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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 47 out of 1,889

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VAERS ID: 1198125 (history)  
Form: Version 2.0  
Age: 27.0  
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 OT / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Presyncope, Visual impairment
SMQs:, Anticholinergic syndrome (broad), 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: seeing spots, near syncope. Evaluated by EMS-Cleared


VAERS ID: 1198130 (history)  
Form: Version 2.0  
Age: 36.0  
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 / 1 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: 10:30am: Pt was sitting in the vaccine site observation area after receiving vaccine for COVID-19 (Janssen). Pt had been sitting for approximately 15 min when RN noticed pt dropped paperwork and cell phone onto the floor. Pt''s head went back, mouth open and eyes closed. Pt visibly pale. RN quickly approached pt while speaking loudly, pt did not respond. Audible "snoring" heard. RN placed pt''s torso and head in her arms and moved patient to the floor into a supine position with legs raised onto his chair (pt did not fall to the ground). Once on the floor, pt opened eyes and asked RN, "Did I fall asleep?" RN reassure pt that he may have fainted while sitting in his chair. RN reassured pt and gave pt bottle water to drink. Color returning to patients face. 10:40: Pt reports "I''m feeling much better." Pt sitting upright on the floor. 10:45: Pt sitting up in chair. Alert to person, place, and time. Color WNL, peripheral pulses strong. Pt reports feeling well enough to leave. RN encourage pt to stay a few minutes longer to make sure able to stand/walk to his car. 10:50: Pt left observation area.


VAERS ID: 1198136 (history)  
Form: Version 2.0  
Age: 48.0  
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
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: lightheaded, dizzy. Evaluated by EMS-Cleared


VAERS ID: 1198164 (history)  
Form: Version 2.0  
Age: 22.0  
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 - / 1 LA / IM

Administered by: Pharmacy       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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: no medications reported
Current Illness:
Preexisting Conditions: asthma
Allergies: peanuts, tree nuts, peanut oil
Diagnostic Lab Data:
CDC Split Type:

Write-up: PATIENT REPORTED BEING LIGHT HEADED AND WARM AFTER RECIVING SHOT. PT DRANK SOME ORANGE JUICE AND WAS RECOVERED BEFORE LEAVING THE PAHRMACY. PT DECLINDED MEDICAL ATTACNTION.


VAERS ID: 1198216 (history)  
Form: Version 2.0  
Age: 70.0  
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 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Interchange of vaccine products
SMQs:, Medication errors (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: As I was entering the data for the covid tracker on 4/11/21, I realized that the number of vaccines administered on 4/10 did not match to the number on the CIR administered report. Since we are closed on Sundays, I checked the immunization screening forms to the ones we did on 4/10. I realized that this particular patient already received both doses of Moderna in March and the JJ we administered did not get registered in the registry. I tried calling the patient twice with no success. And even left messages. I reached out to CIR and they consulted with a physician who said we did nothing wrong and to make a VAERS report.


VAERS ID: 1198218 (history)  
Form: Version 2.0  
Age: 25.0  
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, Head injury, Hyperhidrosis, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Patient received Janssen COVID vaccine at a clinic today at approximately 2:10pm. When seated in a chair in the waiting area, patient stated she started to feel light headed and sweaty and has fainted before (not from a vaccine), so she sat back in the chair and then awoke on the floor. She bumped her forehead on the floor and has an egg-sized raised bump on her forehead. We applied ice instantly and monitored her blood pressure until she felt well enough to sit up. She did not feel she needed an ambulance and refused going to urgent care. She is feeling fine other than the bump. A worker took a report and I discussed with her what to watch for to monitor for concussion. Her roommate is driving her home. Event will also be reported today.


VAERS ID: 1198232 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Georgia  
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 201AZ1A / 1 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Balance disorder, Fatigue, Nausea, Tremor
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Hydroxyzine, weed, and ibuprofen
Current Illness: N/A
Preexisting Conditions: Pityriasis lichenoides chronica
Allergies: N/A
Diagnostic Lab Data: N/a
CDC Split Type:

Write-up: fatigue, shaking, loss of balance, nausea


VAERS ID: 1198292 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Arizona  
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, Hyperhidrosis, Tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Vestibular disorders (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: history of dizziness after vaccination
Other Medications: cochicine, xarelato
Current Illness: gout
Preexisting Conditions: no known chronic condition besides gout
Allergies: no known drug allergies, food, and other products
Diagnostic Lab Data: no known any medical and lab results
CDC Split Type:

Write-up: After 10 minutes of vaccination, patient was sweating and dizzy. Ambulance team arrived check the vital signs which were stable. Patient was alert and conscious at the movement. He indicated that he wanted water. The ambulance team allowed him to drink about 1 sip (10-15 ml) of water. Then he had tachycardia. Then ambulance took him to the hospital. His wife was with him.


VAERS ID: 1198323 (history)  
Form: Version 2.0  
Age: 23.0  
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: Work       Purchased by: ?
Symptoms: Cold sweat, Hyperhidrosis, Pallor
SMQs:, Neuroleptic malignant syndrome (broad), Hypotonic-hyporesponsive episode (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: n/a
Preexisting Conditions: n/a
Allergies: NKA
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Janssen COVID-19 Vaccine: Vaccine administered by pharmacy staff at 1320, patient was observed for 15 minutes without complaint or concern. Upon check-out he stated he was "starting to feel sweaty". He denied dizziness, difficulty breathing, chest pain or other concerns. Systolic blood pressure was 76/40 (manual), heart rate 70. He remained awake, alert, skin pale, clammy, & cool. Sweat noted on forehead, in no acute distress. He was transferred to supine position and given cold water. BP increased to 124/82, heart rate 88, pulse ox 98%. He verbalized he felt much better, stated he began to have concerns about a reaction when he began to feel sweaty. He was unsure if it was anxiety or a reaction to the vaccine as the feelings began to escalate. He has no history of similar reactions but "doesn''t like shots". He has no medical history, takes no medications/supplements and is otherwise "healthy". He ate lunch prior to appointment. Additional BP readings remained within normal limits, skin warm/dry, back to baseline. Observed for an additional 45 minutes and returned to work. Discharge vitals: 116/84, 90, 98%, 16.


VAERS ID: 1198329 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:2021-04-03
Onset:2021-04-12
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN QY3AZIA / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Heart rate decreased, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (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: similar symptoms after 2nd Gardasil/HPV vaccine at 19 years old on 11/23/2007
Other Medications: prenatal vitamin, aller-tec (citirizine), Fluoxitine
Current Illness: none
Preexisting Conditions: asthma
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Approximately 3 min after receiving the shot, I began to feel light headed. Light headedness increased over the next few minutes and I began to feel faint. My activity device indicated my heart rate took a sharp drop. At this point, I thought it best to lie down. I spent the next 5-7 minutes on the floor until I was able to sit up without feeling faint. I waited an additional 15 minutes before leaving. I felt somewhat shaky, but felt better by the minute.


VAERS ID: 1198352 (history)  
Form: Version 2.0  
Age: 18.0  
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 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? Yes
Hospitalized? No
Previous Vaccinations: per MOM she has a history of fainting with vaccines.
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient fainted upon receiving the Janssen COVID-19 vaccine. They were in a chair in the waiting area and did not fall or injure themselves. We gave her no food or drink, took her blood pressure and stayed with her. She then fainted again at which point we called for a paramedic. They evaluated her and took her blood pressure again and her blood sugar. She then recovered and walked out of the store unassisted. She did not go to the ER but chose to go to an urgent care center I believe.


VAERS ID: 1198356 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
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 203A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: NKA
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Within 1 minute of receiving the vaccine, patient reported not feeling well. Administrating technician called for assistance from the pharmacist. Patient was breathing but was unresponsive. Pharmacist instructed store manager (also on scene) to call 911, and gently laid the patient on the floor. Within one minute the patient became responsive, and remained on the floor per instructions received from 911 over the phone. Shortly thereafter EMS arrived and assessed the patient. Patient refused to go with EMS for further medical assistance. She agreed to stay in a chair in front of the pharmacy for further observation for 30 minutes. After the 30 minutes lapsed, patient left the store under her own volition.


VAERS ID: 1198381 (history)  
Form: Version 2.0  
Age: 27.0  
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 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dyspnoea, Fatigue, Heart rate increased, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

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

Write-up: After the initial 15 min wait period I was feeling fine, so i left the pharmacy. About 5-10 min later my heart rate became very fast very quickly and it became more difficult to breathe. I was driving home at the time, had to pull over and wait a few minutes until the event subsided. I debated contacting medical help, but i began recovering and was able to continue driving. Since the event i have been feeling slightly fatigued and i have a slight feverish feeling, but in general have been able to rest and have not had a repeat occurrence. I received no medical attention or treatment.


VAERS ID: 1198385 (history)  
Form: Version 2.0  
Age: 20.0  
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 043A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fall, 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), Accidents and injuries (narrow), 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: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: nkda
Diagnostic Lab Data: Pulse: 77 Blood Pressure: 122/60
CDC Split Type:

Write-up: Vasovagal Syncope Patient was sitting in waiting area when his friend alerted pharmacy staff that he had passed out. Patient was sitting on a backless chair and fell off, but did not hit head or have any apparent abrasions. Pharmacy staff quickly responded and patient was conscious and stated he had a history of vasovagal responses to blood draws.


VAERS ID: 1198401 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
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 042A21A / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Foreign body in throat, Nausea, Throat irritation, Vomiting
SMQs:, Acute pancreatitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Hypertension, GERD, DM II,
Allergies: Zofran, Zoloft, Metformin, Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient presented with nausea and vomiting. Also, c/o itchy throat, like something was stuck in her throat


VAERS ID: 1198407 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
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: Chills, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre 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: asthma
Allergies: shellfish
Diagnostic Lab Data:
CDC Split Type:

Write-up: chills in back of head tingling down left arms


VAERS ID: 1198460 (history)  
Form: Version 2.0  
Age: 31.0  
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 - / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Malaise, Pallor
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (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 received I IM injection of Johnson and Johnson vaccine. Patient went pale in the skin and felt lightheaded and unwell. Nurse supported patient and laid patient down on the cot next to table. Emergency response / Code Green on site vital signs stable patient recovering. Five minutes post incident patient walked to observation no immediate life threatening signs or symptoms. Patient refused additional medical support and transport.


VAERS ID: 1198468 (history)  
Form: Version 2.0  
Age: 34.0  
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: 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? 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: syncopal, vomiting, , nausea. Evaluated by EMS-Refusal to transport.


VAERS ID: 1198486 (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 OT / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Hypoaesthesia oral
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), 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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: mouth has numbness. Evaluated by EMS-Cleared


VAERS ID: 1198499 (history)  
Form: Version 2.0  
Age: 22.0  
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 OT / IM

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

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

Write-up: lightheadedness, syncopal episode. Evaluated by EMS-Cleared


VAERS ID: 1198508 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Florida  
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 1808978 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Failure to thrive
SMQs:, Neonatal 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: Birth Control
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: BP 94/53 Pulse 79
CDC Split Type:

Write-up: Fainted, Recovered in 2 min


VAERS ID: 1198525 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
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, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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

Write-up: pt began to feel light-headed, sweat and blacking out


VAERS ID: 1198526 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-04-08
Onset:2021-04-12
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 LA / SYR

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

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

Write-up: body rash


VAERS ID: 1198529 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Washington  
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: Bradycardia, Presyncope
SMQs:, Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (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: Omeprazole, Resperidone, Keppra, Thorazine
Current Illness: None
Preexisting Conditions: Bi-Polar, Autism
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Bradycardia, near syncopal


VAERS ID: 1198535 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
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 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Hyperhidrosis, Pallor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: Patient became very pale, sweaty and felt like she was going to pass out approximately 5 to 10 minutes after vaccination. After drinking fluids she quickly recovered.


VAERS ID: 1198548 (history)  
Form: Version 2.0  
Age: 41.0  
Sex: Female  
Location: Arizona  
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 1805020 / 1 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Hypoaesthesia, Paraesthesia
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? No
Previous Vaccinations:
Other Medications: Multivitamin, probiotic
Current Illness: Normal cold- ie negative COVID test- 2 weeks prior
Preexisting Conditions: IBS, exercise induced asthma
Allergies: Vicodin, Percocet
Diagnostic Lab Data:
CDC Split Type:

Write-up: Tingly and numbness throughout left arm including forearm, hand, and fingers.


VAERS ID: 1198573 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Nevada  
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: School       Purchased by: ?
Symptoms: Blood glucose normal, Dizziness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: dust mites
Diagnostic Lab Data: BS gluclose 79
CDC Split Type:

Write-up: Patient felt faint, syncopal episode, came to and regained consciousness within 2 to 3 minutes. Full recovery at 11:30 am and left the facility.


VAERS ID: 1198575 (history)  
Form: Version 2.0  
Age: 57.0  
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 043A21A / 1 RA / IM

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

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

Write-up: high blood pressure over 200/80


VAERS ID: 1198579 (history)  
Form: Version 2.0  
Age: 27.0  
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: Unknown       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: Dizziness.


VAERS ID: 1198594 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: Montana  
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: Other       Purchased by: ?
Symptoms: Dysgeusia
SMQs:, Taste and smell disorders (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: DIM Supreme (Solaray) 1 capsules daily (100 mg DiIndolMethane, 100 mg Broccoli Seed Extract ea.) C-Progesterone 150 mg/day before bed, oral capsule Tri-Iodine 25 mg/day in AM or with lunch (Prothera brand or TeriNaturally) Adrenal Health (
Current Illness: None other than a slight intestinal upset lasting a morning, occurring the Tuesday of the week prior to vaccination.
Preexisting Conditions: Treated mild hypothyroid. Post menopause hormone therapy.
Allergies: Some mild weed pollen and mild mold allergies.
Diagnostic Lab Data: I called the clinic where I got the shot to let them know, but I am not particularly concerned about it. I searched the web and my report of metallic taste, although more rare as far as reported side effects go, has been reported before, and seems to last a day to a few days. I will wait to see if it lessens or gets worse. I will report to the clinic and this forum if and when it clears, or if in the unfortunate case it gets worse, or if there are additional effects. I will also report for medical attention if it gets worse or continues, but since it is only 4 hours now, I will wait. But since the vaccines are so new, the clinic said to go ahead and report my experience.
CDC Split Type:

Write-up: About one hour after receiving the vaccination I got a strong, terrible tasting metallic taste in my mouth. Seriously like I had a mouthful of copper pennies in there! It has now been 4 hours later and it is still there, yucky. Food, drink, gum, etc and it is still there.


VAERS ID: 1198602 (history)  
Form: Version 2.0  
Age: 26.0  
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 / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Dizziness, Fall, Head injury, Headache, 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), Accidents and injuries (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: BP 104/60 P 64 PO2 95%
CDC Split Type:

Write-up: Syncopal event falling off chair striking forehead onto floor. Loss of consciousness about 10-15 seconds. Denies neck pain. Pt reports felt dizzy walking to seat post injection. Complains of headache. Pt declined to have driver pick her up. Left under her own power.


VAERS ID: 1198628 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Male  
Location: Missouri  
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: School       Purchased by: ?
Symptoms: Blood test, Crying, Hyperhidrosis, Migraine, Nausea, Pain, Sensory disturbance, Urine analysis, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (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: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: Blood work and pee work. I got an iv of fluids and zofran for nausea.
CDC Split Type:

Write-up: I got the shot on Friday, 4/9/2021 at about 930 am. I had a severe migraine the night of and severe body aching to where I was just laying in bed crying. Saturday, 4/10/2021 I felt okay. Sunday 4/11/2021 I felt perfect and thought I was okay. This morning, Monday 4/12/2021 I woke up at 4am in a puddle of sweat, and started puking at 530am. I puked at least every hour multiple times. My whole body felt as if it was vibrating, or falling asleep (the worst feeling I''ve ever had.)


VAERS ID: 1198641 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Female  
Location: North Carolina  
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
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: Sertraline 50mg po qd, Prempro 0.3mg po qd, Simvastatin 20mg po qd, HCTZ 12.5mg qd
Current Illness:
Preexisting Conditions:
Allergies: NKA
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Dizzy, feeling faint. Placed cold rag on back of her neck, got cold beverage, placed at bench that has arms on either side.


VAERS ID: 1198645 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: New York  
Vaccinated:1983-02-01
Onset:2021-04-12
   Days after vaccination:13950
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: 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: N/A
Current Illness: N/A
Preexisting Conditions: HTN
Allergies: N/A
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Pt fainted 10 minutes after receiving J+J covid 19 vaccine


VAERS ID: 1198657 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Florida  
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: 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: Vaso Vagal reaction


VAERS ID: 1198662 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: New Jersey  
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 206A21A / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Feeling abnormal, Feeling jittery, Heart rate increased, Palpitations
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Cardiomyopathy (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Simvastatin 40MG, Omeprazole 40MG, Dymista Nose spray, Sildenafil 100MG, Zyrtec, Tylenol, baby aspirin
Current Illness: none
Preexisting Conditions: high cholesterol
Allergies: Some allergies to Crab and Lobster. Environmental Allergies such as grass, pollen, pine,
Diagnostic Lab Data: No medical test taken, this was reported to my primary who suggested i re-frame from vigorous activity for a week.
CDC Split Type:

Write-up: Heart racing the next day after vaccination. I went for a walk in the park and i noticed my hear rate jumped up to 165bpm on my fitbit for a period of time even though i just began walking. I wasnt running or anything. I was foggy and very jittery. I also experienced the same symptoms today, 4.12.21 while also heading for a short walk. Im an athlete and in great shape and ive never had my heart jump to 165bpm just walking. That would happen normally after a sprint or long run, but not just walking.


VAERS ID: 1198675 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: North Carolina  
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 - / 1 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Anaphylactic reaction, Cough, Dyspnoea, Oropharyngeal swelling, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Oropharyngeal allergic conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin
Current Illness: None.
Preexisting Conditions: PCOS
Allergies: All nuts - anaphylaxis Shellfish - GI upset
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Anaphylaxis (hives, oropharyngeal swelling, cough, shortness of breath) 20 mins following vaccine administration. Patient given epinephrine at vaccine site 20min after symptom onset with significant improvement in symptoms including improved pharyngeal swelling and resolution of hives. Patient presented to the emergency department 1.5 hours following onset of anaphylaxis with mild cough and mild pharyngeal swelling for observation.


VAERS ID: 1198692 (history)  
Form: Version 2.0  
Age: 43.0  
Sex: Female  
Location: Montana  
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 LA / IM

Administered by: Other       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:
Allergies: None.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Signs/Symptoms: Fainted


VAERS ID: 1198713 (history)  
Form: Version 2.0  
Age: 38.0  
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 / 1 LA / IM

Administered by: Public       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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: After patient received Janssen vaccine patient felt dizzy, stated he had a needle phobia. Informed site lead of situation. Instructed patient to remain seated. Water was given to patient. Instructed patient to lie down on floor with legs elevated, applied cold pack to forehead. Patient stated he felt better, but advised patient to remain lying down for the full 15 minutes of observation. After 15 minutes, patient sat up slowly, then stood up and stated he felt fine and no longer dizzy. Patient walking normally, no signs or symptoms of dizziness or fainting. Patient left accompanied by his wife and child.


VAERS ID: 1198721 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Washington  
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: Bradycardia, Presyncope
SMQs:, Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (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: Zyrtec
Current Illness: None
Preexisting Conditions: None
Allergies: PCN
Diagnostic Lab Data:
CDC Split Type:

Write-up: Bradycardia and near syncope


VAERS ID: 1198722 (history)  
Form: Version 2.0  
Age: 19.0  
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 - / 1 LA / IM

Administered by: School       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: Claritin for seasonal allergies
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Strong headache, chills, fever, fatigue, body weakness.


VAERS ID: 1198762 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: Florida  
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 - / 1 LA / SYR

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

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

Write-up: Fever Chills Sweating Aches Headaches Fatigue


VAERS ID: 1198771 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: South Dakota  
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 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest X-ray normal, Computerised tomogram head normal, Dysarthria, Hypoaesthesia, Laboratory test normal, Magnetic resonance imaging head normal, Muscle spasms, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: unknown
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Patient presented to clinic on 4/12/21, was transferred to the ER and admitted on the same day. There was concern for possibility of stroke, pt had head CT, chest x-ray and MRI of head which were all negative. Labwork unremarkable. Pt admitted for observation.
CDC Split Type:

Write-up: Pt reported to clinic with slurred speech, generalized numbness and tingling, cramps to bilateral hands


VAERS ID: 1198812 (history)  
Form: Version 2.0  
Age: 43.0  
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory distress syndrome, Anaphylactic reaction, Atrioventricular block first degree, Hypertension, Sinus tachycardia, Tachycardia, Tachypnoea, Tongue oedema
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (broad), Interstitial lung disease (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Conduction defects (narrow), Supraventricular tachyarrhythmias (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Oropharyngeal allergic conditions (narrow), Guillain-Barre syndrome (broad), Hypertension (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Breo Ellipta 200 mcg-25 mcg/inh inhalation powder, 1 puffs, Inhale, Daily, 3 refills diazePAM 2 mg oral tablet, 2 mg= 1 tab, Oral, every 8 hr, PRN EPINEPHrine 0.3 mg injectable kit, 0.3 mg= 1 EA, Subcutaneous, As Directed etodolac 500 mg
Current Illness: Hypertension, asthma, anxiety and insomnia
Preexisting Conditions: Hypertension, asthma, anxiety and insomnia
Allergies: ERYTHROMYCIN DERIVATIVES LATEX acetaminophen acetaminophen-oxycodone aspirin azithromycin clarithromycin erythromycin gabapentin (Anaphylaxis) iodinated radiocontrast dyes ketamine (Hallucination) ketorolac metoclopramide ondansetron penicillin penicillins prochlorperazine shellfish strawberries
Diagnostic Lab Data: sinus tachycardia with first-degree AV block hypertensive 143/98, tachycardic (120s), tachypneic (20s). She initially required 15 L via nonrebreather mask and then started on 6 L heated high flow.
CDC Split Type:

Write-up: Anaphylaxis, acute respiratory distress, mild tongue edema


VAERS ID: 1198826 (history)  
Form: Version 2.0  
Age: 46.0  
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 / 1 RA / SYR

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: asthma
Allergies: latex
Diagnostic Lab Data:
CDC Split Type:

Write-up: patient given vaccine and fainted five minutes later


VAERS ID: 1198828 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Washington  
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: Anxiety, Skin tightness
SMQs:, 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: Weaken Immune system
Allergies: Anesthesia -breathing problems.
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient reports check tightness, anxiety. Patient was treated by EMS and nurses on site. Patients symptoms resolved and patient left site via personal vehicle.


VAERS ID: 1198830 (history)  
Form: Version 2.0  
Age: 31.0  
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: 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: otc daily vitamins
Current Illness: no other illnesses
Preexisting Conditions: none
Allergies: no allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient fainted and lost consciousness for about 30 seconds after receiving vaccine. When patient regained consciousness , she was alert and coherent. She was able to hold a conversation until the emergency personnel arrived. They took vitals and she was released to go home without further treatment.


VAERS ID: 1198843 (history)  
Form: Version 2.0  
Age: 25.0  
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 - / 1 LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Dizziness, Musculoskeletal pain
SMQs:, Rhabdomyolysis/myopathy (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Children''s Gummy Multivitamin Gummy Vita D
Current Illness: reports none
Preexisting Conditions: reports none
Allergies: reports none
Diagnostic Lab Data: No tests. Patient pulse was 60. patient was monitor in supine position on cot for 30 minutes after recovery.
CDC Split Type:

Write-up: reported started to feel dizzy after receiving vaccine. Thought it was nerves, tried to walk to chair for monitoring. Observed by clinic staff fainted on way to chair. Medical Doctor who was vaccinating on premises responded to incident immediately and patient came too right away. Patient is reporting butt feels sore, head and shoulders are fine. Place where shot was given feels sore.


VAERS ID: 1198852 (history)  
Form: Version 2.0  
Age: 53.0  
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 043A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site bruising, Injection site pain
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LISINOPRIL 10MG DAILY FLUOXETINE 40MG TWICE DAILY
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: PENICILLIN
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Patient received vaccine on 4/7/21, noticed pain near inject site a few days after administration. On 4/12/21 he noticed a large bruise spanning from the injection site in his deltoid down and around to his bicep.


VAERS ID: 1198855 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Female  
Location: Tennessee  
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: Private       Purchased by: ?
Symptoms: Cold sweat, 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? Yes
Hospitalized? No
Previous Vaccinations: similar even as previously prescribed
Other Medications: OCP
Current Illness: none
Preexisting Conditions: none
Allergies: sulfa, keflex
Diagnostic Lab Data: Vital taken - see above
CDC Split Type:

Write-up: Patient states at 10 min mark post vaccination (around 17:15 PM) that she developed sweats/clammy, some lightheadedness while waiting her 15 minutes in the lobby post vaccination injection. There was no rash, throat swelling, dysphagia, drooling, angioedema, rashes, etc in clinic. Vitals were taken in clinic which were WNL (O2 -98%, RR-16, temp- 98.6, BP - 100/60 (this is Normal for her), and HR -74). Patient states this has happened to her previously receiving injections and has had vagal responses. A cold pack was given to patient to place on head and Patient was monitored for an additional 20 minutes in exam room/clinic without complication. No epi/Benadryl was given/needed and I felt patient was stable/safe for discharge home. No signs of anaphylaxis. However, strict ED precautions given to patient. Patient was in right mind state and capable of making proper decision making.


VAERS ID: 1198856 (history)  
Form: Version 2.0  
Age: 19.0  
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 / 1 LA / IM

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

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

Write-up: A 19 y.o. male fainted about 15 seconds after being seated in the post IMZ waiting area. I had just walked away so didn''t see it happen. I had him lie on the floor until he felt better. He was rubbing his head and thought he may have hit it on the floor. After 40 minutes he said that he felt ok and his head was not very sore. He declined to having us call for medical help.


VAERS ID: 1198867 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
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: Dizziness, Hyperhidrosis, Syncope
SMQs:, Torsade de pointes/QT prolongation (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)

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: None listed
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fainting, sweating, light-headed


VAERS ID: 1198869 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Female  
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 206A21A / 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:
Current Illness:
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient was given the Janssen vaccine and fainted just a few seconds after injection. She awoke shortly after after and was given some water and was monitored by pharmacy and store staff until she felt normal, about 30 minutes. Her boyfriend drove her home.


VAERS ID: 1198871 (history)  
Form: Version 2.0  
Age: 30.0  
Sex: Male  
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 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fall, Head injury, Loss of consciousness, Skin laceration
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), 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: Anything involving a needle
Other Medications: n/a
Current Illness: n/a
Preexisting Conditions: Fear of needles
Allergies: n/a
Diagnostic Lab Data: Blood pressure was taken by paramedics
CDC Split Type:

Write-up: Patient lost consciousness/blacked out and fell out of observation chair. Patient suffered a minor head injury including a laceration. 911 was called. Patient became alert and oriented as well as stopped the bleeding before paramedics arrived. After being assessed by the paramedics, he requested not to go to the hospital and to leave on his own. I requested the patient sit for another 15 minutes before leaving to which he obliged and thanked me before leaving.


VAERS ID: 1198875 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: Washington  
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: Asthenia, Dizziness, Dysstasia
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad)

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

Write-up: Patient reports feeling dizzy, weak, could not stand. Pt was removed from car and placed on stretcher. Pt Vital signs were take and within normal limits. Pt recovered and was sent home via personal vehicle.


VAERS ID: 1198881 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Female  
Location: Washington  
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: Work       Purchased by: ?
Symptoms: Hypoaesthesia oral
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), 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? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Numbness on tongue immediately, lasting over 30 minutes now.


VAERS ID: 1198892 (history)  
Form: Version 2.0  
Age: 54.0  
Sex: Female  
Location: North Carolina  
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 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Condition aggravated, Type 1 diabetes mellitus
SMQs:, Hyperglycaemia/new onset diabetes mellitus (narrow), Immune-mediated/autoimmune disorders (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: Apidra type one diabetes
Current Illness: None
Preexisting Conditions: Type one diabetic
Allergies: Contrast dye
Diagnostic Lab Data: Blood glucose checking every two hours
CDC Split Type:

Write-up: Type one diabetic blood sugar out of control raised up to 441


VAERS ID: 1198911 (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 206A21A / UNK - / -

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

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

Write-up: A few minutes after vaccination patient turned pale and eyes started closing. Patient seems to have fainted. Patient was then in and out of consciousness over the next 5 minutes. Patient was given water and was able to drink. 911 was called immediately, and a cop escorted her out of the pharmacy area and to an ambulance outside


VAERS ID: 1198919 (history)  
Form: Version 2.0  
Age: 54.0  
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 207A21A / 1 LA / IM

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

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

Write-up: Pt was administered the vaccine approximately 10:30 am. She reported feeling fine immediately after receiving the vaccine. She said she was walking around the store when she suddenly felt hot. She began searching for a place to sit down, but was unable to locate a seat. She stood by the refrigerated items in order to cool down when she semi fainted. She was caught by a front store employee. She reported no physical injuries at the time. She was carried to a chair and was able to sit upright on her own. She was able to speak in full complete sentences. She was alert and somewhat oriented. She said she felt very hot and dizzy. Her blood pressure @10:50 am was 108/81, pulse: 62, respiratory rate: 20. Vitals determined within safe limits. Pharmacy provided the patient with some water and Gatorade. We had the patient remain in sitting position. Patient reported slowly feeling better over time. Repeated vitals check @11:10 am with no significant change in blood pressure, pulse, and respiration. Patient remained seated and when she was feeling better, attempted to call friends and family to come pick her up from the store. After approximately 1 hour after the event, patient was back to baseline. She was able to leave on her own without assistance.


VAERS ID: 1198920 (history)  
Form: Version 2.0  
Age: 73.0  
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 206A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Product preparation issue
SMQs:, Medication errors (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: na
Current Illness: na
Preexisting Conditions: na
Allergies: na
Diagnostic Lab Data: none thus far
CDC Split Type:

Write-up: patient was given vaccine after it had been left at room temperature for longer than recommended (4 hours).


VAERS ID: 1198923 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
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: Hyperhidrosis, Loss of consciousness, Pallor, Skin warm
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Approx 5 minutes post vaccine, patient lost consciousness but remained in chair. Patient was immediately given a cold compress to apply to back of neck and wrists. Patient regained consciousness but was very pale and was sweating profusely. Patient was able to hold a conversation but reported feeling very warm and sweating. After approx 5 minutes, patient began to feel normal. Patient''s color returned to normal, stopped sweating and reported feeling normal. Patient was monitored for an additional 15 minutes before leaving.


VAERS ID: 1198929 (history)  
Form: Version 2.0  
Age: 43.0  
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 205A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Injection site pain, Syringe issue, Underdose
SMQs:, Extravasation events (injections, infusions and implants) (broad), Medication errors (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: Patient was monitored for over 15 minutes. Addressed all her concerns. Informed her physician''s assistant.
CDC Split Type:

Write-up: Reporting a faulty syringe. Patient was poked on the left arm and immediately the vaccine started spilling out upon immunizing. No reactions reported from this site, except minimal injection site soreness after 15 minute waiting period. Patient was given a full dose later due to clinical judgement, patient did not receive the first immunization/dose. Patient was monitored over 15 minutes. Followed up with her and reported minimal soreness on arms.


VAERS ID: 1198952 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
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 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Fear of injection, Haemophobia, 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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Penicillin allergy
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Patient reported a fear of needles and blood. Shortly after vaccine administration the patient experience light-headedness and dizziness with some nausea. After about five minutes, the symptoms resolved.


VAERS ID: 1198962 (history)  
Form: Version 2.0  
Age: 39.0  
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 206A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Not known
Current Illness: none listed
Preexisting Conditions: none listed
Allergies: none listed
Diagnostic Lab Data: Not sure it happened in vaccination booth and EMS took the patient in ambulance after running his blood pressure and few test
CDC Split Type:

Write-up: After i gave covid-19 Janssen shot to patient, he passed out (Syncope), out of anxiety and nervousness from the shot per patient and his wife. Incident happened around 3:40 pm. His senses soon come back. We called emergency (911) and they ran some test and took the patient to the emergency. Patient was in senses, responding and alive when he left .


VAERS ID: 1198970 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Washington  
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: Hyperhidrosis, Hypotension, Pallor, Presyncope
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: Pale, sweaty, hypotensive and near syncopal


VAERS ID: 1198980 (history)  
Form: Version 2.0  
Age: 21.0  
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 042A21A / 1 LA / IM

Administered by: Public       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: None
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NKDA
Diagnostic Lab Data: N/A
CDC Split Type: CA134B1001

Write-up: 21 y/o female received Janssen vaccine (Lot# 042A21A) @ 02:22 pm, while in the recovery area, @ 02:26 pm began to c/o (Dizziness and Feeling faint). 02:35 pm vitals: 120/90, 60, 99%. "I feel faint or dizziness every time I get a shot or my blood drawn or if I''m in a doctors office and it last for about 10 minutes and than I''m ok." Patient instructed on deep breathing and posturing to relax. Recovery Nurse worked w/patient to continue relaxed breathing, began to relax. Remained in recovery until 02:57 pm, Patient left with family without getting discharge vitals.


VAERS ID: 1198982 (history)  
Form: Version 2.0  
Age: 25.0  
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 206 A21A / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Circumoral swelling, Respiratory distress
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Acute central respiratory depression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Respiratory failure (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: N/A
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: None
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: A 25 y.o. male showed signs of respiratory distress and swelling around mouth about 15 minutes post vaccine. We immediately called 911 and an Epipen 0.3mg was administered. His breathing quickly began to improve. The paramedics arrived and transported him to the ER. His mother was with him throughout the process.


VAERS ID: 1198990 (history)  
Form: Version 2.0  
Age: 37.0  
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 / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Heart rate decreased, 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: customer had syncope about 5 mins after the vaccine administration. The pharmacist immediately placed a cold compress on her forehead and arms. She was breathing and had a low pulse. She became responsive in 1-2 mins and started responding to our questions. We gave her glucose tablet and some water as she stated she had not had anything to eat for the past 2 hours. We monitored her for additional 30 mins and let her leave when she was normal.


VAERS ID: 1199001 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
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 - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Hyperaesthesia, Pain
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: Spironolactone 25mg, Bupropion 300mg, Buspirone 15 mg
Current Illness: N/A
Preexisting Conditions: PCOS
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hyper skin sensitivity approx 9 hours after injection. No bumps or rash present. Manageable pain all over the body caused by stimuli that do not normally cause pain (ie clothing)


VAERS ID: 1199004 (history)  
Form: Version 2.0  
Age: 18.0  
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: Dizziness, Feeling abnormal, Hyperhidrosis, Nausea
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: Approximately 5 minutes post vaccine, patient reported feeling dizzy, warm and was sweating profusely. Patient was given cold compress for back of neck and wrists. Patient did not lose consciousness but did report dizziness and nausea. Patient was able to hold conversation and reported feeling better after about 5 minutes. Patient was monitored for an additional 15 minutes and reported feeling normal before she left.


VAERS ID: 1199016 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-04-08
Onset:2021-04-12
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042AZ1A / 1 LA / SYR
COVID19: COVID19 (COVID19 (UNKNOWN)) / UNKNOWN MANUFACTURER - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Chills, Fatigue, Myalgia, Nausea, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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: ibuprofen
Current Illness: None
Preexisting Conditions: No.
Allergies: codine
Diagnostic Lab Data: None
CDC Split Type:

Write-up: April 8, 2021 had Janssen shot. April 9 to today date I have been Nausea , severe muscle aches, chill, fever, very tired.


VAERS ID: 1199018 (history)  
Form: Version 2.0  
Age: 25.0  
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 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Mouth swelling, Respiratory distress
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Acute central respiratory depression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Respiratory failure (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: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: None
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: A 25 y.o. male showed signs of respiratory distress and swelling around mouth about 15 minutes post Janssen COVID vaccine. We immediately called 911 and an Epipen 0.3mg was administered. His breathing quickly began to improve. The paramedics arrived and transported him to the ER. His mother was with him throughout the process.


VAERS ID: 1199020 (history)  
Form: Version 2.0  
Age: 42.0  
Sex: Female  
Location: Nebraska  
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 / SYR

Administered by: Private       Purchased by: ?
Symptoms: Dysphagia, Hypoaesthesia, Lymphadenopathy
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), 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: Necon 0.5/35; Furosemide 40mg; Amiloride 2.5mg; Fexofenadine 180mg; B12 1000mcg; Potassium CL ER 20meq; Hair, Skin & Nails multivitamin; Neocell Super Collagen + Vitamin C & Biotin; LifeVantage Omega+; LifeVantage Probio; LifeVantage Protan
Current Illness: None.
Preexisting Conditions: Asthma, Hypoglycemia, Herniated disc, Bilateral Neuropathy
Allergies: Ceclor, Compazine, Vicodin, Darvocet, Latex, Morphine, Dilaudid, Tramadol, Adhesives, Tussi, Neosporin, Plaster of Paris
Diagnostic Lab Data:
CDC Split Type:

Write-up: Numbness of face; Difficulties swallowing; Swollen glands in throat


VAERS ID: 1199037 (history)  
Form: Version 2.0  
Age: 21.0  
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 206A21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cold sweat, 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: n/a
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt felt clammy, sweating a lot. He stated that he felt like he was going to faint.


VAERS ID: 1199056 (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 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Chills, Dysphagia, Dyspnoea, Erythema, Heart rate increased, Pruritus, Rash
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

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

Write-up: Started with skin above eyebrows itching and redness on face behind mask, then chills, then at about 30 minutes post injection increased heart rate and trouble swallowing/ chest tightness Gave dose of Epi and called 911/ As waited for EMS rash showed on arms and she said hard to breath after a few minutes she started breathing easier and rash started going away and she could swallow ok EMS arrived and transported her to hospital for observation


VAERS ID: 1199073 (history)  
Form: Version 2.0  
Age: 23.0  
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 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Hypoaesthesia, Nausea
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: fainting
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient has reported having an issue with fainting with vaccines in the past. Approximately 1 minute post vaccine, patient reported feeling dizziness and nausea. Patient was laid down on the floor with her feet elevated and given a cold compress for the back of her neck and her wrists. Patient did not lose consciousness but did report dizziness, nausea, and numbness in her hands and fingers. Patient was able to hold conversation and reported feeling better after about 5 minutes. Patient was allowed to move to a sitting position and was monitored for any changes. Patient reported feeling better. Patient was monitored for an additional 15 minutes and reported feeling normal before she left.


VAERS ID: 1199077 (history)  
Form: Version 2.0  
Age: 19.0  
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 042A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling abnormal, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (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: patients father stated this has happened in the past
Other Medications: unknown
Current Illness: no known
Preexisting Conditions: no known
Allergies: no known
Diagnostic Lab Data: none
CDC Split Type:

Write-up: While patient was waiting out the 15 min, he states he felt weird and went to let his father know. Upon getting up and leaving waiting area, pt. fainted but was quickly alert and able to speak. Patients father did state the patient has a needle aversion and has experienced this situation in the past.


VAERS ID: 1199079 (history)  
Form: Version 2.0  
Age: 17.0  
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 1805020 / 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? 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: none
CDC Split Type:

Write-up: No adverse event, Janssen vaccine was administered to 17 y/o female.


VAERS ID: 1199094 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
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 206A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain upper, Cold sweat, Deafness, Gaze palsy, Hyperhidrosis, Seizure, Syncope, Vision blurred
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (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), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Hearing impairment (narrow), Ocular motility disorders (narrow), 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: NONE KNOWN
Current Illness: NONE KNOWN
Preexisting Conditions: NONE KNOWN
Allergies: NONE KNOWN
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient fainted and had seizure like symptoms with eyes rolling back in head, clamminess, sweating, severe stomach cramps, blurred vision, and temporary loss of hearing


VAERS ID: 1199112 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
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 206A21A / 1 LA / IM

Administered by: Pharmacy       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? 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 has reported having an issue with fainting with vaccines in the past and patient requested to be given immunization while sitting on the floor. Patient was given a cold compress for his wrists before the vaccine was given. Approximately 1 minute post vaccine, patient reported feeling dizziness and feeling warm. Patient was given a cold compress for the back of the neck and the wrists. Patient did not lose consciousness but did report dizziness. Patient was able to hold conversation and reported feeling better after about 5 minutes. Patient was monitored for an additional 15 minutes and reported feeling normal before he left.


VAERS ID: 1199130 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
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 / 4 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: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: pt felt faint after given shot, had pt sit down, feet up, drink water and given ice compress, after 30 minutes pt left feeling fine


VAERS ID: 1199149 (history)  
Form: Version 2.0  
Age: 15.0  
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 1808978 / 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient underage (15) at time of vaccine. Janssen s approved for 18 and up. Pharmacist discovered error post-vaccination. Informed mother of patient of error and patient was monitored thoroughly prior to leaving facility for adverse reactions. No result of adverse reaction. Mother was made aware of potential side effects and what to expect going forward.


VAERS ID: 1199179 (history)  
Form: Version 2.0  
Age: 41.0  
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 206A21A / 1 RA / IM

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

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

Write-up: Patient was feeling warm and light-headed at 15 minute mark, so we kept for further observation and gave water to hydrate. At about the 17 minute mark patiently suddenly fainted in his chair for 15-30 seconds. He then began to vomit and woke up in the process. Once he fully came back to, he said he felt remarkedly better and no longer felt light-headed or clammy. Following this episode he reported feeling back to normal and that he had just ate a large breakfast before coming in for the shot, but did not feel bad in any way anymore. We observed for another 30 minutes and patient showed no further sign of issues. He was released with his wife.


VAERS ID: 1199180 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: South Carolina  
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: Fatigue, Influenza, Injection site swelling, Lethargy, Lymphadenopathy, Malaise, Mobility decreased, Pain
SMQs:, Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (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: Alprazolam 1 mg: 1 tab up to 3 times a day Aspirin 81 mg enteric-coated: 1 tab once a day Famotidine 20 mg: 1 tab once an evening Metoprolol succinate 25mg ER (generic Toprol-XL): 1 tab once a morning Mirtazapine 15 mg: 1 tab once a night
Current Illness: Back pain
Preexisting Conditions: Anxiety with panic attacks Depression Low back pain Past medical history: Patient reports breast cancer in March 1991 & had axillary lymph nodes removed (per patient, "all nodes removed from ride side, 1 node removed from left side)
Allergies: Codeine Sulfonamides Uncoated Aspirin- gastritis
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Patient noticed swelling in neck (lymphadenopathy) around 10:30 PM (4-5-21). She said there was no pain or discomfort in left arm, but noticed a "small amount of swelling" at the injection site (left deltoid). She went to bed shortly after. Woke up following morning (4-6-21) at 7:15 AM & had generalized aching at the following body sites: back of head, neck, both legs, & both feet. She compared the aches to a case of "bad flu." Also reports malaise (tiredness, lethargy) and spent the entire day "laying around." On 4-7-21, the aches had resolved but she still felt tired & lethargic. On 4-8-21, all symptoms resolved & patient "felt fine." She did contact her primary care provider, & on 4-8-21 she filled a prescription for celecoxib 100 mg: 1 cap once a day, #30 capsules, which she began later that day.


VAERS ID: 1199192 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
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: 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: PT CLAIMED HE FELT LIGHTHEADEDNESS AFTER DONATING BLOOD IN PAST
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: PATIENT FELT LIGHTHEADEDNESS AFTER RECEIVING VACCINE. PT GIVEN COLD WATER TO DRINK AND ICE PACK TO PLACE BEHIND NECK AND TURNED ON FAN TO HELP HIM COOL OFF. PATIENT DRANK WATER AND SAT FOR ABOUT 5MINUTES IN IMMUNIZATION ROOM. THEN FELT FINE. HE WAITED FOR 10 MORE MINUTES IN GENERAL WAITING AREA AND THEN LEFT PHARMACY AREA.


VAERS ID: 1199216 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Texas  
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 RA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Fatigue, Nausea, Pain, 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: Body aches, chills, nausea, vomiting, tiredness.


VAERS ID: 1199217 (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 205A21A / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? 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: Shortly after receiving the COVID19 (Janssen) vaccine the patient reported being faint. While seated with her partner the patient briefly lost consciousness. She regained consciousness quickly and was provided with water, a snack, and a cool/damp towel. The patient was instructed to elevate her legs and maintain a clear airway. Patient remained seated. Patient affect normalized within 10 minutes and the patient reported feeling much better shortly thereafter. Patient and her partner remained waiting at the pharmacy for a total of 30 minutes to ensure that she was alright. Patient reported that she has experienced fainting episodes in high stress situations in the past (eg at concerts, events, etc) and maintained that she will be ok.


VAERS ID: 1199219 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-04-01
Onset:2021-04-12
   Days after vaccination:11
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: Hypoaesthesia, Musculoskeletal stiffness, Paraesthesia, Rash
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient called pharmacy to report she was having numbness, stiffness, and tingling in her arm that starts and stop but dose not seem to go away. She also reported rash under the left eye, right side of the eye. Patient indicated she was going to see her physician for an evaluation.


VAERS ID: 1199243 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Nebraska  
Vaccinated:2021-04-02
Onset:2021-04-12
   Days after vaccination:10
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, Fall, Headache, Loss of consciousness, Malaise
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), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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

Write-up: Around 7 minutes after administration patient started to look like he was having headache. My technician asked if he was doing ok and he replied "no." I then went out and asked what symptoms he was having. He said he was having headache, dizziness, and didn''t feel well. I then stayed with him to monitor him, at which point his arms fell, I was able to lay him on the ground with an associates help without his head hitting the ground. Code white was called and store management came to the scene. Patient regained consciousness, remained on the ground for a few minutes and then said he wanted to sit up. We helped him into a chair, a few moments later, he lost consciousness again. We then laid the patient down one more time and the instore officer requested a squad. Patient was monitored until they arrived and took over.


VAERS ID: 1199253 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Male  
Location: Tennessee  
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: Asthenia, Feeling abnormal, Immediate post-injection reaction, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (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: Reported fainting with vaccines in the past
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt fainted immediately after injection, regained consciousness after about 15 seconds. Reported feeling uneasy and weak for 20-30 minutes following injection. Provided supportive care with water. Pt was able to leave on his own after about 45 minutes.


VAERS ID: 1199268 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Female  
Location: Oregon  
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: Private       Purchased by: ?
Symptoms: Product use issue
SMQs:, Medication errors (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: Sixth dose of vaccine administered from vial when authorized for only 5 doses per vial.


VAERS ID: 1199272 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Female  
Location: North Carolina  
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 (MODERNA)) / MODERNA - / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Computerised tomogram thorax, Pulmonary embolism, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, venous (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

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

Write-up: multiple bilateral PE with syncope


VAERS ID: 1199283 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Oregon  
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: Private       Purchased by: ?
Symptoms: Product use issue
SMQs:, Medication errors (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: SIXTH DOSE FROM VACCINE VIAL ADMINISTERED WHEN VIAL INTENDED FOR ONLY 5 DOSES.


VAERS ID: 1199292 (history)  
Form: Version 2.0  
Age: 52.0  
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 - / 1 LA / -

Administered by: Other       Purchased by: ?
Symptoms: Fatigue, Feeling abnormal, Injection site pain
SMQs:, Dementia (broad), Extravasation events (injections, infusions and implants) (broad)

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

Write-up: 11 am the next day felt slight fatigue and slight pain at the injection site. Around 4 pm, felt more fatigued and fuzzy-headed, similar to mild cold or flu symptoms. As of 9 pm, I am still tired and fuzzy-headed, but not ache-y


VAERS ID: 1199293 (history)  
Form: Version 2.0  
Age: 33.0  
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 - / 1 LA / SYR

Administered by: School       Purchased by: ?
Symptoms: Asthenopia, Eye pain, Feeling cold, Feeling hot, Headache, Influenza like illness, Nausea, Paraesthesia, Peripheral coldness, Pyrexia
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), Corneal 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: NA
Current Illness: NA
Preexisting Conditions: NA
Allergies: NA
Diagnostic Lab Data:
CDC Split Type:

Write-up: After taking the shot at 11am, I felt fine, until about 5:00pm. I started feeling cold and nausea. Back of my eyes were heavy and painful. my right pinky started feel tingly, then both hands became very cold. Very similar symptoms to flu, except I didn''t have any throat pain which I usually get when I''m sick. I ate dinner at about 6:30pm and rested on the couch. I started feeling very hot, and was running the fever of 102.2 F. My arm and legs were tingly. I took advil at around 8pm which relieved some headache, but still feeling hot. Took shower and cutrently resting on the couch.


VAERS ID: 1199297 (history)  
Form: Version 2.0  
Age: 28.0  
Sex: Male  
Location: Oregon  
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: Private       Purchased by: ?
Symptoms: Product use issue
SMQs:, Medication errors (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: SIXTH DOSE FROM VACCINE VIAL ADMINISTERED WHEN ONLY 5 DOSES INTENDED PER VIAL


VAERS ID: 1199303 (history)  
Form: Version 2.0  
Age: 32.0  
Sex: Female  
Location: Washington  
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 - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Erythema, Product use issue, Tenderness
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Medication errors (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: TraZODone,DULoxetine ,Omeprazole ,gabapentin ,ALPRAZolam ,famotidine ,montelukast ,Verapamil ,loratadine ,Ergocalciferol ,Norgestimate, Flonase, EpiPen pr n.
Current Illness: None
Preexisting Conditions: Asthma, HTN, hypercholesterolemia, GERD, anemia, IBS, PCOS, depression, OSA, fibromyalgia
Allergies: Latex, peanut allergies listed
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Local edema, erythema and tenderness


VAERS ID: 1199307 (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 - / UNK - / -

Administered by: Public       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:
Current Illness: None detailed
Preexisting Conditions: None detailed
Allergies: None listed
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt fainted in observation room approximately 5 minutes after vaccination in left arm. Pt lost consciousness for approximately 30 seconds. Pt able to converse with medical personnel after that time, able to sit up approximately 10 minutes after episode and able to walk to his vehicle approximately 25 minutes after episode. Pt driven home by spouse.


VAERS ID: 1199333 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
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 042A21A / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Dizziness, Feeling hot, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

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

Write-up: Johnson and Johnson vaccine given at 1:49 pm. Patient stated they felt really hot, dizzy and was having spotty vision. At 1:57 50mg of generic benadryl was given with water since patient was able to swallow. Pharmacist had patient lie on floor with feet up on chair and cold pack on forehead. After 5 to 10 minutes patient was feeling better. Vision returned to normal. Blood pressure taken was 102/68 pulse of 67, which was near normal per patient. Patient continued to lie on their back until she felt well enough to sit up. Her primary care doc was notified and the nurse there recommended pt go to the emergency room. The patient was going to be with boyfriend rest of the day and evening. They purchased benadryl to take with them.


VAERS ID: 1199351 (history)  
Form: Version 2.0  
Age: 33.0  
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 202A21A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chills, Headache
SMQs:

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

Write-up: Mild headache, strong and persistent chills


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