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From the 9/10/2021 release of VAERS data:

Found 7,242 cases where Vaccine is COVID19 and Manufacturer is JANSSEN and Emergency Room/Doctor Visit



Case Details

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VAERS ID: 1311733 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-08
Onset:2021-04-21
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / N/A LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Headache, Heart rate increased, Pyrexia, Sleep disorder
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin D Coq-10 Omega 369
Current Illness:
Preexisting Conditions:
Allergies: Shrimp-lip swelling
Diagnostic Lab Data:
CDC Split Type: vsafe

Write-up: Two days after the heart rate went up to 135 and I went to the ER. It was better the next day. By day 13 I started to get intermittent headaches that are very sharp. I am still getting them after three weeks. I have tried muscle relaxants and anti-anxiety medicine but they did not help. At night I am able to sleep but, in the morning, when I get up, I get sharp pains that are like ice picks and last for 3-5 seconds. Some of the headaches are more electric and as the day goes on it gets worse. I have tried taking Magnesium and Vitamin B-Complex and the headaches have changed to where they are starting in the afternoon instead of the morning. The headaches are a seven on a scale of 1-10. Sometimes the headaches come with a low grade fever.


VAERS ID: 1311759 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-05
Onset:2021-04-06
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Abdominal distension, Computerised tomogram, Pain, Swelling
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth control Junel FE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CT scan done April 12th. Doctor stated they are cysts and swelling of lymphatic nodes.
CDC Split Type:

Write-up: Lumps on right lower abdomen and spine. Hurts when I bend and lumps stick out.


VAERS ID: 1311765 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-13
Onset:2021-04-21
   Days after vaccination:39
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Deep vein thrombosis, Pulmonary embolism, Ultrasound Doppler abnormal
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: atorvastatin (LIPITOR) 10 MG tablet cholecalciferol, vitamin D3, (VITAMIN D3 ORAL) cinnamon bark (CINNAMON ORAL) docosahexaenoic acid/epa (FISH OIL ORAL) fluticasone propionate (FLONASE) 50 mcg/Actuation nasal guaifenesin/dextromethorphan (
Current Illness:
Preexisting Conditions: Hyperlipidemia, sleep apnea
Allergies: None
Diagnostic Lab Data: 5/12: +venous US RLE for DVT, + R and L PE on CT angiogram
CDC Split Type:

Write-up: Developed LLE DVT and R sided PE. Unclear time correlation with vaccination. Symptoms worsened about 3 weeks ago.


VAERS ID: 1311961 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Alaska  
Vaccinated:2021-05-11
Onset:2021-05-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Anaphylactic shock
SMQs:, Anaphylactic reaction (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypersensitivity (narrow)

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

Write-up: Received the following text message from the mother of the patient: Patient was airlifted to the hospital where she is living. She had the J&J vaccine yesterday and went into anaphylactic shock. She pretty much always been allergic to everything. They put her on a high does of steroids but was just wondering if you had heard any reactions like that. Said it could take up to 6 weeks to settle in her system. She''s fine now.


VAERS ID: 1312221 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-05-12
Onset:2021-04-21
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Laboratory test, Platelet count decreased
SMQs:, Haematopoietic thrombocytopenia (narrow), Systemic lupus erythematosus (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Hydroxychloroquine
Current Illness:
Preexisting Conditions: Auto immune unspecified
Allergies: Tegratol
Diagnostic Lab Data: Tests done at hospital on 4/27/21 Test done at er and hospital 4/30/21
CDC Split Type:

Write-up: Low platlet count of 10k


VAERS ID: 1312229 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-03-16
Onset:2021-04-12
   Days after vaccination:27
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 RA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Abdominal pain, Computerised tomogram abnormal, Dizziness, Head discomfort, Insomnia, Musculoskeletal discomfort, Palpitations, Thrombophlebitis superficial, Ultrasound abdomen normal
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, venous (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Latin fe 1/20 Propranolol Multivitamin
Current Illness: None
Preexisting Conditions: None
Allergies: Metformin
Diagnostic Lab Data: 3/19/2021 Doppler test to confirm clot CT scan - showed no reason for abdomen pain Ultrasound of gallbladder- no inflammation
CDC Split Type:

Write-up: Superficial Thrombophlebitis of right leg, severe abdominal pain with no found explanation as to why, insomnia, dizziness, heart racing at night with neck:head discomfort


VAERS ID: 1312480 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Hawaii  
Vaccinated:2021-05-12
Onset:2021-05-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808986 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Feeling cold
SMQs:

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

Write-up: After 17 minutes, patient started feeling really cold and shivering. She requested a blanket and socks which we got for her. We also called EMS and they took her to the hospital for evaluation


VAERS ID: 1312649 (history)  
Form: Version 2.0  
Age: 95.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-06
Onset:2021-05-12
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 UN / UN

Administered by: Private       Purchased by: ?
Symptoms: Cardiac arrest, Cardioversion, Death, Dyspnoea, Haematemesis, Nausea, Pain, Pallor, Unresponsive to stimuli, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Gastrointestinal haemorrhage (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Respiratory failure (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-12
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Sertraline, Mirtazapine, memantine, Lamotrigine, Donepezil, Acetaminophen-Codeine
Current Illness: Unknown
Preexisting Conditions: Dementia, wheelchair bound
Allergies: NKDA
Diagnostic Lab Data: Covid PCR performed, result pending
CDC Split Type:

Write-up: On 5/12/2021 patient was complaining of generalized body aches, later in the morning when going to a pain management clinic, patient subsequently became nauseous and vomited several times during the course of the day. Reportedly had episode of dark emesis as well. Patient was then found by family around 10pm unresponsive, pale, w/ difficulty breathing, EMS was called, patient was found to be in cardiac arrest in asystole. Patient possibly had v-fib during transport and was defibrillated twice before becoming asystolic again. Patient was subsequently pronounced dead in the Emergency Department on 5/12/21 at 11:04pm.


VAERS ID: 1312758 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Minnesota  
Vaccinated:0000-00-00
Onset:2021-04-13
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Antibody test, Arthralgia, Blood test, Burning sensation, Chest X-ray, Chest pain, Dyspnoea, Electrocardiogram, Injection site pain, Pain in extremity, Pharyngitis, Pneumonitis, SARS-CoV-2 test, Sinusitis
SMQs:, Anaphylactic reaction (broad), Agranulocytosis (broad), Peripheral neuropathy (broad), Interstitial lung disease (narrow), Oropharyngeal infections (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (narrow), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: MELOXICAM
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19
Allergies:
Diagnostic Lab Data: Test Date: 20210312; Test Name: COVID-19 PCR test; Result Unstructured Data: Positive; Comments: The test was performed at clinic; Test Date: 20210409; Test Name: Antibody test; Result Unstructured Data: Positive; Comments: On 11/Apr/2021 the test was positive with results Spike RBD/IGG Titer #1 clone 3,200; Test Date: 20210415; Test Name: Blood test; Result Unstructured Data: Unknown; Test Date: 20210415; Test Name: EKG; Result Unstructured Data: Unknown; Test Date: 20210415; Test Name: Chest X-ray; Result Unstructured Data: Unknown; Test Date: 20210429; Test Name: Blood test; Result Unstructured Data: Lymphocytes and Eosinophil numbers changed; Comments: Lymphocytes and Eosinophil numbers changed
CDC Split Type: USJNJFOC20210505059

Write-up: LUNG INFLAMMATION/ SEEMS LIKE LUNG INFECTION; SHORTNESS OF BREATH/HARD TIME BREATHING; CHEST PAIN/BURNING IN THE CHEST; SINUS INFLAMMATION; THROAT INFLAMMATION; INTERNAL BURNING DOWN HER ARM TO THE WRIST; SHOULDER BLADE AREA PAIN; ARM PAIN; INTERNAL BURNING AT THE INJECTION SITE; This spontaneous report received from a patient concerned a female of unspecified age. The patient''s height, and weight were not reported. The patient''s past medical history included covid -19 infection. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 12-APR-2021 17:00 for prophylactic vaccination. The batch number was not reported and has been requested. Concomitant medications included meloxicam for drug used for unknown indication. On 12-MAR-2021, Laboratory data included: COVID-19 PCR test (NR: not provided) Positive. On 09-APR-2021, Laboratory data included: Antibody test (NR: not provided) Positive. On 13-APR-2021, the subject experienced lung inflammation. On 13-APR-2021, the subject experienced shortness of breath/hard time breathing. On 13-APR-2021, the subject experienced chest pain/burning in the chest. On 13-APR-2021, the subject experienced sinus inflammation. On 13-APR-2021, the subject experienced throat inflammation. On 13-APR-2021, the subject experienced internal burning down her arm to the wrist. On 13-APR-2021, the subject experienced shoulder blade area pain. On 13-APR-2021, the subject experienced arm pain. On 13-APR-2021, the subject experienced internal burning at the injection site. On 15-APR-2021, Laboratory data included: Blood test (NR: not provided) Unknown, Chest X-ray (NR: not provided) Unknown, and EKG (NR: not provided) Unknown. Treatment medications included: ibuprofen. On 29-APR-2021, Laboratory data included: Blood test (NR: not provided) Lymphocytes and Eosinophil numbers changed. On MAY-2021, treatment medications included: omeprazole. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from shortness of breath/hard time breathing, lung inflammation, chest pain/burning in the chest, internal burning at the injection site, shoulder blade area pain, sinus inflammation, throat inflammation, internal burning down her arm to the wrist, and arm pain. This report was non-serious.; Sender''s Comments: V0: Medical Assessment comment not required as per standard procedure as the case assessed as non-serious.


VAERS ID: 1312761 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Mississippi  
Vaccinated:0000-00-00
Onset:2021-03-24
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chest discomfort, Gastrooesophageal reflux disease, Influenza like illness, Investigation, Nausea, Pain, Pain in extremity, Sleep disorder, Urticaria
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Neuropathy
Allergies:
Diagnostic Lab Data: Test Date: 2021; Test Name: Investigation; Result Unstructured Data: blood clots which were negative
CDC Split Type: USJNJFOC20210506793

Write-up: BOTH LEG PAIN; HIVES / WORSENING HIVES; GASTROESOPHAGEAL REFLUX DISEASE; FELT LIKE HAVING HEART ATTACK; SLEEP INTERRUPTIONS; FLU-LIKE SYMPTOMS; ACHES; NAUSEA; This spontaneous report received from a patient concerned a 64 year old female. The patient''s height, and weight were not reported. The patient''s past medical history included neuropathy. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805022, expiry: UNKNOWN) dose was not reported, administered on 06-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 2021, Laboratory data included: Investigation (NR: not provided) blood clots which were negative. On 24-MAR-2021, the subject experienced flu-like symptoms. On 24-MAR-2021, the subject experienced aches. On 24-MAR-2021, the subject experienced sleep interruptions. On 24-MAR-2021, the subject experienced nausea. On 27-MAR-2021, the subject experienced felt like having heart attack. On 27-MAR-2021, the subject experienced gastroesophageal reflux disease. On 30-MAR-2021, the subject experienced hives / worsening hives. On 04-APR-2021, the subject experienced both leg pain. Treatment medications (dates unspecified) included: diphenhydramine hydrochloride, and famotidine. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from flu-like symptoms, aches, felt like having heart attack, sleep interruptions, gastroesophageal reflux disease, hives / worsening hives, and nausea on 2021, and both leg pain on APR-2021. This report was non-serious.; Sender''s Comments: V0: Medical assessment comment not required as per standard procedure as case assessed as non-serious.


VAERS ID: 1312763 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Illinois  
Vaccinated:0000-00-00
Onset:2021-03-16
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal distension, Abdominal tenderness, Allergy to vaccine, Amnesia, Blister, Body temperature, Breast swelling, COVID-19 pneumonia, Eating disorder, Faeces hard, Hypoaesthesia, Muscle spasms, SARS-CoV-2 test positive, Spinal pain, Swelling face, Tinnitus, X-ray
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Peripheral neuropathy (broad), Dementia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hearing impairment (narrow), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: ADHD; Allergic reaction to antibiotics; Allergy; Asthma; Blood pressure high; Bronchitis; Cyst of ovary; Detergent sensitivity; Drug allergy; Dysmenorrhea; Food allergy; GERD; Lactose intolerance; Latex allergy; Menstrual disorder; Penicillin allergy; Tingling of extremity
Preexisting Conditions: Medical History/Concurrent Conditions: Colon operation NOS; Tubal ligation
Allergies:
Diagnostic Lab Data: Test Date: 20210320; Test Name: Body temperature; Result Unstructured Data: High; Test Date: 20210327; Test Name: X-ray; Result Unstructured Data: blood patched, pneumonia; Test Date: 20210327; Test Name: COVID-19 virus test positive; Result Unstructured Data: positive
CDC Split Type: USJNJFOC20210507603

Write-up: COVID-19 PNEUMONIA; ALLERGY TO VACCINE; STOOLS HARD; STOMACH SWELL UP; MUSCLE SPASMS/ CRAMPS; BREAST SWELLING; PAIN FROM BACK OF SPINE TO TOP OF THE HEAD; NUMBNESS IN THE FINGERS; ABDOMINAL TENDERNESS; BLANKED OUT; RINGING IN THE EAR; FACIAL SWELLING; PAINFUL BLISTER; DIFFICULTY EATING; This spontaneous report received from a patient concerned a 48 year old (Indian or Native/aboriginal) female. The patient''s weight was 272 pounds, and height was 66 inches. The patient''s past medical history included partial tubal ligation, and part of colon removed, and concurrent conditions included asthma, bronchitis, bleeding disorder (irregular period), cyst on ovary, gerd, high blood pressure, adhd, dysmenorrhea, tingling of extremities, asa allergy, narcotics allergy, soap residue allergy, lactose intolerance, tramadol allergy, sulfa antibiotics allergy, strawberry extract allergy, penicillin allergy, metronidazole allergy, nalbuphine allergy, oxybutynin allergy, bees wax allergy, haloperidol allergy, fluoxetine allergy, medroxy progesterone allergy, gabapentin allergy, and latex allergy. The patient had a blood test with her MD prior to and was told did not have Covid and could get the shot. The patient received Covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805018, expiry: unknown) dose was not reported, administered to right arm on 16-MAR-2021, around 16:00 for prophylactic vaccination. No concomitant medications were reported. The patient was treated with injections to prevent blood clots (they did injection in the stomach area). On 16-MAR-2021, around 09:00 PM, patient experienced facial swelling and blister on the right side of her lip was burst and formed a scab and that made it difficult to eat. On next morning, 17-MAR-2021, patient had excruciating pain from top of her head to nostrils, it caused being weak and blanked out. On the day after, 18-MAR-2021, patient had a different taste and a different smell, also had ringing in the ear and was nauseous. On the 5th day, 20-MAR-2021, patient''s stomach was swelled and was really tender and breast was also swelled. The patient had a lot of headache, cramps, muscle spasms, body ache and was cold and hot. The patient had diarrhoea and had to lay down and had to crawl to bathroom with throwing up. The patient had high fever and could not keep anything down. On 20-MAR-2021, the patient experienced pain from back of spine to top of the head, numbness in the fingers. On 22-APR-2021, the patient experienced hard stools. On 27-MAR-2021, patient was hospitalized as she was coughing blood. On an unknown date, patient had patches on the x-ray and was diagnosed with pneumonia and her Covid (unknown) test was positive. Patient reported that she was given injections to prevent blood clots in the stomach area. The patient had pain back from spine to top of the head, was weak, had numbness in the fingers. She had headache, had lost appetite. The patient reported that as per her healthcare providers, was allergic to the vaccine as they noted shortness of breath, nausea and diarrhea. Laboratory data included: Body temperature (NR: not provided) High. On 27-MAR-2021, COVID-19 virus test positive (NR: not provided) positive, and X-ray (NR: not provided) blood patched, pneumonia. The action taken with Covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from covid-19 pneumonia, and ringing in the ear, was recovering from facial swelling, painful blister, difficulty eating, stomach swell up, muscle spasms/ cramps, blanked out, and abdominal tenderness, had not recovered from pain from back of spine to top of the head, numbness in the fingers, and stools hard, and the outcome of allergy to vaccine and breast swelling was not reported. This report was serious (Hospitalization Caused / Prolonged).; Sender''s Comments: V0:20210507603-covid-19 vaccine ad26.cov2.s -covid-19 pneumonia. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: UNDERLYING DISEASE


VAERS ID: 1312770 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Michigan  
Vaccinated:0000-00-00
Onset:2021-04-13
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Anaphylactic shock, Chills, Dehydration, Pyrexia, Rash
SMQs:, Anaphylactic reaction (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210509845

Write-up: DEHYDRATION; RASH; CHILLS; HIGH FEVER; ANAPHYLACTIC SHOCK; This spontaneous report received from a patient concerned a female of unspecified age. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number not reported) dose was not reported, administered on 13-APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 13-APR-2021, (after she had vaccine) patient had experienced the anaphylactic shock. She had a high fever and chills the same day she received the vaccine. On 15-APR-2021, she had a rash covering the entirety of her body. She called her PCP (Primary care physician) and was told to went to the emergency room but refused because of covid rates in her city. She had gone to urgent care instead and was given a benadryl shot and a prescription for steroid. The same day, the rash cleared up so she had not started the prescription again. On 17-APR-2021 the rashes were back, so she started the prescription again and she went to hospital and she was diagnosed with dehydration. She was given a new dose of benadryl, pepcid, and solumedrol for the treatment. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the anaphylactic shock, dehydration, rash, high fever and chills was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0- 20210509845- covid-19 vaccine ad26.cov2.s -Anaphylactic shock, Dehydration This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s). 20210509845- covid-19 vaccine ad26.cov2.s -Rash. This event(s) is labeled per RSI and is therefore considered potentially related.


VAERS ID: 1312772 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Arkansas  
Vaccinated:0000-00-00
Onset:2021-04-01
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Chest pain, Computerised tomogram, Fibrin D dimer, Muscular weakness, Pleurisy
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Systemic lupus erythematosus (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Non-smoker; Seasonal allergy
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 2021; Test Name: Computerised tomogram; Result Unstructured Data: It was clear; Test Date: 2021; Test Name: Fibrin D dimer; Result Unstructured Data: Elevated
CDC Split Type: USJNJFOC20210511666

Write-up: CHEST PAIN; RIGHT HAND/WRIST WEAKNESS; REDUCED HAND/GRIP STRENGTH; PLEURISY; This spontaneous report received from a patient concerned a 48 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included seasonal allergies, non alcohol user, and non smoker. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 203A21A expiry: UNKNOWN) dose was not reported, administered on 09-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 2021, the subject experienced pleurisy. Laboratory data included: Computerised tomogram (NR: not provided) It was clear, and Fibrin D dimer (NR: not provided) Elevated. On APR-2021, the subject experienced reduced hand/grip strength. On 20-APR-2021, the subject experienced chest pain. On 20-APR-2021, the subject experienced right hand/wrist weakness. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from chest pain on 30-APR-2021, had not recovered from right hand/wrist weakness, and the outcome of reduced hand/grip strength and pleurisy was not reported. This report was non-serious.; Sender''s Comments: V0: Medical assessment comment not required as per standard procedure as the case assessed as non-serious.


VAERS ID: 1312776 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-03-08
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Computerised tomogram, Electrocardiogram, Eye pain, Headache, Laboratory test, Magnetic resonance imaging, Ophthalmological examination, Pain in extremity, Pyrexia, Thirst, Vision blurred, Visual impairment
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Non-smoker
Preexisting Conditions: Comments: The patient did have no known drug allergies and No known health conditions and not on any medications
Allergies:
Diagnostic Lab Data: Test Date: 2021; Test Name: Electrocardiogram; Result Unstructured Data: couldn''t diagnose; Test Date: 2021; Test Name: MRI; Result Unstructured Data: couldn''t diagnose; Test Date: 2021; Test Name: Lab test; Result Unstructured Data: didn''t see any blockage and couldn''t figure out; Test Date: 2021; Test Name: Eye exam; Result Unstructured Data: couldn''t diagnose; Test Date: 2021; Test Name: CAT scan; Result Unstructured Data: couldn''t diagnose
CDC Split Type: USJNJFOC20210513462

Write-up: EYE PAIN; SEVERE HEADACHE; FEVER; FEELING THIRSTY; FELT MASSIVE PAIN RADIATING IN BODY AND PAIN IN LEGS AND ARMS; BLURRY VISION AND WHITE CLOUD OVER EYES; FELT LIKE LOSING SIGHT; This spontaneous report received from a patient concerned a 56 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included non-alcohol user, and non-smoker, and other pre-existing medical conditions included the patient did have no known drug allergies and no known health conditions and not on any medications. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805022, and batch number: 1805022 expiry: 25-MAY-2021) dose was not reported, administered on 08-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 2021, the subject experienced felt like losing sight. On 2021, the subject experienced blurry vision and white cloud over eyes. On 2021, the subject experienced felt massive pain radiating in body and pain in legs and arms. Laboratory data included: CAT scan (NR: not provided) couldn''t diagnose, Electrocardiogram (NR: not provided) couldn''t diagnose, Eye exam (NR: not provided) couldn''t diagnose, Lab test (NR: not provided) didn''t see any blockage and couldn''t figure out, and MRI (NR: not provided) couldn''t diagnose. On 08-MAR-2021, the subject experienced feeling thirsty. On 09-MAR-2021, the subject experienced eye pain. On 09-MAR-2021, the subject experienced severe headache. On 09-MAR-2021, the subject experienced fever. Treatment medications (dates unspecified) included: macrogol 400/propylene glycol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from eye pain, blurry vision and white cloud over eyes, and felt massive pain radiating in body and pain in legs and arms, and the outcome of feeling thirsty, severe headache, fever and felt like losing sight was not reported. This report was non-serious.; Sender''s Comments: Medical assessment comment is not needed as per standard procedure since case is assessed as non-serious.


VAERS ID: 1312781 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Minnesota  
Vaccinated:0000-00-00
Onset:2021-04-10
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

Administered by: Military       Purchased by: ?
Symptoms: Body temperature, Echocardiogram, Fatigue, Influenza like illness, Pain in extremity, Ultrasound scan
SMQs:, Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: LOSARTAN
Current Illness: Alcohol use (consumes alcohol occasionally); Blood pressure high; Non-smoker
Preexisting Conditions: Comments: No known allergies. No drug abuse/illicit drug use
Allergies:
Diagnostic Lab Data: Test Date: 20210410; Test Name: Body temperature; Result Unstructured Data: 99.0 F; Test Date: 20210414; Test Name: Diagnostic ultrasound; Result Unstructured Data: negative; Test Date: 20210414; Test Name: Echocardiogram; Result Unstructured Data: negative
CDC Split Type: USJNJFOC20210513990

Write-up: SEVERE PAIN ON LEFT LEG; SEVERE FATIGUE; FLU LIKE SYMPTOMS; This spontaneous report received from a consumer concerned a 37 year old male. The patient''s height, and weight were not reported. The patient''s concurrent conditions included high blood pressure, alcohol use, and non smoker, and other pre-existing medical conditions included no known allergies. no drug abuse/illicit drug use. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 203A21A expiry: 23-JUN-2021) dose was not reported, administered on 10-APR-2021 for prophylactic vaccination. Concomitant medications included losartan for high blood pressure. On 10-APR-2021, the subject experienced flu like symptoms. On 10-APR-2021, the subject experienced severe fatigue. Laboratory data included: Body temperature (NR: not provided) 99.0 F. On 14-APR-2021, the subject experienced severe pain on left leg. Laboratory data included: Diagnostic ultrasound (NR: not provided) negative, and Echocardiogram (NR: not provided) negative. Treatment medications (dates unspecified) included: menthol/methyl salicylate, and paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from severe pain on left leg, severe fatigue, and flu like symptoms. This report was non-serious.; Sender''s Comments: V0: Medical assessment comment not required as per standard procedure since case was assessed as non serious.


VAERS ID: 1312782 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: New Mexico  
Vaccinated:0000-00-00
Onset:2021-04-09
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Cerebral thrombosis, Computerised tomogram, Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Name: CT scan; Result Unstructured Data: Discovered blood clot in the brain
CDC Split Type: USJNJFOC20210514154

Write-up: BLOOD CLOT IN BRAIN; BODYACHES; HORRIBLE NAUSEA; SLIGHT FEVER; This spontaneous report received from social media/news via a company representative concerned a female of unspecified age. The patient''s weight, height, and medical history were not reported. The patient received Covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: unknown) dose was not reported, 1 total administered on 08-APR-2021 for prophylactic vaccination. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On 09-APR-2021, the patient developed blood clot in brain and it was discovered by computed tomography (CT) scan (date unspecified), went to emergency room (ER). He was admitted in the hospital (date unspecified) for blood clot in brain. On the same day, the patient also experienced body aches, horrible nausea and horrible headache, slight fever. The action taken with Covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the blood clot in brain, horrible nausea, body aches and slight fever was not reported. This report was serious (Hospitalization Caused / Prolonged).; Sender''s Comments: V0: 20210514154-covid-19 vaccine ad26.cov2.s-blood clot in brain. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).


VAERS ID: 1312819 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-03-01
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Computerised tomogram, Migraine, Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Cerebral arteriovenous malformation haemorrhagic
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210314; Test Name: CT scan; Result Unstructured Data: arterial venous malformation in brain, details of scan unknown
CDC Split Type: USJNJFOC20210518421

Write-up: SEVERE MIGRAINE; LEG PAIN; This spontaneous report received from a patient concerned an adult female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included arterial venous malformation in brain.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: MVX1805031 expiry: UNKNOWN) dose was not reported, administered on 13-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On MAR-2021, the subject experienced leg pain. On 14-MAR-2021, the subject experienced severe migraine. Laboratory data included: CT scan (NR: not provided) arterial venous malformation in brain, details of scan unknown. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from severe migraine, and leg pain. This report was non-serious.


VAERS ID: 1312847 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: North Carolina  
Vaccinated:0000-00-00
Onset:2021-04-07
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Fatigue, Pain in extremity, Pyrexia, Ultrasound scan
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210416; Test Name: Diagnostic ultrasound; Result Unstructured Data: Not had clots
CDC Split Type: USJNJFOC20210520815

Write-up: LEG PAIN; FATIGUE; FEVER; DIZZY; This spontaneous report received from a parent concerned a 21 year old female. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 043A21A expiry: UNKNOWN) dose was not reported, administered on 07-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 07-APR-2021, the subject experienced dizzy. On 07-APR-2021, the subject experienced fatigue. On 07-APR-2021, the subject experienced fever. On 08-APR-2021, the subject experienced leg pain. On 16-APR-2021, Laboratory data included: Diagnostic ultrasound (NR: not provided) Not had clots. Treatment medications (dates unspecified) included: ibuprofen. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from dizzy, fatigue, and fever on 08-APR-2021, and leg pain. This report was non-serious.


VAERS ID: 1312853 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Electric shock sensation, Motion sickness, Presyncope, Vertigo
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210521066

Write-up: FEELING OF BRAIN WAS ROTATING OR SPINNING; LIGHT HEADED; FELLING OF GOING TO FAINT; MOTION SICKNESS; BRAIN JOLTS; This spontaneous report received from a patient via a company representative concerned a female of unspecified age. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: Unk) dose was not reported, administered on 17-MAR-2021 for prophylactic vaccination. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On an unspecified date, the subject experienced feeling of brain was rotating or spinning, light headed, felling of going to faint, motion sickness, and brain jolts. The action taken with covid-19 vaccine was not applicable. The patient recovered from light headed, and felling of going to faint, had not recovered from motion sickness, and the outcome of feeling of brain was rotating or spinning and brain jolts was not reported. This report was non-serious.


VAERS ID: 1313234 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-04-08
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Acute myocardial infarction, Angiogram, Blood cholesterol
SMQs:, Myocardial infarction (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? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Cholesterol high
Preexisting Conditions: Comments: Patient was not having a family history of heart issues. Patient was maybe genetically more prone to heart attacks.
Allergies:
Diagnostic Lab Data: Test Date: 202104; Test Name: Cholesterol; Result Unstructured Data: slightly elevated; Test Date: 202104; Test Name: Angiogram; Result Unstructured Data: not provided
CDC Split Type: USJNJFOC20210504947

Write-up: STEMI HEART ATTACK; This spontaneous report received from a consumer concerned a 31 year old male. The patients height, and weight were not reported. The patients concurrent conditions included elevated cholesterol, and other pre-existing medical conditions included patient was not having a family history of heart issues.May be patient was genetically more prone to heart attacks. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin, and batch number were not reported) dose was not reported, frequency 1 total, administered on APR-2021 for prophylactic vaccination. Batch number was not reported and has been requested. No concomitant medications were reported. On 08-APR-2021 in the morning, the patient experienced stemi heart attack (life-threatening), patient was rushed to Emergency Room at 3:00AM in morning and the patient was hospitalized. The patient experienced permanent heart damage and patient received angiogram and stent in artery was performed for the diagnosis. Laboratory data (dates unspecified) included: Angiogram (NR: not provided) not provided. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the stemi heart attack was not reported. This report was serious (Hospitalization Caused / Prolonged).; Sender''s Comments: V0: 20210504947-COVID-19 VACCINE AD26.COV2.S-STEMI Heart Attack . This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).


VAERS ID: 1313559 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-09
Onset:2021-04-27
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Areflexia, Asthenia, Back injury, Back pain, Blood glucose normal, CSF protein increased, Chest discomfort, Chest pain, Condition aggravated, Demyelinating polyneuropathy, Dysarthria, Fall, Gait disturbance, Hypoaesthesia, Hyponatraemia, Intervertebral disc degeneration, Intervertebral disc protrusion, Intervertebral disc space narrowing, Magnetic resonance imaging spinal abnormal, Muscular weakness, Nausea, Neck pain, Pain, Paraesthesia, Plasmapheresis, Pseudohyponatraemia, Red blood cell count decreased, Spinal osteoarthritis, Spinal stenosis, Urinary incontinence, Vertebral foraminal stenosis, Vertebral osteophyte, Walking aid user, White blood cell count decreased
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Haematopoietic erythropenia (narrow), Haematopoietic leukopenia (narrow), Peripheral neuropathy (narrow), Haemorrhage laboratory terms (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hyponatraemia/SIADH (narrow), Cardiomyopathy (broad), Demyelination (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Chronic kidney disease (broad), Arthritis (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (narrow), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 9 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Arthritis, Back pain, cervical cancer, cerebral vascular accident, diabetes mellitus, headache, hypercholesterolemia, hypertension, hypothyroid, post-hysterectomy menopause, tinnitus, vertigo
Allergies: Erythromycin
Diagnostic Lab Data: 5/7/21 Cerebrospinal fluid analysis: Protein 266, Glucose 97, WBC 4, RBC 3, Appearance Clear, Colorless 5/2/21 MRI lumbar spine w/o contrast: TECHNIQUE: MRI of the lumbar spine was performed. COMPARISON: None. FINDINGS: Degenerative and postoperative changes are present in the lumbar spine. There has been previous surgery at L4-5. Bilateral pedicle screws are present. In degenerative changes are most prominent at the L3-4 level. There is moderate disc space narrowing with endplate changes and erosions. There is no fracture or subluxation. L1-2 and L2-3 have annular bulging with only minimal effacement of the thecal sac. Facets are within normal limits. Foramina remain patent. L3-4 has mild endplate hypertrophy and associated disc bulging with mild effacement of the thecal sac. There mild hypertrophic changes of facets. Moderate to marked foraminal narrowing is present bilaterally greater on the right. L4-5 has had a decompressive laminectomy. There is minimal endplate prominence. There is no spinal stenosis. There is moderate right foraminal narrowing and minimal left foraminal narrowing. L5-S1 has mild endplate prominence and associated annular bulging without disc herniation or spinal stenosis. Mild hypertrophy of the facets is present. There is minimal foraminal narrowing on the right. Signal in the conus is normal. IMPRESSION: Postoperative changes at L4-5. Degenerative changes predominantly at L3-4. There is moderate-to-marked foraminal narrowing greater on the right at this level. 5/8/21 MRI head w/o contrast: FINDINGS: Diffusion-weighted images do not demonstrate any abnormal signal to suggest recent infarct. Sagittal T1 images demonstrate normal appearance of corpus callosum, normal size of the pituitary, and normal position of the cerebellar tonsils. Ventricles and sulci are within normal limits in terms of size. There is mild burden of FLAIR hyperintense lesions within the periventricular and deep bihemispheric white matter as well as within the central pons. Usual major arterial flow voids are present. No significant abnormal fluid signal within the temporal bone structures or paranasal sinuses. Gradient echo sequence is unremarkable. IMPRESSION: 1. No acute intracranial process is identified. No evidence of recent hemorrhage or infarct. 2. No space-occupying lesion is appreciated. 3. Normal brain volume. Mild burden of scattered white matter disease within the bilateral cerebral hemispheres and central pons; this is most consistent with chronic microvascular ischemic change. 5/8/21 MRI Spine cervical w/o contrast: TECHNIQUE: Multisequence, multiplanar, MR images were obtained of the cervical spine without the use of intravenous contrast. FINDINGS: There is no suspicious focal marrow signal abnormality. There are Modic type 2 changes within the marrow adjacent to the C5-C6 disc space and mixed Modic type 1 and type 2 changes within the marrow adjacent to the C6-C7 disc space. The craniovertebral junction is intact. There is no spondylolisthesis. Vertebral body heights are intact. There is diffuse disc desiccation. There is significant disc space height loss at C5-C6 and C6-C7. The cervical cord has normal caliber, contour, and signal throughout. No gross abnormality of the exiting nerve roots. C2-C3: No significant central canal or neural foraminal stenosis. C3-C4: Mild central disc protrusion without cord compression.. Mild bilateral neural foraminal narrowing secondary to facet/uncovertebral joint degenerative changes. C4-C5: Mild broad-based disc bulge. No significant central canal stenosis. Mild bilateral neural foraminal narrowing secondary to facet/uncovertebral joint degenerative changes. C5-C6: Mild broad-based disc osteophyte complex effaces the ventral CSF space but does not compress the cord. There is moderate bilateral neural foraminal narrowing secondary to facet/uncovertebral joint degenerative changes. C6-C7: Mild broad-based disc osteophyte complex. No effect upon the cord. Mild bilateral neural foraminal narrowing. C7-T1: No significant central canal or neural foraminal stenosis. IMPRESSION: 1. No acute fracture or malalignment. 2. Diffuse spondylosis. There is some mild central canal narrowing without any significant effect upon the cord. Diffuse mild to moderate neural foraminal narrowing. 3. Cervical cord has normal caliber, contour, and signal throughout. No gross abnormality of the spinal nerve roots.
CDC Split Type:

Write-up: 4/30/21: This patient comes in complaining of worsening low back pain. She has a history of severe degenerative disease in his had surgery. She was scheduled to see her neurosurgeon last year however it got canceled due to the COVID-19. Patient states she saw her neurologist on Tuesday and was given injections which significantly helped. She states that her pain has returned however. She has had no trauma. No footdrop. No difficulty with her bowel or bladder. Patient states she only uses Tylenol arthritis at home. 5/1/21:The patient is a 70-year-old female presenting to the emergency department for back pain. She has a history of chronic back pain and states that has been worsening. She was recently seen here for the same complaint. She currently rates her pain 10/10 intensity. She reports that she has chronic numbness and tingling of her bilateral arms/hands and legs/feet. She states that this is also worsening. She denies any changes in bowel or bladder function or perineal numbness. She states that she has been using a walker at home and that she has tried to make an appointment with her neurosurgeon who previously operated on her but that she has been unable to get through to their office. She reports that she only called 1 time on a Friday. She is taking Tylenol at home for her pain and reports minimal relief. She denies any fevers or associated concerns at this time. 5/2/21: This is actually her 3rd visit in less than a week with this complaint. She was seen 2 other times at a outside facility. She states that she had back surgery about 10 years ago at Beaumont. She states she was supposed to see her neurosurgeon last year but this did not occur secondary to COVID-19. Her primary care physician had referred her to a neurologist did some injections ahead some relief of her back pain for a week or 2 but this is since worsened. She states that over last several days she has had increasing numbness and tingling in her feet as well as increasing weakness of her lower extremities as well as some now some new incontinence of urine when she stands up. She today she also complains some chest pain she attributes more from just amount of pain he has from her back. She rates her back pain as a 10/10 intensity. She did have 1 episode of a week or 2 ago where she slipped down and fell on her knee but did not hit her back directly. She did not hit her head. She describes the chest discomfort in her upper abdomen lower chest area. She is nauseated but not vomiting here. She denies any exertional dyspnea or orthopnea prior to this. She has had no recent fever chills. 5/11/21: The patient is an 70 y old female admitted on 5/4/2021. The patient was originally seen by Neurology on 05/07/2021 when she presented with diffuse weakness. She has a history of hyperlipidemia, hypertension and diabetes. The patient at that time described the acute onset of weakness ascending from the feet, then involving the legs and arms also associated with sensory symptoms that started about 2 weeks prior to her presentation. She also had persistent neck and back pain radiating to her arm and legs limiting her ability to walk. On neurologic examination at that time the patient had absent deep tendon reflexes in the lower extremities and trace reflexes at the biceps. She had significant weakness in the lower extremities and mild weakness in the upper extremities. She also had a dysarthric speech. Given the patient''s CSF analysis showing protein elevation to 266 with no pleocytosis, wbc''s were only for, there was support for a clinical diagnosis of acute inflammatory demyelinating poly radicular neuropathy or such variant. The patient was started on plasmapheresis and has received her 2nd session of plasmapheresis on 05/09/2021. She will have a total of 5 sections, one every other day. The patient also has hyponatremia, this can be seen in about 5% of patients with Guillain-Barre syndrome, we also do see pseudohyponatremia but this is in patients that have received IVIG.


VAERS ID: 1313562 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-05-12
Onset:2021-05-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Malaise, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad)

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

Write-up: Systemic: Dizziness / Lightheadness-Medium, Systemic: TINGLING-Mild, Additional Details: HAD PATIENT PUT HIS HEAD IN BETWEEN HIS LEGS, GAVE WATER, CHOCOLATE AND A CLIFF BAR. PATIENT STILL WAS NOT FEELING BETTER SO HAD PATIENT LAY DOWN AND HAD LEGS ON CHAIR ABOVE HEAR LEVEL. GAVE PATIENT WATER AND STILL WAS NOT FEELING BETTER SO HAD PATIENT PUT LEGS DOWN ON GROUND. I GRABBED NURSE PRACTITIONER FROM CLINIC AND SHE CHECKED HIM OUT. VITALS WERE NORMAL ACCORDING TO NP. SHE ADVISED TO CALL 911 DUE TO TINGLING IN FINGERS AND NOT GETTING BETTER. WE CALLED AND PATIENT WENT WITH EMS.


VAERS ID: 1313576 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-05-12
Onset:2021-05-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Confusional state, Dizziness, Fatigue, Injection site erythema, Injection site pruritus, Lethargy, Nausea, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Site: Itching at Injection Site-Mild, Site: Redness at Injection Site-Mild, Systemic: Confusion-Medium, Systemic: Dizziness / Lightheadness-Severe, Systemic: Exhaustion / Lethargy-Severe, Systemic: Fainting / Unresponsive-Severe, Systemic: Nausea-Medium, Additional Details: he was fainted right after the shot. my tech called 911 and i stayed with him. after 1 minute he was responding but still needed medical attention. i waited with him until paramedics come.


VAERS ID: 1313623 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-03-19
Onset:2021-03-29
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Acute myocardial infarction, Catheterisation cardiac, Chest pain, Coronary artery occlusion, Coronary artery thrombosis, Electrocardiogram abnormal, Laboratory test abnormal, Stent placement, Troponin increased
SMQs:, Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, arterial (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Metoprolol 25mg daily,
Current Illness: None
Preexisting Conditions: None
Allergies: Allergy to ACE inhibitor
Diagnostic Lab Data: Multiple EKGs, lab draws. Initial testing was negative, Shortly after, tropinin levels increased from 0.05 to 0.19. ekg changes from normal to STEMI.
CDC Split Type:

Write-up: STEMI with 100% blockage in LAD with clot. Emergency cath lab with stents. Symptoms started at 330am on 3-29-21. Came to ED shortly after. Initial testing and labs were negative. Began to have severe symptoms shortly after. Multiple doses of nitro and morphine given for chest pain with no relief. Taken for emergency heart cath by 7am.


VAERS ID: 1313809 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-03-06
Onset:2021-03-22
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Activated partial thromboplastin time normal, Angiogram cerebral normal, Blood glucose increased, Cardiac stress test abnormal, Cerebral infarction, Computerised tomogram head normal, Confusional state, Dysarthria, Dyskinesia, Full blood count normal, Hypertension, International normalised ratio normal, Magnetic resonance imaging head abnormal, Metabolic function test normal, Neurological symptom, Percutaneous coronary intervention, Perfusion brain scan normal, Prothrombin time normal, Troponin increased, Type 2 diabetes mellitus
SMQs:, Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Dyskinesia (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypertension (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Other ischaemic heart disease (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None identified prior to hospital admission on 3/23.
Allergies: None
Diagnostic Lab Data: 3/23: Head CT, CTA, and CT Perfusion: Negative for acute intracranial abnormalities or large vessel occlusion 3/23: Brain MRI: Multiple acute infarcts within the left middle cerebral artery territory. 3/23: Normal CBC and BMP. Blood glucose elevated at 463 mg/dL. PT/INR/aPTT WNL. Troponin elevated 0.20 ng/mL 4/6: Cardiac Stress Test: abnormality noted in LAD. 4/14: Left Heart Cath: PCI performed and DES to mid LAD placed.
CDC Split Type:

Write-up: Patient presented to hospital on 4/23 after experiencing stroke-like symptoms the evening of 4/22. Symptoms included slurred speech, confusion, and repetitive grasping of his L hand. Patient was diagnosed with DM2 and HTN during his hospital admit, but had not previously received treatment.


VAERS ID: 1313833 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Vermont  
Vaccinated:2021-03-05
Onset:2021-03-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Blood lactic acid, Blood test, Chest X-ray, Culture urine, Dizziness, Full blood count, Glomerular filtration rate, Metabolic function test, Pyrexia, Urine analysis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: IBS, GERD, Lactose Intolerance
Allergies: None Known
Diagnostic Lab Data: Automated Differential, CBC with Auto Diff, Comprehensive Metabolic Panel,Estimated GFR, HCG Qual Serum, Lactate, Urinalysis with Reflux Urine Culture, Urine Microscopic, Blood Culture performed 2 times, Urine Culture, EKG 12 Lead Sepsis, XR Chest Single View *All performed on 3/6 between 12AM and 6AM
CDC Split Type:

Write-up: Woke up with heart rate of 146, felt dizzy and faint. Also had fever of 103.5, but I know fevers are part of the anticipated side effects. Called doctor at home, they were worried I might get palpations so they suggested an ER visit for testing. By the time I got to the ER, heart rate had dropped slightly, temp was still high.


VAERS ID: 1313840 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-09
Onset:2021-05-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Fatigue, Hyperhidrosis, Nausea, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Monday 5/10 felt fatigued, Tuesday 5/11 Diaphoretic and nauseous, 5/12 Syncope/Weakness, 5/13 Weakness, called 911 and brought to emergency room


VAERS ID: 1313890 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-03-30
Onset:2021-03-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Cough, Decreased appetite, Headache, Productive cough, Pyrexia, Upper respiratory tract infection
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (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: No
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: CT Scan-normal CBC-normal
CDC Split Type: vsafe

Write-up: The next morning after the vaccine I woke up with a fever, no energy and feeling really drained. 4/1 I lost my appetite and still had the fever for several days. The first week was basically fever, loss of appetitie and lack of energy. By week 2 I started having headaches so I went to the healthcare facility and was prescibed Naprozen but it has been ongoing since. I was diagnosed with a URI and was prescribed Mucinex which did help with the flim that I begin coughing up. I have been struggling with my appetite and has noticed about a 5lb weight loss. It is getting better but still not fully back to normal yet.


VAERS ID: 1313930 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-07
Onset:2021-04-15
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Axillary pain, Blood test, Chest X-ray, Chest pain, Fatigue, Headache, Hypoaesthesia, Magnetic resonance imaging abnormal, Pain in extremity
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Thyroid medication
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Basis blood work and chest x ray, mri of head snd neck to check for pinched nerve . No nerve impingement found ... small abnormality on head MRI unknown if related.
CDC Split Type:

Write-up: Headache, right sided arm and leg numbness, pain in both calves, pain in arm pit which is worse on right side, some center chest pain and extreme tiredness. I have been to ER 3 times as well has PCP once and have follow up with a Neuro.


VAERS ID: 1314013 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-03-03
Onset:2021-05-13
   Days after vaccination:71
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blepharospasm, Electromyogram normal, Hypoaesthesia, Magnetic resonance imaging head normal, Magnetic resonance imaging neck, Magnetic resonance imaging normal, Muscle twitching
SMQs:, Peripheral neuropathy (broad), Dyskinesia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Aimovig Citalipram Wellbutrin Armour Thyroid Crestor
Current Illness: none
Preexisting Conditions: hypo thyroid high cholesterol
Allergies: sulfa
Diagnostic Lab Data: My primary care doctor referred me to Neurology where I had an EMG, MRI of the lumbar and cervical spine and an MRI of the brain to rule out any neuromuscular diseases. ( specifically Multiple Sclerosis). These test were negative, but the symptoms described above are still persisting. I have been referred to the spine clinic for further evaluation.
CDC Split Type:

Write-up: 3 weeks after the vaccine my left eye began to twitch and continued for about 2 weeks. During this time I began to have muscle twitching in my left and right arms. My left leg at the inner calf area became intermittently numb and the muscle twitching began in my legs as well at the same time.


VAERS ID: 1314117 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-12
Onset:2021-05-06
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Methadone flomax
Current Illness: None
Preexisting Conditions: chronic opioid regimen
Allergies: Mr clean upholstery cleaner
Diagnostic Lab Data:
CDC Split Type:

Write-up: LLE DVT and bilateral non occlusive PE


VAERS ID: 1314131 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-05
Onset:2021-04-26
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Erythema, Flushing, Full blood count, Pain, Peripheral swelling, Skin warm, Thyroid function test
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Nortriptyline, trintrillex, hydroxyzine, fish oil, vitamin d
Current Illness: None
Preexisting Conditions: Interstitial cystitis, Sj?gren?s syndrome
Allergies: None
Diagnostic Lab Data: 5-11-21: CBC, thyroid
CDC Split Type:

Write-up: Daily facial flushing. Hand and feet swelling turns red and hot, burning pain on body . Every day occurrence since 4/26/21


VAERS ID: 1314170 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-05-11
Onset:2021-05-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Confusional state, Feeling hot, Hyperhidrosis, Loss of consciousness, Pallor, Speech disorder
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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

Write-up: Patient began sweating profusely approximately 10 minutes after his vaccine. He went to his parent''s car and asked his father to turn on the air conditioning as he was hot. he then passed out in the back seat of the car. His mother came inside and asked for assistance. I grabbed an epi-pen and ran outside to the car. Patient was breathing and had a pulse rate of 64. He aroused shortly after I began asking him if he could hear me and asked if he could tell me his name. He was pale (notably his lips were quite pale) and confused. He could not say his name but could nod appropriately to questions when asked. We immediately called EMS for assistance. They arrived within 4-5 minutes and transported the patient to hospital.


VAERS ID: 1314181 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-07
Onset:2021-04-21
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Cerebrovascular accident, Computerised tomogram, Echocardiogram, Magnetic resonance imaging abnormal
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: I had a CT scan on April 21 when I was brought to local hospital by ambulance I had an MRI on April 26 which confirmed the stroke prior to having my second stroke on April 26. On April 26 I was then readmitted to the hospital and was there until April 29. During my stay in the hospital I had multiple CT scans with and without contrast I also had a heart Doppler as well.
CDC Split Type:

Write-up: I had a stroke on April 21 followed by a second on April 26.


VAERS ID: 1314209 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: D.C.  
Vaccinated:2021-03-06
Onset:2021-03-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Blindness transient, Chest pain, Chills, Electrocardiogram, Heart rate increased, Mobility decreased, Pain in extremity, SARS-CoV-2 test negative
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, arterial (narrow), Parkinson-like events (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Retinal disorders (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Dehydration (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Melatonin the last night
Current Illness: No
Preexisting Conditions: Aspergers Syndrome
Allergies: No
Diagnostic Lab Data: 3/7, ECG and Covid test, vitals were acceptable and covid was negative
CDC Split Type:

Write-up: Aches and pains outside of arm 15 minutes afterwards. Subsided largely, but chills started and became more heightened after strenuous exercise later in the day. After 3 hours of sleep, awoke the next day with chest pain and difficulty moving. Heart rate (normally 60) spiked to 140 and could not see fit five seconds, had to call ambulance. Ambulance determined much of it was due to anxiety (multiple exams and significant work were due soon), and recommended medical supervision to ensure it did not escalate. Went to urgent care and was supervised until 1 pm, 24 hours after the vaccination, by which time symptoms had subsided


VAERS ID: 1314221 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-09
Onset:2021-04-27
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Blindness unilateral, Cerebrovascular accident, Computerised tomogram head abnormal, Hypertension, Intensive care, Magnetic resonance imaging head abnormal, Somnolence, Thrombosis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Hypertension (narrow), Optic nerve disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: Highblood pressure.
Preexisting Conditions: None
Allergies: none
Diagnostic Lab Data: Please ask if you need this
CDC Split Type:

Write-up: Patient got small blood clot show on skin 4 days after shot, it went away lighter red in 1.2 week, blood pressure went up and down suddently. Sunday was fine, Monday the 26 was fine, went to bed at 9:00 PM. Was not able to wake up, went to ER around 8:30 AM on 4/27 AM by daughter call 911. In ER for 28 hour and found out she got stroke. Pnewnewmia. ER gave antibootic around 3:00 PM, transfer to intensive care, MRI around 7:00 PM 4/27/2021 due to CT scan shown stroke. Lost Vision on right side and parcial on left side due to stroke.


VAERS ID: 1314222 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-03-11
Onset:2021-03-15
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / IM

Administered by: Private       Purchased by: ?
Symptoms: Activated partial thromboplastin time, Epistaxis, Full blood count normal, International normalised ratio normal, Prothrombin level normal
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: include but not limited to Humira, Pancrease, Bupropion, Buspirone, Klonopin, Duloxetine, Jardiance, Gabapentin, insulin, hyoscyamine, levothyroxine, metoprolol, omeprazole, oxycodone, promethazine, torsemide, tizanidine
Current Illness: chronic conditions- see below. no acute illness
Preexisting Conditions: type 2 diabetes, psoriasis, fibromyalgia, hypothyroidism, asthma
Allergies: Clonidine, Penicillin, rosuvastatin, sulfa drugs, losartan, ACE inhibitors, vancomycin
Diagnostic Lab Data: CBC, aPTT, PT/INR Apr2021 were WNL
CDC Split Type:

Write-up: Recurrent Epistaxis. presented to ER 4d after Janssen Covid vaccine with epistaxis, no prior hx of this issue, no known bleeding d/o, not on antiplatelet or anticoag agent. recurrent episodes mostly R nostril since then requiring cautery x5, rhino rocket


VAERS ID: 1314231 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-03-25
Onset:2021-04-30
   Days after vaccination:36
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test normal, Fibrin D dimer normal, Full blood count normal, Muscle spasms, Pain, Pain in extremity, Thrombin time normal, Thrombophlebitis superficial, Ultrasound scan abnormal
SMQs:, Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Dystonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin, Gabapentin, Clonadine, Melatonin, Fish Oil, Whey Protein
Current Illness: None
Preexisting Conditions: Insomnia
Allergies: None
Diagnostic Lab Data: May 6th - Ultrasound May 7th - CBC blood panel, D-dimer, PT clotting time
CDC Split Type:

Write-up: April 30th began to notice dull ache in calf. At first assumed it was a muscle cramp. The pain began to increase through the weekend and into the following week. I went to urgent care on May 6th. They sent me to the ER to get an ultra sound as their preliminary evaluation was that it could be a blood clot. The ER ultrasound confirmed the presence of a superficial thrombosis in my left calf. No blood work was performed. I was told to take ibuprofen and use a heated compress and to wear compression stockings. If the pain grew worse, I was to return to the ER. I scheduled a follow-up with my Primary the next day. Blood tests show all values to be in normal range. I have no history of blood clots and perform cardiovascular exercise on a daily basis.


VAERS ID: 1314240 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-03
Onset:2021-04-08
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure increased, Blood test normal, Chest discomfort, Chest pain, Dyspnoea, Electrocardiogram normal, Endoscopy, Heart rate increased, Inflammation, Oesophageal discomfort, Rash
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Shingrix, November 2020 - Urticaria - not sure if this caused it
Other Medications: Tirosint Eva Mist
Current Illness: Urticaria from December 2020 - end of February 2021
Preexisting Conditions: Hypothyroid - thyroidectomy in 2008
Allergies: Wheat
Diagnostic Lab Data: Multiple blood tests and EKGs on all of the dates above. All normal. Endoscopy on 5/7. Waiting for biopsy results.
CDC Split Type:

Write-up: April 3 - vaccine, April 5 - allergy patch test , April 8th - rash on back and stomach; dr prescribed hydroxyzine and Xyzal and Clobetasol lotion. April 18 - started experiencing rapid heart rate and chest tightness - lasted for 4-5 hours. April 19 - saw allergist, blood pressure was elevated, started with rapid heart and chest tightness again. Went to ED, did EKG and blood work. No issues. April 20 - same symptoms went back to ED, EKG and blood work normal. April 23 - Urgent Care, saw Cardiologist for blood pressure, prescribed labetalol. Said it appeared to be chest wall inflammation. April 24 - chest tightness and high blood pressure, went to ED. Gave me a shot of anti inflammatory. April 26 - dr had me go back to ED for CT scan. ED ran blood work and determined I did not need CT scan. April 27 - chest pain, difficulty taking a deep breath and feeling like food stuck in esophagus - went back to ED, gave me a GI cocktail to numb the esophagus. April 30 - chest pain again gave me another GI cocktail and referred me to gastroenterologist. May 6 - chest pain, back to ED, another GI cocktail. May 7 - endoscopy. Will receive results on 5/14


VAERS ID: 1314258 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-05-13
Onset:2021-05-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1816022 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fall, Seizure, Vomiting
SMQs:, Acute pancreatitis (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

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

Write-up: Patient had a seizure and vomited. The seizure lasted a couple of minutes. She feel from the chair that she was sitting in when she got the vaccine. A gentlemen that came with her picked her up and sat her on a chair. He was holding her from there on. We called code Blue on the intercom and called the ambulance. Once she came back from seizure she was fully conscious and aware of her surrounding. She knew her name, address, where she is , etc. The ambulance took her away to Hospital. (She did mention to the ambulance that she had a seizure about a month ago because she took medicine and alcohol that she was not suppose to.)


VAERS ID: 1314279 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-04-07
Onset:2021-04-12
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Burning sensation, Capillary fragility, Chest pain, Coagulation test abnormal, Computerised tomogram head, Computerised tomogram thorax, Fibrin D dimer increased, Fluid retention, Headache, Myalgia, Pain, Pain in extremity, Peripheral swelling, Ultrasound scan normal
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Haemorrhage laboratory terms (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Suboxone, Prilosec
Current Illness: None
Preexisting Conditions: Chiari Malformation
Allergies: Penicillin and Codiene
Diagnostic Lab Data: Blood work, CT scans and Ultrasounds. First test done at Hospital on 4-12-21. Next done on 4-21-21. Third on 5-7-21 and last ultrasound done at hospital on 4-11-21
CDC Split Type:

Write-up: About a week after being vaccinated I started experiencing bad headaches, chest pains and pains in my leg. I went to the emergency department at Hospital to get checked out. They took blood and I had a high d dimer test result. They did an Ultrasound of both legs, and a CT with contrast of the lungs and a CT of the head. No blood clots were evident at the time. Over the next couple of weeks my left leg has continued to swell and hold fluid. On 5-11-2021 I had another ultrasound of the left leg again to rule out a possible blood clot. Again they did not find anything. After reviewing blood work from a coag profile all results were elevated but not worrisome per the dr. I continie to have more swelling in the left lower extremity, muscle aches and pains in that leg along with more busted blood vessels. I have experienced pains in places that I have never had before. Example a sharp pain started around my left pelvic area and shot up to the left shoulder and then burned for several minutes.


VAERS ID: 1314282 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-03
Onset:2021-04-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Adverse reaction, Anxiety, Dry mouth, Dry throat, Electrocardiogram, Heart rate increased, Nausea
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Albuterol inhaler, avascone daily inhaler
Current Illness: asthma and an infection
Preexisting Conditions: Asthma, allergies
Allergies: Amoxycillin, Pollen, dogs, cats, mice, grass, nuts
Diagnostic Lab Data: EKG heart monitor
CDC Split Type: vsafe

Write-up: About 10 minutes after my throat and mouth was extremely dry. I went to the EMT and noticed my heart rate was beating fast. They told me to go to ER and I was having a bizarre reaction and also had an anxiety attack, which took a little while for my heart to go down. I was extremely nauseas the following one week and a half. I am no longer having these symptoms today.


VAERS ID: 1314349 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-09
Onset:2021-04-21
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Ultrasound was done to confirm blood clot.
CDC Split Type:

Write-up: Blood clot developed in the leg 10 days after the injection


VAERS ID: 1314415 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-05-12
Onset:2021-05-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure fluctuation, Dizziness, Dysphagia, Feeling hot, Flushing, Heart rate abnormal, Immediate post-injection reaction, Paraesthesia oral, Pharyngeal paraesthesia, Vision blurred
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Glaucoma (broad), Hypertension (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: low IgG levels, monitored by Clinic, autoimmune disorder
Allergies: benadryl (anaphylaxis)
Diagnostic Lab Data: pharmacy BP reading 144/100, pulse 77
CDC Split Type:

Write-up: immediately post-vaccination pt experienced flushing/warm sensation L side of arm/neck/face. Patient sat in chair x15min, given water. Pt states continued flushing with dizziness and inability to focus vision/blurry vision. Had patient continue to sit and observed additional 30 min. Pt reported no change in symptoms, moved pt back to vaccination room to reduce noise/traffic. Checked BP 144/100, pulse 77. Pt given more water and observed. No labored breathing or obvious distress noted. Pt reported tingling of tongue/throat. No signs of swelling of tongue/throat with examination but increased flushing of face/throat/ears. Pt offered benadryl, she disclosed anaphylaxis to benadryl and refused antihistamine. discussed concern of reaction and use of epipen/EMS services. Patient declined, asked for continued observation. observed x 15 min, no change in status. observed additional 15min, offered loratadine (pt states taken safely in past) pt declined. observed 15min, pt states continued tingling in mouth/throat with slight difficulty swallowing, no observed labored breathing, pt able to carry conversation without effort. Recommended epipen and EMS, pt refused. Pharmacist advised against driving and recommended seeking emergent care. Patient refused EMS and left with friend with request from pharmacist to go to ER. F/u with pt 2 hrs later, pt was at ER but no updated status. Phone call F/u with pt next day (5/13, 1pm). pt states given 1 medication (unknown) that reduced symptoms of tingling but HR/BP continued to fluctuate. ER discharged pt home evening of 5/12 and pt has f/u with primary care 5/14/21.


VAERS ID: 1314430 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: New Mexico  
Vaccinated:2021-03-25
Onset:2021-03-26
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure increased, Chest X-ray, Chest discomfort, Chest pain, Electrocardiogram, Laboratory test
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypertension (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None reported
Current Illness: None reported
Preexisting Conditions: None reported
Allergies: Sulfa, Molybdynum, Vitamin E, anything with cortisone, steroids
Diagnostic Lab Data: lab work x-ray of the chest EKG
CDC Split Type: vsafe

Write-up: I experienced the following day, I started getting very bad chest tightening and felt like spasms. I was not sure if I was having a heart attack, like a gripping pain in my chest, lasted for 1-2 hours. In the meantime, I did go to the ER because I thought I was having a heart attack. EKG and x-ray of the chest was performed, lab work was also performed. My BP went way up as well and I felt very nervous. I also saw a cardiologist for the chest tightening sensation. I think that the J&J vaccine I received was related to my symptoms. I can say today I sometime experience chest tightness but very lightly and at this time I have no symptoms. I do not have my lot# at this time to provide.


VAERS ID: 1314490 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-05-12
Onset:2021-05-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 RA / IM

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

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

Write-up: Patient reported to the emergency room with legs feeling heavy, numb, and tingling with body aches


VAERS ID: 1314530 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-09
Onset:2021-04-14
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: oxycodone, omeprazole, magnesium, vitamin C, vitamin D
Current Illness: Post abdominal hernia repair
Preexisting Conditions: Inflammatory bowel disease
Allergies: NKA
Diagnostic Lab Data: Venous Doppler
CDC Split Type:

Write-up: Left leg DVT


VAERS ID: 1314644 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-04-08
Onset:2021-04-17
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Patient Active Problem List Diagnosis Date Noted ? Headache, migraine 07/08/2020 Once a month, excedrin migraine helps ? Eczema 07/08/2020 ? Vitamin D deficiency 07/08/2020 ? Elevated alkaline phosphatase level 07/08/2020 Bone specific alk phos - Elevated in the past 2 yrs, Vit D 26 Alk phos 181, other LFTs normal, ALT 20, AST 18 BSAP 30.4 Gl 79, cr 0.73, Ca 9.3, TSH 1.33, Mg 1.9, P 3.4, GGT 18 ? Other hyperlipidemia 07/08/2020 ? Hashimoto''s disease ? Shoulder instability 03/12/2015 ? Constipation 02/19/2014 ? Family history of diabetes mellitus 02/19/2014 ? Varicose veins 02/19/2014 ? Hemorrhoids 10/28/2011 ? De Quervain''s tenosynovitis 08/03/2011 ? Muscle spasm 08/03/2011 Lumbar, fell from stairs at acupuncturist office 1.5 yrs ago. Takes naproxen and tylenol PM
Allergies: NKDA
Diagnostic Lab Data: 4/15 : venous doppler (showed positive persistence of superficial thrombophlebitis) , repeat on 5/3- venous doppler (showed persistence of superficial thrombophlebitis) ; was placed on xarelto anticoagulant and remains on this.
CDC Split Type:

Write-up: superficial thrombophlebitis left saphenous vein


VAERS ID: 1314659 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-03-14
Onset:2021-04-24
   Days after vaccination:41
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

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

Write-up: DVT LUE brachial vein on 4/24/2021


VAERS ID: 1314684 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-07
Onset:2021-04-14
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Autonomic nervous system imbalance, Dissociation, Disturbance in attention, Encephalitis, Fatigue, Feeling abnormal, Memory impairment, Neurological examination abnormal, Palpitations, Panic attack, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (narrow), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Depression (excl suicide and self injury) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Glandular thyroid support L-tyrosine, ashwaghanda, milk thistle, NAC, magnesium
Current Illness:
Preexisting Conditions: Hashimoto?s thyroiditis (in remission) Endometriosis
Allergies: Gluten
Diagnostic Lab Data: Comprehensive neurologic testing completed on 5/10/21 showed subacute encephalitis causing cerebellar, meso-limbic, hippocampal, visual cortex, and basal ganglia pathway dysfunction.
CDC Split Type:

Write-up: The first symptom I noticed was extreme brain fog and forgetfulness. Then, 6 days after the vaccine, I started having terrifying episodes of acute dysautonomia and panic attacks that included dissociation. These episodes persisted intermittently for 3 weeks. Between the episodes, I was extremely fatigued, brain dead, and unable to concentrate, with a fine resting tremor and constant heart palpitations. I am finally getting treatment from a chiropractic neurologist for subacute encephalitis that caused the dysautonomia and limbic system derangement. A month later, I am still restricted in my activities and have some remaining symptoms of ANS and brain dysfunction, but I am getting better.


VAERS ID: 1314702 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-13
Onset:2021-05-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Xanax in am
Current Illness: Patient stated not sick today
Preexisting Conditions: Anxiety Pain
Allergies: nka
Diagnostic Lab Data: Not none at this time
CDC Split Type:

Write-up: Patient complained of numbness in both arms and then chest pain following injection. Ambulance was called and treated patient .


VAERS ID: 1314722 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-07
Onset:2021-04-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 7784876 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain, Blood urine present, Cardiac monitoring, Chest X-ray, Chest discomfort, Chest pain, Chills, Dizziness, Dyspnoea, Eyelid disorder, Fall, Feeling abnormal, Feeling hot, Headache, Hypoaesthesia, Laboratory test, Movement disorder, Neurological symptom, Palpitations, Pyrexia, Seizure, Shock, Speech disorder, Sudden hearing loss, Syncope, Tracheal disorder, Vertigo, Vision blurred
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Hypovolaemic shock conditions (narrow), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypoglycaemic and neurogenic shock conditions (narrow), Dementia (broad), Convulsions (narrow), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Psychosis and psychotic disorders (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Hearing impairment (narrow), Vestibular disorders (narrow), Periorbital and eyelid disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Allergies to pollen
Preexisting Conditions: Asthma
Allergies: Penicillin, allergies to pollen
Diagnostic Lab Data: lab work x-ray of the chest
CDC Split Type: vsafe

Write-up: Within 5 minutes from receiving my J&J vaccine, I went to sit down and I started feeling very hot in my body. My heart started to race, had chest discomfort and had trouble breathing, my trachea closed up, had blurry vision and pain in my chest. I felt like I could not breathe and when the nurse came over to ask me I could not speak to her, I went into a shock and I was placed on the floor and I could not hear anything nor could open my eyes, from my hips down to my feet I could not feel anything, my legs went completely numb and I had a syncope. What I was told from the nurse that I was given an Epi-pen to help with my reaction. When I came back my body was having convulsions, felt my head spinning, had pain in my chest that so very intense and the nurse got me up and took me to a nearby ambulance and the EMT staff placed like a heart monitor because my heart was racing super fast. I also felt heaviness in my chest and inside the ambulance I was given two injections on my left arm and when I slowly started coming back, I was already at the hospital. I was at the hospital from 2pm to 4:30pm more less being monitored. At the hospital x-ray of the chest was performed as well as lab work and I was discharged home. When I got home, I still did not feel good, I felt heaviness to my chest, still have trouble breathing and get chills during the night. I also could not stand up and have a nerve sensation to my body and the chest pain to my left side is still very present. I have blurry vision, dizziness, headaches, and my heart-beat continues to race very fast. I get headaches, have abdominal pain and I peed blood few times then that''s when I was able to pee, my abdominal pain was painful like having a baby. On Friday 04-08-2021, I again went to the hospital because I had fallen to the floor on my kitchen floor and my daughter took me to the hospital. I let the nurse staff know that I still have continued chest pain and pressure, difficulty breathing and headaches, dizziness and they monitored and gave me three pills as medication. I was discharged home about 5pm with a referral to see a neurologist due to my chest pain, blurry vision, dizziness and fever which I had these past three weeks. I do not know why I felt all these symptoms after my J&J vaccine.


VAERS ID: 1314744 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-05-13
Onset:2021-05-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cold sweat, Confusional state, Dizziness, Dyskinesia, Loss of consciousness, Nausea, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Dyskinesia (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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: pt reports congenital heart defect that was corrected surgically while an infant
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: pt fainted approx 2 minutes after vaccination while sitting in waiting area. 911 was called. Pt was placed supine and was unconscious for approx 60 seconds with involuntary movements of arms and upper body consistent to passing out (not seizure like in intensity). confused, clamy/nauseas upon awakening, remained supine for 2-3 minutes. upon sitting up pt became dizzy and laid down again. paramedics arrived began assessment. BP, EKG, BG all normal. pt reports not having eaten today, also reports congenital heart defect that was corrected surgically while an infant. Mother arrived and decision was made in conjunction with paramedics to take pt to hospital for further eval based on his symptoms of lightheadedness/nausea continuing.


VAERS ID: 1314755 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-05-13
Onset:2021-05-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 RA / IM

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

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

Write-up: Patient had difficulty breathing, fainted, gasping for breath, given epinephrine injection in thigh, started to become conscious and breath more easily, then started vomiting. Called 911 in meantime. Patient taken to hospital.


VAERS ID: 1314830 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-03-25
Onset:2021-04-07
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Antinuclear antibody, C-reactive protein, Chills, Delirium, Disturbance in attention, Electromyogram, Fatigue, Headache, Hypoaesthesia, Magnetic resonance imaging head, Pain, Paraesthesia, Platelet count decreased, Vein rupture
SMQs:, Haematopoietic thrombocytopenia (narrow), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Rosacea, turmeric, omega-3, vitamin D3, airborne, calcium magnesium zinc, biotin, collagen
Current Illness: None
Preexisting Conditions: TMD, lower back pain. shoulder bursitis
Allergies: None
Diagnostic Lab Data: Low platelet (4/16/2021) Brain MRI (5/4/2021) CRP/ANA test (5/13/2021) Electromyogram (5/14/2021)
CDC Split Type:

Write-up: Chills and body aches (12-24 hours post-vaccination) Numbness/tingling in left leg, numbness/tingling in right hand (weeks 2 & 3 post-vaccination) Fatigue, headache, loss of concentration (weeks 5 & 6 post-vaccination) Ruptured vein in left leg (week 6 post-vaccination) Headache and delerium (week 7 post-vaccination)


VAERS ID: 1314886 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-09
Onset:2021-05-13
   Days after vaccination:34
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram thorax abnormal, Dyspnoea, Pain, Pulmonary embolism, Tachycardia, Ultrasound Doppler normal
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), 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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: hydrocodone
Current Illness: surgery on right shoulder
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: CT lung US leg neg for DVT x 2
CDC Split Type:

Write-up: vaccine 4/9 surgery 5/5 on shoulder 5/10 clinic neg US of leg for DVT due to pain 5/13 PE with increased short of breath and tachycardia


VAERS ID: 1314916 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-04-07
Onset:2021-04-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test, Chills, Dyspnoea, Fatigue, Fibrin D dimer increased, Headache, Myalgia, Nausea, Pain in extremity, Pyrexia, Ultrasound scan
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Haemorrhage laboratory terms (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), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol, Toradol, Phenergan
Current Illness: None
Preexisting Conditions: Lyme Disease
Allergies: Flagyl, Diflucan
Diagnostic Lab Data: They did blood work that showed my D-Dimer was elevated, and an ultrasound of my leg to check for blood clots.
CDC Split Type:

Write-up: My symptoms starting the night I got the vaccine and lasted for 2 weeks after. I had a fever, chills, severe headache, nausea, shortness of breath, muscle aches, fatigue, and pain in my left leg. We ended up going to the emergency room the week after because of fear of blood clots.


VAERS ID: 1314936 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-01
Onset:2021-04-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Back pain, Chills, Dizziness, Headache, Menstrual disorder, Oligomenorrhoea, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Fertility disorders (broad)

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

Write-up: About one hour after my J&J vaccine, I experienced dizziness. I took a shower and felt chills all over my body and back pain as well. I then went to sleep and my head started to hurt. My head pain grew in intensity and I felt dizzy. At about 7pm, I started vomiting profusely because of my headaches. I then went to urgent care because I am also diabetic and was worried of how I was feeling. At the urgent care they gave me Paracetamol and nausea medication. My headaches lasted 3-4 days then they went away. Also since I was on my third day of my menstrual cycle at the time of my J&J vaccine, my menstrual cycle got irregular and lasted 5 days longer than my usual 3 days.


VAERS ID: 1314960 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-13
Onset:2021-05-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

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

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

Write-up: About 5-10 minutes after the patient received the vaccine, she lost consciousness and fell off her chair. She regained consciousness and I had her lay on the ground on her back. Her blood pressure was 88/69, heart rate was 86 and she was sweating a lot. EMS came and took her blood pressure again and it was 110/80. She went to the hospital for further observation and they did an EKG and said everything was normal, and now she is feeling okay.


VAERS ID: 1314964 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Kansas  
Vaccinated:2021-05-13
Onset:2021-05-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 RA / IM

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

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

Write-up: Shortly after receiving the vaccine patient felt light headed and removed mask. He then passed out falling forward in chair and hitting his head he then went into convulsions. Quickly came to and was able to walk out with EMS.


VAERS ID: 1314972 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-05-06
Onset:2021-05-09
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK LA / IM

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

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

Write-up: Lower lip swelling Presented to ED complaining of allergy to vaccine Treated with oral steroids and a dose of Benadryl and felt better so was discharged home


VAERS ID: 1314995 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-02
Onset:2021-04-17
   Days after vaccination:15
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Acute disseminated encephalomyelitis, Angiogram cerebral normal, Angiotensin converting enzyme, Antinuclear antibody negative, Arteriogram carotid normal, Asthenia, Bacterial test negative, Bacterial test positive, Bladder catheterisation, Blood culture negative, Blood electrolytes normal, Blood immunoglobulin G, Blood lactic acid, Blood pressure diastolic increased, C-reactive protein increased, CSF culture negative, CSF virus no organisms observed, Cardiolipin antibody negative, Chest X-ray normal, Chills, Computerised tomogram spine, Computerised tomogram thorax normal, Cryptococcus test, Cytomegalovirus test negative, Differential white blood cell count normal, Double stranded DNA antibody, Enterovirus test negative, Escherichia test negative, Gait disturbance, HIV antibody negative, HIV antigen negative, Haemophilus test, Headache, Hepatic enzyme, Hepatitis B surface antigen negative, Hepatitis C RNA negative, Hepatitis C antibody positive, Herpes simplex test negative, Influenza virus test negative, Listeria test, Magnetic resonance imaging head abnormal, Magnetic resonance imaging spinal abnormal, Metabolic function test normal, Myelitis transverse, Nausea, Neck pain, Neisseria test, Neutrophil percentage increased, Pain, Pain in extremity, Paraesthesia, Pyrexia, Red blood cell sedimentation rate normal, Respiratory syncytial virus test negative, Respiratory viral panel, Rheumatoid factor negative, SARS-CoV-2 RNA undetectable, SARS-CoV-2 test negative, Scan with contrast, Spinal cord disorder, Streptococcus test negative, Treponema test negative, Ultrasound Doppler normal, Urinary retention, Urine analysis, Varicella virus test negative, Viral test negative, Wheelchair user, White blood cell count increased, White blood cells urine negative, White matter lesion
SMQs:, Liver infections (narrow), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Cardiomyopathy (broad), Demyelination (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (narrow), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Flomax, tramadol
Current Illness: None
Preexisting Conditions: Essential hypertension (well-controlled)
Allergies: NKDA
Diagnostic Lab Data: 5/2/21 respiratory viral PCR panel negative 5/1/21 CSF gram stain no organisms, culture no growth to date, CSF meningitis/encephalitis PCR panel negative E. coli K1 Not Detected H. influenzae Not Detected L. monocytogenes Not Detected N. meningitidis Not Detected S. agalactiae (Strep Group B) Not Detected S. pneumoniae Not Detected Cytomegalovirus Not Detected Enterovirus Not Detected HSV 1 Not Detected HSV 2 Not Detected HHV 6 Not Detected Parechovirus Not Detected VZV Not Detected Cryptococcus neoformans/gattii Not Detected 5/1/21 serum cryptococcus antigen negative, RPR nonreactive 4/30/21 blood cultures no growth to date 4/30/21 HIV-1/2 antigen/antibody negative 4/30/21 hepatitis C IgG positive, hepatitis C RNA negative, hepatitis B surface antigen negative 4/30/21 SARS-CoV-2 RNA negative 4/30/21 influenza A/B negative 4/28/21 SARS-CoV-2 RNA negative 4/28/21 blood cultures no growth to date Other: 5/1/21 MOG IgG antibody <1;10; cardiolipin antibody within normal limits; DSDNA antibody negative, ACE within normal limits 4/30/21 ANA negative Recent Imaging Results: CT Head Neck Angiography w and wo IV Contrast Result Date: 5/1/2021 IMPRESSION: 1. No acute intracranial abnormality. 2. No flow-limiting stenosis, occlusion, or aneurysm in the intracranial and extracranial circulations. 3. No dissection in the visualized neck vessels. 4. No acute fracture or malalignment of the cervical spine. For under 40 years: Some imaging findings are common, even in normal, pain-free volunteers. Among people under the age of 40 who do not have back pain, a CT scan will find that about: - 5 in 10 have disk degeneration - 3 in 10 have disk signal loss or desiccation - 3 in 10 have disk height loss - 4 in 10 have a disk bulge - 3 in 10 have a disk protrusion I have personally reviewed the images for this examination and agree with the report transcribed above. Signed"Final report" CT Cervical Spine w IV Contrast Result Date: 5/1/2021 IMPRESSION: 1. No acute intracranial abnormality. 2. No flow-limiting stenosis, occlusion, or aneurysm in the intracranial and extracranial circulations. 3. No dissection in the visualized neck vessels. 4. No acute fracture or malalignment of the cervical spine. For under 40 years: Some imaging findings are common, even in normal, pain-free volunteers. Among people under the age of 40 who do not have back pain, a CT scan will find that about: - 5 in 10 have disk degeneration - 3 in 10 have disk signal loss or desiccation - 3 in 10 have disk height loss - 4 in 10 have a disk bulge - 3 in 10 have a disk protrusion I have personally reviewed the images for this examination and agree with the report transcribed above. Signed"Final report" CT Lumbar Spine wo IV Contrast Result Date: 5/1/2021 IMPRESSION: Please note that these reformations of the lumbar spine were available for review on 5/1/2021 at approximately 4:41 AM. 1. No acute fracture or traumatic malalignment of the lumbar spine. 2. Right lateral recess protrusion at L5/S1. I have personally reviewed the images for this examination and agree with the report transcribed above. Signed"Final report" CT Thoracic Spine wo IV Contrast Result Date: 5/1/2021 IMPRESSION: 1. No acute fracture or traumatic malalignment of the thoracic spine. 2. Spinal cord is incompletely evaluated by CT. Within limitations of a noncontrast exam, no large epidural collections. No high grade osseous narrowing of the spinal canal. 3. Please refer to same day CT chest report detailed extraspinal findings. For under 40 years: Some imaging findings are common, even in normal, pain-free volunteers. Among people under the age of 40 who do not have back pain, a CT scan will find that about: - 5 in 10 have disk degeneration - 3 in 10 have disk signal loss or desiccation - 3 in 10 have disk height loss - 4 in 10 have a disk bulge - 3 in 10 have a disk protrusion I have personally reviewed the images for this examination and agree with the report transcribed above. Signed"Final report" XR Chest 1 View Result Date: 5/1/2021 IMPRESSION: 1. No acute cardiopulmonary disease. I have personally reviewed the images for this examination and agree with the report transcribed above. Signed"Final report" XR Chest 1 View Result Date: 4/28/2021 IMPRESSION: 1. No No pulmonary opacities visualized. Please note that chest radiographs have low sensitivity for subtle groundglass opacities that can be seen in viral infections. significant interval change. I have personally reviewed the images for this examination and agree with the report transcribed above. Signed"Final report" US Lower Extremity Veins Deep Vein Thrombosis Bilateral Result Date: 5/1/2021 IMPRESSION: 1. No ultrasound evidence of deep venous thrombosis. I have personally reviewed the images for this examination and agree with the report transcribed above. Signed"Final report" MR Brain wo IV Contrast Result Date: 5/2/2021 IMPRESSION: 1. No interval significant change. No acute hemorrhage or infarction. 2. Unchanged bilateral supratentorial and infratentorial pattern of multifocal patchy white matter changes as before, without new associated hemorrhage or restricted diffusion. Again findings most concerning for ADEM (acute disseminated encephalomyelitis), other considerations include other demyelinating processes, toxic-metabolic pathology, or potentially atypical viral infection. I have personally reviewed the images for this examination and agree with the report transcribed above. Signed"Final report" MR Brain w and wo Contrast Result Date: 5/1/2021 IMPRESSION: 1. Multifocal patchy white matter signal changes, predominantly in the subcortical white matter, also present in the bilateral thalami and bilateral middle cerebellar peduncle, and redemonstration of extensive cervical cord signal abnormality and expansion. No associated restricted diffusion or enhancement. Broad differential, but given pattern of involvement findings are most concerning for ADEM (acute disseminated encephalomyelitis), other considerations include other demyelinating processes, toxic-metabolic pathology, or potentially atypical viral infection. For between 40-60 years: Some imaging findings are common, even in normal, pain-free volunteers. Among people between the age of 40 and 60 years who do not have back pain, an MRI will find that about: - 8 in 10 have disk degeneration - 7 in 10 have disk signal loss or desiccation - 6 in 10 have disk height loss - 6 in 10 have a disk bulge - 3 in 10 have a disk protrusion - 3 in 10 have an annular fissure I have personally reviewed the images for this examination and agree with the report transcribed above. Signed"Final report" MR Cervical Spine wo IV Contrast Result Date: 5/1/2021 IMPRESSION: 1. Extensive cord signal abnormality in the cervical and thoracic cord as detailed above, with associated expansion of the cord (most pronounced in the cervical cord). Differential includes acute transverse myelitis, demyelination, infection (HIV, syphilis, other viruses)/parainfectious phenomenon, subacute combined degeneration, and inflammatory etiologies. An underlying mass or masses are not excluded but less likely given extensive multifocal patchy involvement. Recommend postcontrast imaging at this time for further workup. Consider brain MR as well to assess for systemic white matter disease. Recommend clinical correlation, consideration of LP, and follow-up imaging. Findings were discussed with doctors at 1:17AM on 5/1/2021. I have personally reviewed the images for this examination and agree with the report transcribed above. Signed"Final report" MR Cervical Spine w and wo IV Contrast Result Date: 5/1/2021 IMPRESSION: 1. Multifocal patchy white matter signal changes, predominantly in the subcortical white matter, also present in the bilateral thalami and bilateral middle cerebellar peduncle, and redemonstration of extensive cervical cord signal abnormality and expansion. No associated restricted diffusion or enhancement. Broad differential, but given pattern of involvement findings are most concerning for ADEM (acute disseminated encephalomyelitis), other considerations include other demyelinating processes, toxic-metabolic pathology, or potentially atypical viral infection. For between 40-60 years: Some imaging findings are common, even in normal, pain-free volunteers. Among people between the age of 40 and 60 years who do not have back pain, an MRI will find that about: - 8 in 10 have disk degeneration - 7 in 10 have disk signal loss or desiccation - 6 in 10 have disk height loss - 6 in 10 have a disk bulge - 3 in 10 have a disk protrusion - 3 in 10 have an annular fissure I have personally reviewed the images for this examination and agree with the report transcribed above. Signed"Final report" MR Thoracic Spine wo IV Contrast Result Date: 5/1/2021 IMPRESSION: 1. Extensive cord signal abnormality in the cervical and thoracic cord as detailed above, with associated expansion of the cord (most pronounced in the cervical cord). Differential includes acute transverse myelitis, demyelination, infection (HIV, syphilis, other viruses)/parainfectious phenomenon, subacute combined degeneration, and inflammatory etiologies. An underlying mass or masses are not excluded but less likely given extensive multifocal patchy involvement. Recommend postcontrast imaging at this time for further workup. Consider brain MR as well to assess for systemic white matter disease. Recommend clinical correlation, consideration of LP, and follow-up imaging. Findings were discussed with doctors at 1:17AM on 5/1/2021. I have personally reviewed the images for this examination and agree with the report transcribed above. Signed"Final report"
CDC Split Type:

Write-up: 36 Y male patient from another country with a past medical history significant for mild HTN (on 2.5 mg amlodipine) who was in his usual state of health until approximately 4/17/21 when he developed acute onset left volar forearm tingling sensation. He had received the Johnson & Johnson vaccine on 4/2/21 in his left arm and states that he did not experience any noticeable reactions after vaccination. He also recalls having had sustained a minor superficial scrape on his left volar forearm by a trash can lid when he had taken out garbage, which occurred very shortly before the onset of this tingling sensation. The tingling sensation then progressively worsened and became more diffuse across most of his body. He then developed fevers up to 102 at home, chills, neck pain, headache, and pain in all extremities (primarily arms but also in his legs). He initially went to the Health Care ED on 4/28/21. He was afebrile at the time and his vital signs at that time were unremarkable with the exception of elevated diastolic blood pressures (90-104 mm Hg). WBC 10.1 with normal differential, electrolytes and liver enzymes within normal limits. Influenza, RSV, and SARS-CoV-2 PCR were negative. Urinalysis showed few bacteria but no WBCs. Chest x-ray was clear. Blood cultures were drawn and patient was then discharged. Patient returned to the ED on 4/29/21 and reported fever to 102-103 d F, chills, nausea, weakness, body aches, and bilateral foot paraesthesias. He was afebrile (98.8) and his vital signs were within normal limits. His WBC was slightly elevated to 12.2 with a normal differential. His ESR was 11, CRP 1.5, CMP within normal limits. He was noted to have urinary retention and a foley was placed and he was given tamsulosin. Patient then returned to the ED again the following day, on 4/30/21, with worsening generalized pain and weakness and difficulty walking. ED course: temperature 101, heart rate 100s-110s, BP 140s-160s/70s-90s, RR low 20s, SaO2 high 90s. Labs remarkable for WBC 13.1 with 82.4% N, ESR 7, CRP 5.9, lactic acid 2.6, RF 10, urinalysis unremarkable, HIV antigen/antibody negative. Several imaging studies were performed. MRI T spine showed "Extensive cord signal abnormality in the cervical and thoracic cord as detailed above, with associated expansion of the cord (most pronounced in the cervical cord). Differential includes acute transverse myelitis, demyelination, infection (HIV, syphilis, other viruses)/parainfectious phenomenon, subacute combined degeneration, and inflammatory etiologies. An underlying mass or masses are not excluded but less likely given extensive multifocal patchy involvement. Recommend postcontrast imaging at this time for further workup. Consider brain MR as well to assess for systemic white matter disease." A lumbar puncture was attempted in the ED but was unable to be performed. Patient was given empiric IV ceftriaxone 1 g q24h and admitted to the hospitalist service. He was evaluated by neurology and was started on Solumedrol 1000 mg for acute transverse myelitis. 5/1/21 MRI brain showed "Multifocal patchy white matter signal changes, predominantly in the subcortical white matter, also present in the bilateral thalami and bilateral middle cerebellar peduncle, and redemonstration of extensive cervical cord signal abnormality and expansion. No associated restricted diffusion or enhancement. Broad differential, but given pattern of involvement findings are most concerning for ADEM (acute disseminated encephalomyelitis), other considerations include other demyelinating processes, toxic-metabolic pathology, or potentially atypical viral infection." Patient was given methylprednisolone for ADEM with transverse myelitis and clinically improved. He was hospitalized from 4/30/21 until being discharged to home in a wheelchair on 5/6/21.


VAERS ID: 1315206 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-04
Onset:2021-04-08
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 - / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Computerised tomogram, Contusion, Headache
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Trazadone, Sertraline
Current Illness: None
Preexisting Conditions: Depression
Allergies: None
Diagnostic Lab Data: ER visit with CT Scan w/o cont
CDC Split Type:

Write-up: Headaches, bruising after 3 days and still continuing


VAERS ID: 1315222 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Vermont  
Vaccinated:2021-05-13
Onset:2021-05-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Lip swelling, Pharyngeal swelling, Pruritus, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Pfizer on 4/22/21
Other Medications:
Current Illness:
Preexisting Conditions: Chron''s
Allergies: Amoxicillin, mushroom,doxycycline,tetracyclines,sulfa,codeine, Tylenol,Fluconazole, PCN, eLAVIL, lORCET, apap, pREDNISONE, vanco, black pepper, clindamycin, cipro, Montelucast
Diagnostic Lab Data:
CDC Split Type:

Write-up: 2 minutes after receiving the vaccine pt began to feel itching to bilaral arms and left rib area. Itching progressively became worse. 50 mg benadryl given. No relief. 16 min after receiving vaccine pt complained of lips swelling and throat tightening and feeling swollen. Lips swollen. 0.3 mg epi auto injector given in left thigh. 911 called. 1-2 minutes after epi throat felt less swollen, itching began to decrease. Pt remained alert and oriented x3 and no evidence of respiratory distress. Ambulance arrived. pt left on stretcher


VAERS ID: 1315233 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-05
Onset:2021-05-08
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Ear pain, Fatigue, Headache, Hypoaesthesia, Magnetic resonance imaging head normal, Ultrasound scan normal
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: 40mg Duloxetine Probiotics
Current Illness: N/A
Preexisting Conditions: Endometriosis Migraine
Allergies: Cipro
Diagnostic Lab Data: May 9, 2021 at ER. MRI of Brain/Neck with & without contrast plus ultrasound. No signs of blood clot or stroke.
CDC Split Type:

Write-up: May 8, 2021 - in addition to headaches, fatigue, dizziness. Left ear pain started at 3PM, and left cheek/face became numb. (Like novocaine wearing off) May 9 - same symptoms as above, but left neck became numb May 13 - same symptoms as above dates persist on Day 8 post shot.


VAERS ID: 1315642 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Maine  
Vaccinated:2021-05-01
Onset:2021-05-03
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Condition aggravated, Ear pain, Mastication disorder, Mobility decreased, Pain, Pain in jaw, Ultrasound scan normal
SMQs:, Parkinson-like events (broad), Osteonecrosis (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth Control (mini pill) Prenatal
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin, Cephalexin
Diagnostic Lab Data: Went to ER on 5/7 due to the radiating leg pain, ultrasound to check for blood clot (none found at that time behind knee, nor in groin). ER doc also did physical exam on ear/jaw, pressing on the painful area, no definitive answer but believes the area is inflamed causing nerve pain/pressure.
CDC Split Type:

Write-up: Extreme pain in left jaw/ear area that continues to be present almost 2weeks post vaccine. Started approximately 48hrs post vaccination. Cannot open mouth fully or chew properly due to the pain. As well as: Joint Pain, more specifically, increased pain in areas with pre-existing nerve issues/concerns (carpal tunnel, damaged ulnar nerve in right arm, sciatic nerve pain in left hip). Radiating pain in left pain from hip to ankle


VAERS ID: 1315684 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-05-13
Onset:2021-05-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypotension, Syncope, Tremor
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: Severe syncope, shaking, low blood pressure


VAERS ID: 1315704 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Maryland  
Vaccinated:0000-00-00
Onset:2021-03-16
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 HCP / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Dyspepsia, Injection site swelling, Laboratory test, Thrombosis
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific dysfunction (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210419; Test Name: Lab test; Result Unstructured Data: heart was normal but found blood clots in legs
CDC Split Type: USJNJFOC20210504455

Write-up: BLOOD CLOTS BOTH LEGS; POSSIBLE HEARTBURN; SWELLING AT INJECTION SITE; This spontaneous report received from a patient concerned a 64 year old male. The patients weight, height, and medical history were not reported.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805022, and expiry: UNKNOWN) dose was not reported, frequency 1 total, administered on 16-MAR-2021 at left arm for prophylactic vaccination. No concomitant medications were reported. On 16-MAR-2021, the patient experienced swelling at injection site. On 19-APR-2021, patient had blood clots (1 in each leg), Hematologist put him on xarelto 10mg, in hospital for few days for blood clots. Patient initially went to hospital ER on 19-APR-2021 because he thought having chest pains or heartburn. Emergency Room ran tests and heart was normal, but found blood clots in his both legs. Lab test (NR: not provided) Heart normal. Treatment medications (dates unspecified) included: rivaroxaban. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from thought having chest pains/heartburn on 22-APR-2021, had not recovered from blood clots both legs, and the outcome of swelling at injection site was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0: 20210504455-COVID-19 VACCINE AD26.COV2.S-Blood clot both legs. This event(s) is considered unassessable. The event(s) has an unknown/unclear temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).


VAERS ID: 1315708 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: California  
Vaccinated:0000-00-00
Onset:2021-04-10
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Asthenopia, Blindness transient, Blood pressure measurement, Cerebral haemorrhage, Chills, Eye injury, Fatigue, Hypertension, Nausea, Ocular discomfort, Skin discolouration, Syncope, Tremor
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Hypertension (narrow), Optic nerve disorders (broad), Cardiomyopathy (broad), Corneal disorders (broad), Retinal disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210422; Test Name: Blood pressure; Result Unstructured Data: High
CDC Split Type: USJNJFOC20210514047

Write-up: CEREBRAL HEMORRHAGE IN HER HEAD/ DIZZINESS/ LOOSE HER BALANCE/ VOMITED/ HEADACHE; BLOOD PRESSURE WAS HIGH; FAINTING; TEMPORARY BLINDNESS; BROWN SPOTS ON FINGER; EYES ALSO HURT; EYE FEELS HEAVY; EYE PRESSURE FROM THE BACK; FATIGUE/ STILL FEEL TIRED; FEELS WEAK; NAUSEA; SHAKING BECAUSE SHE WAS COLD; CHILLS; This spontaneous report was received from a patient and concerned a 53 year old White (Hispanic or latino) female. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 202A21A, expiry: unknown) dose was not reported, administered on 10-APR-2021 to left deltoid for prophylactic vaccination. No concomitant medications were reported. On 10-APR-2021, the patient experienced shaking because of cold, chills, nausea. On 11-APR-2021 patient felt nauseous. On an unknown date the patient had fatigue and headache. On 17-APR-2021, the subject experienced fainting. On 22-APR-2021 patient felt dizzy, vomiting, and was losing balance periodically and got admitted to emergency room; On admission the patient was diagnosed with high blood pressure and cerebral hemorrhage in head due to high blood pressure and patient kept in emergency room under observation. On 24-APR-2021 patient was discharged but still experienced headaches when she returned home. On 30-APR-2021 the patient again visited emergency room and was prescribed unspecified blood pressure medications and Tylenol (paracetamol). On an unknown date, the patient had brown spots appeared on left hand (on top of her middle) the spots covered about half of middle finger. The patient described the headaches as it felt like something was moving inside her head which started on the back of head and right side and moved slowly around which hurt a lot. She mentioned her eyes also hurt. On 05-MAY-2021 the patient visited hospital and reported that they cannot do anything to the headaches. On an unknown date the patient eyes are heavy feels like something is pushing her eye and had temporary blindness Patient was prescribed with butalbital-caffeine with Tylenol for headache; that headache subsides away for 4 hours and comes back. On an unknown date the patient feels tired up and weak. Treatment medications (dates unspecified) included: butalbital/caffeine/paracetamol, and paracetamol. The patient recovered from fainting, and vomited, was recovering from shaking because she was cold, had not recovered from chills, fatigue, headache, brown spots on finger, eye feels heavy, eye pressure from the back, and temporary blindness, and the outcome of nausea, dizziness, blood pressure was high, cerebral hemorrhage in her head, eyes also hurt, loose her balance, still feels tired and feels weak was not reported. This report was serious (Hospitalization Caused / Prolonged, and Other Medically Important Condition).; Sender''s Comments: V0: 20210514047- covid-19 vaccine ad26.cov2.s-Cerebral heamorrhage, High blood pressure, Fainting, Temporary blindness. These events are considered unassessable. The events has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the events.


VAERS ID: 1315709 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Male  
Location: New York  
Vaccinated:0000-00-00
Onset:2021-04-01
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Deep vein thrombosis, Headache, Myalgia, Nausea, Pain, Pain in extremity, Ultrasound scan
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: The patient had no known drug allergies.
Allergies:
Diagnostic Lab Data: Test Date: 20210505; Test Name: Blood test; Result Unstructured Data: all results are normal.; Test Date: 20210505; Test Name: Diagnostic ultrasound; Result Unstructured Data: DVT in right leg
CDC Split Type: USJNJFOC20210515729

Write-up: BLOOD CLOT IN LOWER CALF MUSCLES IN RIGHT LEG (DVT); NAUSEA (AFTER VACCINATION); EXTREMELY BAD HEADACHES; MUSCLES ACHES; BODY ACHE; LEG PAIN; This spontaneous report received from a patient concerned a 33 year old hispanic or latino male. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included the patient had no known drug allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 041A21A, expiry: 21-JUN-2021) dose was not reported, 1 total administered on 02-APR-2021 on left arm for prophylactic vaccination. No concomitant medications were reported. On 03-APR-2021, the patient experienced post vaccine nausea, extremely bad headaches, muscles aches. On 28-APR-2021, the patient experienced blood clot in lower calf muscles in right leg DVT (deep vein thrombosis). At around 2 weeks ago on 28-Apr-2021 or 29-Apr-2021, he started to feel throbbing pain and tightness in calf area. On an unspecified date in APR-2021, the patient experienced body aches specially in leg, back and arms and felt like it was a strain calf muscles or achilles pain, tightness in calf. At around 1-May-2021 to 2-May-2021, he felt the pain was extremely worse although he did not have any trauma and he did not run that may have caused a muscles strain. He went to emergent care on 5-May-2021, as he does not have a medical insurance. The doctor ordered an ultrasound as the pain he was experiencing was unlikely due to muscles strains as he did not do anything that may have caused it. On same day, laboratory data included: blood test (NR: not provided) all results are normal and diagnostic ultrasound showed DVT in lower right calf muscles in right leg. It was reported that, he was asked if he reporting those side effect to Janssen would affect him by anyway if he want to proceed into any legal action against Janssen as he experienced a blood clot. he was also asking if Janssen can provide him for the cost. On 08-May-2021, treatment medications included rivaroxaban. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from nausea (after vaccination), extremely bad headaches, and muscles aches, had not recovered from blood clot in lower calf muscles in right leg (DVT), and the outcome of body ache and leg pain was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0: 20210515729 -Covid-19 vaccine ad26.cov2.s-BLOOD CLOT IN LOWER CALF MUSCLES IN RIGHT LEG (DVT). This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).


VAERS ID: 1315710 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-05-09
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Scan, 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? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: The patient had no blood clots in the past, not on any medications and no recent trauma and surgery.
Allergies:
Diagnostic Lab Data: Test Date: 20210509; Test Name: Scan; Result Unstructured Data: Blood clot in left leg
CDC Split Type: USJNJFOC20210516127

Write-up: BLOOD CLOT IN LEFT LEG; This spontaneous report received from a patient concerned a 48 year old, White and Hispanic or Latino female. The patient''s height, weight and medical history were not reported. The patient had no blood clots in the past or no recent trauma and surgery. The patient was not on any medications. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1802072 and expiry: UNKNOWN) dose was not reported, 1 total, administered to the left arm, on 06-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 09-MAY-2021, the patient came into the hospital with swelling in left leg, a lot of heat and a lot of pain. In emergency room (ER) they did scans and tests and it was found that the patient had a blood clot in left leg. The patient has to stay in the hospital for 24 hours until the blood clot was resolved. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from blood clot in left leg. This report was serious (Hospitalization Caused / Prolonged, and Other Medically Important Condition).; Sender''s Comments: V0;20210516127- covid-19 vaccine ad26.cov2.s-Blood Clot in left leg. This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).


VAERS ID: 1315726 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       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? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210517568

Write-up: BLOOD CLOT IN LEFT CALF; This spontaneous report received from a patient via a company representative through social media concerned a male of unspecified age and ethnicity. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown and expiry: Unknown) dose, start therapy date were not reported, 1 total, administered for prophylactic vaccination. No concomitant medications were reported. On an unspecified date, the subject experienced blood clot in left calf. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of blood clot in left calf was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0;0210517568-covid-19 vaccine ad26.cov2.-Blood clot in left calf. This event is considered unassessable. The event has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event.


VAERS ID: 1315728 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Male  
Location: North Carolina  
Vaccinated:0000-00-00
Onset:2021-04-12
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Computerised tomogram, Electrocardiogram, Hypoaesthesia, Peripheral swelling, Pulmonary thrombosis, SARS-CoV-2 test, Ultrasound scan
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Embolic and thrombotic events, venous (narrow), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), COVID-19 (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: The patient had no history of blood clots.
Allergies:
Diagnostic Lab Data: Test Date: 202104; Test Name: Blood test; Result Unstructured Data: unknown; Test Date: 202104; Test Name: CAT scan; Result Unstructured Data: blood clots in lungs; Test Date: 202104; Test Name: EKG; Result Unstructured Data: unknown; Test Date: 20210422; Test Name: Sonogram; Result Unstructured Data: results awaiting and will get records on wednesday; Test Name: COVID-19 virus test; Result Unstructured Data: negative
CDC Split Type: USJNJFOC20210518013

Write-up: BLOOD CLOTS IN LUNGS; NUMBNESS IN HANDS AND FEET; SWELLING IN HANDS AND FEET; This spontaneous report received from a patient concerned a 58 year old white male. Initial information was processed along with the additional information received on 11-MAY-2021 The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included the patient had no history of blood clots. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, and batch number: 207A21A expiry: UNKNOWN) dose was not reported, 1 total administered to right deltoid on 09-APR-2021 around 13:00 for prophylactic vaccination. No concomitant medications were reported. After receiving the vaccination on 09-APR-2021, the patient went home and slept for 6 hours. One week after vaccination, on 12-APR-2021 the patient experienced swelling in hands and feet. Two weeks after, on 19-APR-2021 the patient experienced numbness in hands and feet. On 21-APR-2021, the patient went to the emergency room (ER) and was given the tests, laboratory data included: Blood test (NR: not provided) unknown, CAT scan (NR: not provided) blood clots in lungs, and EKG (NR: not provided) unknown. The patient experienced blood clots in lungs and was hospitalized. On 22-APR-2021, laboratory data included: Sonogram (NR: not provided) results awaiting and will get records on wednesday. As of 22-APR-2021 the patient was started on blood thinner. Treatment medications included: apixaban (Eliquis) 2 a day. On an unspecified date in APR-2021 while in the hospital the patient was on oxygen (unspecified indication). The patient was discharged on 22-APR-2021 and the duration of hospitalization was 1 day. The patient was released with a prescription of Eliquis for 3 months. Laboratory data (dates unspecified) included: COVID-19 virus test (NR: not provided) negative. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from swelling in hands and feet, numbness in hands and feet, and blood clots in lungs. This report was serious (Hospitalization Caused / Prolonged).; Sender''s Comments: V0 20210518013 -COVID-19 VACCINE AD26.COV2.S- Blood Clots in lungs . This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).


VAERS ID: 1315751 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Ohio  
Vaccinated:0000-00-00
Onset:2021-04-02
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Blood pressure high; Penicillin allergy
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210429; Test Name: Blood test; Result Unstructured Data: NOT REPORTED; Test Date: 20210429; Test Name: Diagnostic ultrasound; Result Unstructured Data: blood clot in left calf
CDC Split Type: USJNJFOC20210520686

Write-up: BLOOD CLOT IN LEFT CALF; PAIN IN ANKLE; PAIN SLOWLY MOVING UP TO THE CALF; SLIGHT HEADACHE; This spontaneous report received from a patient concerned a 79 year old female of unknown race and ethnicity. The patient''s height, and weight were not reported. The patient''s concurrent conditions included high blood pressure, and penicillin allergy. The patient experienced drug allergy when treated with ciprofloxacin, and pethidine hydrochloride. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808980, and expiry: 21-JUN-2021) dose was not reported, 1 total administered on 02-APR-2021 to left arm for prophylactic vaccination. Concomitant medications included blood-pressure pills, water pills and Omega-3. On 02-APR-2021, the patient experienced a slight headache for about 2 days. On 29-APR-2021, the patient felt some pain in ankle, which was slowly moving up to the calf (left leg). The patient was brought to the emergency room, where an ultrasound and blood work was performed. Ultrasound detected a blood clot in her left calf and prescribed with Xarelto daily for 3 months. Patient stated that pain reached its most intense status on 01-MAY-2021 and is slowly getting better. Treatment medications (dates unspecified) included: rivaroxaban. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from headache on 04-APR-2021, was recovering from pain in ankle, and pain moving up to the calf, and had not recovered from blood clot in left calf. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0: 20210520686 -JANSSEN COVID-19 VACCINE Ad26.COV2.S-Thrombosis. The event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).


VAERS ID: 1315780 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-03-12
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Arthritis, Laboratory test interference
SMQs:, Systemic lupus erythematosus (broad), Arthritis (narrow), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: METHOTREXATE
Current Illness: Abstains from alcohol; Iodine contrast media allergy; Non-smoker
Preexisting Conditions: Comments: no drug abuse or illicit drug usage
Allergies:
Diagnostic Lab Data: Test Date: 20210416; Test Name: Laboratory test interference NOS; Result Unstructured Data: inflammatory arthritis on his joints
CDC Split Type: USJNJFOC20210523216

Write-up: INFLAMMATORY ARTHRITIS ON JOINTS; This spontaneous report received from a patient concerned a 75 year old male. The patient''s weight was 216 pounds, and height was 180.34 centimeters. The patient''s concurrent conditions included iodine contrast allergy, non alcohol user, and non smoker, and other pre-existing medical conditions included no drug abuse or illicit drug usage. The patient was previously treated with lisinopril, and prednisone. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, and batch number: 1805029 expiry: 25-MAY-2021) dose was not reported, administered on 11-MAR-2021 for prophylactic vaccination. Concomitant medications included methotrexate. On 12-MAR-2021, the subject experienced inflammatory arthritis on joints. On 16-APR-2021, Laboratory data included: Laboratory test interference NOS (NR: not provided) inflammatory arthritis on his joints. Treatment medications included: prednisone acetate. Additional treatment medications (dates unspecified) included: ibuprofen. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from inflammatory arthritis on joints. This report was non-serious.


VAERS ID: 1315829 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-05-11
Onset:2021-05-14
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / IM

Administered by: Military       Purchased by: ?
Symptoms: Full blood count, Petechiae, Prothrombin time normal
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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril, multivitamin, zinc
Current Illness: None
Preexisting Conditions: HTN
Allergies: None
Diagnostic Lab Data: Normal CBC, PT/INR
CDC Split Type:

Write-up: Developed petechiae to bilateral lower extremities 3 days following vaccination. Otherwise asymptomatic at the time of evaluation.


VAERS ID: 1315839 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-31
Onset:2021-04-12
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Ear discomfort, Ear pain, Emotional distress, Tinnitus
SMQs:, Depression (excl suicide and self injury) (broad), Hearing impairment (narrow)

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

Write-up: patient reports pain and pressure in ears lasting about 4 weeks and currently resolved, and low pitch constant tinnitus that was severe and very distressing for the first week or so to the point that he considered harming himself. The tinnitus persists but is less distressing. He was treated at Urgent Care with a steroid dose pack, a course of prednisone 40 mg/day x 5 days, 10 days of augmentin 875 mg po bid and a week of cortisporin ear drops. None of the treatment helped the tinnitus. He refused an audiogram to evaluate the tinnitus and denies preexisting tinnitus.


VAERS ID: 1315954 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-10
Onset:2021-04-22
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Arthralgia, Back pain, Blood test, Computerised tomogram, Neck pain, Neurological symptom, Pain in extremity, Urine analysis, X-ray
SMQs:, Retroperitoneal fibrosis (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CT scan, x-ray, blood tests, urinalysis- multiple hospital visits 4/22/21-5/6/21 and doctor''s office visit 5/11/21
CDC Split Type:

Write-up: Pain in back, legs, shoulder and neck with ascending neurological symptoms, hypothesized as Guillain-Barre Syndrome. Still undergoing tests and physical therapy.


VAERS ID: 1316012 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-29
Onset:2021-05-12
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Back pain, Guillain-Barre syndrome, Magnetic resonance imaging, Paraesthesia
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (narrow), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Demyelination (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lipitor
Current Illness: None
Preexisting Conditions: Left knee pain
Allergies: None
Diagnostic Lab Data: 5/13/21 MRI
CDC Split Type:

Write-up: Patient developed paresthesia/sensory changes and lower back and abdominal pain. Found to have likely Guillain Barre syndrome. No motor involvement and discharged home.


VAERS ID: 1316346 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Colorado  
Vaccinated:0000-00-00
Onset:2021-04-01
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Anxiety, Blood test, Chest discomfort, Computerised tomogram, Dizziness, Dry eye, Eyelid ptosis, Fatigue, Feeling abnormal, Gastrointestinal sounds abnormal, Head discomfort, Headache, Musculoskeletal stiffness, Myalgia, Palpitations, Tinnitus
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Corneal disorders (broad), Eosinophilic pneumonia (broad), Hearing impairment (narrow), Vestibular disorders (broad), Conjunctival disorders (narrow), Lacrimal disorders (narrow), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 202104; Test Name: Blood test; Result Unstructured Data: NOT REPORTED; Comments: Subject is waiting on the results of some more blood work that was done to see if he needs to see a neurologist and immunologist; Test Date: 20210418; Test Name: CT scan; Result Unstructured Data: Did not find any specific signs causing his symptoms; Test Date: 20210418; Test Name: Blood test; Result Unstructured Data: Did not find any specific signs causing his symptoms; Test Date: 20210426; Test Name: Blood test; Result Unstructured Data: also found nothing unusual.
CDC Split Type: USJNJFOC20210507244

Write-up: HEAD PRESSURE; HEART PALPITATIONS; FEELING OF A RUSH TO THE HEAD AFTER EATING; DRY EYES; RINGING IN THE EARS; MYALGIA; GI ISSUES LIKE BUBBLING STOMACH; FATIGUE; STIFFNESS IN THE NECK/ MUSCLE TIGHTNESS IN THE JAW; DROOPING RIGHT EYE LID; CHEST PRESSURE; ANXIETY; DIZZINESS AFTER GOING FOR A WALK; HEADACHE; This spontaneous report received from a patient concerned a 37 year old male. The patient''s weight, height, and medical history were not reported.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 042A21A, and batch number: 042A21A expiry: UNKNOWN) dose was not reported, administered on 07-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 2021, the subject experienced dizziness after going for a walk. On 2021, the subject experienced anxiety. On 2021, the subject experienced headache. On APR-2021, the subject experienced drooping right eye lid. On APR-2021, the subject experienced chest pressure. On APR-2021, the subject experienced stiffness in the neck/ muscle tightness in the jaw. Laboratory data included: Blood test (NR: not provided) NOT REPORTED. On 07-APR-2021, the subject experienced fatigue. On 08-APR-2021, the subject experienced gi issues like bubbling stomach. On 09-APR-2021, the subject experienced myalgia. On 18-APR-2021, Laboratory data included: Blood test (NR: not provided) did not find any specific signs causing his symptoms, and CT scan (NR: not provided) did not find any specific signs causing his symptoms. On 25-APR-2021, the subject experienced ringing in the ears. On 26-APR-2021, Laboratory data included: Blood test (NR: not provided) also found nothing unusual. On an unspecified date, the subject experienced head pressure, heart palpitations, feeling of a rush to the head after eating, and dry eyes. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from gi issues like bubbling stomach, feeling of a rush to the head after eating, and dizziness after going for a walk, had not recovered from fatigue, myalgia, head pressure, heart palpitations, chest pressure, anxiety, and ringing in the ears, and the outcome of dry eyes, stiffness in the neck/ muscle tightness in the jaw, drooping right eye lid and headache was not reported. This report was non-serious.; Sender''s Comments: V0: Medical assessment comments not required as per standard procedure as the case is assessed non serious.


VAERS ID: 1316348 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Georgia  
Vaccinated:0000-00-00
Onset:2021-03-01
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 180503 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Arthralgia, Axillary pain, Blood lactic acid, Blood magnesium, Body temperature, Burning sensation, Chills, Diarrhoea, Electrocardiogram, Eye contusion, Fatigue, Full blood count, Influenza like illness, Myalgia, Nausea, Pain, Pain in extremity, Paraesthesia, Pyrexia, SARS-CoV-2 test negative, Sensory disturbance, Troponin, Urine analysis
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Non-smoker; Penicillin allergy (Rash and facial swelling of lips, and eyes)
Preexisting Conditions: Medical History/Concurrent Conditions: Cholecystectomy; Hysterotomy; Transient ischemic attack; Comments: no illicit drug use.
Allergies:
Diagnostic Lab Data: Test Date: 202103; Test Name: Body temperature; Result Unstructured Data: 102.5; Test Date: 20210313; Test Name: Body temperature; Result Unstructured Data: 103.0; Test Date: 20210329; Test Name: Troponin; Result Unstructured Data: 2H-6H P; Test Date: 20210329; Test Name: Lactate; Result Unstructured Data: Unknown; Test Date: 20210329; Test Name: Electrocardiogram; Result Unstructured Data: Unknown; Test Date: 20210329; Test Name: Urine analysis; Result Unstructured Data: unknown; Test Date: 20210329; Test Name: Magnesium level; Result Unstructured Data: Unknown; Test Date: 20210329; Test Name: COVID-19 antigen test negative; Result Unstructured Data: Negative; Test Date: 20210329; Test Name: Complete blood count; Result Unstructured Data: Unknown
CDC Split Type: USJNJFOC20210511955

Write-up: PAIN IN BILATERAL LEGS AND ACHY RIGHT SHOULDER AND FOREARM; BOTTOM AND MUSCLE FELT LIKE FIRE; ARMPIT PAIN; FELT LIKE TENDONS PULLED; EXHAUSTION AND TIREDNESS; NAUSEA; MUSCLE ACHES; CHILLS; SORENESS (PAIN) AND BODY ACHE; DIARRHEA; FEVER; TINGLING FROM FINGER TIPS TO ELBOW ALSO TINGLING ON RIGHT ARM AND BOTTOM OF FEET; FLU LIKE SYMPTOM; FELT LIKE BILATERAL EYES WERE BRUISED; JOINT PAIN; This spontaneous report received from a patient concerned a 53 year old female. The patient''s weight was 140 pounds, and height was 158.49 centimeters. The patient''s past medical history included hysterotomy, cholecystectomy, and transient ischemic attack, and concurrent conditions included penicillin allergy, non alcohol user, and non-smoker, and other pre-existing medical conditions included no illicit drug use. The patient experienced drug allergy when treated with pethidine hydrochloride, cefalexin, levofloxacin, and nitrofurantoin. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 180503, and expiry: UNKNOWN) dose was not reported, administered on 13-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 2021, the subject experienced felt like bilateral eyes were bruised. On 2021, the subject experienced joint pain. On MAR-2021, the subject experienced tingling from finger tips to elbow also tingling on right arm and bottom of feet. On MAR-2021, the subject experienced flu like symptom. Laboratory data included: Body temperature (NR: not provided) 102.5. Treatment medications included: ketorolac tromethamine, and paracetamol. On 13-MAR-2021, the subject experienced fever. Laboratory data included: Body temperature (NR: not provided) 103.0. On 14-MAR-2021, the subject experienced soreness (pain) and body ache. On 14-MAR-2021, the subject experienced diarrhea. On 14-MAR-2021, the subject experienced chills. On 14-MAR-2021, the subject experienced nausea. On 14-MAR-2021, the subject experienced muscle aches. On 15-MAR-2021, the subject experienced exhaustion and tiredness. On 16-MAR-2021, the subject experienced felt like tendons pulled. On 17-MAR-2021, the subject experienced armpit pain. On 18-MAR-2021, the subject experienced bottom and muscle felt like fire. On 26-MAR-2021, the subject experienced pain in bilateral legs and achy right shoulder and forearm. On 29-MAR-2021, Laboratory data included: COVID-19 antigen test negative (NR: not provided) Negative, Complete blood count (NR: not provided) Unknown, Electrocardiogram (NR: not provided) Unknown, Lactate (NR: not provided) Unknown, Magnesium level (NR: not provided) Unknown, Troponin (NR: not provided) 2H-6H P, and Urine analysis (NR: not provided) unknown. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the fever, chills, muscle aches, joint pain, soreness (pain) and body ache, nausea, diarrhea, pain in bilateral legs and achy right shoulder and forearm, felt like bilateral eyes were bruised, tingling from finger tips to elbow also tingling on right arm and bottom of feet, exhaustion and tiredness, armpit pain, bottom and muscle felt like fire, flu like symptom and felt like tendons pulled was not reported. This report was non-serious.; Sender''s Comments: V0 : Medical assessment comment not required as per standard procedure as case assessed as non-serious.


VAERS ID: 1316354 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:0000-00-00
Onset:2021-04-01
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / UNK - / -
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Nausea, Pyrexia, Rash, SARS-CoV-2 test, Swelling face
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), 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), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Poison ivy rash
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 202104; Test Name: COVID-19 virus test; Result Unstructured Data: Negative; Test Date: 202104; Test Name: Blood test; Result Unstructured Data: High inflammatory markers present (markers unspecified); Test Name: Blood test; Result Unstructured Data: Normal
CDC Split Type: USJNJFOC20210516576

Write-up: SWOLLEN FACE; RASH WENT DOWN THE BODY TO THE KNEES; NAUSEA; FEVER; This spontaneous report received from a patient concerned a 48 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included poison ivy. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1802070, and expiry: 25-MAY-2021) dose was not reported, administered on 11-MAR-2021 for prophylactic vaccination. Non-company suspect drugs included: amoxicillin/clavulanic acid ( form of admin, route of admin, and batch number were not reported) dose, frequency, and therapy dates were not reported for an unspecified indication. No concomitant medications were reported. On APR-2021, the subject experienced rash went down the body to the knees. On APR-2021, the subject experienced nausea. On APR-2021, the subject experienced fever. Laboratory data included: Blood test (NR: not provided) High inflammatory markers present (markers unspecified), and COVID-19 virus test (NR: not provided) Negative. On 11-APR-2021, the subject experienced swollen face. Laboratory data (dates unspecified) included: Blood test (NR: not provided) Normal. Treatment medications (dates unspecified) included: prednisone. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from rash went down the body to the knees, and swollen face, and the outcome of nausea and fever was not reported. This report was non-serious.; Sender''s Comments: V0: Medical assessment comment is not required as per standard procedure as case assessed as non-serious.


VAERS ID: 1316534 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-04-07
Onset:2021-05-01
   Days after vaccination:24
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Computerised tomogram abnormal, Electrocardiogram, Fibrin D dimer, Pulmonary embolism, Pulmonary infarction
SMQs:, Embolic and thrombotic events, venous (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Multi-vitamin
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: Pennicillan, Ampicillan, Amoxicillan
Diagnostic Lab Data: EKG, D Dymer Levels, CT
CDC Split Type:

Write-up: Pulmonary Embolism and Lung Infarction. Signs began 5/1, to E.R. 5/3. Obviously, doctors unsure if from vaccine.


VAERS ID: 1316576 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-03-06
Onset:2021-03-10
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram, Electroencephalogram, Incontinence, Magnetic resonance imaging, Seizure, Tongue biting
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Methimazole 5 mg Tablets one every other day Diovan HCT/Valsartan (Generic) 320mg/25mg one tablet every day
Current Illness: N/A
Preexisting Conditions: High Blood Pressure Obesity
Allergies: N/A
Diagnostic Lab Data: Had MRI, CAT Scan and EEG. Results both normal
CDC Split Type:

Write-up: Seizure on 3.10.2021. Treated in ER on 3.10.2021. Bit tongue and experience insentience. Prescribe Keppra XR 500 mg Tablet. Take twice a day.


VAERS ID: 1316639 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Abdominal discomfort, Anxiety, Blood test, Burning sensation, Contusion, Fatigue, Fibromyalgia, Formication, Headache, Limb discomfort, Lip pruritus, Lip swelling, Mobility decreased, Neck pain, Nodule, Pain in extremity, Peripheral swelling, Pruritus, Skin burning sensation, Skin discolouration, Swelling face, Weight decreased
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Parkinson-like events (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Arthritis (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:
Other Medications: None that morning.
Current Illness: Symptoms from chronic illness.
Preexisting Conditions: Fibromyalgia, neuropathy, sciatica, rheumatoid and psoriatic arthritis, sleep apnea, high blood pressure.
Allergies: Zithromax.
Diagnostic Lab Data: Above.
CDC Split Type:

Write-up: She got her vaccine, she felt the burning sensation all the way down to her fingers and her wrist. I proceeded to go forward and wait the 15 minutes. She then started to have pain in the side of her neck on the right side, discomfort and pain in her arm. Within the hour she started to have headaches (has had COVID in the past). She went home and it was a nagging pain in her arm, not at the site but the whole arm was sore and limited using the arm due to the discomfort. That night is when she came on the news and started that the vaccine was being pulled from administration. That night it was like a pulling sensation right in her upper arm, up near the armpit and the fatty tissue from the breast and where you raise your arm. When she started noticing the discoloration started in her skin. Her hands started getting black, under both arms were black, the back of her legs was black, and she started feeling worsening fatigue. She started getting worried and was looking at how her veins turned purple blue/green just in the one arm. She was trying to figure out why she had limited use of her arm, and was holding it as if she had a sling on it as when it hung to her side it had the pulling sensation and a crawling sensation in her veins (that night and going into the next day). The next morning she was so exhausted and tired, as was her mother who had the vaccine at the same time, and was not feeling well. She was feeling that possibly due to the fibromyalgia she was have worsening symptoms than her mother. She then started bruises on her body, on the arm itself as if somebody grabbed and squeezed her arm, purplish/black bruising. It had her forearm develop 3 large pockets of swollen, almost as if the medicine was sitting in her arm. She was slowly getting the pulling sensation down to her hand, and she called the UC first and due to the high volume of COVID she wanted to know how long of a wait she would have. They instructed her to go to the ER due to the development of the blood clots on the news. There was no change in her symptoms, and got to the point that she could not move her arm, and the knots stayed in there and there was a reddish discoloration around them. Now she was having a pulling sensation in her chest and palpitations of pain near her heart. She was having soreness in her legs to the point that she was not able to walk, and felt it was in her nerves 3 days after the vaccine. She stayed in the bed the entire week just due to the exhaustion and effects. Every time she would go to reach for something she would have the pulling sensation down to her hand, and the entire arm was swollen with the bruising all over. Her body started having purple and blue knots and also in the left leg. Her arm and fingers were swollen as well. She then started having itching of her arm, and her lips started swelling and got up and went to Hospital and was able to be seen. She was having problems with her stomach as well, having a knot in the stomach where it was protruding and started loosing weight since the vaccine. The ER doctor told her she had a reaction to the vaccine, and did a Doppler to see if she had blood clots. They did not give her the results and didn''t feel that she didn''t have problems. She also went to the UC and back and forth to the ER, and still had the knots and finally looked at the knots and her jaw was swollen, and her arm was still swollen. The UC told her that she was having a fibromyalgia flare. She is still having the same symptoms green/blue and have started protruding. Due to the fatigue she has mainly just stayed in bed and knew that she was to have COVID symptoms, but knows that the crawling sensation and the knots sitting in her arm, and now her arm looks disfigured and the swelling is not going down. They told her that the test was negative for the blood clots. She had made an appointment with her neurologist and has an APT on Tuesday 5/25/21. She continues to loose weight no matter how much she consumes and still continues to have the knots and pain in the arm.


VAERS ID: 1316652 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-05-13
Onset:2021-05-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dyspnoea, Tremor, Violence-related symptom
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Hostility/aggression (narrow), Cardiomyopathy (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Client shook head yes, but could not communicate medicaiton.
Current Illness: denies
Preexisting Conditions: denies
Allergies: Shaking, difficulty breathing
Diagnostic Lab Data:
CDC Split Type:

Write-up: A few minutes after receiving the vaccine patient started shaking and appeared to have difficulty breathing. This happened just a few minutes after saying she wanted to drive her car in a tree.


VAERS ID: 1316759 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-01
Onset:2021-04-13
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Blood test normal, Computerised tomogram normal, Headache, Magnetic resonance imaging normal, Nausea, Ultrasound scan normal, Vomiting
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Contraceptive
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 04/15 - ultrasound, Ct-scan and blood work came out ok Symptoms persisted for one week 04/22 - MRI done came out ok
CDC Split Type:

Write-up: Extreme headaches, nausea, vomit, belly pain


VAERS ID: 1316895 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-11
Onset:2021-04-16
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fibrin D dimer, Hypertension, Muscle spasms, Pain, Pain in extremity, Vital signs measurement
SMQs:, Neuroleptic malignant syndrome (broad), Dystonia (broad), Hypertension (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None known
Diagnostic Lab Data: D-Dimer: Negative(<0.27) - 4/15 BP: 160/84 - 4/15; 140/80 - 4/20; 136/76 - 5/11
CDC Split Type:

Write-up: Shortly after (4 days) receiving the vaccine I began to experience leg pain and minor cramping, in addition to mild general pain. This continued for about 1 week. I still have occasional pain, particularly in the legs, made worse by exercise (lighter exercise than would normally cause pan). I have also been experiencing hypertension that, to my knowledge, did not exist prior to receiving the vaccine. This has persisted since first measured 5 days after the vaccine until today, more than a month after receiving it.


VAERS ID: 1317005 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-05-07
Onset:2021-05-08
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Angiogram cerebral abnormal, Basal ganglia haemorrhage, Basal ganglia infarction, Cerebral artery thrombosis, Computerised tomogram head abnormal, Echocardiogram, Echocardiogram normal, Facial paralysis, Haemorrhagic stroke, Hemiparesis, Ischaemic stroke, Muscular weakness, Subarachnoid haemorrhage
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Hearing impairment (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: not on any medication
Current Illness: history of DM -History of hypertension
Preexisting Conditions: history of hypertension -history on diabetes
Allergies: no Know drug or food allergies
Diagnostic Lab Data: Patient had J and J vaccine 05/07 and had both ischemic and hemorrhagic stroke with thrombosis on 05/08
CDC Split Type:

Write-up: Patient is 41 year old who presented with right sided upper and lower extremities weakness with facial drip , call as code stroke level 1 -CTbrain, CTA showed right basilar ganglia hemorrhage with small volume subarachnoid hemorrhage, left middle cerebral artery thrombosis with left basilar ganglia infarct and right basilar ganglia infarcts. TEE was negative for LV thrombus /vegetation .


VAERS ID: 1317049 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-09
Onset:2021-04-23
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Diverticulitis, Gastrointestinal pain, Injection site joint pain, Joint swelling, Scan abnormal
SMQs:, Acute pancreatitis (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific inflammation (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Iron, Probiotic, Flonase, Excedrin
Current Illness:
Preexisting Conditions: Anemic Degenerative Arthritis
Allergies: Naproxen
Diagnostic Lab Data: 4/24/21: Diagnosed w/ Acute Diverticulitis
CDC Split Type:

Write-up: Gut pain started 2 weeks after my shot on Friday 4/23. I was admitted into the hospital for diverticulitis in which I have never had an episode prior. After 2 scans I still have the infection and have been on antibiotics for 3 weeks now. I also have significant joint pain on my right side which is the side the shot was administered on. My right knee and ankle are inflamed and in severe pain.


VAERS ID: 1317128 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-05-06
Onset:2021-05-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Atrial fibrillation, Cardioversion, Laboratory test
SMQs:, Supraventricular tachyarrhythmias (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Bistolic Sprironolactone ASA HCTZ
Current Illness:
Preexisting Conditions: AFIB HTN ETOH abuse
Allergies: lisinopril wasp stings
Diagnostic Lab Data: lab & cardio-conversion
CDC Split Type:

Write-up: Went in to AFIB requiring conversion in ER on 05/10/2021 early AM


VAERS ID: 1317144 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-08
Onset:2021-05-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Hypoxia, Respiratory disorder
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: Asthma, COPD
Allergies: codeine
Diagnostic Lab Data:
CDC Split Type:

Write-up: patient apparently had taken Johnson Johnson COVID-19 vaccination that the was about 4 days ago. And since the that time patient had been having increasing shortness of breath patient denies any history of any fever chills denies any chest pain in. Of of the by the time patient had presented to the ER patient was hypoxic and was having respiratory of difficulty patient was initially put on a non-rebreather observe mask


VAERS ID: 1317190 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-05-13
Onset:2021-05-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / N/A LA / IM

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

Life Threatening? 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: Patient reported feeling lightheaded and dizzy following a Hepatitis B vaccine roughly 20 years prior.
Other Medications: No known medications or remedies
Current Illness: Patient reported a sore throat in the few days leading to the vaccination but that it had cleared by the vaccination date.
Preexisting Conditions: None known
Allergies: No known allergies
Diagnostic Lab Data: Blood pressure was 130/90 approximately 10 minutes following epinephrine injection.
CDC Split Type:

Write-up: Patient began feeling lightheaded and faint while sitting down approximately five minutes after the vaccination administration. Within 2 minutes of this the patient began having a seizure that lasted for approximately 30 seconds. Patient slid to the floor and become unresponsive. An Epi-pen was administered and shortly after patient stabilized and regained consciousness. Within 2 minutes he was able to answer questions and was oriented to place and time. Within 10 minutes the paramedics were on scene and patient was stable and talking to them. They recorded a blood pressure of 130/90 at this time. They took him to the local hospital from here.


VAERS ID: 1317254 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Epinephrine, Hypoaesthesia, Pain in extremity, Swollen tongue, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None on file
Current Illness:
Preexisting Conditions: Not aware
Allergies: Shellfish
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient reported arm soreness, few minutes later left leg starting to feel numb, shortness of breath. Then he reported tight throat and tongue swelling. Immediately called 911 and activated ems. Vitals: 0xygen 100%, bp 230/130, HR 80. Symptoms seem progressing so epinephrine 0.3 mg was administered at 11:30 a. EMS arrived 2-3 minutes later after epi was administered . Epi lot: OFM242, exp 11/01/2021. Patient left with EMS on gurney


VAERS ID: 1317257 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Nevada  
Vaccinated:2021-03-15
Onset:2021-03-22
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / N/A LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Computerised tomogram, Coronary arterial stent insertion, Coronary artery stent removal, Coronary artery thrombosis, Electrocardiogram, Enzyme level abnormal, Myocardial infarction, Vascular stent thrombosis
SMQs:, Anaphylactic reaction (broad), Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Other ischaemic heart disease (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Methadone Lantus 100 Units Levothyroxine 35mg Lisinopril 10mg Synjardy XR 12.5/100 Trilogy Trulicity 0.5 mg
Current Illness:
Preexisting Conditions: Diabetes Chronic Pain COPD Hypothyroidism
Allergies:
Diagnostic Lab Data: EkG Enzyme Levels CT Scan
CDC Split Type: vsafe

Write-up: I started to get a weird feeling in my chest a week after the vaccine. It was a burning sensation and I thought it was vaping at first. It started to get worse and worse. A week later I went to the ER and they ran some tests. After testing it was confirmed that I was having a heart attack. I had blot clot in my OM1discovered on 04/07/2021. I had had an angiogram in 2019 and there were no problems then. I was hospitalized for four days and I was given a Stent which ended up getting a blood clot. The original Stent was removed and a larger one was put in. I am now taking some blood thinners, Aspirin, Atorvastatin, Carvedilol 6mg, Prasugrel 10mg, and I am scheduled to see a cardiologist because I still a have a little chest pain.


VAERS ID: 1317260 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-10
Onset:2021-05-08
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Back pain, Chest pain, Dyspnoea exertional, Fibrin D dimer increased, Pain, Pain in extremity, Platelet count increased, Pulmonary embolism
SMQs:, Haemorrhage laboratory terms (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, venous (narrow), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: - losartan 25 mg oral tablet: 1 tab(s) orally once a day ******o tranexamic acid 650 mg oral tablet: 5/, 2 tab(s) orally 3 times a day, As Needed for excessive menstrual flow o ibuprofen 800 mg oral tablet: Last Dose Taken: , 2 tab(s) o
Current Illness: HTN (hypertension) Hypothyroidism Iron deficiency anemia Menorrhagia OSA on CPAP
Preexisting Conditions: HTN (hypertension) Hypothyroidism Iron deficiency anemia Menorrhagia OSA on CPAP
Allergies: None
Diagnostic Lab Data: CTA: pulmonary emboli Platelets: 639 D-dimer: 715
CDC Split Type:

Write-up: Multiple pulmonary emboli on CT angio 49 yo F with a PMH IDA with menorrhagia, OSA on CPAP, HTN, and hypothyroidism who presents to ED on 5/10/21 with chest pain. She states her chest pain began during an iron infusion 2 days ago on Friday 5/8. The infusion was briefly stopped and she was given steroids and the pain went away. The next day, however, the same pain recurred and remained until she came to the ED. She describes it as a "pinching" chest pain, constant x 1 day, worse upon inspiration and exertion, and radiating down her left arm and lower back, 10/10 in severity at its peak. She denies chest pressure. Nothing improved the pain in particular but she acknowledges it at rest. Her pain is much improved after being in the ED but is still present. She does not recall having the pain before. She denies cough, wheezing, palpitations, fevers, chills, nausea, vomiting, abdominal pain, diarrhea, constipation, or dysuria. She has never had COVID-19 before but had the Johnson & Johnson vaccine (1 dose) about a month ago. Pt admitted to the hospital, placed on heparin drip and transitioned to Xarelto on discharge.


VAERS ID: 1317365 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-05-14
Onset:2021-05-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypertension
SMQs:, Neuroleptic malignant syndrome (broad), Hypertension (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: FLU SHOTS
Other Medications: BENADRYL 37.5MG DOSE; AND ICE PACKS
Current Illness: ANXIETY/ASTHMA
Preexisting Conditions: ASTHMA/ANXIETY
Allergies: NONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: PATIENT GOT HER SHOT AT 10:55 AM . SHE HAS HX OF PANIC ATTACK ASTHMA AND DEPRESSION. PT SHOWED AT PHARMACY COUNTER AFTER SITTING FOR 20 MINS . CHECKED BP 11:25 151/111, GAVE HER BENADRYL 25MG (10 MLS PO ONCE ). PT WAS ASKED TO SIT ANOTHER 15MINS AND RECHECKED HER BP IT WAS STILL HIGH, OFFERED EMS SERVICE PT INITIALLY DECLINED BUT THEN SHE STILL WAS NOT FEELING ANY DIFFERENT SHE TOOK EMS. PT WAS TRANSPORTED TO THE HOSPITAL


VAERS ID: 1317399 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-13
Onset:2021-05-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Aphasia, Chest discomfort
SMQs:, Anaphylactic reaction (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (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: patient sates every vaccine she has received, unknown dates and age at time of adverse event
Other Medications: Aspirin, Clonazepam , Lasix, losartan, nebivolol, omeprazole, Potassium Chloride, Crestor, Epi pen 0.3mg as needed
Current Illness:
Preexisting Conditions:
Allergies: bee venom, spironolactone, aspirin , Hydrochlorothiazide , atorvastatin , ibupropfen , Iodine contrast dye, amlodipine ,cyclosporine ,latex ,lisinopril penicillin, tramadol
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient became asphasic and was unable to keep her eyes open approximately 5 minutes after injection. Placed on stretcher, vital signs stable. Epi pen injected into her left thigh. Started to complain of chest pressure approximately 25 minutes after epi, ambulance called. Triaged by EMS and taken to ER


VAERS ID: 1317482 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-10
Onset:2021-04-14
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Brain oedema, Cerebral haemorrhage, Cerebrovascular accident, Computerised tomogram head abnormal, Craniotomy, Face injury, Fall, Feeding disorder, Head injury, Movement disorder, Pupillary reflex impaired, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hyponatraemia/SIADH (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), 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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Warfarim Sodium 3mg tablet, Metoprolol Tart 25 mg tablet
Current Illness: n/a
Preexisting Conditions: Heart Valve Balloon Procedure
Allergies: Penicillin
Diagnostic Lab Data: Stroke & Internal bleeding in the brain diagnosed with CT Scan on April 14. Part of Skull removed to relieve swelling
CDC Split Type:

Write-up: Patient was vaccinated on 4/10/2021, with the Johnson & Johnson (Janssen) Covid-19 Vaccine. On 4/14/2021, patient had a stoke and collapsed, falling on her head & face at approiximately 3pm. No signs/symptoms prior to stroke & collapsing. Patient became hospitalized with internal bleeding in her brain and is still unresponsive. ?Unresponsive'' in this case is defined as but not limited to: unable to be mobile / stationary in a reclined bed postion since the incident / no movement of upper & lower extremities / minimal reactionary response in eyes / unable to ingest food by mouth


VAERS ID: 1317525 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-02
Onset:2021-04-23
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / UNK LA / -

Administered by: Other       Purchased by: ?
Symptoms: Deep vein thrombosis, Laboratory test normal, Pain in extremity, Ultrasound scan
SMQs:, Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Necon birth control, Multivitamin, nasal spray (Fluticasone/ Azelastine HCL)
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Venous ultrasound (5/7/21)- Positive for "occlusive thrombus within the right peroneal vein." Lab draw in ER (5/7/21) all wnl.
CDC Split Type:

Write-up: (4/23/21) Symptoms included intermittent (R) lower leg pain. After 3days, started myself on Aspirin which seemed to improve Sx somewhat. Stopped the Aspirin. Then learned of the link of J&J Vaccines to blood clots. Called my primary physician (5/6/21) who suggested testing to r/o DVT. (5/7) Venous ultrasound confirmed a DVT/ blood clot in (R) lower leg. Was then sent directly to ER for further exam and initiation of anti-coagulation therapy. Started on Eliquis starter pack: Initially 10mg BID, then 5mg BID.


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