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

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



Case Details (Reverse Sorted by Onset Date)

This is page 46 out of 1,889

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VAERS ID: 1283101 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-03-15
Onset:2021-04-13
   Days after vaccination:29
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 - / -

Administered by: School       Purchased by: ?
Symptoms: Cyst
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: metropol, ziprol, eltroxin, aspirin
Current Illness: 7/2020; temp 102 COVID; neg called back to come in for a bacterial infection; hooked up to IV for 24-48 hours (L arm) kept for observation in hospital *vein was extremely sensitive
Preexisting Conditions: hypertension
Allergies: tramadol
Diagnostic Lab Data: n/a
CDC Split Type: VSAFE

Write-up: 3/15/2021 vaccination 4/13 Noticed cyst on L wrist; came in on the middle of the night. 1" in diameter. 4/15 Appt with Dr. Gave option to drain cyst. I have been doing some heavy lifting and may have ruptured my rotator cuff. I may need to contact my PCP to follow up.


VAERS ID: 1283752 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-01
Onset:2021-04-13
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 2021-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fluticasone propionate nasal spray 50mcg
Current Illness: None
Preexisting Conditions: None
Allergies: Lactose intolerance, sensitive to egg yoke
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Severe headache on the right hemisphere of my head that lasted all night of the 13 into the am on the 14 of April. I haven''t had a headache like this before. I woke up, took 6 81mg baby aspirin. With in 10 minutes headache was gone


VAERS ID: 1284802 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0151 / 2 RA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Body temperature, Chills, Fatigue, Loss of consciousness, Migraine, Pain, Pyrexia
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), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: High cholesterol; Hypothyroidism
Allergies:
Diagnostic Lab Data: Test Date: 20210413; Test Name: body temperature; Result Unstructured Data: Test Result:slight; Comments: 10:00
CDC Split Type: USPFIZER INC2021434785

Write-up: passed out at home; Migraine; chills; aches; tired; slight temp; This is a spontaneous report from a contactable consumer (patient). A 63-year-old female patient received the second dose of bnt162b2, via an unspecified route of administration, administered in right arm on 12Apr2021 (Lot Number: EW0151) as single dose for covid-19 immunisation. Medical history included High cholesterol, hypothyroidism. The patient''s concomitant medications were not reported. The patient previously received the first dose of bnt162b2, at the age of 63-year-old, via an unspecified route of administration, administered in left arm on 20Mar2021 18:30 (Lot Number: ER8727) as single dose for covid-19 immunisation. The patient was not pregnant. The patient experienced migraine, chills, aches, slight temp and tired on 13Apr2021 10:00; passed out at home 22:30 13Apr2021. No treatment received. The outcome of the events was recovered in Apr2021.


VAERS ID: 1285753 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-04-08
Onset:2021-04-13
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Computerised tomogram head, Mobility decreased, Muscular weakness, Respiration abnormal
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Respiratory failure (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Genvoya, albuterol
Current Illness: "Cold"
Preexisting Conditions: HIV
Allergies: NKDA
Diagnostic Lab Data: CT Brain ordered 5/4/2021.
CDC Split Type:

Write-up: The patient described severe left arm weakness with inability to lift his arm in order to bring a cup to his lips. He has some sort of upper respiratory complaints at after he got the vaccine and received treatment from his PCP.


VAERS ID: 1285806 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Heavy menstrual bleeding, Menstruation irregular
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Fertility disorders (broad)

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

Write-up: Patient has had menstrual bleeding for two weeks after the vaccination and then on random days have heavy and light bleeding .


VAERS ID: 1286212 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-03-30
Onset:2021-04-13
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805020 / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Arthralgia, Chills, Heavy menstrual bleeding, Menstruation delayed, Menstruation irregular, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Fertility disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Wellbutrin 300mg QD Nexium 20mg QD HCTZ 25mg QD Vit D3 500mcg QD Magnesium
Current Illness: None
Preexisting Conditions: Obesity GERD HTN Depression
Allergies: NKDA, no food allergies, general seasonal/environmental allergies
Diagnostic Lab Data: None
CDC Split Type:

Write-up: My period was delayed in starting/started about 7 days late and then I had menstrual bleeding for 18 days that was very heavy. This is very irregular for me. I did also have a fever of 102.9, myalgias, chills, and joint pain on 3/31-4/1/21 right after receiving the vaccine


VAERS ID: 1286235 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-10
Onset:2021-04-13
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 RA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Montelukast Birth control pill Allertec Daily vitamins 5-HTP Lamotrigine Quetiapine Amphetamine
Current Illness: None
Preexisting Conditions: Back pain, bipolar disorder
Allergies: Hazelnuts, chestnuts, apples, pineapples, cucumbers
Diagnostic Lab Data:
CDC Split Type:

Write-up: Suicide ideation and a severe depressive episode that has been hard to break out of.


VAERS ID: 1287365 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808978 / UNK LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Balance disorder, Dizziness, Gait disturbance
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Simvastsatin Vit C Calcium D3 Zinc
Current Illness: No
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: Provider has not done any, has referred me to an ENT. Appoint not until June 2.
CDC Split Type:

Write-up: Very dizzy so I sat down and have felt totally off balance ever since. The room does not spin and I am not nauseous but I am very unsteady on my feet. Then there are times when I feel fine. But off balance on a daily basis.


VAERS ID: 1288387 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-03-31
Onset:2021-04-13
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3247 / 1 RA / -

Administered by: Work       Purchased by: ?
Symptoms: COVID-19, Drug ineffective, SARS-CoV-2 test
SMQs:, Lack of efficacy/effect (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: HUMALOG; LISINOPRIL; SIMVASTATIN; AMITRIPTYLINE; OZEMPIC
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Diabetes
Allergies:
Diagnostic Lab Data: Test Date: 20210413; Test Name: Nasal Swab; Test Result: Positive
CDC Split Type: USPFIZER INC2021437625

Write-up: tested positive for Covid-19 virus; tested positive for Covid-19 virus; This is a spontaneous report from a contactable consumer (patient). A 57-year-old male patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE lot number: EL3247) via an unspecified route of administration, administered on the right arm on 31Mar2021 21:15 at a single dose for COVID-19 immunisation. Medical history included diabetes. Concomitant medications included insulin lispro (HUMALOG), lisinopril, simvastatin, amitriptyline and semaglutide (OZEMPIC). On 13Apr2021 10:00, the patient tested positive for Covid virus. Nasal swab done post vaccination on 13Apr2021: COVID test result: Positive. The event resulted to a Doctor or other healthcare professional office/clinic visit, Emergency room/department or urgent care. Prior to vaccination, the patient was not diagnosed with COVID-19. The facility where the vaccine was administered was in a workplace clinic. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Therapeutic measures were taken as a result of the events which included hydrocodone/chlorphen Suspension, Tylenol. Outcome of the event was recovering.


VAERS ID: 1288388 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-04-05
Onset:2021-04-13
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 RA / OT

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: AVANZA
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: ADD
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021437727

Write-up: Developed two blood clots in my left calf; This is a spontaneous report from a contactable consumer, the patient. An 18-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE, Lot unknown, first dose) solution for injection intramuscular in the right arm on 05Apr2021 at 10:00 (at the age of 18-years-old) as a single dose for COVID-19 vaccination. Medical history included ADD (attention deficit hyperactivity disorder). Concomitant medication included mirtazapine (AVANZA). The patient had no known allergies. The patient did not receive any other vaccine within 4 weeks prior to the vaccine. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient developed two blood clots in my left calf on 13Apr2021 at 14:00 which resulted in emergency room/department or urgent care visit. Treatment for the event blood clots included rivaroxaban (XARELTO). The outcome of the event blood clots was recovering. The patient was not tested for Covid post vaccination. Information on the lot/batch number has been requested.


VAERS ID: 1290180 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: Idaho  
Vaccinated:2021-04-08
Onset:2021-04-13
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 UN / SYR

Administered by: Other       Purchased by: ?
Symptoms: C-reactive protein increased, Haematocrit increased, Haemoglobin increased, Platelet count normal, Red blood cell count increased
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: MED/ALLERGY DATA GATHERED INCLUDING RECENTLY EXPIRED PRESCRIPTIONS AND REMOTE (NON-PORTLAND) VA PRESCRIPTIONS Active and Recently Expired Outpatient Medications (excluding Supplies): Inactive Outpatient Medications
Current Illness: No
Preexisting Conditions: Patient is transgender on testosterone therapy but has been on this since 2018 Current smoker
Allergies: None
Diagnostic Lab Data: 4/13/2021 HCt 61.5 Hgb 21 platelet 271 5/3/2021 labs RBC 6.52 (H) Hemoglobin 21.0 * (!) Hematocrit 61.5 * (!) CRP UltraSens 5.8 (H)
CDC Split Type:

Write-up: Patient with elevated hematocrit (though has other reasons for this) Asytmpomatic but found on lab testing


VAERS ID: 1291159 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: California  
Vaccinated:2021-03-27
Onset:2021-04-13
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP6955 / UNK LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Bell's palsy, Ear infection, Ear pain, Headache, Hypoaesthesia, Pain in jaw
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hearing impairment (broad), Osteonecrosis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ATORVASTATIN; ZIRTEC
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021438474

Write-up: Bell''s Palsy; Headache; jaw ache; ear ache; numbness in face; Assuming ear infection; This is a spontaneous report from a contactable consumer (patient). This 56-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in arm left on 27Mar2021 12:45 (Lot Number: EP6955) as single dose (at 56 years old) for COVID-19 immunisation. Medical history included none. Concomitant medications included atorvastatin, cetirizine hydrochloride (ZIRTEC), Forces of Nature Skin Tag. On 13Apr2021, the patient experienced Bell''s Palsy (medically significant), headache, jaw ache, ear ache, numbness in face, assuming ear infection. Therapeutic measures were taken as a result of the events included Prednisone. The outcome of the events was recovering. The patient required a visit to the emergency room and diagnosed with Bell''s Palsy. Prior to vaccination, the patient was not diagnosed with COVID-19 and since the vaccination, the patient had not been tested for COVID-19. The patient was not pregnant at the time of vaccination.


VAERS ID: 1291323 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-01-30
Onset:2021-04-13
   Days after vaccination:73
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, SARS-CoV-2 test, Vaccination failure
SMQs:, Lack of efficacy/effect (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Allergy to nuts
Allergies:
Diagnostic Lab Data: Test Date: 20210413; Test Name: Nasal Swab; Test Result: Positive
CDC Split Type: USPFIZER INC2021456226

Write-up: Got covid 13Apr2021; Covid test result=Positive; This is a spontaneous report from a contactable other healthcare professional (patient). A 21-year-old female patient received the bnt162b2 (BNT162B2), dose 2 via an unspecified route of administration, administered in Arm Left on 30Jan2021 (Batch/Lot number was not reported) (received at the age of 20-years-old) as single dose, dose 1 via an unspecified route of administration, administered in Arm Left on 06Jan2021 12:00 (Batch/Lot number was not reported) (received at the age of 20-years-old) as single dose for COVID-19 immunisation. The vaccine was administered at a hospital. The patient did not receive any other vaccines within four weeks prior to receiving the Pfizer vaccine. Medical history included known allergy to tree nuts. She has no other medical history. She had no covid prior to vaccination. She was not pregnant at the time of vaccination and adverse events. There were no concomitant medications. It was reported that patient got covid on 13Apr2021. The patient was tested for covid post vaccination. She had undergone a nasal swab on 13Apr2021 and the result was positive. Outcome of the events was unknown. Information on the lot/batch number has been requested.; Sender''s Comments: Based on the available information, the reported COVID infection as documented by a positive nasal swab in the context of a vaccine failure is possible. The case will be assessed further upon receipt of additional information.


VAERS ID: 1291329 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-04-13
Onset:2021-04-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EIM0162 / 2 LA / -

Administered by: Public       Purchased by: ?
Symptoms: Condition aggravated, Deafness, Dysacusis, Hypoacusis
SMQs:, Hearing impairment (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: COVID-19
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021456254

Write-up: hearing loss; muffled hearing; echoing in ear; it got worse; This is a spontaneous report from a contactable consumer. This 26-year-old female consumer (patient) received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), dose 2 via an unspecified route of administration, administered in Arm Left on 13Apr2021 14:45 (Batch/Lot Number: EIM0162) as SINGLE DOSE for covid-19 immunisation. Medical history included covid-19 from an unknown date and unknown if ongoing. Historical vaccine included BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), dose 1 (lot number= ER8727) on 22Mar2021 at 02:45PM on right arm and experienced ringing and pulsing in left ear. The patient''s concomitant medications were not reported. After second shot on 13Apr2021, the patient reported "it got worse, hearing loss, muffled hearing and echoing in ear" with outcome of not recovered. Therapeutic measures were taken as a result of reported events included over the counter medications. The patient was not tested positive for COVID post vaccination.


VAERS ID: 1292633 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Oregon  
Vaccinated:2021-04-10
Onset:2021-04-13
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-05-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Feeling cold, Hypoaesthesia, Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: None Known
Preexisting Conditions: None known
Allergies: NKA
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Numbness in arm started the day after getting covid injection, J&J 4 wks ago. Location of numbness was pinky and fourth finger now pinky and thumb. Also from elbow down. Arm feels tired but not weak. Gets random sharp feelings in arm at times. Gets an intermittent cooling sensation on arm also.


VAERS ID: 1294668 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-12
Onset:2021-04-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8734 / 2 LA / -

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Blood glucose, Blood glucose increased, Immobile, Platelet count, Platelet count decreased
SMQs:, Haematopoietic thrombocytopenia (narrow), Hyperglycaemia/new onset diabetes mellitus (narrow), Systemic lupus erythematosus (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: High cholesterol (other medical history: High cholesterol)
Allergies:
Diagnostic Lab Data: Test Name: glucose; Result Unstructured Data: Test Result:spiked up; Test Name: platelets; Result Unstructured Data: Test Result:decreased
CDC Split Type: USPFIZER INC2021443586

Write-up: Decreased blood platelet counts; spiked up glucose; immobility; foot joint pain; This is a spontaneous report from a contactable consumer (patient). A 43-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), second dose at the age of 43-years-old via an unspecified route of administration, administered in arm left on 12Apr2021 11:30 (Batch/Lot Number: ER8734) as single dose for covid-19 immunisation. Medical history included blood cholesterol increased (other medical history: High cholesterol) from an unknown date and unknown if ongoing. The patient has no covid prior to vaccination, has not been tested post vaccination and has no known allergies. There were no concomitant medications. The patient received the first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE) at the age of 43-years-old on 03Mar2021 11:00 (lot number: EN6204) on the left arm for covid-19 immunisation. The patient reported soon after his vaccination, he was in acute foot joint pain on 13Apr2021 03:45. Immobilized depending on she''ll chair (for further clarification). His blood report on an unspecified date showed decreased blood platelet counts and spiked up glucose and so many other bio markers. He was on steroid and painkiller to manage the pain but he was not getting relief. New pains coming up. He was loosing lots of employment and fun actionable opportunities due this pain and immobility. The events resulted in doctor or other healthcare professional office/clinic visit, disability or permanent damage. The patient underwent lab tests and procedure which included platelets: decreased and glucose: spiked up on an unspecified date. Therapeutic measures were taken as a result of foot joint pain and immobile which included steroid, Tylenol 3000 mg, Diclofenac 150 mg. The patient did not recover from the events.


VAERS ID: 1294712 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:2018-06-29
Onset:2021-04-13
   Days after vaccination:1019
Submitted: 0000-00-00
Entered: 2021-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER 2101911 / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: TRACLEER [BOSENTAN]; ADCIRCA
Current Illness: Pulmonary arterial hypertension (Ongoing, Current Condition, Pulmonary arterial hypertension)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC2021452558

Write-up: COVID vaccine causing her arm, hand and face to go numb; COVID vaccine causing her arm, hand and face to go numb; This is a spontaneous report from a contactable consumer (patient) based on the information received by Pfizer (manufacturer control number: UNT-2021-006890). A 40-year-old female patient received BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: Unknown), via an unspecified route of administration on an unspecified date as single dose for COVID-19 immunization. Medical history included ongoing pulmonary arterial hypertension. Co-suspect medication was treprostinil sodium (TYVASO) via inhalation route at 60-120 ug (10-20 breaths), four times a day for pulmonary arterial hypertension from 29Jun2018, Concomitant medications bosentan (TRACLEER) and tadalafil (ADCIRCA). The patient was admitted to the hospital (in Apr2021) with possible adverse event from COVID vaccine causing her arm, hand and face to go numb on 13Apr2021. The action taken with treprostinil was unknown. The clinical outcomes of the "COVID vaccine causing her arm, hand and face to go numb" were unknown. Case Description: This case is a spontaneous report received on 14Apr2021, from a consumer via (pharmacy name). This 40-year-old, 125-lb, female patient began therapy with IH Tyvaso (treprostinil sodium, concentration of 0.6 mg/ml) delivered by Tyvaso Inhalation Device (TD-300/A), on 29Jun2018 for primary pulmonary arterial hypertension. The current dose was reported as 60-120 ug (10-20 breaths), four times a day (QID) (off label use), via inhalation (IH) route. On 13Apr2021, the patient experienced the event term of COVID vaccine causing her arm, hand and face to go numb (hypoaesthesia, hospitalized). Co-suspect included coronavirus disease (COVID-19) vaccine. Concomitant medications included Tracleer (bosentan) and Adcirca (tadalafil). Relevant medical history included primary pulmonary arterial hypertension. On 13Apr2021, 2 years, 9 months, and 16 days after initiating IH Tyvaso, the patient was admitted to the hospital with possible adverse event from COVID vaccine causing her arm, hand and face to go numb. Action taken with IH Tyvaso was not reported for the event of hypoaesthesia. Action taken with Covid-19 vaccine was not applicable for the event of hypoaesthesia. At the time of reporting, the outcome of hypoaesthesia and off label use was unknown. The reporter did not provide causality for the event of hypoaesthesia. Case Comment: The company has assessed the serious adverse event of hypoaesthesia as not related to IH treprostinil and TD-300/A device. The event was likely post vaccination with COVID vaccine. Pfizer is a marketing authorization holder of BNT162b2 in the country of incidence or the country where the product was purchased (if different). This may be a duplicate report if another marketing authorization holder of BNT162b2 has submitted the same report to the regulatory authorities. No follow-up attempts are possible. Information about BNT162b2 vaccine lot/batch number cannot be obtained.


VAERS ID: 1195615 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-04-11
Onset:2021-04-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chills, Myalgia, Pyrexia
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)

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

Write-up: fever, chills, muscle pain


VAERS ID: 1195622 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-11
Onset:2021-04-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN J&J 202A21A / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Hypopnoea, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Respiratory failure (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fluoxetine 20mg
Current Illness:
Preexisting Conditions: Vaso vagal syncope
Allergies:
Diagnostic Lab Data: N/a
CDC Split Type:

Write-up: Vaso vagal syncopy symptoms developed while sleeping. Brief shallow breathing, not responsive to verbal questions for 2-3 minutes. History of Vaso vagal responses to shots as child, but not for past 20 years. Symptoms this evening were consistent with experience as a child .


VAERS ID: 1195894 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-11
Onset:2021-04-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK LA / IM

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

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

Write-up: Fatigue, chills, moderate weakness, headache. Fever rising to 100.5 by 8 hours after the reaction began.


VAERS ID: 1196018 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Hyperhidrosis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: Patient became diaphoretic and light headed. Patient had some apple juice and stated he felt better. VSS HR 56; BP 104/84


VAERS ID: 1196037 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-11
Onset:2021-04-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dehydration, Head discomfort, Hyperhidrosis, Muscle spasms, Pain, Thirst
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Hypoglycaemia (broad), Dehydration (narrow)

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

Write-up: I went to bed and I felt OK I woke up about 1 o?clock and my head was exploring my body was aching and I was so thirsty I can?t explain it so I got up and I drank a bunch of water and seltzer I didn?t really want to take the Advil at that point because I had nothing in my stomach I just wanted to get back in bed. My legs kept cramping up because I was sweating so much I guess I was dehydrated this went on at three and then again at five. I finally got up at five and I took a piece of bread and two Advil drank some more water finally starting to feel better it was like having the virus all over again but much milder


VAERS ID: 1196186 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-04-10
Onset:2021-04-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / IM

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

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

Write-up: Fever body acky 12 hours .. tylenol advil rest hydration


VAERS ID: 1196204 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-11
Onset:2021-04-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Body temperature increased, Nausea
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 202A21A

Write-up: temperature 101 and nausea


VAERS ID: 1196363 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-10
Onset:2021-04-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Syncope, Urticaria
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Angioedema (narrow), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), 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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: None known
Preexisting Conditions: Unknown
Allergies: None
Diagnostic Lab Data: known at this time
CDC Split Type:

Write-up: Patient fainted shortly after receiving dose on 4/10. Patient did respond shortly afterwards and was given juice and a ice pack. Continued to monitor for some 30 plus minutes prior to releasing. Called patient around 5PM same day, patient sounded great and was doing well. Note: Patient has a history of fainting upon vaccine admin. but did not indicate to provider prior to administering vaccine. Patent called at moms request on 4/12 at 9:54 am and indicated she noted upon waking 2 hives in crevasse of arm which spread to all over body. Advised patient to call MD office for guidance and speak to live person. Spoke to doctor''s office whom indicated they would address hives condition and then advise provider this provider.


VAERS ID: 1196431 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK - / -

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

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

Write-up: Light headed, history of vasovagal


VAERS ID: 1196438 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-09
Onset:2021-04-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 RA / IM

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

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

Write-up: After 12 hours the start of flu like symptoms: aches, chills, fever. Progressed to intense chills and fever, aches. 24 hours later chills subside, aches remain, headaches persist. 36 hours later symptoms largely subsided.


VAERS ID: 1196474 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling hot, Loss of consciousness, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), 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? No
Hospitalized? No
Previous Vaccinations: unkown dates, dizzy after previous vaccines
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: BP 100/50 4/12/21
CDC Split Type:

Write-up: Patient received his vaccine and immediately sat down in the observation chair. About 3-4 minutes after his vaccine, he slumped over in the chair and was unresponsive. The pharmacist and store manager stayed with him as a technician called 911. He was unresponsive for about 30 seconds before he came to but then continued to go in and out of consciousness for the next couple of minutes. He said he had a history of dizziness after vaccines. When he was finally able to hold a conversation with us, he said he felt hot and we gave him a cold bottle to put on his head until the paramedics arrived. His blood pressure was 100/50 when the paramedics arrived about 7-10 minutes after we called and patient was fully responsive then. Paramedics continued to monitor him and followed him home to make sure he was okay.


VAERS ID: 1196586 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-04-05
Onset:2021-04-12
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood glucose normal, Eye movement disorder, Musculoskeletal stiffness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Arthritis (broad), Hypoglycaemia (broad)

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

Write-up: Patient recived Janssen COVID 19 vaccine. After receiving the shot, patient went stiff and fainted with rolling of the eyes. Team member was able to help patient to ground. EMS service was called. EMS checked BP and blood glucose which was in normal range and recommended to have caregiver come pick patient up and rest. Patients fiancÚ came and took home. Team member escorted patient out


VAERS ID: 1196601 (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: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Dizziness, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

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

Write-up: Chills, vomiting, nausea, lightheaded within 5 minutes of vaccine administration


VAERS ID: 1196620 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-04-11
Onset:2021-04-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

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

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

Write-up: Mild left facial swelling noted morning after vaccine. Onset 630am (received vaccine 11am yesterday).


VAERS ID: 1196642 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-06
Onset:2021-04-12
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Dizziness, Headache, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Severe nerve pain in hands for several weeks. Was prescribed Gabapentin to ease the symptoms. 61 years-old. Vaccinated on 08/18/
Other Medications: Trazadone, multi-vitamin, vitamin D, turmeric, and St-John''s Wort.
Current Illness: None
Preexisting Conditions: None
Allergies: Doxycycline base, anhydrous
Diagnostic Lab Data: None at this time
CDC Split Type:

Write-up: mild headache, dizziness, nausea, and lack of energy six days after shot... Let''s hope this won''t last long.


VAERS ID: 1196717 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / N/A LA / IM

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

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

Write-up: Vasovagal syncope within 10 minutes following administration of vaccine


VAERS ID: 1196754 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Gaze palsy, Hypoaesthesia, Hypoaesthesia oral, Musculoskeletal stiffness, Tremor, Vision blurred
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Ocular motility disorders (narrow), Arthritis (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: seizure disorder
Allergies: Erythromycin, Penicillin
Diagnostic Lab Data: BP log on 4/12/21: 175/94, 179/79,158/72
CDC Split Type:

Write-up: Patient experienced numbness in peripheral extremities and lips, headache, hypertension, neck stiffness, tremor, and blurred vision


VAERS ID: 1196779 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNKNOWN
Current Illness: UNKNOWN
Preexisting Conditions: UNKNOWN
Allergies: NKA
Diagnostic Lab Data: TOOK PULSE OF 80
CDC Split Type:

Write-up: PATIENT WENT TO WAITING AREA AND FIANTED WHILE SITTING IN CHAIR


VAERS ID: 1196797 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: patient stated they have a history of fainting after vaccines
Other Medications: Lamotrigine 200mg Venlafaxine ER 150mg
Current Illness: none known
Preexisting Conditions: unknown
Allergies: none known
Diagnostic Lab Data:
CDC Split Type:

Write-up: patient fainted, then came to, had nausea, then vomited. Had patient sit and drink water afterwards ~30 minutes.


VAERS ID: 1196831 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK 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? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Administration of COVID vaccine resulted in brief syncope.
CDC Split Type:

Write-up: Approx 5 minutes after receiving the vaccine, the patient experienced syncope and slid out of her chair. She was unconscious for approx 10 seconds. After lying down for approx 10 minutes and using a cold compress on her forehead, she felt better and was able to walk unassisted. Her mother is taking her to Care to be checked.


VAERS ID: 1196832 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-03-17
Onset:2021-04-12
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 044A21A / 1 - / -

Administered by: Public       Purchased by: ?
Symptoms: Chest pain, Diarrhoea, Dizziness, Dyspnoea, Epistaxis, Hyperhidrosis, Loss of consciousness, Nausea, Pain, Presyncope, Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Noninfectious diarrhoea (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, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Current Outpatient Medications: ? allopurinol (ZYLOPRIM) 100 MG tablet, TAKE ONE TABLET BY MOUTH TWICE DAILY, Disp: 60 tablet, Rfl: 11 ? carbidopa-levodopa (SINEMET) 25-100 MG per tablet, Take 1 tablet by mouth 2 times daily, Disp: 60 ta
Current Illness:
Preexisting Conditions:
Allergies: nka
Diagnostic Lab Data:
CDC Split Type:

Write-up: 61 y.o. female who presents with chest pain and syncope. Patient reports she began feeling ill around 6:00 p.m. last night. Patient reports she was having nausea, vomiting, and diarrhea. She denies any hematemesis or hematochezia. Patient states she awoke around 11:00 p.m. and felt like she was needing to vomit so she went to the bathroom. Patient reports that upon getting up she noticed pain across her chest. She described her pain as a midsternal pain with radiation across the chest. She described as a dull pressure. She currently reports no chest pain upon arrival to ER. Patient reports associated shortness of breath, lightheadedness, nausea, vomiting, and diaphoresis with the pain. Patient''s cardiac risk factors include hypertension, smoking, age, obesity, and family history. Once patient was in to bathroom, she states she began having nausea, vomiting, and diarrhea. Patient subsequently passed out and hit her head on the bathtub. Patient had slight nose bleed. Patient''s family found her lying in the floor and call 911. Patient was unsure of how long she was out during her syncopal episode. admitted to hospital Observation dx chst pain, vasovagal syncope


VAERS ID: 1196837 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-04-09
Onset:2021-04-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Feeling abnormal, Headache, Panic attack
SMQs:, Dementia (broad)

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

Write-up: The day of cold chills, headache. the next day headache foggy feeling, three days afterwards wanting to cry panic attack had the feeling of dieing


VAERS ID: 1196917 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Virginia  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: patient fainted in post vaccination waiting area, quickly regained consciousness


VAERS ID: 1197014 (history)  
Form: Version 2.0  
Age: 47.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

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

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

Write-up: Became itchy on extremities. Developed rash but chest and throat. Started to have swelling to forehead and eyes. Denies SOA but states chest feels heavy. PT sent tp ED via Ambulance.


VAERS ID: 1197034 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

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

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

Write-up: Patient lost consciousness during the 15 minute waiting period after receiving the vaccine. He was pale and sweating, and lacerated his nose as he fell to the to floor. It appears that he fainted.


VAERS ID: 1197080 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: New Jersey  
Vaccinated:2021-04-11
Onset:2021-04-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Asthenia, Chills, Diarrhoea, Headache, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Headache, chills, fever, vomiting, diarrhea, weakness. From just after midnight day of injection for around 12 hours following on and off.


VAERS ID: 1197101 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

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

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

Write-up: syncope. Evaluated by EMS-Refusal to transport.


VAERS ID: 1197114 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dyspnoea, Heart rate increased
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Dehydration (broad)

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

Write-up: elevated heart rate, SOB. Evaluated by EMS-Refusal to transport.


VAERS ID: 1197124 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 UN / IM

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

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

Write-up: SYNCOPE. Evaluated by EMS-Refusal to transport.


VAERS ID: 1197127 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dyspnoea, Presyncope, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), 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: Albuterol
Current Illness: UNKNOWN
Preexisting Conditions: Asthma
Allergies: Cipro
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: Shortness of breath, tightening of throat, near syncope. PT had a Hx asthma and allergic reactions to antibiotics. 0.3 mg EPI via autoinjector left medical thigh. 8 doses of albuterol MDI PT improved after treatment. Evaluated, treated by EMS. Transported to ED for further evaluation and treatment.


VAERS ID: 1197135 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dyspnoea, Heart rate increased, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Dehydration (broad)

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

Write-up: SOB, WHEEZING, ELEVATED HR, EPI X1. Evaluated by EMS- Transported to Emergency room/department or urgent care.


VAERS ID: 1197145 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Unknown       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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: NAUSEA/VOMITING, HEADACHE. Evaluated by EMS-Cleared


VAERS ID: 1197155 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-09
Onset:2021-04-12
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / SYR

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: none
Preexisting Conditions: obesity
Allergies: benadryl, nyquil, sulfa (alcohol), goat cheese, bees, watermelon, lobster, amoxicillan, some antihistemines
Diagnostic Lab Data: bloodwork IV Steroids
CDC Split Type:

Write-up: 7:00am hives right arm 11:00am hives spread on left arm 12:30pm hives spread to neck and face under chin and cheeks 1:00pm went to ER


VAERS ID: 1197157 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 OT / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Presyncope
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: LIGHTHEADED, PRESYNCOPE. Evaluated by EMS-Cleared


VAERS ID: 1197167 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Feeling hot, Flushing, Nausea, Paraesthesia, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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: Moderna COVID vaccine on 12/24/2021 (already a VAERS report)
Other Medications:
Current Illness:
Preexisting Conditions: Diabetes, GERD
Allergies: Allergic reaction to Moderna COVID vaccine
Diagnostic Lab Data: No labs or tests done in ER
CDC Split Type:

Write-up: Patient became very warm, with tingling and nausea. Pt vomited approximately 30 minutes after vaccine and face and neck became flushed. Taken to ER for continued monitoring and treatment


VAERS ID: 1197172 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Hyperhidrosis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: dizziness, diaphoretic. Evaluated by EMS-Cleared


VAERS ID: 1197174 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Hyperhidrosis, Malaise, Seizure
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

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

Write-up: Pt reported not feeling well in less than 5 minutes after shot. Initially he was sweating, followed by dizziness. In few seconds, he started convulsing. I administer Epi-pen 0.3 mg, 1 adult dose in his left thigh. His convulsion stopped at very moment, paramedics took over from there. His vitals were checked and monitored by paramedics for few minutes. He did not require hospitalization at this moment, however advise to seek medical attention if he feels something abnormal. He was able to walk himself to his car, where his family member drove him to home.


VAERS ID: 1197182 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Heart rate increased, Nausea
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Dehydration (broad)

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

Write-up: nausea, dizziness, elevated HR. Evaluated by EMS-Cleared


VAERS ID: 1197183 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Unevaluable event
SMQs:

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

Write-up: None stated.


VAERS ID: 1197198 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 046B21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Disorientation, Dizziness, Hyperhidrosis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (broad), Hypoglycaemia (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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt. was found diaphoretic and disoriented. Pt. expressed feeling dizzy and faint, RN''s assisted in laying the pt. on the floor. EMS was contacted and pt. was transported to the hospital by Fire Rescue


VAERS ID: 1197208 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Hypoaesthesia, Nausea, Paraesthesia
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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

Write-up: nausea, numbness/tingling hands. Evaluated by EMS-Cleared


VAERS ID: 1197231 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Nausea, Presyncope, Visual impairment
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: presyncope, nausea, black spots in vision. Evaluated by EMS-Cleared


VAERS ID: 1197235 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad)

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

Write-up: lightheaded, SOB, nausea. Evaluated by EMS-Cleared


VAERS ID: 1197255 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-11
Onset:2021-04-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Chills, Dizziness, Headache, Pain, Pyrexia, Sleep disorder
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: progesterone and estradiol for Hormone Replacement Therapy
Current Illness: no but had Covid 19 on Dec 15, 2020
Preexisting Conditions: no
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Fever, 100.5 with chills and body aches, couldn''t sleep all night. Headache and dizziness in the morning. Took Tylenol in the morning to reduce fever, which worked. It''s only 10:45 AM now and I didn''t get up until 9:30 AM.


VAERS ID: 1197257 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-04-11
Onset:2021-04-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / N/A LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chills, Dizziness, Headache, Pallor, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Chills, shivering, fever, paleness in hands and face, vomiting, intense headache, faintness. Felt chills and fever for 1.5 hours, stood up, vomited. Vomited again 2 hours later. Intense headache overnight.


VAERS ID: 1197265 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

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

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

Write-up: DEVELOPED 3 HIVES ON LEG 5X5 INCHES


VAERS ID: 1197289 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Oregon  
Vaccinated:2021-04-07
Onset:2021-04-12
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

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

Write-up: Patient is a 16 year old patient that received vaccine


VAERS ID: 1197307 (history)  
Form: Version 2.0  
Age: 44.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-11
Onset:2021-04-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / UNK LA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, Chills, Fatigue, Headache, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Januvia, Atorvastatin
Current Illness: none
Preexisting Conditions: diabetes
Allergies: allergy to sulpha
Diagnostic Lab Data: No medical tests done after the vaccine administration
CDC Split Type: Notknown

Write-up: I took the Johnson vaccine on 4/11 at 6 pm PST at the drive through. At about midnight, I started having severe chills, fever of 38.4, extreme weakness and nausea. I had a Tylenol 500mg on 4/12 at 00:30 am. I am extremely fatigued and can''t even get out of the bed. My whole body has been hurting.


VAERS ID: 1197377 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Missouri  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21S / 1 LA / IM

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

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

Write-up: PATIENT STARTED TO FEEL DIZZY/LIGHT HEADED ABOUT 5 MINUTES AFTER HER VACCINATION. WE LAID HER DOWN AND RAISED HER FEET AND SHE STARTED TO FEEL BETTER. PATIENT RECOVERED. SHE DID STATE SHE HAS HAD REACTIONS TO VACCINE (FAINTING) IN THE PAST PRIOR TO RECEIVING HER COVID SHOT.


VAERS ID: 1197624 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure fluctuation, Hyperhidrosis, Nausea, Pallor, Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Approx 6 mins after vaccination pt fainted. She recovered on her own within a minute and was very diaphoretic and pale, but was alert and oriented x 3. Pt then stated she was feeling very nauseous and proceeded to vomit. 911 was called and B/P 87/58, HR 91 and O2 99. EMS arrived B/P was fluctuating and pt was brought to ED for evaluation


VAERS ID: 1197635 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: patient stated that she has felt light headed to another injection before
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Almost immediately after giving the injection for the janssen covid vaccine, the patient felt light headed and dizzy. After asking if it was ok, I rolled up her jacket and put it on the floor and assisted her in laying down with her feet up on a chair. After less than 5 minutes the patient felt better, got up, and sat in one of our designated post-vaccine chairs to finish out the 15 minutes. When asked, she stated that she had a similar reaction to another injectable at the dr office and she wasn''t too concerned. Before leaving, her husband had come to meet her (he was already in the store) and she said she was feeling fine.


VAERS ID: 1197670 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Feeling hot, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: about ten minutes post vaccine patient complaint of feeling warm and itching


VAERS ID: 1197674 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Delaware  
Vaccinated:2021-04-11
Onset:2021-04-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling jittery, Hyperhidrosis, Nausea, Vision blurred
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: no
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Patient has felt Extreme nausea, mild to moderate sweating, gittery feeling and blurred vision for about 2-3 minutes.


VAERS ID: 1197685 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-10
Onset:2021-04-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808982 / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Burning sensation, Fatigue, Headache, Herpes zoster, Injection site pain, Pain, Skin lesion, Tinnitus
SMQs:, Peripheral neuropathy (broad), Extravasation events (injections, infusions and implants) (broad), Hearing impairment (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid, Slow Fe
Current Illness: Iron Deficiency anemia, hypothyroid
Preexisting Conditions:
Allergies: Codeine
Diagnostic Lab Data:
CDC Split Type:

Write-up: Covid Janssen vaccine 4/10/2021 at 2 PM. Symptoms noticed 4/11/2021- 7 AM- tinnitus, headache, injection site pain, fatigue. On 4/12, 7 AM- woke & noted shingles-type lesions on R ribcage, R side of body with burning sensation & pain, headache and fatigue- confirmed by MD. Prescribed Valtrex 1 gm TID x7 days.


VAERS ID: 1197686 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-10
Onset:2021-04-12
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 LA / -

Administered by: Other       Purchased by: ?
Symptoms: Body temperature increased, Chills, Ear swelling, Fatigue, Headache, Pain, Pyrexia, SARS-CoV-2 test, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: exercise induced asthma
Allergies: Seasonal allergies
Diagnostic Lab Data: None, visit to urgent care walk-in clinic, COVID - 19 test done as precaution, however patient felt fine with no symptoms prior to and during time of vaccination.
CDC Split Type:

Write-up: 6 hrs after injection developed fever, chills, headache, body aches, fatigue, sent home from work went to bed, temperature 101 degrees F. Symptoms continued through Sunday, fever down between 99-100 degrees F, chills and body aches mild, still fatigue. By Monday morning around 2am hives developed, spread across body, face, lips and ears very swollen, went to walk-in clinic by 9am Monday morning. Patient prescribed prednisone and benadryl for relief of symptoms most likely due to vaccination.


VAERS ID: 1197711 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Mississippi  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK LA / IM

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

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

Write-up: Patient received J&J COVID Vaccine 4/12/21 around 12:05 pm. Patient waited in waiting area and complained to her husband about feeling dizzy and might faint. Pharmacists went to aid the patient and lay her down gently, monitored her blood pressure which was high at the time, once patient sat up her BP decreased, it fluctuated the whole time, EMT was called and once they arrived and monitored her, they said the cause of her fainting was due to her blood pressure. Patient was alert and responsive the whole time. Patient was unsure if she took her BP medicine this morning.


VAERS ID: 1197740 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 6964823 / 1 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Anaphylactic reaction, Dysphagia, Dyspnoea, Eye movement disorder, Loss of consciousness, Pharyngeal swelling, Swelling face
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Tb test
Other Medications: Claritin D Levothyroxine Metformin
Current Illness: None
Preexisting Conditions: Allergies
Allergies: Penicillin Ceclor Zpack Tb test Steroids Heparin
Diagnostic Lab Data: Epinephrine and Benadryl
CDC Split Type:

Write-up: Anaphylactic reaction Swelling in face and throat Passing out feeling Rapid eyelid movement Trouble breathing, trouble swallowing


VAERS ID: 1197746 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Maryland  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / UNK - / IM

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

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

Write-up: patient complaint of feeling warm and dizzy 5-7 minutes post vaccination


VAERS ID: 1197747 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

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

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

Write-up: Patient had a covid vaccine appointment at 11:20a 4/12/21. 5 minutes after administering the Janssen vaccine to patient, she alerted us stating that she was starting to feel lightheaded and nausea. Patient was instructed to lay on her back with her feet elevated. A cold compress was also provided to her. A member of management was also notified. Her blood pressure was monitored at 125/92 at 12:10p and 123/88 at 12:30p. Calling for an ambulance was denied by patient. Patient doesn''t have a primary care provider for me to inform. Patient was with her mother who will be driving her home. Patient stayed for at least 30 minutes before leaving pharmacy.


VAERS ID: 1197754 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 RA / IM

Administered by: Public       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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: anti-anxiety meds patient declined to answer which one
Current Illness: none
Preexisting Conditions: anxiety
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient passed out at clinic - he has a history of anxiety and did not take meds before the shot because he was concerned about an interaction. The patient received his shot, sat down and fell out of the chair. He landed face first on the ground and hit his head on the corner of a post. He was rolled over and feet elevated. He came around quickly. He had a mark on his head. 911 was called on the scene to evaluate his head injury. Patient declined transport to the hospital and returned home. He was instructed to call 911 or report to hospital if he did not feel well tonight.


VAERS ID: 1197772 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient had two syncopal events without incident.


VAERS ID: 1197782 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 RA / IM

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

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

Write-up: Patient felt dizzy when she got ready to stand up after waiting for 15 minutes after her immunization. The technician told me and I went and talked to the lady. She said she was feeling better but I asked her to wait another 15 minutes. I checked on her again and she said she was feeling fine and was ready to leave. I told her that if she wasn''t sure to wait longer but she insisted she was ok and left.


VAERS ID: 1197786 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

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

Write-up: Administered 40 days too soon. Administered 4-12-2021. She turns 18 later


VAERS ID: 1197800 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: NKA
Diagnostic Lab Data: none
CDC Split Type:

Write-up: After a few minutes receiving Janssen Vaccine at 12:45pm . Patient had syncope, patient fainted for about 10 seconds sitting on chair, regain conscious after. Decline additional treatment or call for emergency. Patient refused to stay for 30 minutes because of her anxiety. contacted patient at 1:55pm. Patient was back to home resting without any addition symptoms. Patient was instructed again to contact MD or emergency if any symptoms worsen ie skin rash , SOB, swelling or severe dizziness.


VAERS ID: 1197836 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / UNK LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NOT LISTED
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NOT LISTED
Diagnostic Lab Data:
CDC Split Type:

Write-up: PATIENT WAS WAITING IN THE WAITING AREA AFTER VACCINATION AND WITHIN 10 MINUTES OF WAIT REACHED OUT TO THE PHARMACIST COMPLAINING OF LIGHTHEADEDNESS AND DIZZIINESS. THE PATIENT WASN''T COMFORTABLE LYING DOWN IN THE OPEN AREA SO USED THE VACCINATION PRIVACY SCREEN TO COVER THE AREA AND WE MADE THE PATIENT LIE DOWN ON THE FLOOR WITH HIS FEET ELEVATED USING A CHAIR, AND DID SOME COLD COMPRESS USING A WET PAPER TOWELL. AFTER LYING DOWN FOR GOOD 15 MINUTES THE PATIENT SEEMED TO BE DOING FINE.DRANK SOME MORE WATER AND SAT ON THE CHAIR FOR ANOTHER 10 MINUTES.AFTER FEELING ALRIGHT PATIENT SAID HE FEELS OK AND LEFT THE PHARMACY.


VAERS ID: 1197847 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

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

Write-up: Client is 17 years old. Client wrote 18 years old on paperwork and listed DOB of 2/18/2003. DOB confirmed as 2/18/2004 in MCIR, EPIC and per client''s mother.


VAERS ID: 1197869 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Hyperhidrosis, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (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? No
Hospitalized? No
Previous Vaccinations: Pt. has a history of passing out after any shot.
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Pt. became diaphoretic and had a syncopal episode. Pt. was caught by staff and lowered to the ground. Pt. was assessed by EMS and stated to them that he "always passes out when he get a shot." Pt. refused transport or treatment. Pt. left the vaccination site under his own power.


VAERS ID: 1197875 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Male  
Location: Maine  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Loss of consciousness, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient blacked out while seated in waiting area after vaccine. He did not respond to multiple questions for about 5 minutes until he slowly started coming around again. EMS was called and they put him on the stretcher and raised his legs until the moved him to a seated position.


VAERS ID: 1197878 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Blood pressure decreased, Fall, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), 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), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: blood pressure, ems came to the pharmacy
CDC Split Type:

Write-up: patient experienced low BP (68/39) and passed out, fell off the chair and onto the floor, woke up on the floor within 30 seconds.


VAERS ID: 1197886 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Oklahoma  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Dyskinesia, Flushing, Loss of consciousness, Pallor
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dyskinesia (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: no
Preexisting Conditions: no
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient stood up after the vaccine and became flush, pale, he briefly loss consciousness about 10 seconds and then jerked awake. He remembered the incident. Did not hit his head. He drank a bottle of gatorade and was monitored for an hour before leaving. He felt fine at discharge per patient.


VAERS ID: 1197888 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-04-11
Onset:2021-04-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 203A21A / 1 LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Migraine, Nausea, Pain, Pain in extremity
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multi vitamin, vitamin D, Aleve, members mark 10 strain Probiotic digestive care supplement, Dotti (estradiol transdermal system USP)
Current Illness: Seasonal allergies
Preexisting Conditions: No
Allergies: Penicillin, strong anesthesia...
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Very sore arm after shot at 4:21 pm on 4/11. Woke up at 4:30 am on 4/12 with terrible migraine, sore all over and experienced nausea but did not throw up. Drank water and took Tylenol which seemed to help...Stayed in bed until noon. Starting to feel better but still experiencing fatigue and body aches.


VAERS ID: 1197900 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Eye swelling, Skin swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PQQ, Green tea extract, Acyclovir , Vitamin C, D3, Zinc
Current Illness: None
Preexisting Conditions: High BP
Allergies: Prednisone, Bactrim, latex, MSG, Nitrates and nitrites
Diagnostic Lab Data:
CDC Split Type:

Write-up: Slight swelling right eye (left corner) small mole - swelled up no other affects surfaced about 1 hr after vaccine.


VAERS ID: 1197936 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Delaware  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Hyperhidrosis, Hypoaesthesia, Nausea, Vision blurred
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)

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

Write-up: Patient has felt Blurred vision, extreme nausea. Numbness in hands and legs. sweaty and most imp. Felt CHEAST PAIN from it.


VAERS ID: 1197955 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / UNK RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Feeling cold, Hyperhidrosis, Pallor, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient sitting in waiting area states her legs feel cold and shaky. Patient diaphoretic and pale. Patient layed down on stretcher. VSS, O2 sats 99, BP stable, HR 66.


VAERS ID: 1197987 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / N/A RA / IM

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

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

Write-up: Immediately after receiving his covid vaccine patient started feeling nauseaus/dizzy, and threw up. After throwing up he felt better.


VAERS ID: 1198007 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 206A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Eye movement disorder, Hyperhidrosis, Malaise, Pallor, Panic attack, Peripheral coldness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Patient didn''t specified, however, she told the paramedic personnel when they asked if she has anxiety attack before and she answered yes. The paramedic personnel told me based on her symptoms (sweating, numbing on hands which lead to pain, and breathing fast), she probably have anxiety attacked.
Preexisting Conditions: Based on the profile we have for patient, no chronic health condition. Patient didn''t specified when she come to get the vaccine today.
Allergies: Shell Fish: She have trouble breathing Robaxin: She swollen up but took when she was around 16 years old, so she can''t recall if ther e is any breathing problem.
Diagnostic Lab Data:
CDC Split Type:

Write-up: After about 7 minutes of getting the Janssen Covid-19 vaccines, patient husband said patient is not feeling well. I attended to patient immediately. She said she is not feeling well, and her eye was rolling (as if when she tried to look up and couldn''t get their eye to remain open) a for about few seconds and then she her eye was open back to normal. She was sweating on both hands and face were cold to the touch. I got the manager from the store to help me lie patient flat on the floor''s surface gently to prevent her from falling off the chair. Based on this our adverse event protocol, patient exhibited similar symptoms to Syncope (paleness, sweating, coldness of extremities), so I patient is lying flat on the floor, feet elevated, and cold compression was apply on her arms and face. Unfortunately, patient conditions was not improving as it seem but she was alert and able to breath (fast pace) the whole entire time the incident occurred where she answer all questions when we myself, then the paramedics asked her questions. Paramedic arrived at scene within 10 minutes after individual got off the phone with 911. They took her away around 9 am and said patient probably experience anxiety attack.


VAERS ID: 1198030 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / UNK LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad)

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

Write-up: Patient received Janssen vaccine around 10:30. He left the observation room feeling fine. once he got at his car and started to drive, he felt shortness of breath and some weakness. Then, he came back to the SR Vaccine site to get help around 10:50. We met him in front of the parking lot, he was having some trouble of breath and weakness. We put him in a wheelchair, brought him back to the Observation area. I asked him to lay down with elevated legs on a chair. He instantly felt better, no more shortness of breath. He did not need to use any Oxygen supply. Also, he drank some water, sit back in the chair and felt better ready to leave with his brother who came to help him just in case. At 11:10 he left the building with orientations about worsening of symptoms and when to call EMS.


VAERS ID: 1198056 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Hypoaesthesia, Pharyngeal swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: swelling in throat, numbness (face). Evaluated by EMS-Refusal to transport.


VAERS ID: 1198077 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Pruritus, Respiratory rate increased, Tachypnoea
SMQs:, Anaphylactic reaction (narrow), Asthma/bronchospasm (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad)

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

Write-up: breathing faster, tachypnea, itching. Evaluated by EMS-Cleared


VAERS ID: 1198088 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 LA / IM

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

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

Write-up: AFTER RECEIVING THE IMMUNIZATION, PATIENT SLOWLY MOVED FROM THE CHAIR TO THE CORNER OF WALL AND SAID HE FELT FAINT. HE BECAME UNSCONSCIOUS FOR A FEW SECONDS AND WHEN HE BECAME ALERT, BEGAN CONVULSING. WE CALLED THE PARAMEDICS. WHEN THEY ARRIVED, THE PATIENT REFUSED TREATMENT.


VAERS ID: 1198090 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
Location: New York  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Hyperhidrosis, Nausea, Pallor, Retching
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Approx 5 mins after vaccination patient reported feeling dizzy, lightheaded and nauseous (dry heaving), pt looked pale and diaphoretic - symptoms lasted approx 5-10 minutes. Left on her own, no EMS needed


VAERS ID: 1198094 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Cerebral haemorrhage, Cerebrovascular accident, Chills, Computerised tomogram, Echocardiogram, Electrocardiogram, Fatigue, Headache, Magnetic resonance imaging, Pain, Ultrasound abdomen
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? 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: metformin
Current Illness:
Preexisting Conditions: type 2 diabetes, anxiety
Allergies: none
Diagnostic Lab Data: MRI, 2 CT scans, EKG, Ultrasounds, echocardiogram
CDC Split Type:

Write-up: Covid like symptoms the day after Thursday March 25, 2021, chils , fatigue, body aches , headache , tired. On Monday March 29,2021 brain bleed led to stroke, woke up at 6 Am went to ER by 10:30. I have no health issues that would be considered a precursor for a stroke


VAERS ID: 1198111 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-04-12
Onset:2021-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 OT / IM

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

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

Write-up: syncope. Evaluated by EMS-Refusal to transport.


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