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From the 5/7/2021 release of VAERS data:

Found 188,897 cases where Vaccine is COVID19 and Patient Did Not Die



Case Details (Reverse Sorted by Onset Date)

This is page 40 out of 1,889

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VAERS ID: 1201999 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-08
Onset:2021-04-13
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

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

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

Write-up: Hives and itching on injection arm(5) and side(1). Was advised to take Benadryl


VAERS ID: 1202068 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Body temperature increased, Fatigue, Swelling, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: A temperature of 103.8 for more then 5 hours, excessive tiredness, swelling of the face and neck area. Extreme weakness


VAERS ID: 1202121 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-13
Onset:2021-04-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

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

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

Write-up: diaphoresis with shortness of breath


VAERS ID: 1202132 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 RA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Headache
SMQs:

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

Write-up: severe headache (uncommon) the morning after. Went away after 600 mg. of Motrin + 1,000 mg. of Tylenol


VAERS ID: 1202264 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-04-06
Onset:2021-04-13
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

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

Write-up: On day of: after 8 hours, intense chills of body. Muscle aches from shivering due to chills. Lasted about 4-6 hours, with no residual effects the next day. 7 days after administration: rashes all over body, including both arms, legs, and sides. Rashes were prominent and itchy during the morning, and slowly got better over the day. Daily Claritin was taken in morning.


VAERS ID: 1202280 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-04-08
Onset:2021-04-13
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling jittery, Hypoaesthesia, Palpitations, Paraesthesia, Sensory disturbance
SMQs:, Peripheral neuropathy (narrow), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Rosuvastatin 10mg Lisinopril 10mg
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: I have not contacted my doctor yet.
CDC Split Type:

Write-up: Thursday April 8th 1:00PM Shot was injected into my left arm 1:15PM left hand was numb and tingling 2:00 PM left side of my face went numb and tingled. cheek, ear, neck and into my hair line Friday (4/19) midnight my heart was racing for about 2 hours. It was like I drank WAY too much caffeine Sunday (4/11) my hand was back to "normal" Tuesday (4/13) my left side of my face is getting much better, but it still feels a little different


VAERS ID: 1202333 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-31
Onset:2021-04-13
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: No adverse event, Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

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

Write-up: PT WAS UNDER 18 AT THE TIME THE VACCINE WAS GIVEN. NO ADVERSE REACTION


VAERS ID: 1202351 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

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

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

Write-up: Patient has a rash on left hand that shoots up to the inside of his elbow


VAERS ID: 1202379 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-14
Onset:2021-04-13
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 UN / UN

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Computerised tomogram head, Dysphagia, Monoplegia, Paralysis
SMQs:, Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: no medications
Current Illness: none
Preexisting Conditions: Mild Hypertension, no prescribed medications
Allergies: No Known Allergies
Diagnostic Lab Data: CT Scan Head/brain, Chest X-ray, Blood work
CDC Split Type:

Write-up: Significant flaccid paralysis in the right arm and right leg with some difficulty swallowing


VAERS ID: 1202388 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-07
Onset:2021-04-13
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1898082 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Headache
SMQs:

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

Write-up: PT REPORTS ACUTE ONSET OF HEADACHE ON 4/13/2021. SEVERITY OF HEADACHE IS MILD. HA IS INTERMITTENT AND SEEMS TO COME ON AFTER EATING PIZZA


VAERS ID: 1202404 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-10
Onset:2021-04-13
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain, Chills, Fatigue, Nausea, Pain, Palpitations
SMQs:, Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)

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

Write-up: chills, body aches, abdominal pain, nausea, palpitations, fatigue


VAERS ID: 1202666 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN OU3A21A / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Fatigue, Headache, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Spironolactone and turmeric
Current Illness:
Preexisting Conditions:
Allergies: Mold
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever, chills, headache, fatigue, aches, pain in legs


VAERS ID: 1202715 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-02-04
Onset:2021-04-13
   Days after vaccination:68
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012M20A / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood culture, Cerebral haemorrhage, Computerised tomogram head abnormal, Headache, Impaired work ability, Magnetic resonance imaging head abnormal, Scan with contrast abnormal, Venogram
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Malignancy related therapeutic and diagnostic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: escitalopram 20mg daily zyrtec multivitamin omaga 3 albuterol inhaler PRN
Current Illness: none
Preexisting Conditions: thyroid nodule mild athsma depression anxiety
Allergies: none
Diagnostic Lab Data: MRI MRV MRI with contrast CT scan Labs - multiple tests, including blood cultures
CDC Split Type:

Write-up: I developed a sudden, sharp stabbing pain in the left side of my head while at work. I had not fallen nor had any injuries/illness. I went to ER; CT scan was concerning for clot in sinus so I was sent via ambulance to inpatient neurology where further MRI/MRV scans determined it was not in fact a clot, but a small bleed of unknown origin. Again, I had no injuries. I was hospitalized while multiple scans were completed along with lab work. Home now following up with neurology, still have head pain, unable to fully work, etc. Hematoma is still there but not growing.


VAERS ID: 1202772 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-10
Onset:2021-04-13
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Feeling hot, Mouth haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NOT KNOWN
Current Illness: NOTHING REPORTED
Preexisting Conditions: NONE
Allergies: NO KNOW ALLERGIES REPORTED
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient called on 04/13/2021 at 110pm reporting that when she woke up today, 04/13/2021 she had some blood on her pillow and said that the blood came out of her mouth. She did not think that she vomited the blood. She also reported some chills and worm feelings.


VAERS ID: 1202788 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-10
Onset:2021-04-13
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Abdominal pain upper, Abdominal tenderness, Anxiety, Blood lactic acid, Computerised tomogram abdomen, Fatigue, Haematocrit normal, Haemoglobin normal, International normalised ratio normal, Nausea, Nervousness, Nitrite urine absent, Pain in extremity, Platelet count normal, Prothrombin time shortened, Pyrexia, Red blood cell count normal, Red blood cells urine positive, Ultrasound Doppler normal, Urine leukocyte esterase positive, White blood cell count normal, White blood cells urine positive
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Chronic kidney disease (broad), Tubulointerstitial diseases (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: influenza vaccine (no additional information in chart)
Other Medications: ibuprofen (MOTRIN) 600 mg tablet olmesartan (BENICAR) 20 mg tablet pantoprazole DR (PROTONIX) 20 mg tablet amLODIPine (NORVASC) 5 mg tablet ergocalciferol 50,000 unit capsule (VITAMIN D2, DRISDOL) EPINEPHrine (AUVI-Q) 0.3 mg/0.3 mL auto-inj
Current Illness: Medication reaction to amlodipine 4/12 (swollen legs and feet) Maxillary sinusitis prescribed Augmentin, then Cephalexin Chest pain of unknown origin (possible rxn to HCTZ)
Preexisting Conditions: Cardiovascular Benign essential hypertension Hypercholesteremia Endocrinology Ovarian cyst Other Obesity, Class I, BMI 30-34.9 Vitamin D deficiency
Allergies: Dotarem [Gadoterate Meglumine]Swelling, Shortness of Breath, Other: See Comments AcyclovirIntolerance Adipex-p [Phentermine Hcl]Other: See Comments Bactrim [Sulfamethoxazole-trimethoprim]Anaphylaxis Imitrex [Sumatriptan]Swelling, Shortness of Breath Ivp Dye [Iodine]Unknown PeanutAnaphylaxis Sulfa (Sulfonamide Antibiotics)Anaphylaxis
Diagnostic Lab Data: Labs 4/13: WBC; 5.41 RBC: 5.11 Hg: 14.9 Hct: 45.9 Plt: 245 PT 10.7 INR 1 Lactate 1.7 UA: 0-5 WBC, 3-5 RBC, 25 Leukest, Negative Nitrites Imaging 4/13 Abdomen/Pelvis: 1. T-shaped IUD present within the uterus. Suspect fluid in the posterior cul-de-sac with possible subtle increased density of the fluid. Question recently ruptured hemorrhagic ovarian cyst. Further evaluation/characterization can be performed with pelvic ultrasound. 2. Nonobstructing 4 mm right lower pole calculus. 4/13: DVT bilateral scan IMPRESSION: NEGATIVE STUDY FOR ACUTE PROXIMAL DVT IN THE LEFT AND RIGHT LOWER EXTREMITIES. NEGATIVE STUDY FOR ACUTE CALF DVT IN THE LEFT AND RIGHT LOWER EXTREMITIES. NEGATIVE STUDY FOR ACUTE SUPERFICIAL THROMBOPHLEBITIS IN THE IMAGED SEGMENTS OF THE LEFT AND RIGHT LOWER EXTREMITIES.
CDC Split Type:

Write-up: 4/10 - vaccine administered 4/12 - Per patient, "I started the amlodipine and my legs and feet got so swollen and painful." changed from amlodipine to hydrochlorothiazide 4/13: Per patient, "Hi, I had my covid vaccine on 4/10/21 I had the Johnson & Johnson (Janssen) Lot# 201A21A Exp date: 6/23/21. If it could be added to my immunization list. Also I had terrible side effects including high fever which finally subsided yesterday, however my stomach feels like it is being twisted in knots. I''m having terrible cramping pains since Saturday and continues. I have been taking Motrin and Tylenol since Saturday for fever but the stomach pains are unbearable. 4/13 - Presented to ER: 37-year-old female presents emergency department for complaints of right lower leg pain and severe abdominal pain. Reported the patient had her Johnson & Johnson vaccine on Saturday a.m. several hours afterwards developed severe abdominal pain and tenderness with nausea. Denies any other specific reason for why this would have occurred. The patient states that the pain has been increasing since its onset and she is try to tough it at home taking Tylenol. Patient denies difficulty moving her bowel or bladder. Patient states in addition to this she developed right lower calf pain and tenderness and is concerned about a DVT. Patient denies any history of DVT. Patient otherwise denies any chest pain or shortness of breath. The patient relates that she has had a fever that was noted on Saturday as well and believes it was just sensitivity to the vaccine. She states she last noted the fever yesterday with T-max of 101. Review of Systems Constitutional: Positive for fatigue and fever. Respiratory: Negative for cough and shortness of breath. Gastrointestinal: Positive for abdominal pain and nausea. Negative for constipation and diarrhea. Genitourinary: Negative for difficulty urinating, flank pain and frequency. Psychiatric/Behavioral: The patient is nervous/anxious. All other systems reviewed and are negative. Physical Exam BP 132/82 | Pulse 86 | Temp (Src) 97.9 (Oral) | Resp 18 | Ht 5'' 7" (1.70m) | Wt 210 lb (95.3kg) | SpO2 100% | LMP 01/25/2021 | BMI 32.88 kg/(m^2). O2 Therapy: Room Air Physical Exam Vitals and nursing note reviewed. Constitutional: Appearance: Normal appearance. HENT: Head: Normocephalic and atraumatic. Eyes: General: No scleral icterus. Pupils: Pupils are equal, round, and reactive to light. Cardiovascular: Rate and Rhythm: Normal rate and regular rhythm. Pulses: Normal pulses. Heart sounds: Normal heart sounds. Pulmonary: Effort: Pulmonary effort is normal. Breath sounds: Normal breath sounds. Abdominal: General: There is no distension. Palpations: There is no mass. Tenderness: There is abdominal tenderness. There is no guarding or rebound. Hernia: No hernia is present. Musculoskeletal: General: Tenderness present. Right lower leg: No edema. Left lower leg: No edema. Comments: Right calf pain Skin: General: Skin is warm and dry. Capillary Refill: Capillary refill takes less than 2 seconds. Neurological: General: No focal deficit present. Mental Status: She is alert and oriented to person, place, and time. Mental status is at baseline. Psychiatric: Mood and Affect: Mood normal. Thought Content: Thought content normal.


VAERS ID: 1202804 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-06
Onset:2021-04-13
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Cerebral artery embolism, Computerised tomogram, Headache
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Previous clotting disorders - factor V and MTHFR
Allergies: None
Diagnostic Lab Data: CT scan
CDC Split Type:

Write-up: My wife was sent to the ER with a headache this morning and has confirmed cerebral embolism


VAERS ID: 1203200 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-06
Onset:2021-04-13
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Systemic: Allergic: Difficulty Breathing-Medium, Systemic: shortness of breath/pain in legs-Medium


VAERS ID: 1203212 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-13
Onset:2021-04-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray, Chills, Full blood count, Hyperhidrosis, Metabolic function test
SMQs:, Neuroleptic malignant 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? No
Hospitalized? No
Previous Vaccinations: Influenza vaccine, unknown dates and brands
Other Medications: none
Current Illness: none
Preexisting Conditions: Hx of COVID 12/15/2020. Hx of prolonged reactions to influenza vaccine.
Allergies: none
Diagnostic Lab Data: CBC, CMP, CXR.
CDC Split Type:

Write-up: Has prolonged chills and sweats and still has not recovered completely.


VAERS ID: 1203226 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

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

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

Write-up: Severe rash on the face and the back. Started in early morning and had resolved by noon. Advised patient to take benadryl and if not better or getting worse within 4 hours to be seen by a physician.


VAERS ID: 1203288 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Arizona  
Vaccinated:2021-03-17
Onset:2021-04-13
   Days after vaccination:27
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 RA / IM

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

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

Write-up: pt developed a blood clot in his ear and sought treatment 9 d after vaccination


VAERS ID: 1203333 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-10
Onset:2021-04-13
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Erythema, Skin discolouration
SMQs:, Anaphylactic reaction (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient developed bilateral erythema/hyperpigmentation to toes and cold feet.


VAERS ID: 1203366 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-10
Onset:2021-04-13
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A2IA / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Body temperature increased, Feeling cold, Headache, Pain
SMQs:, Neuroleptic malignant syndrome (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prescription: Blisovi Birth control Supplements: Fish Oil, Vitamin D, Iron, Women''s Multi-Vitamin
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: High fever for two days up to 102.5 and third day was still at 101.7 - Tylenol and ibuprofen headache - continues up today, the 4th day body ache chills


VAERS ID: 1203400 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature increased, Chills, Fatigue, Pain in extremity, Sinus headache
SMQs:, Neuroleptic malignant syndrome (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No known
Preexisting Conditions: No known
Allergies: No known allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient reported headache in sinus area, chills, fatigue, and arm soreness. Measured temperature of 101.5.


VAERS ID: 1203425 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Headache, Hyperhidrosis
SMQs:, Neuroleptic malignant syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: probiotics, vitamin d, omega 3, multi vitamin
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: severe headache. Tylenol doesnt help. sweats and chills


VAERS ID: 1203474 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-08
Onset:2021-04-13
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

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

Write-up: Urticaria -treated with antihistaimes


VAERS ID: 1203492 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chills, Headache, Hyperhidrosis, Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/a
Current Illness: None
Preexisting Conditions: None
Allergies: N/a
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever of 101.7 chills, body aches, headaches, sweating , nausea


VAERS ID: 1203647 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Headache, Injection site pain, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)

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

Write-up: headaches, body aches, pain in arm where vaccine was administered, tiredness, fatigue, exhaustion,


VAERS ID: 1203681 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-04-11
Onset:2021-04-13
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure increased, Blood test normal, Heart rate increased, Hypoaesthesia, Ultrasound scan normal
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Hypertension (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: Symbicort, albuterol, benadryl
Current Illness: jan 1st testing positive for covid-19
Preexisting Conditions: now has chronic lung condition
Allergies: no known allergy
Diagnostic Lab Data: today went to er, had ultrasound to rule out blood clots, blood pressure monitiored and cardiac labs as well, negative for blood clots and negative for MI
CDC Split Type:

Write-up: starting having rapid heart rate, increased blood pressure, eventually resulting in a numb left arm


VAERS ID: 1203729 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Abdominal pain, Condition aggravated, Headache, Muscle spasms, Pain, Pain in extremity
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lamictal and Trintilex
Current Illness: Sciatic pain left leg
Preexisting Conditions: Depression and 2 years of Sciatic pain (left leg)
Allergies: none
Diagnostic Lab Data: na, Symptoms are subsiding.
CDC Split Type:

Write-up: Leg cramps and pain on both legs, Abdominal cramping, severe headache.


VAERS ID: 1203742 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chest pain, Chills, Headache, Hyperhidrosis, Malaise, Nausea, Pyrexia, Vertigo
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: I was in Covid isolation with Covid-19 from March 13-March 24
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: I woke up around 1 am so sick that I could not sleep. My head was throbbing with every single heart beat. I had a fever of 102 and was constantly switching between chills and sweating through my sheets. The room felt like it was spinning and I felt like I was going to puke. Lastly I started to get chest pain which was by far the most concerning part to me. I still have a headache and chills but the fever is gone, and I am recovering


VAERS ID: 1203793 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Migraine, Muscle spasms, Nausea, Paraesthesia, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

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

Write-up: Intense leg cramping in both legs, couldn?t sit still or lay down until my Aleve kicked in. Prickly feeling in arms when I tried to lay down. Vomiting Dizzy, nauseous, warm temperature Migraine


VAERS ID: 1203828 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Dizziness, Fatigue, Feeling hot, Motor developmental delay, Nausea, Pain
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

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

Write-up: pt says he feels like has been hit by a train. He is very achy, chills, fatigue, hot with no fever, nauseated, light headiness, dizziness. Feeling of being drunk like his motor sensors are off. He has taken ibuprofen for his symptoms.


VAERS ID: 1204002 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 UN / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Pain in extremity, Skin discolouration, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Combigan, Lisinopril, Preservision AREDS capsule
Current Illness:
Preexisting Conditions: Glaucoma, Hypertension, Macular degeneration, DVT history
Allergies: NKA
Diagnostic Lab Data: Right lower extremity US completed- shows right greater saphenous vein thrombosis
CDC Split Type:

Write-up: Right lower extremity pain, redness/discoloration , and swelling.


VAERS ID: 1204003 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-10
Onset:2021-04-13
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN FB-201A21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Anxiety, Chest pain, Chills, Dizziness, Dreamy state, Emotional disorder, Fatigue, Feeling abnormal, Headache, Heart rate increased, Impaired work ability, Injection site pain, Loss of personal independence in daily activities, Malaise, Mental impairment, Nausea
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Generalised convulsive seizures following immunisation (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: dairy allergy
Diagnostic Lab Data: I do not want to go to the hospital. I have bad experiences seeking medical attention where they make things far worse. I am unaware of what the result of this will be at this time, but I feel it is my responsibility to fill this out.
CDC Split Type:

Write-up: After I got the vaccine my heart rate went over 100 and I had to lay down at the hospital to recover because I was so dizzy. On Saturday night and Sunday I felt some normal side effects like a severe headache, chills, nausea, and fatigue. Monday I felt better than normal and I thought I was in the all clear. Today (Tuesday) I woke up feeling like I had a stroke. I can still lift both arms and both sides of my face, but I can not think and feel like I am dying. I am scared to go to the hospital. I am unable to work. I feel incredibly emotional and unable to think. I feel so tired and the pain at the injection site is now even worse. I am getting chest pains, dizzy spells, really bad headache, and it feel like I am in a dream state unable to do things I normally can do. I am not okay and really regret getting the vaccine. I had no prior health concerns and probably would have survived covid, but it feels like I may never get my mental functioning back again.


VAERS ID: 1204023 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Fatigue, Loss of personal independence in daily activities, Mental impairment
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad)

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

Write-up: Fatigue, dizziness, trouble moving, thinking, and functioning for 24 hours after receiving the vaccine. Tylenol has allowed me to function, but the side effects are worrisome.


VAERS ID: 1204040 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-13
Onset:2021-04-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: anxiety with shots
Other Medications: LOSARTAN, AMLODIPINE, DICLOFENAC, OMEPRAZOLE, TIZANIDINE
Current Illness: HYPOTHYROIDISM, GERD, HYPERTENSION,MUSCLE SPASMS, PAIN, S/P CONCUSSION FROM RECENT AUTO ACCIDENT
Preexisting Conditions: HYPOTHROIDISM, HYPERTENSION
Allergies: NONE KNOWN
Diagnostic Lab Data: bp 88/58mmhg with hr of 48.
CDC Split Type:

Write-up: patient became dizzy almost immediately upon standing after imz . asked wife for something to drink before she received her covid imz. he started fanning himself. i asked technician to come stand with him and observe while i attended to his wife''s imz. i checked his bp because i wasn''t sure if he was just anxious (both he and his wife reported that he always got nervous with shots even though he had received numerous imz. his blood pressure was 88/58mmhg with hr of 48. i got a mat to have him lie on the floor to elevate his feet but he declined. he sat another 10 minutes and said he felt better and said he was ok to leave with his wife without further assistance.


VAERS ID: 1204063 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-13
Onset:2021-04-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye pruritus, Oropharyngeal discomfort
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)

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

Write-up: Patient received her Covid 19 Janssen vaccine at approximately 7:00am. At approximately 8:00am she started experiencing itching in her eyes. As time went on she stated she started to experience itching all over her body and a tickle in throat. She called her doctor and they advised her to take benadryl to manage the adverse reaction.


VAERS ID: 1204090 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-03
Onset:2021-04-13
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 5 LA / IM

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

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

Write-up: Pt got the Janssen (Johnson and Johnson) vaccine on 4/3/2021, and today on 4/13/2021 he reported to us that he had a systematic rash though out his body. We saw rashes on his arm and torso. He also reported bumps on his torso and arms as well.


VAERS ID: 1204180 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-13
Onset:2021-04-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 044A21A / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Chest pain
SMQs:, 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? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: anxiety, patient was taken to Hospital treated for chest pains


VAERS ID: 1204240 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-04-11
Onset:2021-04-13
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Thrombophlebitis superficial, Ultrasound scan abnormal
SMQs:, Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Thrombophlebitis (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NOne
Current Illness: None
Preexisting Conditions: None
Allergies: NKA
Diagnostic Lab Data: As above, Confirmed with Ultrasound.
CDC Split Type:

Write-up: Left Leg Superficial Thrombosis.


VAERS ID: 1204241 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Electric shock sensation, Fatigue, Headache, Heart rate increased, Hyperhidrosis, Lethargy, Sleep disorder, Tremor
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: N/A
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache and very tired the night of the vaccine. At 12:30 AM that night I woke up to what felt like electric shocks going through my body (painful zaps) and in a full body sweat. No fever. I then started shaking uncontrollably and my heart rate increased to the 100s. The shaking and rapid heart rate lasted for 30 minutes. Woke up again multiple times with body sweats. In the morning still lethargic but all symptoms resolved by noon.


VAERS ID: 1204344 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Deep vein thrombosis, Pain in extremity, Ultrasound scan abnormal
SMQs:, Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Thrombophlebitis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: no
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: ultrasound duplex dvt study of b/l lower extremities on 4/13/2021
CDC Split Type:

Write-up: patient developed leg pains bilaterally. went to emergency room and diagnosed with DVT in right leg


VAERS ID: 1204354 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-13
Onset:2021-04-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006B21A / 2 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood glucose normal, Electrocardiogram normal, Gaze palsy, Miosis, Pupillary light reflex tests abnormal, Seizure like phenomena, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (narrow), Retinal disorders (narrow), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Amilodipine; hydrochlorithiazide; metoprolol
Current Illness: Unknown
Preexisting Conditions: Hypertension; ? prior CVA as uses a walker. No family accompanied this patient, only a family friend.
Allergies: None stated
Diagnostic Lab Data: Finger stick glucose: 89; EKG - NSR with no ectopy.
CDC Split Type:

Write-up: Vaccine in at 2:27 pm. Taken to Observation for 30 minutes. Left Observation at 2:57 pm. Was being assisted outside clinic entrance into a car (while in her walker) and was noted to have seizure like activity. Taken back into Observation area. NP and EMS onsite assessed patient. 15:20 VS: 97/71; p.88; Sat 97; R 10 and shallow. Airway opened. 15:20. EMS called per Police Officer onsite. Pupils pinpoint and non reactive. Bilateral downward gaze noted. Did not respond to verbal commands. Moaned to sternal rub. IV started in R arm TKO. O2 administered at 2 L. 15:29; BP 190/92''; p 94, fingerstick BS 89; R. 12. on cardiac monitor showing NSR. 15:42. BP 192/109; HR 90. Transferred to Fire Dept care @ 3:49 pm.


VAERS ID: 1204438 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-05
Onset:2021-04-13
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / UNK - / IM

Administered by: Other       Purchased by: ?
Symptoms: Deep vein thrombosis, Pain in extremity, Ultrasound Doppler, Ultrasound scan abnormal
SMQs:, Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Thrombophlebitis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: no
Preexisting Conditions: none
Allergies: Sulfa
Diagnostic Lab Data: ultrasound duplex dvt study of b/l lower extremities on 4/13/2021
CDC Split Type:

Write-up: patient developed leg pains bilaterally. went to emergency room and diagnosed with DVT in right leg


VAERS ID: 1204489 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Rhode Island  
Vaccinated:2021-04-11
Onset:2021-04-13
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain, Chills, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Swelling and itching from influenza vaccine around injection location and very soon after the injection (this happened only once
Other Medications: Medications: Escitalopram (10 mg) Bupropion HCL SR (150 mg) Amoxicillin (500 mg four times per day; for infection prevention from a very recent tooth fracture) OTC Omeprazole (20 mg) Ketoconazole 2% shampoo (for scalp acne) Supplements: Vi
Current Illness:
Preexisting Conditions: Gastroesophageal reflux disease Anxiety Depression
Allergies: Allergic to both codeine (severe reaction) and Accutane (hives)
Diagnostic Lab Data: None as of yet
CDC Split Type:

Write-up: Mild fever and severe body chills beginning at about 4:00 to 4:30 am on Monday, April 12, 2021 (which lasted for only about two-to-three hours) Mild-to-severe abdominal pain beginning at about 12:30 pm on Tuesday, April 13, 2021 (ongoing and no treatment as of yet)


VAERS ID: 1204497 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Pyrexia, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Patient reports having fever and chills overnight. At approximately 6am he had a fainting episode followed by two other fainting episodes later in the morning. At approximately 3pm when I talked to him, he was still fatigued but feeling better.


VAERS ID: 1204503 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Iowa  
Vaccinated:2021-04-08
Onset:2021-04-13
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea, Fatigue, Full blood count, Headache, Malaise, Metabolic function test, Myalgia, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: none
Preexisting Conditions: none
Allergies: No known allergies
Diagnostic Lab Data: CBC and BMP obtained
CDC Split Type:

Write-up: Patient complained of right lower leg pain with shortness of breath and headache starting on 04/12. He was seen in the medical office for complaints along with malaise, fatigue and muscle pain. Patient was diagnosed with acute vital syndrome


VAERS ID: 1204535 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-04-11
Onset:2021-04-13
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 - / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Pain, Pyrexia, Rash, Rash erythematous, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Provitelize b12
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever chills body aches 13 hours after shot itchy red rash all over 2 Days after shot took benadryl waiting for redults


VAERS ID: 1204576 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Limb discomfort, Muscle spasms, Pain
SMQs:, Dystonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Sambucus
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Have not had medical treatment.
CDC Split Type:

Write-up: Serve cramping and shooting pain in thighs and lower legs.


VAERS ID: 1204626 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Headache, Muscle spasms, Pain
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: Headache Abdominal pain Leg cramp Pain


VAERS ID: 1204669 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Headache, Mobility decreased, Nausea, Pain, Pregnancy test urine negative
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 325 MG tablet Take 650 mg by mouth every 6 hours as needed for Pain. albuterol (PROVENTIL HFA) 108 (90 Base) MCG/ACT inhaler Inhale 2 puffs into the lungs every 4 hours as needed for Wheezing or Shortness of Breath.
Current Illness: vaginal yeast infection- treated with diflucan
Preexisting Conditions: Leucopenia Major depressive disorder
Allergies: amoxicillin, sulfa drugs
Diagnostic Lab Data: Pregnancy urine test negative. UA microscopic- blood 1+
CDC Split Type:

Write-up: Dr writes the following " is a 20 y.o. female with a history of leukopenia who is here today for evaluation of lower back pain. Patient states that she got the J&J vaccine yesterday and then over night she had onset of severe lower back pain that is localized to her back, but can occasionally be felt in her buttocks area. She first noticed body aches prior to bed. She woke around 3am to use bathroom and had terrible headache and back pain. Headache had subsided, but the back pain has persisted. The pain is located along her lower back, bilaterally. Sometimes the pain is felt in her buttocks. Pain otherwise is localized. Pain is dull, but intense. She rates the pain as a 8 or 9/10. Pain can not be alleviated. She tried a hot pack, with no relief. Laying down increases the pain, and the pain is so severe that she is unable to move. She feels afraid to move the pain is so intense. She has noticed no other symptoms. All other symptoms from the shot have subsided. Patient also became nauseated while in the exam room. Patient had negative pregnancy test yesterday. "


VAERS ID: 1204714 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Cold sweat, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Chills and cold sweats throughout the night. Awoke with fever and severe pain throughout body. Chills subsided, but temperature left and came back. Pain was consistent. Sweat a lot and felt better but 1-2 hours later, symptoms began to reemerge.


VAERS ID: 1204743 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: School       Purchased by: ?
Symptoms: Asthenia, Body temperature fluctuation, Chills, Dizziness, Headache, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Apri (birth control)
Current Illness: None
Preexisting Conditions: None
Allergies: I am allergic to Keflex
Diagnostic Lab Data: None
CDC Split Type:

Write-up: At 2:30am on April 13, I woke up with a 101-degree fever. Throughout the rest of the day I have felt chills, a headache, soreness all over my body, dizziness and overall weak. My temperature had fluctuated around 99.5-100 degrees all day.


VAERS ID: 1204895 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-13
Onset:2021-04-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cough, Decreased appetite, Oropharyngeal pain, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: patient came back 4/13/2021 the day the vaccine was paused due to thrombotic events concerned about her risk and health. She reported having body aches, sore throat, low grade fever, cough, and loss of appetite.


VAERS ID: 1205011 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Body temperature increased, Bone pain, Fatigue, Nausea, Somnolence
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Osteonecrosis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Headache, 99 - 102 fever, queasy stomach, aches in bones, fatigue and sleepy.


VAERS ID: 1205023 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-03
Onset:2021-04-13
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Neurological examination
SMQs:

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

Write-up: Severe headache this morning and all today. We went to the pediatrician and they performed neurological tests because of the blood clots that were reported. She was sent home and alerted to go to ER if any other symptoms develop


VAERS ID: 1205115 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-13
Onset:2021-04-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 UN / IM

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

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

Write-up: per pt is having swelling at ankles near sock indention


VAERS ID: 1205307 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-04-11
Onset:2021-04-13
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202121A / 1 - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Headache
SMQs:

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

Write-up: Headaches


VAERS ID: 1205324 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-01
Onset:2021-04-13
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chills, Fatigue, Feeling abnormal, Headache, Hyperhidrosis, Periorbital swelling, Tenderness
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Dementia (broad), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Chills, sweats, eye puffy, headache, sore, fatigue, foggy headed


VAERS ID: 1205362 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Eye irritation, Fatigue, Headache, Pain, Sinus pain
SMQs:, Corneal 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache, tiredness, sinus, body aches, eyes burning, sore


VAERS ID: 1205370 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Pain in extremity, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: CHF meds
Current Illness:
Preexisting Conditions: CHF
Allergies:
Diagnostic Lab Data: referred to emergency room for DVT eval
CDC Split Type:

Write-up: patient woke with Left leg swelling and pain, s/p Johnson/johnson vaccine. Pt referred to ER for R/O DVT


VAERS ID: 1205371 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-04-07
Onset:2021-04-13
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Diarrhoea, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (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: Unknown
Current Illness: None reported
Preexisting Conditions: None reported to pharmacy
Allergies: No known allergies
Diagnostic Lab Data: Unknown at this time. Patient''s wife stated that her husband did not have a primary care physician and was instructed to go to the nearest ER.
CDC Split Type:

Write-up: Patient''s wife called and stated that he was experiencing stomach pain, vomiting, and diarrhea. She stated her husband said it felt like his stomach was going to burst. Patient received vaccine on 4/7/21 and reported reaction started on 4/13/21.


VAERS ID: 1205378 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-04-09
Onset:2021-04-13
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Headache
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: migraines
Allergies: none
Diagnostic Lab Data: None, headache eventually dicipated. I dont think it was anything out of the normal. I feel fine now
CDC Split Type:

Write-up: Severe Headache starting approximately 9 hours after vaccine received. Lasted about 24 hours. Mild on and off headaches since.


VAERS ID: 1205477 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046B21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fear
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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: LOVASTATIN, LISINOPRIL, BYSTOLIC, VENTOLIN, HYDROCODONE/APAP, JANUMET XR, LANTUS, ISOSORBIDE, LEXAPRO
Current Illness: UNKNOWN
Preexisting Conditions: DIABETES, HEART DISEASE, PAIN
Allergies: METHADONE, PROTON PUMP INHIBITORS, PENICILLINS
Diagnostic Lab Data: UNKNOWN
CDC Split Type:

Write-up: PATIENT WENT TO THE HOSPITAL AFRAID THAT SHE HAS A BLOOD CLOT.


VAERS ID: 1205537 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-04-10
Onset:2021-04-13
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 2 RA / SYR

Administered by: School       Purchased by: ?
Symptoms: Arthralgia, Neck pain
SMQs:, 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Pollen
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Since day one shoulder pain has increased each day. On third day pain is now in my neck


VAERS ID: 1205571 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Headache, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Jansen COVID-19 Vaccine EAU. Fever and headache. Started approximately 9 hours after receiving vaccine. Subsided after taking 400mg of Tylenol.


VAERS ID: 1205587 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-10
Onset:2021-04-13
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Impaired work ability, Pain, Pain in extremity, Vaccination complication
SMQs:, Tendinopathies and ligament disorders (broad)

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

Write-up: The patient called today complaining of pain, primarily in her legs, that had not improved since receiving the Janssen vaccine on 4/10. She thought it felt muscular but wasn''t sure. The pain was affecting her ability to work today. I advised her to contact her primary care dr''s office or go to urgent care. She called back after seeing her dr today - the dr recommended ibuprofen for pain and said she had a "strong reaction" to the vaccine. According to the patient, no further concerns were identified.


VAERS ID: 1205604 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-13
Onset:2021-04-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

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

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

Write-up: Patient experienced nausea shortly after receiving the vaccine which lead to vomiting. The patient stated she was nervous about getting the vaccine and felt better immediately after.


VAERS ID: 1205607 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-08
Onset:2021-04-13
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pruritus, Rash erythematous, Rash macular, Skin burning sensation, Skin warm
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: Unknown
Diagnostic Lab Data:
CDC Split Type:

Write-up: Approximately 5 days after receiving vaccine I woke at 6:30am to an itchy scalp. As the day progressed my skin became increasingly hot and felt like a sunburn. It is itchy all over and has developed to blotches all over my skin. The heat and burning feeling is also all over.


VAERS ID: 1205613 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-11
Onset:2021-04-13
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Visual impairment
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)

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

Write-up: The patient called today complaining of visual disturbances two days after receiving the Janssen COVID-19 vaccine. She did not have headache or other symptoms corresponding with the visual disturbances. I advised her to contact her primary care dr to assess the need for further evaluation or to go to the urgent care/ER if her symptoms worsened.


VAERS ID: 1205624 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: atenolol, synthyord,welchoi,gabieton,subxone,effesor,cbd,ibprofin,alka seltzer
Current Illness:
Preexisting Conditions: arthritis
Allergies: penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: head ache tired sore arm


VAERS ID: 1205698 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Headache, Nausea, Pyrexia, Rash, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Rash on face, vomiting, fever, nausea, chills, headache Vomiting stopped after 10 hours, other reactions still present 28 hours after vaccination


VAERS ID: 1205740 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-09
Onset:2021-04-13
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: 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:
Current Illness:
Preexisting Conditions: Ewing sarcoma
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: pulmonary embolus


VAERS ID: 1205765 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Delaware  
Vaccinated:2021-03-27
Onset:2021-04-13
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Chills, Cold sweat, Headache, Musculoskeletal chest pain, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever of 101.7 within 12 hours of the shot. The fever lasted for 24 hours at different temps. Chills and cold sweats for 24 hours. A sever headache that lasted for 48 hours. About a week later, random sharp pains would radiate under my left breast. They didn?t happen before the vaccine but I can?t verify they are occurring from the vaccine.


VAERS ID: 1205770 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-04-06
Onset:2021-04-13
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Dizziness, Headache
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zocor, Mobic, Vitamins C and D and B12, zinc
Current Illness: None
Preexisting Conditions: None
Allergies: No
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Onset severe headache that went away, dizziness that diminished when he lay down, two previous nights of stomach cramps


VAERS ID: 1205797 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2021-04-07
Onset:2021-04-13
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Dizziness, Nausea, Tremor, Vision blurred
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Hydrochlorothiazide 12.5 mg Lisinopril 20 mg Metformin HCL 1000 mg Atorvastatin 80 mg Venlafaxine 75 mg Hydrocodon-Acetaminoph 7.5-325 Gabapentin 30 mg
Current Illness: None
Preexisting Conditions: Diabetes Hypertension
Allergies: None
Diagnostic Lab Data: None
CDC Split Type: 3513510

Write-up: Blurred vision, dizziness, nausea and shakes.


VAERS ID: 1205833 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

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

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

Write-up: Severe headache, hives.


VAERS ID: 1206007 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-03-01
Onset:2021-04-13
   Days after vaccination:43
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / UNK LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Dizziness, Headache, Immediate post-injection reaction, Nausea, Pain
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Gabapentin Hydroxychloraquin Diltiazem Levothyroxin Spironolactone Omeprazole
Current Illness: Hemochromatosis Fibromyalgia
Preexisting Conditions: Hemachromatosis Fibromyalgia
Allergies: Erythromiasin
Diagnostic Lab Data: Still waiting to hear from my doctor
CDC Split Type:

Write-up: I was immediately nauseous and a moderate headache started about 15 mins after the shot. The next day I had moderate body aches, nausea, and mild light headedness. I''ve had those ongoing symptoms (minus the body aches) up to the present day. They''ve never really gone away, and continue to persist. I did not have any of these symptoms prior to the shot. I called my doctors office today to report the symptoms, and I''m still waiting to hear back.


VAERS ID: 1206033 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-11
Onset:2021-04-13
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 4D / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Menstruation irregular
SMQs:, Fertility 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Mirena IUD
Current Illness: None
Preexisting Conditions: Asthma
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Irregular period


VAERS ID: 1206035 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / N/A LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Chills, Fatigue, Influenza like illness, Injection site pain, Injection site reaction, Insomnia, Limb discomfort, Muscular weakness, Photopsia, Sleep disorder, Visual impairment
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (narrow), Hypoglycaemia (broad)

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

Write-up: All times in format HH:MM:SS after injection T+00:05:00: Heaviness, weakness in left arm. Gradually cessated over four hours. T+08:00:00: Interrupted sleep; insomnia lasting four hours; visual disturbances (flashing lights, geometric patterns). Ceased within 2 hours. T+18:00:00: Fever of ~1.5 degree F above normal; injection site reaction (soreness); weakness; fatigue; chills; all symptoms ?flu-like?. Slowly resolved over next 18 hours.


VAERS ID: 1206044 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-13
Onset:2021-04-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038B21A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Anaphylactic reaction, Breath sounds abnormal, Chest discomfort, Chills, Diarrhoea, Heart rate increased, Nausea, Oropharyngeal pain, Retching, Tachycardia, Vomiting
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Respiratory failure (narrow), Dehydration (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: fever, chills, headache and body aches with first Moderna vaccine, age 39. Similar reaction with influenza vaccine.
Other Medications: Current Outpatient Medications ? Ascorbic Acid (VITAMIN C PO) Take by mouth (unknown dose) ? Cyanocobalamin (B-12 PO) Take by mouth (unknown dose). ? Cholecalciferol (VITAMIN D PO) (unknown dose) daily
Current Illness: none
Preexisting Conditions: Asthma, infrequent. No history of intubations. No current albuterol usage. last prescribed for patient in 2019
Allergies: TERBUTALINE - HIVES GABAPENTIN - anxiety
Diagnostic Lab Data: no testing. Patient transferred to higher level of care - ER via 911 - ALS (EMS) transport.
CDC Split Type: n/a

Write-up: 39 y.o. female with history of asthma but no previous anaphylaxis to vaccines received covid-19 vaccine (Moderna) at 4:15pm today and within a few minutes developed tachycardia, nausea and vomiting No shortness of breath, no wheezing, speaking in full sentences No chest pain She has a history of asthma and hives to terbutaline, and anxiety reaction to gabepentin. No history of intubation or serious reaction from asthma Transferred to the procedure room by RN with my assistance Blood pressure 132/82 pulse of 135, 02 sat 100% on RA, speaking full sentences, stating she had some chills lungs clear, tachycardic, and moving air well, no wheezing. Patient stated said she had to the bathroom right away, was going to have diarrhea. Said she could walk, and was walked across hall with assistance to bathroom, where I stayed with patient. I accompanied patient to bathroom, she had one episode of diarrhea, and dry heaving, returned to procedure room, lied supine, IV started, NS bag hung. RN present, additional ARNP present, staff aware, anaphylaxis kit present. Patient tachycardic and continued with normal 02 sat and good air movement, EMS with request for ALS activated due to reaction to vaccine. I made decision to give epinephrine with her tachycardia and continued nausea with diagnosis of anaphylaxis, and as preparing epinephrine, patient stated she started to feel tight in chest, epinephrine given 0.3mg of 1:1000 IM. Lungs notable for reduced air movement lung bases. Patient denied throat tightening, rash, lip swelling, but she continued to have dry heaves, and stated she had a "sore throat". EMS had already been activated before first epinephrine dose. Awaiting medics, patient given Solumedrol 125mg IV, benadryl 50mg IV, and zofran 4mg IV Patient also given four puffs of albuterol MDI with spacer. Medics arrived, patient still feeling tight in chest, blood pressure 125/70, 02 sat 100%, lungs still tight with reduced air movement Patient given second dose of epinephrine 0.3mg, 1:1000 IM, approximately 7-8 min after the first dose. EMS transferred patient to gurney with transport to PEMC Patient alert during entire reaction. PEMC notified. To ED via ALS PEMC notified Timeline of anaphylactic reaction: 1615: Covid Moderna 2nd injection given RN notified of patient feeling rapid heart rate and nausea. Patient pulled back to procedure room. 1631: Vitals: BP 132/82, HR 135, Temp 97.1, O2 sat 100% 1637: IV start in LAC, NS running 1645: 0.3 mg IM Epi - administered by RN 1648: 4 mg IV Zofran - administered by ARNP 1650: 4 puff Albuterol sulfate 90 mgc given via spacer - administered by MD 1651: 50 mg IV Benadryl - administered by ARNP 1652: 125 mg IV Solumedrol - administered by ARNP 1653: 0.3 mg IM Epi - administered by RN


VAERS ID: 1206052 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: West Virginia  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lysine, magnesium, venlafaxine, atorvastatin, hydrochlorothiazide, bupropion, nuvaring.
Current Illness: None
Preexisting Conditions: Migraines
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Slight arm pain, headache, right eye pain.


VAERS ID: 1206057 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / -

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Discomfort, Head discomfort
SMQs:

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

Write-up: Last night I felt discomfort in my body so I took a Tylenol, since I woke up in the morning I felt discomfort in my head, I felt chills until the end of the day around 6:00 pm the discomfort went away


VAERS ID: 1206065 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-03-19
Onset:2021-04-13
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN Y80860 / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Dysmenorrhoea, Heavy menstrual bleeding, Impaired work ability, Menstrual disorder, Pain
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Adipex Milk thistle Elderberry Vitamin D Multi vitamin Claritin
Current Illness: None
Preexisting Conditions: None
Allergies: Sulfa drugs Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: First day of menstrual cycle has produced large clots and severe cramping. Normally my periods are light with zero cramps. I was in so pain today I was unable to work even after taking 1200mg of ibuprofen


VAERS ID: 1206080 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood blister, Dysphagia, Erythema, Eye pruritus, Headache, Hypoaesthesia, Paraesthesia, Pharyngeal swelling, Rash, Sneezing, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: 4-12-2021 Facial tingling & numbness, tightness/swelling of throat, difficulty swallowing, Given Prednisone 40 mg, 2 Benadryl and 1 Pepcit at ER visit. Prescribed Prednisone 40 mg /5 days, Benadryl & Pepcid for as long as symptoms are present. 4-13-2021 Headache, itchy eyes, sneezing, small red blood blister like areas on arms, chest, back and thighs. When Benadryl wears off throat tightness returns. Visited ER on advice from nurse hotline to check out the red blood blister like marks as she thought it was a new rash type symptom. ER recomended remaining on previously prescribed course of meds and to watch for further symptoms.


VAERS ID: 1206151 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-04-07
Onset:2021-04-13
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Arthralgia, Burning sensation, Chills, Cognitive disorder, Dizziness, Ear discomfort, Fatigue, Headache, Insomnia, Ocular discomfort, Pain, Photophobia, Pyrexia, Rash, Restlessness, Sensory disturbance, Skin burning sensation, Sleep disorder, Throat irritation
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Dementia (broad), Akathisia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: sensitive to gluten/wheat products
Diagnostic Lab Data: none yet going to the doctor tomorrow.
CDC Split Type:

Write-up: When I first got the shot I noticed it in my throat. I told the nurses they had me wait 20 minutes before I could leave. I felt dizzy but not dizzy enough to not go home. It felt like it went to my stomach, then my head, and then I could feel it in my joints. I drove home from the city. Two hours pass, I notice a rash but I didn''t think anything of it due to indoor allergens, springtime plus it went away within an hour. I started to get chills and fever. I had a lack of sleep due to pain throughout the first night. I was waking up feeling like my head was on fire from my ears to the top of the skull area and in front of my face by my eyes too. My eyes felt like they were going to burst. I layed in bed for 24 hours. Day two: pain, tiredness, headache, and sensitivity to light for the next few days. Symptoms come and go for days then wean off. Next, I had issues with anxiety, sleeping, yet being really tired as well coupled with problems sitting still. These are subsiding but still there. I am still very tired today and a bit anxious on April 13th, 2021. I also notice my typing skills, as well as testing skills, are not as sharp as before the vaccination.


VAERS ID: 1206222 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Nevada  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Immediate post-injection reaction, Pain, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prevacid 30mg daily, metformin 500 mg twice daily, mens over 50 vitamin supplement and vitamin D
Current Illness: Fatty liver 63%, F3 fibrosis scan for liver scarring and diabetes
Preexisting Conditions: Diabetes
Allergies: Tetracycline
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Arm hurt badly immediately after shot, around 12:30pm today I started to feel aches, chills and headache, and fever of 101.7 around 7:30pm


VAERS ID: 1206290 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-03-24
Onset:2021-04-13
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Myalgia, Pain, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Benadryl and citirizine. Over the counter, once pill of each at night before bed
Current Illness: no
Preexisting Conditions: asthma
Allergies: no
Diagnostic Lab Data:
CDC Split Type:

Write-up: Woke up on 4/13 and got out of bed. Left upper left calf was painful when straightening my leg. Has not improved throughout the day. Feels tight and as if strained, but I have literally done nothing but walk or sit at my computer in the last week and cannot pinpoint an activity that would have strained a muscle.


VAERS ID: 1206292 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-04
Onset:2021-04-13
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Fatigue, Muscle spasms
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: Abnominal pain, leg cramp, fatigue.


VAERS ID: 1206298 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-13
Onset:2021-04-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Cerebellar stroke
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow)

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

Write-up: cerebellar stroke


VAERS ID: 1206317 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-04-10
Onset:2021-04-13
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Chest pain, Diarrhoea, Electrocardiogram, Gastroenteritis, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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: SINGULAIR, ZYRTEC, LEXAPRO, BENICAR, XIDUO, ALLPURINOL, ACTOS, JANUVIA, PANTOPRAZOLE
Current Illness: NONE
Preexisting Conditions: DIABETES, HIGH BLOOS PRESSURE
Allergies: ZOCOR, SIMVASTATIN
Diagnostic Lab Data: 4/13/2021 - 9:05AM MORNING AT URGENT CARE ABDOMINAL PAIN - GASTROENTERITIS; 4/13/2021 - 8:45PM FEVER, PERFORMED EKG, BLOOD PRESSURE, BLOOD GLUCOSE
CDC Split Type:

Write-up: 4/13/2021 - FEVER, ABDOMINAL PAIN, VOMITING, CHEST PAIN, DIARRHEA


VAERS ID: 1206394 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-13
Onset:2021-04-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dizziness postural, Dysstasia, Feeling hot, Headache, Heavy menstrual bleeding, Laboratory test, Loss of personal independence in daily activities, Menstruation irregular, Nausea, Vaccination complication, Vertigo, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (narrow), Fertility 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: Only daily vitamins
Current Illness: None
Preexisting Conditions: None
Allergies: Tetracycline
Diagnostic Lab Data: I got a full blood work up after I was okay enough to move after that severe dizziness. I was certain it was vaccine side-effect because there was nothing else. I specifically asked for plat
CDC Split Type:

Write-up: The night of the vaccination (3/8), my body felt very hot (not fever) like it was going to catch on fire. I took Tylenol to be safe and went to bed taking it as a sign that the vaccine was working. I thought I was mostly over the next day, but four days later on 3/12, I started bleeding only two weeks after my last period, and the it was quite different than usual - very fresh blood and lots of it. This continued for 15 days at time with very heavy flow - I bleed non-stop, and I worried that I was going to bleed to death. The worst adverse effect happened 10 days after the vaccination on 3/18. Out of blue without anything unusual, I started feeling very dizzy, nausea, and vomiting. After much vomiting, nausea stopped, but the dizziness just got so bad, I couldn''t move or even keep my eyes open (things were spinning even with my eyes closed). I couldn''t even stand up by myself. This most horrible severe vertigo lasted two and got gradually better. It took about 5 days before I felt safe enough to be alone by myself. During this time, I had a excruciating headache on my left side. It was so bad, I quickly took some painkillers which knock me out for a day. The important thing is that I don''t ever get headaches; this is the first one I had aside from one I had when going through IVF more than a decade ago.


VAERS ID: 1206560 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dyspnoea, Headache, Illness, Nausea, Pain in extremity, Pyrexia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (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: N/A
Current Illness: N/A
Preexisting Conditions:
Allergies: N/A
Diagnostic Lab Data: Reason for appointment: fever, Nausea. Diagnoses: Postimmunization reaction, initial encounter. Pain, dental. Has been treated
CDC Split Type:

Write-up: Fever, headache, arms pain, sickness, leg pain and, difficulty breathing.


VAERS ID: 1206763 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-11
Onset:2021-04-13
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Lymphadenopathy
SMQs:, 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Mirena IUD; Lisinopril; meloxicam; Chantix; b-12; iron.
Current Illness: None
Preexisting Conditions: High blood pressure, knee pain
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: Swollen lymph node in left armpit


VAERS ID: 1206769 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Nevada  
Vaccinated:2021-04-10
Onset:2021-04-13
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Hydrocodone, Ibuprofen, Lisinopril, Amlodipine, Phentermine, Magnesium Citrate, D3, Biotin,
Current Illness: None
Preexisting Conditions: Chronic pain & elevated blood pressure due to orthopedic pain
Allergies: Severe allergy to bee pollen and bee stings
Diagnostic Lab Data:
CDC Split Type:

Write-up: Tinnitus started on the third evening following the vaccine. It''s so loud that it''s preventing me from sleeping.


VAERS ID: 1206774 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chills, Fatigue, Feeling hot, Influenza like illness, Malaise, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ibuprofen, 400mg, PO 30 minutes prior to receiving vaccine. Ibuprofen, 400mg, PO 12 hrs after receiving vaccine
Current Illness: None
Preexisting Conditions: Mitral valve prolapse
Allergies: Latex and metal allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: I had received the vaccine on April 12, 2021 at 11:30am. I felt a warm sensation go down my arm when I received the vaccine. No ill effects however. Around 2:30am the following morning (April 13, 2021) I started feeling ill. I had flu-like symptoms including: body aches, chills, fatigue, etc. I did not take my temperature, however, I believe I was feverish. I took 400mg of Ibuprofen around 11:30am (24 hours after receiving the vaccine). After sleeping for 2 hours, I began feeling better.


VAERS ID: 1207032 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Vermont  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, Headache, Mental impairment, Nausea, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: OTC women''s multivitamin with zinc. Eli triptan as required for migraines, but none taken in 48h prior to vaccine.
Current Illness: None known.
Preexisting Conditions: Occasional migraines since 2008.
Allergies: None known
Diagnostic Lab Data: Not at present, seeking advice from doctor about any recommended tests.
CDC Split Type:

Write-up: 18 hours after vaccination, developed headache with severe nausea and intermittent vomiting and fever of between 99.5-101 when read via forehead. Symptoms lasted for approximately 10 hours, with 1-3 bouts of vomiting during that time. Due to vomiting, OTC pain relievers taken by mouth were not effective. Symptoms have since subsided except for weakness, slight headache, and mental fog.


VAERS ID: 1207071 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A214 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Headache, Injection site joint pain, Injection site pain, Musculoskeletal stiffness, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Janssen COVID-19 Vaccine EUA Injection site pain; muscle stiffness; joint pain in shoulders, elbows, knuckles, hips, knees; severe headache; nasua; fatigue; low grade fever


VAERS ID: 1207114 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Fatigue, Injection site pain, Myalgia, Nausea
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

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

Write-up: Pain at injection site, joint pain, muscle pain, periods of nausea, tiredness.


VAERS ID: 1207179 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-09
Onset:2021-04-13
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril 20 mg tabs 2x day
Current Illness:
Preexisting Conditions:
Allergies: N/a
Diagnostic Lab Data:
CDC Split Type:

Write-up: Sudden striking pain going through right leg about 7:30 that morning , I was at work at time, but as day went by it finally went away unit my daughter messaged me about the Janssen Vaccine clothing and I started to worry if I was having some symptoms, No now it''s April 4/14/21 I''m having same issues now both legs I''m having some striking pain going through legs, I hope not issues. I hope to hear from some one soon, Do I need to see my Doctor?


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