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

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



Case Details

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VAERS ID: 1324558 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: Nebraska  
Vaccinated:2021-03-06
Onset:2021-03-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test abnormal, Pain in extremity, Rheumatoid arthritis
SMQs:, Arthritis (narrow), Tendinopathies and ligament disorders (broad), Immune-mediated/autoimmune disorders (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? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Blood work done on May 3rd came back that I was now diagnosed with Rheumatoid Arthritis and never had any of these symtoms or issues of any kind til after my Johnson and Johnson shot Now have an appointment June 25th with a Rheumatologist
CDC Split Type:

Write-up: left arm pain, right arm pain, toe pain, 3 fingers on right hand pain and pains so severe started March 7th went to Urgent care March 8th then called march 11th and 12th and 13th and was seen again because of more severe pains on April 15th and then it got bad again after the steriods did nothing and went in for blood work on May 3rd Treatments have been steriods, and muscle relaxer and prescription ibprophen None of that worked


VAERS ID: 1324742 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-02
Onset:2021-04-05
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Back pain, Body temperature increased, Computerised tomogram head, Computerised tomogram neck, Electrocardiogram, Fatigue, Full blood count, Hallucination, visual, Headache, Metabolic function test, Nausea, Pain, Photophobia, SARS-CoV-2 antibody test negative, Sciatica, Troponin
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: vit C, metformin, vit D, vit B12, xiidra drops, metamucil, fish oil, zyrtec, pravastatin, ventolin
Current Illness: none
Preexisting Conditions: type 2 dm, asthma, allergic rhinitis, hx back pain
Allergies: tree nuts, pear, peaches, pollen, possibly bee stings
Diagnostic Lab Data: in ER, she had nl head CT, nl CTA head/neck, cbc, bmp, troponin and borderline ekg. she was d/c''d home. she is slowly recovering still on 5/6/21. still c/o fatigue and brain fog. i ordered covid Ab and it was neg.
CDC Split Type:

Write-up: after her vaccination on 4/2/21, she was tired on 4/5/21. on 4/11, she was achy, had HA, sens to light, stomach, backache, nauseous, bilat sciatic pain, temp up to 102, fatigued, oxygen sat 92%. she had visual hallucinations. she went to ER on 4/15/21.


VAERS ID: 1324746 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Pharyngeal swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Allergic to influenza vaccine
Other Medications: Lipitor, calcium, Zyrtec, vitamin D, lisinopril, trazadone, vitamin A,
Current Illness: none
Preexisting Conditions: GERD, hypertension, migraines.
Allergies: sulfa, salmon, influenza vaccination, iodine, Imitrex, eggs, codeine, capsacian, augmentin, haemophilus influenza,
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient was brought in by ambulance from pharmacy due to throat swelling and difficulty breathing after receiving the COVID vaccine. Pt was given 50mg IM Benadryl by pharmacy staff.


VAERS ID: 1324762 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

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

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

Write-up: Patient was sweating, dizzy and experienced pain on left side of stomach. 911 was called and patient was brought to the hospital.


VAERS ID: 1324987 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-09
Onset:2021-04-01
Submitted: 0000-00-00
Entered: 2021-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 - / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood thyroid stimulating hormone, Fibrin D dimer, Full blood count, Headache, Malaise, Metabolic function test, Somnolence
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: vit C 500 mg po daily vit d 3 1000 iu daily zinc 50 mg daily
Current Illness: unclear, not been seen in my clinic since 2013.
Preexisting Conditions: chronic sinusitis
Allergies: Lactose intolerance
Diagnostic Lab Data: CMP, TSH, CBC with differential, D-dimer
CDC Split Type:

Write-up: developed headache and malaise after, symptoms have persisted up through visit on 05/14/2021. At that point, headaches or varying from bad to mild, continue to be drowsy, continued to feel best when lying down


VAERS ID: 1324988 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-05-15
Onset:2021-05-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205121A / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Fall, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Patient experienced syncope, fell onto the ground. 911 was called


VAERS ID: 1325229 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-08
Onset:2021-04-20
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram, Electrocardiogram, Laboratory test, Migraine
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: Zyrtec Folic Acid 800
Current Illness: allergies (grasses)
Preexisting Conditions: no
Allergies: none
Diagnostic Lab Data: CATSCAN ELECTROCARDIO Bloodtest
CDC Split Type:

Write-up: Developed severe and persistent migraines almost two weeks after the vaccine that last for a week or longer. Never had migraines that lasted for longer than a day only 1-2x per month.


VAERS ID: 1325242 (history)  
Form: Version 2.0  
Age: 91.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-03-01
Onset:2021-03-26
   Days after vaccination:25
Submitted: 0000-00-00
Entered: 2021-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Blood test, Cardiovascular symptom, Computerised tomogram head, Dizziness, Electrocardiogram, Fall, Neurological symptom, Syncope, Urine analysis, Vertigo
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Vestibular disorders (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin, hydralazine
Current Illness: None
Preexisting Conditions: Diabetic, High blood pressure
Allergies: Codeine, pentathol
Diagnostic Lab Data: EKG, CT scan, blood work, urine analysis
CDC Split Type:

Write-up: J&J vaccine, extremely dizzy, fainting spells, vertigo started on March 26, 2021. Went to ER after reaction becoming worse on April 8, resulting in falling outside in yard. Dr advised going to ER after visit on April 13. Symptoms were stroke and or blood clots. At hospital they took multiple tests but inconclusive if she had a stroke or blood clots. Took CT scan of brain looking for bleeding on the brain. They have all test results. Today still has vertigo, weakness, and fainting spells.


VAERS ID: 1325371 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-03-21
Onset:2021-05-11
   Days after vaccination:51
Submitted: 0000-00-00
Entered: 2021-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / UNK LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abortion spontaneous, Exposure during pregnancy, Human chorionic gonadotropin decreased, Pregnancy test positive, Ultrasound antenatal screen abnormal
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Foetal disorders (narrow), Termination of pregnancy and risk of abortion (narrow), Normal pregnancy conditions and outcomes (narrow), Fertility disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lamotrigine, prenatal vitamin, fish oil
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: May 12, 2021: U/S obstetric, 1st trim, single - IMPRESSION: There is no intrauterine gestational sac. May 12, 2021: HCG 5,520 MIU/ML
CDC Split Type:

Write-up: I want to report a miscarriage. I got the vaccine when I was 5 weeks and 1 day pregnant. I didn''t know I was pregnant when I got the vaccine, but I got a positive pregnancy test 2 days after. It was a "missed miscarriage" because I had my 10 week ultrasound on May 10 and it showed that the embryo had died at 6 weeks and 2 days. I started miscarrying that day on May 10.


VAERS ID: 1325839 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: California  
Vaccinated:0000-00-00
Onset:2021-04-02
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042AZ1A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Cardiac stress test, Chest discomfort, Computerised tomogram, Dyspnoea, Headache, Scan with contrast, Ultrasound chest
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Non-smoker
Preexisting Conditions: Comments: The patient had no history of drug abuse or illicit drug usage and no medical history.
Allergies:
Diagnostic Lab Data: Test Date: 20210414; Test Name: Blood test; Result Unstructured Data: unknown; Test Date: 20210414; Test Name: Ultrasound chest; Result Unstructured Data: unknown; Test Date: 20210416; Test Name: Stress test; Result Unstructured Data: negative/false positive; Test Date: 20210505; Test Name: Scan with contrast; Result Unstructured Data: not definitive; Test Date: 20210505; Test Name: CT scan; Result Unstructured Data: results awaiting
CDC Split Type: USJNJFOC20210516748

Write-up: SHORTNESS OF BREATH; HEAVINESS IN CHEST; HEADACHES; This spontaneous report received from a patient concerned a 66 year old female. The patient''s weight was 135 pounds, and height was 162.56 centimeters. The patient''s concurrent conditions included non alcohol user, and non-smoker, and other pre-existing medical conditions included the patient had no history of drug abuse or illicit drug usage and no medical history. The patient experienced drug allergy when treated with hydrocodone bitartrate/paracetamol. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 042AZ1A, expiry: UNKNOWN) dose was not reported, administered on 02-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 02-APR-2021, the subject experienced shortness of breath. On 02-APR-2021, the subject experienced heaviness in chest. On 02-APR-2021, the subject experienced headaches. On 14-APR-2021, Laboratory data included: Blood test (NR: not provided) unknown, and Ultrasound chest (NR: not provided) unknown. On 16-APR-2021, Laboratory data included: Stress test (NR: not provided) negative/false positive. On 05-MAY-2021, Laboratory data included: CT scan (NR: not provided) results awaiting, and Scan with contrast (NR: not provided) not definitive. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from heaviness in chest, shortness of breath, and headaches. This report was non-serious.; Sender''s Comments: V0 Medical assessment comment not required as per standard procedure as the case was assessed as non-serious.


VAERS ID: 1325846 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:0000-00-00
Onset:2021-04-06
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chest pain, Diarrhoea, Nausea, Pain, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Allergy to nuts; Asthma; Cigarette smoker
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210520702

Write-up: VOMITING; CHEST PAIN; TOTAL BODY PAIN; DIARRHOEA; NAUSEA; This spontaneous report received from a patient concerned a 53 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included cigarette smoker, asthma, and allergic to nuts. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 041A21A, and batch number: 041A21A expiry: UNKNOWN) dose was not reported, administered on 06-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 06-APR-2021, the subject experienced vomiting. On 06-APR-2021, the subject experienced chest pain. On 06-APR-2021, the subject experienced total body pain. On 06-APR-2021, the subject experienced diarrhoea. On 06-APR-2021, the subject experienced nausea. Treatment medications (dates unspecified) included: bismuth subsalicylate. The action taken with covid-19 vaccine was not applicable. The patient had not recovered from total body pain, vomiting, nausea, chest pain, and diarrhoea. 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: 1325849 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-05-10
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Injection site pain, Myalgia, Pain, Pyrexia, Vision blurred
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Glaucoma (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (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? 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: USJNJFOC20210520833

Write-up: BLURRED VISION; BODY ACHES; FEVER; MUSCLE ACHES; TIREDNESS; INJECTION SITE SORENESS; This spontaneous report received from a patient concerned a female of unspecified age. The patients weight, height, and medical history were not reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, 1 total administered on 10-MAY-2021 17:30 on left arm 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 10-MAY-2021, she had injection site soreness (described as soreness around where she got the shot), then was okay during the day and night and had no immediate reaction. She also felt tired. She had usual side effects but on 11-MAY-2021, was experiencing blurred vision at the report time. On 11-MAY-2021, she started with fever. There was no measurement of fever but had all symptoms of fever, body aches and muscle aches. She had to do some work and did not rest then started with blurry vision. She had heard that it was a more dangerous side effect. She also did not have her vaccination card on hand and could not share the lot number or expiry of the vaccine. She indicated she would find it and call back. The caller was asking for advice on how to manage the blurred vision. She was advised during the call to seek the attention of a health care provider. She indicated that she had already contacted a pharmacy and was told to contact the vaccination provider. She was not able to obtain help. She did not know any providers in the area as she was a visitor. The action taken with covid-19 vaccine was not applicable. The patient had not recovered from blurred vision, and the outcome of body aches, injection site soreness, fever, muscle aches and tiredness was not reported. This report was not serious.; Sender''s Comments: V0: Medical assessment comment not required as per standard procedure since case was assessed as non serious


VAERS ID: 1325850 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Washington  
Vaccinated:0000-00-00
Onset:2021-05-05
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abscess limb, Blood pressure measurement, Body temperature, Cellulitis, Erythema, Headache, Heart rate, Hypertension, Laboratory test, Pain, Pain assessment, Pyrexia, Sepsis, White blood cell count
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypertension (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sepsis (narrow), Opportunistic infections (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: Medical History/Concurrent Conditions: Convulsive disorder
Allergies:
Diagnostic Lab Data: Test Date: 202105; Test Name: White blood cell count; Result Unstructured Data: 14.63, unit not reported; Test Date: 202105; Test Name: Body temperature; Result Unstructured Data: 100.4, unit not reported; Test Date: 202105; Test Name: Laboratory test; Result Unstructured Data: unknown; Test Date: 20210506; Test Name: Pain scale; Result Unstructured Data: Level 8-10; Test Date: 20210507; Test Name: Body temperature; Result Unstructured Data: 101.9, unit not reported; Test Date: 20210510; Test Name: Heart rate; Result Unstructured Data: 147, unit not reported; Test Date: 20210510; Test Name: White blood cell count; Result Unstructured Data: 18.53, High; Test Date: 20210510; Test Name: Blood pressure; Result Unstructured Data: 159/108, unit not reported
CDC Split Type: USJNJFOC20210521005

Write-up: CELLULITIS; HIGH BLOOD PRESSURE; ABSCESS IN ARM; HEADACHE; SEPSIS; PAIN; REDNESS IN ARM; FEVER; This spontaneous report received from a 49 year old patient of unspecified sex and ethnic origin. The patient''s height and weight were not reported. The patient''s past medical history included seizure disorder but had not experienced since 1998. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 202A21A, and expiry: UNKNOWN) dose was not reported, 1 total, administered on 04-MAY-2021 13:00 on right arm for prophylactic vaccination. No concomitant medications were reported. On 05-MAY-2021, the patient experienced redness in arm and fever. On 06-MAY-2021, the patient experienced pain. Laboratory data included: Pain scale (NR: not provided) Level 8-10. On 07-MAY-2021, the patient experienced sepsis, headache, abscess in arm. On the same date, the patient reported initially low fever and later high fever, body temperature was (NR: not provided) 101.9 (unit not reported). On unspecified date MAY-2021 the patient went to emergency room for fever. Patient went to physician where took blood work .On 10-MAY-2021, patient''s White blood cell count was high 18.53 (unit not reported) and the patient experienced cellulitis, was treated with liquid Augmentin and blood pressure was high 159/108 (unit not reported), Heart rate was high 147 (unit not reported). On an unspecified date in MAY-2021, second attempt White blood cell count was high 14.63. diagnosed as sepsis and treated with dose of antibiotic unasyn. Currently on unspecified date in MAY-2021 patient had fever of 101.4 (unit not reported). Patient had to be cautious of fevers due to a seizure disorder. On 12-MAY-2021 patient went to ortho surgeon and went back to hospital to treat arm abscess drained.100 cc was removed and still draining puss. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from fever, pain, redness in arm, cellulitis, high blood pressure, headache, sepsis and abscess This report was serious (Other Medically Important Condition).; Sender''s Comments: V0: 20210521005-covid-19 vaccine ad26.cov2.s-Sepsis, cellulitis and abscess in arm. 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: 1325851 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-05-10
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Date: 20210510; Test Name: Lab test; Result Unstructured Data: Found nothing of significance
CDC Split Type: USJNJFOC20210521196

Write-up: UNCONSCIOUSNESS WITHIN MINUTES AND COULD NOT REGAIN SUSTAINED CONSCIOUSNESS; BODY IMMEDIATELY WENT INTO SHOCK; This spontaneous report received from social media from a parent via a company representative concerned a 19 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 administration not reported, batch number: Unknown) frequency one total, dose was not reported, administered on 10-MAY-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. The parent reported that the healthy patient after receiving vaccine on 10-MAY-2021, experienced unconsciousness within minutes and could not regain sustained consciousness. He was rushed to the emergency room via ambulance and ran some tests, found nothing of significance. His body immediately went into shock. The patient seemed stable now. He was admitted to the hospital on 10-MAY-2021 and the duration of hospitalization was not reported. Laboratory data included: Lab test (NR: not provided) Found nothing of significance. Discharge date of hospitalization was not specified. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from unconsciousness within minutes and could not regain sustained consciousness, and body immediately went into shock. This report was serious (Hospitalization Caused / Prolonged).; Sender''s Comments: V0:20210521196-JANSSEN COVID-19 VACCINE-unconscious within minutes and could not regain sustained consciousness, body immediately went into shock. 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: 1325855 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210523565

Write-up: ILLNESS; This spontaneous report received from a parent concerned a male 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: unknown) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On an unspecified date, the subject experienced illness. The action taken with covid-19 vaccine was not applicable. The patient had not recovered from illness. 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: 1325864 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Unknown  
Location: Washington  
Vaccinated:0000-00-00
Onset:2021-05-07
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210525721

Write-up: ABSCESS/ARM DRAINED; This spontaneous report received from a patient concerned a 39 year old white, Not Hispanic or Latino of unspecified sex. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, once total administered on 04-MAY-2021 on right arm for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. Patient reported that ,saw a primary care and an orthopedic, sent back to the hospital to had the arm drained and was given antibiotics in the ER. 100 cc was removed and was still draining puss. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from abscess/arm drained. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0: 20210525721-JANSSEN COVID-19 VACCINE Ad26.COV2.S- Abscess/arm drained. 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: 1325932 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-05-04
Onset:2021-05-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure increased, Palpitations, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hypertension (narrow), Cardiomyopathy (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: Women?s multivitamin
Current Illness: None
Preexisting Conditions: None
Allergies: Aspirin
Diagnostic Lab Data: A full work-up plan done in the ER 5/5/21
CDC Split Type:

Write-up: I went to the ER because I had a fever of 103 and my blood pressure was 153/111 and it felt like my heart was racing. At the ER I stayed until 8am was given fluids.


VAERS ID: 1326096 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Texas  
Vaccinated:0000-00-00
Onset:2021-03-17
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Cerebrovascular accident, Computerised tomogram, Fall
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), 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? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Diabetes; High cholesterol; Hypertension; Non-smoker
Preexisting Conditions: Comments: The patient had no known allergies
Allergies:
Diagnostic Lab Data: Test Date: 20210317; Test Name: CAT scan; Result Unstructured Data: confirmed stroke
CDC Split Type: USJNJFOC20210515350

Write-up: STROKE; FELL DOWN; This spontaneous report received from a health care professional (patient''s wife) concerned a 54 year old male of Hispanic or Latino other race. The patient''s height, and weight were not reported. The patient''s concurrent conditions included hypertension, diabetes, and high cholesterol. The patient had no known allergies and was non smoker. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown, expiry: unknown) dose was not reported, administered on 16-MAR-2021 at 16:00 to right arm for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. After vaccination, later on that evening her husband mentioned that he did not feel too good. He took a Tylenol and then went to bed. At around 3:00 that evening his wife woke up to go to the bathroom and noticed her husband was awake. When she asked he responded that he thought he might have suffered a stroke. On unspecified date he experienced fell down and unable to move the right side of his body. On 17-MAR-2021 at around 5:00 that morning, she took him to the emergency room (ER). There the ER department performed a computerized tomography (CAT) scan and confirmed that he indeed had a stroke and decided to transfer him to another hospital. On 22-MAR-2021, he was then discharged. He was hospitalized for 5 days. A few days later on 24 or 25-MAR-2021 she took him to her Doctor Of Medicine (MD.) where they had him do rehab which consisted of daily walking. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from stroke, and the outcome of fell down was not reported. This report was serious (Hospitalization Caused / Prolonged).; Sender''s Comments: V0: 20210515350-Covid-19 vaccine ad26.cov2.s- A 54- year- old male of Hispanic or Latino other race presents with Stroke. 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: MEDICAL HISTORY


VAERS ID: 1326491 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Electrocardiogram, Fatigue, Headache, Myalgia, Pain, Pain in extremity, Pyrexia, SARS-CoV-2 test negative
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (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: progesterone''s 100mg daily
Current Illness: no
Preexisting Conditions: no
Allergies: penicillin
Diagnostic Lab Data: ekg covid test
CDC Split Type: vsafe

Write-up: Instantly I felt pain my arm hurt which was kinda weird through the day I felt tired bad headache took Advil it did not go away also took extrin next day had 102 fever and had pain in the head achy, arm hurt, muscle hurt this went on for the whole week, I stayed in bed the whole week on sat i thought i had covid so i went to Dr and got a test the test was negative the did an ekg shot a toroidal which is a pain med for headach the pain they asked me to go the er but i wanted to wait it out these same symptoms continued


VAERS ID: 1326500 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-01
Onset:2021-04-24
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling abnormal, Hypoaesthesia, Muscle spasms, Pain in extremity, Paraesthesia, Ultrasound scan normal
SMQs:, Peripheral neuropathy (broad), Dementia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Cipro
Diagnostic Lab Data: Ultrasound, April 24 2021
CDC Split Type:

Write-up: Two weeks after vaccine woke up with tingling running up and down left leg and being based in the left foot. Throughout the day tingling turned to numbness as if leg were asleep, and feeling in foot turned to strong pain. Had ultrasound in the leg to check for clots (although they did not check foot) and nothing was discovered. After this pain escalated and a week after I was unable to keep my foot still for more than a minute without the intense pain rushing back - the feeling was as if my foot were cramping to an extreme. Elevating helped somewhat but for the most part if I wasn?t moving I was crying in pain. The numb feeling is still there as of over a month later but I?m able to hold still without feeling as if my foot is rapidly atrophying.


VAERS ID: 1326547 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-17
Onset:2021-05-03
   Days after vaccination:47
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805018 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cerebral mass effect, Headache, Magnetic resonance imaging abnormal, Subdural haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Accidents and injuries (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

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

Write-up: Patient received J&J Covid vaccine on 3/17/21. She began experiencing daily headaches on 4/1/21. She initially presented to her PCP on 5/3/21. MRI was ordered and conducted on 5/6/21, revealing a large subdural hematoma with midline shift. Patient was referred to neurosurgery and ultimately opted for outpatient management with course of steroids and close follow up.


VAERS ID: 1326566 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-09
Onset:2021-04-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 - / SYR

Administered by: Public       Purchased by: ?
Symptoms: Bipolar disorder, Chills, Condition aggravated, Headache, Malaise, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Hostility/aggression (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: latuda, lamictal, gabapenton, prosac
Current Illness: none
Preexisting Conditions: bi-polar depression anxiety
Allergies: na
Diagnostic Lab Data:
CDC Split Type:

Write-up: extremely sick headaches shaking chills the next day... then once my period started it made my mood and hormones out of control its effected my bi-polar severely the medicines that have always stabilized me are not working I had covid back in January and the adverse effects have been 1,000 times worse then having a pretty bad case of covid. My mental health has totally gone out of control


VAERS ID: 1326570 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Behaviour disorder, Blood pressure decreased, Blood pressure increased, Disorientation, Dizziness, Gait disturbance, Pain in extremity, Pyrexia, Somnolence, Tremor, Vertigo
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Dementia (broad), Parkinson-like events (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Hypertension (narrow), Vestibular disorders (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Childhood vaccination reaction, not sure which one did it.
Other Medications: Lexapro Aldactone Zyxal Lipitor Singulair Xanax Merana IUD Mary Ruth Multivitamin
Current Illness: None
Preexisting Conditions: None
Allergies: Ciprofloxacin Coconut Soy Tomato Latex
Diagnostic Lab Data: No labs were done.
CDC Split Type: vsafe

Write-up: 4/11/2021- I woke up shaking, I could barely walk, had fever 103.5. I was having trouble breathing, took 800mg motrin, did not lower temp. Called nurses line, they told me to call ambulance to go to ERE, BP 157/110 then dropped to 97/50, was dizzy and disorientated, hospital said vitals normal but I could not walk due to dizziness. Doc sent me home with meds for vertigo, temp fell to 99.5, discharged around 5 am, was still disoriented, I slept for about 2-3 days, saw Doc 4/15/2021, everything looked ok and after a few days all symptoms had subsided. Arm stayed sore for about two weeks.


VAERS ID: 1326571 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-20
Onset:2021-03-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 045A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure increased, Blood test normal, Dizziness, Dysgeusia, Facial paralysis, Feeling abnormal, Feeling hot, Flushing, Influenza, Malaise, Mental impairment, Speech disorder, Vision blurred
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Hypertension (narrow), Lens disorders (broad), Retinal disorders (broad), Hearing impairment (broad), Vestibular disorders (broad), Hypersensitivity (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (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: rabies; passed out
Other Medications: vit C, Zinc, Synthroid, Cholesterol medications,
Current Illness: n/a
Preexisting Conditions: Graves disease (sx) Hypothyroidism 75% removed, cholesterol, saracoidosis of the lungs 2013
Allergies: avelox, morphine, erythromycin, Demerol
Diagnostic Lab Data: Blood panel; Neg r/out blood clot
CDC Split Type: vsafe

Write-up: 3/20/2021 @ 1:00 vaccination I sat in a chair for 5 minutes. After, I felt warm, I was flushed. Fifteen minutes later I walked out, driving down road with friend and I said ''something is wrong''; really bad ''metal taste'' in mouth, blurred vision, grabbed her arm and said I am going to throw up, I was so dizzy and I said I can''t think. My face was drooping, I couldn''t say my A,B,C''s, and by the time I got to the ER they got me on an IV. I couldn''t talk, think, and had the metal taste for a few hours. The dr. said we are going to give you fluids, my BP was elevated for 6 hours 198/130, no clots. BP went down to 178/98, taste started to go down, I was drinking fluids, I was able to talk a little bit. I felt like in a ''bubble'', I couldn''t think. When I was discharged I had no temp, my BP was normal. *my body reacted to the vaccination. *6 hours my body reacted *body had felt like I was recovering from the flu for 2 weeks *Never ran a temperature


VAERS ID: 1326577 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-05
Onset:2021-05-08
   Days after vaccination:33
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041 A21 A / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram normal, Electrocardiogram normal, Magnetic resonance imaging normal, Transient global amnesia
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vitamin D and Biotin
Current Illness: None
Preexisting Conditions: None (used to have asthma).
Allergies: Allergic to horses, dust and dust mites. Sometimes allergic to cats.
Diagnostic Lab Data: MRI (on 5/9), CAT Scan and EKG (on 5/8) were all normal to reinforce that it was a TGA (and not a TIA).
CDC Split Type:

Write-up: I am not sure if the transient global amnesia (TGA) I experienced on May 8th is affiliated with the COVID vaccine but three other people had TGA around the same time that I had it at the healthcare facility so I was encouraged to report this (although a month had passed since I had the J&J vaccine).


VAERS ID: 1326742 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-03-08
Onset:2021-03-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805029 / N/A RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Dizziness, Dysstasia, Electrocardiogram, Eye movement disorder, Fatigue, Feeling abnormal, Impaired work ability
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Ocular motility disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Xarelto Methimazole Losartan
Current Illness:
Preexisting Conditions: Graves Disease Antiphospholipid Syndrome Hypertension
Allergies: Sulfa-anaphylactic
Diagnostic Lab Data: EKG Blood Work
CDC Split Type: vsafe

Write-up: The day after the vaccine I was working and later in the day I started to feel dizzy. Within an hour and a half I could not stand up and I was very dizzy. My coworkers said my eyes rolled back in my head. The ambulance transported me to the ER and my Blood Pressure was at 80 Systolic. I was given fluids and I was discharged after five hours. I still couldn''t work the next day and I was still really tired for the rest of the week. It seemed to take a couple of weeks to feel normal but the fatigue was extreme for the first week after the episode of dizziness. I have two autoimmune diseases and a history of blood clots so I might not have gotten the Janssen vaccine if the risk was known. The blood thinner I was taking at the time might have helped but my blood pressure on discharge was still only 110/60.


VAERS ID: 1326752 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Heart rate irregular, Immediate post-injection reaction, Lip swelling, Nervousness, Pharyngeal swelling, Pruritus
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: none
Preexisting Conditions: mitral valve prolapse, arrhythmia
Allergies: sulfa, shellfish, levaquin, biaxin, statin
Diagnostic Lab Data:
CDC Split Type:

Write-up: A few minutes after the patient received dose 1 of the Janssen Covid-19 vaccine, the patient started having trouble breathing, her throat felt "swollen and thick", was shaky, had itchy hands, and her lip was swelling. Her blood pressure was 174/86 and her pulse was fluctuating in the mid-high 80s. I administered 1 tablet of diphenhydramine (25mg) and 1 dose of the 0.3mg epi-pen. After about 7-10 minutes, she said her symptoms started to level out and were no longer getting worse. Her lip swelling started going down by the time EMS arrived. I continuously checked her blood pressure, heart rate, and heart rhythm while waiting for EMS to arrive and take over her care. They took her to the closest emergency room for continued monitoring.


VAERS ID: 1326795 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-11
Onset:2021-04-17
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / N/A LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test normal, COVID-19, Chest X-ray normal, Chills, Fatigue, Headache, Malaise, Pain, Rhinorrhoea, SARS-CoV-2 test positive, Somnolence
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: flu shot - every time I get one - I get flu like symptoms so I don''t get them anymore
Other Medications: Albuterol inhaler; Symbicort Steroid inhaler;
Current Illness: asthma
Preexisting Conditions: asthma; sarcoidosis
Allergies: Gabapentin; latex
Diagnostic Lab Data: 18th-ER - COVID test - positive result; bloodwork; chest x-ray - everything was good on those tests
CDC Split Type: vsafe

Write-up: I felt like I was getting a really bad cold - like a worse cold ever - runny nose and bad headache and my body aches; chills. My body aches were really bad. I was tired and wanted to just sleep - I was drained. I went to ER - they ran some tests and gave me IV fluids. Tylenol and Ibuprofen - alternated for my headache. It took me about a week and a half to get better. A day or two after the shot, my breathing was good and it was better than it had every been and it is still better. I feel great! It had always been hard for me to take a deep breath but ever since then when I take a deep breath and I have expected it to not to come out good but it comes out good. Even through my COVID symptoms I experienced these better breathing symptoms.


VAERS ID: 1326832 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-04-05
Onset:2021-05-18
   Days after vaccination:43
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Deep vein thrombosis, Pain in extremity, 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), 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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: US confirms DVT
CDC Split Type:

Write-up: Presented to ED for left leg pain. Noted to have a DVT


VAERS ID: 1326835 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-19
Onset:2021-04-18
   Days after vaccination:30
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Exposure during pregnancy, Forceps delivery, Intensive care, Transfusion, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prenatal vitamins
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vaginal bleeding one week post partum. Due date 4/6/2021. Delivered on 4/11/2021. Healthy boy, 7 lbs 6 oz. Forecept-assisted delivery. Bleeding started one week later. Large amount of bleeding. Three units of blood transfused. In ER/ICU for approximately 40 hours.


VAERS ID: 1326864 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-06
Onset:2021-04-13
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN JANSSEN / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Computerised tomogram, Laboratory test, Movement disorder, Muscle spasms
SMQs:, Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (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: Lisinopril 20
Current Illness: None
Preexisting Conditions: Hypertension
Allergies: None
Diagnostic Lab Data: Lab work, CT Scan, were performed at Medical Center
CDC Split Type:

Write-up: Severe muscles spasm that started a week after the vaccine date and got progressively worse as time went on. The worst date was Friday April 16 when I was unable to move when I woke up at 2 am in bed. Asked my husband to take me to the emergency room where they gave me Vallium for muscle relaxing and took a CT scan of the neck area.


VAERS ID: 1326882 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dyskinesia, Loss of consciousness, Pallor, Posture abnormal, Retching, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dyskinesia (narrow), Dystonia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: zantac zofran
Diagnostic Lab Data: Hospital gave him IV fluids, but that''s all to my knowledge.
CDC Split Type:

Write-up: After 5 minutes from giving the vaccine. Patient started to say he was getting dizzy. He lost coloration at first, but could speak just fine. Then a few seconds later he appeared to lost consciousness, his head fell back, and he started to have jerking movements. He was making noises that almost sounded like a snore to me right at first, but it was more than likely him gagging on saliva. 911 was called, and his symptoms continued for roughly 30-60 seconds. EMS took him to hospital where they diagnosed it as vasovagal syncope and just gave him some fluids.


VAERS ID: 1326885 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-03-06
Onset:2021-03-17
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / N/A - / IM

Administered by: Other       Purchased by: ?
Symptoms: Chest X-ray, Dyspnoea, Feeling abnormal, Laboratory test, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Valtrex Verapamil Vitamin D
Current Illness:
Preexisting Conditions:
Allergies: Latex
Diagnostic Lab Data: Chest X-Ray Covid-19 Blood Work
CDC Split Type: vsafe

Write-up: I developed shortness of breath about ten days after the vaccine. I felt off when I got up in the morning. I could not finish a sentence without pausing for air. It seemed OK if I was sitting still but if I tried to move I got really short of breath. I went to the ER and they ran tests but they did not find anything. I was discharged and I felt a little better that evening. The following day I still had difficulty catching my breath with activity. On the third day I felt normal with no trouble breathing.


VAERS ID: 1327032 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-03-17
Onset:2021-03-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / N/A LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chest X-ray normal, Cough, Echocardiogram normal, Immediate post-injection reaction, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (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: Omeprazole; Multi-Vitamin
Current Illness: no
Preexisting Conditions: GERD; sleep apnea
Allergies: no
Diagnostic Lab Data: ER - For checking on possible blood clot - March 23, 2021 - Echocardiogram and chest x-ray - normal
CDC Split Type: vsafe

Write-up: Coughing started right away and has gotten progressively worse. I saw a specialist about three weeks ago and I''m not bad enough to have COPD but close. Treatments with inhalers with steroids and I have been on those for two weeks. I started feeling pain in back of my left leg. I thought it was a blood clot and went to ER but it wasn''t a blood clot. No treatment for that. I still feel the pain occasionally at this time. I have been taking Tylenol for it.


VAERS ID: 1327098 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-23
Onset:2021-04-13
   Days after vaccination:21
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 UN / IM

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

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

Write-up: s/p vaccine 3 weeks Pt c/o headaches, nausea, vomiting, currently Pt continues to have headaches .


VAERS ID: 1327117 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-08
Onset:2021-04-10
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Abdominal rigidity, Blood pressure increased, Blood test, Dehydration, Dyspepsia, EGFR status assay, Electrocardiogram, Full blood count, Headache, Muscle contracture, Muscle spasms, Rash macular, Urine analysis
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Dystonia (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (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: Gabapentin Cyclobenzaprine Victoza Prenatal Vitamin Probiotic Baby Aspirin Vitamin D3 4000 units/daily
Current Illness:
Preexisting Conditions: Herniated disc Degenerated disc L4/L5
Allergies: Cows milk Mold Dog Dander
Diagnostic Lab Data: Blood Work-CBC Metabolic Panel Blood Work other Chest Panel Urinalysis EGFR ECG 12 lead
CDC Split Type: vsafe

Write-up: Two days after the vaccine I was getting headaches and my blood pressure was a little high. I was given new blood pressure medicine when I visited my doctor. The headaches continued intermittently for two weeks and then they came back. Three weeks after the vaccine I had muscle contractions with the headaches from the base of my neck up to my head. I was also getting cramps in my legs. I went to the ER and they said I was extremely dehydrated, so they gave me an IV. I was given a muscle relaxant. The muscle contractions subsided in two days. I developed a big red spot which my doctor identified as a Hematoma a week later where the IV was inserted. About two days later I developed a big red blotch on my stomach which looked like the spot on my arm. My doctor said she thought it was a yeast infection on my stomach. I have also been having weird stomach pains in the last couple of days which started as spasms before but now it feels like my stomach is on fire. The headaches cleared up after four weeks but they are better now. ER


VAERS ID: 1327189 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: 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), 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: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: Patient was vaccinated at 6:00pm and told to stay at the store until 6:15pm. At approximately 6:40, while sitting in her car, she passed out. She had a friend with her that either called 911 or drove her to the emergency room.


VAERS ID: 1327245 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-04-11
Onset:2021-04-16
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / N/A LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Computerised tomogram, Electrocardiogram, Head discomfort, Headache, Magnetic resonance imaging, Ophthalmological examination normal, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin B, Vitamin D, Probiotic, Iron supplement
Current Illness: None
Preexisting Conditions: Fibromyalgia, Ehlers Danlos syndrome
Allergies: Tree nut, Calphlex
Diagnostic Lab Data: Blood work, MRI, CT, ECG from ER Eye exam from Optometrist Dr.
CDC Split Type: vsafe

Write-up: I woke up that morning with blurred vision in one eye, over the day pressure built in my head which caused a headache. Went to Dr. for blood work, on Monday still had the headache and blurred vision. I was sent to the ER for bloodwork and was called back for a MRI. I also went to the eye doctor but nothing was found.


VAERS ID: 1327254 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-05-14
Onset:2021-05-18
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pain, Injection site pruritus, Injection site rash
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)

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

Write-up: Patient presented to pharmacy with a rash at the injection site. Pain to touch and itching.


VAERS ID: 1327298 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-03-26
Onset:2021-05-02
   Days after vaccination:37
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chest X-ray, Computerised tomogram thorax abnormal, Deep vein thrombosis, Dyspnoea, Electrocardiogram, Heart rate increased, Laboratory test, Pulmonary embolism, Ultrasound Doppler abnormal
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Arthritis (broad), Dehydration (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, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Synthroid 112, Liothyronine 5 mcg, Atorvastatin 10 mg, Fish Oil 1290 mg, and Calcium Citrate with Vitamin D
Current Illness: None
Preexisting Conditions: Thyroid cancer
Allergies: None known
Diagnostic Lab Data: 5/02/21: EKG, Lab work, CT of Chest, Ultrasound od legs, Chest X-ray, etc.
CDC Split Type:

Write-up: Recall right knee pain about 10 days after injection. Have had previous knee surgery years ago and discounted it. Then on morning of 5/02 had two episodes of severe shortness of breath with elevated, resting heart rate (high 130 beats per minute) per Fitbit. Went to Emergency Room at 1 PM and was diagnosed with two large, bilateral pulmonary embolisms and two DVTs in right leg. Transferred to another Hospital as this hospital did not have a Pulmonologist on site for the weekend. Admitted ICU at about 6 PM.


VAERS ID: 1327305 (history)  
Form: Version 2.0  
Age: 89.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-03
Onset:2021-05-13
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Activated partial thromboplastin time shortened, Alanine aminotransferase normal, Aspartate aminotransferase normal, Blood albumin decreased, Blood alkaline phosphatase normal, Blood calcium normal, Blood chloride normal, Blood creatinine decreased, Blood glucose increased, Blood glucose normal, Blood potassium normal, Blood sodium normal, Blood thyroid stimulating hormone decreased, Blood urea normal, Carbon dioxide normal, Deep vein thrombosis, Dysarthria, Dysstasia, Fall, Feeling abnormal, Gait inability, Haematocrit decreased, Haemoglobin decreased, Headache, International normalised ratio increased, Mean cell haemoglobin concentration decreased, Mean cell volume normal, Muscular weakness, Peripheral swelling, Peripheral vein thrombus extension, Platelet count normal, Protein total normal, Prothrombin time prolonged, Red blood cell count decreased, SARS-CoV-2 test negative, White blood cell count normal
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Liver-related coagulation and bleeding disturbances (narrow), Angioedema (broad), Haematopoietic erythropenia (narrow), Peripheral neuropathy (broad), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Anticholinergic syndrome (broad), Dementia (broad), Embolic and thrombotic events, venous (narrow), Dystonia (broad), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypothyroidism (broad), Hyperthyroidism (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Atorvastatin 20 mg daily, Oscal with Vitamin D 500 mg daily, Vitamin B 12 1,000 mcg daily, Docusate 100 mg daily, Omeprazole 40 mg daily, Senna 1 daily. Enoxaparin was discontinued in April 2021 (had been treatment dose of 80 mg SC daily)
Current Illness: Advanced dementia, HLD, HTN
Preexisting Conditions: Endometrial cancer in remission, DVT and PE 1 year ago s/p an acute COVID infection, has indwelling IVC filter, enoxap
Allergies: None
Diagnostic Lab Data: 5/18/21 TB 0.5, DB 0.2, Alk Phos 62, AST 30, ALT 10, Alb 3.3, Protein 6.9 5/18/21 WBC 8.9, RBC 3.52, Hg 10.1, HCT 32.6, MCV 93, MCH 28.7, MCHC 31, Plt 295 5/18/21 Na 138, K 3.7, Cl Cl 103, CO2 24, AG 11, BUN 23, Glucose 115, SCr 1.64, Ca 9.6. Estimated CrCl 29 5/18/21 SARS Co-V-2 RNA: negative 5/17/21 TSH 0.89 5/17/21 PTT 31 5/17/21 PT 13.1 INR 1.12
CDC Split Type:

Write-up: Patient presented to the ED 5/18/21 with voice slurring, headache, leg swelling. Patient with symptoms starting on Friday 5/14/21. Patient with profound weakness of her lower extremities, unable to ambulate around the house which is new. Patient also reporting she feels "different/wrong." While here in the Emergency department, patient fell onto her rear while at ultrasound, did not hit her head. Unable to stand on her own after. Patient was found to have an acute left lower extremity DVT on 5/17/21: Acute deep venous thrombosis throughout the left lower extremity with most proximal extension of thrombus into the common femoral vein noting that the external iliac vein could not be visualized


VAERS ID: 1327431 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / N/A RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Dyspnoea, Headache, Pulmonary pain, X-ray
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Epseradiol - vagina dryness; post menopause; Acyclovir- genital herpes; Multi-Vitamin; Vit D; Benafiber; allubuterol as needed - but I usually I don''t need it - it''s usually dust in the air, bronchial infections or stress that causes me t
Current Illness: rhinitis - nose was draining - so maybe it was the pollen with a high pollen count at that time - a couple weeks before
Preexisting Conditions: Breast cancer survivor; pulmonary infiltrations in my lungs - scarring from previous infection; IBS sydrome -undiagnosed; acid reflux
Allergies: breatst cancer survivor - Taxotore - chemo drug
Diagnostic Lab Data: ER - X-Ray; IV for fluids - just for a short time - didn''t get the full dose. They monitored my vitals. They drew blood to make sure there were no clots and that came back normal.
CDC Split Type: vsafe

Write-up: Trigger asthma symptoms; headaches - I noticed headaches the next day; On Wednesday I had a really bad one all day. The headache kept going until I went to ER (sent me there said they couldn''t treat me at Urgent Care) on Friday when my breathing was getting very compromised - pain in my right lung on Thursday and Friday and It felt like I had a really bad bronchial infection. Before I went to ER - I was using my inhaler all the time - 4-6 times a day (14th, 15th, 16th and the first half following the ER visit.) No other treatment - they said just follow up with Primary care or Pulmonologist. After my ER visit, I used my inhaler for the first half of the week and then it started getting better and also the environment was having less pollen and so that was improving as well.


VAERS ID: 1327442 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-05-14
Onset:2021-05-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Rectal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal haemorrhage (narrow), Ischaemic colitis (broad)

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

Write-up: Rectal Bleeding


VAERS ID: 1327450 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-02
Onset:2021-04-21
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 RA / SYR

Administered by: Pharmacy       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? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Diabetes Type 2; Asthma; HTN;
Allergies: Morphine, Codeine, Serapin, Ava Pro, BenaCar, Bydureon
Diagnostic Lab Data: Ultrasound
CDC Split Type:

Write-up: DVT RIGHT LEG


VAERS ID: 1327483 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-04-08
Onset:2021-04-19
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthma, Chest pain, Computerised tomogram abdomen normal, Computerised tomogram thorax normal, Cough, Dyspnoea, Laboratory test normal
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None reported
Current Illness: Lupus, PE blood clots
Preexisting Conditions: Lupus, PE blood clots
Allergies: Ceclor
Diagnostic Lab Data: lab work CT scan of the chest CT scan of the upper abdomen
CDC Split Type: vsafe

Write-up: I experienced chest pains, felt like hard time breathing, little cough that felt like an asthma attach but not quite. I''ve had PE blood clots I went to urgent care on 04-23-2021, where they did CT scans of the chest and upper abdomen and lab work and my exams were negative. I can say today that I have recovered from my symptoms.


VAERS ID: 1327489 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-03-01
Onset:2021-03-20
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / 1 RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Blood test, Decreased appetite, Diarrhoea, Gait disturbance, Grip strength decreased, Headache, Impaired work ability, Joint stiffness, Joint swelling, Loss of personal independence in daily activities, Muscle twitching, Osteoarthritis, Pain in extremity, Peripheral swelling, Photopsia, Ultrasound scan, X-ray
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Retinal disorders (narrow), Arthritis (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: I''ve had blood work x3, xrays x2, sonogram
CDC Split Type:

Write-up: Hello, I received the J&J vaccine on 3/12/2021. Eight days later on the 20th when I went to bed I had a lot of pain in my left heel and left thumb. The next day, on a Sunday, the pain was now in my left heel, left thumb at the big knuckle and top and bottom below my thumb, and just behind the inside of my left ankle, and I had a terrible headache. I was unable to grasp anything or widen my grip because the pain was so intense in my thumb. It was so bad I went to my local ER who did xrays and told me it was just osteoarthritis. The next day, Monday, the pain was terrible. It was in my left thumb, the middle of my left hand, left ankle, the arch of my left foot top and bottom, the big knuckle at the bottom of my left big toe, my right hand was also now hurting at my middle finger the big knuckle at the bottom. I went to see my family doctor who really was unsure at the time what was going on and said it''s still just must be the osteoarthritis. The next day on Tuesday I still have the headache I was out unable to open my own water bottles or prescription bottles because the pain was so intense in my left hand. It was now extremely painful to walk on my left foot and I had no appetite. The following day on Wednesday the pain was bad and my right hand that I was unable to touch my ring finger or my pinky with my thumb. As hard as I try my thumb just would not reach those two fingers oh. I now couldn''t open any of the doors in my house unless I use the base of my Palms on both hands turn the knob. I now couldn''t even comb my own hair or pull my pants up wipe myself properly. I couldn''t hold a pencil or anything because the pain was so unbearable. I had no appetite and now I have diarrhea. I called my husband at work and had him come home and we went to the emergency room because it was a bigger facility. The doctor there told me he thought it was something more like rheumatoid arthritis or lupus. This was by far my worst d ay even though I was unable to work this entire week. Oh and did I mention the only reason I got that back who was because my boss with bullying me and pressuring me every day to get the vaccine. He even went so far as to come of my office and he wanted to use my keyboard to schedule my vaccine himself. The next day on Thursday I was still having a hard time walking I still couldn''t touch my ring finger on my pinky with my right hand still unable to open anything with either one of my hands. My husband had to open all the water bottles and prescription bottles and just set the caps on them before he went to work. I now had flashing light in my eyes which lasted about a week. The following day I had all the same symptoms but now my left foot was so swollen I couldn''t even get a shoe on it. The big knuckle at the base of my right hand hurts so bad at this point and so does the big knuckle at the base of my left thumb. The swelling and the pain is just unbearable at this point. The following day on Saturday my mom had come up from Florida and stay with me for two weeks take care of me someday the next day on March 28th I start all the same symptoms but now my muscles were quivering on the back of both thighs. By the middle of next week I still had all of the same pain and now I''m realizing that I can''t span open my fingers on my right hand and I''m unable to snap my fingers. Side note as of today I still cannot snap my fingers on my right hand. At this point I have been keeping a diary every day of where my pain was in what the pain level was each day. So strange that it''s affecting joints on both sides but just in my hands the inside of my wrist and my left foot. Are April 28th I finally got into the rheumatologist. He had me go to the hospital and get blood work done and x-rays. On Thursday May 6th I was unable to go to work. It seems like I can go to work about 3 days a week and the pain is so intense that I''m missing about two days a week. Dr called me and said all of my tests came negative for rheumatoid arthritis.He told me not just because I was a patient but if I was his own sister he would suggest going to the Clinic right away. He said they have a larger database and if anybody else was having the same reaction to the covid vaccine they would know about it. My husband came home from work and made the four-hour drive to the Clinic. I was there Thursday and Friday they the blood work a sonogram x-rays the whole gamut of tests. The rheumatologist in the ER said that he thinks it''s still something like rheumatoid arthritis or lupus but that was in the early stages and not showing up positive on the test. On Friday I met with dr. a rheumatologist oh, and the chairman at the Clinic. They said this is a very rare reaction to the J&J vaccine and they''re hopeful by prescribing me a non-steroidal anti-inflammatory and Voltaren gel that hopefully I will have some relief within a week and they were hopeful that the symptoms will go away within 3 months. They also took me off work for the next week. Did I mention got the first month that was going on they have me on 50 mg of Prednisone for one week then 100 mg of Prednisone for 2 weeks and then back down to 50 mg for one week. After being on that high dosage of Prednisone for an entire month I still have all of the swelling and pain in my joints. My joints are very stiff at this point. The prednisone maybe eased the pain just a touch but the pain and swelling was definitely there, and the pain is excruciating. I''m feeling so alone, and scared because I don''t know anybody else that''s having the same reaction. I''m also fearful I''m going to lose my job I''m missing so much work. But I also feel like my boss pressured me into this and now I''m suffering. If anybody is having the same reactions to Johnson & Johnson vaccine please reach out to me. I have my vaccination card I can show you and I have a ton of doctor and hospital records to verify my story. I''m really worried because I''m not sure what''s going on with me, how long it''s going to last, and is it going to come back if I do get these symptoms to go away. My work place offers no paid extended leave, and has repeatedly asked me I''d I was quitting my job. I''m only having these problems because I was pressured and bullied into getting this vaccine. I completely blame my boss. I would have never got vaccinated if he wasn''t on me about it every single day repeatedly. I''m at a loss as to what to do from here. I have no income coming in. Do I qualify for unemployment or some sort of disability benefits? If anybody can please give me some suggestions I''m open to whatever you have to say


VAERS ID: 1327491 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-10
Onset:2021-04-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Eye movement disorder, Hyperhidrosis, Musculoskeletal stiffness, Seizure, Syncope, Tremor, Vaccination complication
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Arthritis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: asthma, migraine, idiopathic scoliosis, IGA deficiency, weakness in R leg
Preexisting Conditions:
Allergies: codeine, olives, vaccine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt presented to ER early the following am, with seizures. Pt reports having a small reactions immediately after vaccine administration. Pt reports muscle stiffness, eyes rolling back, shaking, diaphoretic. Pt also reports having a second episode of syncope when she arrived home.


VAERS ID: 1327541 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-30
Onset:2021-03-31
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK RA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Back pain, Blood test abnormal, Chest pain, Depression, Diarrhoea, Dyspnoea, Headache, Malaise, Mobility decreased, Nausea, Pain, Thrombosis
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Parkinson-like events (broad), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Depression (excl suicide and self injury) (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad)

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

Write-up: The next day of vaccine on 03/31/2021 I had a severe headache, nauseas, I had diarrhea. As the days passed I started getting worst and worst I was loosing mobility in my body my husband had to take me to the restroom. On 04/06/2021 is when I went to the Emergency Room. When I got to the hospital I could not breath my ribs hurt a lot & I had horrible back pain. They put me oxygen and gave me fluids but they said I had to get transfer to another hospital and they transferred me on an ambulance. In the other hospital us where they transferred me they kept poking my stomach when I asked them why they kept poking it they told me that it was to stop the blood cloths. I was hospitalized for 5 days. When I was sent home I was still not feeling good I was feeling sick still I''ve been trying to recover slowly but I am not the same. I''m still in a lot of pain I can''t move my arms because of how much it hurts my back keeps hurting a lot as well. I want to go back to normal to how I was I can''t do anything I can''t even cook for my kids. I now have depression.


VAERS ID: 1327593 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-04
Onset:2021-05-11
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiac stress test, Computerised tomogram, Electrocardiogram, Magnetic resonance imaging, Pancreatitis acute, X-ray
SMQs:, Acute pancreatitis (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, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zyrtec
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: X-Ray 5/11/2021 , EKG 11 May, Cat Scan 5/12/2021 May, MRI 5/18/2021, Heart Stress Test 5/18
CDC Split Type:

Write-up: Admitted to local hospital with Acute Pancreatitus.


VAERS ID: 1327596 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-05-04
Onset:2021-05-08
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Myocardial infarction
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zyrtec; fish oil; tangy tangerine 2.0 tablets; baby aspirin; turmeric; D3; Ester C Super Beets
Current Illness: None
Preexisting Conditions: None
Allergies: Valtrex; amoxicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Major heart attack.


VAERS ID: 1327608 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-13
Onset:2021-04-05
   Days after vaccination:23
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802072 / N/A UN / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Atrial fibrillation, Blood test, Cardiac failure congestive, Cardiac stress test, Computerised tomogram, Dyspnoea, Echocardiogram abnormal, Electrocardiogram abnormal, Joint swelling, Pulmonary oedema, Ultrasound scan, Weight increased
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (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? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Thyroid Medication Multi Vitamins Coq10 Omega 3 Vitamin E
Current Illness:
Preexisting Conditions: Hypothyroidism
Allergies:
Diagnostic Lab Data: Stress Test Echo Cardiogram EKG CT Scan Ultrasound Blood Tests
CDC Split Type: vsafe

Write-up: Three weeks after the vaccine my ankles were swelled up. I gained 30 pounds over the course of fourteen days. I was having trouble breathing. I was admitted to the hospital and diagnosed with Atrial Fibrillation and Congestive Heart Failure. I also had water in my lungs. I have not had any heart symptoms before that. I tested positive for Covid-19 antibodies in June of 2020. I had multiple tests on every organ. There were no clogged arteries and no heart problems except for AFIB. My blood pressure is fine but I am taking half a blood pressure pill. I am trying to lose weight. I am scheduled to see a cardiologist on 05/25/2021


VAERS ID: 1327710 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041821A / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Condition aggravated, Dyspnoea, Fatigue, Laboratory test normal, Limb discomfort, Mobility decreased, Pyrexia, Respiratory tract congestion, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: phenonium shot, suffered from extreme tiredness
Other Medications: immune health support vitamin d
Current Illness: no
Preexisting Conditions: shorter arms then normal
Allergies:
Diagnostic Lab Data: lab work looked good covid test came back negative
CDC Split Type: vsafe

Write-up: I woke up the next day with a fever , the fever went and then I had trouble breathing with congestion I went to urgent and went on antibiotic the congestion cleared up then I had extreme tiredness for 3 days I am still having trouble with my left arm and cannot reach it above my head the energy level has returned to normal around Thursday and Friday of last week but the rotation of the left arm is still difficult


VAERS ID: 1327726 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, 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), 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: unknown
Current Illness: none reported
Preexisting Conditions: heart murmur
Allergies: none reported
Diagnostic Lab Data: none
CDC Split Type:

Write-up: patient felt dizzy, lightheaded, passed out


VAERS ID: 1327783 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / N/A LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Back pain, Blood pressure increased, Blood test normal, Chest X-ray normal, Dehydration, Dizziness, Electrocardiogram normal, Fatigue, Fear, Feeling abnormal, Gastrointestinal disorder, Impaired driving ability, Laboratory test normal, Malaise, Mental impairment, Mobility decreased, Nausea, Throat tightness
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Vestibular disorders (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Dehydration (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lovoxal - for thyroid; Acolate - asthma pills; fish oil; Vit D; I took a Claritin D that day - 12 hour one - maybe Vit C
Current Illness: no - but do have allergies and I did have allergies that day
Preexisting Conditions: mild lupus and asthma; IBS; bad seasonal allergies - other then seasonal, I do great and high chemical sensitivities
Allergies: Penicillin; sulpha drugs; Clindamycin; Oxycodone; eggs - but can eat a few eggs but can''t go overboard - was severely allergic when I was young; I don''t usually take a vaccine because of the eggs
Diagnostic Lab Data: On the 12th - Hospital ER - Bloodwork; EKG; chest x-ray - checked for blood clots - they did everything - it came normal
CDC Split Type: vsafe

Write-up: Right away, they were watching me because I felt like my throat was tightening up a little bit. My blood pressure sky rocketed. Then I was okay after awhile. They pharmacist said to take some Benadryl when I got home if I needed it. He knew I had taken Claritin D earlier. I was okay though. But the next morning, I was so exhausted I could barely get out of bed. The next day, I was still really tired. On Sunday morning, 10th, it hit me - I woke up at 04:00 in am. Nauseous; light-headed; gastro-intestinal issues; extremely ill. I called my brother in and was afraid to be by myself. I could barely move around to even get water or go to bathroom. I got through it somehow that day and on Monday I was just maybe a little but that isn''t saying much - still severe. By Tuesday, I called the pharmacy - I was so light-headed I thought I was going to pass out and they told me to go to ER and someone took me and doctor said he was seeing a lot of this. Gave me IV fluids. It was difficult to stay hydrated - they gave me paperwork on what to drink to stay hydrated - Pedialyte - anything that had water in it. I drank Essentia Water, too. I couldn''t stay hydrated and I was so light-headed (kept feeling like I was going to pass out) that I could have gone to ER again two days later. Doctor said take it easy - he said my body was busy making antibodies. That light-headedness for about a week - but I couldn''t drive for two weeks because of it - was still so dehydrated. I had a strange sensation - like I was outside my body - I couldn''t think straight. I was feeling pain in my back by my kidneys and went to my doctor.


VAERS ID: 1327810 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-03-31
Onset:2021-05-13
   Days after vaccination:43
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Angiogram pulmonary abnormal, Anticoagulant therapy, Blood test, Chest X-ray, Dyspnoea, Pain, Pulmonary embolism, Pulmonary infarction, Pyrexia, Ultrasound abdomen
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 6 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Levothyroxine, Prednisone, Plaquenil, Imuran, Hiprex, Toprol, Zoloft, Klonopin, Orencia IV, Vitamin B12, Vitamin D, Xopenex inhaler
Current Illness: Hashimotos, Auto immune hepatitis, RA, Pernicious anemia, Macrocytosis, Ehlers Danlos,Hypophistis, asthma,Major depressive disorder
Preexisting Conditions: Hashimotos, Auto immune hepatitis, RA, Pernicious anemia, Macrocytosis, Ehlers Danlos,Hypophistis, asthma,Major depressive disorder
Allergies: PCN, Peridium
Diagnostic Lab Data: CT Angiography Chest Xray Ultrasound abdomen too much blood work to name.
CDC Split Type:

Write-up: 5 weeks and 6 days later I suffered a PE with Infarct. was hospitalized 6 days. anticoagulants, IV antibiotics, s/s pain, fever,shortness of breath.


VAERS ID: 1327811 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 041A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pain, Swollen tongue
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: The first night I experienced pain on the injection site of the arm. Tongue was very swollen the next day. I went to the emergency room and was given medication.


VAERS ID: 1327968 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-04-12
Onset:2021-04-17
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Arrhythmia, Computerised tomogram thorax abnormal, Electrocardiogram abnormal, Musculoskeletal chest pain, Pain in extremity, Pulmonary thrombosis, Thrombosis, Ultrasound scan abnormal
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Thrombophlebitis (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Valsarten Diclofenac
Current Illness: N/A
Preexisting Conditions: High blood pressure
Allergies: Pennacillian Erthyomycin Duricef
Diagnostic Lab Data: CT Scan 5/8 showing blood clots in lung Sonogram 5/8 showing clot in left leg EKG 5/8 showing heart arrhythmia
CDC Split Type:

Write-up: 5 days after dose had pain in left calf. On May 8th went to the hospital with pain under my left rib cage. It was determined by testing that I had a blood clot in left leg and one in each lung. There was also heart arrhythmia. I was given blood thinners for the clots which I am still taking. I was also given medication to help with high blood pressure and to help with heart beat.


VAERS ID: 1328002 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Montana  
Vaccinated:2021-04-05
Onset:2021-04-12
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / N/A RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood test normal, Computerised tomogram normal, Dizziness, Electrocardiogram normal, Feeling abnormal
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: no
Current Illness: no
Preexisting Conditions: migraines
Allergies: shellfish; fish allergy
Diagnostic Lab Data: Monday the 12th of April - Benefis ER - Great Falls - EKG - on heart - normal; bloodwork - clear results; CT Scan - clear ; IV fluids; medications for migraines - and some Anti- vertigos to take while I was at home.
CDC Split Type: vsafe

Write-up: Monday I was super dizzy and lightheaded. Felt brain fog. It didn''t fell like a migraine brain fog. It lasted for a long time and I went to ER. I called Urgent care first but they sent me to ER. Dizzy - still but they still sent me home. I was off and on dizzy for about a week. The brain fog improved throughout the week - Monday was the worst day but it was progressively getting better by the next Monday.


VAERS ID: 1328036 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: New York  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Anxiety
SMQs:, Hypoglycaemia (broad)

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

Write-up: patient had an anxiety attack related to vaccine administration (needles) and potential side effects after administration. vitals : hr 50, r 30, BP 140/100,m o2 sat 88%. EMS was called due to dropping o2 sat and HR. vitals reached normal range after EMS arrived. final vitals upon leaving facility: HR 56, R 25, BP 138/90, O2SAT 99%. EMS took patient to mt sinai west in NYC for further observation.


VAERS ID: 1328229 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cold sweat, Dyspnoea, Hyperhidrosis, Pallor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: gabapentin 600mg; omeprazle 40mg; chantix 1mg
Current Illness: None reported
Preexisting Conditions: Diabetes, hypertension, anxiety
Allergies: NKDA
Diagnostic Lab Data: None reported
CDC Split Type:

Write-up: The patient returned to the pharmacy shortly after receiving a Janssen COVID vaccine. He was sweating, pale, clammy, and breathing hard. We had him sit, helped him calm his breathing; I assessed for wheezing and swelling of the tongue, but he did not have those symptoms. The patient was able to speak and did not report dizziness or lose consciousness. Paramedics responded. I spoke with the patient this morning, and he reports no residual symptoms.


VAERS ID: 1328523 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-05-17
Onset:2021-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Hyperhidrosis, Syncope, Throat tightness, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (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), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

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

Write-up: After receiving the vaccine, the patient stated that he felt light-headed, and was sweating profusely. He vomited. His blood pressure was 118/82 mmHg, pulse 81 bpm, and respirations 16 bpm. He said he felt like his throat was closing, so we gave him liquid diphenhydramine. At this point, we called 911. The patient was alert and talking the whole time. The patient went with EMS. The patient came back later after being released from the hospital and said that he didn''t have an allergic reaction, but he had vasovagal syndrome.


VAERS ID: 1328558 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: No Known Allergies
Diagnostic Lab Data: Blood pressure 05/18/2021 @ 10:12 am was 113/60
CDC Split Type:

Write-up: Patient fainted within 5 minutes of vaccine administration. She came to within 15 seconds, at that time she was laid down in a supine position. Once she stabilized and identified who she was, where she was, and what had just happened, I sat her up and checked her blood pressure (113/60 at 10:12am). I stayed with the patient and continued to assess the situation and her until EMS arrived and took over care.


VAERS ID: 1328729 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-21
Onset:2021-04-25
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blindness unilateral, Blood test, Cerebral artery thrombosis, Cerebrovascular accident, Computerised tomogram head abnormal, Headache, Hypertension, Surgery, Ultrasound scan
SMQs:, Neuroleptic malignant syndrome (broad), 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), Glaucoma (broad), Hypertension (narrow), Optic nerve disorders (broad), Retinal disorders (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, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: CT scans, ultra sound, blood drawn, surgery, etc
CDC Split Type:

Write-up: Very strong headaches and high blood pressure for two weeks. Went to the hospital twice in that span of time. Monday May 10, he couldn?t see through his right eyes. He went to the ER and they found a blood clot in his artery(thrombosis) and that night had a stroke in the brain. Still at hospital.


VAERS ID: 1328732 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-13
Onset:2021-03-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 - / SYR

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Dizziness, Feeling abnormal, Hypoacusis, Magnetic resonance imaging, Speech disorder
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hearing impairment (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: High blood pressure intermittent
Allergies: None
Diagnostic Lab Data: MRI April 2021 Bloodwork March 2021
CDC Split Type:

Write-up: Chronic dizziness continues 3-10 times a day Brain fog improving Static in ears constant Speech interruption improved Continuing under doctors care for dizziness and brain fog... waiting for therapy for balance and prescribed meds that did not help


VAERS ID: 1328901 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-12
Onset:2021-04-17
   Days after vaccination:36
Submitted: 0000-00-00
Entered: 2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / 1 LA / SYR

Administered by: Work       Purchased by: ?
Symptoms: Balance disorder, Computerised tomogram, Electrocardiogram, Fatigue, Headache, Laboratory test, Palpitations, Sudden hearing loss, Tinnitus
SMQs:, Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hearing impairment (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Daily women?s vitamin with iron, probiotic, turmeric supplement, fish oil
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin
Diagnostic Lab Data: CT scan (with and without contrast), blood work, EKG, three in-office visits and course of steroids.
CDC Split Type:

Write-up: Experienced a short episode of what felt like heart palpitations and extreme fatigue, then a sudden hearing loss that has persisted for five weeks and continuing. Also experiencing, as a result of hearing loss: tinnitus, balance issues, and headaches. Possible permanent hearing loss.


VAERS ID: 1328996 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-03-16
Onset:2021-03-20
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN J&J / 1 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Back pain, Computerised tomogram thorax abnormal, Groin pain, Motor dysfunction, Muscular weakness, Pulmonary thrombosis, Thrombosis, X-ray normal
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Osteonecrosis (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, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Original CT results 04/16/2021 showed blood clots in lung and back.
CDC Split Type:

Write-up: abdominal pain. The pain was so severe that my knees would buckle and several times if I was holding anything, it caused me to drop it. After about a week, I had an appointment at 4:30 and was scheduled for the next morning at 8:30 to meet with a back and spine doctor for xrays. Xrays were negative. I was then schedule with a neck and hand specialist a few days later. This appointment could not provide a diagnosis. Back and abdominal pain increase and soreness had spread to the stomach and groin. After the news broke of the cerebral blood clots in 6 women. See attached Continuation Page.


VAERS ID: 1329072 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-03-28
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / UNK - / -

Administered by: Military       Purchased by: ?
Symptoms: Cerebrovascular accident, Computerised tomogram, Magnetic resonance imaging, Pain in extremity
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), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Hypertension; Type II diabetes mellitus
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data: Test Name: CAT scan; Result Unstructured Data: scan did not show the stroke; Test Name: MRI; Result Unstructured Data: small spot (stroke confirmed)
CDC Split Type: USJNJFOC20210518127

Write-up: STROKE; SORE ARM; This spontaneous report received from a patient concerned a male of unspecified age. The patient''s height, and weight were not reported. The patient''s concurrent conditions included hypertension, and diabetes type 2.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1802068, and expiry: UNKNOWN) dose was not reported, frequency 1 total, administered on 04-MAR-2021 at left arm for prophylactic vaccination. No concomitant medications were reported. On unspecified date, the patient had sore arm. On 28-MAR-2021, the patient''s right peripheral vision was gone and went to emergency room and diagnosed with stroke. The patient got hospitalized. At hospital, alteplase was administered as the treatment medication for stroke. Patient was discharged on 02-APR-2021. The magnetic resonance imaging (MRI) has shown small spot (stroke confirmed) while Computerized axial tomography scan (CAT) scan did not show the stroke. The patient was hospitalized for 5 days. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from stroke on 02-APR-2021 and the outcome of sore arm was not reported. This report was serious (Hospitalization Caused / Prolonged).; Sender''s Comments: V0;20210518127-covid-19 vaccine ad26.cov2.s-Stroke. This event is considered not related. The event 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 than the drug. Specifically: MEDICAL HISTORY, UNDERLYING DISEASE.


VAERS ID: 1329073 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: South Carolina  
Vaccinated:0000-00-00
Onset:2021-04-01
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Cerebrovascular accident, Computerised tomogram, Dyspnoea, Magnetic resonance imaging
SMQs:, Anaphylactic reaction (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), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ASPRIN; LISINOPRIL; CLOPIDOGREL BISULFATE; VERAPAMIL HCL; BRILINTA; ATORVASTATIN; GABAPENTIN; LEVOTHYROXINE; HYDROXYCHLOROQUINE SULFATE; FINASTERIDE; ESCITALOPRAM; VITAMIN D3; ALPHA LIPOIC ACID
Current Illness: Blood pressure high; Cardiac disorder; Non-smoker; Social alcohol drinker (On special occasions.)
Preexisting Conditions: Medical History/Concurrent Conditions: Clot blood; Comments: The patient had no known allergies. The patient did not have any drug abuse/illicit drug use.
Allergies:
Diagnostic Lab Data: Test Date: 20210418; Test Name: CT scan; Result Unstructured Data: not reported; Test Date: 20210419; Test Name: MRI; Result Unstructured Data: stroke, plaque around the brain
CDC Split Type: USJNJFOC20210518146

Write-up: STROKE; SHORT WINDED; This spontaneous report received from a patient concerned a 78 year old White and not Hispanic or Latino male. The patient''s height, and weight were not reported. The patient''s past medical history included blood clot in leg around 10 year ago, and concurrent conditions included high blood pressure, social drinker, hole in heart from birth, and non-smoker, and other pre-existing medical conditions included the patient had no known allergies. the patient did not have any drug abuse/illicit drug use. 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 left arm on 11-APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. Concomitant medications included acetylsalicylic acid, atorvastatin, clopidogrel bisulfate, colecalciferol, escitalopram, finasteride, gabapentin, hydroxychloroquine sulfate, levothyroxine, lisinopril, thioctic acid, ticagrelor and verapamil hydrochloride were drug used for unknown indication. On 12-APR-2021, the patient experienced headaches, which lasted 1 week. On 18-APR-2021, the patient had CT scan (computerized tomography) result was not reported. Patient was sent home for tension headache. On same day, patient had also experienced no energy. On 19-APR-2021, the patient was Hospitalized for MRI (Magnetic resonance imaging) which showed patient had stroke within 5 days and also had plaque around the brain. Patient was started on Plavix and aspirin. On 21-APR-2021, the patient discharged from hospital. On same date, the patient went to cardiologist to have monitor placed where patient had another stroke and patient was readmitted to the hospital. patient was taken off Plavix and started on Lisinopril and placed on heart monitor. On 23-APR-2021, the patient was discharged from hospital. Patient was hospitalized for 5 days. On APR-2021 patient had experienced down hill, short winded and voice was gone. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from stroke, and had not recovered from short winded. This report was serious (Hospitalization Caused / Prolonged).; Sender''s Comments: V0. 20210518146-COVID-19 VACCINE AD26.COV2.S-Stroke. 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: MEDICAL HISTORY


VAERS ID: 1329075 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Chest pain, Pain in extremity
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210519898

Write-up: HEART PAIN; LEG PAIN; 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 (suspension for injection, route of admin not reported, batch number: Unknown) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On an unspecified date, the subject experienced heart pain, and leg pain. The action taken with covid-19 vaccine was not applicable. The outcome of the heart pain and leg pain 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: 1329079 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: South Carolina  
Vaccinated:0000-00-00
Onset:2021-04-27
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal discomfort, Abdominal pain, Back pain, Bone pain, Chest X-ray, Chest pain, Chills, Dizziness, Electrocardiogram, Fatigue, Feeling cold, Hyperhidrosis, Injection site pain, Limb discomfort, Malaise, Muscle tightness, Nausea, Pain, Pain in extremity
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Osteonecrosis (broad), Tendinopathies and ligament 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? No
Previous Vaccinations:
Other Medications:
Current Illness: Abstains from alcohol; Glucose-6-phosphate dehydrogenase deficiency; Non-smoker; Osteoporosis; Soy allergy; Sulfonamide allergy; Type II diabetes mellitus
Preexisting Conditions: Medical History/Concurrent Conditions: Allergic reaction to antibiotics; Comments: There was no drug abuse or illicit drug usage.
Allergies:
Diagnostic Lab Data: Test Date: 20210511; Test Name: Chest X-ray; Result Unstructured Data: Negative for heart attack; Test Date: 20210511; Test Name: ECG; Result Unstructured Data: Negative for heart attack
CDC Split Type: USJNJFOC20210523146

Write-up: BACK PAIN; PAIN IN LEFT SIDE OF CHEST; ARMS PAIN; BODY PAIN/EXCRUCIATING PAIN; FELT SO SICK; CHILLS; NAUSEA; TIREDNESS/EXHAUSTED; BURNING SENSATION ON RIGHT ARM; COLD AS INSIDE AN IGLOO; DIZZINESS; ABDOMINAL PAIN; PAIN IN THE BONES OF THE CHEST; BURNING SENSATION ON RIGHT ARM THAT EXTENDED TO ABDOMEN; SWEATING; HEAVINESS IN RIGHT ARM; TIGHTNESS ON THE RIGHT ARM; This spontaneous report received from a patient concerned a 54 year old female. The patient''s weight was 158 pounds, and height was 159 centimeters. The patient''s concurrent conditions included hereditary condition called g6pd, type 2 diabetes, osteoporosis, allergy to sulfa based meds, allergy to soy, non smoker, non alcohol user, and tetracycline allergy, and other pre-existing medical conditions included there was no drug abuse or illicit drug usage. The patient experienced drug allergy when treated with acetylsalicylic acid. The patient received covid-19 vaccine (suspension for injection, intramuscular, batch number: 206A21A expiry: UNKNOWN) dose was not reported, administered on 27-APR-2021 for prevention of covid-19 disease. No concomitant medications were reported. On 2021, the subject experienced tightness on the right arm. On 2021, the subject experienced sweating. On 2021, the subject experienced heaviness in right arm. On 27-APR-2021, the subject experienced abdominal pain. On 27-APR-2021, the subject experienced pain in the bones of the chest. On 27-APR-2021, the subject experienced burning sensation on right arm that extended to abdomen. On 27-APR-2021, the subject experienced dizziness. On 27-APR-2021, the subject experienced cold as inside an igloo. On 27-APR-2021, the subject experienced felt so sick. On 27-APR-2021, the subject experienced chills. On 27-APR-2021, the subject experienced nausea. On 27-APR-2021, the subject experienced tiredness/exhausted. On 27-APR-2021, the subject experienced burning sensation on right arm. On 10-MAY-2021, the subject experienced body pain/excruciating pain. On 11-MAY-2021, the subject experienced back pain. On 11-MAY-2021, the subject experienced pain in left side of chest. On 11-MAY-2021, the subject experienced arms pain. Laboratory data included: Chest X-ray (NR: not provided) Negative for heart attack, and ECG (NR: not provided) Negative for heart attack. Treatment medications (dates unspecified) included: ketorolac tromethamine, paracetamol, and ibuprofen. The action taken with covid-19 vaccine was not applicable. The patient had not recovered from abdominal pain, chills, pain in the bones of the chest, dizziness, tiredness/exhausted, nausea, body pain/excruciating pain, and cold as inside an igloo, and the outcome of burning sensation on right arm that extended to abdomen, felt so sick, pain in left side of chest, arms pain, heaviness in right arm, burning sensation on right arm, sweating, back pain and tightness on the right arm 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 considered non serious.


VAERS ID: 1329081 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: New Jersey  
Vaccinated:0000-00-00
Onset:2021-04-29
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 20UA21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Dizziness, Dyspnoea, Fatigue, Feeling abnormal, Sensory disturbance
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: XARELTO; TIKOSYN; DILTIAZEM; SPIRONOLACTONE; ATORVASTATIN; CALTRATE D3; VITAMIN D [ERGOCALCIFEROL]
Current Illness: Abstains from alcohol; Atrial fibrillation; Chronic bronchitis; Macular degeneration; Non-smoker
Preexisting Conditions: Comments: The patient had no known allergies.
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210523346

Write-up: LEGS WERE RUBBERY; TIRED FEELING FROM BOTTOM TO MY NECK/ARMS AND CHEST TIRED; HAD SHORTNESS OF BREATH; VERY LIGHT-HEADED/VERY DIZZY; FEEL BEAT UP; NO ENERGY; This spontaneous report received from a patient concerned an 81 year old female. The patient''s height, and weight were not reported. The patient''s concurrent conditions included atrial fibrillation, chronic bronchitis, macular degeneration, no alcohol use, and non smoker, and other pre-existing medical conditions included the patient had no known allergies. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 20UA21A, expiry: UNKNOWN) dose was not reported, administered on 12-APR-2021 for prophylactic vaccination. Concomitant medications included rivaroxaban for atrial fibrillation, atorvastatin, calcium carbonate/colecalciferol, diltiazem, dofetilide, ergocalciferol, and spironolactone. On 2021, the subject experienced feel beat up. On 2021, the subject experienced no energy. On 29-APR-2021, the subject experienced very light-headed/very dizzy. On 30-APR-2021, the subject experienced legs were rubbery. On 30-APR-2021, the subject experienced tired feeling from bottom to my neck/arms and chest tired. The action taken with covid-19 vaccine was not applicable. The patient recovered from very light-headed/very dizzy on 2021, and tired feeling from bottom to my neck/arms and chest tired on 05-MAY-2021, was recovering from feel beat up, and the outcome of legs were rubbery, no energy and had shortness of breath 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: 1329085 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2021-05-11
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN XD955 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Headache, Neuralgia, Neuritis, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20210524207

Write-up: NEURALGIA; NEURITIS; VOMITING; DIZZINESS; HEADACHE; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient''s weight, height, and medical history were not reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: XD955 and expiry: UNKNOWN) dose was not reported, administered on 30-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 2021, the subject experienced headache. On 11-MAY-2021, the subject experienced neuralgia. On 11-MAY-2021, the subject experienced neuritis. On 11-MAY-2021, the subject experienced vomiting. On 11-MAY-2021, the subject experienced dizziness. The action taken with covid-19 vaccine was not applicable. The outcome of the headache, vomiting, dizziness, neuralgia and neuritis 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: 1329086 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Louisiana  
Vaccinated:0000-00-00
Onset:2021-04-02
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Blood pressure high (Well controlled); Platelet rich plasma therapy (PRP therapy at left elbow for tendonosis); Tendinosis (Platelet rich plasma therapy); Type II diabetes mellitus
Preexisting Conditions: Medical History/Concurrent Conditions: Spinal operation; Comments: Patient had no genetic conditions which would explain the clotting. Patient had no prior history of blood clots.
Allergies:
Diagnostic Lab Data: Test Date: 20210402; Test Name: Diagnostic ultrasound; Result Unstructured Data: DVT and clot blood confirmed; Comments: DVT and extensive clotting to right left and abdomen.; Test Date: 20210407; Test Name: CT scan; Result Unstructured Data: Bilateral pulmonary embolism; Test Date: 20210423; Test Name: Diagnostic ultrasound; Result Unstructured Data: not provided; Test Date: 20210430; Test Name: Diagnostic ultrasound; Result Unstructured Data: Rethrombosis confirmed
CDC Split Type: USJNJFOC20210525688

Write-up: BILATERAL PULMONARY EMBOLISM; EXTENSIVE CLOTTING TO RIGHT LEFT AND ABDOMEN; DEEP VEIN THROMBOSIS; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient''s height, and weight were not reported. The patient''s past medical history included four spine surgeries, and concurrent conditions included tendinosis, high blood pressure, type 2 diabetes, and platelet rich plasma therapy, and other pre-existing medical conditions included patient had no genetic conditions which would explain the clotting. patient had no prior history of blood clots. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: unknown) dose was not reported, frequency 1 total, administered on 21-MAR-2021 for prophylactic vaccination. Batch number was not reported and has been requested. No concomitant medications were reported. On 25-MAR-2021 and 1-APR-2021 patient underwent a series of Platelet Rich Plasma (PRP) Injections for left elbow for tendinosis. On 02-APR-2021, the patient experienced deep vein thrombosis and extensive clotting to right left and abdomen, and was hospitalized. Laboratory data included: Diagnostic ultrasound (NR: not provided) DVT and clot blood confirmed. Treatment medications included: heparin non-company. The patient was discharged on 03-APR-2021 with instructions to take Eliquis. On 07-APR-2021, the patient experienced bilateral pulmonary embolism and the patient was readmitted to the hospital. Laboratory data included: computed tomography (CT) scan (NR: not provided) Bilateral pulmonary embolism. Discharged on 09-APR-2021. On 23-APR-2021, Laboratory data included: Diagnostic ultrasound (NR: not provided) not provided. On 26-APR-2021, the patient was readmitted and thrombectomy was performed. The patient was discharged on 27-APR-2021. On 30-APR-2021, the patient experienced rethrombosis. Laboratory data included: Diagnostic ultrasound (NR: not provided) Rethrombosis confirmed. Treatment medications included: bivalirudin, where doctor placed a catheter and administered an Angiomax IV for 72 hours. On 03-MAY-2021, thrombolysis and thrombectomy surgery was performed. Patient was discharged on an unspcified date with additional treatment medications (dates unspecified) included: clopidogrel bisulfate, acetylsalicylic acid, and levofloxacin. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the extensive clotting to right left and abdomen, deep vein thrombosis, and bilateral pulmonary embolism was not reported. This report was serious (Hospitalization Caused / Prolonged).; Sender''s Comments: V0: 20210525688-COVID-19 VACCINE AD26.COV2.S-extensive clotting to right left and abdomen, deep vein thrombosis, bilateral pulmonary embolism. 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: MEDICAL HISTORY, UNDERLYING DISEASE


VAERS ID: 1329088 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2021-04-03
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Cough, Dizziness, Dyspnoea, Fatigue, Haematochezia, Haemorrhoids, Headache, Myalgia, Pain in extremity, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Gastrointestinal haemorrhage (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Ischaemic colitis (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (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: Patient had no relevant medical history and was not on regular medication
Allergies:
Diagnostic Lab Data: Test Date: 20210504; Test Name: Blood test; Result Unstructured Data: NOT REPORTED; Test Date: 20210504; Test Name: Chest X-ray; Result Unstructured Data: NOT REPORTED
CDC Split Type: USJNJFOC20210526242

Write-up: BLOOD IN THE STOOL; SHORTNESS OF BREATHE; TINGLING IN THE FINGERTIPS AND THE TOES; SORENESS IN THE RIBCAGE NEAR THE HEART/LEFT CALF SORENESS; PUMPING SENSATION IN RIGHT SIDE OF HEAD; TIREDNESS; RIGHT ARM SORENESS; COUGHING; LIGHT HEADEDNESS SENSATION; HEMORRHOIDS; This spontaneous report received from a patient concerned a 56 year old male. The patient''s height, and weight were not reported. The patient had no relevant medical history and was not on regular medication. 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, once total administered on 01-APR-2021 on left arm for prophylactic vaccination. No concomitant medications were reported. Patient reported that, he received the vaccine on 01-APR-2021. Approximately 2 days after he coughed and felt lightheaded and noticed some lights around his eyes. Approximately 7 days after patient noticed a list of symptoms including a pumping sensation in the right side of his head, left calf soreness, soreness in the ribcage near the heart, a tingling sensation in the fingertips and toes (but not at the center), sense of tiredness, shortness of breath, blood in stool that he referred to repeatedly as clots, right arm soreness (although the injection was given in the left arm). Patient called his doctor twice and was told to go to the hospital. Patient went to the hospital on 04-MAY-2021. Arrived at 12 PM and discharged at 11 PM approximately. Conducted a chest x-ray, took a blood sample twice, and put some stuff on patient''s chest. Patient was discharged on 04-MAY-2021 and given a prescription for Motrin 800 mg taken three times per day as needed, and for cyclobenzaprine 10 mg taken twice a day as needed for spasms. Patient decided not to take these medications as he was unsure if they were pain medications and felt apprehensive. He main concerns seemed to be the pumping sensation in the right side of his head and the blood in his stool which he repeatedly referred to as a clot. His family doctor is aware of the situation and says he thinks its hemorrhoids. He refers to the clot as darker red in colour and also mentions that there is regular red blood in stool alongside the darker clot. Patient notices this about 3 times per week. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from coughing, and light headedness sensation on 03-APR-2021, was recovering from right arm soreness, and had not recovered from pumping sensation in right side of head, soreness in the ribcage near the heart/left calf soreness, tingling in the fingertips and the toes, tiredness, shortness of breathe, blood in the stool, and hemorrhoids. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0.20210526242-covid-19 vaccine ad26.cov2.s -blood in stool . 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: 1329093 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Florida  
Vaccinated:0000-00-00
Onset:2021-04-03
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / UNK - / -
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / OT
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure increased, Blood pressure measurement, Diarrhoea, Fatigue, Headache, Heart rate, Hypersomnia, Illness, Injection site pain, Laboratory test, Palpitations, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (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), Hypertension (narrow), Cardiomyopathy (broad), Depression (excl suicide and self injury) (broad), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Blood pressure; Drug hypersensitivity
Preexisting Conditions: Medical History/Concurrent Conditions: Adverse drug reaction; Comments: The patient had adverse reaction to beta blockers. The patient had 15 medicinal allergies and reaction to drugs.
Allergies:
Diagnostic Lab Data: Test Date: 20210411; Test Name: Blood pressure; Result Unstructured Data: 190/100 mmHg; Test Date: 202105; Test Name: Blood pressure; Result Unstructured Data: 210/99 mmHg; Test Date: 202105; Test Name: Blood pressure; Result Unstructured Data: 188/86 mmHg; Test Date: 202105; Test Name: Blood pressure; Result Unstructured Data: 160/79 mmHg; Test Date: 202105; Test Name: Heart rate; Result Unstructured Data: 95 (not reported); Test Date: 20210509; Test Name: Lab test; Result Unstructured Data: all tests were good; Test Date: 20210509; Test Name: Blood pressure; Result Unstructured Data: low to 129 over something mmHg; Test Date: 20210509; Test Name: Blood pressure; Result Unstructured Data: 215/105 mmHg; Test Name: Blood pressure; Result Unstructured Data: 130/140 over 70 mmHg; Test Name: Heart rate; Result Unstructured Data: 60 (unit not reported)
CDC Split Type: USJNJFOC20210529638

Write-up: HIGH BLOOD PRESSURE; HEART PALPITATION; SEVERE DIARRHEA; HEADACHE/THROBBING IN THE TEMPLES; TIRED; INJECTION SITE PAIN; VOMITING/THROWING UP; SICK; FELL ASLEEP; This spontaneous report received from a patient concerned a 67 year old female. The patient''s height, and weight were not reported. The patient''s past medical history included adverse reaction to beta blockers, and concurrent conditions included blood pressure, and hypersensitive to drugs, and other pre-existing medical conditions included the patient had adverse reaction to beta blockers. The patient had 15 medicinal allergies and reaction to drugs. 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, 1 in total administered at left arm on 03-APR-2021 for prophylactic vaccination. Non-company suspect drugs included: nebivolol hydrochloride (form of admin, route of admin, and batch number were not reported) 5 mg, frequency was not reported, from 2021, and 2.5 mg, frequency, and therapy dates were not reported for high blood pressure; and losartan (form of admin, route of admin, and batch number were not reported) 25 mg, 2 times every 1 day, from 2021 for high blood pressure. No concomitant medications were reported. On 03-APR-2021 (on the day of injection), the patient had injection site pain on the day of injection. On 05-APR-2021, the patient starred to getting tired. On 07-APR-2021 or 08-APR-2021, the patient woke up with heart palpitation, throbbing in the temples and diarrhea. Were on vacation, left and came home, still did not feel good, went to urgent care on 11-APR-2021 and blood pressure was 190/100 mmHg. The patient have had blood pressure before, but had been controlled for years until this. Went to cardiologist twice, gave her another medication (carvedilol) which did not bring it down. Carvedilol increased her blood pressure. She was taking 3.175 in morning and 3.175 at night. The patient was tried another medication Bystolic 5 mg that did not bring it down. Cardiologist said they could not do anything else for patient. Referred to a nephrologist that she was not seen yet. No tests from the nephrologist yet. Kidneys were working fine. Meanwhile went to her primary care 3 times, tried on 2 other medications but blood pressure didn''t come down. primary care physician lowered the Bystolic to 2.5 mg because she was getting sick from it. Started Losartan 25 mg morning and 25 mg at night, started getting headache. Last night she started getting headaches and throwing up which she said were side effects of the losartan. She went to emergency room on 09-MAY-2021 blood pressure was 215/105 mmHg and kidney was fine, heart was fine, all tests were good (coded as unspecified lab test) and emergency room physician gave her clonidine 0.1 and blood pressure went really low to 129 mmHg over something and she got really sick. They gave her a prescription of clonidine. Family physician told her to take 1/2 of the clonidine if her blood pressure was over 190. On 15-MAY-2021, the patient went to emergency room again because the heart rate was higher (95 ) usually was 60 and blood pressure was 210 over 99 mmHg. She took 1/4 of clonidine and it did drop it down to 160/79 mmHg. She took 1/4 of Xanax and fell asleep. She woke up with severe diarrhea and threw up. Medications included 1/4 Losartan last night. 20 mg Enalapril (original medication) and Hydrochlorothiazide 25 mg and xanax and blood pressure didn''t come down. She was taking a 3 course medication therapy all along. For 5 weeks she had been housebound, tryied different medications, throwing up, diarrhea, and xanax tried to bring it down blood pressure right now 188/ 86 mmHg. The patient had been taking the blood pressure medicine and diuretic and a quarter of the Xanax . Her usual BP was 130/140 over 70 mmHg. The action taken with covid-19 vaccine ad26.cov2.s was not applicable; and action taken with nebivolol hydrochloride, and losartan was not reported. The patient was recovering from high blood pressure, and the outcome of injection site pain, headache/throbbing in the temples, heart palpitation, severe diarrhea, vomiting/throwing up, tired, sick and fell asleep was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0: 20210529638--High blood pressure. This event is considered not related. The event 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 than the drug. Specifically: MEDICAL HISTORY


VAERS ID: 1329096 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Virginia  
Vaccinated:0000-00-00
Onset:2021-05-01
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Dysphagia, Fatigue, Headache, Hypoaesthesia oral, Insomnia, Nasopharyngitis, Neck pain, Odynophagia, Pharyngeal swelling, Swelling
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? 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: USJNJFOC20210529708

Write-up: LEFT SIDE LIPS NUMBNESS; LEFT SIDE OF NECK AREA HURTS; THROAT SWELLING; SWOLLEN LEFT SIDE OF THE NECK; HARD TIME TO SWALLOW; COLD; TIRED; HEADACHES; DIDN''T SLEEP VERY WELL; SWALLOWING HURTS A LOT; This spontaneous report received from a patient concerned a 21 year old female. The patient''s height, and weight were not reported. The patient''s pre-existing medical conditions included unknown.The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 203A21A, and batch number: 203A21A expiry: UNKNOWN) dose was not reported, administered on 12-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On MAY-2021, the subject experienced swallowing hurts a lot. On 12-MAY-2021, the subject experienced didn''t sleep very well. On 12-MAY-2021, the subject experienced tired. On 12-MAY-2021, the subject experienced headaches. On 13-MAY-2021, the subject experienced cold. On 14-MAY-2021, the subject experienced throat swelling. On 14-MAY-2021, the subject experienced hard time to swallow. On 14-MAY-2021, the subject experienced left side of neck area hurts. On 14-MAY-2021, the subject experienced swollen left side of the neck. On 15-MAY-2021, the subject experienced left side lips numbness. The action taken with covid-19 vaccine was not applicable. The patient recovered from didn''t sleep very well, and cold on MAY-2021, tired on 12-MAY-2021, and headaches on 13-MAY-2021, and had not recovered from throat swelling, hard time to swallow, left side lips numbness, left side of neck area hurts, swallowing hurts a lot, and swollen left side of the neck. This report was non-serious.


VAERS ID: 1329107 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:2021-05-12
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Computerised tomogram, Electrocardiogram, Migraine, Speech disorder, Toxicologic test
SMQs:, Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (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 not have any history of drug abuse or illicit drug use The patient did not have any no known allergies. The patient was not pregnant at the time of reporting.
Allergies:
Diagnostic Lab Data: Test Date: 20210513; Test Name: Toxicologic test; Result Unstructured Data: Negative; Test Date: 20210513; Test Name: EKG; Result Unstructured Data: Negative; Test Date: 20210513; Test Name: CT scan; Result Unstructured Data: Clear
CDC Split Type: USJNJFOC20210530300

Write-up: MIGRAINE; DIFFICULTY SPEAKING (STUTTER WITH A SLIGHT SLUR); This spontaneous report received from a parent concerned an 18 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 not have any history of drug abuse or illicit drug use the patient did not have any no known allergies. the patient was not pregnant at the time of reporting. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 202A21A, and expiry: UNKNOWN) dose was not reported, administered on 10-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 12-MAY-2021, the subject experienced difficulty speaking (stutter with a slight slur). On 13-MAY-2021, Laboratory data included: CT scan (NR: not provided) Clear, EKG (NR: not provided) Negative, and Toxicologic test (NR: not provided) Negative. On an unspecified date, the subject experienced migraine. Treatment medications (dates unspecified) included: escitalopram oxalate. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from difficulty speaking (stutter with a slight slur), and the outcome of migraine was not reported. This report was non-serious.


VAERS ID: 1329664 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-05-19
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? Yes
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:
CDC Split Type: USJNJFOC20210530971

Write-up: BLOOD CLOTS; This spontaneous report received from a patient concerned multiple patients. 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 1 total ,start therapy date were not reported for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On 2021, the subject experienced blood clots, and was hospitalized (date unspecified). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of blood clots leading to hospitalization was not reported. This report was serious (Hospitalization Caused / Prolonged).; Sender''s Comments: v0-20210530971-covid-19 vaccine ad26.cov2.s-Blood Clots. This event(s) is considered Un assessable. 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: 1329927 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-03-12
Onset:2021-04-09
   Days after vaccination:28
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Aphasia, Cerebrovascular accident, Dyspnoea, Headache, Pain in extremity
SMQs:, Anaphylactic reaction (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), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zyrtec Citrucel Viitamin D3 Centrum Silver Metformin HCL ER Carvedilol Spironolactone Torsemide Entresto Eliquis Citrucel Pravastatin Sodium Tamsulosin HCL Finasetride
Current Illness: Congested Heart Failure
Preexisting Conditions: Diabetes
Allergies: Steroid Creams
Diagnostic Lab Data: Cat scan
CDC Split Type:

Write-up: Stoke occurred, including symptoms of: severe headache, shortness of breath, trouble speaking, plus leg pain


VAERS ID: 1329929 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-03-21
Onset:2021-03-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805022 / N/A LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Anxiety, Back pain, Blood test normal, Blood urine present, Bundle branch block right, Chest X-ray normal, Chest discomfort, Computerised tomogram, Cough, Dizziness, Dyspnoea, Fatigue, Heart rate increased, Impaired work ability, Muscle spasms, Nausea, Palpitations, Pyrexia, Retching, Sensation of foreign body, Serum ferritin, Syncope, Tachycardia, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Conduction defects (narrow), Retroperitoneal fibrosis (broad), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (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: Multi vitamin, Nextlanon birth control,
Current Illness:
Preexisting Conditions:
Allergies: maple
Diagnostic Lab Data: March 24 routine blood work, all normal except Ferritin levels. April 5 chest xray it was clear April 7 they did a test for hemochromatosis April 8 CT scan of chest
CDC Split Type: vsafe

Write-up: On March 22 2021, I had leg cramps that felt like Charlie horses, I had a fever of 102 and I missed work. On March 24 I went to my doctor because my legs were still bothering me. That same night I ended up experiencing extreme dizzy spells, I fainted. On March 25 called my doctor I told them my symptoms were getting worse, the office made me a follow up appointment for April 2 for dizzy spells and fatigue. My symptoms continued to get worse, I had a tele visit April 5. Then, I started developing a dry cough. I called again that same day 4/5 for shortness of breath and went in to my doctors office 1:10pm. They did a chest xray. April 6th I had another tele appointment for anxiety Because I started developing anxiety from all my symptoms. April 7th I called again I had blood in my urine and back pain, It was very alarming because my last period was & years ago. April 7th I went to an Urgent Care . April 8th it got really bad. I went emergency room, I felt like I had a lump in my throat and experiencing some chest tightness, my pulse was 101 beats per minute, heart 118, BP was 143/106 I presented with unspecified Right Bundle Branch block and I ended up tachycardia, they did a CT scan of my chest. the doctor gave me Valium & Hydroxyzine. At the hospital I started dry heaving and vomiting. April 9th saw a new doctor still very nauseated and I was experienced nausea and heart palpitations, and rapid heart.


VAERS ID: 1329936 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-05-05
Onset:2021-05-06
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Fatigue, Haematology test, Laboratory test, Migraine, Nausea, Oropharyngeal pain, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vitamin c, vitamin d, fish oil, gingko biloba, collagen, folate, biotin, milk thistle, hyaluronic acid
Current Illness: None
Preexisting Conditions: None
Allergies: Sulfa and ceclor
Diagnostic Lab Data: Emergency room visit on 5/6. The doctor administered saline, morphine, and something for nausea. They also did Chem and hematology labs Because I do not have insurance, I was released as soon as I started feeling a little better. The symptoms returned that night and have continued in waves a full 2 weeks later.
CDC Split Type:

Write-up: Migraine, fever, sore throat, dizziness, exhaustion, nausea/ vomiting. It has been 14 days since I got my vaccine and all of these symptoms have continued to come and go in waves.


VAERS ID: 1329948 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-05-15
Onset:2021-05-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 022B21A / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine Lisinopril Hydrochlorothiazide
Current Illness: n/a
Preexisting Conditions: Hypertension
Allergies: Celecoxib Dapsone Loop diuretics Sulfonamides / Sulfa Saccharin Tetracyclines Thiazide-type diuretics Tigecycline Triptans
Diagnostic Lab Data:
CDC Split Type:

Write-up: 5:15pm: Light headedness and soreness along right forearm down to right hand. 5:30pm: BP 184/110. Pt sitting on ground. Alert and talking/laughing/normal breathing. Was told by EMS to not give pt water/food in case of exacerbation. 5:40pm: EMS arrived 6:30pm: Pt discharged, reported BP down to 140/??


VAERS ID: 1329985 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-05-19
Onset:2021-05-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: clondine, adderal, duloxetine
Current Illness: none
Preexisting Conditions: PTSD
Allergies: none
Diagnostic Lab Data: Patient taken to ED via stretcher with code team to be monitored
CDC Split Type:

Write-up: Patient anxious complained of arm pain with injection and approximately 3 minutes later patient had loss of consciousness for approximately 2 minutes. BP low normal 108/60. Patient pale, diaphoretic and cool to touch, Patient assisted to stretcher and on monitor and found to be bradycardic HR as low as 38 . CODE team arrived and within 5 minutes patient back to baseline


VAERS ID: 1329988 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 204A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Nausea, Syncope, Unresponsive to stimuli, Vomiting
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), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Medium, Systemic: Nausea-Medium, Additional Details: patient fainted and vomiting after receiving vaccine, ambulance was called patient was evaluated and vitals were within normal limits. Patient was contacted 6 hours after event and stated she was feeling much better. patient was observed after vaccine for 1 hour


VAERS ID: 1329996 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: California  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821286 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dizziness, Dyspnoea, Flushing, Hyperhidrosis, Nausea, Visual impairment
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

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

Write-up: Systemic: Allergic: Difficulty Breathing-Medium, Systemic: Chills-Medium, Systemic: Dizziness / Lightheadness-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Nausea-Medium, Systemic: Visual Changes/Disturbances-Medium


VAERS ID: 1330054 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-03-31
Onset:2021-04-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / 1 RA / IM

Administered by: Work       Purchased by: ?
Symptoms: Chest X-ray, Chest pain, Computerised tomogram head, Computerised tomogram thorax, Dyspnoea, Echocardiogram abnormal, Electrocardiogram, Electrocardiogram ST segment elevation, Fibrin D dimer, Headache, Heart rate increased, Impaired work ability, Myocardial necrosis marker, Palpitations, Troponin normal
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Wellbutrin XR 150mg daily, Clonazepam 0.5mg BID, Tizanidine 4mg at night prn
Current Illness: none
Preexisting Conditions: none
Allergies: Ancef
Diagnostic Lab Data: Chest X-Ray and D- Dimer 4/15/21-ER Chest X-Ray, d-dimer and ekg- 4/19/21- ER Chest and head CT 5/4, echo 5/5, D- Dimer 5/4-Hospital- admitted to Tele unit overnight, diffuse ST elevations, negative trop, cardiac labs etc
CDC Split Type:

Write-up: Headache since getting the vaccine that has not stopped. Shortness of breath, chest pain and palpitations with any activity. HR has significant increase with any activity. Headache gets worse after episode of chest pain, sob etc. Pressure headache that is in the front of the head since getting vaccine. Now on a beta blocker to help with Heart rate and out of work since getting vaccine.


VAERS ID: 1330070 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-04-29
Onset:2021-05-15
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, COVID-19 pneumonia, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: aspirin, atorvastatin, empagliflozin, insulin glargine, lisinopril, metformin, multivitamin, silver sulfadiazine cream, vitamin D.
Current Illness:
Preexisting Conditions: HTN, diabetic reoccuring foot wounds, DM 2, hyperglycemia, morbid obesity.
Allergies: No known Allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt received COVID-19 J&J vaccination on 4/29/2021. Pt began having symptoms of COVID around 5/8/2021, worsening to the point of needing hospitalization on 5/15/2021. Diagnosed with COVID pneumonia. Hospitalized for 3 days, symptoms improved enough to discharge.


VAERS ID: 1330225 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood glucose, Blood test, Hyperhidrosis, Loss of consciousness, Nausea, Tremor
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), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Albuterol Inhaler, one a day women''s vitamin
Current Illness: no
Preexisting Conditions: no
Allergies: synergic, Compazine
Diagnostic Lab Data: Blood Sugar, Blood Work, IV of fluids
CDC Split Type: vsafe

Write-up: Within 15 mins I was sweating and nausea, shaking, I passed out for less than 30 secs. I was shaking.


VAERS ID: 1330290 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-03-09
Onset:2021-03-15
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Adverse drug reaction, Agitation, Anxiety, Blood test, Electrocardiogram, Electroencephalogram abnormal, Heart rate increased, Hypertension, Magnetic resonance imaging, Mental status changes, Posterior reversible encephalopathy syndrome
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Hostility/aggression (broad), Hypertension (narrow), Cardiomyopathy (broad), Hypoglycaemia (broad), Dehydration (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, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: prograf cellcept prednisone baby aspirin
Current Illness: kidney transplant in may 8 2020 blind
Preexisting Conditions: kidney transplant blind
Allergies: none
Diagnostic Lab Data: blood tests mri eeg ekg close monitoring hospital stay for 8 days at clinic on kidney transplant floor
CDC Split Type:

Write-up: change in mental status agitation anxiety high heart rate high blood pressure diagnosed with PRES cause of adverse reaction of anti rejection prograf that she was on for 9 months, could covid vaccine have triggered this serious medical condition


VAERS ID: 1330384 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-16
Onset:2021-03-26
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK RA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram abnormal, Dyspnoea, Fatigue, Laboratory test, Pulmonary embolism
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Diabetes medicine
Current Illness:
Preexisting Conditions: Diabetes
Allergies:
Diagnostic Lab Data: Lab work & CT scan.
CDC Split Type: vsafe

Write-up: About 1 week in a half later after the vaccine I felt very tired and felt like I couldn''t breath. I went to the Emergency room they did lab work & a CT scan and that''s when they seen I had a blood cloth in my lungs. I got admitted I was hospitalized for 2 days and they also gave me oxygen to take home when I was released. I am currently still on oxygen and I still feel very tired I can''t do a lot of things because I get tired right away. I also have back pain and I have to continue paying for my medication something that was not in my budget.


VAERS ID: 1330508 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: New York  
Vaccinated:2021-05-17
Onset:2021-05-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808986 / 1 RA / IM

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

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

Write-up: patient stated he ended up in the hospital with blood clot in the lungs


VAERS ID: 1330512 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Utah  
Vaccinated:2021-03-08
Onset:2021-03-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / N/A LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Chills, Cold sweat, Feeling cold, Pain, SARS-CoV-2 test positive
SMQs:, Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: fish oil, vitamin d, Flonase
Current Illness: late January had a virus felt similar covid 19.
Preexisting Conditions: mild to moderate asthma
Allergies: Cipro (quinolones)
Diagnostic Lab Data: Covid swab
CDC Split Type: vsafe

Write-up: about 10 at night I started feeling cold, followed by chills that were uncontrollable for like four hours, body aches, sweating cold sweat all through the night. about 6 weeks later started having symptoms like a sinus infection went to an Urgent care, they did a covid test it was positive.


VAERS ID: 1330560 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-05-11
Onset:2021-05-17
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Dyspnoea, Headache, Pain, Rash, Respiratory tract congestion, Sinus congestion
SMQs:, Anaphylactic reaction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: bupropion 150 mg daily
Current Illness: Patient denied
Preexisting Conditions: no
Allergies: nkda, no food allergies, past history of seasonal allergies as child
Diagnostic Lab Data: Seen at on 5/18/21
CDC Split Type:

Write-up: Patient received Janssen vaccine on 5/11/21 @ Pharmacy, noted 12 hours after the vaccine had headache, body aches, and chills. The on 5/17/21 woke with a head to tow rash. Went to ED and was treated with Prednisone and antihistamines. 5/19/21 noted chest and head congestion, shortness of breath and return of rash on his back only. Patient referred to see provider 5/19/21 to rule out covid infection and discuss the treatment of symptoms.


VAERS ID: 1330569 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-03-10
Onset:2021-03-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, Electrocardiogram, Gastroenteritis viral, Hypoaesthesia, Paraesthesia, Peripheral swelling, Rash, Rash erythematous, Ultrasound abdomen
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Yes I''m taking medications.
Current Illness: None
Preexisting Conditions: None
Allergies: Yes allergic and known at the time of vaccination because provided a list.
Diagnostic Lab Data: Ultrasound of stomach EKG
CDC Split Type: vsafe

Write-up: I got a severe stomach flu and joint elbow pain and went behind my knee, lesions started on lower leg with red bumps and went across ankles and feet but still experiencing lesions which are extremely painful, feet are swollen and tingling and numbness of pain. I''ve been to ER and had an EKG and ultrasound performed.


VAERS ID: 1330588 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Idaho  
Vaccinated:2021-04-09
Onset:2021-04-10
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Irregular breathing, Wheezing, X-ray
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (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: Thyroid medication
Current Illness:
Preexisting Conditions: Thyroidectomy, Gout, Osteoarthritis
Allergies: Atorpin
Diagnostic Lab Data: x-rays
CDC Split Type: vsafe

Write-up: I experienced day after vaccine, really horrible chest pains. I went to ER after 8 hours, and had blood pressure 160/100 and pulse of 120. They did x-rays, treated like a heart attack and gave me medicine for an ulcer and some other type of injection placed in IV line. On Sunday I have breathing issues, wheezing and could not catch my breath.


VAERS ID: 1330591 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chest X-ray, Chills, Cough, Full blood count normal, Headache, Hyperhidrosis, Metabolic function test, Nausea, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: loratadine as needed for allergies and sumatriptan as needed for headaches
Current Illness: None
Preexisting Conditions: Allergic rhinitis and headaches
Allergies: Amoxicillin- Headaches
Diagnostic Lab Data: Chest xray (5/19/21): negative CMP and CBC normal
CDC Split Type:

Write-up: Patient received the J&J vaccine on 5/18/21. 12 hours later, he developed nausea, vomiting, cough, weakness, headaches, sweats, and chills. On 5/19/21, he came to the emergency department. He received 1L of NS, ketorolac 30 mg, ondansetron 4 mg, and orphenadrine 60 mg.


VAERS ID: 1330635 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-09
Onset:2021-04-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / N/A RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Breath sounds abnormal, Cough, Injection site pain, Musculoskeletal stiffness, Pain, Pruritus, SARS-CoV-2 test negative
SMQs:, Anaphylactic reaction (narrow), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (narrow), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad), Arthritis (broad), Respiratory failure (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: flu shot - about 10 years ago - never took the flu shot again after that because I got deathly sick
Other Medications: no
Current Illness: no
Preexisting Conditions: Bronchial asthma - I usually get that twice a year. High Blood Pressure; Fibromyalgia; Cerebral Palsy; Strabismus - eye condition; bi-polar depression
Allergies: antibiotics in general - penicillin; cestin; Biaxin; Cipro; Doxycycline; Azithromycin; sulfa - all these itching or rash morphine -throw up/vomiting; codeine - heart palpitations; Corn - shortness of breath
Diagnostic Lab Data: Saturday - May 15th COVID - negative - CLINIC - here in
CDC Split Type: vsafe

Write-up: First I had the itching and I came home and took a Benadryl and it subsided. The next day, I woke up stiff as a board. Everything hurt. Like I remember having the flu - feeling you get when joints etc. hurts all over. I took Tylenol - maybe took 1000 mg twice in that day. I have fibromyalgia and this was over and above that. The third day, the injection site on arm really hurt. The fourth or fifth day, the cough started - first a little irritation and then I started coughing and rattling and I have had the cough ever since. I have seen my doctor four times in the last month to get medications that work. I had to go to the walk in (Urgent Care at the clinic on Weekends) this Saturday (5/15/2021) and get this new medication that seems to be working - it''s a steroid - it''s Levaquin . Although, yesterday, I still had that overall body hurt (I was in bed all day) - could have been side affect of medication but today (after two doses) seems to be better and I''m not coughing as much.


VAERS ID: 1330656 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Nebraska  
Vaccinated:2021-05-19
Onset:2021-05-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fall, Head injury, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: Gave patient vaccine at 9:55 AM. Patient was instructed to hang out seated in the pharmacy department for 15 minutes. Patient was feeling fine and proceeded to head to customer service counter in store where he lost consciousness falling forward hitting his face on the counter, and then fell back hitting the back of his head on the floor.


VAERS ID: 1330717 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-05-18
Onset:2021-05-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808609 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Per patient had a seizure after HPV vaccine, no problems with other vaccines.
Other Medications: Nonne
Current Illness: None
Preexisting Conditions: History of depressionn and asthma.
Allergies: Penicillin - Rash
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pateint was given vaccine on 5/18/2021, soon after her injection, she passed out in the lobby. Code Blue was called. After medical team arrived, her HR= 48; BP= 89/56; O2= 100% on 3L and she responded to verbal commands. Hx of needle phobia. Not sure whether her Syncope was secondary to Vasovagal vs. J&J Vaccine vs. Seizures, therefore, we called EMS to take her for further evaluation.


VAERS ID: 1330753 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-19
Onset:2021-05-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808979 / N/A RA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Confusional state, Hypoxia
SMQs:, Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Hypoglycaemia (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: unknown, but per facility nurse, pt is NOT on blood thinners.
Current Illness:
Preexisting Conditions:
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: J&J vaccine was administered to patient. Consent form states that patient will be receiving J&J vaccine today. Pt is confused per medical baseline. Notified facility nurse, RN that I will be given J&J to patient and was okay with giving. After vaccine was given a second facility nurse, RN confirmed that pt was supposed to received second dose of Pfizer vaccine today. Pt was closely monitored in area for 30 minutes, facility Dr was notified. No acute distress noted, vital sign stable, no reactions noted, no active bleeding noted during 30 minutes of observation. Pt was taken back to her room and 15 minutes after observation at around 09:35AM, facility staff notified pt was desatting, was placed on oxygen and ambulance was called and taken to emergency room.


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