweats. Recovered fully 24 hours after injection. May 5th, 2021 ~7:30 am (4 days post-vaccination) I stood up from a seated position and then collapsed moments later and had, what my brother described as, a seizure which was followed by confusion, nausea, and fatigue.


VAERS ID: 1292020 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-05-05
Onset:2021-05-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 AR / IM

Administered by: School       Purchased by: ?
Symptoms: Hyperhidrosis, Muscle contracture, Pallor, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: PATIENT OBSERVED TO HAVE POSSIBLE SEIZURE ACTIVITY IN CHAIR. PATIENT BROUGHT TO THE FLOOR AND LASTED ABOUT 1 MINUTE. PATIENT HAD CONTRACTED ARMS, HUNCHED OVER, PALE, DIAPHORETIC, AND VERBALLY UNRESPONSIVE. 911 DISPATCHED AND ARRIVED WITHIN FEW MINUTES. PATIENT DID NOT RECALL EVENT ONCE VITALS STABILIZED AND WAS TRANSPORTED TO NEAREST HOSPITAL.


VAERS ID: 1292043 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-03-30
Onset:2021-04-20
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Acoustic stimulation tests normal, Aura, Blood test normal, Computerised tomogram normal, Dizziness, Electrocardiogram normal, Tinnitus
SMQs:, Anticholinergic syndrome (broad), Convulsions (broad), Hearing impairment (narrow), Vestibular disorders (broad), Generalised convulsive seizures following immunisation (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 vitamin
Current Illness: none
Preexisting Conditions: kidney stones
Allergies: none
Diagnostic Lab Data: EKG, bloodwork, CT Head, Hearing test for Fluid, Hearing Test; all came back normal
CDC Split Type:

Write-up: approximately three weeks after the shot, I developed sudden on-set dizziness with aural fullness and tinnitus


VAERS ID: 1292053 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-04-06
Onset:2021-05-05
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test normal, Chest X-ray abnormal, Chest pain, Electrocardiogram abnormal, Pericarditis
SMQs:, Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Immune-mediated/autoimmune 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? No
Previous Vaccinations:
Other Medications: None
Current Illness: None.
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Blood tests to check cardiac enzymes, rule out bloodclot, X-rays, EKGs.
CDC Split Type:

Write-up: Severe chest pain, diagnosed as Pericarditis. No prior history, no prior surgeries, no risk factors, no illnesses. In addition, patient is very healthy, has never had COVID, he is provided free COVID tests and work, has tested negative regularly for months, gets him temperature taken at work every day before entering.


VAERS ID: 1292061 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-04-09
Onset:2021-04-27
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Abdominal distension, Abdominal pain upper, Blood pressure increased, Intestinal obstruction, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal obstruction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (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? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none known of
Allergies: none
Diagnostic Lab Data: no test in clinic, all testing done at hospital
CDC Split Type:

Write-up: 4/27/21 pt started to have nausea and upper abdominal pain, 4/28/21 presented to the clinic due to nausea, vomiting and abdominal pain. Examination showed elevated BP, mild upper abdominal distention and pain. Pt given Zofran 4mg for nausea, sent home to rest. Pt reported the next day to be feeling better, but got worse that night 4/29/21, went to the ER, diagnosed with a bowel obstruction.


VAERS ID: 1292120 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-30
Onset:2021-05-05
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Discomfort, Electrocardiogram, Heart rate increased
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: Increase heart rate. Started 5/5/21 at about 6:45PM and continued through the rest of the day. Leading up to the hear rate increasing I was fine and just enjoying my day. No drugs or alcohol or did not do any exercise that day. Felt uncomfortable and with some anxiety I visited a urgent care facility. The visit was about 45 minutes and left. As I am writing this, my heart rate is still a bit above normal but doing better.


VAERS ID: 1292192 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-27
Onset:2021-04-29
   Days after vaccination:33
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / UNK LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Computerised tomogram thorax abnormal, Intensive care, Pulmonary embolism, Thromboembolectomy
SMQs:, Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, venous (narrow), Cardiomyopathy (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Asthma
Allergies: Famotidine Prednisone
Diagnostic Lab Data: Ct scan on 4/30/21 confirmed diagnosis
CDC Split Type:

Write-up: Saddle pulmonary embolus requiring embolys removal with ICU admission


VAERS ID: 1292209 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-03-17
Onset:2021-03-22
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anaemia, Aphasia, Blindness transient, Blood test, Carotid endarterectomy, Cerebrovascular accident, Computerised tomogram head abnormal, Dizziness, Electrocardiogram, Fatigue, Fibrin D dimer increased, Hypoaesthesia, Incoherent, Magnetic resonance imaging head abnormal, Somnolence, Speech disorder
SMQs:, Haematopoietic erythropenia (broad), Peripheral neuropathy (broad), Haemorrhage laboratory terms (broad), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Optic nerve disorders (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Vestibular disorders (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: vitamin D
Current Illness: none
Preexisting Conditions: none
Allergies: Sulfa, Sulfites, Alcohol, Novacaine, Pain Meds, Anesthesia
Diagnostic Lab Data: EKG,MRI, CAT SCAN, BLOOD TEST, ECT.
CDC Split Type:

Write-up: 3/18/21, Day after Vaccine, drowzy in the morning, around 12:00 p.m. I had a brief period of incoherent speach and a few moments of having trouble putting sentences together. Around 2:00 a moment of temporary blindness in my left eye. 03/19/21 -03/20/21, extreme fatigue, stayed in bed. 03/21/21, fatigue, light-headed, slightly dizzy 03/22/21, right side leg and arm became numb as if asleep. Went to Hospital Emergency. I had a stroke, had a Carotid Endarterectomy at medical center, was in the Hospital for 5 days, two weeks after surgery became seriously enemic and d_Dimers are still elevated THE CONTINUATION PAGE IS INOPT. AND WOULD HAVE LIKED TO EXPLAIN IN FURTHER DETAIL.


VAERS ID: 1292494 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-04-07
Onset:2021-04-15
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Deep vein thrombosis, Pain in extremity, Platelet count decreased, Pulmonary embolism
SMQs:, Haematopoietic thrombocytopenia (narrow), Systemic lupus erythematosus (broad), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (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: Multivitamins
Current Illness:
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data: +DVT, +PE, PLT=92
CDC Split Type:

Write-up: Pt developed calf pain ~ 1-2 week after COVID vaccine. Diagnosed with DVT/PE on 5/6 with platelet count decreased from baseline at 92,000.


VAERS ID: 1292501 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-19
Onset:2021-03-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / N/A RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Feeling cold, Headache, Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling, Pain
SMQs:, 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Blood Pressure Anxiety Depression
Current Illness:
Preexisting Conditions: Hypertension Anxiety
Allergies: Keflex
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: The day the vaccine I had body aches all over, chills and cold. I had those symptoms for three days. Over the next week I got a red spot around the site of the shot which got bigger. It was sore itchy and tender. It grew to the size of two inches in a circle around the site of the shot .I also had a headache for a week that was constant for the whole day. I went to the ER and they just told me to take Tylenol for the pain. My arm was still effected, for two weeks total and it itched toward the last few days. My headache also got better.


VAERS ID: 1292506 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-04-03
Onset:2021-04-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Cerebrovascular accident, Chills, Computerised tomogram head abnormal, Dizziness, Headache, Magnetic resonance imaging, Nausea, Neck pain
SMQs:, Acute pancreatitis (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), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 19 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Aleve, prilosec & ambiem
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Multiple MRI & CT Scans 4/11/21
CDC Split Type:

Write-up: neck and head ache, chills, nausea, lightheaded. On 4/11/21 suffered a stroke.


VAERS ID: 1292523 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-03-27
Onset:2021-04-03
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain upper, Blood test, Dizziness, Feeling abnormal, Tinnitus
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hearing impairment (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: multi vitamin & Vitamin C & D
Current Illness: none
Preexisting Conditions:
Allergies: no
Diagnostic Lab Data: Blood tests 4/12/21
CDC Split Type:

Write-up: Extreme tinnitus, brain fog, dizzieness and stomach pain 1-4 weeks after. Extreme tinnitus has not resolved yet.


VAERS ID: 1292550 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-20
Onset:2021-03-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / N/A RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arrhythmia, Blood test, Chest X-ray, Dyspnoea, Palpitations, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Blood Tests Chest X-Ray Covid-19
CDC Split Type: vsafe

Write-up: About six hours after my shot I started having shortness of breath and heart palpitations. I went to the ER and they gave me some fluids and testing and I was discharged the next day. I had a mild heart arrhythmia which was not present two days later when I went to the doctor. I had a little shortness of breath and experienced a few heart palpitations for a week after the vaccine. I have not had any more since then.


VAERS ID: 1292637 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Vermont  
Vaccinated:2021-05-06
Onset:2021-05-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Delirium, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad)

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

Write-up: Pt received vaccine and roughly 5 mins post vaccination pt became delirious and then fainted. Pt was put supine on ground to prevent falling. 911 was dialed. Pt came to roughly 30 seconds after fainting. Paramedics came and treated the pt 10 mins after episode.


VAERS ID: 1292647 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-09
Onset:2021-04-19
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Aphasia, Blood test, Cerebrovascular accident, Computerised tomogram head abnormal, Fatigue, Feeling abnormal, Speech disorder, Urine analysis, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), 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: vitamin C, D3, Calcium
Current Illness:
Preexisting Conditions:
Allergies: nka
Diagnostic Lab Data: blood and urine test CT
CDC Split Type:

Write-up: pt stated she was watching TV about 10 days after taking the vax she had a stroke. She became where she couldnt talk and was speaking jibber jabber. Her eyes blurred. These symptoms went away and she felt better. On 4/23/21 she went to ER. Her BP was 212/117. She had multiple test. She was diagnosed w/ Stroke. She was prescribed water pills and sent home to FU w/ PCP. On 5/3/21 she saw PCP. He prescribed blood pressure medicine. She is waiting on them to call her back w/ appt date for a Carotid US. She feels better but says she has brain fog, has fatigue and right eye is still blurry.


VAERS ID: 1292661 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: South Dakota  
Vaccinated:2021-05-06
Onset:2021-05-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / N/A UN / IM

Administered by: Public       Purchased by: ?
Symptoms: Cough, Pain, Skin burning sensation
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad)

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

Write-up: Patient reports skin feels like on fire, hurts, cough 1 hour after vaccination


VAERS ID: 1292675 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pain in extremity, Peripheral swelling, Rash, Rash erythematous, Rash papular, Ultrasound scan
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), 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: 2 Tylenol half an hour before my vaccine
Current Illness:
Preexisting Conditions:
Allergies: Environmental allergies
Diagnostic Lab Data: u/s of left upper extremity
CDC Split Type: vsafe

Write-up: After my vaccine, I experienced redness sensation to my arm. My left arm was swollen and raised bump with a rash. I called my doctor and he thought it was possible cellulitis. He prescribed Prednisone and an antibiotic for seven days. After the seven days my rash was gone but I still had the raised bump. I went to an urgent care facility where they performed an ultrasound of left upper extremity and no blood clot was found. I was told to apply warm compresses to my left arm once a day. To this day I still have an aching sensation to my left arm and is also sore and my left arm is still red but flat in shape.


VAERS ID: 1292699 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-09
Onset:2021-04-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, Hypoaesthesia, Inflammation, Muscular weakness, Pain, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

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

Write-up: Arm and body pain that does not go away with medication, inflammation, leg pain left side of body feels hot and arm is starting to feel numb/weak and it is spreading to face and the rest of the left side of the body.


VAERS ID: 1292741 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-09
Onset:2021-04-22
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anticoagulant therapy, Chest X-ray, Computerised tomogram thorax abnormal, Deep vein thrombosis, Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Cardiomyopathy (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CT w/PE protocol Chest Xray
CDC Split Type:

Write-up: DVT w/PE 13 days post vaccination. Two day admission to hospital. Treatment of Eluiquis ongoing.


VAERS ID: 1292891 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-13
Onset:2021-04-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Hypoaesthesia, Limb discomfort, Muscle spasms, Pain in extremity, Ultrasound scan, X-ray
SMQs:, Peripheral neuropathy (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Ultrasound Blood work Xrays 3 visits to the ER
CDC Split Type:

Write-up: Pain on both legs, heaviness, numbness cramps


VAERS ID: 1292896 (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: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Flushing, Hyperhidrosis
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (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-Medium, Systemic: Flushed / Sweating-Medium


VAERS ID: 1292994 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-05-06
Onset:2021-05-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), 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: Citalopram 20mg, Amlodipine 5mg, Metformin 500mg, Metoprolol ER 25mg,
Current Illness: none
Preexisting Conditions: Diabetes, asthma
Allergies: KNDA
Diagnostic Lab Data: none
CDC Split Type:

Write-up: After administering the Janssen vaccine the patient began to have dizziness and difficulty breathing. The patient''s airway did not completely close up as he was able to respond and talk to me. Called 911 and administered 10mL (25mg) of Diphenhydramine and gave the patient a bottle of water. He was already worked up as he was scared of needles. He continued to breath better but still had difficulty. The EMT arrived in under 5 minutes as they were already on a call close by and was rerouted. EMT administered breathing treatment and took vitals and eventually took the patient to the hospital as a precaution. (Technician administered vaccine)


VAERS ID: 1293085 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-05-06
Onset:2021-05-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Hypoaesthesia, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 188/128, 84, 20, 99% RA
CDC Split Type:

Write-up: c/o numbness and tingling in both extremities for 2 days. Became dizzy after vaccine


VAERS ID: 1293097 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-05-05
Onset:2021-05-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Confusional state, Dizziness, Dyspnoea, Fatigue, Injection site pain, Lethargy, Syncope, Tremor, 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), Dementia (broad), 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), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Site: Pain at Injection Site-Mild, Systemic: Allergic: Difficulty Breathing-Medium, Systemic: Confusion-Severe, Systemic: Dizziness / Lightheadness-Severe, Systemic: Exhaustion / Lethargy-Severe, Systemic: Fainting / Unresponsive-Severe, Systemic: Shakiness-Severe, Systemic: Weakness-Severe


VAERS ID: 1293109 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Puerto Rico  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood glucose increased, Computerised tomogram, Contusion, Dyspnoea, Full blood count, Peripheral swelling, Pyrexia, Tremor, Ultrasound scan
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 9 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: HUMALOG INSULIN AND LANTUS INSULIN
Current Illness: DIABETES
Preexisting Conditions: DIABETES
Allergies: NO
Diagnostic Lab Data: CT SCAN, COMPLETE BLOOD WORK, SONOGRAM
CDC Split Type:

Write-up: PATIENT INDICATED BLOOD GLUCOSE WAS 500, TREMORS, FEVER, SWOLLEN FEET, DIFFICULTY BREATHING, BRUISES IN ARMS AND THIGHS


VAERS ID: 1293230 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-07
Onset:2021-05-03
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN N/A / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Deep vein thrombosis, Erythema, Heparin-induced thrombocytopenia test positive, Peripheral swelling, Pulmonary embolism, Subclavian vein thrombosis
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received J&J covid vaccine on 4/7/2021. Patient presented to the ED on 5/3 for right arm swelling with redness. Patient was found to have proximal right upper extremity DVT extending to right subclavian vein along with bilateral PE in the ED. The provider noted the patient had no risk factors other than receiving the vaccine, requested a hematology/oncology consult for evaluation hypercoagulable , patient started on bivalirudin while HIT work-up completed plan to transfer to oral anticoagulation upon discharge.


VAERS ID: 1293287 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-16
Onset:2021-03-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain upper, Cholelithiasis
SMQs:, Acute pancreatitis (broad), Gallbladder related disorders (narrow), Gallstone related disorders (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: I experienced upper abdominal pain and it would not go away. I went to the urgent care and it turns out it was gall bladder stones.


VAERS ID: 1293291 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Vermont  
Vaccinated:2021-04-11
Onset:2021-04-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Atrial fibrillation, Blood pressure increased, Blood test, Nausea, Palpitations, Sensory disturbance
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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: n/a
Current Illness: n/a
Preexisting Conditions: arthritis; skin CA
Allergies: clams
Diagnostic Lab Data: Blood enzymes vitals
CDC Split Type: vsafe

Write-up: 4/11 11:30 vaccination 11:40 I felt had a head rush and my heart started pounding like it never had before. I reported back to the EMTs on site. They monitored me. After another 10 minutes, I was not feeling better, nauseous. My BP rose and I went into a fibrillation. They transported me at that time to the ER. The Afib went away on its own. It was probably an hour at the mobile clinic and ER ride; by the time I had arrived my afib had resolved on its own. Discharged Heart palpitations over the next few weeks. The following Sunday, I started to feel like I was going back into Afib. By the time I got there, everything was ok. They sent me home with a heart monitor for 48 hours. I will get the information on 5/7/2021. *5/7/2021 follow up appointment with PCM to find results of HR monitor.


VAERS ID: 1293356 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Blood test abnormal, Pain in extremity, Thrombosis
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: lexapro, vit d3, k2
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: Sonogram
CDC Split Type: vsafe

Write-up: 4/10/2021 vaccination 4/11 or 4/12 at the latest, I started feeling a pain in my R calf. It was constant pain for a week and decided to go to the walk in clinic. Blood work which was high and they referred me to the ER and administered a sonogram. *positive for blood clot Eloquence for 30 day starter pack. PCM is going to extend till July in which he will administer another sonogram. *COVID +; 01/2021


VAERS ID: 1293364 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-15
Onset:2021-03-24
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Biopsy skin abnormal, Cutaneous vasculitis
SMQs:, Severe cutaneous adverse reactions (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Vasculitis (narrow), Skin tumours of unspecified malignancy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Benadryl , zquil
Current Illness: None
Preexisting Conditions: None
Allergies: Vanilla extract, lavender
Diagnostic Lab Data: Skin biopsy ( left and right legs) Skin punch collected on 4/9/21 Lab received 4/12/21 Final report 4/16/21 Diagnosis: Leukocytoclastic Vasculitis For both legs
CDC Split Type:

Write-up: Leukocytoclastic Vasculitis Flare ups lasted 1 week. Prednisone 20 MG for 4 weeks


VAERS ID: 1293365 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-05-06
Onset:2021-05-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / N/A RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Malaise, Nausea, Throat tightness
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (broad)

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

Write-up: Patient complaining of feeling ill about 4 minutes after vaccine was given. Patient complained about nausea and felt like she was going to vomit. She never did vomit. She then complained of trouble breathing " my throat feels like it is closing" She continued to complain of trouble breathing therefore EMS was initiated and 0.3mg of epinepherine was given in right thigh via epipen. This was at 2:14pm. EMS arrived and patient was taken to Hospital ER.


VAERS ID: 1293400 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-01
Onset:2021-04-07
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Headache, Magnetic resonance imaging head abnormal, Scan with contrast abnormal, Tunnel vision
SMQs:, Malignancy related therapeutic and diagnostic procedures (narrow), Optic nerve disorders (broad), Retinal 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, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: NKDA
Diagnostic Lab Data: Brain MRI: Small area of cortical enhancement involving the left posterior temporal lobe/occipital lobe. No associated restricted diffusion to suggest acute ischemia. Findings may be infectious, inflammatory, or secondary to recent ischemia. Correlate with prior imaging.
CDC Split Type:

Write-up: From Physician H&P: Patient is a 59-year-old man multiple medical chronic conditions, including known protein S deficiency not on anticoagulation, sinus bradycardia, hypercholesterolemia, chronic neuropathy of the lower extremities, who presented to the emergency room at the recommendation of his primary care office for possible stroke and persistent headache. He reports that his history of present illness begins on 4/7/2021, for which after he had received the COVID-19 Johnson & Johnson vaccine he started to have throbbing headache. He stated that it was diffuse and pounding in quality, up to 10 out of 10 pain. However this resolved on its own, and since then and has been intermittent with this type of headache. He did report 2 weeks ago, that he had a brief episode of tunnel vision as he describes it, where his vision seemed to narrow while he was looking at his phone. This only lasted no more than 10-30 minutes, and this resolved on its own as well. He continues to have intermittent headaches, again otherwise nonspecific with pounding quality however the intensity is improved. Humidifier regarding the Johnson & Johnson vaccine to report any side effects, for which she had notified his primary care doctor who then decided to proceed with MRI of the brain to evaluate for possible etiology. The MRI was done with and without contrast at facility on 5/4/2021, for which there was concern for possible left temporal posterior stroke, and if there was any concern for venous thrombosis, further imaging was necessary. He was then recommended to go to the emergency room for evaluation. He otherwise is in his regular state of health. He denies any recent fever or chills or cough, no chest pain or shortness of breath, nausea, vomiting, abdominal pain. No changes in bowel or bladder habits.


VAERS ID: 1293426 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-05-06
Onset:2021-05-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Hyperhidrosis, Malaise, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: SPECIFICS UNKNOWN - REFERENCED OTHER INJECTIONS
Other Medications: NOT FULL HISTORY
Current Illness: NONE PRESENT
Preexisting Conditions: SOME GASTRIC PROBLEMS - PAST YEAR OR SO
Allergies: NOT FULL HISTORY
Diagnostic Lab Data: PENDING
CDC Split Type: 05062112171962

Write-up: PATIENT RECEIVED DOSE AT 11:30AM, AND FELT OK. WAS APPREHENSIVE BEFORE RECEIVING AND ADMITTED BEING FEARFUL YESTERDAY. SHE WALKED TO THE FRONT OF THE STORE AND ALERTED MY TECH THAT SHE WAS NOT FEELING WELL. PATIENT WAS SHAKY AND SWEATING, AND GENERALLY FEELING UNWELL. SHE FELT ''FAINT'' AND WE HELPED HER TO A CHAIR. A BYSTANDER, NURSING AIDE, ASSISTED IN CALMING PATIENT. APPROX 11:40 PATIENT FELT SOME CHEST PAIN AND WE HAD ACTIVATED EMS TO EVALUATE. RESPONSE WAS APPROX 11:46 AND SHE WAS ASSESSED. PARAMEDIC SUGGESTED PATIENT BE CHECKED UP TO THE LOCAL EMERGENCY DEPARTMENT. TRANSPORTED APPROX 11:52.


VAERS ID: 1293439 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-05-06
Onset:2021-05-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Hypotension
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (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: None
Current Illness: None
Preexisting Conditions: None
Allergies: None that I am aware of
Diagnostic Lab Data:
CDC Split Type:

Write-up: Dizziness caused by low BP


VAERS ID: 1293539 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-05-06
Onset:2021-05-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Balance disorder, Chest pain, Dizziness, Dysstasia, Erythema, Headache, Hypoaesthesia, Nausea, Photophobia, Skin warm, Vertigo
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Corneal disorders (broad), Retinal disorders (broad), Vestibular disorders (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

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

Write-up: Patient experienced sudden dizziness and nausea within 5 minutes of receiving Janssen COVID-19 immunization. Gave her water, crackers and cold/wet rags for her forehead as she felt hot. Took her temperature, returned normal. Gave her a trash can to keep near. Kept an eye on the patient and realized she was getting red in the face and more dizzy than she had been. Went out and stood next to patient, with her mom on her other side. Began to experience light sensitivity, feeling like the room was spinning. Patient almost fell out of the chair while sitting still. Mom used a personal pulse oximeter on patient, all results normal. Asked the patient about other symptoms, such as chest/abdominal/leg pain, headache, shortness of breath. Patient reported a headache, dizziness, nausea and leg numbness roughly 30 minutes following the vaccine. I recommended going to the ER, mom believed it would pass with time, but insisted she never responds this way to immunizations. Patient began to experience stabbing chest and abdominal pain around 45 minutes. Patient''s mom was still hesitant to take her to the ER immediately on her own and asked us to call her PCP. He wanted the patient to go to the ER. Patient believed she would fall if she stood, offered to get a motorized cart, wheelchair or call an ambulance to transport her. Both patient and mom requested the ambulance. Asked a technician to check patient medications and allergies for EMTs, retook the patient''s temperature which was normal again. Stayed with patient until EMTs arrived, reported all symptoms patient was experiencing.


VAERS ID: 1293591 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-03
Onset:2021-04-06
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / N/A LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Induration, Nodule, Pain, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (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: progesterone shots
Current Illness: no
Preexisting Conditions: chronic bronchitis; might have asthma
Allergies: sulpha
Diagnostic Lab Data: no
CDC Split Type: vsafe

Write-up: I didn''t have any side affects except for pain and stinging my arm and a really hard lump that lasted for about four weeks. It''s tiny now - I can still feel it but for the most part it''s down to just a little lump. Went to Urgent Care - about two weeks after the vaccine. Topical ointment was given to me and was told to take Benadryl. I took it for two days and then went to see the other doctor and he said that the ointment wouldn''t do anything and it hadn''t so I stopped taking the Benadryl and using the ointment. That doctor wrote down how big the lump was. It was a few cm around. His


VAERS ID: 1293595 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-30
Onset:2021-03-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / N/A RA / IM

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

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Eliquis
Current Illness:
Preexisting Conditions:
Allergies: Bee Stings-Anaphylactic
Diagnostic Lab Data: Ultrasound-04/13/2021 Blood Tests
CDC Split Type: vsafe

Write-up: The evening of the shot I woke up with pain in my legs near my hips which lasted for a day. On 04/12/2021 my left leg was swollen and painful. I was already taking blood thinner. I went to the Emergency Room the next day and they found a blood clot in my leg. The Thrombosis was behind my left knee. My leg was swollen from the knee down and my ankle was very swollen. My Eliquis dosage has been increased from 2.5mg to 5mg twice daily. I did not have a repeat sonogram but my leg is no longer swollen.


VAERS ID: 1293663 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-06
Onset:2021-05-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood glucose normal, Fall, Foaming at mouth, Heart rate increased, Hyperhidrosis, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: novolin N insulin, lisinopril/hctz, rosuvastatin, phenteramine
Current Illness:
Preexisting Conditions: diabetes, HTN, hypocholesteremia
Allergies: NKA
Diagnostic Lab Data: unknown, patient was taken to ER, only took blood sugar which was 146
CDC Split Type:

Write-up: Patient within 5 minutes after receiving injection was being monitored and began to slump forward in the chair. The patient quickly became completely unconscious and was helped to the floor. The patient was presenting with seizure like symptoms, foaming at the mouth and loss of body functions. Patient remained unconscious for 1 minute or less before regaining consciousness. He was able to speak immediately after. Patient had a rapid heart rate and was sweating. Patients blood pressure was elevated as well. Patients blood sugar was tested and was 146. 911 was called immediately at time of emergency and when they arrived they help that patient sit up. They took the patient to the emergency room since he did not immediately regain all functions and this vitals remained elevated.


VAERS ID: 1293664 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-18
Onset:2021-03-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / N/A RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Diarrhoea, Gastric haemorrhage, Haematochezia
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Pseudomembranous colitis (broad), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Noninfectious diarrhoea (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: Synthroid; blood pressure pills: Varanpronil - 200 something; Losartan with Potassium; water pill
Current Illness: no
Preexisting Conditions: High blood pressure; asthma; hashimoto''s disease - all chronic but under control
Allergies: Any type of antibiotic with sulphur
Diagnostic Lab Data: No - just an exam and asked a lot of questions at Urgent Care on Saturday or Sunday.
CDC Split Type: vsafe

Write-up: The day of the vaccine, in the evening, I got severe stomach cramps and then I got diarrhea really bad. The cramps went on all night into the next day. They were so painful - like labor pain. The next day, I had a GI hemorrhage - it was clots of blood coming out of the digestive system. I contacted my regular practitioner doctor and sent him a picture of the clots and he instructed me to go to ER. I ended up going to Urgent Care. I went to the Urgent Care on Saturday or Sunday. The Urgent Care doctor there thought I had food poisoning. But that day I didn''t eat anything - I just had had ginger ale, cranberries and cashews. He was puzzled as to why I had these symptoms. He gave me medication to stop the cramping in my stomach. Medication is: Hyoscyamine. I used it even two weeks after the fact because I would occasionally get real bad stomach cramps. I was also referred to get a colonoscopy - haven''t been able to get in yet. The GI hemorrhaging lasted two or three days and then disappeared.


VAERS ID: 1293851 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-10
Onset:2021-04-21
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Aplastic anaemia, Biopsy bone marrow, Haemoglobin decreased, Increased tendency to bruise, Neutrophil count decreased, Platelet count decreased, White blood cell count decreased
SMQs:, Agranulocytosis (narrow), Haematopoietic cytopenias affecting more than one type of blood cell (narrow), Haematopoietic erythropenia (narrow), Haematopoietic leukopenia (narrow), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Systemic lupus erythematosus (broad), Myelodysplastic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (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, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: Slight fatigue 3 days prior to vaccination.
Preexisting Conditions: None
Allergies: NKDA
Diagnostic Lab Data: 4-22-21 ANC 0.7 / WBC 2.5 / Hgb 9.3 / Plt 12 Bone marrow biopsy completed 4/26/21 - results
CDC Split Type:

Write-up: Pt with increased bruising - presented to ED - admitted to the hospital - continued workup and pt with BM results aplastic anemia.


VAERS ID: 1293939 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-06
Onset:2021-05-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure increased, Chest discomfort, Dyspnoea, Throat tightness, Tongue disorder
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Hypertension (narrow), Cardiomyopathy (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: Flu shot has caused cellulitis 3 times previously, but no history of allergic reaction to injectables.
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Type 1 diabetes, other conditions unknown
Allergies: Jalapenos (anaphylactic shock), sulfa drugs (anaphylactic shock), morphine (hives), Tylenol (hives)
Diagnostic Lab Data: After first dose epinephrine: BP 143/105 (elevated over patient normal of 120s/80s), HR 114
CDC Split Type:

Write-up: Patient began experiencing chest tightness between 10-15 minutes after vaccination, followed by throat tightness and tongue thickness. Banophen (diphenhydramine) 50 mg administered PO. Shortness of breath began about 10 minutes after initial complaint, at which time epinephrine 0.3 mg was administered IM R thigh. Patient reported increasing shortness of breath and tightness of chest and throat, 0.3 mg epinephrine administered again IM left thigh about 6 minutes after previous dose. Patient requested additional diphenhydramine, so 50 mg Banophen administered PO. Continued increasing severity of symptoms, another epinephrine 0.3 mg IM right thigh 7-9 minutes after previous dose. Patient care was then transferred to EMS services.


VAERS ID: 1294015 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Utah  
Vaccinated:0000-00-00
Onset:2021-03-18
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chest discomfort, Fluid retention, Oedema peripheral, Peripheral swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210503860

Write-up: FEET SWELLING UP; EDEMA IN LEGS; PRESSURE ON CHEST; WATER RETENTION; This spontaneous report received from a patient via a company representative concerned a 51 year old female. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown, and batch number: 1805029 expiry: UNKNOWN) dose was not reported, administered on 15-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 2021, the subject experienced water retention. On 18-MAR-2021, the subject experienced feet swelling up. On 18-MAR-2021, the subject experienced edema in legs. On 18-MAR-2021, the subject experienced pressure on chest. Treatment medications (dates unspecified) included: furosemide. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from pressure on chest, feet swelling up, and edema in legs, and the outcome of water retention was not reported. This report was non-serious.


VAERS ID: 1294016 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Computerised tomogram, Peripheral swelling, Swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Name: CT scan; Result Unstructured Data: normal
CDC Split Type: USJNJFOC20210504056

Write-up: NECK SWOLLEN; LEFT ARM SWOLLEN TO WRIST; This spontaneous report received from a patient via a company representative concerned a female of unspecified age. The patient''s weight, height, and medical history were not reported.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unk) dose, start therapy date were not reported for prophylactic vaccination. Batch number was not reported. Per procedure, no follow up will be requested for this case. No concomitant medications were reported. On an unspecified date, the subject experienced neck swollen, and left arm swollen to wrist. Laboratory data (dates unspecified) included: CT scan (NR: not provided) normal. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the neck swollen and left arm swollen to wrist was not reported. This report was non-serious.


VAERS ID: 1294052 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Florida  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Facial pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Glaucoma (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210507588

Write-up: PAIN IN SIDE OF FACE; TINGLING; This spontaneous report received from a consumer via a company representative concerned a patient of unspecified age and sex. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On an unspecified date, the subject experienced pain in side of face, and tingling. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the pain in side of face and tingling was not reported. This report was non-serious.


VAERS ID: 1294127 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: New York  
Vaccinated:2021-05-06
Onset:2021-05-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

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

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

Write-up: Patient fainted for 1 to 2mins after receiving the vaccination. This happened 5 to 6 mins after the injection. The patient was sitting down, so I approached to see if it was an allergic reaction or not. I checked for breathing and had another patient call 911. Patient woke back up while we had the 911 operator on the phone. He asked for some water and he felt light headed.


VAERS ID: 1294131 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-03-24
Onset:2021-03-28
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: School       Purchased by: ?
Symptoms: Blood test normal, Computerised tomogram normal, Confusional state, Electrocardiogram normal, Electroencephalogram normal, Gene mutation identification test negative, Headache, Lumbar puncture normal, Magnetic resonance imaging normal, Neurological symptom, Scan with contrast normal, Seizure, Venogram normal, Vision blurred
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Naproxen
Diagnostic Lab Data: CT CT MRI MRI with contrast MRV LP EKG EEG Genetic testing, bloodwork All are negative
CDC Split Type:

Write-up: 3/31 stroke like symptoms ED with admission for testing 4/20 stroke like symptoms ED with admission for testing 4/27 seizure 4/28 seizure during MRV confirmed no stroke 5/2 15 seizures ED visit to stop seizure activity 5/3 19 seizures, admission for LP and EEG study 5/4 4 seizures discharged, tests inconclusive 5/5 2 seizures 5/6 2 seizures All are accompanied by severe headache, blurred vision, confusion


VAERS ID: 1294449 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Amnesia, Asthenia, Computerised tomogram head normal, Electrocardiogram normal, Feeling abnormal, Hypersomnia, Malaise, Mobility decreased, Neurological symptom, Pain in extremity, Peripheral swelling, Pharyngeal swelling, Rash, Swelling face, Swollen tongue, Ultrasound Doppler normal, Urine analysis normal
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Dementia (broad), Parkinson-like events (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Depression (excl suicide and self injury) (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (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? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Marlissa Seroquel
Current Illness: UTI
Preexisting Conditions: Possible endometriosis and possible Gastroparesis, Anxiety and depression
Allergies: None
Diagnostic Lab Data: Your analysis, CT of the brain, ECG 12 lead, peripheral venous duplex of upper arm.
CDC Split Type:

Write-up: Pt''s throat and tongue and jaw felt like it was swelling. She had extreme pain in her arm and her hands started swelling. She got a rash on her arms and on her hands. I took her to the urgent care facility and they gave her a shot of Decadron and a shot of Benadryl. They also Prescribed steroids. She was very sick like she had a severe flu. I was very worried as her mother. She was weak and slept constantly. Her arm could barely move and It almost appears as if she had had a stroke. She had brain fog and she wasn''t remembering her days like she was missing memory. After five days, the reaction started up again so we took her to the emergency room. They did a variety of tests including a urinalysis, CT of the brain, ECG 12 lead, peripheral venous duplex of her upper arm. Everything checked out OK so they put her on more steroids and sent her home. Pt is still having arm pain a month later but finally feels better.


VAERS ID: 1294490 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-04-05
Onset:2021-04-13
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: olmesartan hctz, dipyridamole, amlodipine, simvastatin, multi vitamin, fish oil, zinc
Current Illness: none
Preexisting Conditions: stroke 15 years ago
Allergies: none
Diagnostic Lab Data: ultra sound
CDC Split Type:

Write-up: blood clot in left leg calf


VAERS ID: 1294513 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-04-07
Onset:2021-05-07
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Blood test, Computerised tomogram, Confusional state, Dyspepsia, Dyspnoea, Electrocardiogram, Fatigue, Feeling abnormal, Headache, Hypoaesthesia, Motion sickness, Nausea, Neck pain, Ultrasound scan, X-ray
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Arthritis (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec night before
Current Illness: Sinus infection
Preexisting Conditions: None
Allergies: Wheat, malt, barley, rye, rice, dairy, onion, egg, shellfish
Diagnostic Lab Data: CT, x-rays, ekg and the scans for clotting, blood tests over the past month. Multiple visits to doctor, med checks, one ER trip
CDC Split Type:

Write-up: 2 weeks of intense nausea, confusion, foggy, fatigue, motion sickness, headache, arm numbing, heart burn, short of breath, neck pain, shoulder pain. Neck pain and shoulder pain remain at 4 weeks post vaccine. Pain level 9 on a 1-10 scale.


VAERS ID: 1294545 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-13
Onset:2021-05-07
   Days after vaccination:55
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Cerebrovascular accident, Computerised tomogram head abnormal, Echocardiogram, Hypoaesthesia, Limb discomfort, Magnetic resonance imaging head abnormal
SMQs:, Peripheral neuropathy (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Sexual dysfunction (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 15 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Penicilyn
Diagnostic Lab Data: Cats can. MRI. Echocardiogram Diagnosis was Stroke CVA
CDC Split Type:

Write-up: My left foot felt very heavy then my left lower leg started to get numb. We all 911 by the time the ambulance came my left arm was getting numb. I was transported in helicopter to regional Hospital I was having a stroke


VAERS ID: 1294656 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-05-04
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Lymphadenopathy, Rash erythematous, Urticaria, Vital signs measurement
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: Abstains from alcohol; Non-smoker
Preexisting Conditions: Comments: The patient had no known drug allergies.
Allergies:
Diagnostic Lab Data: Test Date: 20210504; Test Name: Vital signs measurement; Result Unstructured Data: not reported
CDC Split Type: USJNJFOC20210507890

Write-up: ITCHY HIVES; SWOLLEN LYMPH NODES NEAR THROAT; RED RASH ON LEG; This spontaneous report received from a patient concerned a 38 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included non-alcohol user, and non-smoker, and other pre-existing medical conditions included the patient had no known drug allergies.The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 204A21A, and batch number: 204A21A expiry: 23-JUN-2021) dose was not reported, administered on 04-MAY-2021 13:00 for prophylactic vaccination. No concomitant medications were reported. On 04-MAY-2021, the subject experienced swollen lymph nodes near throat. On 04-MAY-2021, the subject experienced red rash on leg. Laboratory data included: Vital signs measurement (NR: not provided) not reported. On 04-MAY-2021 17:00, the subject experienced itchy hives. The action taken with covid-19 vaccine was not applicable. The patient recovered from itchy hives on 04-MAY-2021, was recovering from red rash on leg, and had not recovered from swollen lymph nodes near throat. This report was non-serious.


VAERS ID: 1295048 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-04-08
Onset:2021-04-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Chills, Cough, Fatigue, Myalgia, Nausea, Pyrexia, SARS-CoV-2 test
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations: Flu Vaccine, over 30 years ago.
Other Medications: Insulin 70/30
Current Illness: None
Preexisting Conditions: Type 2 diabetes, chronic lung condition
Allergies: Hydromorphine
Diagnostic Lab Data: Blood work, Lung X-Ray and Covid 19 Test
CDC Split Type:

Write-up: Chills, Fever, Muscular Aches and Pain, Coughing, Nausea, and Feeling Tired.


VAERS ID: 1295135 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-05
Onset:2021-04-19
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Blood test normal, Limb discomfort, Paraesthesia, Ultrasound scan normal
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: Minocycline, Scallops
Diagnostic Lab Data: Bloodwork to rule out anemia, diabetes, and vitamin deficiencies. Ultrasound to rule out blood clots.
CDC Split Type:

Write-up: Paresthesia in both lower legs and arms plus some joint paint in hands and elbow for 18 days to date. Symptoms are still occurring. I visited Urgent Care, Emergency Room, and Primary Care Doctor so far. Bloodwork and ultrasounds came back normal. Vaccine seems to be the only cause.


VAERS ID: 1295137 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-06
Onset:2021-05-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypotension
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: Systemic: Hypotension-Severe


VAERS ID: 1295141 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-05-06
Onset:2021-05-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Facial discomfort, Flushing, Headache, Hyperhidrosis, Injection site pain, Paraesthesia, Syncope, Tinnitus, Unresponsive to stimuli, Vision blurred, Visual impairment
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Peripheral neuropathy (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), Extravasation events (injections, infusions and implants) (broad), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Hearing impairment (narrow), 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: Site: Pain at Injection Site-Mild, Systemic: Dizziness / Lightheadness-Mild, Systemic: Fainting / Unresponsive-Mild, Systemic: Flushed / Sweating-Mild, Systemic: Headache-Mild, Systemic: Tingling (specify: facial area, extemities)-Mild, Systemic: Tinnitus-Mild, Systemic: Visual Changes/Disturbances-Mild, Additional Details: Within a few minutes, pt began to sweat/feel light headed/dizzy/ringing in the ears. Pt stated he felt like he was going to pass out. Pt reported no symptoms related to anaphylaxis. Pt did not lose consciousness and symptoms started improving within 10 minutes. Pt then noticed blurry vision which resolved. Pt''s BP was checked: 120/90, pulse WNL. Pt. was feeling fine but per PCP guidance, went to ER for a follow up when I followed up via phone. Reported no further issues after leaving pharmacy


VAERS ID: 1295200 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-03-19
Onset:2021-03-23
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN NOT KNOWN / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Acute kidney injury, Anticoagulant therapy, COVID-19, Chest tube insertion, Death, Dyspnoea, Encephalopathy, Endotracheal intubation, Intensive care, Mechanical ventilation, Peripheral ischaemia, Pyrexia, Renal replacement therapy, Respiratory failure, SARS-CoV-2 test positive, Shock, Thrombectomy
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (narrow), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (narrow), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypoglycaemic and neurogenic shock conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Chronic kidney disease (narrow), Hypersensitivity (narrow), Tumour lysis syndrome (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad), Hypokalaemia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-29
   Days after onset: 37
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 38 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: GERD, history of Afib and CVA
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt received Covid-19 vaccine on 3/19 then presented to ED with fever and shortness of breath on 3/23 admitted to the hospital found to be COVID 19+ and requiring 2L oxygen via NC. Treated with dexamethasone, remdesivir and empiric antibiotics. Following admission, O2 requirement increased, received tocilizumab then required transfer to the ICU on 3/29. On 3/31 developed right leg ischemia, underwent thrombectomy and heparin infusion then on 4/1 patient intubated due to increased need for respiratory support and had bilateral chest tubes placed, post-intubation course complicated by shock with AKI requiring pressor support, prolonged encephalolpathy. On 4/24 with worsening shock, hypoxemic resp failure, AKI requiring pressors and CRRT with broad spectrum antibiotics and resumption of stress dose steroids, the family was transitioned to comfort measures and passed away on 4/29.


VAERS ID: 1295283 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-05-04
Onset:2021-05-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205 A21 A / N/A LA / SYR

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

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

Write-up: Body turned red. Itching was extremely bad and started at 3:30 on May 4th. Got prescribed Vistaril and a steroid. Back at the ER on the 6th blotchy and red streaks and itching EVERYWHERE. Changed steroid and gave me cream


VAERS ID: 1295292 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-07
Onset:2021-04-14
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram head, Pain in extremity, Paraesthesia, Ultrasound scan normal
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Mucinex-D
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: amoxicillin
Diagnostic Lab Data: Head CT - negative for tumor/clots Sonogram on left leg - negative for clots Diagnosed with hypertension - taking lisinopril
CDC Split Type:

Write-up: When I got the vaccine I had an immediate sharp pain in my arm, almost like a nerve was pinched, and it went down my left leg. It lasted for about 20 minutes then went away. Seven days later I admitted myself o the hospital because my left leg was tingling. No blood clots in my leg were found and a head CT didn''t show any abnormalities. I still have the tingling in my left leg that I and going to see a neurologist for and will be getting blood tests done to see what else could be going on.


VAERS ID: 1295307 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-05-03
Onset:2021-05-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Chills, Computerised tomogram normal, Dyspnoea, Myalgia, Pain in extremity, Pyrexia, Ultrasound scan normal
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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: Multivitamin
Current Illness: 0
Preexisting Conditions: No long term illnesses
Allergies: Pecans, seasonal allergies, penicillin
Diagnostic Lab Data: Ultra sounds and cat scan on 5/4 came back clear for any clotting.
CDC Split Type:

Write-up: A few hours after vaccination the fever started and muscle aches/chills also began. Around 10:00 P.M., pain in the right calf started and light pain in the left side of the chest with shortness of breath. Patient went to the ER and was hospitalized for 1 day.


VAERS ID: 1295340 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-05-06
Onset:2021-05-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dry throat, Interchange of vaccine products, Throat irritation
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Medication errors (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Received first dose of Moderna on 1/19. Felt flushed, nauseous, anxious, and tightness in throat, hives on arms within 20-40 min
Other Medications: none noted
Current Illness: none noted
Preexisting Conditions: none noted
Allergies: Received first dose of Moderna on 1/19. Felt flushed, nauseous, anxious, and tightness in throat, hives on arms within 20-40 minutes of injection. Was given steroids and fluids in ambulance, later epinephrine at hospital following anaphylaxis symptoms. Received an allergy test for overall Moderna vaccine on 1/26 and had a reaction to PEG and Moderna dose. Any reactions to PEG were unknown prior to this event.
Diagnostic Lab Data: none at the time of the event on site
CDC Split Type:

Write-up: Pt. received 1st dose of Jannsen vaccine at 1503 by EMT. Approximately 25 min post vaccine administration she started to feel a "burning sensation" in her throat, similar to the reaction after her first dose of Moderna on 1/29/21. We observed her for another 10-15 min and then she c/o of dryness in her throat, no compromise to airway, but concern about possible delayed reaction to this vaccine admin. Decision was made to call 911 and have her evaluated at Medical Center. Transported via ambulance by FD


VAERS ID: 1295377 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-03-18
Onset:2021-03-25
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Computerised tomogram head, Electroencephalogram normal, Laboratory test, Magnetic resonance imaging head normal, Seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: premarin levothyroxine multivitamin d3 magnesium asa 81 mg turmeric
Current Illness: no illnesses.
Preexisting Conditions: hypothyroidism eczema
Allergies: codeine
Diagnostic Lab Data: ER visit, head CT 3/25/21 EEG 4/1/21 MRI head w/wo contrast 4/2/21 Full labs, normal.
CDC Split Type:

Write-up: seizure, 3/25/21


VAERS ID: 1295391 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-10
Onset:2021-04-18
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Biopsy bone marrow, Immunoglobulin therapy, Petechiae, Platelet count decreased, Thrombocytopenia
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Methylphenidate (chronically)
Current Illness: None
Preexisting Conditions: ADD
Allergies: PCN
Diagnostic Lab Data: As above
CDC Split Type:

Write-up: Severe thrombocytopenia (<2000) 8 days after vaccination resulting in widespread petechiae Hospitalized for IVIG and corticosteroid treatment with slow rise in platelets to 58,000 then discharged. Seen by me in clinic 4 days after discharge and repeat platelet count again <2000 and re-admitted. Bone marrow biopsy was reassuring and he was started on high dose prednisone (150mg/day) to be tapered over the next 6 weeks Discharged 5/1/2021 with follow up with me 5/5/2021 and follow up with hematology 5/7/2021


VAERS ID: 1295578 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: West Virginia  
Vaccinated:2021-04-02
Onset:2021-04-14
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / 1 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram abnormal, Magnetic resonance imaging normal, Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NA
Current Illness: wheezing at night, unintentional weight loss
Preexisting Conditions: HTN, DM2, BPH. chronic smoking, alcohol dependence, hx adrenal adenomas, thyroid nodules
Allergies: NKDA
Diagnostic Lab Data: CT scan, small pulmonary embolism, 4/14/21
CDC Split Type:

Write-up: Veteran scheduled for CT scan for screening for malignancy due to unintentional weight loss. Incidental finding of Tiny linear pulmonary embolus in lower lobe pulmonary arteries on the right that is nonocclusive. Follow-up MRI negative for malignancy. CT scan was completed 4/14/21. Patient was asymptomatic in terms of PE symptoms


VAERS ID: 1295589 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-04-04
Onset:2021-05-01
   Days after vaccination:27
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Anticoagulant therapy, Chest pain, Dyspnoea, Fibrin D dimer increased, Nausea, Pain, Pulmonary embolism, Troponin increased, Ventilation/perfusion scan abnormal
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Haemorrhage laboratory terms (broad), Myocardial infarction (narrow), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Respiratory failure (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Clonidine, Colchicine, Glipizide, Lisinopril-hydrochlorothiazide, metoprolol, tamsulosin
Current Illness: BPH,HTN, DM
Preexisting Conditions: BPH,HTN, DM
Allergies: No known allergies
Diagnostic Lab Data: VQ lung scan on 5/3/21 showed moderate to high probability for pulmonary embolus based on nuclear scanning. Also troponin on 5/3/21 was 0.44 ng/ml
CDC Split Type:

Write-up: On 5/2/21 patient presented to Emergency Room with Rt upper chest pain that is worse after meals and associated with vague nausea and some sob. Reported that pain was constant and burning in nature. Pt was admitted to hospital with mildly elevated troponin. D-dimer was greater than 20. Pt had a VQ lung scan which confirmed the diagnosis of pulmonary emobolus. Pt was given Enoxaparin 100 mg subcutaneously every 12 hours from 5/2-5/7. Then patient was started on Apixaban 10 mg po bid x 7 days which will transition to 5 mg po bid. Pt improved and will be discharged today 5/7/21.


VAERS ID: 1295596 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-04-09
Onset:2021-04-16
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A71A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anxiety, Dizziness, Fatigue, Feeling abnormal, Head discomfort, Hypoaesthesia, Menstruation irregular, Muscle spasms, Nausea, Paraesthesia, Vision blurred
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Fertility disorders (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: One a day, vitamin c, fiber, probiotic
Current Illness: None
Preexisting Conditions: None
Allergies: No known allergies
Diagnostic Lab Data: None
CDC Split Type:

Write-up: The day of and the first week after I only felt a little lightheaded. Seven days after the vaccine I began having dizzy spells, extreme fatigue and nausea, blurred vision, extreme right head pressure, floaty sensation, numbness and tingling in my right arm and leg, muscle spasms, and extreme anxiety. All things I have never experienced before. And they have persisted daily since they began. My first period one week after the injection was a couple days late and very light and only lasted a few days, which is also not normal roe me. I have short periods of relief and then the symptoms return. It is very scary and I need help. I have been to my pcp several times and the Er. They can?t explain my symptoms.


VAERS ID: 1295618 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-03-06
Onset:2021-03-15
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Amnesia, Anxiety, Cerebral disorder, Circadian rhythm sleep disorder, Dyspnoea, Emotional disorder, Insomnia, Loss of personal independence in daily activities, Retching, Vision blurred
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Hydroxyzine, tums
Current Illness: possible long covid
Preexisting Conditions: R-CPD, acid reflux, IBS, anorexia (when younger, no longer an issue but difficulty gaining weight)
Allergies: n/a
Diagnostic Lab Data: My partner who I am no longer with was a symptomatic covid person, and I was exposed to this person intimately. At the end of January when we broke up, I got nearly a dozen PCR swabs through a pharmacy, all coming back negative, but I was 100% exposed through saliva, bodily fluids, and just sleeping in the same bed. It is possible I had long-covid symptoms prior to receiving the J+J vaccine. I never experienced symptoms, and all tests came back negative, but I did not swab very far up my nose as the pharmacy makes you swab yourself. In March I went to the emergency room where I was told I had anxiety/depression. I went to an immediate care where I also described sexual dysfunction symptoms, although I have no recollection of this encounter (I received a bill in the mail). I also got at least 3 PCR covid tests in March as I thought I had possibly gotten covid. All turned up negative.
CDC Split Type:

Write-up: A week and a half approximately after the initial vaccination of the J+J covid vaccine I started having a course of strange symptoms. Insomnia, inability to focus on things directly in front of me (a hand in front of my face would go out of focus automatically after a second), blurred vision, short term/long term memory loss, severe emotional issues, difficulty breathing, anxiety. Shortness of breath at a certain point was so bad I thought I was not going to make it. One very troublesome symptom that culminated after weeks of 4 hours of sleep was that my brain started feeling "funny". The best way to describe it was a brain "orgasm" which I have never experienced before. At the same time I experienced dry heaving for several minutes, and severe shortness of breath. After this experience my symptoms gradually improved over the next week or two. Prior to this it felt like my brain was not getting enough oxygen/blood, which could have been feeding my insomnia. When I would try to sleep, I would wake up at 4 am gasping for air, as I felt like my breathing was labored when sleeping. I could not focus on my computer screen to do my job at home. Large amounts of melatonin seemed to help my brain feel better and get some rest. I took hydroxyzine for unrelated reasons prior to the vaccine injection as needed, however not too often. During March I did not take it, as I had experienced disruptions in circadian rhythm due to the medication. I feel it is possible I had a blood clot that has been described in the news, although now there may be no way to know for sure. I talked with my primary care physician about this, and he did not think this was the case because I was male. However I have a BMI of 18.7 and some issues females have such as TMJ and inability gain weight/anorexia diagnosis when younger. I also was recently diagnosed with an only recently described actual medical issue called R-CPD, which is the complete inability to burp or belch. I felt like during the time when I experienced the side effects, that this condition was heightened (bloating/loss of appetite). I lost quite a bit of weight during March, I usually weigh 135-140, and was down to 115 at a certain point. I am now back up to 130. I now take sertraline at 1/4 pill dosage to treat the anxiety I experienced as a result of these symptoms as well as some other personal issues. I experienced severe side effects from the sertraline taking it at full dosage, and still experience some at 1/4 pill dosage.


VAERS ID: 1295672 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-05-06
Onset:2021-05-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fall, Loss of consciousness, Skin laceration, 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), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hostility/aggression (broad), 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: Unknown
Preexisting Conditions: Unknown
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient experienced vasovagal syncope approximately 5 minutes following vaccination. Patient regained consciousness but was standing at time of incident and has a cut above eye after falling. He was taken by EMS to attend to the cut.


VAERS ID: 1295697 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-07
Onset:2021-05-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / N/A RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dysphonia, Flushing, Hyperhidrosis, Paraesthesia oral, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre 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: Flu vaccine. Patient receives hives and whole body aches and pains. Has not received it in the last 5 years due to these symptom
Other Medications: Loratadine 10 mg once daily
Current Illness: Mild Cold (sore throat)
Preexisting Conditions: Rheumatoid arthritis Asthma Spinal stenosis
Allergies: Eggs - anaphylaxis Sulfa - rash Pennicillin - rash, full body hives Tobramycin - rash Nitrofurantoin - rash Hydrocodone/Acetaminophen - rash
Diagnostic Lab Data:
CDC Split Type:

Write-up: Approximately 10 minutes after vaccine administration, patient reported tongue tingling and throat tightness. Nurse reported flushing. After arrival to the ED approximately 10 minutes patient also reported voice hoarseness and sweating. On arrival to ED, patient received Epinephrine 0.3 mg IM, diphenhydramine 50 mg IV, famotidine 20 mg IV and methylprednisolone 125 mg IV Patient began feeling better shortly after. Currently (~2.5 hours after vaccine administration), patient is sleeping in ER. Anticipated discharge later today with a steroid taper.


VAERS ID: 1295797 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-04-09
Onset:2021-04-15
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Acute kidney injury, Blood creatinine increased, Blood potassium increased, Blood urea increased, Chills, Decreased appetite, Diarrhoea, Haemodialysis, Nausea, Pyrexia, Respiratory symptom, SARS-CoV-2 test positive, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Acute pancreatitis (broad), 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), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Chronic kidney disease (narrow), Noninfectious diarrhoea (narrow), Tumour lysis syndrome (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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? No
Previous Vaccinations:
Other Medications: losartan-HCTZ, acetaminophen, diphenhydramine
Current Illness: none
Preexisting Conditions: hypertension, hyperlipidemia
Allergies: none
Diagnostic Lab Data: Scr - 23.7, BUN - 179, K - 5.4 (5/2/21)
CDC Split Type:

Write-up: Patient received J&J Covid-19 vaccine on 4/9/21. Patient developed upper respiratory symptoms, fever, chills, nausea, vomiting, diarrhea, anorexia on 4/15/21. Patient tested positive for Covid-19 rapid test on 4/19/21. Patient presented to emergency department on 5/2 with continued symptoms. Patient found to be in acute renal failure with serum creatinine 23.7, BUN 179, and potassium 5.4. As of 5/7/21, patient''s renal function has improved following daily hemodialysis and will be monitored for further renal recovery.


VAERS ID: 1295856 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-03-13
Onset:2021-04-08
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / 1 RA / UN

Administered by: Private       Purchased by: ?
Symptoms: Cardiac monitoring, Computerised tomogram head, Echocardiogram normal, Hemiparesis, Hypertension, Magnetic resonance imaging head, Nerve compression, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Accidents and injuries (broad), Hypertension (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (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: lisinopril armour thyroid calcium supplement multi vitamin supplement
Current Illness: none
Preexisting Conditions: none
Allergies: penicillin shellfish
Diagnostic Lab Data: April 8 and 9 2021 the emergency room did a CT scan of my head, then an MRI of my head and then an Echocardiogram was also done I have also worn a Heart Monitoring system for almost two weeks which will be completed on Monday, May 10th and am awaiting results from that. As of now all the test results have shown no abnormalities or concerns
CDC Split Type:

Write-up: I had an event where my blood pressure was very high and the left side of my body became tingly and weak. I went to the doctor and stayed two nights for observation. They ran many diagnostic tests but nothing was diagnosed. I continued to have the tingling and weakness and began to feel it could be a pinched nerve in my back/shoulder. I went to a chiropractor and was treated twice for adjustments to my back, neck area and the tingling, weakness has not occurred again. I am monitoring my blood pressure at home and have a doctor check up scheduled for the end of this month. Confident it was not a medical event due to the Covid vaccine but still following up.


VAERS ID: 1295876 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-05
Onset:2021-05-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Glassy eyes, Hyperhidrosis, Pallor, Seizure like phenomena, Syncope, Vital signs measurement
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: not reported (unknown)
Current Illness: not reported (unknown)
Preexisting Conditions: not reported (unknown)
Allergies: not reported (unknown)
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient displayed syncope and observed contracting arms (those who witness expressed seizure like activity lasting less than one minute). Patient was pale and diaphoretic with a glazed over look. Vitals were taken and patient was transported to hospital for evaluation.


VAERS ID: 1295878 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-04-25
Onset:2021-04-26
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN EW0172 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Bed rest, Intermenstrual bleeding, Pregnancy, Premature labour
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Normal pregnancy conditions and outcomes (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: OTC prenatal vitamins, 3 DSA Fisho oil 9.5grams, baby aspirin
Current Illness:
Preexisting Conditions:
Allergies: None
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: On 04-25-2021 I started to bleed and spotting vaginally. My water broke and I went into labor. I was admitted to the hospital on 04-27-2021. I was in the hospital for one week. I had a covid-19 injection 04-26-2021 at 28 weeks. At the moment I am on bed rest up till my 36 weeks.


VAERS ID: 1295900 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-04-03
Onset:2021-04-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure increased, Dyspnoea, Headache, Swelling face, Swollen tongue
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Hypertension (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: I take Seroquel, Topamax, Lisinopril,
Current Illness: None
Preexisting Conditions: High Blood Pressure
Allergies: Sulfa, and Latex
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: My tongue swelled up. My face swelled I had problem breathing. I had a severe headache. My blood pressure went up to 181/119


VAERS ID: 1295921 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-05-07
Onset:2021-05-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Epistaxis, Face injury, Fall, Feeling hot, Mouth haemorrhage, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Haemorrhage terms (excl laboratory terms) (narrow), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Patient felt really hot. stood up and fainted. fell to the floor hitting her face. ended up with blood in the mouth and nose. Went with EMS


VAERS ID: 1295948 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-01
Onset:2021-04-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Generalised tonic-clonic seizure, Hyperhidrosis, Paraesthesia, Paraesthesia oral
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (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: Patient received vaccine in a drive up clinic and was waiting in his car during the 15 minute observation time. 10 minutes after the vaccine, he became lightheaded and alerted for medical attention. When we arrived at his car he was having tonic clonic seizure like activity which lasted about 20 seconds. Patient was reclined in his car seat, VS taken and stable. Oriented x4 but described feeling light headed, tingling in left arm and lips, and diaphoresis. EMS arrived and assumed care. Extended observation showed improving vital signs, and resolution of described symptoms. Patient was released from EMS care and was transported to the ER by a friend for further eval.


VAERS ID: 1296009 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-04
Onset:2021-04-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / N/A LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Ear pain, Fatigue, Feeling hot, Pain, Pain in extremity, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: A few minutes after the vaccine I had a lot of heat and pain in my left ear. My left ear is still painful after four weeks. I am scheduled to see an ENT doctor today. I had to go to the emergency room because I was throwing up starting two hours after the vaccine and I was in pain all over my body. I became extremely fatigued, and I could not stop throwing up. I was given Reglan, to stop the vomiting, and I am still taking it twice daily after four weeks. I was also given Benadryl which seemed to help. I tried to stop taking the nausea medicine after three weeks and the vomiting returned. I threw up eight times that day. I still have aches in my legs and ear pain every day after four weeks. My fatigue has improved a little.


VAERS ID: 1296069 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: New York  
Vaccinated:2021-05-06
Onset:2021-05-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1816022 / 1 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Consciousness fluctuating
SMQs:, Neuroleptic malignant syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)

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

Write-up: PATIENT WAS GIVEN COVID 19 SHOT , 10 MINUTES LATER PATIENT WAS IN AND OUT OF CONSCIOUSNESS . CALL 911, PATIENT WAS TAKEN TO THE ER


VAERS ID: 1296129 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-05-05
Onset:2021-05-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood urine present, Chills, Condition aggravated, Culture urine, Dysuria, Feeling hot, Genital discomfort, Hyperhidrosis, Influenza like illness, Pain, Urinary tract infection
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Neuroleptic malignant syndrome (broad), Hypoglycaemia (broad), Sexual dysfunction (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: over counter sleep aid medicine
Current Illness:
Preexisting Conditions: insomnia
Allergies: Vicodin
Diagnostic Lab Data: Urine test
CDC Split Type:

Write-up: pt says she had some uncomfortableness in her private area the morning she woke up to get her vax. She urinated before getting the vax. About 30 minutes after taking the vax she has to urinate again and she had pain while urinating and blood clots in her urine. She contacted her PCP and was told to the emergency room. On 5/5/21 she went to ER. They took vitals and gave her a urine test. Pt was diagnosed w/ UTI. They told her that the vax had flared up this condition. They gave her Nitrofurantoin mono-mcr 100mg and Phenazopyridine 200mg. She has other flu like symptoms including cold sweats, shivers, and body aches and pain, body is hot to the touch but no fever.


VAERS ID: 1296151 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-15
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood test normal, Chest pain, Dizziness, Electrocardiogram normal, Fatigue, Headache, Hypoaesthesia, Muscle fatigue, Muscle spasms, Musculoskeletal chest pain, Neck pain, Pain, Pain in extremity, Paraesthesia, Pruritus, Ultrasound Doppler normal
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Asthma
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: I got blood work, an EKG and ultrasound on my left leg done. Everything came out normal.
CDC Split Type:

Write-up: I started feeling fatigue and soreness in both of my legs and arms about a 5 after the vaccine. At day 7 I started to feel sharp, cramps, tingly sensation and numbness in different parts of my legs, arms feet and hands. I also had headaches and felt dizzy. Headaches went away by day 15, but the pain, tingly sensation and fatigue in my arms and legs still remain (tomorrow it?s going to be a month since I got my shot). It gets significantly worse when I walk and I feel very fatigued after walking for about 30 minutes. The pin has also appeared less frequently on other parts of my body, like my heart, my neck and around my rib area. Over the last two weeks my legs have also been getting itchy.


VAERS ID: 1296176 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Kansas  
Vaccinated:2021-04-09
Onset:2021-04-21
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Brain scan abnormal, Chest scan, Erythema, Headache, Paraesthesia, Swelling, Thrombosis, Transient ischaemic attack, Ultrasound Doppler abnormal
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Flexeril 5mg every night Lexapro, 5mg daily quinopril, 10mg daily topamax, 25mg in AM, 50mg every night prilosec, 40mg
Current Illness:
Preexisting Conditions: Asthma, migraines
Allergies: macrodantin augmentin
Diagnostic Lab Data: various scans of leg, head, neck, and heart
CDC Split Type:

Write-up: On 04/21 left knee pain, outside/back of knee 04/23 - left side tingling , went to urgent care and then referred to ED due to concern about stroke. Sent home after leg scan - was told it was normal and referred to neurologist 04/29 - back to ED, admitted overnight, scan from 04/23 showed blood clot behind the knee. Also diagnosed by neuro with TIA Also stated she had swelling, redness, and headaches for 4-5 days after vaccine


VAERS ID: 1296328 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-09
Onset:2021-04-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiac murmur, Chills, Electrocardiogram, Malaise, Muscle spasms, Pain, Pain in extremity, Pyrexia, Ultrasound scan normal
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Pulmonary hypertension (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: 2008 gardasil; lymph nodes
Other Medications: Allegra daily
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: penicillin
Diagnostic Lab Data: ultra sound; negative EKG; slightly abnormal
CDC Split Type: vsafe

Write-up: 4/9/2021 vaccination 4/10/2021 fever, malaise, body aches, chills. Lasted for 24 hours. 4/16/2021 cramping in leg, calf pain. Tried stretching, ibuprofen. Telemed. Keep eye on it, seemed muscular. Didn''t get better over next few days 4/18/2021 Couldn''t r/out blood clot. Noticed heart murmur. Sent me to ER to r/out blood clot. Referral to cardiologist. 4/20 observed heart murmur. blood work; normal. Echocardiogram week later 4/28 Echocardiogram results; ''Reaction to the vaccine''. Didn''t see anything alarming. To do normal check-ups with PCM. *COVID +; 12/9/2020


VAERS ID: 1296342 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-10
Onset:2021-04-16
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asymptomatic COVID-19, Blood test, Bone pain, COVID-19, Chest X-ray abnormal, Eosinophil count increased, Full blood count normal, Hypertension, Malaise, Monocyte count increased, Myalgia, Myocardial necrosis marker normal, Pain, Pain in extremity, SARS-CoV-2 antibody test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Hypertension (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (narrow), Osteonecrosis (broad), Hypersensitivity (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Aspirin 81mg, Multivitamin (Equate for Men), Tums as needed, Levothyroxine 50mcg
Current Illness: None
Preexisting Conditions: Hypothyroidism, joint pain, superficial blood clot in leg two years prior, bloody nose, undiagnosed prostate condition, cysts, lung burning
Allergies: Quinolones, Vantin, amoxicillin, Augmentin
Diagnostic Lab Data: LabCor (3/3/21) - positive COVID antibody test, asymptomatic at time of test ER (4/27 admission around 4:00am) Bloodwork - Normal cardiac enzymes, normal CBC and increased esosinophils, increased monocytes. Medical Imaging - X-ray, shadowing in pleural cavity Hematologist - did a blood draw of about 20 vials pending results at time of report
CDC Split Type:

Write-up: Beginning about 10 days after vaccination, the patient noticed pain in his arm and he started ?not feeling so great.? Over several days, this pain began to radiate and involve muscle and bone aches. He continued to feel ill to what he described as the worst symptoms on Monday, April 26th, which included severe pain, high blood pressure (211/113 documented by the ER), symptoms similar to cardiac event. The patient was seen by Emergency Department who did not find a diagnosis, but gave the patient medication to lower blood pressure and referred further treatment to his Primary Care Provider. Blood pressure mediation was taken to lower his blood pressure and clonidine 0.1mg was prescribed by his PCP because of elevated BP (over 150/90). The patient was also instructed to take Advil for pain and was referred to get an X-ray with follow up in 2 weeks on 5/13.


VAERS ID: 1296387 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-24
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Antinuclear antibody negative, Blood cholesterol increased, Blood folate normal, Blood thyroid stimulating hormone normal, C-reactive protein normal, Feeling hot, Full blood count normal, Gait inability, Glycosylated haemoglobin normal, Joint swelling, Limb discomfort, Lipids increased, Low density lipoprotein increased, Metabolic function test normal, Pain in extremity, Peripheral swelling, Pyrexia, Rash, Red blood cell sedimentation rate normal, Rheumatoid factor negative, Vitamin B12 normal, Vitamin D decreased, Weight bearing difficulty
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Dyslipidaemia (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Lipodystrophy (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: estarylla Birthcontrol
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: ESR Wes+ANA+CRP; Comp. Metabolic Panel (14); CBC, Platelet, No Differential; Lipid Panel; Vitamin B12 and Folate; Hemoglobin A1c; TSH; Rheumatoid Arthritis Factor; Vitamin D, 25-Hydroxy; Venipuncture. Outcome by my Physician Your RF, ANA, CRP, ESR, CRP reports are negative. Your TSH, Vitamin B12 level, folate level and HbA1c reports are within normal limits. Please continue with your Vitamin B12 supplement. Your CMP (comprehensive metabolic panel) and CBC (complete blood count) reports are unremarkable. Your Vitamin D level is 18.7 (desired is $g 30). I recommend that you take a Vitamin D 1000 IU tablet once daily. Your lipid panel includes total cholesterol 232 (desired is < 200) and your LDL cholesterol 140 (desired is < 130). I recommend a low cholesterol diet, and regular "cardio" exercise management. I recommend a consultation with the Wellness dietition. I recommend a recheck of your fasting lipid panel in one year with your annual medical visit.
CDC Split Type:

Write-up: 4/8/2021- After shot I had high fever fluctuated between 101-104 and went away next morning 4/12/2021- I saw 3 circular tiny rashes on my left chest, above my brests. It eventually lightened and went away after 2 weeks. 4/24/2021- I noticed inflammation in my left knee and it blew up by 4/26/2021 and I was not able to walk. 4/26/2021 Spoke with my primary physician and was advised to visit the urgent care, the pain was a 9 out 10 . 10 the extreme 4/26/2021 - Visited Urgent Care , Two injection were given Tordal and Decadron. Was prescribed Medrol 25mg for next 6 days 4/27/2021- There was no pain, there was swelling/inflammation present, Continued wearing compression socks and treated with ice pack 3-5 times a day 4/29/2021- Inflammation was gone 5/1/2021- Inflammation on right ankle, took advil 5/3/2021 - I had no issues(inflammation) until this weekend and also completed medrol dose . However, this morning I started seeing inflammation on my right ankle, this has started impacting my normal walk. I am using icepack and the socks to provide some relief. took advil and continued with ice pack and wearing compression socks 5/5/20211. the pain and inflammation has shifted to my top of right upper foot. feeling discomfort, swelling , warmth from my toe to area to the middle top of right foot.My walking is painful, if I put weight on my right foot. I had taken ibuprofen and continued wearing the socks. Also another development on my right hand wrist same thing , I could not brush with wrist movement toward the right side. 5/6/2021- Same pain and had a virtual visit with my primary physician 5/7/2020 - Going in for more lab work for uric acid level


VAERS ID: 1296439 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-05
Onset:2021-05-06
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Patient reports anaphylaxis to crab, shellfish, red dye, niacin, penicillin and povidone-iodine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient experience shortness of breath, hives, itching approx 8-12 hours post vaccination. No reaction reported within 4 hours post-injection


VAERS ID: 1296455 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-05-07
Onset:2021-05-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blindness, Feeling hot, Hyperhidrosis, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Retinal disorders (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: She said she has painted before with communization
Other Medications: None
Current Illness: None
Preexisting Conditions: Patient disclose information after the immunization that she faint sometimes when she gets immunized.
Allergies: None
Diagnostic Lab Data: Patient got warm was sweating fainted temporarily lost eyesight.... 911 was called.
CDC Split Type:

Write-up: Patient got warm was sweating fainted temporarily lost eyesight


VAERS ID: 1296456 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-09
Onset:2021-04-16
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chest X-ray abnormal, Computerised tomogram thorax abnormal, Dyspnoea, Pain, Pain in extremity, Pulmonary embolism, Thrombosis, Ultrasound Doppler abnormal
SMQs:, Anaphylactic reaction (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), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vitamin B12 5000mcg , Slow Release Iron 45mg, Hydrochlorothiazide 12.5 mg, Norethindrone and Ethinyl Estradiol 0.4/0.035 mg
Current Illness: Nothing
Preexisting Conditions: Nothing
Allergies: No Allergies
Diagnostic Lab Data: Test :Ultrasound on right leg - Result : Blood clot Test: Chest RX and CT Scan - Result : Blood clot in the left lung.
CDC Split Type:

Write-up: Sharp pain on right leg, difficulty breathing.


VAERS ID: 1296459 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-05-07
Onset:2021-05-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205C21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood glucose decreased, Blood pressure decreased, Dyskinesia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Dyskinesia (narrow), Noninfectious encephalopathy/delirium (broad), Hypoglycaemia (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: low dose aspirin, plavix
Current Illness:
Preexisting Conditions: heart attack 6 years ago
Allergies:
Diagnostic Lab Data: Slightly low blood sugar and blood pressure by EMS
CDC Split Type:

Write-up: Wife reported patient "jerked" forward while sitting and almost fell off chair to the left side


VAERS ID: 1296468 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-03-30
Onset:2021-04-07
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Amnesia, Blindness, Cerebral thrombosis, Cerebrovascular accident, Dysarthria, Gait disturbance, Headache, Magnetic resonance imaging head abnormal, Paraesthesia, Sensitive skin, Tenderness, Walking aid user
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Retroperitoneal fibrosis (broad), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (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, 21 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: Depression and PTSD
Allergies: No
Diagnostic Lab Data: MRI, and I cannot remember all the other test because I was under medicine and don''t have much memory
CDC Split Type:

Write-up: One week after vaccination, I had to all 911 and was put in the hospital, I had a stroke, I had a blood clot in my brain, and severe abdominal pain, and terrible headache where the clot was, I couldn''t see, my legs weren''t working right. My head was sensitive on the right side, like a tingling and sore to touch, then the headache started in the center of my head. I stayed in the hospital for 3 weeks. I''m home but have slurred speech and I use a walker now.


VAERS ID: 1296470 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-01
Onset:2021-05-04
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Dyskinesia, Dysstasia, Extraocular muscle paresis, Feeling abnormal, Gait disturbance, Hemiparesis, Jaw disorder, Scan normal, Speech disorder
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Dyskinesia (narrow), Parkinson-like events (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Vestibular disorders (broad), 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: Calcibon D Calcitrion Rivotril 0.5 mg (am) Lamictal 400 mg Wellbutrin 300 mg Brintellix 30mg Rivotril 0.5 (pm)
Current Illness: Hypothyroidism Depression Hyperparathiroidism Osteoporosis
Preexisting Conditions: Controlled Depression
Allergies: Allergy to plasil (for vomit)
Diagnostic Lab Data: I was at the hospital. They did a TAC scan and everything was perfect. Saturation OK Heart OK Presi?n OK
CDC Split Type:

Write-up: 1. Dizzy 30 mins later 2. As if I was drugged 1 hour later 3. Not speaking coherent 1:40 hour later 4. Walking supported/leaning by a wall 2:00 hours later 5. Could not walk alone and had involuntary movements 6. Dislodged jaw 7. Not standing by my self 9. Winking eyes and not able to open them 10. The left side was weaker than my right side


VAERS ID: 1296510 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-05-07
Onset:2021-05-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Seizure
SMQs:, Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (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: NO
Current Illness: NO
Preexisting Conditions: NO
Allergies: NO
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt. was light-headed right after she was injected with the Janssen vaccine which she explains happens when she gets shots. She started to seize after 2 minutes, which lasted for about 5 seconds. 911 was called and ambulance took her to the hospital.


VAERS ID: 1296626 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-30
Onset:2021-04-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Hemiparesis, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Noninfectious encephalitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), 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: Amlodipine, Aspirin, Atorvastatin, Isosorbide Mononitrate
Current Illness:
Preexisting Conditions: Obesity, Mild Asthma, HTN, Hyperlipedemia
Allergies: Penicillin v
Diagnostic Lab Data:
CDC Split Type:

Write-up: Lt sided weakness, subjective fevers, body aches, seen in the ER, continues to have symptoms


VAERS ID: 1296644 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: Rhode Island  
Vaccinated:2021-04-07
Onset:2021-05-04
   Days after vaccination:27
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Bell's palsy, Blood test, Computerised tomogram
SMQs:, Hearing impairment (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin ,levoxyl ,simvastatin, Januvia, amlodipine, omeprazole, losartan
Current Illness: none
Preexisting Conditions: diabetic
Allergies: levaquin
Diagnostic Lab Data: CT scan 5/6/21 Blood Work 5/6/21 Blood Work 5/7/21
CDC Split Type:

Write-up: Bell Palsey


VAERS ID: 1296667 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-10
Onset:2021-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness
SMQs:, Anticholinergic syndrome (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:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Lightheaded; EMS at bedside.


VAERS ID: 1296684 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-05
Onset:2021-05-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: Dysphagia, Dyspnoea, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None reported 2 weeks prior to vaccination
Preexisting Conditions:
Allergies: Anaphylaxsis to banana and melons
Diagnostic Lab Data:
CDC Split Type:

Write-up: This is a 57 year old male, received the Janssen COVID-19 vaccination on 5/4/21, at clinic in Jail, approx 10 minutes post vaccination, patient developed throat tightness, difficulty breathing and swallowing. He was immediately assessed by this writer, EMS activated as code. Given epi-pen to left thigh at 11:23, 50 mg of IM Benadryl to right deltoid at 11:25. Patient reported improvement in his throat tightness, shortness of breath and difficulty swallowing post epi-pen administration. Patient was sent to the ED


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